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10 values
intervention
stringclasses
10 values
initial_rationale
stringclasses
10 values
observed_outcomes
stringclasses
10 values
time_to_signal
stringclasses
6 values
unintended_effects
stringclasses
9 values
competing_explanations
stringclasses
8 values
alignment_score
stringclasses
3 values
gold_alignment_break
stringclasses
9 values
gold_next_action
stringclasses
9 values
gold_stop_or_continue
stringclasses
3 values
notes
stringclasses
9 values
constraints
stringclasses
1 value
OA-001
Antibiotics
Treat infection
No improvement
48h
renal injury
wrong source
low
no response
reimage
adapt
Outcome mismatch
Under 320 words
OA-002
Diuretic
Reduce edema
BP drop
6h
hypotension
overdiuresis
low
BP fall
reduce dose
adapt
Signal drift
Under 320 words
OA-003
Beta blocker
Rate control
Rate improved
2h
fatigue
none
high
none
continue
continue
Aligned
Under 320 words
OA-004
Steroid
Inflammation
Glucose spike
24h
hyperglycemia
drug effect
med
metabolic drift
add insulin
adapt
Tradeoff
Under 320 words
OA-005
Transfusion
Raise Hb
Hb stable
4h
fluid overload
CHF
med
volume
diurese
adapt
Balance
Under 320 words
OA-006
Vent change
Improve oxygen
No change
1h
none
PE
low
no oxygen gain
scan
adapt
Mismatch
Under 320 words
OA-007
Insulin
Lower glucose
Glucose low
2h
hypo
overdose
low
overshoot
reduce
adapt
Overcorrect
Under 320 words
OA-008
Fluids
Raise BP
BP stable
1h
edema
none
high
none
continue
continue
Aligned
Under 320 words
OA-009
Anticoag
Prevent clot
Bleed
24h
bleed
drug effect
low
bleed
stop
stop
Harm
Under 320 words
OA-010
Analgesia
Pain control
Pain unchanged
2h
none
wrong cause
low
no relief
reassess
adapt
Ineffective
Under 320 words

Goal
Judge whether outcomes match the rationale trajectory.

Model must

  • detect misalignment
  • recommend continue, adapt, or stop

Use
Completes the rationale → execution → outcome loop.

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