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FA-64811 / Clinical triage scoring / Open access

Cervical spine imaging decision rule: bilateral rotation requirement · case 01

A patient who can only rotate to one side is cleared.

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

ROOT CAUSE

The rotation test accepts either side instead of both.

VERIFIED REPAIR

Require at least 45 degrees to both the left and the right.

Unsuccessful approach: Using a strict > 45 fails patients who reach exactly 45 degrees.

Case contract

Input {age, gcs, dangerous_mechanism, paresthesias, simple_rear_end, sitting, ambulatory, delayed_onset, no_midline_tenderness, rotate_left, rotate_right (degrees)}. Toy rule: age < 16 or gcs < 15 NOT_APPLICABLE. High risk (age >= 65, dangerous mechanism or paresthesias) -> IMAGE. If none of the low-risk factors (simple rear-end collision, sitting, ambulatory, delayed onset, no midline tenderness) is present -> IMAGE. Otherwise NO_IMAGE when active rotation reaches 45 degrees both left and right, else IMAGE. Return {decision}.

Why this case matters

Imaging decision rules chain any-of and all-of gates; confusing the quantifiers or thresholds is a distinct defect at each gate.

1 / The failure

Exit 1
"""Failure Map reference implementation. Python standard library only."""
import json

N = 1
observations = []
def solve(x):
    if x['age'] < 16 or x['gcs'] < 15:
        return {'decision': 'NOT_APPLICABLE'}
    if x['age'] >= 65 or x['dangerous_mechanism'] or x['paresthesias']:
        return {'decision': 'IMAGE'}
    low = [x['simple_rear_end'], x['sitting'], x['ambulatory'], x['delayed_onset'], x['no_midline_tenderness']]
    if not any(low):
        return {'decision': 'IMAGE'}
    if x['rotate_left'] >= 45 or x['rotate_right'] >= 45:
        return {'decision': 'NO_IMAGE'}
    return {'decision': 'IMAGE'}
def check(label, actual, expected):
    observations.append({"check": label, "actual": actual, "expected": expected, "passed": actual == expected})
fixtures = [[('age exactly 65',
   {'age': 65,
    'gcs': 15,
    'dangerous_mechanism': False,
    'paresthesias': False,
    'simple_rear_end': False,
    'sitting': True,
    'ambulatory': True,
    'delayed_onset': False,
    'no_midline_tenderness': False,
    'rotate_left': 60,
    'rotate_right': 60},
   {'decision': 'IMAGE'}),
  ('age 64 with low-risk factors',
   {'age': 64,
    'gcs': 15,
    'dangerous_mechanism': False,
    'paresthesias': False,
    'simple_rear_end': False,
    'sitting': False,
    'ambulatory': True,
    'delayed_onset': False,
    'no_midline_tenderness': False,
    'rotate_left': 60,
    'rotate_right': 60},
   {'decision': 'NO_IMAGE'}),
  ('single low-risk factor',
   {'age': 40,
    'gcs': 15,
    'dangerous_mechanism': False,
    'paresthesias': False,
    'simple_rear_end': False,
    'sitting': True,
    'ambulatory': False,
    'delayed_onset': False,
    'no_midline_tenderness': False,
    'rotate_left': 51,
    'rotate_right': 60},
   {'decision': 'NO_IMAGE'}),
  ('two low-risk factors',
   {'age': 40,
    'gcs': 15,
    'dangerous_mechanism': False,
    'paresthesias': False,
    'simple_rear_end': False,
    'sitting': True,
    'ambulatory': True,
    'delayed_onset': False,
    'no_midline_tenderness': False,
    'rotate_left': 60,
    'rotate_right': 61},
   {'decision': 'NO_IMAGE'}),
  ('all low-risk factors',
   {'age': 31,
    'gcs': 15,
    'dangerous_mechanism': False,
    'paresthesias': False,
    'simple_rear_end': True,
    'sitting': True,
    'ambulatory': True,
    'delayed_onset': True,
    'no_midline_tenderness': True,
    'rotate_left': 60,
    'rotate_right': 60},
   {'decision': 'NO_IMAGE'}),
  ('rotation exactly 45 both ways',
   {'age': 21,
    'gcs': 15,
    'dangerous_mechanism': False,
    'paresthesias': False,
    'simple_rear_end': False,
    'sitting': False,
    'ambulatory': True,
    'delayed_onset': False,
    'no_midline_tenderness': False,
    'rotate_left': 45,
    'rotate_right': 45},
   {'decision': 'NO_IMAGE'}),
  ('rotation limited to one side',
   {'age': 40,
    'gcs': 15,
    'dangerous_mechanism': False,
    'paresthesias': False,
    'simple_rear_end': False,
    'sitting': False,
    'ambulatory': True,
    'delayed_onset': False,
    'no_midline_tenderness': False,
    'rotate_left': 31,
    'rotate_right': 70},
   {'decision': 'IMAGE'}),
  ('paresthesias in ambulatory patient',
   {'age': 26,
    'gcs': 15,
    'dangerous_mechanism': False,
    'paresthesias': True,
    'simple_rear_end': False,
    'sitting': False,
    'ambulatory': True,
    'delayed_onset': False,
    'no_midline_tenderness': False,
    'rotate_left': 60,
    'rotate_right': 60},
   {'decision': 'IMAGE'}),
  ('paresthesias non-ambulatory',
   {'age': 35,
    'gcs': 15,
    'dangerous_mechanism': False,
    'paresthesias': True,
    'simple_rear_end': False,
    'sitting': True,
    'ambulatory': False,
    'delayed_onset': False,
    'no_midline_tenderness': False,
    'rotate_left': 60,
    'rotate_right': 60},
   {'decision': 'IMAGE'}),
  ('adolescent below applicability',
   {'age': 15,
    'gcs': 15,
    'dangerous_mechanism': False,
    'paresthesias': False,
    'simple_rear_end': False,
    'sitting': False,
    'ambulatory': True,
    'delayed_onset': False,
    'no_midline_tenderness': False,
    'rotate_left': 60,
    'rotate_right': 60},
   {'decision': 'NOT_APPLICABLE'})],
 [('age exactly 65',
   {'age': 65,
    'gcs': 15,
    'dangerous_mechanism': False,
    'paresthesias': False,
    'simple_rear_end': False,
    'sitting': True,
    'ambulatory': True,
    'delayed_onset': False,
    'no_midline_tenderness': False,
    'rotate_left': 60,
    'rotate_right': 60},
   {'decision': 'IMAGE'}),
  ('age 64 with low-risk factors',
   {'age': 64,
    'gcs': 15,
    'dangerous_mechanism': False,
    'paresthesias': False,
    'simple_rear_end': False,
    'sitting': True,
    'ambulatory': True,
    'delayed_onset': False,
    'no_midline_tenderness': False,
    'rotate_left': 60,
    'rotate_right': 60},
   {'decision': 'NO_IMAGE'}),
  ('single low-risk factor',
   {'age': 40,
    'gcs': 15,
    'dangerous_mechanism': False,
    'paresthesias': False,
    'simple_rear_end': False,
    'sitting': True,
    'ambulatory': False,
    'delayed_onset': False,
    'no_midline_tenderness': False,
    'rotate_left': 52,
    'rotate_right': 60},
   {'decision': 'NO_IMAGE'}),
  ('two low-risk factors',
   {'age': 40,
    'gcs': 15,
    'dangerous_mechanism': False,
    'paresthesias': False,
    'simple_rear_end': False,
    'sitting': True,
    'ambulatory': True,
    'delayed_onset': False,
    'no_midline_tenderness': False,
    'rotate_left': 60,
    'rotate_right': 62},
   {'decision': 'NO_IMAGE'}),
  ('all low-risk factors',
   {'age': 32,
    'gcs': 15,
    'dangerous_mechanism': False,
    'paresthesias': False,
    'simple_rear_end': True,
    'sitting': True,
    'ambulatory': True,
    'delayed_onset': True,
    'no_midline_tenderness': True,
    'rotate_left': 60,
    'rotate_right': 60},
   {'decision': 'NO_IMAGE'}),
  ('rotation exactly 45 both ways',
   {'age': 22,
    'gcs': 15,
    'dangerous_mechanism': False,
    'paresthesias': False,
    'simple_rear_end': False,
    'sitting': False,
    'ambulatory': True,
    'delayed_onset': False,
    'no_midline_tenderness': False,
    'rotate_left': 45,
    'rotate_right': 45},
   {'decision': 'NO_IMAGE'}),
  ('rotation limited to one side',
   {'age': 40,
    'gcs': 15,
    'dangerous_mechanism': False,
    'paresthesias': False,
    'simple_rear_end': False,
    'sitting': False,
    'ambulatory': True,
    'delayed_onset': False,
    'no_midline_tenderness': False,
    'rotate_left': 32,
    'rotate_right': 70},
   {'decision': 'IMAGE'}),
  ('paresthesias in ambulatory patient',
   {'age': 27,
    'gcs': 15,
    'dangerous_mechanism': False,
    'paresthesias': True,
    'simple_rear_end': False,
    'sitting': False,
    'ambulatory': True,
    'delayed_onset': False,
    'no_midline_tenderness': False,
    'rotate_left': 60,
    'rotate_right': 60},
   {'decision': 'IMAGE'}),
  ('paresthesias non-ambulatory',
   {'age': 35,
    'gcs': 15,
    'dangerous_mechanism': False,
    'paresthesias': True,
    'simple_rear_end': False,
    'sitting': True,
    'ambulatory': False,
    'delayed_onset': False,
    'no_midline_tenderness': False,
    'rotate_left': 60,
    'rotate_right': 60},
   {'decision': 'IMAGE'}),
  ('adolescent below applicability',
   {'age': 15,
    'gcs': 15,
    'dangerous_mechanism': False,
    'paresthesias': False,
    'simple_rear_end': False,
    'sitting': False,
    'ambulatory': True,
    'delayed_onset': False,
    'no_midline_tenderness': False,
    'rotate_left': 60,
    'rotate_right': 60},
   {'decision': 'NOT_APPLICABLE'})],
 [('age exactly 65',
   {'age': 65,
    'gcs': 15,
    'dangerous_mechanism': False,
    'paresthesias': False,
    'simple_rear_end': False,
    'sitting': True,
    'ambulatory': True,
    'delayed_onset': False,
    'no_midline_tenderness': False,
    'rotate_left': 60,
    'rotate_right': 60},
   {'decision': 'IMAGE'}),
  ('age 64 with low-risk factors',
   {'age': 64,
    'gcs': 15,
    'dangerous_mechanism': False,
    'paresthesias': False,
    'simple_rear_end': False,
    'sitting': False,
    'ambulatory': True,
    'delayed_onset': False,
    'no_midline_tenderness': False,
    'rotate_left': 60,
    'rotate_right': 60},
   {'decision': 'NO_IMAGE'}),
  ('single low-risk factor',
   {'age': 40,
    'gcs': 15,
    'dangerous_mechanism': False,
    'paresthesias': False,
    'simple_rear_end': False,
    'sitting': True,
    'ambulatory': False,
    'delayed_onset': False,
    'no_midline_tenderness': False,
    'rotate_left': 53,
    'rotate_right': 60},
   {'decision': 'NO_IMAGE'}),
  ('two low-risk factors',
   {'age': 40,
    'gcs': 15,
    'dangerous_mechanism': False,
    'paresthesias': False,
    'simple_rear_end': False,
    'sitting': True,
    'ambulatory': True,
    'delayed_onset': False,
    'no_midline_tenderness': False,
    'rotate_left': 60,
    'rotate_right': 63},
   {'decision': 'NO_IMAGE'}),
  ('all low-risk factors',
   {'age': 33,
    'gcs': 15,
    'dangerous_mechanism': False,
    'paresthesias': False,
    'simple_rear_end': True,
    'sitting': True,
    'ambulatory': True,
    'delayed_onset': True,
    'no_midline_tenderness': True,
    'rotate_left': 60,
    'rotate_right': 60},
   {'decision': 'NO_IMAGE'}),
  ('rotation exactly 45 both ways',
   {'age': 23,
    'gcs': 15,
    'dangerous_mechanism': False,
    'paresthesias': False,
    'simple_rear_end': False,
    'sitting': False,
    'ambulatory': True,
    'delayed_onset': False,
    'no_midline_tenderness': False,
    'rotate_left': 45,
    'rotate_right': 45},
   {'decision': 'NO_IMAGE'}),
  ('rotation limited to one side',
   {'age': 40,
    'gcs': 15,
    'dangerous_mechanism': False,
    'paresthesias': False,
    'simple_rear_end': False,
    'sitting': False,
    'ambulatory': True,
    'delayed_onset': False,
    'no_midline_tenderness': False,
    'rotate_left': 33,
    'rotate_right': 70},
   {'decision': 'IMAGE'}),
  ('paresthesias in ambulatory patient',
   {'age': 28,
    'gcs': 15,
    'dangerous_mechanism': False,
    'paresthesias': True,
    'simple_rear_end': False,
    'sitting': False,
    'ambulatory': True,
    'delayed_onset': False,
    'no_midline_tenderness': False,
    'rotate_left': 60,
    'rotate_right': 60},
   {'decision': 'IMAGE'}),
  ('paresthesias non-ambulatory',
   {'age': 35,
    'gcs': 15,
    'dangerous_mechanism': False,
    'paresthesias': True,
    'simple_rear_end': False,
    'sitting': True,
    'ambulatory': False,
    'delayed_onset': False,
    'no_midline_tenderness': False,
    'rotate_left': 60,
    'rotate_right': 60},
   {'decision': 'IMAGE'}),
  ('adolescent below applicability',
   {'age': 15,
    'gcs': 15,
    'dangerous_mechanism': False,
    'paresthesias': False,
    'simple_rear_end': False,
    'sitting': False,
    'ambulatory': True,
    'delayed_onset': False,
    'no_midline_tenderness': False,
    'rotate_left': 60,
    'rotate_right': 60},
   {'decision': 'NOT_APPLICABLE'})],
 [('age exactly 65',
   {'age': 65,
    'gcs': 15,
    'dangerous_mechanism': False,
    'paresthesias': False,
    'simple_rear_end': False,
    'sitting': True,
    'ambulatory': True,
    'delayed_onset': False,
    'no_midline_tenderness': False,
    'rotate_left': 60,
    'rotate_right': 60},
   {'decision': 'IMAGE'}),
  ('age 64 with low-risk factors',
   {'age': 64,
    'gcs': 15,
    'dangerous_mechanism': False,
    'paresthesias': False,
    'simple_rear_end': False,
    'sitting': True,
    'ambulatory': True,
    'delayed_onset': False,
    'no_midline_tenderness': False,
    'rotate_left': 60,
    'rotate_right': 60},
   {'decision': 'NO_IMAGE'}),
  ('single low-risk factor',
   {'age': 40,
    'gcs': 15,
    'dangerous_mechanism': False,
    'paresthesias': False,
    'simple_rear_end': False,
    'sitting': True,
    'ambulatory': False,
    'delayed_onset': False,
    'no_midline_tenderness': False,
    'rotate_left': 54,
    'rotate_right': 60},
   {'decision': 'NO_IMAGE'}),
  ('two low-risk factors',
   {'age': 40,
    'gcs': 15,
    'dangerous_mechanism': False,
    'paresthesias': False,
    'simple_rear_end': False,
    'sitting': True,
    'ambulatory': True,
    'delayed_onset': False,
    'no_midline_tenderness': False,
    'rotate_left': 60,
    'rotate_right': 64},
   {'decision': 'NO_IMAGE'}),
  ('all low-risk factors',
   {'age': 34,
    'gcs': 15,
    'dangerous_mechanism': False,
    'paresthesias': False,
    'simple_rear_end': True,
    'sitting': True,
    'ambulatory': True,
    'delayed_onset': True,
    'no_midline_tenderness': True,
    'rotate_left': 60,
    'rotate_right': 60},
   {'decision': 'NO_IMAGE'}),
  ('rotation exactly 45 both ways',
   {'age': 24,
    'gcs': 15,
    'dangerous_mechanism': False,
    'paresthesias': False,
    'simple_rear_end': False,
    'sitting': False,
    'ambulatory': True,
    'delayed_onset': False,
    'no_midline_tenderness': False,
    'rotate_left': 45,
    'rotate_right': 45},
   {'decision': 'NO_IMAGE'}),
  ('rotation limited to one side',
   {'age': 40,
    'gcs': 15,
    'dangerous_mechanism': False,
    'paresthesias': False,
    'simple_rear_end': False,
    'sitting': False,
    'ambulatory': True,
    'delayed_onset': False,
    'no_midline_tenderness': False,
    'rotate_left': 34,
    'rotate_right': 70},
   {'decision': 'IMAGE'}),
  ('paresthesias in ambulatory patient',
   {'age': 29,
    'gcs': 15,
    'dangerous_mechanism': False,
    'paresthesias': True,
    'simple_rear_end': False,
    'sitting': False,
    'ambulatory': True,
    'delayed_onset': False,
    'no_midline_tenderness': False,
    'rotate_left': 60,
    'rotate_right': 60},
   {'decision': 'IMAGE'}),
  ('paresthesias non-ambulatory',
   {'age': 35,
    'gcs': 15,
    'dangerous_mechanism': False,
    'paresthesias': True,
    'simple_rear_end': False,
    'sitting': True,
    'ambulatory': False,
    'delayed_onset': False,
    'no_midline_tenderness': False,
    'rotate_left': 60,
    'rotate_right': 60},
   {'decision': 'IMAGE'}),
  ('adolescent below applicability',
   {'age': 15,
    'gcs': 15,
    'dangerous_mechanism': False,
    'paresthesias': False,
    'simple_rear_end': False,
    'sitting': False,
    'ambulatory': True,
    'delayed_onset': False,
    'no_midline_tenderness': False,
    'rotate_left': 60,
    'rotate_right': 60},
   {'decision': 'NOT_APPLICABLE'})],
 [('age exactly 65',
   {'age': 65,
    'gcs': 15,
    'dangerous_mechanism': False,
    'paresthesias': False,
    'simple_rear_end': False,
    'sitting': True,
    'ambulatory': True,
    'delayed_onset': False,
    'no_midline_tenderness': False,
    'rotate_left': 60,
    'rotate_right': 60},
   {'decision': 'IMAGE'}),
  ('age 64 with low-risk factors',
   {'age': 64,
    'gcs': 15,
    'dangerous_mechanism': False,
    'paresthesias': False,
    'simple_rear_end': False,
    'sitting': False,
    'ambulatory': True,
    'delayed_onset': False,
    'no_midline_tenderness': False,
    'rotate_left': 60,
    'rotate_right': 60},
   {'decision': 'NO_IMAGE'}),
  ('single low-risk factor',
   {'age': 40,
    'gcs': 15,
    'dangerous_mechanism': False,
    'paresthesias': False,
    'simple_rear_end': False,
    'sitting': True,
    'ambulatory': False,
    'delayed_onset': False,
    'no_midline_tenderness': False,
    'rotate_left': 55,
    'rotate_right': 60},
   {'decision': 'NO_IMAGE'}),
  ('two low-risk factors',
   {'age': 40,
    'gcs': 15,
    'dangerous_mechanism': False,
    'paresthesias': False,
    'simple_rear_end': False,
    'sitting': True,
    'ambulatory': True,
    'delayed_onset': False,
    'no_midline_tenderness': False,
    'rotate_left': 60,
    'rotate_right': 65},
   {'decision': 'NO_IMAGE'}),
  ('all low-risk factors',
   {'age': 35,
    'gcs': 15,
    'dangerous_mechanism': False,
    'paresthesias': False,
    'simple_rear_end': True,
    'sitting': True,
    'ambulatory': True,
    'delayed_onset': True,
    'no_midline_tenderness': True,
    'rotate_left': 60,
    'rotate_right': 60},
   {'decision': 'NO_IMAGE'}),
  ('rotation exactly 45 both ways',
   {'age': 25,
    'gcs': 15,
    'dangerous_mechanism': False,
    'paresthesias': False,
    'simple_rear_end': False,
    'sitting': False,
    'ambulatory': True,
    'delayed_onset': False,
    'no_midline_tenderness': False,
    'rotate_left': 45,
    'rotate_right': 45},
   {'decision': 'NO_IMAGE'}),
  ('rotation limited to one side',
   {'age': 40,
    'gcs': 15,
    'dangerous_mechanism': False,
    'paresthesias': False,
    'simple_rear_end': False,
    'sitting': False,
    'ambulatory': True,
    'delayed_onset': False,
    'no_midline_tenderness': False,
    'rotate_left': 35,
    'rotate_right': 70},
   {'decision': 'IMAGE'}),
  ('paresthesias in ambulatory patient',
   {'age': 30,
    'gcs': 15,
    'dangerous_mechanism': False,
    'paresthesias': True,
    'simple_rear_end': False,
    'sitting': False,
    'ambulatory': True,
    'delayed_onset': False,
    'no_midline_tenderness': False,
    'rotate_left': 60,
    'rotate_right': 60},
   {'decision': 'IMAGE'}),
  ('paresthesias non-ambulatory',
   {'age': 35,
    'gcs': 15,
    'dangerous_mechanism': False,
    'paresthesias': True,
    'simple_rear_end': False,
    'sitting': True,
    'ambulatory': False,
    'delayed_onset': False,
    'no_midline_tenderness': False,
    'rotate_left': 60,
    'rotate_right': 60},
   {'decision': 'IMAGE'}),
  ('adolescent below applicability',
   {'age': 15,
    'gcs': 15,
    'dangerous_mechanism': False,
    'paresthesias': False,
    'simple_rear_end': False,
    'sitting': False,
    'ambulatory': True,
    'delayed_onset': False,
    'no_midline_tenderness': False,
    'rotate_left': 60,
    'rotate_right': 60},
   {'decision': 'NOT_APPLICABLE'})]]
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
age exactly 65{'decision': 'IMAGE'}{'decision': 'IMAGE'}Passed
age 64 with low-risk factors{'decision': 'NO_IMAGE'}{'decision': 'NO_IMAGE'}Passed
single low-risk factor{'decision': 'NO_IMAGE'}{'decision': 'NO_IMAGE'}Passed
two low-risk factors{'decision': 'NO_IMAGE'}{'decision': 'NO_IMAGE'}Passed
all low-risk factors{'decision': 'NO_IMAGE'}{'decision': 'NO_IMAGE'}Passed
rotation exactly 45 both ways{'decision': 'NO_IMAGE'}{'decision': 'NO_IMAGE'}Passed
rotation limited to one side{'decision': 'NO_IMAGE'}{'decision': 'IMAGE'}Failed
paresthesias in ambulatory patient{'decision': 'IMAGE'}{'decision': 'IMAGE'}Passed
paresthesias non-ambulatory{'decision': 'IMAGE'}{'decision': 'IMAGE'}Passed
adolescent below applicability{'decision': 'NOT_APPLICABLE'}{'decision': 'NOT_APPLICABLE'}Passed

SHA-256 / a1f4e49eaf92f553b775a241708008a9613e31d0da0297c2699b0881547a4849

2 / The unsuccessful fix

Exit 1
"""Failure Map reference implementation. Python standard library only."""
import json

N = 1
observations = []
def solve(x):
    if x['age'] < 16 or x['gcs'] < 15:
        return {'decision': 'NOT_APPLICABLE'}
    if x['age'] >= 65 or x['dangerous_mechanism'] or x['paresthesias']:
        return {'decision': 'IMAGE'}
    low = [x['simple_rear_end'], x['sitting'], x['ambulatory'], x['delayed_onset'], x['no_midline_tenderness']]
    if not any(low):
        return {'decision': 'IMAGE'}
    if min(x['rotate_left'], x['rotate_right']) > 45:
        return {'decision': 'NO_IMAGE'}
    return {'decision': 'IMAGE'}
def check(label, actual, expected):
    observations.append({"check": label, "actual": actual, "expected": expected, "passed": actual == expected})
fixtures = [[('age exactly 65',
   {'age': 65,
    'gcs': 15,
    'dangerous_mechanism': False,
    'paresthesias': False,
    'simple_rear_end': False,
    'sitting': True,
    'ambulatory': True,
    'delayed_onset': False,
    'no_midline_tenderness': False,
    'rotate_left': 60,
    'rotate_right': 60},
   {'decision': 'IMAGE'}),
  ('age 64 with low-risk factors',
   {'age': 64,
    'gcs': 15,
    'dangerous_mechanism': False,
    'paresthesias': False,
    'simple_rear_end': False,
    'sitting': False,
    'ambulatory': True,
    'delayed_onset': False,
    'no_midline_tenderness': False,
    'rotate_left': 60,
    'rotate_right': 60},
   {'decision': 'NO_IMAGE'}),
  ('single low-risk factor',
   {'age': 40,
    'gcs': 15,
    'dangerous_mechanism': False,
    'paresthesias': False,
    'simple_rear_end': False,
    'sitting': True,
    'ambulatory': False,
    'delayed_onset': False,
    'no_midline_tenderness': False,
    'rotate_left': 51,
    'rotate_right': 60},
   {'decision': 'NO_IMAGE'}),
  ('two low-risk factors',
   {'age': 40,
    'gcs': 15,
    'dangerous_mechanism': False,
    'paresthesias': False,
    'simple_rear_end': False,
    'sitting': True,
    'ambulatory': True,
    'delayed_onset': False,
    'no_midline_tenderness': False,
    'rotate_left': 60,
    'rotate_right': 61},
   {'decision': 'NO_IMAGE'}),
  ('all low-risk factors',
   {'age': 31,
    'gcs': 15,
    'dangerous_mechanism': False,
    'paresthesias': False,
    'simple_rear_end': True,
    'sitting': True,
    'ambulatory': True,
    'delayed_onset': True,
    'no_midline_tenderness': True,
    'rotate_left': 60,
    'rotate_right': 60},
   {'decision': 'NO_IMAGE'}),
  ('rotation exactly 45 both ways',
   {'age': 21,
    'gcs': 15,
    'dangerous_mechanism': False,
    'paresthesias': False,
    'simple_rear_end': False,
    'sitting': False,
    'ambulatory': True,
    'delayed_onset': False,
    'no_midline_tenderness': False,
    'rotate_left': 45,
    'rotate_right': 45},
   {'decision': 'NO_IMAGE'}),
  ('rotation limited to one side',
   {'age': 40,
    'gcs': 15,
    'dangerous_mechanism': False,
    'paresthesias': False,
    'simple_rear_end': False,
    'sitting': False,
    'ambulatory': True,
    'delayed_onset': False,
    'no_midline_tenderness': False,
    'rotate_left': 31,
    'rotate_right': 70},
   {'decision': 'IMAGE'}),
  ('paresthesias in ambulatory patient',
   {'age': 26,
    'gcs': 15,
    'dangerous_mechanism': False,
    'paresthesias': True,
    'simple_rear_end': False,
    'sitting': False,
    'ambulatory': True,
    'delayed_onset': False,
    'no_midline_tenderness': False,
    'rotate_left': 60,
    'rotate_right': 60},
   {'decision': 'IMAGE'}),
  ('paresthesias non-ambulatory',
   {'age': 35,
    'gcs': 15,
    'dangerous_mechanism': False,
    'paresthesias': True,
    'simple_rear_end': False,
    'sitting': True,
    'ambulatory': False,
    'delayed_onset': False,
    'no_midline_tenderness': False,
    'rotate_left': 60,
    'rotate_right': 60},
   {'decision': 'IMAGE'}),
  ('adolescent below applicability',
   {'age': 15,
    'gcs': 15,
    'dangerous_mechanism': False,
    'paresthesias': False,
    'simple_rear_end': False,
    'sitting': False,
    'ambulatory': True,
    'delayed_onset': False,
    'no_midline_tenderness': False,
    'rotate_left': 60,
    'rotate_right': 60},
   {'decision': 'NOT_APPLICABLE'})],
 [('age exactly 65',
   {'age': 65,
    'gcs': 15,
    'dangerous_mechanism': False,
    'paresthesias': False,
    'simple_rear_end': False,
    'sitting': True,
    'ambulatory': True,
    'delayed_onset': False,
    'no_midline_tenderness': False,
    'rotate_left': 60,
    'rotate_right': 60},
   {'decision': 'IMAGE'}),
  ('age 64 with low-risk factors',
   {'age': 64,
    'gcs': 15,
    'dangerous_mechanism': False,
    'paresthesias': False,
    'simple_rear_end': False,
    'sitting': True,
    'ambulatory': True,
    'delayed_onset': False,
    'no_midline_tenderness': False,
    'rotate_left': 60,
    'rotate_right': 60},
   {'decision': 'NO_IMAGE'}),
  ('single low-risk factor',
   {'age': 40,
    'gcs': 15,
    'dangerous_mechanism': False,
    'paresthesias': False,
    'simple_rear_end': False,
    'sitting': True,
    'ambulatory': False,
    'delayed_onset': False,
    'no_midline_tenderness': False,
    'rotate_left': 52,
    'rotate_right': 60},
   {'decision': 'NO_IMAGE'}),
  ('two low-risk factors',
   {'age': 40,
    'gcs': 15,
    'dangerous_mechanism': False,
    'paresthesias': False,
    'simple_rear_end': False,
    'sitting': True,
    'ambulatory': True,
    'delayed_onset': False,
    'no_midline_tenderness': False,
    'rotate_left': 60,
    'rotate_right': 62},
   {'decision': 'NO_IMAGE'}),
  ('all low-risk factors',
   {'age': 32,
    'gcs': 15,
    'dangerous_mechanism': False,
    'paresthesias': False,
    'simple_rear_end': True,
    'sitting': True,
    'ambulatory': True,
    'delayed_onset': True,
    'no_midline_tenderness': True,
    'rotate_left': 60,
    'rotate_right': 60},
   {'decision': 'NO_IMAGE'}),
  ('rotation exactly 45 both ways',
   {'age': 22,
    'gcs': 15,
    'dangerous_mechanism': False,
    'paresthesias': False,
    'simple_rear_end': False,
    'sitting': False,
    'ambulatory': True,
    'delayed_onset': False,
    'no_midline_tenderness': False,
    'rotate_left': 45,
    'rotate_right': 45},
   {'decision': 'NO_IMAGE'}),
  ('rotation limited to one side',
   {'age': 40,
    'gcs': 15,
    'dangerous_mechanism': False,
    'paresthesias': False,
    'simple_rear_end': False,
    'sitting': False,
    'ambulatory': True,
    'delayed_onset': False,
    'no_midline_tenderness': False,
    'rotate_left': 32,
    'rotate_right': 70},
   {'decision': 'IMAGE'}),
  ('paresthesias in ambulatory patient',
   {'age': 27,
    'gcs': 15,
    'dangerous_mechanism': False,
    'paresthesias': True,
    'simple_rear_end': False,
    'sitting': False,
    'ambulatory': True,
    'delayed_onset': False,
    'no_midline_tenderness': False,
    'rotate_left': 60,
    'rotate_right': 60},
   {'decision': 'IMAGE'}),
  ('paresthesias non-ambulatory',
   {'age': 35,
    'gcs': 15,
    'dangerous_mechanism': False,
    'paresthesias': True,
    'simple_rear_end': False,
    'sitting': True,
    'ambulatory': False,
    'delayed_onset': False,
    'no_midline_tenderness': False,
    'rotate_left': 60,
    'rotate_right': 60},
   {'decision': 'IMAGE'}),
  ('adolescent below applicability',
   {'age': 15,
    'gcs': 15,
    'dangerous_mechanism': False,
    'paresthesias': False,
    'simple_rear_end': False,
    'sitting': False,
    'ambulatory': True,
    'delayed_onset': False,
    'no_midline_tenderness': False,
    'rotate_left': 60,
    'rotate_right': 60},
   {'decision': 'NOT_APPLICABLE'})],
 [('age exactly 65',
   {'age': 65,
    'gcs': 15,
    'dangerous_mechanism': False,
    'paresthesias': False,
    'simple_rear_end': False,
    'sitting': True,
    'ambulatory': True,
    'delayed_onset': False,
    'no_midline_tenderness': False,
    'rotate_left': 60,
    'rotate_right': 60},
   {'decision': 'IMAGE'}),
  ('age 64 with low-risk factors',
   {'age': 64,
    'gcs': 15,
    'dangerous_mechanism': False,
    'paresthesias': False,
    'simple_rear_end': False,
    'sitting': False,
    'ambulatory': True,
    'delayed_onset': False,
    'no_midline_tenderness': False,
    'rotate_left': 60,
    'rotate_right': 60},
   {'decision': 'NO_IMAGE'}),
  ('single low-risk factor',
   {'age': 40,
    'gcs': 15,
    'dangerous_mechanism': False,
    'paresthesias': False,
    'simple_rear_end': False,
    'sitting': True,
    'ambulatory': False,
    'delayed_onset': False,
    'no_midline_tenderness': False,
    'rotate_left': 53,
    'rotate_right': 60},
   {'decision': 'NO_IMAGE'}),
  ('two low-risk factors',
   {'age': 40,
    'gcs': 15,
    'dangerous_mechanism': False,
    'paresthesias': False,
    'simple_rear_end': False,
    'sitting': True,
    'ambulatory': True,
    'delayed_onset': False,
    'no_midline_tenderness': False,
    'rotate_left': 60,
    'rotate_right': 63},
   {'decision': 'NO_IMAGE'}),
  ('all low-risk factors',
   {'age': 33,
    'gcs': 15,
    'dangerous_mechanism': False,
    'paresthesias': False,
    'simple_rear_end': True,
    'sitting': True,
    'ambulatory': True,
    'delayed_onset': True,
    'no_midline_tenderness': True,
    'rotate_left': 60,
    'rotate_right': 60},
   {'decision': 'NO_IMAGE'}),
  ('rotation exactly 45 both ways',
   {'age': 23,
    'gcs': 15,
    'dangerous_mechanism': False,
    'paresthesias': False,
    'simple_rear_end': False,
    'sitting': False,
    'ambulatory': True,
    'delayed_onset': False,
    'no_midline_tenderness': False,
    'rotate_left': 45,
    'rotate_right': 45},
   {'decision': 'NO_IMAGE'}),
  ('rotation limited to one side',
   {'age': 40,
    'gcs': 15,
    'dangerous_mechanism': False,
    'paresthesias': False,
    'simple_rear_end': False,
    'sitting': False,
    'ambulatory': True,
    'delayed_onset': False,
    'no_midline_tenderness': False,
    'rotate_left': 33,
    'rotate_right': 70},
   {'decision': 'IMAGE'}),
  ('paresthesias in ambulatory patient',
   {'age': 28,
    'gcs': 15,
    'dangerous_mechanism': False,
    'paresthesias': True,
    'simple_rear_end': False,
    'sitting': False,
    'ambulatory': True,
    'delayed_onset': False,
    'no_midline_tenderness': False,
    'rotate_left': 60,
    'rotate_right': 60},
   {'decision': 'IMAGE'}),
  ('paresthesias non-ambulatory',
   {'age': 35,
    'gcs': 15,
    'dangerous_mechanism': False,
    'paresthesias': True,
    'simple_rear_end': False,
    'sitting': True,
    'ambulatory': False,
    'delayed_onset': False,
    'no_midline_tenderness': False,
    'rotate_left': 60,
    'rotate_right': 60},
   {'decision': 'IMAGE'}),
  ('adolescent below applicability',
   {'age': 15,
    'gcs': 15,
    'dangerous_mechanism': False,
    'paresthesias': False,
    'simple_rear_end': False,
    'sitting': False,
    'ambulatory': True,
    'delayed_onset': False,
    'no_midline_tenderness': False,
    'rotate_left': 60,
    'rotate_right': 60},
   {'decision': 'NOT_APPLICABLE'})],
 [('age exactly 65',
   {'age': 65,
    'gcs': 15,
    'dangerous_mechanism': False,
    'paresthesias': False,
    'simple_rear_end': False,
    'sitting': True,
    'ambulatory': True,
    'delayed_onset': False,
    'no_midline_tenderness': False,
    'rotate_left': 60,
    'rotate_right': 60},
   {'decision': 'IMAGE'}),
  ('age 64 with low-risk factors',
   {'age': 64,
    'gcs': 15,
    'dangerous_mechanism': False,
    'paresthesias': False,
    'simple_rear_end': False,
    'sitting': True,
    'ambulatory': True,
    'delayed_onset': False,
    'no_midline_tenderness': False,
    'rotate_left': 60,
    'rotate_right': 60},
   {'decision': 'NO_IMAGE'}),
  ('single low-risk factor',
   {'age': 40,
    'gcs': 15,
    'dangerous_mechanism': False,
    'paresthesias': False,
    'simple_rear_end': False,
    'sitting': True,
    'ambulatory': False,
    'delayed_onset': False,
    'no_midline_tenderness': False,
    'rotate_left': 54,
    'rotate_right': 60},
   {'decision': 'NO_IMAGE'}),
  ('two low-risk factors',
   {'age': 40,
    'gcs': 15,
    'dangerous_mechanism': False,
    'paresthesias': False,
    'simple_rear_end': False,
    'sitting': True,
    'ambulatory': True,
    'delayed_onset': False,
    'no_midline_tenderness': False,
    'rotate_left': 60,
    'rotate_right': 64},
   {'decision': 'NO_IMAGE'}),
  ('all low-risk factors',
   {'age': 34,
    'gcs': 15,
    'dangerous_mechanism': False,
    'paresthesias': False,
    'simple_rear_end': True,
    'sitting': True,
    'ambulatory': True,
    'delayed_onset': True,
    'no_midline_tenderness': True,
    'rotate_left': 60,
    'rotate_right': 60},
   {'decision': 'NO_IMAGE'}),
  ('rotation exactly 45 both ways',
   {'age': 24,
    'gcs': 15,
    'dangerous_mechanism': False,
    'paresthesias': False,
    'simple_rear_end': False,
    'sitting': False,
    'ambulatory': True,
    'delayed_onset': False,
    'no_midline_tenderness': False,
    'rotate_left': 45,
    'rotate_right': 45},
   {'decision': 'NO_IMAGE'}),
  ('rotation limited to one side',
   {'age': 40,
    'gcs': 15,
    'dangerous_mechanism': False,
    'paresthesias': False,
    'simple_rear_end': False,
    'sitting': False,
    'ambulatory': True,
    'delayed_onset': False,
    'no_midline_tenderness': False,
    'rotate_left': 34,
    'rotate_right': 70},
   {'decision': 'IMAGE'}),
  ('paresthesias in ambulatory patient',
   {'age': 29,
    'gcs': 15,
    'dangerous_mechanism': False,
    'paresthesias': True,
    'simple_rear_end': False,
    'sitting': False,
    'ambulatory': True,
    'delayed_onset': False,
    'no_midline_tenderness': False,
    'rotate_left': 60,
    'rotate_right': 60},
   {'decision': 'IMAGE'}),
  ('paresthesias non-ambulatory',
   {'age': 35,
    'gcs': 15,
    'dangerous_mechanism': False,
    'paresthesias': True,
    'simple_rear_end': False,
    'sitting': True,
    'ambulatory': False,
    'delayed_onset': False,
    'no_midline_tenderness': False,
    'rotate_left': 60,
    'rotate_right': 60},
   {'decision': 'IMAGE'}),
  ('adolescent below applicability',
   {'age': 15,
    'gcs': 15,
    'dangerous_mechanism': False,
    'paresthesias': False,
    'simple_rear_end': False,
    'sitting': False,
    'ambulatory': True,
    'delayed_onset': False,
    'no_midline_tenderness': False,
    'rotate_left': 60,
    'rotate_right': 60},
   {'decision': 'NOT_APPLICABLE'})],
 [('age exactly 65',
   {'age': 65,
    'gcs': 15,
    'dangerous_mechanism': False,
    'paresthesias': False,
    'simple_rear_end': False,
    'sitting': True,
    'ambulatory': True,
    'delayed_onset': False,
    'no_midline_tenderness': False,
    'rotate_left': 60,
    'rotate_right': 60},
   {'decision': 'IMAGE'}),
  ('age 64 with low-risk factors',
   {'age': 64,
    'gcs': 15,
    'dangerous_mechanism': False,
    'paresthesias': False,
    'simple_rear_end': False,
    'sitting': False,
    'ambulatory': True,
    'delayed_onset': False,
    'no_midline_tenderness': False,
    'rotate_left': 60,
    'rotate_right': 60},
   {'decision': 'NO_IMAGE'}),
  ('single low-risk factor',
   {'age': 40,
    'gcs': 15,
    'dangerous_mechanism': False,
    'paresthesias': False,
    'simple_rear_end': False,
    'sitting': True,
    'ambulatory': False,
    'delayed_onset': False,
    'no_midline_tenderness': False,
    'rotate_left': 55,
    'rotate_right': 60},
   {'decision': 'NO_IMAGE'}),
  ('two low-risk factors',
   {'age': 40,
    'gcs': 15,
    'dangerous_mechanism': False,
    'paresthesias': False,
    'simple_rear_end': False,
    'sitting': True,
    'ambulatory': True,
    'delayed_onset': False,
    'no_midline_tenderness': False,
    'rotate_left': 60,
    'rotate_right': 65},
   {'decision': 'NO_IMAGE'}),
  ('all low-risk factors',
   {'age': 35,
    'gcs': 15,
    'dangerous_mechanism': False,
    'paresthesias': False,
    'simple_rear_end': True,
    'sitting': True,
    'ambulatory': True,
    'delayed_onset': True,
    'no_midline_tenderness': True,
    'rotate_left': 60,
    'rotate_right': 60},
   {'decision': 'NO_IMAGE'}),
  ('rotation exactly 45 both ways',
   {'age': 25,
    'gcs': 15,
    'dangerous_mechanism': False,
    'paresthesias': False,
    'simple_rear_end': False,
    'sitting': False,
    'ambulatory': True,
    'delayed_onset': False,
    'no_midline_tenderness': False,
    'rotate_left': 45,
    'rotate_right': 45},
   {'decision': 'NO_IMAGE'}),
  ('rotation limited to one side',
   {'age': 40,
    'gcs': 15,
    'dangerous_mechanism': False,
    'paresthesias': False,
    'simple_rear_end': False,
    'sitting': False,
    'ambulatory': True,
    'delayed_onset': False,
    'no_midline_tenderness': False,
    'rotate_left': 35,
    'rotate_right': 70},
   {'decision': 'IMAGE'}),
  ('paresthesias in ambulatory patient',
   {'age': 30,
    'gcs': 15,
    'dangerous_mechanism': False,
    'paresthesias': True,
    'simple_rear_end': False,
    'sitting': False,
    'ambulatory': True,
    'delayed_onset': False,
    'no_midline_tenderness': False,
    'rotate_left': 60,
    'rotate_right': 60},
   {'decision': 'IMAGE'}),
  ('paresthesias non-ambulatory',
   {'age': 35,
    'gcs': 15,
    'dangerous_mechanism': False,
    'paresthesias': True,
    'simple_rear_end': False,
    'sitting': True,
    'ambulatory': False,
    'delayed_onset': False,
    'no_midline_tenderness': False,
    'rotate_left': 60,
    'rotate_right': 60},
   {'decision': 'IMAGE'}),
  ('adolescent below applicability',
   {'age': 15,
    'gcs': 15,
    'dangerous_mechanism': False,
    'paresthesias': False,
    'simple_rear_end': False,
    'sitting': False,
    'ambulatory': True,
    'delayed_onset': False,
    'no_midline_tenderness': False,
    'rotate_left': 60,
    'rotate_right': 60},
   {'decision': 'NOT_APPLICABLE'})]]
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
age exactly 65{'decision': 'IMAGE'}{'decision': 'IMAGE'}Passed
age 64 with low-risk factors{'decision': 'NO_IMAGE'}{'decision': 'NO_IMAGE'}Passed
single low-risk factor{'decision': 'NO_IMAGE'}{'decision': 'NO_IMAGE'}Passed
two low-risk factors{'decision': 'NO_IMAGE'}{'decision': 'NO_IMAGE'}Passed
all low-risk factors{'decision': 'NO_IMAGE'}{'decision': 'NO_IMAGE'}Passed
rotation exactly 45 both ways{'decision': 'IMAGE'}{'decision': 'NO_IMAGE'}Failed
rotation limited to one side{'decision': 'IMAGE'}{'decision': 'IMAGE'}Passed
paresthesias in ambulatory patient{'decision': 'IMAGE'}{'decision': 'IMAGE'}Passed
paresthesias non-ambulatory{'decision': 'IMAGE'}{'decision': 'IMAGE'}Passed
adolescent below applicability{'decision': 'NOT_APPLICABLE'}{'decision': 'NOT_APPLICABLE'}Passed

SHA-256 / 1815159e1a6ef1e8cb5ecf269423fe884c3db3273f18456e6e5897d1bf6f5b5e

3 / The verified repair

Exit 0
"""Failure Map reference implementation. Python standard library only."""
import json

N = 1
observations = []
def solve(x):
    if x['age'] < 16 or x['gcs'] < 15:
        return {'decision': 'NOT_APPLICABLE'}
    if x['age'] >= 65 or x['dangerous_mechanism'] or x['paresthesias']:
        return {'decision': 'IMAGE'}
    low = [x['simple_rear_end'], x['sitting'], x['ambulatory'], x['delayed_onset'], x['no_midline_tenderness']]
    if not any(low):
        return {'decision': 'IMAGE'}
    if x['rotate_left'] >= 45 and x['rotate_right'] >= 45:
        return {'decision': 'NO_IMAGE'}
    return {'decision': 'IMAGE'}
def check(label, actual, expected):
    observations.append({"check": label, "actual": actual, "expected": expected, "passed": actual == expected})
fixtures = [[('age exactly 65',
   {'age': 65,
    'gcs': 15,
    'dangerous_mechanism': False,
    'paresthesias': False,
    'simple_rear_end': False,
    'sitting': True,
    'ambulatory': True,
    'delayed_onset': False,
    'no_midline_tenderness': False,
    'rotate_left': 60,
    'rotate_right': 60},
   {'decision': 'IMAGE'}),
  ('age 64 with low-risk factors',
   {'age': 64,
    'gcs': 15,
    'dangerous_mechanism': False,
    'paresthesias': False,
    'simple_rear_end': False,
    'sitting': False,
    'ambulatory': True,
    'delayed_onset': False,
    'no_midline_tenderness': False,
    'rotate_left': 60,
    'rotate_right': 60},
   {'decision': 'NO_IMAGE'}),
  ('single low-risk factor',
   {'age': 40,
    'gcs': 15,
    'dangerous_mechanism': False,
    'paresthesias': False,
    'simple_rear_end': False,
    'sitting': True,
    'ambulatory': False,
    'delayed_onset': False,
    'no_midline_tenderness': False,
    'rotate_left': 51,
    'rotate_right': 60},
   {'decision': 'NO_IMAGE'}),
  ('two low-risk factors',
   {'age': 40,
    'gcs': 15,
    'dangerous_mechanism': False,
    'paresthesias': False,
    'simple_rear_end': False,
    'sitting': True,
    'ambulatory': True,
    'delayed_onset': False,
    'no_midline_tenderness': False,
    'rotate_left': 60,
    'rotate_right': 61},
   {'decision': 'NO_IMAGE'}),
  ('all low-risk factors',
   {'age': 31,
    'gcs': 15,
    'dangerous_mechanism': False,
    'paresthesias': False,
    'simple_rear_end': True,
    'sitting': True,
    'ambulatory': True,
    'delayed_onset': True,
    'no_midline_tenderness': True,
    'rotate_left': 60,
    'rotate_right': 60},
   {'decision': 'NO_IMAGE'}),
  ('rotation exactly 45 both ways',
   {'age': 21,
    'gcs': 15,
    'dangerous_mechanism': False,
    'paresthesias': False,
    'simple_rear_end': False,
    'sitting': False,
    'ambulatory': True,
    'delayed_onset': False,
    'no_midline_tenderness': False,
    'rotate_left': 45,
    'rotate_right': 45},
   {'decision': 'NO_IMAGE'}),
  ('rotation limited to one side',
   {'age': 40,
    'gcs': 15,
    'dangerous_mechanism': False,
    'paresthesias': False,
    'simple_rear_end': False,
    'sitting': False,
    'ambulatory': True,
    'delayed_onset': False,
    'no_midline_tenderness': False,
    'rotate_left': 31,
    'rotate_right': 70},
   {'decision': 'IMAGE'}),
  ('paresthesias in ambulatory patient',
   {'age': 26,
    'gcs': 15,
    'dangerous_mechanism': False,
    'paresthesias': True,
    'simple_rear_end': False,
    'sitting': False,
    'ambulatory': True,
    'delayed_onset': False,
    'no_midline_tenderness': False,
    'rotate_left': 60,
    'rotate_right': 60},
   {'decision': 'IMAGE'}),
  ('paresthesias non-ambulatory',
   {'age': 35,
    'gcs': 15,
    'dangerous_mechanism': False,
    'paresthesias': True,
    'simple_rear_end': False,
    'sitting': True,
    'ambulatory': False,
    'delayed_onset': False,
    'no_midline_tenderness': False,
    'rotate_left': 60,
    'rotate_right': 60},
   {'decision': 'IMAGE'}),
  ('adolescent below applicability',
   {'age': 15,
    'gcs': 15,
    'dangerous_mechanism': False,
    'paresthesias': False,
    'simple_rear_end': False,
    'sitting': False,
    'ambulatory': True,
    'delayed_onset': False,
    'no_midline_tenderness': False,
    'rotate_left': 60,
    'rotate_right': 60},
   {'decision': 'NOT_APPLICABLE'})],
 [('age exactly 65',
   {'age': 65,
    'gcs': 15,
    'dangerous_mechanism': False,
    'paresthesias': False,
    'simple_rear_end': False,
    'sitting': True,
    'ambulatory': True,
    'delayed_onset': False,
    'no_midline_tenderness': False,
    'rotate_left': 60,
    'rotate_right': 60},
   {'decision': 'IMAGE'}),
  ('age 64 with low-risk factors',
   {'age': 64,
    'gcs': 15,
    'dangerous_mechanism': False,
    'paresthesias': False,
    'simple_rear_end': False,
    'sitting': True,
    'ambulatory': True,
    'delayed_onset': False,
    'no_midline_tenderness': False,
    'rotate_left': 60,
    'rotate_right': 60},
   {'decision': 'NO_IMAGE'}),
  ('single low-risk factor',
   {'age': 40,
    'gcs': 15,
    'dangerous_mechanism': False,
    'paresthesias': False,
    'simple_rear_end': False,
    'sitting': True,
    'ambulatory': False,
    'delayed_onset': False,
    'no_midline_tenderness': False,
    'rotate_left': 52,
    'rotate_right': 60},
   {'decision': 'NO_IMAGE'}),
  ('two low-risk factors',
   {'age': 40,
    'gcs': 15,
    'dangerous_mechanism': False,
    'paresthesias': False,
    'simple_rear_end': False,
    'sitting': True,
    'ambulatory': True,
    'delayed_onset': False,
    'no_midline_tenderness': False,
    'rotate_left': 60,
    'rotate_right': 62},
   {'decision': 'NO_IMAGE'}),
  ('all low-risk factors',
   {'age': 32,
    'gcs': 15,
    'dangerous_mechanism': False,
    'paresthesias': False,
    'simple_rear_end': True,
    'sitting': True,
    'ambulatory': True,
    'delayed_onset': True,
    'no_midline_tenderness': True,
    'rotate_left': 60,
    'rotate_right': 60},
   {'decision': 'NO_IMAGE'}),
  ('rotation exactly 45 both ways',
   {'age': 22,
    'gcs': 15,
    'dangerous_mechanism': False,
    'paresthesias': False,
    'simple_rear_end': False,
    'sitting': False,
    'ambulatory': True,
    'delayed_onset': False,
    'no_midline_tenderness': False,
    'rotate_left': 45,
    'rotate_right': 45},
   {'decision': 'NO_IMAGE'}),
  ('rotation limited to one side',
   {'age': 40,
    'gcs': 15,
    'dangerous_mechanism': False,
    'paresthesias': False,
    'simple_rear_end': False,
    'sitting': False,
    'ambulatory': True,
    'delayed_onset': False,
    'no_midline_tenderness': False,
    'rotate_left': 32,
    'rotate_right': 70},
   {'decision': 'IMAGE'}),
  ('paresthesias in ambulatory patient',
   {'age': 27,
    'gcs': 15,
    'dangerous_mechanism': False,
    'paresthesias': True,
    'simple_rear_end': False,
    'sitting': False,
    'ambulatory': True,
    'delayed_onset': False,
    'no_midline_tenderness': False,
    'rotate_left': 60,
    'rotate_right': 60},
   {'decision': 'IMAGE'}),
  ('paresthesias non-ambulatory',
   {'age': 35,
    'gcs': 15,
    'dangerous_mechanism': False,
    'paresthesias': True,
    'simple_rear_end': False,
    'sitting': True,
    'ambulatory': False,
    'delayed_onset': False,
    'no_midline_tenderness': False,
    'rotate_left': 60,
    'rotate_right': 60},
   {'decision': 'IMAGE'}),
  ('adolescent below applicability',
   {'age': 15,
    'gcs': 15,
    'dangerous_mechanism': False,
    'paresthesias': False,
    'simple_rear_end': False,
    'sitting': False,
    'ambulatory': True,
    'delayed_onset': False,
    'no_midline_tenderness': False,
    'rotate_left': 60,
    'rotate_right': 60},
   {'decision': 'NOT_APPLICABLE'})],
 [('age exactly 65',
   {'age': 65,
    'gcs': 15,
    'dangerous_mechanism': False,
    'paresthesias': False,
    'simple_rear_end': False,
    'sitting': True,
    'ambulatory': True,
    'delayed_onset': False,
    'no_midline_tenderness': False,
    'rotate_left': 60,
    'rotate_right': 60},
   {'decision': 'IMAGE'}),
  ('age 64 with low-risk factors',
   {'age': 64,
    'gcs': 15,
    'dangerous_mechanism': False,
    'paresthesias': False,
    'simple_rear_end': False,
    'sitting': False,
    'ambulatory': True,
    'delayed_onset': False,
    'no_midline_tenderness': False,
    'rotate_left': 60,
    'rotate_right': 60},
   {'decision': 'NO_IMAGE'}),
  ('single low-risk factor',
   {'age': 40,
    'gcs': 15,
    'dangerous_mechanism': False,
    'paresthesias': False,
    'simple_rear_end': False,
    'sitting': True,
    'ambulatory': False,
    'delayed_onset': False,
    'no_midline_tenderness': False,
    'rotate_left': 53,
    'rotate_right': 60},
   {'decision': 'NO_IMAGE'}),
  ('two low-risk factors',
   {'age': 40,
    'gcs': 15,
    'dangerous_mechanism': False,
    'paresthesias': False,
    'simple_rear_end': False,
    'sitting': True,
    'ambulatory': True,
    'delayed_onset': False,
    'no_midline_tenderness': False,
    'rotate_left': 60,
    'rotate_right': 63},
   {'decision': 'NO_IMAGE'}),
  ('all low-risk factors',
   {'age': 33,
    'gcs': 15,
    'dangerous_mechanism': False,
    'paresthesias': False,
    'simple_rear_end': True,
    'sitting': True,
    'ambulatory': True,
    'delayed_onset': True,
    'no_midline_tenderness': True,
    'rotate_left': 60,
    'rotate_right': 60},
   {'decision': 'NO_IMAGE'}),
  ('rotation exactly 45 both ways',
   {'age': 23,
    'gcs': 15,
    'dangerous_mechanism': False,
    'paresthesias': False,
    'simple_rear_end': False,
    'sitting': False,
    'ambulatory': True,
    'delayed_onset': False,
    'no_midline_tenderness': False,
    'rotate_left': 45,
    'rotate_right': 45},
   {'decision': 'NO_IMAGE'}),
  ('rotation limited to one side',
   {'age': 40,
    'gcs': 15,
    'dangerous_mechanism': False,
    'paresthesias': False,
    'simple_rear_end': False,
    'sitting': False,
    'ambulatory': True,
    'delayed_onset': False,
    'no_midline_tenderness': False,
    'rotate_left': 33,
    'rotate_right': 70},
   {'decision': 'IMAGE'}),
  ('paresthesias in ambulatory patient',
   {'age': 28,
    'gcs': 15,
    'dangerous_mechanism': False,
    'paresthesias': True,
    'simple_rear_end': False,
    'sitting': False,
    'ambulatory': True,
    'delayed_onset': False,
    'no_midline_tenderness': False,
    'rotate_left': 60,
    'rotate_right': 60},
   {'decision': 'IMAGE'}),
  ('paresthesias non-ambulatory',
   {'age': 35,
    'gcs': 15,
    'dangerous_mechanism': False,
    'paresthesias': True,
    'simple_rear_end': False,
    'sitting': True,
    'ambulatory': False,
    'delayed_onset': False,
    'no_midline_tenderness': False,
    'rotate_left': 60,
    'rotate_right': 60},
   {'decision': 'IMAGE'}),
  ('adolescent below applicability',
   {'age': 15,
    'gcs': 15,
    'dangerous_mechanism': False,
    'paresthesias': False,
    'simple_rear_end': False,
    'sitting': False,
    'ambulatory': True,
    'delayed_onset': False,
    'no_midline_tenderness': False,
    'rotate_left': 60,
    'rotate_right': 60},
   {'decision': 'NOT_APPLICABLE'})],
 [('age exactly 65',
   {'age': 65,
    'gcs': 15,
    'dangerous_mechanism': False,
    'paresthesias': False,
    'simple_rear_end': False,
    'sitting': True,
    'ambulatory': True,
    'delayed_onset': False,
    'no_midline_tenderness': False,
    'rotate_left': 60,
    'rotate_right': 60},
   {'decision': 'IMAGE'}),
  ('age 64 with low-risk factors',
   {'age': 64,
    'gcs': 15,
    'dangerous_mechanism': False,
    'paresthesias': False,
    'simple_rear_end': False,
    'sitting': True,
    'ambulatory': True,
    'delayed_onset': False,
    'no_midline_tenderness': False,
    'rotate_left': 60,
    'rotate_right': 60},
   {'decision': 'NO_IMAGE'}),
  ('single low-risk factor',
   {'age': 40,
    'gcs': 15,
    'dangerous_mechanism': False,
    'paresthesias': False,
    'simple_rear_end': False,
    'sitting': True,
    'ambulatory': False,
    'delayed_onset': False,
    'no_midline_tenderness': False,
    'rotate_left': 54,
    'rotate_right': 60},
   {'decision': 'NO_IMAGE'}),
  ('two low-risk factors',
   {'age': 40,
    'gcs': 15,
    'dangerous_mechanism': False,
    'paresthesias': False,
    'simple_rear_end': False,
    'sitting': True,
    'ambulatory': True,
    'delayed_onset': False,
    'no_midline_tenderness': False,
    'rotate_left': 60,
    'rotate_right': 64},
   {'decision': 'NO_IMAGE'}),
  ('all low-risk factors',
   {'age': 34,
    'gcs': 15,
    'dangerous_mechanism': False,
    'paresthesias': False,
    'simple_rear_end': True,
    'sitting': True,
    'ambulatory': True,
    'delayed_onset': True,
    'no_midline_tenderness': True,
    'rotate_left': 60,
    'rotate_right': 60},
   {'decision': 'NO_IMAGE'}),
  ('rotation exactly 45 both ways',
   {'age': 24,
    'gcs': 15,
    'dangerous_mechanism': False,
    'paresthesias': False,
    'simple_rear_end': False,
    'sitting': False,
    'ambulatory': True,
    'delayed_onset': False,
    'no_midline_tenderness': False,
    'rotate_left': 45,
    'rotate_right': 45},
   {'decision': 'NO_IMAGE'}),
  ('rotation limited to one side',
   {'age': 40,
    'gcs': 15,
    'dangerous_mechanism': False,
    'paresthesias': False,
    'simple_rear_end': False,
    'sitting': False,
    'ambulatory': True,
    'delayed_onset': False,
    'no_midline_tenderness': False,
    'rotate_left': 34,
    'rotate_right': 70},
   {'decision': 'IMAGE'}),
  ('paresthesias in ambulatory patient',
   {'age': 29,
    'gcs': 15,
    'dangerous_mechanism': False,
    'paresthesias': True,
    'simple_rear_end': False,
    'sitting': False,
    'ambulatory': True,
    'delayed_onset': False,
    'no_midline_tenderness': False,
    'rotate_left': 60,
    'rotate_right': 60},
   {'decision': 'IMAGE'}),
  ('paresthesias non-ambulatory',
   {'age': 35,
    'gcs': 15,
    'dangerous_mechanism': False,
    'paresthesias': True,
    'simple_rear_end': False,
    'sitting': True,
    'ambulatory': False,
    'delayed_onset': False,
    'no_midline_tenderness': False,
    'rotate_left': 60,
    'rotate_right': 60},
   {'decision': 'IMAGE'}),
  ('adolescent below applicability',
   {'age': 15,
    'gcs': 15,
    'dangerous_mechanism': False,
    'paresthesias': False,
    'simple_rear_end': False,
    'sitting': False,
    'ambulatory': True,
    'delayed_onset': False,
    'no_midline_tenderness': False,
    'rotate_left': 60,
    'rotate_right': 60},
   {'decision': 'NOT_APPLICABLE'})],
 [('age exactly 65',
   {'age': 65,
    'gcs': 15,
    'dangerous_mechanism': False,
    'paresthesias': False,
    'simple_rear_end': False,
    'sitting': True,
    'ambulatory': True,
    'delayed_onset': False,
    'no_midline_tenderness': False,
    'rotate_left': 60,
    'rotate_right': 60},
   {'decision': 'IMAGE'}),
  ('age 64 with low-risk factors',
   {'age': 64,
    'gcs': 15,
    'dangerous_mechanism': False,
    'paresthesias': False,
    'simple_rear_end': False,
    'sitting': False,
    'ambulatory': True,
    'delayed_onset': False,
    'no_midline_tenderness': False,
    'rotate_left': 60,
    'rotate_right': 60},
   {'decision': 'NO_IMAGE'}),
  ('single low-risk factor',
   {'age': 40,
    'gcs': 15,
    'dangerous_mechanism': False,
    'paresthesias': False,
    'simple_rear_end': False,
    'sitting': True,
    'ambulatory': False,
    'delayed_onset': False,
    'no_midline_tenderness': False,
    'rotate_left': 55,
    'rotate_right': 60},
   {'decision': 'NO_IMAGE'}),
  ('two low-risk factors',
   {'age': 40,
    'gcs': 15,
    'dangerous_mechanism': False,
    'paresthesias': False,
    'simple_rear_end': False,
    'sitting': True,
    'ambulatory': True,
    'delayed_onset': False,
    'no_midline_tenderness': False,
    'rotate_left': 60,
    'rotate_right': 65},
   {'decision': 'NO_IMAGE'}),
  ('all low-risk factors',
   {'age': 35,
    'gcs': 15,
    'dangerous_mechanism': False,
    'paresthesias': False,
    'simple_rear_end': True,
    'sitting': True,
    'ambulatory': True,
    'delayed_onset': True,
    'no_midline_tenderness': True,
    'rotate_left': 60,
    'rotate_right': 60},
   {'decision': 'NO_IMAGE'}),
  ('rotation exactly 45 both ways',
   {'age': 25,
    'gcs': 15,
    'dangerous_mechanism': False,
    'paresthesias': False,
    'simple_rear_end': False,
    'sitting': False,
    'ambulatory': True,
    'delayed_onset': False,
    'no_midline_tenderness': False,
    'rotate_left': 45,
    'rotate_right': 45},
   {'decision': 'NO_IMAGE'}),
  ('rotation limited to one side',
   {'age': 40,
    'gcs': 15,
    'dangerous_mechanism': False,
    'paresthesias': False,
    'simple_rear_end': False,
    'sitting': False,
    'ambulatory': True,
    'delayed_onset': False,
    'no_midline_tenderness': False,
    'rotate_left': 35,
    'rotate_right': 70},
   {'decision': 'IMAGE'}),
  ('paresthesias in ambulatory patient',
   {'age': 30,
    'gcs': 15,
    'dangerous_mechanism': False,
    'paresthesias': True,
    'simple_rear_end': False,
    'sitting': False,
    'ambulatory': True,
    'delayed_onset': False,
    'no_midline_tenderness': False,
    'rotate_left': 60,
    'rotate_right': 60},
   {'decision': 'IMAGE'}),
  ('paresthesias non-ambulatory',
   {'age': 35,
    'gcs': 15,
    'dangerous_mechanism': False,
    'paresthesias': True,
    'simple_rear_end': False,
    'sitting': True,
    'ambulatory': False,
    'delayed_onset': False,
    'no_midline_tenderness': False,
    'rotate_left': 60,
    'rotate_right': 60},
   {'decision': 'IMAGE'}),
  ('adolescent below applicability',
   {'age': 15,
    'gcs': 15,
    'dangerous_mechanism': False,
    'paresthesias': False,
    'simple_rear_end': False,
    'sitting': False,
    'ambulatory': True,
    'delayed_onset': False,
    'no_midline_tenderness': False,
    'rotate_left': 60,
    'rotate_right': 60},
   {'decision': 'NOT_APPLICABLE'})]]
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
age exactly 65{'decision': 'IMAGE'}{'decision': 'IMAGE'}Passed
age 64 with low-risk factors{'decision': 'NO_IMAGE'}{'decision': 'NO_IMAGE'}Passed
single low-risk factor{'decision': 'NO_IMAGE'}{'decision': 'NO_IMAGE'}Passed
two low-risk factors{'decision': 'NO_IMAGE'}{'decision': 'NO_IMAGE'}Passed
all low-risk factors{'decision': 'NO_IMAGE'}{'decision': 'NO_IMAGE'}Passed
rotation exactly 45 both ways{'decision': 'NO_IMAGE'}{'decision': 'NO_IMAGE'}Passed
rotation limited to one side{'decision': 'IMAGE'}{'decision': 'IMAGE'}Passed
paresthesias in ambulatory patient{'decision': 'IMAGE'}{'decision': 'IMAGE'}Passed
paresthesias non-ambulatory{'decision': 'IMAGE'}{'decision': 'IMAGE'}Passed
adolescent below applicability{'decision': 'NOT_APPLICABLE'}{'decision': 'NOT_APPLICABLE'}Passed

SHA-256 / 4ae95c76837b99926340bb6dab1260432d77a024e4a10f2630f08710aa8c369f

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 2026-09-29T14:47:28.131817+00:00.

Case digest / d2d21994deb78a1ffb83224953bc9ecc5e3f1d4bb122d55fb4244caa60b40cba