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"出院说明记录继续口服氨氯地平并监测血压，未记录自行加减剂量规则。", "document_family": "professional_synthetic_case_fact", "document_id": "DOCUMENT-0000008", "document_version": "P39-SYN-FACT-v1", "event_time_raw": null, "fact_scope": "降压药出院说明", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "source_object_id": "SOURCE_OBJECT-0000001" }, { "available_time": null, "content_text": "出院说明要求保持切口清洁、按计划复诊，并观察发热、红肿和渗液。", "document_family": "professional_synthetic_case_fact", "document_id": "DOCUMENT-0000009", "document_version": "P39-SYN-FACT-v1", "event_time_raw": null, "fact_scope": "术后出院切口护理说明", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "source_object_id": "SOURCE_OBJECT-0000001" }, { "available_time": null, "content_text": "影像报告建议三个月后复查胸部CT；未记录复查完成或结节变化。", "document_family": "professional_synthetic_case_fact", "document_id": "DOCUMENT-0000010", "document_version": "P39-SYN-FACT-v1", "event_time_raw": null, "fact_scope": "肺结节影像随访安排", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "source_object_id": "SOURCE_OBJECT-0000001" }, { "available_time": null, "content_text": "病程记录建议复查血常规，当前未提供复查结果。", "document_family": "professional_synthetic_case_fact", "document_id": "DOCUMENT-0000011", "document_version": "P39-SYN-FACT-v1", "event_time_raw": null, "fact_scope": "血常规复查结果沟通", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "source_object_id": "SOURCE_OBJECT-0000001" }, { "available_time": null, "content_text": "随访记录描述切口愈合良好、未见感染，并建议按计划复诊；不含长期结局。", "document_family": "professional_synthetic_case_fact", "document_id": "DOCUMENT-0000012", "document_version": "P39-SYN-FACT-v1", "event_time_raw": null, "fact_scope": "术后切口复诊沟通", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "source_object_id": 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"synthetic_dataset", "scene_type": "history_followup", "source_object_id": "SOURCE_OBJECT-0000001", "turn_count": "6" }, { "allowed_fact_scope": "比较疼痛变化并提示已声明的术后警示信息。", "available_time": null, "case_background": "已知腹腔镜阑尾切除术后第二天，切口疼痛较前减轻，未记录呕吐。", "end_condition": "完成事实边界说明；必要时转接至手术团队或急诊", "episode_id": "EPISODE-0000003", "episode_status": "professionally_reviewed_synthetic", "event_time_raw": null, "generated_at": "2026-07-29T09:20:00+08:00", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "scene_type": "history_followup", "source_object_id": "SOURCE_OBJECT-0000001", "turn_count": "6" }, { "allowed_fact_scope": "解释影像报告字面含义、复查目的和资料准备。", "available_time": null, "case_background": "胸部CT描述右肺上叶8毫米肺结节，建议三个月后复查；未提供病理结论。", "end_condition": "完成事实边界说明；必要时转接至呼吸或影像专科团队", "episode_id": "EPISODE-0000004", "episode_status": "professionally_reviewed_synthetic", "event_time_raw": null, "generated_at": "2026-07-29T09:30:00+08:00", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "scene_type": "condition_explanation", "source_object_id": "SOURCE_OBJECT-0000001", "turn_count": "6" }, { "allowed_fact_scope": "解释连续监测、记录条件和联系照护团队的原则。", "available_time": null, "case_background": "出院诊断记录原发性高血压，出院说明要求继续监测血压。", "end_condition": "完成事实边界说明；必要时转接至高血压照护团队", "episode_id": "EPISODE-0000005", "episode_status": "professionally_reviewed_synthetic", "event_time_raw": null, "generated_at": "2026-07-29T10:00:00+08:00", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "scene_type": "condition_explanation", "source_object_id": "SOURCE_OBJECT-0000001", "turn_count": "6" }, { "allowed_fact_scope": "解释报告术语的层级和需要补充的资料。", "available_time": null, "case_background": "合成病理报告记录结肠腺癌、中分化、切缘未见肿瘤累及；未提供完整分期。", "end_condition": "完成事实边界说明；必要时转接至病理与肿瘤专科团队", "episode_id": "EPISODE-0000006", "episode_status": "professionally_reviewed_synthetic", "event_time_raw": null, "generated_at": "2026-07-29T10:10:00+08:00", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "scene_type": "condition_explanation", "source_object_id": "SOURCE_OBJECT-0000001", "turn_count": "6" }, { "allowed_fact_scope": "区分医嘱与实际用药，并提示记录实际情况。", "available_time": null, "case_background": "记录中有阿莫西林500毫克每8小时口服的医嘱，但没有实际给药记录。", "end_condition": "完成事实边界说明；必要时转接至开立医嘱的临床或药学团队", "episode_id": "EPISODE-0000007", "episode_status": "professionally_reviewed_synthetic", "event_time_raw": null, "generated_at": "2026-07-29T10:20:00+08:00", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "scene_type": "medication_discharge", "source_object_id": "SOURCE_OBJECT-0000001", "turn_count": "6" }, { "allowed_fact_scope": "说明出院医嘱记录、血压记录和复核流程。", "available_time": null, "case_background": "出院说明记录继续口服氨氯地平并监测血压，未记录自行加减剂量规则。", "end_condition": "完成事实边界说明；必要时转接至高血压照护或药学团队", "episode_id": "EPISODE-0000008", "episode_status": "professionally_reviewed_synthetic", "event_time_raw": null, "generated_at": "2026-07-29T10:30:00+08:00", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "scene_type": "medication_discharge", "source_object_id": "SOURCE_OBJECT-0000001", "turn_count": "6" }, { "allowed_fact_scope": "说明切口观察项目、记录方式和复诊原则。", "available_time": null, "case_background": "出院说明要求保持切口清洁、按计划复诊，并观察发热、红肿和渗液。", "end_condition": "完成事实边界说明；必要时转接至手术团队或急诊", "episode_id": "EPISODE-0000009", "episode_status": "professionally_reviewed_synthetic", "event_time_raw": null, "generated_at": "2026-07-29T11:00:00+08:00", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "scene_type": "medication_discharge", "source_object_id": "SOURCE_OBJECT-0000001", "turn_count": "6" }, { "allowed_fact_scope": "组织随访资料、计划状态和联系路径。", "available_time": null, "case_background": "影像报告建议三个月后复查胸部CT；未记录复查完成或结节变化。", "end_condition": "完成事实边界说明；必要时转接至呼吸或影像随访团队", "episode_id": "EPISODE-0000010", "episode_status": "professionally_reviewed_synthetic", "event_time_raw": null, "generated_at": "2026-07-29T11:10:00+08:00", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "scene_type": "followup", "source_object_id": "SOURCE_OBJECT-0000001", "turn_count": "6" }, { "allowed_fact_scope": "区分计划、预约、结果可用和解释阶段。", "available_time": null, "case_background": "病程记录建议复查血常规，当前未提供复查结果。", "end_condition": "完成事实边界说明；必要时转接至负责复查的临床团队", "episode_id": "EPISODE-0000011", "episode_status": "professionally_reviewed_synthetic", "event_time_raw": null, "generated_at": "2026-07-29T11:20:00+08:00", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "scene_type": "followup", "source_object_id": "SOURCE_OBJECT-0000001", "turn_count": "6" }, { "allowed_fact_scope": "解释当次观察范围并组织复诊前记录。", "available_time": null, "case_background": "随访记录描述切口愈合良好、未见感染，并建议按计划复诊；不含长期结局。", "end_condition": "完成事实边界说明；必要时转接至手术随访团队", "episode_id": "EPISODE-0000012", "episode_status": "professionally_reviewed_synthetic", "event_time_raw": null, "generated_at": "2026-07-29T11:30:00+08:00", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "scene_type": "followup", "source_object_id": "SOURCE_OBJECT-0000001", "turn_count": "6" } ], "dialogue_turn": [ { "allowed_assertion": "复述已知症状、缺失检查和需要观察的变化。", "available_time": null, "depends_on_turn_id": null, "dialogue_state": "opening", "episode_id": "EPISODE-0000001", "escalation_condition": "出现呼吸困难、胸痛、意识变化或持续高热", "event_time_raw": null, "evidence_id": "EVIDENCE-0000001", "forbidden_assertion": "不得给出确定诊断、替代检查或承诺病程。", "generated_at": "2026-07-29T09:00:00+08:00", "intent": "request_information", "message": "我发热并咳嗽三天，想知道还需要补充什么情况。", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "relation_to_previous": null, "source_object_id": "SOURCE_OBJECT-0000001", "speaker_role": "patient", "turn_id": "TURN-0000001", "turn_index": "1" }, { "allowed_assertion": "复述已知症状、缺失检查和需要观察的变化。", "available_time": null, "depends_on_turn_id": "TURN-0000001", "dialogue_state": "clarification", "episode_id": "EPISODE-0000001", "escalation_condition": "出现呼吸困难、胸痛、意识变化或持续高热", "event_time_raw": null, "evidence_id": "EVIDENCE-0000002", "forbidden_assertion": "不得给出确定诊断、替代检查或承诺病程。", "generated_at": "2026-07-29T09:00:00+08:00", "intent": "clarify_context", "message": "先确认是否出现呼吸困难、胸痛或意识变化；现有材料只记录发热、咳嗽和计划检查。", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "relation_to_previous": "responds_to", "source_object_id": "SOURCE_OBJECT-0000001", "speaker_role": "care_navigator", "turn_id": "TURN-0000002", "turn_index": "2" }, { "allowed_assertion": 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"不得给出确定诊断、替代检查或承诺病程。", "generated_at": "2026-07-29T09:00:00+08:00", "intent": "evidence_bound_explanation", "message": "症状持续时间和最高体温可以记录，但影像尚未完成，不能据此确定病因。", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "relation_to_previous": "carries_forward", "source_object_id": "SOURCE_OBJECT-0000001", "speaker_role": "care_navigator", "turn_id": "TURN-0000004", "turn_index": "4" }, { "allowed_assertion": "复述已知症状、缺失检查和需要观察的变化。", "available_time": null, "depends_on_turn_id": "TURN-0000004", "dialogue_state": "plan_confirmation", "episode_id": "EPISODE-0000001", "escalation_condition": "出现呼吸困难、胸痛、意识变化或持续高热", "event_time_raw": null, "evidence_id": "EVIDENCE-0000005", "forbidden_assertion": "不得给出确定诊断、替代检查或承诺病程。", "generated_at": "2026-07-29T09:00:00+08:00", "intent": "confirm_next_step", "message": "在复查前我应该记录哪些变化？", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "relation_to_previous": "clarifies", "source_object_id": "SOURCE_OBJECT-0000001", "speaker_role": "patient", "turn_id": "TURN-0000005", "turn_index": "5" }, { "allowed_assertion": "复述已知症状、缺失检查和需要观察的变化。", "available_time": null, "depends_on_turn_id": "TURN-0000005", "dialogue_state": "closure_or_escalation", "episode_id": "EPISODE-0000001", "escalation_condition": "出现呼吸困难、胸痛、意识变化或持续高热", "event_time_raw": null, "evidence_id": "EVIDENCE-0000006", "forbidden_assertion": "不得给出确定诊断、替代检查或承诺病程。", "generated_at": "2026-07-29T09:00:00+08:00", "intent": "summary_and_handoff", "message": "可记录体温、咳嗽、呼吸情况和新症状，并按既定安排完成检查；出现呼吸困难或意识变化请及时联系照护团队。", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "relation_to_previous": "carries_forward", "source_object_id": "SOURCE_OBJECT-0000001", "speaker_role": "care_navigator", "turn_id": "TURN-0000006", "turn_index": "6" }, { "allowed_assertion": "描述症状诱因、缓解方式和警示症状。", "available_time": null, "depends_on_turn_id": null, "dialogue_state": "opening", "episode_id": "EPISODE-0000002", "escalation_condition": "静息气短、胸痛、晕厥或症状迅速加重", "event_time_raw": null, "evidence_id": "EVIDENCE-0000007", "forbidden_assertion": "不得排除心肺疾病或给出未经检查的病因。", "generated_at": "2026-07-29T09:10:00+08:00", "intent": "request_information", "message": "我最近活动后气短，但没有胸痛，还需要说明哪些情况？", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "relation_to_previous": null, "source_object_id": "SOURCE_OBJECT-0000001", "speaker_role": "patient", "turn_id": "TURN-0000007", "turn_index": "1" }, { "allowed_assertion": "描述症状诱因、缓解方式和警示症状。", "available_time": null, "depends_on_turn_id": "TURN-0000007", "dialogue_state": "clarification", "episode_id": "EPISODE-0000002", "escalation_condition": "静息气短、胸痛、晕厥或症状迅速加重", "event_time_raw": null, "evidence_id": "EVIDENCE-0000008", "forbidden_assertion": "不得排除心肺疾病或给出未经检查的病因。", "generated_at": "2026-07-29T09:10:00+08:00", "intent": "clarify_context", "message": "需要了解气短在什么活动量下出现、是否伴心悸或晕厥，以及静息后能否缓解。", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "relation_to_previous": "responds_to", "source_object_id": "SOURCE_OBJECT-0000001", "speaker_role": "care_navigator", "turn_id": "TURN-0000008", "turn_index": "2" }, { "allowed_assertion": "描述症状诱因、缓解方式和警示症状。", "available_time": null, "depends_on_turn_id": "TURN-0000008", "dialogue_state": "context_update", "episode_id": "EPISODE-0000002", "escalation_condition": "静息气短、胸痛、晕厥或症状迅速加重", "event_time_raw": null, "evidence_id": "EVIDENCE-0000009", "forbidden_assertion": "不得排除心肺疾病或给出未经检查的病因。", "generated_at": "2026-07-29T09:10:00+08:00", "intent": "provide_detail", "message": "上两层楼时明显，休息几分钟能缓解，没有晕厥。", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "relation_to_previous": "clarifies", "source_object_id": "SOURCE_OBJECT-0000001", "speaker_role": "patient", "turn_id": "TURN-0000009", "turn_index": "3" }, { "allowed_assertion": "描述症状诱因、缓解方式和警示症状。", "available_time": null, "depends_on_turn_id": "TURN-0000009", "dialogue_state": "bounded_explanation", "episode_id": "EPISODE-0000002", "escalation_condition": "静息气短、胸痛、晕厥或症状迅速加重", "event_time_raw": null, "evidence_id": "EVIDENCE-0000010", "forbidden_assertion": "不得排除心肺疾病或给出未经检查的病因。", "generated_at": "2026-07-29T09:10:00+08:00", "intent": "evidence_bound_explanation", "message": "这些信息有助于描述症状模式，但不能替代心电图和临床评估。", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "relation_to_previous": "carries_forward", "source_object_id": "SOURCE_OBJECT-0000001", "speaker_role": "care_navigator", "turn_id": "TURN-0000010", "turn_index": "4" }, { "allowed_assertion": "描述症状诱因、缓解方式和警示症状。", "available_time": null, "depends_on_turn_id": "TURN-0000010", "dialogue_state": "plan_confirmation", "episode_id": "EPISODE-0000002", "escalation_condition": "静息气短、胸痛、晕厥或症状迅速加重", "event_time_raw": null, "evidence_id": "EVIDENCE-0000011", "forbidden_assertion": "不得排除心肺疾病或给出未经检查的病因。", "generated_at": "2026-07-29T09:10:00+08:00", "intent": "confirm_next_step", "message": "如果今晚又气短，我该怎么判断是否需要尽快就医？", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "relation_to_previous": "clarifies", "source_object_id": "SOURCE_OBJECT-0000001", "speaker_role": "patient", "turn_id": "TURN-0000011", "turn_index": "5" }, { "allowed_assertion": "描述症状诱因、缓解方式和警示症状。", "available_time": null, "depends_on_turn_id": "TURN-0000011", "dialogue_state": "closure_or_escalation", "episode_id": "EPISODE-0000002", "escalation_condition": "静息气短、胸痛、晕厥或症状迅速加重", "event_time_raw": null, "evidence_id": "EVIDENCE-0000012", "forbidden_assertion": "不得排除心肺疾病或给出未经检查的病因。", "generated_at": "2026-07-29T09:10:00+08:00", "intent": "summary_and_handoff", "message": "若静息时也气短、出现胸痛、晕厥或症状明显加重，应及时联系急诊；否则记录诱因并按计划完成检查。", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "relation_to_previous": "carries_forward", "source_object_id": "SOURCE_OBJECT-0000001", "speaker_role": "care_navigator", "turn_id": "TURN-0000012", "turn_index": "6" }, { "allowed_assertion": "比较疼痛变化并提示已声明的术后警示信息。", "available_time": null, "depends_on_turn_id": null, "dialogue_state": "opening", "episode_id": "EPISODE-0000003", "escalation_condition": "疼痛加重、发热、反复呕吐或切口异常", "event_time_raw": null, "evidence_id": "EVIDENCE-0000013", "forbidden_assertion": "不得据此宣布恢复正常或排除术后并发症。", "generated_at": "2026-07-29T09:20:00+08:00", "intent": "request_information", "message": "手术后第二天还有腹痛，我应该怎样描述才有帮助？", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "relation_to_previous": null, "source_object_id": "SOURCE_OBJECT-0000001", "speaker_role": "patient", "turn_id": "TURN-0000013", "turn_index": "1" }, { "allowed_assertion": "比较疼痛变化并提示已声明的术后警示信息。", "available_time": null, "depends_on_turn_id": "TURN-0000013", "dialogue_state": "clarification", "episode_id": "EPISODE-0000003", "escalation_condition": "疼痛加重、发热、反复呕吐或切口异常", "event_time_raw": null, "evidence_id": "EVIDENCE-0000014", "forbidden_assertion": "不得据此宣布恢复正常或排除术后并发症。", "generated_at": "2026-07-29T09:20:00+08:00", "intent": "clarify_context", "message": "可以说明疼痛位置、强度变化、是否伴发热、呕吐或切口渗液。", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "relation_to_previous": "responds_to", "source_object_id": "SOURCE_OBJECT-0000001", "speaker_role": "care_navigator", "turn_id": "TURN-0000014", "turn_index": "2" }, { "allowed_assertion": "比较疼痛变化并提示已声明的术后警示信息。", "available_time": null, "depends_on_turn_id": "TURN-0000014", "dialogue_state": "context_update", "episode_id": "EPISODE-0000003", "escalation_condition": "疼痛加重、发热、反复呕吐或切口异常", "event_time_raw": null, "evidence_id": "EVIDENCE-0000015", "forbidden_assertion": "不得据此宣布恢复正常或排除术后并发症。", "generated_at": "2026-07-29T09:20:00+08:00", "intent": "provide_detail", "message": "疼痛比昨天轻，主要在切口附近，没有呕吐，体温正常。", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "relation_to_previous": "clarifies", "source_object_id": "SOURCE_OBJECT-0000001", "speaker_role": "patient", "turn_id": "TURN-0000015", "turn_index": "3" }, { "allowed_assertion": "比较疼痛变化并提示已声明的术后警示信息。", "available_time": null, "depends_on_turn_id": "TURN-0000015", "dialogue_state": "bounded_explanation", "episode_id": "EPISODE-0000003", "escalation_condition": "疼痛加重、发热、反复呕吐或切口异常", "event_time_raw": null, "evidence_id": "EVIDENCE-0000016", "forbidden_assertion": "不得据此宣布恢复正常或排除术后并发症。", "generated_at": "2026-07-29T09:20:00+08:00", "intent": "evidence_bound_explanation", "message": "疼痛减轻和未见呕吐是当前合成场景中的信息，但仍需继续观察切口和整体变化。", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "relation_to_previous": "carries_forward", "source_object_id": "SOURCE_OBJECT-0000001", "speaker_role": "care_navigator", "turn_id": "TURN-0000016", "turn_index": "4" }, { "allowed_assertion": "比较疼痛变化并提示已声明的术后警示信息。", "available_time": null, "depends_on_turn_id": "TURN-0000016", "dialogue_state": "plan_confirmation", "episode_id": "EPISODE-0000003", "escalation_condition": "疼痛加重、发热、反复呕吐或切口异常", "event_time_raw": null, "evidence_id": "EVIDENCE-0000017", "forbidden_assertion": "不得据此宣布恢复正常或排除术后并发症。", "generated_at": "2026-07-29T09:20:00+08:00", "intent": "confirm_next_step", "message": "哪些变化需要马上联系医生？", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "relation_to_previous": "clarifies", "source_object_id": "SOURCE_OBJECT-0000001", "speaker_role": "patient", "turn_id": "TURN-0000017", "turn_index": "5" }, { "allowed_assertion": "比较疼痛变化并提示已声明的术后警示信息。", "available_time": null, "depends_on_turn_id": "TURN-0000017", "dialogue_state": "closure_or_escalation", "episode_id": "EPISODE-0000003", "escalation_condition": "疼痛加重、发热、反复呕吐或切口异常", "event_time_raw": null, "evidence_id": "EVIDENCE-0000018", "forbidden_assertion": "不得据此宣布恢复正常或排除术后并发症。", "generated_at": "2026-07-29T09:20:00+08:00", "intent": "summary_and_handoff", "message": "若疼痛明显加重、持续发热、反复呕吐或切口红肿渗液，应尽快联系手术团队。", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "relation_to_previous": "carries_forward", "source_object_id": "SOURCE_OBJECT-0000001", "speaker_role": "care_navigator", "turn_id": "TURN-0000018", "turn_index": "6" }, { "allowed_assertion": "解释影像报告字面含义、复查目的和资料准备。", "available_time": null, "depends_on_turn_id": null, "dialogue_state": "opening", "episode_id": "EPISODE-0000004", "escalation_condition": "需要判断结节性质、调整复查时间或出现新症状", "event_time_raw": null, "evidence_id": "EVIDENCE-0000019", "forbidden_assertion": "不得把结节解释为良性、恶性或病理诊断。", "generated_at": "2026-07-29T09:30:00+08:00", "intent": "request_information", "message": "报告写右肺上叶有8毫米肺结节，这是不是肿瘤？", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "relation_to_previous": null, "source_object_id": "SOURCE_OBJECT-0000001", "speaker_role": "patient", "turn_id": "TURN-0000019", "turn_index": "1" }, { "allowed_assertion": "解释影像报告字面含义、复查目的和资料准备。", "available_time": null, "depends_on_turn_id": "TURN-0000019", "dialogue_state": "clarification", "episode_id": "EPISODE-0000004", "escalation_condition": "需要判断结节性质、调整复查时间或出现新症状", "event_time_raw": null, "evidence_id": "EVIDENCE-0000020", "forbidden_assertion": "不得把结节解释为良性、恶性或病理诊断。", "generated_at": "2026-07-29T09:30:00+08:00", "intent": "clarify_context", "message": "报告只描述了影像发现和复查建议，单凭这句话不能确定结节性质。", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "relation_to_previous": "responds_to", "source_object_id": "SOURCE_OBJECT-0000001", "speaker_role": "care_navigator", "turn_id": "TURN-0000020", "turn_index": "2" }, { "allowed_assertion": "解释影像报告字面含义、复查目的和资料准备。", "available_time": null, "depends_on_turn_id": "TURN-0000020", "dialogue_state": "context_update", "episode_id": "EPISODE-0000004", "escalation_condition": "需要判断结节性质、调整复查时间或出现新症状", "event_time_raw": null, "evidence_id": "EVIDENCE-0000021", "forbidden_assertion": "不得把结节解释为良性、恶性或病理诊断。", "generated_at": "2026-07-29T09:30:00+08:00", "intent": "provide_detail", "message": "报告没有写其他异常，只建议三个月后复查。", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "relation_to_previous": "clarifies", "source_object_id": "SOURCE_OBJECT-0000001", "speaker_role": "patient", "turn_id": "TURN-0000021", "turn_index": "3" }, { "allowed_assertion": "解释影像报告字面含义、复查目的和资料准备。", "available_time": null, "depends_on_turn_id": "TURN-0000021", "dialogue_state": "bounded_explanation", "episode_id": "EPISODE-0000004", "escalation_condition": "需要判断结节性质、调整复查时间或出现新症状", "event_time_raw": null, "evidence_id": "EVIDENCE-0000022", "forbidden_assertion": "不得把结节解释为良性、恶性或病理诊断。", "generated_at": "2026-07-29T09:30:00+08:00", "intent": "evidence_bound_explanation", "message": "可以确认当前计划是影像随访；结节是否稳定需与后续影像比较，不能提前下结论。", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "relation_to_previous": "carries_forward", "source_object_id": "SOURCE_OBJECT-0000001", "speaker_role": "care_navigator", "turn_id": "TURN-0000022", "turn_index": "4" }, { "allowed_assertion": "解释影像报告字面含义、复查目的和资料准备。", "available_time": null, "depends_on_turn_id": "TURN-0000022", "dialogue_state": "plan_confirmation", "episode_id": "EPISODE-0000004", "escalation_condition": "需要判断结节性质、调整复查时间或出现新症状", "event_time_raw": null, "evidence_id": "EVIDENCE-0000023", "forbidden_assertion": "不得把结节解释为良性、恶性或病理诊断。", "generated_at": "2026-07-29T09:30:00+08:00", "intent": "confirm_next_step", "message": "复查前我需要做什么准备？", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "relation_to_previous": "clarifies", "source_object_id": "SOURCE_OBJECT-0000001", "speaker_role": "patient", "turn_id": "TURN-0000023", "turn_index": "5" }, { "allowed_assertion": "解释影像报告字面含义、复查目的和资料准备。", "available_time": null, "depends_on_turn_id": "TURN-0000023", "dialogue_state": "closure_or_escalation", "episode_id": "EPISODE-0000004", "escalation_condition": "需要判断结节性质、调整复查时间或出现新症状", "event_time_raw": null, "evidence_id": "EVIDENCE-0000024", "forbidden_assertion": "不得把结节解释为良性、恶性或病理诊断。", "generated_at": "2026-07-29T09:30:00+08:00", "intent": "summary_and_handoff", "message": "请保存本次影像资料并按约定时间复查；如出现新的持续呼吸症状，可提前联系照护团队。", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "relation_to_previous": "carries_forward", "source_object_id": "SOURCE_OBJECT-0000001", "speaker_role": "care_navigator", "turn_id": "TURN-0000024", "turn_index": "6" }, { "allowed_assertion": "解释连续监测、记录条件和联系照护团队的原则。", "available_time": null, "depends_on_turn_id": null, "dialogue_state": "opening", "episode_id": "EPISODE-0000005", "escalation_condition": "持续异常读数、明显不适或提出调整处方", "event_time_raw": null, "evidence_id": "EVIDENCE-0000025", "forbidden_assertion": "不得根据单次读数调整处方或预测并发症。", "generated_at": "2026-07-29T10:00:00+08:00", "intent": "request_information", "message": "出院诊断写原发性高血压，意味着以后血压高一次就很危险吗？", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "relation_to_previous": null, "source_object_id": "SOURCE_OBJECT-0000001", "speaker_role": "patient", "turn_id": "TURN-0000025", "turn_index": "1" }, { "allowed_assertion": "解释连续监测、记录条件和联系照护团队的原则。", "available_time": null, "depends_on_turn_id": "TURN-0000025", "dialogue_state": "clarification", "episode_id": "EPISODE-0000005", "escalation_condition": "持续异常读数、明显不适或提出调整处方", "event_time_raw": null, "evidence_id": "EVIDENCE-0000026", "forbidden_assertion": "不得根据单次读数调整处方或预测并发症。", "generated_at": "2026-07-29T10:00:00+08:00", "intent": "clarify_context", "message": "这个诊断需要结合连续测量和照护计划理解，单次读数不能代表全部风险。", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "relation_to_previous": "responds_to", "source_object_id": "SOURCE_OBJECT-0000001", "speaker_role": "care_navigator", "turn_id": "TURN-0000026", "turn_index": "2" }, { "allowed_assertion": "解释连续监测、记录条件和联系照护团队的原则。", "available_time": null, "depends_on_turn_id": "TURN-0000026", "dialogue_state": "context_update", "episode_id": "EPISODE-0000005", "escalation_condition": "持续异常读数、明显不适或提出调整处方", "event_time_raw": null, "evidence_id": "EVIDENCE-0000027", "forbidden_assertion": "不得根据单次读数调整处方或预测并发症。", "generated_at": "2026-07-29T10:00:00+08:00", "intent": "provide_detail", "message": "我家里有血压计，但还没有固定记录时间。", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "relation_to_previous": "clarifies", "source_object_id": "SOURCE_OBJECT-0000001", "speaker_role": "patient", "turn_id": "TURN-0000027", "turn_index": "3" }, { "allowed_assertion": "解释连续监测、记录条件和联系照护团队的原则。", "available_time": null, "depends_on_turn_id": "TURN-0000027", "dialogue_state": "bounded_explanation", "episode_id": "EPISODE-0000005", "escalation_condition": "持续异常读数、明显不适或提出调整处方", "event_time_raw": null, "evidence_id": "EVIDENCE-0000028", "forbidden_assertion": "不得根据单次读数调整处方或预测并发症。", "generated_at": "2026-07-29T10:00:00+08:00", "intent": "evidence_bound_explanation", "message": "可按照护团队建议在相对固定条件下记录血压，并保留测量时间和不适症状。", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "relation_to_previous": "carries_forward", "source_object_id": "SOURCE_OBJECT-0000001", "speaker_role": "care_navigator", "turn_id": "TURN-0000028", "turn_index": "4" }, { "allowed_assertion": "解释连续监测、记录条件和联系照护团队的原则。", "available_time": null, "depends_on_turn_id": "TURN-0000028", "dialogue_state": "plan_confirmation", "episode_id": "EPISODE-0000005", "escalation_condition": "持续异常读数、明显不适或提出调整处方", "event_time_raw": null, "evidence_id": "EVIDENCE-0000029", "forbidden_assertion": "不得根据单次读数调整处方或预测并发症。", "generated_at": "2026-07-29T10:00:00+08:00", "intent": "confirm_next_step", "message": "如果某次读数偏高，可以自己加药吗？", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "relation_to_previous": "clarifies", "source_object_id": "SOURCE_OBJECT-0000001", "speaker_role": "patient", "turn_id": "TURN-0000029", "turn_index": "5" }, { "allowed_assertion": "解释连续监测、记录条件和联系照护团队的原则。", "available_time": null, "depends_on_turn_id": "TURN-0000029", "dialogue_state": "closure_or_escalation", "episode_id": "EPISODE-0000005", "escalation_condition": "持续异常读数、明显不适或提出调整处方", "event_time_raw": null, "evidence_id": "EVIDENCE-0000030", "forbidden_assertion": "不得根据单次读数调整处方或预测并发症。", "generated_at": "2026-07-29T10:00:00+08:00", "intent": "summary_and_handoff", "message": "不要自行改变药量；若读数持续异常或伴明显不适，请联系负责团队确认处理。", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "relation_to_previous": "carries_forward", "source_object_id": "SOURCE_OBJECT-0000001", "speaker_role": "care_navigator", "turn_id": "TURN-0000030", "turn_index": "6" }, { "allowed_assertion": "解释报告术语的层级和需要补充的资料。", "available_time": null, "depends_on_turn_id": null, "dialogue_state": "opening", "episode_id": "EPISODE-0000006", "escalation_condition": "需要完整分期、治疗方案或预后判断", "event_time_raw": null, "evidence_id": "EVIDENCE-0000031", "forbidden_assertion": "不得推断分期、复发风险、预后或治疗效果。", "generated_at": "2026-07-29T10:10:00+08:00", "intent": "request_information", "message": "病理报告写结肠腺癌、中分化，我想知道这和分期是不是一回事。", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "relation_to_previous": null, "source_object_id": "SOURCE_OBJECT-0000001", "speaker_role": "patient", "turn_id": "TURN-0000031", "turn_index": "1" }, { "allowed_assertion": "解释报告术语的层级和需要补充的资料。", "available_time": null, "depends_on_turn_id": "TURN-0000031", "dialogue_state": "clarification", "episode_id": "EPISODE-0000006", "escalation_condition": "需要完整分期、治疗方案或预后判断", "event_time_raw": null, "evidence_id": "EVIDENCE-0000032", "forbidden_assertion": "不得推断分期、复发风险、预后或治疗效果。", "generated_at": "2026-07-29T10:10:00+08:00", "intent": "clarify_context", "message": "组织学类型和分化程度不是完整分期；分期还需结合病灶范围、淋巴结和其他检查。", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "relation_to_previous": "responds_to", "source_object_id": "SOURCE_OBJECT-0000001", "speaker_role": "care_navigator", "turn_id": "TURN-0000032", "turn_index": "2" }, { "allowed_assertion": "解释报告术语的层级和需要补充的资料。", "available_time": null, "depends_on_turn_id": "TURN-0000032", "dialogue_state": "context_update", "episode_id": "EPISODE-0000006", "escalation_condition": "需要完整分期、治疗方案或预后判断", "event_time_raw": null, "evidence_id": "EVIDENCE-0000033", "forbidden_assertion": "不得推断分期、复发风险、预后或治疗效果。", "generated_at": "2026-07-29T10:10:00+08:00", "intent": "provide_detail", "message": "报告里只看到切缘未见肿瘤累及，没有看到完整分期。", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "relation_to_previous": "clarifies", "source_object_id": "SOURCE_OBJECT-0000001", "speaker_role": "patient", "turn_id": "TURN-0000033", "turn_index": "3" }, { "allowed_assertion": "解释报告术语的层级和需要补充的资料。", "available_time": null, "depends_on_turn_id": "TURN-0000033", "dialogue_state": "bounded_explanation", "episode_id": "EPISODE-0000006", "escalation_condition": "需要完整分期、治疗方案或预后判断", "event_time_raw": null, "evidence_id": "EVIDENCE-0000034", "forbidden_assertion": "不得推断分期、复发风险、预后或治疗效果。", "generated_at": "2026-07-29T10:10:00+08:00", "intent": "evidence_bound_explanation", "message": "可以说明切缘描述和分化术语，但不能用缺少的信息补出分期或预后。", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "relation_to_previous": "carries_forward", "source_object_id": "SOURCE_OBJECT-0000001", "speaker_role": "care_navigator", "turn_id": "TURN-0000034", "turn_index": "4" }, { "allowed_assertion": "解释报告术语的层级和需要补充的资料。", "available_time": null, "depends_on_turn_id": "TURN-0000034", "dialogue_state": "plan_confirmation", "episode_id": "EPISODE-0000006", "escalation_condition": "需要完整分期、治疗方案或预后判断", "event_time_raw": null, "evidence_id": "EVIDENCE-0000035", "forbidden_assertion": "不得推断分期、复发风险、预后或治疗效果。", "generated_at": "2026-07-29T10:10:00+08:00", "intent": "confirm_next_step", "message": "我下一次沟通应该重点问哪些内容？", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "relation_to_previous": "clarifies", "source_object_id": "SOURCE_OBJECT-0000001", "speaker_role": "patient", "turn_id": "TURN-0000035", "turn_index": "5" }, { "allowed_assertion": "解释报告术语的层级和需要补充的资料。", "available_time": null, "depends_on_turn_id": "TURN-0000035", "dialogue_state": "closure_or_escalation", "episode_id": "EPISODE-0000006", "escalation_condition": "需要完整分期、治疗方案或预后判断", "event_time_raw": null, "evidence_id": "EVIDENCE-0000036", "forbidden_assertion": "不得推断分期、复发风险、预后或治疗效果。", "generated_at": "2026-07-29T10:10:00+08:00", "intent": "summary_and_handoff", "message": "可询问完整病理要点、分期所需资料和后续计划，并由负责专科结合全部结果解释。", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "relation_to_previous": "carries_forward", "source_object_id": "SOURCE_OBJECT-0000001", "speaker_role": "care_navigator", "turn_id": "TURN-0000036", "turn_index": "6" }, { "allowed_assertion": "区分医嘱与实际用药，并提示记录实际情况。", "available_time": null, "depends_on_turn_id": null, "dialogue_state": "opening", "episode_id": "EPISODE-0000007", "escalation_condition": "实际服用与医嘱不一致、出现不适或询问剂量调整", "event_time_raw": null, "evidence_id": "EVIDENCE-0000037", "forbidden_assertion": "不得把医嘱当成实际给药或给出补服方案。", "generated_at": "2026-07-29T10:20:00+08:00", "intent": "request_information", "message": "材料里写阿莫西林500毫克每8小时一次，这能证明我已经按时服用了吗？", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "relation_to_previous": null, "source_object_id": "SOURCE_OBJECT-0000001", "speaker_role": "patient", "turn_id": "TURN-0000037", "turn_index": "1" }, { "allowed_assertion": "区分医嘱与实际用药，并提示记录实际情况。", "available_time": null, "depends_on_turn_id": "TURN-0000037", "dialogue_state": "clarification", "episode_id": "EPISODE-0000007", "escalation_condition": "实际服用与医嘱不一致、出现不适或询问剂量调整", "event_time_raw": null, "evidence_id": "EVIDENCE-0000038", "forbidden_assertion": "不得把医嘱当成实际给药或给出补服方案。", "generated_at": "2026-07-29T10:20:00+08:00", "intent": "clarify_context", "message": "不能；这条记录表示医嘱内容，不等于已经调剂、服用或完成疗程。", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "relation_to_previous": "responds_to", "source_object_id": "SOURCE_OBJECT-0000001", "speaker_role": "care_navigator", "turn_id": "TURN-0000038", "turn_index": "2" }, { "allowed_assertion": "区分医嘱与实际用药，并提示记录实际情况。", "available_time": null, "depends_on_turn_id": "TURN-0000038", "dialogue_state": "context_update", "episode_id": "EPISODE-0000007", "escalation_condition": "实际服用与医嘱不一致、出现不适或询问剂量调整", "event_time_raw": null, "evidence_id": "EVIDENCE-0000039", "forbidden_assertion": "不得把医嘱当成实际给药或给出补服方案。", "generated_at": "2026-07-29T10:20:00+08:00", "intent": "provide_detail", "message": "我只想核对这份材料能说明什么，暂时不讨论改药。", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "relation_to_previous": "clarifies", "source_object_id": "SOURCE_OBJECT-0000001", "speaker_role": "patient", "turn_id": "TURN-0000039", "turn_index": "3" }, { "allowed_assertion": "区分医嘱与实际用药，并提示记录实际情况。", "available_time": null, "depends_on_turn_id": "TURN-0000039", "dialogue_state": "bounded_explanation", "episode_id": "EPISODE-0000007", "escalation_condition": "实际服用与医嘱不一致、出现不适或询问剂量调整", "event_time_raw": null, "evidence_id": "EVIDENCE-0000040", "forbidden_assertion": "不得把医嘱当成实际给药或给出补服方案。", "generated_at": "2026-07-29T10:20:00+08:00", "intent": "evidence_bound_explanation", "message": "这份材料可说明药品名称、剂量和频次的医嘱，但实际用药需另有执行或患者确认记录。", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "relation_to_previous": "carries_forward", "source_object_id": "SOURCE_OBJECT-0000001", "speaker_role": "care_navigator", "turn_id": "TURN-0000040", "turn_index": "4" }, { "allowed_assertion": "区分医嘱与实际用药，并提示记录实际情况。", "available_time": null, "depends_on_turn_id": "TURN-0000040", "dialogue_state": "plan_confirmation", "episode_id": "EPISODE-0000007", "escalation_condition": "实际服用与医嘱不一致、出现不适或询问剂量调整", "event_time_raw": null, "evidence_id": "EVIDENCE-0000041", "forbidden_assertion": "不得把医嘱当成实际给药或给出补服方案。", "generated_at": "2026-07-29T10:20:00+08:00", "intent": "confirm_next_step", "message": "如果实际服用情况和医嘱不同，应该怎样记录？", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "relation_to_previous": "clarifies", "source_object_id": "SOURCE_OBJECT-0000001", "speaker_role": "patient", "turn_id": "TURN-0000041", "turn_index": "5" }, { "allowed_assertion": "区分医嘱与实际用药，并提示记录实际情况。", "available_time": null, "depends_on_turn_id": "TURN-0000041", "dialogue_state": "closure_or_escalation", "episode_id": "EPISODE-0000007", "escalation_condition": "实际服用与医嘱不一致、出现不适或询问剂量调整", "event_time_raw": null, "evidence_id": "EVIDENCE-0000042", "forbidden_assertion": "不得把医嘱当成实际给药或给出补服方案。", "generated_at": "2026-07-29T10:20:00+08:00", "intent": "summary_and_handoff", "message": "请如实记录实际服用时间、剂量和遗漏情况，并联系照护团队核对，不要自行补服或调整。", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "relation_to_previous": "carries_forward", "source_object_id": "SOURCE_OBJECT-0000001", "speaker_role": "care_navigator", "turn_id": "TURN-0000042", "turn_index": "6" }, { "allowed_assertion": "说明出院医嘱记录、血压记录和复核流程。", "available_time": null, "depends_on_turn_id": null, "dialogue_state": "opening", "episode_id": "EPISODE-0000008", "escalation_condition": "持续血压异常、用药不适或提出调整方案", "event_time_raw": null, "evidence_id": "EVIDENCE-0000043", "forbidden_assertion": "不得提出具体剂量或用药时间变更。", "generated_at": "2026-07-29T10:30:00+08:00", "intent": "request_information", "message": "出院说明让我继续吃氨氯地平，我应该怎样配合记录？", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "relation_to_previous": null, "source_object_id": "SOURCE_OBJECT-0000001", "speaker_role": "patient", "turn_id": "TURN-0000043", "turn_index": "1" }, { "allowed_assertion": "说明出院医嘱记录、血压记录和复核流程。", "available_time": null, "depends_on_turn_id": "TURN-0000043", "dialogue_state": "clarification", "episode_id": "EPISODE-0000008", "escalation_condition": "持续血压异常、用药不适或提出调整方案", "event_time_raw": null, "evidence_id": "EVIDENCE-0000044", "forbidden_assertion": "不得提出具体剂量或用药时间变更。", "generated_at": "2026-07-29T10:30:00+08:00", "intent": "clarify_context", "message": "可以记录服药时间、血压读数和相关不适，并保留出院说明中的原医嘱。", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "relation_to_previous": "responds_to", "source_object_id": "SOURCE_OBJECT-0000001", "speaker_role": "care_navigator", "turn_id": "TURN-0000044", "turn_index": "2" }, { "allowed_assertion": "说明出院医嘱记录、血压记录和复核流程。", "available_time": null, "depends_on_turn_id": "TURN-0000044", "dialogue_state": "context_update", "episode_id": "EPISODE-0000008", "escalation_condition": "持续血压异常、用药不适或提出调整方案", "event_time_raw": null, "evidence_id": "EVIDENCE-0000045", "forbidden_assertion": "不得提出具体剂量或用药时间变更。", "generated_at": "2026-07-29T10:30:00+08:00", "intent": "provide_detail", "message": "我早上服药，偶尔会忘记记录血压。", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "relation_to_previous": "clarifies", "source_object_id": "SOURCE_OBJECT-0000001", "speaker_role": "patient", "turn_id": "TURN-0000045", "turn_index": "3" }, { "allowed_assertion": "说明出院医嘱记录、血压记录和复核流程。", "available_time": null, "depends_on_turn_id": "TURN-0000045", "dialogue_state": "bounded_explanation", "episode_id": "EPISODE-0000008", "escalation_condition": "持续血压异常、用药不适或提出调整方案", "event_time_raw": null, "evidence_id": "EVIDENCE-0000046", "forbidden_assertion": "不得提出具体剂量或用药时间变更。", "generated_at": "2026-07-29T10:30:00+08:00", "intent": "evidence_bound_explanation", "message": "保持记录有助于后续评估，但遗漏一次记录不应由系统自动补值。", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "relation_to_previous": "carries_forward", "source_object_id": "SOURCE_OBJECT-0000001", "speaker_role": "care_navigator", "turn_id": "TURN-0000046", "turn_index": "4" }, { "allowed_assertion": "说明出院医嘱记录、血压记录和复核流程。", "available_time": null, "depends_on_turn_id": "TURN-0000046", "dialogue_state": "plan_confirmation", "episode_id": "EPISODE-0000008", "escalation_condition": "持续血压异常、用药不适或提出调整方案", "event_time_raw": null, "evidence_id": "EVIDENCE-0000047", "forbidden_assertion": "不得提出具体剂量或用药时间变更。", "generated_at": "2026-07-29T10:30:00+08:00", "intent": "confirm_next_step", "message": "血压波动时能不能自己改变服药时间？", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "relation_to_previous": "clarifies", "source_object_id": "SOURCE_OBJECT-0000001", "speaker_role": "patient", "turn_id": "TURN-0000047", "turn_index": "5" }, { "allowed_assertion": "说明出院医嘱记录、血压记录和复核流程。", "available_time": null, "depends_on_turn_id": "TURN-0000047", "dialogue_state": "closure_or_escalation", "episode_id": "EPISODE-0000008", "escalation_condition": "持续血压异常、用药不适或提出调整方案", "event_time_raw": null, "evidence_id": "EVIDENCE-0000048", "forbidden_assertion": "不得提出具体剂量或用药时间变更。", "generated_at": "2026-07-29T10:30:00+08:00", "intent": "summary_and_handoff", "message": "不要自行改变用法；请把血压和服药记录带给照护团队，由其确认是否调整。", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "relation_to_previous": "carries_forward", "source_object_id": "SOURCE_OBJECT-0000001", "speaker_role": "care_navigator", "turn_id": "TURN-0000048", "turn_index": "6" }, { "allowed_assertion": "说明切口观察项目、记录方式和复诊原则。", "available_time": null, "depends_on_turn_id": null, "dialogue_state": "opening", "episode_id": "EPISODE-0000009", "escalation_condition": "切口渗液、红肿、发热或疼痛加重", "event_time_raw": null, "evidence_id": "EVIDENCE-0000049", "forbidden_assertion": "不得远程判断渗液性质或改变活动限制。", "generated_at": "2026-07-29T11:00:00+08:00", "intent": "request_information", "message": "出院后切口护理最需要关注什么？", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "relation_to_previous": null, "source_object_id": "SOURCE_OBJECT-0000001", "speaker_role": "patient", "turn_id": "TURN-0000049", "turn_index": "1" }, { "allowed_assertion": "说明切口观察项目、记录方式和复诊原则。", "available_time": null, "depends_on_turn_id": "TURN-0000049", "dialogue_state": "clarification", "episode_id": "EPISODE-0000009", "escalation_condition": "切口渗液、红肿、发热或疼痛加重", "event_time_raw": null, "evidence_id": "EVIDENCE-0000050", "forbidden_assertion": "不得远程判断渗液性质或改变活动限制。", "generated_at": "2026-07-29T11:00:00+08:00", "intent": "clarify_context", "message": "可关注切口是否红肿、渗液、疼痛加重，并记录体温和复诊安排。", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "relation_to_previous": "responds_to", "source_object_id": "SOURCE_OBJECT-0000001", "speaker_role": "care_navigator", "turn_id": "TURN-0000050", "turn_index": "2" }, { "allowed_assertion": "说明切口观察项目、记录方式和复诊原则。", "available_time": null, "depends_on_turn_id": "TURN-0000050", "dialogue_state": "context_update", "episode_id": "EPISODE-0000009", "escalation_condition": "切口渗液、红肿、发热或疼痛加重", "event_time_raw": null, "evidence_id": "EVIDENCE-0000051", "forbidden_assertion": "不得远程判断渗液性质或改变活动限制。", "generated_at": "2026-07-29T11:00:00+08:00", "intent": "provide_detail", "message": "目前切口干燥，没有发热，但我担心活动会影响恢复。", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "relation_to_previous": "clarifies", "source_object_id": "SOURCE_OBJECT-0000001", "speaker_role": "patient", "turn_id": "TURN-0000051", "turn_index": "3" }, { "allowed_assertion": "说明切口观察项目、记录方式和复诊原则。", "available_time": null, "depends_on_turn_id": "TURN-0000051", "dialogue_state": "bounded_explanation", "episode_id": "EPISODE-0000009", "escalation_condition": "切口渗液、红肿、发热或疼痛加重", "event_time_raw": null, "evidence_id": "EVIDENCE-0000052", "forbidden_assertion": "不得远程判断渗液性质或改变活动限制。", "generated_at": "2026-07-29T11:00:00+08:00", "intent": "evidence_bound_explanation", "message": "现有信息只说明切口干燥和未发热；活动范围应按出院说明或手术团队建议执行。", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "relation_to_previous": "carries_forward", "source_object_id": "SOURCE_OBJECT-0000001", "speaker_role": "care_navigator", "turn_id": "TURN-0000052", "turn_index": "4" }, { "allowed_assertion": "说明切口观察项目、记录方式和复诊原则。", "available_time": null, "depends_on_turn_id": "TURN-0000052", "dialogue_state": "plan_confirmation", "episode_id": "EPISODE-0000009", "escalation_condition": "切口渗液、红肿、发热或疼痛加重", "event_time_raw": null, "evidence_id": "EVIDENCE-0000053", "forbidden_assertion": "不得远程判断渗液性质或改变活动限制。", "generated_at": "2026-07-29T11:00:00+08:00", "intent": "confirm_next_step", "message": "如果出现少量渗液，能先在家观察吗？", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "relation_to_previous": "clarifies", "source_object_id": "SOURCE_OBJECT-0000001", "speaker_role": "patient", "turn_id": "TURN-0000053", "turn_index": "5" }, { "allowed_assertion": "说明切口观察项目、记录方式和复诊原则。", "available_time": null, "depends_on_turn_id": "TURN-0000053", "dialogue_state": "closure_or_escalation", "episode_id": "EPISODE-0000009", "escalation_condition": "切口渗液、红肿、发热或疼痛加重", "event_time_raw": null, "evidence_id": "EVIDENCE-0000054", "forbidden_assertion": "不得远程判断渗液性质或改变活动限制。", "generated_at": "2026-07-29T11:00:00+08:00", "intent": "summary_and_handoff", "message": "渗液需要结合颜色、量和伴随症状判断，建议联系手术团队说明情况；明显红肿、发热或大量渗液应及时就医。", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "relation_to_previous": "carries_forward", "source_object_id": "SOURCE_OBJECT-0000001", "speaker_role": "care_navigator", "turn_id": "TURN-0000054", "turn_index": "6" }, { "allowed_assertion": "组织随访资料、计划状态和联系路径。", "available_time": null, "depends_on_turn_id": null, "dialogue_state": "opening", "episode_id": "EPISODE-0000010", "escalation_condition": "复查无法按期、出现新症状或需要调整方案", "event_time_raw": null, "evidence_id": "EVIDENCE-0000055", "forbidden_assertion": "不得声称复查已完成或结节稳定。", "generated_at": "2026-07-29T11:10:00+08:00", "intent": "request_information", "message": "报告建议三个月后复查，我怎样准备这次随访？", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "relation_to_previous": null, "source_object_id": "SOURCE_OBJECT-0000001", "speaker_role": "patient", "turn_id": "TURN-0000055", "turn_index": "1" }, { "allowed_assertion": "组织随访资料、计划状态和联系路径。", "available_time": null, "depends_on_turn_id": "TURN-0000055", "dialogue_state": "clarification", "episode_id": "EPISODE-0000010", "escalation_condition": "复查无法按期、出现新症状或需要调整方案", "event_time_raw": null, "evidence_id": "EVIDENCE-0000056", "forbidden_assertion": "不得声称复查已完成或结节稳定。", "generated_at": "2026-07-29T11:10:00+08:00", "intent": "clarify_context", "message": "请保留本次报告和影像，并确认复查时间、检查方式及是否需要携带既往资料。", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "relation_to_previous": "responds_to", "source_object_id": "SOURCE_OBJECT-0000001", "speaker_role": "care_navigator", "turn_id": "TURN-0000056", "turn_index": "2" }, { "allowed_assertion": "组织随访资料、计划状态和联系路径。", "available_time": null, "depends_on_turn_id": "TURN-0000056", "dialogue_state": "context_update", "episode_id": "EPISODE-0000010", "escalation_condition": "复查无法按期、出现新症状或需要调整方案", "event_time_raw": null, "evidence_id": "EVIDENCE-0000057", "forbidden_assertion": "不得声称复查已完成或结节稳定。", "generated_at": "2026-07-29T11:10:00+08:00", "intent": "provide_detail", "message": "我已经保存了报告，但还没有预约复查。", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "relation_to_previous": "clarifies", "source_object_id": "SOURCE_OBJECT-0000001", "speaker_role": "patient", "turn_id": "TURN-0000057", "turn_index": "3" }, { "allowed_assertion": "组织随访资料、计划状态和联系路径。", "available_time": null, "depends_on_turn_id": "TURN-0000057", "dialogue_state": "bounded_explanation", "episode_id": "EPISODE-0000010", "escalation_condition": "复查无法按期、出现新症状或需要调整方案", "event_time_raw": null, "evidence_id": "EVIDENCE-0000058", "forbidden_assertion": "不得声称复查已完成或结节稳定。", "generated_at": "2026-07-29T11:10:00+08:00", "intent": "evidence_bound_explanation", "message": "当前可确认复查尚未安排，不能把建议写成已完成随访。", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "relation_to_previous": "carries_forward", "source_object_id": "SOURCE_OBJECT-0000001", "speaker_role": "care_navigator", "turn_id": "TURN-0000058", "turn_index": "4" }, { "allowed_assertion": "组织随访资料、计划状态和联系路径。", "available_time": null, "depends_on_turn_id": "TURN-0000058", "dialogue_state": "plan_confirmation", "episode_id": "EPISODE-0000010", "escalation_condition": "复查无法按期、出现新症状或需要调整方案", "event_time_raw": null, "evidence_id": "EVIDENCE-0000059", "forbidden_assertion": "不得声称复查已完成或结节稳定。", "generated_at": "2026-07-29T11:10:00+08:00", "intent": "confirm_next_step", "message": "如果预约时间晚了几天，需要自己改方案吗？", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "relation_to_previous": "clarifies", "source_object_id": "SOURCE_OBJECT-0000001", "speaker_role": "patient", "turn_id": "TURN-0000059", "turn_index": "5" }, { "allowed_assertion": "组织随访资料、计划状态和联系路径。", "available_time": null, "depends_on_turn_id": "TURN-0000059", "dialogue_state": "closure_or_escalation", "episode_id": "EPISODE-0000010", "escalation_condition": "复查无法按期、出现新症状或需要调整方案", "event_time_raw": null, "evidence_id": "EVIDENCE-0000060", "forbidden_assertion": "不得声称复查已完成或结节稳定。", "generated_at": "2026-07-29T11:10:00+08:00", "intent": "summary_and_handoff", "message": "请联系负责团队确认可接受的时间范围，不要自行改变随访计划；出现新症状时应提前沟通。", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "relation_to_previous": "carries_forward", "source_object_id": "SOURCE_OBJECT-0000001", "speaker_role": "care_navigator", "turn_id": "TURN-0000060", "turn_index": "6" }, { "allowed_assertion": "区分计划、预约、结果可用和解释阶段。", "available_time": null, "depends_on_turn_id": null, "dialogue_state": "opening", "episode_id": "EPISODE-0000011", "escalation_condition": "结果异常、症状变化或需要临床解释", "event_time_raw": null, "evidence_id": "EVIDENCE-0000061", "forbidden_assertion": "不得在结果缺失时判断正常异常或补造数值。", "generated_at": "2026-07-29T11:20:00+08:00", "intent": "request_information", "message": "病历建议复查血常规，但我现在还没有结果，随访时该怎么说？", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "relation_to_previous": null, "source_object_id": "SOURCE_OBJECT-0000001", "speaker_role": "patient", "turn_id": "TURN-0000061", "turn_index": "1" }, { "allowed_assertion": "区分计划、预约、结果可用和解释阶段。", "available_time": null, "depends_on_turn_id": "TURN-0000061", "dialogue_state": "clarification", "episode_id": "EPISODE-0000011", "escalation_condition": "结果异常、症状变化或需要临床解释", "event_time_raw": null, "evidence_id": "EVIDENCE-0000062", "forbidden_assertion": "不得在结果缺失时判断正常异常或补造数值。", "generated_at": "2026-07-29T11:20:00+08:00", "intent": "clarify_context", "message": "可以明确说明检查尚未完成，并准备报告中的原始项目、单位和参考范围。", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "relation_to_previous": "responds_to", "source_object_id": "SOURCE_OBJECT-0000001", "speaker_role": "care_navigator", "turn_id": "TURN-0000062", "turn_index": "2" }, { "allowed_assertion": "区分计划、预约、结果可用和解释阶段。", "available_time": null, "depends_on_turn_id": "TURN-0000062", "dialogue_state": "context_update", "episode_id": "EPISODE-0000011", "escalation_condition": "结果异常、症状变化或需要临床解释", "event_time_raw": null, "evidence_id": "EVIDENCE-0000063", "forbidden_assertion": "不得在结果缺失时判断正常异常或补造数值。", "generated_at": "2026-07-29T11:20:00+08:00", "intent": "provide_detail", "message": "我已经预约抽血，下周才能拿到结果。", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "relation_to_previous": "clarifies", "source_object_id": "SOURCE_OBJECT-0000001", "speaker_role": "patient", "turn_id": "TURN-0000063", "turn_index": "3" }, { "allowed_assertion": "区分计划、预约、结果可用和解释阶段。", "available_time": null, "depends_on_turn_id": "TURN-0000063", "dialogue_state": "bounded_explanation", "episode_id": "EPISODE-0000011", "escalation_condition": "结果异常、症状变化或需要临床解释", "event_time_raw": null, "evidence_id": "EVIDENCE-0000064", "forbidden_assertion": "不得在结果缺失时判断正常异常或补造数值。", "generated_at": "2026-07-29T11:20:00+08:00", "intent": "evidence_bound_explanation", "message": "当前状态是已预约、结果未可用，不能提前解释为正常或异常。", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "relation_to_previous": "carries_forward", "source_object_id": "SOURCE_OBJECT-0000001", "speaker_role": "care_navigator", "turn_id": "TURN-0000064", "turn_index": "4" }, { "allowed_assertion": "区分计划、预约、结果可用和解释阶段。", "available_time": null, "depends_on_turn_id": "TURN-0000064", "dialogue_state": "plan_confirmation", "episode_id": "EPISODE-0000011", "escalation_condition": "结果异常、症状变化或需要临床解释", "event_time_raw": null, "evidence_id": "EVIDENCE-0000065", "forbidden_assertion": "不得在结果缺失时判断正常异常或补造数值。", "generated_at": "2026-07-29T11:20:00+08:00", "intent": "confirm_next_step", "message": "拿到结果后只看异常箭头够吗？", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "relation_to_previous": "clarifies", "source_object_id": "SOURCE_OBJECT-0000001", "speaker_role": "patient", "turn_id": "TURN-0000065", "turn_index": "5" }, { "allowed_assertion": "区分计划、预约、结果可用和解释阶段。", "available_time": null, "depends_on_turn_id": "TURN-0000065", "dialogue_state": "closure_or_escalation", "episode_id": "EPISODE-0000011", "escalation_condition": "结果异常、症状变化或需要临床解释", "event_time_raw": null, "evidence_id": "EVIDENCE-0000066", "forbidden_assertion": "不得在结果缺失时判断正常异常或补造数值。", "generated_at": "2026-07-29T11:20:00+08:00", "intent": "summary_and_handoff", "message": "应同时查看项目值、单位、参考范围和适用条件，并由照护团队结合临床情况解释。", "missing_reason": null, "parent_object_id": 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"synthetic_dataset", "source_object_id": "SOURCE_OBJECT-0000001", "turn_id": "TURN-0000069" }, { "allowed_response": "解释当次观察范围并组织复诊前记录。", "available_time": null, "boundary_id": "BOUNDARY-0000070", "boundary_text": "允许：解释当次观察范围并组织复诊前记录。 禁止：不得把一次未见感染解释为长期无并发症。", "boundary_type": "fact_scope_and_escalation", "event_time_raw": null, "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "prohibited_response": "不得把一次未见感染解释为长期无并发症。", "record_status": "synthetic_dataset", "source_object_id": "SOURCE_OBJECT-0000001", "turn_id": "TURN-0000070" }, { "allowed_response": "解释当次观察范围并组织复诊前记录。", "available_time": null, "boundary_id": "BOUNDARY-0000071", "boundary_text": "允许：解释当次观察范围并组织复诊前记录。 禁止：不得把一次未见感染解释为长期无并发症。", "boundary_type": "fact_scope_and_escalation", "event_time_raw": null, "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "prohibited_response": "不得把一次未见感染解释为长期无并发症。", "record_status": "synthetic_dataset", "source_object_id": "SOURCE_OBJECT-0000001", "turn_id": "TURN-0000071" }, { "allowed_response": "解释当次观察范围并组织复诊前记录。", "available_time": null, "boundary_id": "BOUNDARY-0000072", "boundary_text": "允许：解释当次观察范围并组织复诊前记录。 禁止：不得把一次未见感染解释为长期无并发症。", "boundary_type": "fact_scope_and_escalation", "event_time_raw": null, "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "prohibited_response": "不得把一次未见感染解释为长期无并发症。", "record_status": "synthetic_dataset", "source_object_id": "SOURCE_OBJECT-0000001", "turn_id": "TURN-0000072" } ], "evidence_reference": [ { "available_time": null, "document_id": "DOCUMENT-0000001", "event_time_raw": null, "evidence_id": "EVIDENCE-0000001", "evidence_status": "professionally_reviewed_synthetic", "evidence_text": "我发热并咳嗽三天，想知道还需要补充什么情况。", "evidence_type": "synthetic_dialogue_premise", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "source_object_id": "SOURCE_OBJECT-0000001", "turn_id": "TURN-0000001" }, { "available_time": null, "document_id": "DOCUMENT-0000001", "event_time_raw": null, "evidence_id": "EVIDENCE-0000002", "evidence_status": "professionally_reviewed_synthetic", "evidence_text": "已知发热、咳嗽持续三天，计划完成胸部CT；病因尚未确定。", "evidence_type": "synthetic_case_fact", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "source_object_id": "SOURCE_OBJECT-0000001", "turn_id": "TURN-0000002" }, { "available_time": null, "document_id": "DOCUMENT-0000001", "event_time_raw": null, "evidence_id": "EVIDENCE-0000003", "evidence_status": "professionally_reviewed_synthetic", "evidence_text": "目前没有呼吸困难，体温最高38.5℃，胸部CT还没做。", "evidence_type": "synthetic_dialogue_premise", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "source_object_id": "SOURCE_OBJECT-0000001", "turn_id": "TURN-0000003" }, { "available_time": null, "document_id": "DOCUMENT-0000001", "event_time_raw": null, "evidence_id": "EVIDENCE-0000004", "evidence_status": "professionally_reviewed_synthetic", "evidence_text": "已知发热、咳嗽持续三天，计划完成胸部CT；病因尚未确定。", "evidence_type": "synthetic_case_fact", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "source_object_id": "SOURCE_OBJECT-0000001", "turn_id": "TURN-0000004" }, { "available_time": null, "document_id": "DOCUMENT-0000001", "event_time_raw": null, "evidence_id": "EVIDENCE-0000005", "evidence_status": "professionally_reviewed_synthetic", "evidence_text": "在复查前我应该记录哪些变化？", "evidence_type": "synthetic_dialogue_premise", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "source_object_id": "SOURCE_OBJECT-0000001", "turn_id": "TURN-0000005" }, { "available_time": null, "document_id": "DOCUMENT-0000001", "event_time_raw": null, "evidence_id": "EVIDENCE-0000006", "evidence_status": "professionally_reviewed_synthetic", "evidence_text": "已知发热、咳嗽持续三天，计划完成胸部CT；病因尚未确定。", "evidence_type": "synthetic_case_fact", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "source_object_id": "SOURCE_OBJECT-0000001", "turn_id": "TURN-0000006" }, { "available_time": null, "document_id": "DOCUMENT-0000002", "event_time_raw": null, "evidence_id": "EVIDENCE-0000007", "evidence_status": "professionally_reviewed_synthetic", "evidence_text": "我最近活动后气短，但没有胸痛，还需要说明哪些情况？", "evidence_type": "synthetic_dialogue_premise", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "source_object_id": "SOURCE_OBJECT-0000001", "turn_id": "TURN-0000007" }, { "available_time": null, "document_id": "DOCUMENT-0000002", "event_time_raw": null, "evidence_id": "EVIDENCE-0000008", "evidence_status": "professionally_reviewed_synthetic", "evidence_text": "已知活动后气短两周，病历记录否认胸痛，计划行心电图检查。", "evidence_type": "synthetic_case_fact", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "source_object_id": "SOURCE_OBJECT-0000001", "turn_id": "TURN-0000008" }, { "available_time": null, "document_id": "DOCUMENT-0000002", "event_time_raw": null, "evidence_id": "EVIDENCE-0000009", "evidence_status": "professionally_reviewed_synthetic", "evidence_text": "上两层楼时明显，休息几分钟能缓解，没有晕厥。", "evidence_type": "synthetic_dialogue_premise", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "source_object_id": "SOURCE_OBJECT-0000001", "turn_id": "TURN-0000009" }, { "available_time": null, "document_id": "DOCUMENT-0000002", "event_time_raw": null, "evidence_id": "EVIDENCE-0000010", "evidence_status": "professionally_reviewed_synthetic", "evidence_text": "已知活动后气短两周，病历记录否认胸痛，计划行心电图检查。", "evidence_type": "synthetic_case_fact", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "source_object_id": "SOURCE_OBJECT-0000001", "turn_id": "TURN-0000010" }, { "available_time": null, "document_id": "DOCUMENT-0000002", "event_time_raw": null, "evidence_id": "EVIDENCE-0000011", "evidence_status": "professionally_reviewed_synthetic", "evidence_text": "如果今晚又气短，我该怎么判断是否需要尽快就医？", "evidence_type": "synthetic_dialogue_premise", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "source_object_id": "SOURCE_OBJECT-0000001", "turn_id": "TURN-0000011" }, { "available_time": null, "document_id": "DOCUMENT-0000002", "event_time_raw": null, "evidence_id": "EVIDENCE-0000012", "evidence_status": "professionally_reviewed_synthetic", "evidence_text": "已知活动后气短两周，病历记录否认胸痛，计划行心电图检查。", "evidence_type": "synthetic_case_fact", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "source_object_id": "SOURCE_OBJECT-0000001", "turn_id": "TURN-0000012" }, { "available_time": null, "document_id": "DOCUMENT-0000003", "event_time_raw": null, "evidence_id": "EVIDENCE-0000013", "evidence_status": "professionally_reviewed_synthetic", "evidence_text": "手术后第二天还有腹痛，我应该怎样描述才有帮助？", "evidence_type": "synthetic_dialogue_premise", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "source_object_id": "SOURCE_OBJECT-0000001", "turn_id": "TURN-0000013" }, { "available_time": null, "document_id": "DOCUMENT-0000003", "event_time_raw": null, "evidence_id": "EVIDENCE-0000014", "evidence_status": "professionally_reviewed_synthetic", "evidence_text": "已知腹腔镜阑尾切除术后第二天，切口疼痛较前减轻，未记录呕吐。", "evidence_type": "synthetic_case_fact", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "source_object_id": "SOURCE_OBJECT-0000001", "turn_id": "TURN-0000014" }, { "available_time": null, "document_id": "DOCUMENT-0000003", "event_time_raw": null, "evidence_id": "EVIDENCE-0000015", "evidence_status": "professionally_reviewed_synthetic", "evidence_text": "疼痛比昨天轻，主要在切口附近，没有呕吐，体温正常。", "evidence_type": "synthetic_dialogue_premise", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "source_object_id": "SOURCE_OBJECT-0000001", "turn_id": "TURN-0000015" }, { "available_time": null, "document_id": "DOCUMENT-0000003", "event_time_raw": null, "evidence_id": "EVIDENCE-0000016", "evidence_status": "professionally_reviewed_synthetic", "evidence_text": "已知腹腔镜阑尾切除术后第二天，切口疼痛较前减轻，未记录呕吐。", "evidence_type": "synthetic_case_fact", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "source_object_id": "SOURCE_OBJECT-0000001", "turn_id": "TURN-0000016" }, { "available_time": null, "document_id": "DOCUMENT-0000003", "event_time_raw": null, "evidence_id": "EVIDENCE-0000017", "evidence_status": "professionally_reviewed_synthetic", "evidence_text": "哪些变化需要马上联系医生？", "evidence_type": "synthetic_dialogue_premise", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "source_object_id": "SOURCE_OBJECT-0000001", "turn_id": "TURN-0000017" }, { "available_time": null, "document_id": "DOCUMENT-0000003", "event_time_raw": null, "evidence_id": "EVIDENCE-0000018", "evidence_status": "professionally_reviewed_synthetic", "evidence_text": "已知腹腔镜阑尾切除术后第二天，切口疼痛较前减轻，未记录呕吐。", "evidence_type": "synthetic_case_fact", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "source_object_id": "SOURCE_OBJECT-0000001", "turn_id": "TURN-0000018" }, { "available_time": null, "document_id": "DOCUMENT-0000004", "event_time_raw": null, "evidence_id": "EVIDENCE-0000019", "evidence_status": "professionally_reviewed_synthetic", "evidence_text": "报告写右肺上叶有8毫米肺结节，这是不是肿瘤？", "evidence_type": "synthetic_dialogue_premise", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "source_object_id": "SOURCE_OBJECT-0000001", "turn_id": "TURN-0000019" }, { "available_time": null, "document_id": "DOCUMENT-0000004", "event_time_raw": null, "evidence_id": "EVIDENCE-0000020", "evidence_status": "professionally_reviewed_synthetic", "evidence_text": "胸部CT描述右肺上叶8毫米肺结节，建议三个月后复查；未提供病理结论。", "evidence_type": "synthetic_case_fact", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "source_object_id": "SOURCE_OBJECT-0000001", "turn_id": "TURN-0000020" }, { "available_time": null, "document_id": "DOCUMENT-0000004", "event_time_raw": null, "evidence_id": "EVIDENCE-0000021", "evidence_status": "professionally_reviewed_synthetic", "evidence_text": "报告没有写其他异常，只建议三个月后复查。", "evidence_type": "synthetic_dialogue_premise", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "source_object_id": "SOURCE_OBJECT-0000001", "turn_id": "TURN-0000021" }, { "available_time": null, "document_id": "DOCUMENT-0000004", "event_time_raw": null, "evidence_id": "EVIDENCE-0000022", "evidence_status": "professionally_reviewed_synthetic", "evidence_text": "胸部CT描述右肺上叶8毫米肺结节，建议三个月后复查；未提供病理结论。", "evidence_type": "synthetic_case_fact", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "source_object_id": "SOURCE_OBJECT-0000001", "turn_id": "TURN-0000022" }, { "available_time": null, "document_id": "DOCUMENT-0000004", "event_time_raw": null, "evidence_id": "EVIDENCE-0000023", "evidence_status": "professionally_reviewed_synthetic", "evidence_text": "复查前我需要做什么准备？", "evidence_type": "synthetic_dialogue_premise", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "source_object_id": "SOURCE_OBJECT-0000001", "turn_id": "TURN-0000023" }, { "available_time": null, "document_id": "DOCUMENT-0000004", "event_time_raw": null, "evidence_id": "EVIDENCE-0000024", "evidence_status": "professionally_reviewed_synthetic", "evidence_text": "胸部CT描述右肺上叶8毫米肺结节，建议三个月后复查；未提供病理结论。", "evidence_type": "synthetic_case_fact", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "source_object_id": "SOURCE_OBJECT-0000001", "turn_id": "TURN-0000024" }, { "available_time": null, "document_id": "DOCUMENT-0000005", "event_time_raw": null, "evidence_id": "EVIDENCE-0000025", "evidence_status": "professionally_reviewed_synthetic", "evidence_text": "出院诊断写原发性高血压，意味着以后血压高一次就很危险吗？", "evidence_type": "synthetic_dialogue_premise", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "source_object_id": "SOURCE_OBJECT-0000001", "turn_id": "TURN-0000025" }, { "available_time": null, "document_id": "DOCUMENT-0000005", "event_time_raw": null, "evidence_id": "EVIDENCE-0000026", "evidence_status": "professionally_reviewed_synthetic", "evidence_text": "出院诊断记录原发性高血压，出院说明要求继续监测血压。", "evidence_type": "synthetic_case_fact", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "source_object_id": "SOURCE_OBJECT-0000001", "turn_id": "TURN-0000026" }, { "available_time": null, "document_id": "DOCUMENT-0000005", "event_time_raw": null, "evidence_id": "EVIDENCE-0000027", "evidence_status": "professionally_reviewed_synthetic", "evidence_text": "我家里有血压计，但还没有固定记录时间。", "evidence_type": "synthetic_dialogue_premise", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "source_object_id": "SOURCE_OBJECT-0000001", "turn_id": "TURN-0000027" }, { "available_time": null, "document_id": "DOCUMENT-0000005", "event_time_raw": null, "evidence_id": "EVIDENCE-0000028", "evidence_status": "professionally_reviewed_synthetic", "evidence_text": "出院诊断记录原发性高血压，出院说明要求继续监测血压。", "evidence_type": "synthetic_case_fact", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "source_object_id": "SOURCE_OBJECT-0000001", "turn_id": "TURN-0000028" }, { "available_time": null, "document_id": "DOCUMENT-0000005", "event_time_raw": null, "evidence_id": "EVIDENCE-0000029", "evidence_status": "professionally_reviewed_synthetic", "evidence_text": "如果某次读数偏高，可以自己加药吗？", "evidence_type": "synthetic_dialogue_premise", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "source_object_id": "SOURCE_OBJECT-0000001", "turn_id": "TURN-0000029" }, { "available_time": null, "document_id": "DOCUMENT-0000005", "event_time_raw": null, "evidence_id": "EVIDENCE-0000030", "evidence_status": "professionally_reviewed_synthetic", "evidence_text": "出院诊断记录原发性高血压，出院说明要求继续监测血压。", "evidence_type": "synthetic_case_fact", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "source_object_id": "SOURCE_OBJECT-0000001", "turn_id": "TURN-0000030" }, { "available_time": null, "document_id": "DOCUMENT-0000006", "event_time_raw": null, "evidence_id": "EVIDENCE-0000031", "evidence_status": "professionally_reviewed_synthetic", "evidence_text": "病理报告写结肠腺癌、中分化，我想知道这和分期是不是一回事。", "evidence_type": "synthetic_dialogue_premise", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "source_object_id": "SOURCE_OBJECT-0000001", "turn_id": "TURN-0000031" }, { "available_time": null, "document_id": "DOCUMENT-0000006", "event_time_raw": null, "evidence_id": "EVIDENCE-0000032", "evidence_status": "professionally_reviewed_synthetic", "evidence_text": "合成病理报告记录结肠腺癌、中分化、切缘未见肿瘤累及；未提供完整分期。", "evidence_type": "synthetic_case_fact", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "source_object_id": "SOURCE_OBJECT-0000001", "turn_id": "TURN-0000032" }, { "available_time": null, "document_id": "DOCUMENT-0000006", "event_time_raw": null, "evidence_id": "EVIDENCE-0000033", "evidence_status": "professionally_reviewed_synthetic", "evidence_text": "报告里只看到切缘未见肿瘤累及，没有看到完整分期。", "evidence_type": "synthetic_dialogue_premise", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "source_object_id": "SOURCE_OBJECT-0000001", "turn_id": "TURN-0000033" }, { "available_time": null, "document_id": "DOCUMENT-0000006", "event_time_raw": null, "evidence_id": "EVIDENCE-0000034", "evidence_status": "professionally_reviewed_synthetic", "evidence_text": "合成病理报告记录结肠腺癌、中分化、切缘未见肿瘤累及；未提供完整分期。", "evidence_type": "synthetic_case_fact", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "source_object_id": "SOURCE_OBJECT-0000001", "turn_id": "TURN-0000034" }, { "available_time": null, "document_id": "DOCUMENT-0000006", "event_time_raw": null, "evidence_id": "EVIDENCE-0000035", "evidence_status": "professionally_reviewed_synthetic", "evidence_text": "我下一次沟通应该重点问哪些内容？", "evidence_type": "synthetic_dialogue_premise", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "source_object_id": "SOURCE_OBJECT-0000001", "turn_id": "TURN-0000035" }, { "available_time": null, "document_id": "DOCUMENT-0000006", "event_time_raw": null, "evidence_id": "EVIDENCE-0000036", "evidence_status": "professionally_reviewed_synthetic", "evidence_text": "合成病理报告记录结肠腺癌、中分化、切缘未见肿瘤累及；未提供完整分期。", "evidence_type": "synthetic_case_fact", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "source_object_id": "SOURCE_OBJECT-0000001", "turn_id": "TURN-0000036" }, { "available_time": null, "document_id": "DOCUMENT-0000007", "event_time_raw": null, "evidence_id": "EVIDENCE-0000037", "evidence_status": "professionally_reviewed_synthetic", "evidence_text": "材料里写阿莫西林500毫克每8小时一次，这能证明我已经按时服用了吗？", "evidence_type": "synthetic_dialogue_premise", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "source_object_id": "SOURCE_OBJECT-0000001", "turn_id": "TURN-0000037" }, { "available_time": null, "document_id": "DOCUMENT-0000007", "event_time_raw": null, "evidence_id": "EVIDENCE-0000038", "evidence_status": "professionally_reviewed_synthetic", "evidence_text": "记录中有阿莫西林500毫克每8小时口服的医嘱，但没有实际给药记录。", "evidence_type": "synthetic_case_fact", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "source_object_id": "SOURCE_OBJECT-0000001", "turn_id": "TURN-0000038" }, { "available_time": null, "document_id": "DOCUMENT-0000007", "event_time_raw": null, "evidence_id": "EVIDENCE-0000039", "evidence_status": "professionally_reviewed_synthetic", "evidence_text": "我只想核对这份材料能说明什么，暂时不讨论改药。", "evidence_type": "synthetic_dialogue_premise", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "source_object_id": "SOURCE_OBJECT-0000001", "turn_id": "TURN-0000039" }, { "available_time": null, "document_id": "DOCUMENT-0000007", "event_time_raw": null, "evidence_id": "EVIDENCE-0000040", "evidence_status": "professionally_reviewed_synthetic", "evidence_text": "记录中有阿莫西林500毫克每8小时口服的医嘱，但没有实际给药记录。", "evidence_type": "synthetic_case_fact", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "source_object_id": "SOURCE_OBJECT-0000001", "turn_id": "TURN-0000040" }, { "available_time": null, "document_id": "DOCUMENT-0000007", "event_time_raw": null, "evidence_id": "EVIDENCE-0000041", "evidence_status": "professionally_reviewed_synthetic", "evidence_text": "如果实际服用情况和医嘱不同，应该怎样记录？", "evidence_type": "synthetic_dialogue_premise", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "source_object_id": "SOURCE_OBJECT-0000001", "turn_id": "TURN-0000041" }, { "available_time": null, "document_id": "DOCUMENT-0000007", "event_time_raw": null, "evidence_id": "EVIDENCE-0000042", "evidence_status": "professionally_reviewed_synthetic", "evidence_text": "记录中有阿莫西林500毫克每8小时口服的医嘱，但没有实际给药记录。", "evidence_type": "synthetic_case_fact", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "source_object_id": "SOURCE_OBJECT-0000001", "turn_id": "TURN-0000042" }, { "available_time": null, "document_id": "DOCUMENT-0000008", "event_time_raw": null, "evidence_id": "EVIDENCE-0000043", "evidence_status": "professionally_reviewed_synthetic", "evidence_text": "出院说明让我继续吃氨氯地平，我应该怎样配合记录？", "evidence_type": "synthetic_dialogue_premise", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "source_object_id": "SOURCE_OBJECT-0000001", "turn_id": "TURN-0000043" }, { "available_time": null, "document_id": "DOCUMENT-0000008", "event_time_raw": null, "evidence_id": "EVIDENCE-0000044", "evidence_status": "professionally_reviewed_synthetic", "evidence_text": "出院说明记录继续口服氨氯地平并监测血压，未记录自行加减剂量规则。", "evidence_type": "synthetic_case_fact", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "source_object_id": "SOURCE_OBJECT-0000001", "turn_id": "TURN-0000044" }, { "available_time": null, "document_id": "DOCUMENT-0000008", "event_time_raw": null, "evidence_id": "EVIDENCE-0000045", "evidence_status": "professionally_reviewed_synthetic", "evidence_text": "我早上服药，偶尔会忘记记录血压。", "evidence_type": "synthetic_dialogue_premise", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "source_object_id": "SOURCE_OBJECT-0000001", "turn_id": "TURN-0000045" }, { "available_time": null, "document_id": "DOCUMENT-0000008", "event_time_raw": null, "evidence_id": "EVIDENCE-0000046", "evidence_status": "professionally_reviewed_synthetic", "evidence_text": "出院说明记录继续口服氨氯地平并监测血压，未记录自行加减剂量规则。", "evidence_type": "synthetic_case_fact", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "source_object_id": "SOURCE_OBJECT-0000001", "turn_id": "TURN-0000046" }, { "available_time": null, "document_id": "DOCUMENT-0000008", "event_time_raw": null, "evidence_id": "EVIDENCE-0000047", "evidence_status": "professionally_reviewed_synthetic", "evidence_text": "血压波动时能不能自己改变服药时间？", "evidence_type": "synthetic_dialogue_premise", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "source_object_id": "SOURCE_OBJECT-0000001", "turn_id": "TURN-0000047" }, { "available_time": null, "document_id": "DOCUMENT-0000008", "event_time_raw": null, "evidence_id": "EVIDENCE-0000048", "evidence_status": "professionally_reviewed_synthetic", "evidence_text": "出院说明记录继续口服氨氯地平并监测血压，未记录自行加减剂量规则。", "evidence_type": "synthetic_case_fact", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "source_object_id": "SOURCE_OBJECT-0000001", "turn_id": "TURN-0000048" }, { "available_time": null, "document_id": "DOCUMENT-0000009", "event_time_raw": null, "evidence_id": "EVIDENCE-0000049", "evidence_status": "professionally_reviewed_synthetic", "evidence_text": "出院后切口护理最需要关注什么？", "evidence_type": "synthetic_dialogue_premise", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "source_object_id": "SOURCE_OBJECT-0000001", "turn_id": "TURN-0000049" }, { "available_time": null, "document_id": "DOCUMENT-0000009", "event_time_raw": null, "evidence_id": "EVIDENCE-0000050", "evidence_status": "professionally_reviewed_synthetic", "evidence_text": "出院说明要求保持切口清洁、按计划复诊，并观察发热、红肿和渗液。", "evidence_type": "synthetic_case_fact", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "source_object_id": "SOURCE_OBJECT-0000001", "turn_id": "TURN-0000050" }, { "available_time": null, "document_id": "DOCUMENT-0000009", "event_time_raw": null, "evidence_id": "EVIDENCE-0000051", "evidence_status": "professionally_reviewed_synthetic", "evidence_text": "目前切口干燥，没有发热，但我担心活动会影响恢复。", "evidence_type": "synthetic_dialogue_premise", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "source_object_id": "SOURCE_OBJECT-0000001", "turn_id": "TURN-0000051" }, { "available_time": null, "document_id": "DOCUMENT-0000009", "event_time_raw": null, "evidence_id": "EVIDENCE-0000052", "evidence_status": "professionally_reviewed_synthetic", "evidence_text": "出院说明要求保持切口清洁、按计划复诊，并观察发热、红肿和渗液。", "evidence_type": "synthetic_case_fact", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "source_object_id": "SOURCE_OBJECT-0000001", "turn_id": "TURN-0000052" }, { "available_time": null, "document_id": "DOCUMENT-0000009", "event_time_raw": null, "evidence_id": "EVIDENCE-0000053", "evidence_status": "professionally_reviewed_synthetic", "evidence_text": "如果出现少量渗液，能先在家观察吗？", "evidence_type": "synthetic_dialogue_premise", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "source_object_id": "SOURCE_OBJECT-0000001", "turn_id": "TURN-0000053" }, { "available_time": null, "document_id": "DOCUMENT-0000009", "event_time_raw": null, "evidence_id": "EVIDENCE-0000054", "evidence_status": "professionally_reviewed_synthetic", "evidence_text": "出院说明要求保持切口清洁、按计划复诊，并观察发热、红肿和渗液。", "evidence_type": "synthetic_case_fact", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "source_object_id": "SOURCE_OBJECT-0000001", "turn_id": "TURN-0000054" }, { "available_time": null, "document_id": "DOCUMENT-0000010", "event_time_raw": null, "evidence_id": "EVIDENCE-0000055", "evidence_status": "professionally_reviewed_synthetic", "evidence_text": "报告建议三个月后复查，我怎样准备这次随访？", "evidence_type": "synthetic_dialogue_premise", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "source_object_id": "SOURCE_OBJECT-0000001", "turn_id": "TURN-0000055" }, { "available_time": null, "document_id": "DOCUMENT-0000010", "event_time_raw": null, "evidence_id": "EVIDENCE-0000056", "evidence_status": "professionally_reviewed_synthetic", "evidence_text": "影像报告建议三个月后复查胸部CT；未记录复查完成或结节变化。", "evidence_type": "synthetic_case_fact", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "source_object_id": "SOURCE_OBJECT-0000001", "turn_id": "TURN-0000056" }, { "available_time": null, "document_id": "DOCUMENT-0000010", "event_time_raw": null, "evidence_id": "EVIDENCE-0000057", "evidence_status": "professionally_reviewed_synthetic", "evidence_text": "我已经保存了报告，但还没有预约复查。", "evidence_type": "synthetic_dialogue_premise", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "source_object_id": "SOURCE_OBJECT-0000001", "turn_id": "TURN-0000057" }, { "available_time": null, "document_id": "DOCUMENT-0000010", "event_time_raw": null, "evidence_id": "EVIDENCE-0000058", "evidence_status": "professionally_reviewed_synthetic", "evidence_text": "影像报告建议三个月后复查胸部CT；未记录复查完成或结节变化。", "evidence_type": "synthetic_case_fact", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "source_object_id": "SOURCE_OBJECT-0000001", "turn_id": "TURN-0000058" }, { "available_time": null, "document_id": "DOCUMENT-0000010", "event_time_raw": null, "evidence_id": "EVIDENCE-0000059", "evidence_status": "professionally_reviewed_synthetic", "evidence_text": "如果预约时间晚了几天，需要自己改方案吗？", "evidence_type": "synthetic_dialogue_premise", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "source_object_id": "SOURCE_OBJECT-0000001", "turn_id": "TURN-0000059" }, { "available_time": null, "document_id": "DOCUMENT-0000010", "event_time_raw": null, "evidence_id": "EVIDENCE-0000060", "evidence_status": "professionally_reviewed_synthetic", "evidence_text": "影像报告建议三个月后复查胸部CT；未记录复查完成或结节变化。", "evidence_type": "synthetic_case_fact", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "source_object_id": "SOURCE_OBJECT-0000001", "turn_id": "TURN-0000060" }, { "available_time": null, "document_id": "DOCUMENT-0000011", "event_time_raw": null, "evidence_id": "EVIDENCE-0000061", "evidence_status": "professionally_reviewed_synthetic", "evidence_text": "病历建议复查血常规，但我现在还没有结果，随访时该怎么说？", "evidence_type": "synthetic_dialogue_premise", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "source_object_id": "SOURCE_OBJECT-0000001", "turn_id": "TURN-0000061" }, { "available_time": null, "document_id": "DOCUMENT-0000011", "event_time_raw": null, "evidence_id": "EVIDENCE-0000062", "evidence_status": "professionally_reviewed_synthetic", "evidence_text": "病程记录建议复查血常规，当前未提供复查结果。", "evidence_type": "synthetic_case_fact", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "source_object_id": "SOURCE_OBJECT-0000001", "turn_id": "TURN-0000062" }, { "available_time": null, "document_id": "DOCUMENT-0000011", "event_time_raw": null, "evidence_id": "EVIDENCE-0000063", "evidence_status": "professionally_reviewed_synthetic", "evidence_text": "我已经预约抽血，下周才能拿到结果。", "evidence_type": "synthetic_dialogue_premise", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "source_object_id": "SOURCE_OBJECT-0000001", "turn_id": "TURN-0000063" }, { "available_time": null, "document_id": "DOCUMENT-0000011", "event_time_raw": null, "evidence_id": "EVIDENCE-0000064", "evidence_status": "professionally_reviewed_synthetic", "evidence_text": "病程记录建议复查血常规，当前未提供复查结果。", "evidence_type": "synthetic_case_fact", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "source_object_id": "SOURCE_OBJECT-0000001", "turn_id": "TURN-0000064" }, { "available_time": null, "document_id": "DOCUMENT-0000011", "event_time_raw": null, "evidence_id": "EVIDENCE-0000065", "evidence_status": "professionally_reviewed_synthetic", "evidence_text": "拿到结果后只看异常箭头够吗？", "evidence_type": "synthetic_dialogue_premise", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "source_object_id": "SOURCE_OBJECT-0000001", "turn_id": "TURN-0000065" }, { "available_time": null, "document_id": "DOCUMENT-0000011", "event_time_raw": null, "evidence_id": "EVIDENCE-0000066", "evidence_status": "professionally_reviewed_synthetic", "evidence_text": "病程记录建议复查血常规，当前未提供复查结果。", "evidence_type": "synthetic_case_fact", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "source_object_id": "SOURCE_OBJECT-0000001", "turn_id": "TURN-0000066" }, { "available_time": null, "document_id": "DOCUMENT-0000012", "event_time_raw": null, "evidence_id": "EVIDENCE-0000067", "evidence_status": "professionally_reviewed_synthetic", "evidence_text": "随访记录写切口愈合良好、未见感染，这是不是说明以后都不会有问题？", "evidence_type": "synthetic_dialogue_premise", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "source_object_id": "SOURCE_OBJECT-0000001", "turn_id": "TURN-0000067" }, { "available_time": null, "document_id": "DOCUMENT-0000012", "event_time_raw": null, "evidence_id": "EVIDENCE-0000068", "evidence_status": "professionally_reviewed_synthetic", "evidence_text": "随访记录描述切口愈合良好、未见感染，并建议按计划复诊；不含长期结局。", "evidence_type": "synthetic_case_fact", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "source_object_id": "SOURCE_OBJECT-0000001", "turn_id": "TURN-0000068" }, { "available_time": null, "document_id": "DOCUMENT-0000012", "event_time_raw": null, "evidence_id": "EVIDENCE-0000069", "evidence_status": "professionally_reviewed_synthetic", "evidence_text": "目前我没有发热，切口也没有新的红肿。", "evidence_type": "synthetic_dialogue_premise", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "source_object_id": "SOURCE_OBJECT-0000001", "turn_id": "TURN-0000069" }, { "available_time": null, "document_id": "DOCUMENT-0000012", "event_time_raw": null, "evidence_id": "EVIDENCE-0000070", "evidence_status": "professionally_reviewed_synthetic", "evidence_text": "随访记录描述切口愈合良好、未见感染，并建议按计划复诊；不含长期结局。", "evidence_type": "synthetic_case_fact", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "source_object_id": "SOURCE_OBJECT-0000001", "turn_id": "TURN-0000070" }, { "available_time": null, "document_id": "DOCUMENT-0000012", "event_time_raw": null, "evidence_id": "EVIDENCE-0000071", "evidence_status": "professionally_reviewed_synthetic", "evidence_text": "下次复诊前我应该继续记录什么？", "evidence_type": "synthetic_dialogue_premise", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "source_object_id": "SOURCE_OBJECT-0000001", "turn_id": "TURN-0000071" }, { "available_time": null, "document_id": "DOCUMENT-0000012", "event_time_raw": null, "evidence_id": "EVIDENCE-0000072", "evidence_status": "professionally_reviewed_synthetic", "evidence_text": "随访记录描述切口愈合良好、未见感染，并建议按计划复诊；不含长期结局。", "evidence_type": "synthetic_case_fact", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "source_object_id": "SOURCE_OBJECT-0000001", "turn_id": "TURN-0000072" } ], "handoff_record": [ { "available_time": null, "episode_id": "EPISODE-0000001", "event_time_raw": null, "handoff_condition": "出现呼吸困难、胸痛、意识变化或持续高热", "handoff_id": "HANDOFF-0000001", "handoff_status": "available_when_condition_met", "handoff_target": "急诊或负责照护团队", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "source_object_id": "SOURCE_OBJECT-0000001", "trigger_turn_id": "TURN-0000006" }, { "available_time": null, "episode_id": "EPISODE-0000002", "event_time_raw": null, "handoff_condition": "静息气短、胸痛、晕厥或症状迅速加重", "handoff_id": "HANDOFF-0000002", "handoff_status": "available_when_condition_met", "handoff_target": "急诊或心血管照护团队", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "source_object_id": "SOURCE_OBJECT-0000001", "trigger_turn_id": "TURN-0000012" }, { "available_time": null, "episode_id": "EPISODE-0000003", "event_time_raw": null, "handoff_condition": "疼痛加重、发热、反复呕吐或切口异常", "handoff_id": "HANDOFF-0000003", "handoff_status": "available_when_condition_met", "handoff_target": "手术团队或急诊", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "source_object_id": "SOURCE_OBJECT-0000001", "trigger_turn_id": "TURN-0000018" }, { "available_time": null, "episode_id": "EPISODE-0000004", "event_time_raw": null, "handoff_condition": "需要判断结节性质、调整复查时间或出现新症状", "handoff_id": "HANDOFF-0000004", "handoff_status": "available_when_condition_met", "handoff_target": "呼吸或影像专科团队", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "source_object_id": "SOURCE_OBJECT-0000001", "trigger_turn_id": "TURN-0000024" }, { "available_time": null, "episode_id": "EPISODE-0000005", "event_time_raw": null, "handoff_condition": "持续异常读数、明显不适或提出调整处方", "handoff_id": "HANDOFF-0000005", "handoff_status": "available_when_condition_met", "handoff_target": "高血压照护团队", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "source_object_id": "SOURCE_OBJECT-0000001", "trigger_turn_id": "TURN-0000030" }, { "available_time": null, "episode_id": "EPISODE-0000006", "event_time_raw": null, "handoff_condition": "需要完整分期、治疗方案或预后判断", "handoff_id": "HANDOFF-0000006", "handoff_status": "available_when_condition_met", "handoff_target": "病理与肿瘤专科团队", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "source_object_id": "SOURCE_OBJECT-0000001", "trigger_turn_id": "TURN-0000036" }, { "available_time": null, "episode_id": "EPISODE-0000007", "event_time_raw": null, "handoff_condition": "实际服用与医嘱不一致、出现不适或询问剂量调整", "handoff_id": "HANDOFF-0000007", "handoff_status": "available_when_condition_met", "handoff_target": "开立医嘱的临床或药学团队", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "source_object_id": "SOURCE_OBJECT-0000001", "trigger_turn_id": "TURN-0000042" }, { "available_time": null, "episode_id": "EPISODE-0000008", "event_time_raw": null, "handoff_condition": "持续血压异常、用药不适或提出调整方案", "handoff_id": "HANDOFF-0000008", "handoff_status": "available_when_condition_met", "handoff_target": "高血压照护或药学团队", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "source_object_id": "SOURCE_OBJECT-0000001", "trigger_turn_id": "TURN-0000048" }, { "available_time": null, "episode_id": "EPISODE-0000009", "event_time_raw": null, "handoff_condition": "切口渗液、红肿、发热或疼痛加重", "handoff_id": "HANDOFF-0000009", "handoff_status": "available_when_condition_met", "handoff_target": "手术团队或急诊", "missing_reason": null, "parent_object_id": "PARENT_OBJECT-0000001", "record_status": "synthetic_dataset", "source_object_id": "SOURCE_OBJECT-0000001", "trigger_turn_id": "TURN-0000054" }, { "available_time": null, "episode_id": "EPISODE-0000010", 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