chore: add .gitignore
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output/structured/104_23001083/CRO_23001083_cim10.json
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output/structured/104_23001083/CRO_23001083_cim10.json
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{
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"source_file": "CRO 23001083.pdf",
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"document_type": "crh",
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"sejour": {
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"sexe": "M"
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},
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"diagnostic_principal": {
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"texte": "Thromboembolie veineuse",
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"cim10_suggestion": "I82.9",
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"cim10_confidence": "high",
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"cim10_final": "I82.9",
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"sources_rag": [],
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"preuves_cliniques": [],
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"est_cma": true,
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"niveau_severite": "non_evalue",
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"niveau_cma": 2,
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"source": "nuke3"
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},
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"dp_selection": {
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"chosen_index": 1,
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"chosen_term": "Thromboembolie veineuse",
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"chosen_code": "I82.9",
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"confidence": "medium",
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"verdict": "CONFIRMED",
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"evidence": [
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"Score 4.0 — source: llm_das",
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"Delta +3.0 vs Chimiothérapie, (Z51.1)"
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],
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"reason": "Écart score 3.0 >= seuil 3.0",
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"candidates": [
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{
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"index": 1,
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"term": "Thromboembolie veineuse",
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"code": "I82.9",
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"confidence": "high",
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"source": "llm_das",
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"is_comorbidity_like": false,
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"is_symptom_like": false,
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"is_act_only": false,
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"section_strength": 1,
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"num_occurrences": 1,
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"score": 4.0,
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"score_details": {
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"section": 1,
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"confidence": 3
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}
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},
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{
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"index": 0,
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"term": "Chimiothérapie,",
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"code": "Z51.1",
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"confidence": "high",
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"source": "edsnlp",
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"is_comorbidity_like": false,
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"is_symptom_like": false,
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"is_act_only": true,
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"section_strength": 2,
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"num_occurrences": 1,
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"score": 1.0,
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"score_details": {
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"section": 2,
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"confidence": 3,
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"act_only_malus": -4
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}
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}
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],
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"debug_scores": {
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"top1": 4.0,
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"top2": 1.0,
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"delta": 3.0
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}
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},
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"dp_crh_only": {
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"chosen_index": 1,
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"chosen_term": "Thromboembolie veineuse",
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"chosen_code": "I82.9",
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"confidence": "medium",
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"verdict": "CONFIRMED",
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"evidence": [
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"Score 4.0 — source: llm_das",
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"Delta +3.0 vs Chimiothérapie, (Z51.1)"
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],
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"reason": "Écart score 3.0 >= seuil 3.0",
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"candidates": [
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{
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"index": 1,
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"term": "Thromboembolie veineuse",
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"code": "I82.9",
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"confidence": "high",
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"source": "llm_das",
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"is_comorbidity_like": false,
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"is_symptom_like": false,
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"is_act_only": false,
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"section_strength": 1,
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"num_occurrences": 1,
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"score": 4.0,
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"score_details": {
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"section": 1,
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"confidence": 3
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}
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},
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{
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"index": 0,
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"term": "Chimiothérapie,",
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"code": "Z51.1",
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"confidence": "high",
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"source": "edsnlp",
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"is_comorbidity_like": false,
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"is_symptom_like": false,
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"is_act_only": true,
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"section_strength": 2,
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"num_occurrences": 1,
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"score": 1.0,
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"score_details": {
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"section": 2,
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"confidence": 3,
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"act_only_malus": -4
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}
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}
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],
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"debug_scores": {
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"top1": 4.0,
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"top2": 1.0,
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"delta": 3.0
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}
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},
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"dp_final": {
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"chosen_index": 1,
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"chosen_term": "Thromboembolie veineuse",
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"chosen_code": "I82.9",
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"confidence": "medium",
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"verdict": "CONFIRMED",
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"evidence": [
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"Score 4.0 — source: llm_das",
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"Delta +3.0 vs Chimiothérapie, (Z51.1)"
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],
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"reason": "Écart score 3.0 >= seuil 3.0",
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"candidates": [
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{
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"index": 1,
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"term": "Thromboembolie veineuse",
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"code": "I82.9",
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"confidence": "high",
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"source": "llm_das",
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"is_comorbidity_like": false,
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"is_symptom_like": false,
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"is_act_only": false,
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"section_strength": 1,
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"num_occurrences": 1,
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"score": 4.0,
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"score_details": {
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"section": 1,
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"confidence": 3
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}
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},
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{
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"index": 0,
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"term": "Chimiothérapie,",
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"code": "Z51.1",
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"confidence": "high",
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"source": "edsnlp",
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"is_comorbidity_like": false,
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"is_symptom_like": false,
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"is_act_only": true,
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"section_strength": 2,
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"num_occurrences": 1,
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"score": 1.0,
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"score_details": {
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"section": 2,
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"confidence": 3,
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"act_only_malus": -4
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}
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}
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],
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"debug_scores": {
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"top1": 4.0,
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"top2": 1.0,
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"delta": 3.0
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}
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},
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"quality_flags": {
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"crh_only_mode": true
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},
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"diagnostics_associes": [],
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"actes_ccam": [],
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"antecedents": [],
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"traitements_sortie": [],
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"biologie_cle": [],
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"biologie_discarded": [],
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"imagerie": [],
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"complications": [],
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"alertes_codage": [
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"CMA niveau 2 : 'Thromboembolie veineuse' (I82.9) — sévérité non_evalue",
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"QC: DP I82.9 confiance medium→high — Le code I82.9 (Thromboembolie veineuse, non spécifiée) nécessite une justification clinique précise. L'absence de preuves cliniques dans le dossier rend ce codage non justifié. Un code plus général pourrait être envisagé si une thrombose veineuse est confirmée, mais sans preuve, il est préférable de le supprimer. Il est crucial d'obtenir des informations supplémentaires (antécédents, examens complémentaires, symptômes) pour justifier un tel diagnostic.",
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"QC: L'absence de justification clinique pour le code I82.9 est un point critique. Veuillez vérifier le dossier clinique pour identifier des éléments de preuve (examens, symptômes, antécédents) qui pourraient soutenir ce diagnostic. Sans cela, le codage est incorrect et peut entraîner des problèmes de remboursement et de qualité des données.",
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"QC: Il est impératif de documenter clairement la justification clinique de chaque code dans le dossier patient.",
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"VETOS[PDF]: FAIL (score=40)",
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"VETO-02 [HARD] diagnostic_principal: DP I82.9 sans preuve exploitable",
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"VETO-12 [HARD] diagnostic_principal: DP I82.9 en high sans preuve"
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],
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"source_files": [],
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"ghm_estimation": {
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"cmd": "05",
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"cmd_libelle": "Affections de l'appareil circulatoire",
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"type_ghm": "M",
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"severite": 1,
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"ghm_approx": "05M??1",
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"cma_count": 0,
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"cms_count": 0,
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"alertes": []
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},
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"controles_cpam": [],
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"veto_report": {
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"verdict": "FAIL",
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"score_contestabilite": 40,
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"issues": [
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{
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"veto": "VETO-02",
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"severity": "HARD",
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"where": "diagnostic_principal",
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"message": "DP I82.9 sans preuve exploitable"
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},
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{
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"veto": "VETO-12",
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"severity": "HARD",
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"where": "diagnostic_principal",
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"message": "DP I82.9 en high sans preuve"
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}
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]
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},
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"processing_time_s": 41.81,
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"metrics": {
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"das_total": 0,
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"das_active": 0,
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"das_excluded": 0,
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"das_removed": 0,
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"das_ruled_out": 0,
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"das_no_code": 0,
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"actes_total": 0,
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"actes_with_code": 0,
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"dp_has_code": true
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},
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"rules_runtime": {
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"router_version": 1,
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"mode": "strict",
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"enabled_packs": [
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"decisions_core",
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"vetos_core"
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],
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"always_on_rules": [],
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"triggers_fired": []
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}
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}
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