{"reference":": Bonjour, madam, je suis le docteur qui va vous prendre en charge aujourd’hui. Please have a seat. I understand you have had abdominal pain for at least four days. : Yes, Doctor. It started on Sunday evening. : Okay. Can you tell me where the pain began exactly? : It was right here in my upper belly. But now it's mostly down on the right side. : Je comprends. So it started in the upper abdomen and moved to the right lower side. Is that? : Oui docteur, effectivement. : okay? Okay. Was the pain sudden or gradual? : It was gradual. Just a dull ache at first. But now, It's sharp about eight out of ten. : okay, okay. Et est-ce que la douleur se propage autre part? Par exemple, votre dos où alors vos épaules? : No, doctor, it stays in the lower right. : Okay. Anything makes him better or worse? : Doctor nothing really helps. Moving around makes it a bit worse. : Et avez-vous de la fièvre aussi ? : Oui docteur, j’ai fait de la fièvre la nuit dernière et lorsque j’ai vérifié ma température, j’étais à 38 degrés. : Et quand est-il des nausées où alors les vomissements ? : I've vomited three times, especially after eating. I have no appetite at all. : Okay. Any diarrhea où alors de la constipation? : No, Doctor. Bowel movements are normal. : Any burning when you pass urine or going more often? : Non docteur, tout est bon de ce côté. : Okay. Okey je comprends. I'm going to press gently. You tell me when it's tender. Okay. : Ow. That hurts right there. : Okay. Okay. How about when I let go? : Worse Doctor, that really hurts. : Okay, je vais aussi mettre de pression sur le côté gauche. Let me know. Okay? : feel pain on the right side when you do that. : Okay. You have tenderness gathering and rebound tenderness in your right lower abdomen. Also a positive rough things sign. They are very suggestive of acute appendices. : Dr. but, is it serious? : It can be if not treated. The appendix may be inflamed and could rupture. We need to do blood work, CBC, CRP and likely an abdominal ultrasound or CT to confirm that. : Doctor, do I need surgery? : Plus au moins, plus au moins, Laparoscopic. But we will confirm first. I'm going to start IV fluid, pain relief and antibiotics. You should eat or drink anything now in case we are going to operate you, okay? : Okay. Doctor, should I call my family? : Oui Oui allez-y, allez-y , c’est important. We will admit you and have the surgical team to see within the hours. Donc, ils vont programmer si on va vous opérer et ils vont donner la période exacte de l’opération, d’accord? : D’accord docteur, merci beaucoup. : Okay, You're welcome. You're welcome. We take good care of you and rest assured. Ici avec nous, c’est la guérison assurée. Vous allez forcément trouver guérison et solution à votre problème. D’accord madame? : D’accord docteur.","products":{"hanah":[{"label":"Run 1","wer":7.739307535641547,"text":"Bonjour madame. Je suis le docteur qui va vous prendre en charge aujourd'hui. Please have a seat. Understand your fat abdominal pain for at least 4 days?\n\n  Yes, doctor. It started on Sunday evening.\n\n  Okay. Can you tell me where the pain began exactly?\n\n  It was right here, in my upper belly. But now it's mostly down on the right side.\n\n  Je comprends. So it started in the upper abdomen, and moved to the right lower side. Is that—\n\n  Oui, docteur, effectivement.\n\n  Okay, okay. Was the pain sudden or gradual?\n\n  It was gradual, just a dull ache at first, but now it's sharp, about 8 out of 10.\n\n  Okay, okay. Et est-ce que la douleur se propage autre part, par exemple votre dos ou alors vos épaules?\n\n  No, doctor, it stays in the lower right.\n\n  Okay. Anything makes it better or worse?\n\n  Um, doctor, nothing really helps. Moving around makes it a bit worse.\n\n  Et avez-vous de la fièvre aussi?\n\n  Oui, docteur, j'ai fait de la fièvre la nuit dernière, et lorsque j'ai vérifié ma température, j'étais à 38 degrés.\n\n  Et qu'en est-il des nausées, ou alors du vomissement?\n\n  I vomited 3 times, especially after eating. I have no appetite at all.\n\n  Okay. Any diarrhea, or de la constipation?\n\n  No, doctor. Bowel movements are normal.\n\n  Any burning when you pass urine? Or going more often?\n\n  Um, no, doctor. Tout est bon de ce côté.\n\n  Okay, okay. Je comprends. I'm going to press gently. You tell me when it's tender, okay?\n\n  Ow! That hurts right there.\n\n  Okay, okay. How about when I let go?\n\n  Worse, doctor. That really hurts.\n\n  Okay. Je vais aussi mettre un peu de pression sur le côté gauche. Let me know, okay?\n\n  Um, I feel pain on the right side when you do that.\n\n  Okay. You have tenderness. Gathering and rebound tenderness in your right lower abdomen. Also, a positive rough things sign. There are very suggestive of acute appendicitis.\n\n  Doctor, burnt? Is it serious?\n\n  It can be, if not treated. The appendix may be inflamed. And cold rupture. We need to do blood work: CBC, CRP, and likely an abdominal ultrasound or CT. To confirm that.\n\n  Doctor, um, do I need surgery?\n\n  Euh, plus ou moins, plus ou moins. Laparoscopique, but we will confirm first. I'm going to start IV fluid. Pain relief and antibiotics. You should eat or drink anything now. In case we're going to operate you. Okay?\n\n  Okay, doctor. Should I call my family?\n\n  Euh, oui, oui, oui. Allez-y, allez-y. C'est important. We will admit you and have the surgical team. To see within the hours. Donc, ils vont programmer si on va vous opérer et ils vont donner la période exacte de l'opération.\n\n  D'accord, docteur. Merci beaucoup.\n\n  Okay. You're welcome, you're welcome. We'll take good care of you and rest assured. Ici avec nous, c'est la guérison assurée. Vous allez forcément trouver guérison et solution à votre problème. D'accord, madame?\n\n  D'accord, docteur.","marks":[[8,15,"madam",false],[65,77,"aujourd hui.",false],[109,117,"you have had",false],[686,688,"où",false],[776,778,"him",false],[922,926,"j ai",false],[974,978,"j ai",false],[1003,1010,"j étais",false],[1030,1035,"quand",false],[1056,1058,"où",false],[1065,1085,"les vomissements I've",false],[1178,1180,"où alors",false],[1304,1319,"Non docteur",false],[1354,1359,"Okey",false],[1575,1581,"",false],[1816,1821,"They",false],[1851,1881,"appendices. Dr. but",false],[1962,1966,"could",false],[2108,2111,"",false],[2118,2120,"au",false],[2133,2135,"au",false],[2143,2157,"Laparoscopic.",false],[2290,2295,"we are",false],[2369,2377,"",false],[2407,2412,"c est",false],[2582,2606,"l opération d accord D accord",false],[2674,2679,"We",false],[2735,2740,"c est",false],[2830,2838,"D accord",false],[2851,2859,"D accord",false]],"facts":[["Records four days of abdominal pain beginning Sunday evening, initially upper abdominal then migrating to the right lower abdomen.","yes","\"Abdominal pain x4 days, onset Sunday evening. Initially upper abdomen; migrated to RLQ.\""],["Records gradual onset, initially dull then sharp, currently 8/10.","yes","\"Gradual onset, initially dull → sharp; severity 8/10\"."],["Records pain worsened by movement, nothing relieving it, and no radiation to back or shoulder.","yes","\"No radiation to back or shoulders. Worse with movement; no relieving factors.\""],["Records fever last night with measured temperature 38 degrees, without inventing other measured vitals.","yes","\"Fever overnight; self-measured T 38°C\"; no other vitals invented."],["Records three vomiting episodes especially after eating, and absent appetite.","yes","\"Vomiting x3, especially after eating; anorexia\"."],["Records normal bowel movements and denial of urinary burning or increased frequency.","yes","\"Denies diarrhea, constipation, dysuria, urinary frequency; bowel movements normal\"."],["Records right lower abdominal tenderness and rebound tenderness, and right-sided pain elicited by left abdominal pressure.","yes","RLQ tenderness, RLQ rebound and \"Right-sided pain elicited with left-sided abdominal pressure\"."],["Identifies suspected acute appendicitis and risk of rupture if untreated.","yes","\"Suspected acute appendicitis\" and \"Discussed risk of appendix rupture if untreated\"."],["Plans CBC and CRP blood tests, with abdominal ultrasound or CT to confirm.","yes","\"Blood tests: CBC, CRP. Abdominal US or CT for confirmation.\""],["Discusses likely laparoscopic surgery after confirmation and admission with surgical team review within hours.","yes","Possible laparoscopic surgery pending confirmation, \"Admit to hospital\", \"Surgical team review within hours\"."],["Plans IV fluids, analgesia and antibiotics.","yes","\"Start IV fluids, analgesia, and antibiotics\"."],["Encourages contacting family and provides reassurance.","partial","\"Wishes to contact family; agreed\" recorded, but clinician reassurance is not documented."]],"claims":[],"note":"Subjective\nAbdominal pain x4 days, onset Sunday evening.\nInitially upper abdomen; migrated to RLQ.\nGradual onset, initially dull → sharp; severity 8/10.\nNo radiation to back or shoulders.\nWorse with movement; no relieving factors.\nFever overnight; self-measured T 38°C.\nVomiting x3, especially after eating; anorexia.\nDenies diarrhea, constipation, dysuria, urinary frequency; bowel movements normal.\nAsked whether surgery will be required; advised possible laparoscopic surgery pending confirmation.\nWishes to contact family; agreed.\nObjective\nRLQ tenderness on palpation.\nRLQ rebound tenderness.\nRight-sided pain elicited with left-sided abdominal pressure; documented positive Rovsing sign.\nAssessment\nSuspected acute appendicitis: migratory abdominal pain to RLQ with fever, vomiting/anorexia, RLQ tenderness/rebound, and positive Rovsing sign.\nDiscussed risk of appendix rupture if untreated.\nPlan\nAdmit to hospital.\nNPO.\nStart IV fluids, analgesia, and antibiotics.\nBlood tests: CBC, CRP.\nAbdominal US or CT for confirmation.\nSurgical team review within hours; operative timing to be determined.","review":57.5,"saved":221.5,"clean":false,"effort":4.166666666666666,"sig":[]},{"label":"Run 2","wer":6.924643584521386,"text":"Bonjour madame. Je suis le docteur qui va vous prendre en charge aujourd'hui. Please have a seat. Understand you have had abdominal pain for at least 4 days?\n\n  Yes, doctor. It started on Sunday evening.\n\n  Okay. Can you tell me where the pain began exactly?\n\n  It was right here, in my upper belly. But now it's mostly down on the right side.\n\n  Je comprends. So it started in the upper abdomen, and moved to the right lower side. Is that—\n\n  Oui, docteur, effectivement.\n\n  Okay, okay. Was the pain sudden or gradual?\n\n  It was gradual, just a dull ache at first, but now it's sharp, about 8 out of 10.\n\n  Okay, okay. Et est-ce que la douleur se propage autre part, par exemple votre dos ou alors vos épaules?\n\n  No, doctor, it stays in the lower right.\n\n  Okay. Anything makes it better or worse?\n\n  Um, doctor, nothing really helps. Moving around makes it a bit worse.\n\n  Et avez-vous de la fièvre aussi?\n\n  Oui, docteur, j'ai fait de la fièvre la nuit dernière, et lorsque j'ai vérifié ma température, j'étais à 38 degrés.\n\n  Et qu'en est-il des nausées ou alors du vomissement?\n\n  I vomited 3 times. Especially after eating. I have no appetite at all.\n\n  Okay. Any diarrhea ou alors de la constipation?\n\n  No, doctor. Bowel movements are normal.\n\n  Any burning when you pass urine? Or going more often?\n\n  Um, no, doctor. Tout est bon de ce côté.\n\n  Okay, okay. Je comprends. I'm going to press gently. You tell me when it's tender, okay?\n\n  Ow! That hurts right there.\n\n  Okay, okay. How about when I let go?\n\n  Worse, doctor. That really hurts.\n\n  Okay. Je vais aussi mettre un peu de pression sur le côté gauche. Let me know, okay?\n\n  Um, I feel pain on the right side when you do that.\n\n  Okay. You have tenderness. Gathering and rebound tenderness in your right lower abdomen. Also, a positive rough things sign. There are very suggestive of acute appendicite.\n\n  Doctor, but is it serious?\n\n  It can be, if not treated. The appendix may be inflamed. And cold rupture. We need to do blood work: CBC, CRP, and likely an abdominal ultrasound or CT. To confirm that.\n\n  Doctor, um, do I need surgery?\n\n  Euh, plus ou moins, plus ou moins. La paroscopique, but we will confirm first. I'm going to start IV fluid. Pain relief and antibiotics. You should eat or drink anything now. In case we're going to operate you. Okay?\n\n  Okay, doctor. Should I call my family?\n\n  Euh, oui, oui, oui. Allez-y, allez-y. C'est important. We will admit you and have the surgical team. To see within the hours. Donc, ils vont programmer si on va vous opérer et ils vont donner la période exacte de l'opération.\n\n  D'accord, docteur. Merci beaucoup.\n\n  Okay. You're welcome, you're welcome. We'll take good care of you and rest assured. Ici avec nous, c'est la guérison assurée. Vous allez forcément trouver guérison et solution à votre problème. D'accord, madame?\n\n  D'accord, docteur.","marks":[[8,15,"madam",false],[65,77,"aujourd hui.",false],[690,692,"où",false],[780,782,"him",false],[926,930,"j ai",false],[978,982,"j ai",false],[1007,1014,"j étais",false],[1034,1039,"quand",false],[1059,1061,"où",false],[1068,1088,"les vomissements I've",false],[1180,1182,"où",false],[1312,1327,"Non docteur",false],[1362,1367,"Okey",false],[1583,1589,"",false],[1824,1829,"They",false],[1859,1881,"appendices. Dr.",false],[1966,1970,"could",false],[2112,2115,"",false],[2122,2124,"au",false],[2137,2139,"au",false],[2147,2162,"Laparoscopic.",false],[2295,2300,"we are",false],[2374,2382,"",false],[2412,2417,"c est",false],[2587,2611,"l opération d accord D accord",false],[2679,2684,"We",false],[2740,2745,"c est",false],[2835,2843,"D accord",false],[2856,2864,"D accord",false]],"facts":[["Records four days of abdominal pain beginning Sunday evening, initially upper abdominal then migrating to the right lower abdomen.","yes","\"Abdominal pain x 4 days; onset Sunday evening\", upper abdominal migrated to RLQ."],["Records gradual onset, initially dull then sharp, currently 8/10.","partial","\"Initially dull...now sharp, 8/10\" but gradual onset not stated."],["Records pain worsened by movement, nothing relieving it, and no radiation to back or shoulder.","yes","\"Pain non-radiating; worsened by movement; no relieving factors.\""],["Records fever last night with measured temperature 38 degrees, without inventing other measured vitals.","yes","\"Reported fever overnight; self-measured T 38°C\" with no other vitals."],["Records three vomiting episodes especially after eating, and absent appetite.","yes","\"vomited 3 times, particularly after eating; anorexia\"."],["Records normal bowel movements and denial of urinary burning or increased frequency.","yes","\"Denies diarrhoea or constipation; BMs normal. Denies dysuria or urinary frequency.\""],["Records right lower abdominal tenderness and rebound tenderness, and right-sided pain elicited by left abdominal pressure.","yes","RLQ tenderness, rebound, and \"RLQ pain elicited with left-sided abdominal pressure\"."],["Identifies suspected acute appendicitis and risk of rupture if untreated.","yes","\"Suspected acute appendicitis\" and \"risk of appendiceal rupture if untreated\"."],["Plans CBC and CRP blood tests, with abdominal ultrasound or CT to confirm.","yes","\"Blood tests: CBC and CRP. Abdominal US and/or CT to confirm diagnosis.\""],["Discusses likely laparoscopic surgery after confirmation and admission with surgical team review within hours.","yes","\"Admit for surgical assessment within hours\" and possible laparoscopic surgery pending confirmation."],["Plans IV fluids, analgesia and antibiotics.","yes","\"Start IV fluids, analgesia, and antibiotics.\""],["Encourages contacting family and provides reassurance.","partial","\"Patient advised to contact family\" but reassurance not recorded."]],"claims":[],"note":"Subjective\nAbdominal pain x 4 days; onset Sunday evening.\nInitially dull upper abdominal pain; migrated to RLQ and now sharp, 8/10.\nPain non-radiating; worsened by movement; no relieving factors.\nReported fever overnight; self-measured T 38°C.\nN/V: vomited 3 times, particularly after eating; anorexia.\nDenies diarrhoea or constipation; BMs normal.\nDenies dysuria or urinary frequency.\nObjective\nRLQ tenderness on palpation.\nRebound tenderness in RLQ.\nRLQ pain elicited with left-sided abdominal pressure; positive Rovsing sign.\nAssessment\nSuspected acute appendicitis.\nMigratory abdominal pain to RLQ, fever, vomiting/anorexia, RLQ tenderness with rebound, and positive Rovsing sign are suggestive.\nDiscussed risk of appendiceal rupture if untreated.\nPlan\nAdmit for surgical assessment within hours.\nBlood tests: CBC and CRP.\nAbdominal US and/or CT to confirm diagnosis.\nStart IV fluids, analgesia, and antibiotics.\nNPO pending possible surgery.\nDiscussed possible laparoscopic surgery pending diagnostic confirmation.\nPatient advised to contact family.","review":69.36842105263159,"saved":209.6315789473684,"clean":false,"effort":8.333333333333332,"sig":[],"mb":6.481635,"latency":14.951,"signable":84.31942105263158},{"label":"Run 3","wer":7.942973523421588,"text":"Bonjour madame. Je suis le docteur qui va vous prendre en charge aujourd'hui. Please have a seat. Understand you've had abdominal pain for at least 4 days?\n\n  Yes, doctor. It started on Sunday evening.\n\n  Okay. Can you tell me where the pain began exactly?\n\n  It was right here, in my upper belly. But now it's mostly down on the right side.\n\n  Je comprends. So it started in the upper abdomen, and moved to the right lower side. Is that—\n\n  Oui, docteur, effectivement.\n\n  Okay, okay. Was the pain sudden or gradual?\n\n  It was gradual, just a dull ache at first, but now it's sharp, about 8 out of 10.\n\n  Okay, okay. Et est-ce que la douleur se propage autre part, par exemple votre dos ou alors vos épaules?\n\n  No, doctor, it stays in the lower right.\n\n  Okay. Anything makes it better, or worse?\n\n  Um, doctor, nothing really helps. Moving around makes it a bit worse.\n\n  Et avez-vous de la fièvre aussi?\n\n  Oui, docteur, j'ai fait de la fièvre la nuit dernière, et lorsque j'ai vérifié ma température, j'étais à 38 degrés.\n\n  Et qu'en est-il des nausées, ou alors du vomissement?\n\n  I've vomited 3 times, especially after eating. I have no appetite at all.\n\n  Okay. Any diarrhea, or de la constipation?\n\n  No, doctor. Bon mouvement anormal.\n\n  Any burning when you pass urine? Or going more often?\n\n  Um, no, doctor. Tout est bon de ce côté.\n\n  Okay, okay. Je comprends. I'm going to press gently. You tell me when it's tender, okay?\n\n  Ow! That hurts right there.\n\n  Okay, okay. How about when I let go?\n\n  Worse, doctor. That really hurts.\n\n  Okay. Je vais aussi mettre un peu de pression sur le côté gauche. Let me know, okay?\n\n  Um, I feel pain on the right side when you do that.\n\n  Okay. You have tenderness gathering and rebound tenderness in your right lower abdomen. Also, a positive rough things sign. There are very suggestive of acute appendicite.\n\n  Doctor, but is it serious?\n\n  It can be, if not treated. The appendix may be inflamed. And cold rupture. We need to do blood work: CBC, CRP, and likely an abdominal ultrasound or CT.\n\n  Doctor, do I need surgery?\n\n  Euh, plus ou moins, plus ou moins. Laparoscopique? But we will confirm first. I'm going to start IV fluid. Pain relief and antibiotics. You should eat or drink anything now. In case we're going to operate you. Okay?\n\n  Okay, doctor. Should I call my family?\n\n  Oui, oui, oui. Allez-y, allez-y. C'est important. We will admit you and have the surgical team to see within the hours. Donc, ils vont programmer si on va vous opérer et ils vont donner la période exacte de l'opération. D'accord?\n\n  D'accord, docteur. Merci beaucoup.\n\n  Okay. You're welcome, you're welcome. We'll take good care of you and rest assured. Ici avec nous, c'est la guérison assurée. Vous allez forcément trouver guérison et solution à votre problème. D'accord, madame?\n\n  D'accord, docteur.","marks":[[8,15,"madam",false],[65,77,"aujourd hui.",false],[109,115,"you have",false],[688,690,"où",false],[778,780,"him",false],[925,929,"j ai",false],[977,981,"j ai",false],[1006,1013,"j étais",false],[1033,1038,"quand",false],[1059,1061,"où",false],[1068,1082,"les vomissements",false],[1184,1186,"où alors",false],[1222,1244,"Bowel movements are normal.",true],[1305,1320,"Non docteur",false],[1355,1360,"Okey",false],[1576,1582,"",false],[1816,1821,"They",false],[1851,1873,"appendices. Dr.",false],[1958,1962,"could",false],[2049,2049,"to confirm that.",false],[2083,2086,"",false],[2093,2095,"au",false],[2108,2110,"au",false],[2118,2132,"Laparoscopic.",false],[2265,2270,"we are",false],[2354,2358,"",false],[2377,2382,"c est",false],[2551,2585,"l opération d accord D accord",false],[2653,2658,"We",false],[2714,2719,"c est",false],[2809,2817,"D accord",false],[2830,2838,"D accord",false]],"facts":[["Records four days of abdominal pain beginning Sunday evening, initially upper abdominal then migrating to the right lower abdomen.","yes","\"Abdominal pain x ≥4 days, onset Sunday evening. Initially upper abdominal; migrated to RLQ.\""],["Records gradual onset, initially dull then sharp, currently 8/10.","yes","\"Gradual onset; initially dull, now sharp, 8/10.\""],["Records pain worsened by movement, nothing relieving it, and no radiation to back or shoulder.","yes","\"Worse with movement; no relieving factors reported\" and \"no radiation to back or shoulders\"."],["Records fever last night with measured temperature 38 degrees, without inventing other measured vitals.","yes","\"Fever overnight; reported temperature 38°C\" with no invented vitals."],["Records three vomiting episodes especially after eating, and absent appetite.","yes","\"Vomiting x3, especially after eating; anorexia.\""],["Records normal bowel movements and denial of urinary burning or increased frequency.","yes","Denies diarrhea/constipation (normal bowels) and \"Denies dysuria or urinary frequency\"."],["Records right lower abdominal tenderness and rebound tenderness, and right-sided pain elicited by left abdominal pressure.","yes","RLQ tenderness with rebound, and \"Pain elicited in RLQ with pressure applied to left side\"."],["Identifies suspected acute appendicitis and risk of rupture if untreated.","yes","\"Suspected acute appendicitis\" and \"risk of appendiceal rupture if untreated\"."],["Plans CBC and CRP blood tests, with abdominal ultrasound or CT to confirm.","yes","\"Order CBC and CRP. Obtain abdominal US and/or CT for diagnostic confirmation.\""],["Discusses likely laparoscopic surgery after confirmation and admission with surgical team review within hours.","yes","Admit, surgical review within hours, laparoscopic surgery to be determined after further assessment."],["Plans IV fluids, analgesia and antibiotics.","yes","\"Start IV fluids, analgesia, and antibiotics.\""],["Encourages contacting family and provides reassurance.","no","No mention of advising the patient to contact family or of reassurance."]],"claims":[],"note":"Subjective\nAbdominal pain x ≥4 days, onset Sunday evening.\nInitially upper abdominal; migrated to RLQ.\nGradual onset; initially dull, now sharp, 8/10.\nPain localized to RLQ; no radiation to back or shoulders.\nWorse with movement; no relieving factors reported.\nFever overnight; reported temperature 38°C.\nVomiting x3, especially after eating; anorexia.\nDenies diarrhea and constipation.\nDenies dysuria or urinary frequency.\nObjective\nAbdominal examination: RLQ tenderness with rebound tenderness.\nPain elicited in RLQ with pressure applied to left side of abdomen; positive Rovsing sign.\nAssessment\nSuspected acute appendicitis.\nMigratory abdominal pain now localized to RLQ, fever, vomiting/anorexia, RLQ tenderness, rebound tenderness, and positive Rovsing sign are suggestive.\nDiscussed potential risk of appendiceal rupture if untreated.\nPlan\nAdmit to hospital.\nSurgical team review within hours; operative timing/need for laparoscopic surgery to be determined after further assessment.\nKeep NPO pending possible surgery.\nStart IV fluids, analgesia, and antibiotics.\nOrder CBC and CRP.\nObtain abdominal US and/or CT for diagnostic confirmation.","review":64.84210526315789,"saved":214.1578947368421,"clean":false,"effort":8.333333333333332,"sig":[],"mb":6.467213,"latency":12.248,"signable":77.0901052631579},{"label":"Run 4","wer":7.3319755600814664,"text":"Bonjour madame. Je suis le docteur qui va vous prendre en charge aujourd'hui. Please have a seat. Understand you've had abdominal pain for at least 4 days?\n\n  Yes, doctor. It started on Sunday evening.\n\n  Okay. Can you tell me where the pain began exactly?\n\n  It was right here, in my upper belly. But now it's mostly down on the right side.\n\n  Je comprends. So it started in the upper abdomen, and moved to the right lower side. Is that—\n\n  Oui, docteur, effectivement.\n\n  Okay, okay. Was the pain sudden or gradual?\n\n  It was gradual, just a dull ache at first, but now it's sharp, about 8 out of 10.\n\n  Okay, okay. Et est-ce que la douleur se propage autre part, par exemple votre dos ou alors vos épaules?\n\n  No, doctor, it stays in the lower right.\n\n  Okay. Anything makes it better or worse?\n\n  Um, doctor, nothing really helps. Moving around makes it a bit worse.\n\n  Et avez-vous de la fièvre aussi?\n\n  Oui, docteur, j'ai fait de la fièvre la nuit dernière, et lorsque j'ai vérifié ma température, j'étais à 38 degrés.\n\n  Et qu'en est-il des nausées, ou alors du vomissement?\n\n  I vomited 3 times, especially after eating. I have no appetite at all.\n\n  Okay. Any diarrhea, or de la constipation?\n\n  No, doctor. Bowel movements are normal.\n\n  Any burning when you pass urine? Or going more often?\n\n  Um, no, doctor. Tout est bon de ce côté.\n\n  Okay, okay. Je comprends. I'm going to press gently. You tell me when it's tender, okay?\n\n  Ow! That hurts right there.\n\n  Okay, okay. How about when I let go?\n\n  Worse, doctor. That really hurts.\n\n  Okay. Je vais aussi mettre un peu de pression sur le côté gauche. Let me know, okay?\n\n  Um, I feel pain on the right side when you do that.\n\n  Okay. You have tenderness. Gathering and rebound tenderness in your right lower abdomen. Also, a positive rough things sign. There are very suggestive of acute appendicite.\n\n  Doctor, but is it serious?\n\n  It can be, if not treated. The appendix may be inflamed. And cold rupture. We need to do blood work: CBC, CRP, and likely an abdominal ultrasound or CT. To confirm that.\n\n  Doctor, um, do I need surgery?\n\n  Euh, plus ou moins, plus ou moins. La paroscopique— But we will confirm first. I'm going to start IV fluid. Pain relief and antibiotics. You should eat or drink anything now. In case we're going to operate you. Okay?\n\n  Okay, doctor. Should I call my family?\n\n  Oui, oui, oui. Allez-y, allez-y. C'est important. We will admit you and have the surgical team. To see within the hours. Donc, ils vont programmer si on va vous opérer et ils vont donner la période exacte de l'opération.\n\n  D'accord, docteur. Merci beaucoup.\n\n  Okay. You're welcome, you're welcome. We'll take good care of you and rest assured. Ici avec nous, c'est la guérison assurée. Vous allez forcément trouver guérison et solution à votre problème. D'accord, madame?\n\n  D'accord, docteur.","marks":[[8,15,"madam",false],[65,77,"aujourd hui.",false],[109,115,"you have",false],[688,690,"où",false],[778,780,"him",false],[924,928,"j ai",false],[976,980,"j ai",false],[1005,1012,"j étais",false],[1032,1037,"quand",false],[1058,1060,"où",false],[1067,1087,"les vomissements I've",false],[1180,1182,"où alors",false],[1306,1321,"Non docteur",false],[1356,1361,"Okey",false],[1577,1583,"",false],[1818,1823,"They",false],[1853,1875,"appendices. Dr.",false],[1960,1964,"could",false],[2106,2109,"",false],[2116,2118,"au",false],[2131,2133,"au",false],[2141,2156,"Laparoscopic.",false],[2289,2294,"we are",false],[2378,2382,"",false],[2401,2406,"c est",false],[2576,2600,"l opération d accord D accord",false],[2668,2673,"We",false],[2729,2734,"c est",false],[2824,2832,"D accord",false],[2845,2853,"D accord",false]],"facts":[["Records four days of abdominal pain beginning Sunday evening, initially upper abdominal then migrating to the right lower abdomen.","yes","Records '≥4 days, onset Sunday evening', initially upper abdomen now RLQ."],["Records gradual onset, initially dull then sharp, currently 8/10.","yes","'Gradual onset; initially dull, now sharp, 8/10.'"],["Records pain worsened by movement, nothing relieving it, and no radiation to back or shoulder.","yes","'Worse with movement; no relieving factors' and no radiation to back or shoulders."],["Records fever last night with measured temperature 38 degrees, without inventing other measured vitals.","yes","'Reported fever overnight; measured temperature 38°C' with no invented vitals."],["Records three vomiting episodes especially after eating, and absent appetite.","yes","'Vomiting x3, particularly after eating; anorexia.'"],["Records normal bowel movements and denial of urinary burning or increased frequency.","yes","'bowel motions normal' and 'Denies dysuria or urinary frequency.'"],["Records right lower abdominal tenderness and rebound tenderness, and right-sided pain elicited by left abdominal pressure.","yes","RLQ tenderness, rebound tenderness and RLQ pain with left-sided pressure documented."],["Identifies suspected acute appendicitis and risk of rupture if untreated.","partial","Suspected acute appendicitis documented, but risk of rupture if untreated is not mentioned."],["Plans CBC and CRP blood tests, with abdominal ultrasound or CT to confirm.","yes","'Arrange CBC, CRP, and abdominal US and/or CT to confirm diagnosis.'"],["Discusses likely laparoscopic surgery after confirmation and admission with surgical team review within hours.","yes","Admission for surgical assessment within hours and possible laparoscopic surgery pending confirmation documented."],["Plans IV fluids, analgesia and antibiotics.","yes","'Start IV fluids, analgesia, and antibiotics.'"],["Encourages contacting family and provides reassurance.","partial","'Patient may contact family' recorded but reassurance given is not documented."]],"claims":[],"note":"Subjective\nAbdominal pain x ≥4 days, onset Sunday evening.\nPain initially upper abdomen; now localized to RLQ.\nGradual onset; initially dull, now sharp, 8/10.\nWorse with movement; no relieving factors reported.\nNo radiation to back or shoulders.\nReported fever overnight; measured temperature 38°C.\nVomiting x3, particularly after eating; anorexia.\nDenies diarrhoea or constipation; bowel motions normal.\nDenies dysuria or urinary frequency.\nObjective\nRLQ tenderness on palpation.\nRebound tenderness in RLQ.\nPain in RLQ with left-sided abdominal pressure; positive Rovsing’s sign.\nAssessment\nSuspected acute appendicitis.\nMigratory abdominal pain now localized to RLQ, fever, vomiting/anorexia, RLQ tenderness with rebound, and positive Rovsing’s sign are highly suggestive.\nPlan\nAdmit for urgent surgical assessment within hours.\nArrange CBC, CRP, and abdominal US and/or CT to confirm diagnosis.\nStart IV fluids, analgesia, and antibiotics.\nKeep NPO pending possible operative management.\nDiscussed possible laparoscopic surgery, pending confirmation and surgical team decision.\nPatient may contact family.","review":71.26315789473685,"saved":207.73684210526315,"clean":false,"effort":8.333333333333332,"sig":[],"mb":6.533421,"latency":13.206,"signable":84.46915789473685},{"label":"Run 5","wer":6.313645621181263,"text":"Bonjour madame. Je suis le docteur qui va vous prendre en charge aujourd'hui. Please have a seat. Understand you have had abdominal pain for at least 4 days?\n\n  Yes, doctor. It started on Sunday evening.\n\n  Okay. Can you tell me where the pain began exactly?\n\n  It was right here, in my upper belly. But now it's mostly down on the right side.\n\n  Je comprends. So it started in the upper abdomen, and moved to the right lower side. Is that—\n\n  Oui, docteur, effectivement.\n\n  Okay, okay. Was the pain sudden or gradual?\n\n  It was gradual, just a dull ache at first, but now it's sharp, about 8 out of 10.\n\n  Okay, okay. Et est-ce que la douleur se propage autre part, par exemple votre dos ou alors vos épaules?\n\n  No, doctor, it stays in the lower right.\n\n  Okay. Anything makes it better or worse?\n\n  Um, doctor, nothing really helps. Moving around makes it a bit worse.\n\n  Et avez-vous de la fièvre aussi?\n\n  Oui, docteur, j'ai fait de la fièvre la nuit dernière, et lorsque j'ai vérifié ma température, j'étais à 38 degrés.\n\n  Et qu'en est-il des nausées, ou alors du vomissement?\n\n  I've vomited 3 times, especially after eating. I have no appetite at all.\n\n  Okay. Any diarrhea, or de la constipation?\n\n  No, doctor. Bowel movements are normal.\n\n  Any burning when you pass urine? Or going more often?\n\n  Um, no, doctor. Tout est bon de ce côté.\n\n  Okay, okay. Je comprends. I'm going to press gently. You tell me when it's tender, okay?\n\n  Ow! That hurts right there.\n\n  Okay, okay. How about when I let go?\n\n  Worse, doctor. That really hurts.\n\n  Okay. Je vais aussi mettre un peu de pression sur le côté gauche. Let me know, okay?\n\n  Um, I feel pain on the right side when you do that.\n\n  Okay. You have tenderness. Gathering and rebound tenderness in your right lower abdomen. Also, a positive rough things sign. There are very suggestive of acute appendicite.\n\n  Doctor, but is it serious?\n\n  It can be, if not treated. The appendix may be inflamed. And cold rupture. We need to do blood work: CBC, CRP, and likely an abdominal ultrasound or CT. To confirm that.\n\n  Doctor, um, do I need surgery?\n\n  Euh, plus ou moins, plus ou moins. Laparoscopique. But we will confirm first. I'm going to start IV fluid. Pain relief and antibiotics. You should eat or drink anything now. In case we're going to operate you. Okay?\n\n  Okay, doctor. Should I call my family?\n\n  Oui, oui, oui. Allez-y, allez-y. C'est important. We will admit you and have the surgical team. To see within the hours. Donc, ils vont programmer si on va vous opérer et ils vont donner la période exacte de l'opération. D'accord?\n\n  D'accord, docteur. Merci beaucoup.\n\n  Okay. You're welcome, you're welcome. We'll take good care of you and rest assured. Ici avec nous, c'est la guérison assurée. Vous allez forcément trouver guérison et solution à votre problème. D'accord, madame?\n\n  D'accord, docteur.","marks":[[8,15,"madam",false],[65,77,"aujourd hui.",false],[690,692,"où",false],[780,782,"him",false],[926,930,"j ai",false],[978,982,"j ai",false],[1007,1014,"j étais",false],[1034,1039,"quand",false],[1060,1062,"où",false],[1069,1083,"les vomissements",false],[1185,1187,"où alors",false],[1311,1326,"Non docteur",false],[1361,1366,"Okey",false],[1582,1588,"",false],[1823,1828,"They",false],[1858,1880,"appendices. Dr.",false],[1965,1969,"could",false],[2111,2114,"",false],[2121,2123,"au",false],[2136,2138,"au",false],[2146,2161,"Laparoscopic.",false],[2293,2298,"we are",false],[2382,2386,"",false],[2405,2410,"c est",false],[2580,2614,"l opération d accord D accord",false],[2682,2687,"We",false],[2743,2748,"c est",false],[2838,2846,"D accord",false],[2859,2867,"D accord",false]],"facts":[["Records four days of abdominal pain beginning Sunday evening, initially upper abdominal then migrating to the right lower abdomen.","yes","'≥4 days; onset Sunday evening. Initially upper abdominal, migrated to RLQ.'"],["Records gradual onset, initially dull then sharp, currently 8/10.","yes","'Gradual onset; initially dull, now sharp, 8/10.'"],["Records pain worsened by movement, nothing relieving it, and no radiation to back or shoulder.","yes","'Worse with movement; no relieving factors. No radiation.'"],["Records fever last night with measured temperature 38 degrees, without inventing other measured vitals.","yes","'Reports fever overnight; home temperature 38°C' with no other vitals invented."],["Records three vomiting episodes especially after eating, and absent appetite.","yes","'N/V x3, particularly after eating; anorexia.'"],["Records normal bowel movements and denial of urinary burning or increased frequency.","yes","Denies diarrhoea, constipation, dysuria and frequency, capturing normal bowels and no urinary symptoms."],["Records right lower abdominal tenderness and rebound tenderness, and right-sided pain elicited by left abdominal pressure.","yes","RLQ tenderness, rebound, and 'left-sided pressure elicited right-sided pain' documented."],["Identifies suspected acute appendicitis and risk of rupture if untreated.","yes","Suspected acute appendicitis and 'risk of appendiceal rupture if untreated' documented."],["Plans CBC and CRP blood tests, with abdominal ultrasound or CT to confirm.","yes","'CBC and CRP; abdominal US and/or CT to confirm diagnosis.'"],["Discusses likely laparoscopic surgery after confirmation and admission with surgical team review within hours.","yes","Admission for surgical review within hours and possible laparoscopic surgery documented."],["Plans IV fluids, analgesia and antibiotics.","yes","'Start IV fluids, analgesia, and antibiotics.'"],["Encourages contacting family and provides reassurance.","no","Neither encouragement to contact family nor reassurance is documented."]],"claims":[],"note":"Subjective\nAbdominal pain x ≥4 days; onset Sunday evening.\nInitially upper abdominal, migrated to RLQ.\nGradual onset; initially dull, now sharp, 8/10.\nWorse with movement; no relieving factors. No radiation.\nReports fever overnight; home temperature 38°C.\nN/V x3, particularly after eating; anorexia.\nDenies diarrhoea, constipation, dysuria, and urinary frequency.\nObjective\nRLQ tenderness on palpation.\nRebound tenderness in RLQ.\nPositive Rovsing’s sign: left-sided pressure elicited right-sided pain.\nAssessment\nSuspected acute appendicitis.\nMigratory abdominal pain to RLQ with fever, vomiting/anorexia, RLQ tenderness, rebound tenderness, and positive Rovsing’s sign are suggestive of acute appendicitis.\nDiscussed potential risk of appendiceal rupture if untreated.\nPlan\nAdmit for urgent surgical review within hours.\nCBC and CRP; abdominal US and/or CT to confirm diagnosis.\nStart IV fluids, analgesia, and antibiotics.\nKeep NPO pending possible laparoscopic surgery.\nSurgical team to determine operative need and timing.","review":60.10526315789473,"saved":218.89473684210526,"clean":false,"effort":8.333333333333332,"sig":[],"mb":6.489308,"latency":15.498,"signable":75.60326315789473}],"heidi":[{"label":"Run 1","wer":12.219959266802444,"text":"Bonjour madame, je suis le docteur qui va vous prendre en charge aujourd'hui. So please have a seat. I understand you have had abdominal pain for at least four days ?\n\nYes, doctor. It started on Sunday evening. Okay. Can you tell me where the pain began exactly? It was right here in my upper belly, but now it's mostly down on the right side. So it started in the upper abdomen and moved to the right\n\nLower side. Is that- Right doctor, effectively now. Okay, okay. Was the pain sudden or gradual? It was gradual. Just a dull ache at first, but now it's sharp, about eight out of ten. Okay, okay. Et est-ce que la douleur se propage autre part ? Par exemple, votre dos ou alors, euh, vos épaules ? No, doctor. It stays in the lower right. Okay. Anything makes it better or worse? Mm, doctor, nothing really helps.\n\nMoving around makes it a bit worse. Et avez-vous de la fièvre aussi ? Oui docteur, j'ai fait de la fièvre la nuit dernière et lorsque j'ai vérifié ma température, j'étais à trente-huit degrés. Et qu'en est-il des nausées ou alors du vomissement ? I vomited three times, especially after eating. I have no appetite at all. OK. Any diarrhea ou alors euh, de la constipation ? No doctor. Bowel movements are normal.\n\nAny burning when you pass urine or going more often? Euh, none doctor. Tout est bon de ce côté. OK, OK. Je comprends. I'm going to press gently. You tell me when it's tender, OK ? Aouch ! That hurts right there. Mh. OK, OK. How about when I let go? Worse, doctor. That really hurts. OK. Je vais aussi, euh, mettre un peu de pression sur le côté gauche.\n\nLet me know, okay? Mm, I feel pain on the right side when you do that. Okay. You have tenderness, guarding, and rebound tenderness in your right lower abdomen. Also, a positive Rovsing's sign. They are very suggestive of acute appendicitis. Dr. Bert, is it serious? It can be if not treated.\n\nThe appendix may be inflamed and could rupture. We need to do blood work, CBC, CRP, and likely an abdominal ultrasound or CT to confirm that. Doctor, mm, do I need surgery? Eh, presumably, presumably laparoscopic. But we will confirm first. I'm going to start IV fluid.\n\nPain relief and antibiotics. You should eat or drink anything now in case we are going to operate you. OK? OK, doctor. Should I call my family? Oui, oui, oui. Allez-y, allez-y. C'est, c'est important. We will admit you and have the surgical team to see within the hours. Donc, ils vont programmer si on va vous opérer et ils vont donner la période exacte de l'opération. D'accord ?\n\nD'accord docteur. Merci beaucoup. OK. You're welcome. You're welcome. We'll take, euh, good care of you and, euh, rest assured ici avec nous, c'est la guérison assurée. Vous allez forcément trouver guérison et pro-- et solution à votre problème. D'accord, madame ? D'accord, docteur.","marks":[[8,14,"madam",false],[65,80,"aujourd hui.",false],[343,343,"Je comprends.",false],[418,454,"that Oui docteur effectivement.",false],[670,672,"où",false],[680,683,"",false],[761,763,"him",false],[899,903,"j ai",false],[950,954,"j ai",false],[979,986,"j étais",false],[989,1000,"38",false],[1012,1017,"quand",false],[1037,1039,"où",false],[1046,1064,"les vomissements I've",false],[1155,1157,"où",false],[1164,1167,"",false],[1283,1300,"Non docteur",false],[1326,1333,"Okay. Okey",false],[1405,1415,"Okay. Ow.",false],[1442,1453,"Okay. Okay.",false],[1532,1535,"",false],[1544,1550,"",false],[1682,1690,"gathering",false],[1761,1770,"rough things",false],[1811,1824,"appendices.",false],[1829,1833,"but",false],[2050,2076,"Plus au moins plus au moins",false],[2302,2306,"",false],[2325,2337,"c est",false],[2506,2539,"l opération d accord D accord",false],[2601,2606,"We",false],[2613,2616,"",false],[2640,2643,"",false],[2673,2678,"c est",false],[2741,2749,"",false],[2777,2785,"D accord",false],[2796,2804,"D accord",false]],"facts":[["Records four days of abdominal pain beginning Sunday evening, initially upper abdominal then migrating to the right lower abdomen.","partial","Four days and upper abdomen to RLQ migration recorded, but Sunday evening onset omitted."],["Records gradual onset, initially dull then sharp, currently 8/10.","partial","\"Gradual onset\" and \"Now sharp, 8/10\" recorded, but the initial dull character is omitted."],["Records pain worsened by movement, nothing relieving it, and no radiation to back or shoulder.","yes","\"Movement exacerbates pain; no relieving factors\"; \"No radiation to back or shoulders\"."],["Records fever last night with measured temperature 38 degrees, without inventing other measured vitals.","yes","\"Fever last night, temp 38°C\"; no other vitals invented."],["Records three vomiting episodes especially after eating, and absent appetite.","yes","\"Vomiting x3, particularly after eating; complete loss of appetite.\""],["Records normal bowel movements and denial of urinary burning or increased frequency.","yes","\"Bowel movements normal\"; \"No dysuria or increased urinary frequency.\""],["Records right lower abdominal tenderness and rebound tenderness, and right-sided pain elicited by left abdominal pressure.","yes","Tenderness and rebound tenderness in RLQ plus \"Positive Rovsing's sign\"."],["Identifies suspected acute appendicitis and risk of rupture if untreated.","yes","\"highly suggestive of acute appendicitis\"; \"at risk of rupture if untreated\"."],["Plans CBC and CRP blood tests, with abdominal ultrasound or CT to confirm.","yes","\"Bloods: FBC, CRP\" (FBC = CBC) and \"Abdominal ultrasound or CT to confirm diagnosis\"."],["Discusses likely laparoscopic surgery after confirmation and admission with surgical team review within hours.","yes","Laparoscopic surgery to confirm after investigations, admission, surgical review within hours."],["Plans IV fluids, analgesia and antibiotics.","yes","\"Commence IV fluids, analgesia and antibiotics.\""],["Encourages contacting family and provides reassurance.","partial","\"Encouraged to contact family\" recorded, but reassurance is not."]],"claims":[],"note":"Subjective\n\n- Gradual onset abdominal pain x4 days, beginning in upper abdomen and migrating to RLQ\n\n- Now sharp, 8/10\n\n- Movement exacerbates pain; no relieving factors\n\n- No radiation to back or shoulders\n\n- Fever last night, temp 38°C\n\n- Vomiting x3, particularly after eating; complete loss of appetite\n\n- Bowel movements normal; no diarrhoea or constipation\n\n- No dysuria or increased urinary frequency\n\n\n\n\nObjective\n\n- Abdominal exam: tenderness, guarding and rebound tenderness in RLQ\n\n- Positive Rovsing's sign\n\n\n\n\nAssessment\n\n- Findings highly suggestive of acute appendicitis\n\n- Appendix may be inflamed and at risk of rupture if untreated\n\n\n\n\nPlan\n\n- Bloods: FBC, CRP\n\n- Abdominal ultrasound or CT to confirm diagnosis\n\n- Presumed laparoscopic surgery; to confirm after investigations\n\n- Commence IV fluids, analgesia and antibiotics\n\n- NBM in preparation for potential surgery\n\n- Admission to hospital\n\n- Surgical team review within hours to schedule surgery and provide timeframe\n\n- Encouraged to contact family","review":85.14473684210526,"saved":193.85526315789474,"clean":false,"effort":12.5,"sig":[],"mb":33.655297,"latency":23.486,"signable":108.63073684210526},{"label":"Run 2","wer":12.627291242362526,"text":"Bonjour madame, je suis le docteur qui va vous prendre en charge aujourd'hui. Please have a seat. I understand you have had abdominal pain\n\nFor at least four days? Yes, doctor. It started on Sunday evening. Okay. Can you tell me where the pain began exactly? It was right here in my upper belly, but now it's mostly down on the right side.\n\nJe comprends. So it started in the upper abdomen and moved to the right lower side. Is that? Right, Doctor. Effectivement. OK, OK. Was the pain sudden or gradual? It was gradual. Just a dull ache at first, but now it's sharp, about eight out of ten. OK, OK. Et est-ce que la douleur se propage autre part ? Par exemple, votre dos ou alors, euh, vos épaules ? No, Doctor. It stays in the lower right. OK. Anything makes it better or worse?\n\nEuh, docteur, nothing really helps. Moving around makes it a bit worse. Et avez-vous de la fièvre aussi ? Oui docteur, j'ai fait de la fièvre la nuit dernière et lorsque j'ai vérifié ma température, j'étais à trente-huit degrés. Et qu'en est-il des nausées ou alors du vomissement ? I vomited three times, especially after eating. I have no appetite at all. OK. Any diarrhea ou alors, euh, de la constipation ? No, doctor.\n\nBowel movements are normal. Any burning when you pass urine or going more often? Mm, none, doctor. Tutto è buon, tutto è buon. Okay. Okay. Je comprends. I'm going to press gently. You tell me when it's tender, okay? Ow! That hurts right there. Mm. Okay. Okay. How about when I let go? Worse, doctor. That really hurts. Okay. Je vais aussi, euh...\n\nmettre un peu de pression sur le côté gauche. Let me know, okay? Euh, I feel pain on the right side when you do that. Ok. You have tenderness, gathering and rebound tenderness in your right lower abdomen. Also a positive Rovsing's sign. They are very suggestive of acute appendicitis. Doctor Bert, is it serious?\n\nIt can be if not treated. The appendix may be inflamed and could rupture. We need to do blood work, CBC, CRP, and likely an abdominal ultrasound or CT to confirm that. Doctor, um, do I need surgery? Uh, plus or minus, plus or minus laparoscopic. But we will confirm first. I'm going to start IV fluid.\n\nPain relief and antibiotics. You should eat or drink anything now in case we're going to operate you. OK? OK, doctor. Should I call my family? Oui, oui, oui. Allez-y, allez-y. C'est, c'est important. We will admit you and have the surgical team to see within the hours. Donc, ils vont programmer si on va vous opérer et ils vont donner la période exacte de l'opération. D'accord ?\n\nD'accord docteur. Merci beaucoup. OK. You're welcome. You're welcome. We'll take, euh, good care of you and, euh, rest assured. Ici avec nous, c'est la guérison assurée. Vous allez forcément trouver guérison et pro-- et solution à votre problème. D'accord, madame ? D'accord, docteur.","marks":[[8,14,"madam",false],[65,77,"aujourd hui.",false],[434,448,"Oui docteur",false],[671,673,"où",false],[681,684,"",false],[760,762,"him",false],[781,793,"Doctor",false],[900,904,"j ai",false],[951,955,"j ai",false],[980,987,"j étais",false],[990,1001,"38",false],[1013,1018,"quand",false],[1038,1040,"où",false],[1047,1065,"les vomissements I've",false],[1156,1158,"où",false],[1166,1169,"",false],[1286,1331,"Non docteur tout est bon de ce côté.",false],[1338,1343,"Okey",false],[1545,1551,"",false],[1560,1566,"",false],[1618,1624,"",false],[1774,1783,"rough things",false],[1824,1849,"appendices. Dr. but",false],[2075,2083,"au moins",false],[2090,2098,"au moins",false],[2244,2249,"we are",false],[2323,2327,"",false],[2346,2358,"c est",false],[2527,2560,"l opération d accord D accord",false],[2622,2627,"We",false],[2634,2637,"",false],[2661,2664,"",false],[2695,2700,"c est",false],[2763,2771,"",false],[2799,2807,"D accord",false],[2818,2826,"D accord",false]],"facts":[["Records four days of abdominal pain beginning Sunday evening, initially upper abdominal then migrating to the right lower abdomen.","partial","Records onset \"since Sunday evening\" and upper abdomen moving to RLQ, but does not state the four-day duration."],["Records gradual onset, initially dull then sharp, currently 8/10.","yes","\"Gradual onset\", \"Initially dull ache... now sharp, 8/10\"."],["Records pain worsened by movement, nothing relieving it, and no radiation to back or shoulder.","partial","\"Exacerbated by movement\" and \"No radiation\" recorded, but nothing relieving it is omitted."],["Records fever last night with measured temperature 38 degrees, without inventing other measured vitals.","yes","\"Fever 38°C last night\" with no other invented vitals."],["Records three vomiting episodes especially after eating, and absent appetite.","yes","\"Vomiting x3, particularly post-prandial\" and \"Loss of appetite\"."],["Records normal bowel movements and denial of urinary burning or increased frequency.","yes","\"Normal bowel movements\" and \"No dysuria or increased urinary frequency\"."],["Records right lower abdominal tenderness and rebound tenderness, and right-sided pain elicited by left abdominal pressure.","yes","\"Tenderness RLQ\", \"Rebound tenderness RLQ\", \"Positive Rovsing's sign\"."],["Identifies suspected acute appendicitis and risk of rupture if untreated.","partial","\"highly suggestive of acute appendicitis\" but no mention of rupture risk if untreated."],["Plans CBC and CRP blood tests, with abdominal ultrasound or CT to confirm.","yes","\"FBC, CRP; abdominal ultrasound or CT to confirm diagnosis\" (FBC equivalent to CBC)."],["Discusses likely laparoscopic surgery after confirmation and admission with surgical team review within hours.","yes","\"Admit\" and \"Surgical team review within hours... (laparoscopic appendectomy +/-)\" after confirmatory imaging."],["Plans IV fluids, analgesia and antibiotics.","yes","\"IV fluids\", \"Analgesia\", \"Antibiotics\"."],["Encourages contacting family and provides reassurance.","partial","\"Advised to contact family\" captured; reassurance not recorded."]],"claims":[],"note":"Subjective\n\n- Gradual onset abdominal pain since Sunday evening.\n\n- Initially dull ache in upper abdomen, now sharp, 8/10, localised to RLQ.\n\n- Exacerbated by movement.\n\n- No radiation.\n\n- Fever 38°C last night.\n\n- Vomiting x3, particularly post-prandial.\n\n- Loss of appetite.\n\n- Normal bowel movements.\n\n- No dysuria or increased urinary frequency.\n\n\n\n\nObjective\n\n- Abdominal exam:\n\n  - Tenderness RLQ.\n\n  - Guarding RLQ.\n\n  - Rebound tenderness RLQ.\n\n  - Positive Rovsing's sign.\n\n\n\n\nAssessment\n\n- Clinical presentation highly suggestive of acute appendicitis.\n\n\n\n\nPlan\n\n- Admit for further management.\n\n- IV fluids.\n\n- Analgesia.\n\n- Antibiotics.\n\n- NBM in preparation for potential surgery.\n\n- Investigations: FBC, CRP; abdominal ultrasound or CT to confirm diagnosis.\n\n- Surgical team review within hours for assessment and surgical planning (laparoscopic appendectomy +/-).\n\n- Advised to contact family.","review":92.55263157894737,"saved":186.44736842105263,"clean":false,"effort":16.666666666666664,"sig":[],"mb":29.963303,"latency":28.073,"signable":120.62563157894738},{"label":"Run 3","wer":11.405295315682281,"text":"Bonjour madame, je suis le docteur qui va vous prendre en charge aujourd'hui. Please have a seat. I understand\n\nYou have had abdominal pain for at least four days? Yes, doctor. It started on Sunday evening. Okay. Can you tell me where the pain began exactly? It was right here in my upper belly, but now\n\nIt's mostly down on the right side Je comprends. So it started in the upper abdomen and moved to the right lower side. Is that- Right doctor. Effectivement Okay. Okay. Was the pain sudden or gradual? It was gradual. Just a dull ache at first, but now it's sharp. About eight out of 10. Okay. Okay. Et est-ce que la douleur se propage autre part? Par exemple, votre dos ou alors, euh, vos épaules? No, doctor. It stays in the lower right\n\nOkay. Anything makes it better or worse? Hmm, doctor, nothing really helps. Moving around makes it a bit worse. Et avez-vous de la fièvre aussi? Oui, docteur. J'ai fait de la fièvre la nuit dernière et lorsque j'ai vérifié ma température, j'étais à trente-huit degrés. Et qu'en est-il des nausées ou alors du vomissement? I vomited three times, especially after eating. I have no appetite at all. Okay. Any diarrhea?\n\nOu alors, euh, de la constipation? No, doctor. Bowel movements are normal. Any burning when you pass urine or going more often? Mmh. Non, docteur. Tout est bon de ce côté. Ok, ok. Je comprends. I'm going to press gently. You tell me when it's tender, OK? Aww, that hurts right there. Mmh. Ok, ok. How about when I let go?\n\nWorse, doctor. That really hurts. Okay. Je vais aussi, euh, mettre un peu de pression sur le côté gauche. Let me know, okay? Hmm, I feel pain on the right side when you do that. Okay. You have tenderness, gathering and rebound tenderness in your right lower abdomen. Also, a positive Rovsing's sign. They are very suggestive of acute appendicitis\n\nDr. Bert, is it serious? It can be if not treated. The appendix may be inflamed and could rupture. We need to do blood work, CBC, CRP, and likely an abdominal ultrasound or CT to confirm that. Doctor, um, do I need surgery? Eh, please hold on, please hold on.\n\nLaparoscopic. But we will confirm first. I'm going to start IV fluid, pain relief and antibiotics. You shouldn't eat or drink anything now in case we're going to operate you. Okay? Okay, doctor. Should I call my family? Uh, oui, oui, oui. フランス語 We will admit you and have the surgical team to see\n\nWithin the hours. Donc, ils vont programmer si on va vous opérer et ils vont donner la période exacte de l'opération. D'accord ? D'accord, docteur. Merci beaucoup. Ok. You're welcome. You're welcome. We take uh, good care of you and uh, rest assured. Ici, avec nous, c'est la guérison assurée. Vous allez forcément trouver guérison et pro-- et solution à votre problème. D'accord, madame ? D'accord, docteur.","marks":[[8,14,"madam",false],[65,77,"aujourd hui.",false],[427,446,"that Oui docteur",false],[674,676,"où",false],[684,687,"",false],[764,766,"him",false],[902,906,"j ai",false],[953,957,"j ai",false],[982,989,"j étais",false],[992,1003,"38",false],[1015,1020,"quand",false],[1040,1042,"où",false],[1049,1066,"les vomissements I've",false],[1161,1163,"où",false],[1171,1174,"",false],[1289,1293,"",false],[1333,1340,"Okay. Okey",false],[1412,1419,"Okay. Ow.",false],[1445,1457,"Okay. Okay.",false],[1539,1542,"",false],[1551,1557,"",false],[1768,1777,"rough things",false],[1818,1830,"appendices.",false],[1836,1840,"but",false],[2056,2091,"Plus au moins plus au moins",false],[2196,2205,"should",false],[2240,2245,"we are",false],[2327,2337,"allez-y allez-y c est important.",false],[2496,2528,"l opération d accord D accord",false],[2658,2663,"c est",false],[2726,2734,"",false],[2762,2770,"D accord",false],[2781,2789,"D accord",false]],"facts":[["Records four days of abdominal pain beginning Sunday evening, initially upper abdominal then migrating to the right lower abdomen.","yes","\"Abdominal pain x4 days, commenced Sunday evening\"; began upper abdomen, now right lower side."],["Records gradual onset, initially dull then sharp, currently 8/10.","yes","\"Gradual onset, initially dull ache, now sharp, rated 8/10\"."],["Records pain worsened by movement, nothing relieving it, and no radiation to back or shoulder.","yes","\"Movement exacerbates pain; nothing relieves\" and \"No radiation to back or shoulders\"."],["Records fever last night with measured temperature 38 degrees, without inventing other measured vitals.","yes","\"Fever last night, temp 38°C\" with no other vitals invented."],["Records three vomiting episodes especially after eating, and absent appetite.","yes","\"Vomited x3, particularly after eating; no appetite\"."],["Records normal bowel movements and denial of urinary burning or increased frequency.","yes","\"Bowels normal\" and \"Denies dysuria or increased urinary frequency\"."],["Records right lower abdominal tenderness and rebound tenderness, and right-sided pain elicited by left abdominal pressure.","yes","Right lower tenderness with rebound and positive Rovsing's sign."],["Identifies suspected acute appendicitis and risk of rupture if untreated.","yes","\"highly suggestive of acute appendicitis\" and \"at risk of rupture if untreated\"."],["Plans CBC and CRP blood tests, with abdominal ultrasound or CT to confirm.","yes","\"Bloods: FBC, CRP\" and \"abdominal ultrasound or CT to confirm diagnosis\"."],["Discusses likely laparoscopic surgery after confirmation and admission with surgical team review within hours.","partial","Admission and surgical review for potential laparoscopic appendicectomy, but 'within hours' is omitted."],["Plans IV fluids, analgesia and antibiotics.","yes","\"Commence IV fluids\", \"Administer analgesia\", \"Commence antibiotics\"."],["Encourages contacting family and provides reassurance.","partial","States \"Family notified\" rather than patient encouraged to call family; no reassurance recorded."]],"claims":[["Family notified of admission and potential surgery","Transcript only has the doctor telling the patient to go ahead and call her family; no notification is recorded as having occurred."]],"note":"Subjective\n\n- Abdominal pain x4 days, commenced Sunday evening\n\n- Pain began in upper abdomen, now localised to right lower side\n\n- Gradual onset, initially dull ache, now sharp, rated 8/10\n\n- No radiation to back or shoulders\n\n- Movement exacerbates pain; nothing relieves\n\n- Fever last night, temp 38°C\n\n- Vomited x3, particularly after eating; no appetite\n\n- Bowels normal\n\n- Denies dysuria or increased urinary frequency\n\n\n\n\nObjective\n\n- Tenderness, guarding and rebound tenderness in right lower abdomen\n\n- Positive Rovsing's sign\n\n\n\n\nAssessment\n\n- Findings highly suggestive of acute appendicitis\n\n- Appendix may be inflamed and at risk of rupture if untreated\n\n\n\n\nPlan\n\n- Admit for further management\n\n- Commence IV fluids\n\n- Administer analgesia\n\n- Commence antibiotics\n\n- NBM in anticipation of potential surgery\n\n- Bloods: FBC, CRP\n\n- Imaging: abdominal ultrasound or CT to confirm diagnosis\n\n- Surgical team review to determine timing for potential laparoscopic appendicectomy\n\n- Family notified of admission and potential surgery","review":80.89473684210526,"saved":198.10526315789474,"clean":false,"effort":16.666666666666664,"sig":[],"mb":29.104869,"latency":40.373,"signable":121.26773684210525},{"label":"Run 4","wer":14.25661914460285,"text":"Bonjour madame, je suis le docteur qui va vous prendre en charge aujourd'hui. So please have a seat. I understand you have had abdominal pain for at least four days\n\nYes, doctor. It started on Sunday evening. Okay. Can you tell me where the pain began exactly? It was right here in my upper belly, but now it's mostly down on the right side. So it started in the upper abdomen and moved to the right\n\nLower side. Is that- Right doctor. Effective now. Okay. Okay. Was the pain sudden or gradual? It was gradual. Just a dull ache at first, but now it's sharp, about eight out of ten. Okay. Okay. No, doctor. It stays in the lower right. Okay. Anything makes it better or worse? Mm, doctor, nothing really helps.\n\nMoving around makes it a bit worse. Et avez-vous de la fièvre aussi ? Oui docteur, j'ai fait de la fièvre la nuit dernière et lorsque j'ai vérifié ma température, j'étais à 38 degrés. Et qu'en est-il des nausées ou alors du vomissement ? I vomited three times, especially after eating. I have no appetite at all. OK. Any diarrhea ou alors, euh, de la constipation ? No doctor. Bowel movements are normal.\n\nAny burning when you pass urine or going more often? Euh, non, docteur. Tout est bon de ce côté. OK, OK. Je comprends. I'm going to press gently. You tell me when it's tender, OK ? Aouch ! That hurts right there. Mh. OK, OK. How about when I let go ? Worse, docteur. That really hurts. OK. Je vais aussi, euh, mettre un peu de pression sur le côté gauche.\n\nLet me know, okay? Mm, I feel pain on the right side when you do that. Okay. You have tenderness, guarding, and rebound tenderness in your right lower abdomen. Also, a positive Rovsing's sign. They are very suggestive of acute appendicitis. Dr. Berg, is it serious? It can be if not treated.\n\nThe appendix may be inflamed and could rupture. We need to do blood work, CBC, CRP, and likely an abdominal ultrasound or CT to confirm that. Doctor, mm, do I need surgery? Eh, plus or moins, plus or moins. Laparoscopic. But we will confirm first. I'm going to start IV fluid.\n\nPain relief and antibiotics. You should eat or drink anything now in case we are going to operate you. OK? OK, doctor. Should I call my family? Oui, oui, oui. Allez-y, allez-y. C'est, c'est important. We will admit you and have the surgical team to see within the hours. Donc, ils vont programmer si on va vous opérer et ils vont donner la période exacte de l'opération. D'accord ?\n\nD'accord docteur. Merci beaucoup. OK. You're welcome. You're welcome. We'll take, euh, good care of you and, euh, rest assured, ici avec nous, c'est la guérison assurée. Vous allez forcément trouver guérison et pro-- et solution à votre problème. D'accord, madame ? D'accord, docteur.","marks":[[8,14,"madam",false],[65,80,"aujourd hui.",false],[341,341,"Je comprends.",false],[416,450,"that Oui docteur effectivement.",false],[593,593,"Et est-ce que la douleur se propage autre part Par exemple votre dos où alors vos épaules",false],[656,658,"him",false],[794,798,"j ai",false],[845,849,"j ai",false],[874,881,"j étais",false],[898,903,"quand",false],[923,925,"où",false],[932,950,"les vomissements I've",false],[1041,1043,"où",false],[1051,1054,"",false],[1170,1173,"",false],[1214,1221,"Okay. Okey",false],[1293,1303,"Okay. Ow.",false],[1330,1341,"Okay. Okay.",false],[1375,1383,"Doctor",false],[1422,1425,"",false],[1434,1440,"",false],[1572,1580,"gathering",false],[1651,1660,"rough things",false],[1701,1714,"appendices.",false],[1719,1723,"but",false],[1940,1942,"",false],[1949,1951,"au",false],[1964,1966,"au",false],[2199,2203,"",false],[2222,2234,"c est",false],[2403,2436,"l opération d accord D accord",false],[2498,2503,"We",false],[2510,2513,"",false],[2537,2540,"",false],[2571,2576,"c est",false],[2639,2647,"",false],[2675,2683,"D accord",false],[2694,2702,"D accord",false]],"facts":[["Records four days of abdominal pain beginning Sunday evening, initially upper abdominal then migrating to the right lower abdomen.","yes","\"Abdominal pain x4 days, commenced Sunday evening\", upper abdomen now RLQ."],["Records gradual onset, initially dull then sharp, currently 8/10.","yes","\"Gradual onset, dull ache initially, now sharp, rated 8/10\"."],["Records pain worsened by movement, nothing relieving it, and no radiation to back or shoulder.","partial","Aggravated by movement and nothing relieves recorded; no radiation not mentioned."],["Records fever last night with measured temperature 38 degrees, without inventing other measured vitals.","yes","\"Fever last night, temp 38°C\"."],["Records three vomiting episodes especially after eating, and absent appetite.","yes","Vomiting x3 post-prandial and loss of appetite."],["Records normal bowel movements and denial of urinary burning or increased frequency.","yes","Bowel movements normal; no dysuria or frequency."],["Records right lower abdominal tenderness and rebound tenderness, and right-sided pain elicited by left abdominal pressure.","yes","RLQ tenderness, rebound tenderness and positive Rovsing sign."],["Identifies suspected acute appendicitis and risk of rupture if untreated.","partial","Acute appendicitis identified but rupture risk not recorded."],["Plans CBC and CRP blood tests, with abdominal ultrasound or CT to confirm.","yes","FBC (CBC), CRP and abdominal USS or CT."],["Discusses likely laparoscopic surgery after confirmation and admission with surgical team review within hours.","yes","Admit, surgical review within hours, potential laparoscopic appendectomy."],["Plans IV fluids, analgesia and antibiotics.","yes","IV fluids, analgesia, antibiotics."],["Encourages contacting family and provides reassurance.","partial","Advice to contact family recorded but no reassurance documented."]],"claims":[],"note":"Subjective\n\n- Abdominal pain x4 days, commenced Sunday evening\n\n- Initially upper abdomen, now predominantly RLQ\n\n- Gradual onset, dull ache initially, now sharp, rated 8/10\n\n- Aggravated by movement, nothing relieves\n\n- Fever last night, temp 38°C\n\n- Vomiting x3, particularly post-prandial\n\n- Loss of appetite\n\n- Bowel movements normal\n\n- No dysuria or increased urinary frequency\n\n\n\n\nObjective\n\n- Tenderness, guarding and rebound tenderness in RLQ\n\n- Positive Rovsing's sign\n\n\n\n\nAssessment\n\n- Findings highly suggestive of acute appendicitis\n\n\n\n\nPlan\n\n- IV fluids\n\n- Analgesia\n\n- Antibiotics\n\n- NBM for potential surgery\n\n- Urgent bloods: FBC, CRP\n\n- Urgent abdominal USS or CT\n\n- Admit\n\n- Surgical team review within hours for assessment and potential laparoscopic appendectomy\n\n- Advised to contact family","review":71.40789473684211,"saved":207.5921052631579,"clean":false,"effort":12.5,"sig":[],"mb":34.270003,"latency":24.726,"signable":96.13389473684211},{"label":"Run 5","wer":15.071283095723015,"text":"Bonjour madame, je suis le docteur qui va vous prendre en charge aujourd'hui. Please have a seat. I understand\n\nYou have had abdominal pain for at least four days? Yes, doctor. It started on Sunday evening. Okay. Can you tell me where the pain began exactly? It was right here in my upper belly, but now\n\nIt's mostly down on the right side. You comprend. So it started in the upper abdomen and moved to the right lower side. Is that- Right doctor. Effectivement Okay. Okay. Was the pain sudden or gradual? It was gradual. Just a dull ache at first, but now it's sharp, about eight out of ten. Okay. Okay. No, doctor. It stays in the lower right.\n\nOkay. Anything makes it better or worse? Hmm, doctor, nothing really helps. Moving around makes it a bit worse. Et avez-vous de la fièvre aussi ? Oui, docteur. J'ai fait de la fièvre la nuit dernière et lorsque j'ai vérifié ma température, j'étais à trente-huit degrés. Et qu'en est-il des nausées ou alors du vomissement ? I vomited three times, especially after eating. I have no appetite at all. Okay. Any diarrhea?\n\nOu alors, euh, de la constipation? No, doctor. Bowel movements are normal. Any burning when you pass urine or going more often? Mmh. Non, docteur. Tout est bon de ce côté. Ok, ok. Je comprends. I'm going to press gently. You tell me when it's tender, OK? Aww, that hurts right there. Mmh. Ok, ok. How about when I let go?\n\nWorse, doctor. That really hurts. Okay. Je vais aussi, euh, mettre un peu de pression sur le côté gauche. Let me know, okay? Hmm. I feel pain on the right side when you do that. Hmm, okay. You have tenderness, gathering and rebound tenderness in your right lower abdomen. Also, a positive Rovsing's sign. They are very suggestive of acute appendicitis\n\nDr. Burke, is it serious? It can be if not treated. The appendix may be inflamed and could rupture. We need to do blood work, CBC, CRP, and likely an abdominal ultrasound or CT to confirm that. Doctor, mm, do I need surgery? Eh, presume one, presume one.\n\nLaparoscopic. But we will confirm first. I'm going to start IV fluid, pain relief and antibiotics. You shouldn't eat or drink anything now in case we're going to operate you. Okay? Okay, doctor. Should I call my family? Uh, oui, oui, oui. We will admit you and have the surgical team to see\n\nWithin the hours. Donc, ils vont programmer si on va vous opérer et ils vont donner la période exacte de l'opération. D'accord ? D'accord, docteur. Merci beaucoup. Ok. You're welcome. You're welcome. We take uh good care of you and uh rest assured. Ici, avec nous, c'est la guérison assurée. Vous allez forcément trouver guérison et pro-- et solution à votre problème. D'accord, madame ? D'accord, docteur.","marks":[[8,14,"madam",false],[65,77,"aujourd hui.",false],[341,354,"Je comprends.",false],[428,447,"that Oui docteur",false],[604,604,"Et est-ce que la douleur se propage autre part Par exemple votre dos où alors vos épaules",false],[668,670,"him",false],[807,811,"j ai",false],[858,862,"j ai",false],[887,894,"j étais",false],[897,908,"38",false],[920,925,"quand",false],[945,947,"où",false],[954,972,"les vomissements I've",false],[1067,1069,"où",false],[1077,1080,"",false],[1195,1199,"",false],[1239,1246,"Okay. Okey",false],[1318,1325,"Okay. Ow.",false],[1351,1363,"Okay. Okay.",false],[1445,1448,"",false],[1457,1463,"",false],[1679,1688,"rough things",false],[1729,1741,"appendices.",false],[1747,1752,"but",false],[1968,1997,"Plus au moins plus au moins",false],[2102,2111,"should",false],[2146,2151,"we are",false],[2233,2237,"allez-y allez-y c est important.",false],[2396,2428,"l opération d accord D accord",false],[2556,2561,"c est",false],[2624,2632,"",false],[2660,2668,"D accord",false],[2679,2687,"D accord",false]],"facts":[["Records four days of abdominal pain beginning Sunday evening, initially upper abdominal then migrating to the right lower abdomen.","yes","'Abdominal pain x 4 days, commencing Sunday evening', upper abdomen now RLQ."],["Records gradual onset, initially dull then sharp, currently 8/10.","partial","'Initially dull ache... now sharp... 8/10' but gradual onset not explicitly stated."],["Records pain worsened by movement, nothing relieving it, and no radiation to back or shoulder.","partial","'Not alleviated by anything; exacerbated by movement' but no radiation to back/shoulder omitted."],["Records fever last night with measured temperature 38 degrees, without inventing other measured vitals.","yes","'Fever last night, temp 38°C' with no invented vitals."],["Records three vomiting episodes especially after eating, and absent appetite.","yes","'vomiting x 3, post-prandial' and 'Loss of appetite'."],["Records normal bowel movements and denial of urinary burning or increased frequency.","yes","'Bowel motions normal' and 'No dysuria or increased urinary frequency'."],["Records right lower abdominal tenderness and rebound tenderness, and right-sided pain elicited by left abdominal pressure.","yes","RLQ tenderness and rebound tenderness plus 'Positive Rovsing's sign'."],["Identifies suspected acute appendicitis and risk of rupture if untreated.","partial","Acute appendicitis identified but risk of rupture not mentioned."],["Plans CBC and CRP blood tests, with abdominal ultrasound or CT to confirm.","yes","'Bloods: FBC, CRP' and 'abdominal ultrasound or CT to confirm diagnosis'."],["Discusses likely laparoscopic surgery after confirmation and admission with surgical team review within hours.","yes","Admission, surgical team 'within hours', 'consideration of laparoscopic appendectomy'."],["Plans IV fluids, analgesia and antibiotics.","yes","'IV fluids', 'Analgesia', 'Commence antibiotics'."],["Encourages contacting family and provides reassurance.","no","Neither contacting family nor reassurance is recorded."]],"claims":[],"note":"Subjective\n\n- Abdominal pain x 4 days, commencing Sunday evening.\n\n- Initially dull ache in upper abdomen, now sharp and localised to RLQ, rated 8/10.\n\n- Not alleviated by anything; exacerbated by movement.\n\n- Fever last night, temp 38°C.\n\n- Nausea and vomiting x 3, post-prandial.\n\n- Loss of appetite.\n\n- Bowel motions normal; no diarrhoea or constipation.\n\n- No dysuria or increased urinary frequency.\n\n\n\n\nObjective\n\n- Abdominal exam: tenderness, guarding and rebound tenderness in RLQ.\n\n- Positive Rovsing's sign.\n\n\n\n\nAssessment\n\n- Clinical presentation highly suggestive of acute appendicitis.\n\n\n\n\nPlan\n\n- IV fluids.\n\n- Analgesia.\n\n- Commence antibiotics.\n\n- NBM in preparation for potential surgery.\n\n- Bloods: FBC, CRP.\n\n- Imaging: abdominal ultrasound or CT to confirm diagnosis.\n\n- Referral to surgical team for assessment within hours for consideration of laparoscopic appendectomy.\n\n- Admission for ongoing care and definitive management.","review":94.72368421052632,"saved":184.2763157894737,"clean":false,"effort":20.833333333333336,"sig":[],"mb":29.332127,"latency":25.072,"signable":119.79568421052632},{"label":"Run 6","wer":11.405295315682281,"text":"Bonjour madame, je suis le docteur qui va vous prendre en charge aujourd'hui. So please have a seat. I understand you have had abdominal pain for at least four days\n\nYes, doctor. It started on Sunday evening. Okay. Can you tell me where the pain began exactly? It was right here in my upper belly, but now it's mostly down on the right side. You confirm. So it started in the upper abdomen and moved to the right\n\nLower side. Is that- Right Doctor, if that you remember Okay, okay. Was the pain sudden or gradual? It was gradual. Just a dull ache at first, but now it's sharp, about eight out of ten. Okay, okay. Et est-ce que la douleur se propage autre part? Par exemple, votre dos ou alors, euh, vos épaules? No, doctor. It stays in the lower right. Okay. Anything makes it better or worse? Mm, doctor, nothing really helps\n\nMoving around makes it a bit worse. Et avez-vous de la fièvre aussi ? Oui, docteur. J'ai fait de la fièvre la nuit dernière et lorsque j'ai vérifié ma température, j'étais à 38 degrés. Et qu'en est-il des nausées ou alors du vomissement ? I vomited three times, especially after eating. I have no appetite at all. OK. Any diarrhea ou alors, euh, de la constipation ? No, doctor. Bowel movements are normal.\n\nAny burning when you pass urine or going more often? Mh, non, docteur. Tout est bon de ce côté. OK, OK. Je comprends. I'm going to press gently. You tell me when it's tender, OK ? Aouch! That hurts right there. Mh, OK, OK. How about when I let go? Worse, doctor. That really hurts. OK. Je vais aussi, euh, mettre un peu de pression sur le côté gauche.\n\nLet me know, okay? Mm, I feel pain on the right side when you do that. Mm, okay. You have tenderness, gathering and rebound tenderness in your right lower abdomen. Also a positive Rovsing's sign. They are very suggestive of acute appendicitis. Dr. Bert, is it serious? It can be if not treated.\n\nThe appendix may be inflamed and could rupture. We need to do blood work, CBC, CRP, and likely an abdominal ultrasound or CT to confirm that. Doctor, um, do I need surgery? Uh, plus or minus, plus or minus. Laparoscopic. But we will confirm first. I'm going to start IV fluid.\n\nPain relief and antibiotics. You should eat or drink anything now in case we are going to operate you. OK? OK, doctor. Should I call my family? Oui, oui, oui. Allez-y, allez-y. C'est, c'est important. We will admit you and have the surgical team to see within the hours. Donc, ils vont programmer si on va vous opérer et ils vont donner la période exacte de l'opération. D'accord ?\n\nD'accord docteur. Merci beaucoup. OK. You're welcome. You're welcome. We take, euh, good care of you and, euh, rest assured. Ici avec nous, c'est la guérison assurée. Vous allez forcément trouver guérison et pro-- et solution à votre problème. D'accord, madame ? D'accord, docteur.","marks":[[8,14,"madam",false],[65,80,"aujourd hui.",false],[342,354,"Je comprends.",false],[429,451,"",false],[457,469,"Oui docteur effectivement.",false],[684,686,"où",false],[694,697,"",false],[774,776,"him",false],[912,916,"j ai",false],[963,967,"j ai",false],[992,999,"j étais",false],[1016,1021,"quand",false],[1041,1043,"où",false],[1050,1068,"les vomissements I've",false],[1159,1161,"où",false],[1169,1172,"",false],[1289,1291,"",false],[1332,1339,"Okay. Okey",false],[1411,1421,"Okay. Ow.",false],[1447,1458,"Okay. Okay.",false],[1537,1540,"",false],[1549,1555,"",false],[1769,1778,"rough things",false],[1819,1832,"appendices.",false],[1837,1841,"but",false],[2067,2075,"au moins",false],[2082,2091,"au moins",false],[2317,2321,"",false],[2340,2352,"c est",false],[2521,2554,"l opération d accord D accord",false],[2625,2628,"",false],[2652,2655,"",false],[2686,2691,"c est",false],[2754,2762,"",false],[2790,2798,"D accord",false],[2809,2817,"D accord",false]],"facts":[["Records four days of abdominal pain beginning Sunday evening, initially upper abdominal then migrating to the right lower abdomen.","yes","x4 days from Sunday evening, upper abdomen now RIF."],["Records gradual onset, initially dull then sharp, currently 8/10.","partial","Dull then sharp, 8/10 recorded but gradual onset not stated."],["Records pain worsened by movement, nothing relieving it, and no radiation to back or shoulder.","partial","No radiation and worse with movement recorded; lack of relieving factors omitted."],["Records fever last night with measured temperature 38 degrees, without inventing other measured vitals.","yes","\"Fever last night, temp 38°C\"."],["Records three vomiting episodes especially after eating, and absent appetite.","yes","Vomiting x3 after eating; no appetite."],["Records normal bowel movements and denial of urinary burning or increased frequency.","yes","Bowels normal; no dysuria or frequency."],["Records right lower abdominal tenderness and rebound tenderness, and right-sided pain elicited by left abdominal pressure.","yes","RIF tenderness, rebound tenderness, positive Rovsing sign."],["Identifies suspected acute appendicitis and risk of rupture if untreated.","partial","Acute appendicitis identified but rupture risk not recorded."],["Plans CBC and CRP blood tests, with abdominal ultrasound or CT to confirm.","yes","\"Ix: FBC, CRP, abdominal US or CT\"."],["Discusses likely laparoscopic surgery after confirmation and admission with surgical team review within hours.","yes","Admission, surgical review within hours, likely laparoscopic appendicectomy if confirmed."],["Plans IV fluids, analgesia and antibiotics.","yes","IV fluids, pain relief, antibiotics."],["Encourages contacting family and provides reassurance.","partial","\"Family to be informed\" recorded; no reassurance documented."]],"claims":[],"note":"Subjective\n\n- Abdominal pain x4 days, commenced Sunday evening\n\n- Initially dull ache in upper abdomen, now sharp and localised to RIF, severity 8/10\n\n- No radiation to back or shoulders\n\n- Worsened by movement\n\n- Fever last night, temp 38°C\n\n- Vomiting x3, particularly after eating; no appetite\n\n- Bowels normal, no diarrhoea or constipation\n\n- No dysuria or increased urinary frequency\n\n\n\n\nObjective\n\n- Abdominal exam: tenderness, guarding and rebound tenderness in RIF\n\n- Positive Rovsing's sign\n\n\n\n\nAssessment\n\n- Clinical findings highly suggestive of acute appendicitis\n\n\n\n\nPlan\n\n- IV fluids commenced\n\n- Pain relief administered\n\n- Antibiotics commenced\n\n- NBM in preparation for potential surgery\n\n- Ix: FBC, CRP, abdominal US or CT\n\n- Admission to hospital\n\n- Surgical team review within hours for assessment and surgical planning (likely laparoscopic appendicectomy if confirmed)\n\n- Family to be informed","review":89.59210526315789,"saved":189.4078947368421,"clean":false,"effort":16.666666666666664,"sig":[],"mb":34.012023,"latency":25.762,"signable":115.35410526315789}],"freed":[{"label":"Run 1","wer":26.476578411405292,"text":"Bonjour madame, je suis le docteur qui va vous prendre en charge aujourd 'hui. Please have a seat. I understand you have had abdominal pain for at least 4 days?\n  Yes doctor, it started on Sunday evening.\n  Okay, can you tell me where the pain began exactly?\n  It was right here in my upper belly. It's mostly down on the right side.\n  So it started in the upper abdomen and moved to the right lower side.\n  Was the pain sudden or gradual? It was gradual, just a dull ache at first, but now it's sharp, about 8 out of 10.\n  Does the pain spread elsewhere? For example, your back or your shoulders?\n  No, doctor. It stays in the lower right.\n  Anything makes it better or worse?\n  Doctor, nothing really helps. Moving around makes it a bit worse.\n  Do you have a fever too?\n  Yes, Doctor. I had a fever last night, and when I checked my temperature, I was at 38 degrees.\n  And what about nausea, or vomiting?\n  I vomited 3 times, especially after eating. I have no appetite at all.\n  Okay. Any diarrhea, or constipation?\n  No, Doctor. Bowel movements are normal.\n  Any burning when you pass urine? Or going more often?\n  Non docteur, tout est bon de ce côté.\n  Okay, okay, je comprends. I'm going to press gently. You tell me when it's tender, okay?\n  Ow, that hurts right there.\n  OK, OK. How about when I let go?\n  Words, doctor, that really hurts.\n  OK. Je vais aussi mettre un peu de pression sur le côté gauche. Let me know, OK?\n  I feel pain on the right side when you do that.\n  OK. You have tenderness, gathering, and... Rebound tenderness in your right lower abdomen, also a positive roughness sign. They are very suggestive of acute appendicitis.\n  Is it serious?\n  It can be, if not treated. The appendix may be inflamed. and called rupture. We need to do blood work, CBC, CRB, and likely an abdominal ultrasound or CT to confirm that.\n  Doctor, do I need surgery?\n  But, we will confirm 1st, I'm going to start IV fluid, pain relief and antibiotics. You should eat or drink anything now in case we are going to operate you. Okay?\n  Okay, Doctor. Should I call my family?\n  Oui, oui, oui. Allez-y, allez-y. C 'est important. We will admit you and have the surgical team to see within the hours. Donc, ils vont programmerer si on va vous opérer et ils vont donner la période exacte de l 'opération. D 'accord?\n  D 'accord, docteur. Merci beaucoup.\n  Okay. You're welcome. You're welcome. We'll take good care of you and rest assured, ici avec nous, c 'est la guérison. Don't worry, you're going to find a cure and solution to your problem. Okay, madam?","marks":[[8,14,"madam",false],[73,78,"hui.",false],[297,297,"But now",false],[333,333,"Je comprends.",false],[405,405,"Is that Oui docteur effectivement. okay Okay.",false],[524,596,"okay okay. Et est-ce que la douleur se propage autre part Par exemple votre dos où alors vos épaules",false],[658,660,"him",false],[748,857,"Et avez-vous de la fièvre aussi Oui docteur j ai fait de la fièvre la nuit dernière et lorsque j ai vérifié ma température j étais à",false],[861,911,"degrés. Et quand est-il des nausées où alors les vomissements I've",false],[1003,1005,"où alors de la",false],[1166,1170,"Okey",false],[1316,1321,"Worse",false],[1377,1383,"",false],[1592,1601,"rough things",false],[1642,1655,"appendices. Dr. but",false],[1736,1742,"could",false],[1783,1786,"CRP",true],[1873,1873,"Plus au moins plus au moins Laparoscopic.",true],[1898,1901,"first.",false],[2094,2098,"",false],[2119,2123,"est",false],[2220,2232,"programmer",false],[2296,2307,"opération",false],[2310,2317,"accord",false],[2323,2330,"accord",false],[2397,2402,"We",false],[2460,2464,"est",false],[2478,2522,"assurée. Vous allez forcément trouver guérison et",false],[2532,2560,"à votre problème. D accord madame D accord docteur.",false]],"facts":[["Records four days of abdominal pain beginning Sunday evening, initially upper abdominal then migrating to the right lower abdomen.","yes","Records 4-day pain from Sunday evening, upper abdomen migrating to right lower quadrant."],["Records gradual onset, initially dull then sharp, currently 8/10.","yes","\"began as a dull ache and has progressively worsened to a sharp character, rated 8 out of 10\"."],["Records pain worsened by movement, nothing relieving it, and no radiation to back or shoulder.","yes","Records movement aggravates, nothing relieves, no radiation to back or shoulders."],["Records fever last night with measured temperature 38 degrees, without inventing other measured vitals.","yes","Fever with 38 degrees Celsius last night recorded; no other measured vitals invented."],["Records three vomiting episodes especially after eating, and absent appetite.","yes","Records vomiting three times particularly after eating and complete loss of appetite."],["Records normal bowel movements and denial of urinary burning or increased frequency.","yes","Records normal bowel movements and denial of dysuria or urinary frequency."],["Records right lower abdominal tenderness and rebound tenderness, and right-sided pain elicited by left abdominal pressure.","yes","RLQ tenderness, rebound tenderness and positive Rovsing sign (right pain on left pressure) recorded."],["Identifies suspected acute appendicitis and risk of rupture if untreated.","partial","Identifies acute appendicitis but omits the risk of rupture if untreated."],["Plans CBC and CRP blood tests, with abdominal ultrasound or CT to confirm.","yes","Plans CBC and CRP plus abdominal ultrasound or CT to confirm."],["Discusses likely laparoscopic surgery after confirmation and admission with surgical team review within hours.","partial","Admission and surgical team review within hours recorded, but laparoscopic approach not mentioned."],["Plans IV fluids, analgesia and antibiotics.","yes","Plans IV fluids, pain relief and antibiotics."],["Encourages contacting family and provides reassurance.","partial","Advises contacting family but omits the reassurance given to the patient."]],"claims":[],"note":"Subjective\nCliniTech Benchmark 1b0084e8 presents with abdominal pain that began on Sunday evening, approximately 4 days ago. The pain initially started in the upper abdomen and gradually migrated to the right lower quadrant. It began as a dull ache and has progressively worsened to a sharp character, rated 8 out of 10 in severity. The patient reports that nothing alleviates the pain, and movement tends to aggravate it. She denies radiation of the pain to the back or shoulders.\n\nShe reports an associated fever, measured at 38 degrees Celsius the previous night. She has vomited three times, particularly after eating, and reports complete loss of appetite. She denies diarrhea or constipation, stating that bowel movements have been normal. She denies dysuria or urinary frequency.\n\nReview of Systems  \n- General: Positive for fever and decreased appetite  \n- Gastrointestinal: Positive for vomiting, denies diarrhea, constipation  \n- Genitourinary: Denies dysuria, urinary frequency\n\nObjective\nPhysical Examination  \n- Abdomen: Tenderness in the right lower abdomen. Rebound tenderness present. Positive Rovsing sign\n\nAssessment & Plan\nPatient presents with 4-day history of abdominal pain that started in the upper abdomen and migrated to the right lower quadrant, associated with fever, nausea, and vomiting.\n\nAcute appendicitis  \nAssessment: Patient presents with classic signs and symptoms of acute appendicitis. Pain began 4 days ago in the epigastrium and has migrated to the right lower quadrant, which is characteristic of appendiceal inflammation. Pain has progressed from a dull ache to sharp 8/10 intensity. Associated symptoms include fever of 38°C, nausea, vomiting particularly after eating, and anorexia. Physical examination reveals tenderness, guarding, and rebound tenderness in the right lower abdomen with a positive Rovsing's sign. These clinical findings are highly suggestive of acute appendicitis requiring prompt surgical evaluation.  \nPlan:  \n- Obtain CBC and CRP blood work  \n- Order abdominal ultrasound or CT scan to confirm diagnosis  \n- Start IV fluids  \n- Administer pain relief medication  \n- Initiate antibiotic therapy  \n- Keep patient NPO in preparation for possible surgery  \n- Admit to hospital  \n- Consult surgical team for evaluation within hours  \n- Surgical team will determine timing of appendectomy if indicated  \n- Patient advised to contact family members regarding admission\n","review":146.76315789473685,"saved":132.23684210526315,"clean":false,"effort":12.5,"sig":[],"mb":11.685892,"latency":41.35,"signable":178.47515789473684},{"label":"Run 2","wer":26.476578411405292,"text":"Bonjour madame, je suis le docteur qui va vous prendre en charge aujourd 'hui. Please have a seat. I understand you have had abdominal pain for at least 4 days?\n  Yes doctor, it started on Sunday evening.\n  Okay, can you tell me where the pain began exactly?\n  It was right here in my upper belly. It's mostly down on the right side.\n  So it started in the upper abdomen and moved to the right lower side.\n  Was the pain sudden or gradual? It was gradual, just a dull ache at first, but now it's sharp, about 8 out of 10.\n  Does the pain spread elsewhere? For example, your back or your shoulders?\n  No, doctor. It stays in the lower right.\n  Anything makes it better or worse?\n  Doctor, nothing really helps. Moving around makes it a bit worse.\n  Do you have a fever too?\n  Yes, Doctor. I had a fever last night, and when I checked my temperature, I was at 38 degrees.\n  And what about nausea, or vomiting?\n  I vomited 3 times, especially after eating. I have no appetite at all.\n  Okay. Any diarrhea, or constipation?\n  No, Doctor. Bowel movements are normal.\n  Any burning when you pass urine? Or going more often?\n  Non docteur, tout est bon de ce côté.\n  Okay, okay, je comprends. I'm going to press gently. You tell me when it's tender, okay?\n  Ow, that hurts right there.\n  OK, OK. How about when I let go?\n  Words, doctor, that really hurts.\n  OK. Je vais aussi mettre un peu de pression sur le côté gauche. Let me know, OK?\n  I feel pain on the right side when you do that.\n  OK. You have tenderness, gathering, and... Rebound tenderness in your right lower abdomen, also a positive roughness sign. They are very suggestive of acute appendicitis.\n  Is it serious?\n  It can be, if not treated. The appendix may be inflamed. and called rupture. We need to do blood work, CBC, CRB, and likely an abdominal ultrasound or CT to confirm that.\n  Doctor, do I need surgery?\n  But, we will confirm 1st, I'm going to start IV fluid, pain relief and antibiotics. You should eat or drink anything now in case we are going to operate you. Okay?\n  Okay, Doctor. Should I call my family?\n  Oui, oui, oui. Allez-y, allez-y. C 'est important. We will admit you and have the surgical team to see within the hours. Donc, ils vont programmerer si on va vous opérer et ils vont donner la période exacte de l 'opération. D 'accord?\n  D 'accord, docteur. Merci beaucoup.\n  Okay. You're welcome. You're welcome. We'll take good care of you and rest assured, ici avec nous, c 'est la guérison. Don't worry, you're going to find a cure and solution to your problem. Okay, madam?","marks":[[8,14,"madam",false],[73,78,"hui.",false],[297,297,"But now",false],[333,333,"Je comprends.",false],[405,405,"Is that Oui docteur effectivement. okay Okay.",false],[524,596,"okay okay. Et est-ce que la douleur se propage autre part Par exemple votre dos où alors vos épaules",false],[658,660,"him",false],[748,857,"Et avez-vous de la fièvre aussi Oui docteur j ai fait de la fièvre la nuit dernière et lorsque j ai vérifié ma température j étais à",false],[861,911,"degrés. Et quand est-il des nausées où alors les vomissements I've",false],[1003,1005,"où alors de la",false],[1166,1170,"Okey",false],[1316,1321,"Worse",false],[1377,1383,"",false],[1592,1601,"rough things",false],[1642,1655,"appendices. Dr. but",false],[1736,1742,"could",false],[1783,1786,"CRP",true],[1873,1873,"Plus au moins plus au moins Laparoscopic.",true],[1898,1901,"first.",false],[2094,2098,"",false],[2119,2123,"est",false],[2220,2232,"programmer",false],[2296,2307,"opération",false],[2310,2317,"accord",false],[2323,2330,"accord",false],[2397,2402,"We",false],[2460,2464,"est",false],[2478,2522,"assurée. Vous allez forcément trouver guérison et",false],[2532,2560,"à votre problème. D accord madame D accord docteur.",false]],"facts":[["Records four days of abdominal pain beginning Sunday evening, initially upper abdominal then migrating to the right lower abdomen.","yes","Records 4 days from Sunday evening, upper abdomen then right lower side."],["Records gradual onset, initially dull then sharp, currently 8/10.","yes","Dull ache progressively worsened to sharp 8/10."],["Records pain worsened by movement, nothing relieving it, and no radiation to back or shoulder.","yes","Movement aggravates, nothing relieves, denies radiation to back or shoulders."],["Records fever last night with measured temperature 38 degrees, without inventing other measured vitals.","yes","Fever last night measured at 38 degrees; no other vitals invented."],["Records three vomiting episodes especially after eating, and absent appetite.","yes","Three vomiting episodes especially after eating, and no appetite."],["Records normal bowel movements and denial of urinary burning or increased frequency.","yes","Normal bowel movements; denies dysuria and increased frequency."],["Records right lower abdominal tenderness and rebound tenderness, and right-sided pain elicited by left abdominal pressure.","yes","RLQ tenderness, rebound tenderness and Rovsing sign (right pain on left pressure) recorded."],["Identifies suspected acute appendicitis and risk of rupture if untreated.","partial","Suspected appendicitis recorded but risk of rupture if untreated is not mentioned."],["Plans CBC and CRP blood tests, with abdominal ultrasound or CT to confirm.","yes","CBC and CRP plus abdominal ultrasound or CT to confirm."],["Discusses likely laparoscopic surgery after confirmation and admission with surgical team review within hours.","partial","Admission and surgical review within hours recorded; laparoscopic surgery after confirmation not stated beyond \"possible surgery\"."],["Plans IV fluids, analgesia and antibiotics.","yes","IV fluids, pain relief and antibiotics planned."],["Encourages contacting family and provides reassurance.","partial","Advised to contact family; reassurance not recorded."]],"claims":[],"note":"Subjective\nCliniTech Benchmark 6af0f381 presents with a 4-day history of abdominal pain that began on Sunday evening. The pain initially started in the upper abdomen and gradually migrated to the right lower quadrant. It began as a dull ache but has progressively worsened to a sharp character, rated 8 out of 10 in severity. The patient reports that movement aggravates the pain and that nothing provides relief. She denies radiation of the pain to the back or shoulders.\n\nShe reports an associated fever, measured at 38 degrees Celsius the previous night. She has vomited three times, particularly after eating, and reports complete loss of appetite. She denies diarrhea or constipation, stating that bowel movements have been normal. She denies dysuria or urinary frequency.\n\nReview of Systems  \n- General: Positive for fever and decreased appetite  \n- Gastrointestinal: Positive for vomiting, negative for diarrhea, constipation  \n- Genitourinary: Negative for dysuria, urinary frequency\n\nObjective\nPhysical Examination  \n- Abdomen: Right lower abdominal tenderness, rebound tenderness, and positive Rovsing sign\n\nAssessment & Plan\nPatient presents with 4-day history of abdominal pain that started in upper abdomen and migrated to right lower quadrant, associated with fever, nausea, and vomiting.\n\nAcute Appendicitis  \nAssessment: Patient presents with classic signs of acute appendicitis including 4-day history of abdominal pain that began in the upper abdomen and migrated to the right lower quadrant. Pain has progressed from dull ache to sharp 8/10 intensity, worsened by movement. Associated symptoms include fever of 38°C, nausea, vomiting three times after eating, and anorexia. Physical examination reveals tenderness, guarding, and rebound tenderness in the right lower abdomen with positive Rovsing's sign. These clinical findings are highly suggestive of acute appendicitis requiring urgent surgical evaluation.  \nPlan:  \n- Obtain blood work including CBC and CRP  \n- Order abdominal ultrasound or CT scan to confirm diagnosis  \n- Start IV fluids, pain relief, and antibiotics  \n- Keep patient NPO in preparation for possible surgery  \n- Admit patient to hospital  \n- Consult surgical team for evaluation within hours  \n- Patient advised to contact family members\n","review":141.71052631578948,"saved":137.28947368421052,"clean":false,"effort":12.5,"sig":[],"mb":9.516664,"latency":61.148,"signable":183.78252631578948},{"label":"Run 3","wer":26.476578411405292,"text":"Bonjour madame, je suis le docteur qui va vous prendre en charge aujourd 'hui. Please have a seat. I understand you have had abdominal pain for at least 4 days?\n  Yes doctor, it started on Sunday evening.\n  Okay, can you tell me where the pain began exactly?\n  It was right here in my upper belly. It's mostly down on the right side.\n  So it started in the upper abdomen and moved to the right lower side.\n  Was the pain sudden or gradual? It was gradual, just a dull ache at first, but now it's sharp, about 8 out of 10.\n  Does the pain spread elsewhere? For example, your back or your shoulders?\n  No, doctor. It stays in the lower right.\n  Anything makes it better or worse?\n  Doctor, nothing really helps. Moving around makes it a bit worse.\n  Do you have a fever too?\n  Yes, Doctor. I had a fever last night, and when I checked my temperature, I was at 38 degrees.\n  And what about nausea, or vomiting?\n  I vomited 3 times, especially after eating. I have no appetite at all.\n  Okay. Any diarrhea, or constipation?\n  No, Doctor. Bowel movements are normal.\n  Any burning when you pass urine? Or going more often?\n  Non docteur, tout est bon de ce côté.\n  Okay, okay, je comprends. I'm going to press gently. You tell me when it's tender, okay?\n  Ow, that hurts right there.\n  OK, OK. How about when I let go?\n  Words, doctor, that really hurts.\n  OK. Je vais aussi mettre un peu de pression sur le côté gauche. Let me know, OK?\n  I feel pain on the right side when you do that.\n  OK. You have tenderness, gathering, and... Rebound tenderness in your right lower abdomen, also a positive roughness sign. They are very suggestive of acute appendicitis.\n  Is it serious?\n  It can be, if not treated. The appendix may be inflamed. and called rupture. We need to do blood work, CBC, CRB, and likely an abdominal ultrasound or CT to confirm that.\n  Doctor, do I need surgery?\n  But, we will confirm 1st, I'm going to start IV fluid, pain relief and antibiotics. You should eat or drink anything now in case we are going to operate you. Okay?\n  Okay, Doctor. Should I call my family?\n  Oui, oui, oui. Allez-y, allez-y. C 'est important. We will admit you and have the surgical team to see within the hours. Donc, ils vont programmerer si on va vous opérer et ils vont donner la période exacte de l 'opération. D 'accord?\n  D 'accord, docteur. Merci beaucoup.\n  Okay. You're welcome. You're welcome. We'll take good care of you and rest assured, ici avec nous, c 'est la guérison. Don't worry, you're going to find a cure and solution to your problem. Okay, madam?","marks":[[8,14,"madam",false],[73,78,"hui.",false],[297,297,"But now",false],[333,333,"Je comprends.",false],[405,405,"Is that Oui docteur effectivement. okay Okay.",false],[524,596,"okay okay. Et est-ce que la douleur se propage autre part Par exemple votre dos où alors vos épaules",false],[658,660,"him",false],[748,857,"Et avez-vous de la fièvre aussi Oui docteur j ai fait de la fièvre la nuit dernière et lorsque j ai vérifié ma température j étais à",false],[861,911,"degrés. Et quand est-il des nausées où alors les vomissements I've",false],[1003,1005,"où alors de la",false],[1166,1170,"Okey",false],[1316,1321,"Worse",false],[1377,1383,"",false],[1592,1601,"rough things",false],[1642,1655,"appendices. Dr. but",false],[1736,1742,"could",false],[1783,1786,"CRP",true],[1873,1873,"Plus au moins plus au moins Laparoscopic.",true],[1898,1901,"first.",false],[2094,2098,"",false],[2119,2123,"est",false],[2220,2232,"programmer",false],[2296,2307,"opération",false],[2310,2317,"accord",false],[2323,2330,"accord",false],[2397,2402,"We",false],[2460,2464,"est",false],[2478,2522,"assurée. Vous allez forcément trouver guérison et",false],[2532,2560,"à votre problème. D accord madame D accord docteur.",false]],"facts":[["Records four days of abdominal pain beginning Sunday evening, initially upper abdominal then migrating to the right lower abdomen.","yes","Records 4-day pain from Sunday evening, upper abdomen migrating to right lower quadrant."],["Records gradual onset, initially dull then sharp, currently 8/10.","yes","\"began as a dull ache and has progressively worsened to a sharp character, rated 8 out of 10\"."],["Records pain worsened by movement, nothing relieving it, and no radiation to back or shoulder.","yes","Records movement aggravates, nothing relieves, no radiation to back or shoulders."],["Records fever last night with measured temperature 38 degrees, without inventing other measured vitals.","yes","Fever with 38 degrees Celsius last night recorded; no other measured vitals invented."],["Records three vomiting episodes especially after eating, and absent appetite.","yes","Records vomiting three times particularly after eating and complete loss of appetite."],["Records normal bowel movements and denial of urinary burning or increased frequency.","yes","Records normal bowel movements and denial of dysuria or urinary frequency."],["Records right lower abdominal tenderness and rebound tenderness, and right-sided pain elicited by left abdominal pressure.","yes","RLQ tenderness, rebound tenderness and positive Rovsing sign (right pain on left pressure) recorded."],["Identifies suspected acute appendicitis and risk of rupture if untreated.","yes","\"warrant urgent surgical evaluation given the risk of appendiceal rupture if left untreated\"."],["Plans CBC and CRP blood tests, with abdominal ultrasound or CT to confirm.","yes","Plans CBC and CRP plus abdominal ultrasound or CT to confirm."],["Discusses likely laparoscopic surgery after confirmation and admission with surgical team review within hours.","partial","Admission and surgical team review within hours recorded, but laparoscopic approach not mentioned."],["Plans IV fluids, analgesia and antibiotics.","yes","Plans IV fluids, pain relief and antibiotics."],["Encourages contacting family and provides reassurance.","partial","Advises contacting family but omits the reassurance given to the patient."]],"claims":[],"note":"Subjective\nCliniTech Benchmark d756f8e9 presents with a 4-day history of abdominal pain that began on Sunday evening. The pain initially started in the upper abdomen and gradually migrated to the right lower quadrant. It began as a dull ache and has progressively worsened to a sharp character, rated 8 out of 10 in severity. The pain does not radiate to the back or shoulders and remains localized to the right lower abdomen. Movement aggravates the pain, and nothing provides relief.\n\nThe patient reports associated fever, with a recorded temperature of 38 degrees Celsius last night, nausea, and vomiting on three occasions, particularly after eating. The patient reports complete loss of appetite. The patient denies diarrhea or constipation, stating bowel movements are normal. The patient also denies dysuria or urinary frequency.\n\nReview of Systems  \n- General: Positive for fever and decreased appetite  \n- Gastrointestinal: Positive for nausea and vomiting, denies diarrhea, constipation  \n- Genitourinary: Denies dysuria, urinary frequency\n\nObjective\nPhysical Examination  \n- Abdomen: Tenderness in the right lower abdomen. Rebound tenderness present. Positive Rovsing sign\n\nAssessment & Plan\nPatient presents with 4-day history of abdominal pain that started in upper abdomen and migrated to right lower quadrant, associated with fever, nausea, and vomiting.\n\nAcute appendicitis  \nAssessment: Patient presents with classic signs and symptoms suggestive of acute appendicitis. Pain began 4 days ago in the epigastric region and has migrated to the right lower quadrant, which is characteristic of appendiceal inflammation. Pain has progressed from a dull ache to sharp, severe pain rated 8/10 in intensity. Associated symptoms include fever of 38°C, nausea, vomiting occurring 3 times particularly after eating, and anorexia. Physical examination reveals tenderness, guarding, and rebound tenderness in the right lower abdomen, along with a positive Rovsing's sign. These clinical findings are highly suggestive of acute appendicitis and warrant urgent surgical evaluation given the risk of appendiceal rupture if left untreated.  \nPlan:  \n- Obtain blood work including CBC and CRP  \n- Obtain abdominal ultrasound or CT scan to confirm diagnosis  \n- Start IV fluids  \n- Administer pain relief medication  \n- Start antibiotics  \n- Keep patient NPO in preparation for possible surgery  \n- Admit patient to hospital  \n- Consult surgical team for evaluation within the next few hours  \n- Surgical team will determine need for appendectomy and provide specific timing for operation  \n- Patient advised to contact family members given potential need for surgery\n","review":146.26315789473685,"saved":132.73684210526315,"clean":false,"effort":8.333333333333332,"sig":[],"mb":11.917533,"latency":45.282,"signable":180.94815789473685},{"label":"Run 4","wer":26.476578411405292,"text":"Bonjour madame, je suis le docteur qui va vous prendre en charge aujourd 'hui. Please have a seat. I understand you have had abdominal pain for at least 4 days?\n  Yes doctor, it started on Sunday evening.\n  Okay, can you tell me where the pain began exactly?\n  It was right here in my upper belly. It's mostly down on the right side.\n  So it started in the upper abdomen and moved to the right lower side.\n  Was the pain sudden or gradual? It was gradual, just a dull ache at first, but now it's sharp, about 8 out of 10.\n  Does the pain spread elsewhere? For example, your back or your shoulders?\n  No, doctor. It stays in the lower right.\n  Anything makes it better or worse?\n  Doctor, nothing really helps. Moving around makes it a bit worse.\n  Do you have a fever too?\n  Yes, Doctor. I had a fever last night, and when I checked my temperature, I was at 38 degrees.\n  And what about nausea, or vomiting?\n  I vomited 3 times, especially after eating. I have no appetite at all.\n  Okay. Any diarrhea, or constipation?\n  No, Doctor. Bowel movements are normal.\n  Any burning when you pass urine? Or going more often?\n  Non docteur, tout est bon de ce côté.\n  Okay, okay, je comprends. I'm going to press gently. You tell me when it's tender, okay?\n  Ow, that hurts right there.\n  OK, OK. How about when I let go?\n  Words, doctor, that really hurts.\n  OK. Je vais aussi mettre un peu de pression sur le côté gauche. Let me know, OK?\n  I feel pain on the right side when you do that.\n  OK. You have tenderness, gathering, and... Rebound tenderness in your right lower abdomen, also a positive roughness sign. They are very suggestive of acute appendicitis.\n  Is it serious?\n  It can be, if not treated. The appendix may be inflamed. and called rupture. We need to do blood work, CBC, CRB, and likely an abdominal ultrasound or CT to confirm that.\n  Doctor, do I need surgery?\n  But, we will confirm 1st, I'm going to start IV fluid, pain relief and antibiotics. You should eat or drink anything now in case we are going to operate you. Okay?\n  Okay, Doctor. Should I call my family?\n  Oui, oui, oui. Allez-y, allez-y. C 'est important. We will admit you and have the surgical team to see within the hours. Donc, ils vont programmerer si on va vous opérer et ils vont donner la période exacte de l 'opération. D 'accord?\n  D 'accord, docteur. Merci beaucoup.\n  Okay. You're welcome. You're welcome. We'll take good care of you and rest assured, ici avec nous, c 'est la guérison. Don't worry, you're going to find a cure and solution to your problem. Okay, madam?","marks":[[8,14,"madam",false],[73,78,"hui.",false],[297,297,"But now",false],[333,333,"Je comprends.",false],[405,405,"Is that Oui docteur effectivement. okay Okay.",false],[524,596,"okay okay. Et est-ce que la douleur se propage autre part Par exemple votre dos où alors vos épaules",false],[658,660,"him",false],[748,857,"Et avez-vous de la fièvre aussi Oui docteur j ai fait de la fièvre la nuit dernière et lorsque j ai vérifié ma température j étais à",false],[861,911,"degrés. Et quand est-il des nausées où alors les vomissements I've",false],[1003,1005,"où alors de la",false],[1166,1170,"Okey",false],[1316,1321,"Worse",false],[1377,1383,"",false],[1592,1601,"rough things",false],[1642,1655,"appendices. Dr. but",false],[1736,1742,"could",false],[1783,1786,"CRP",true],[1873,1873,"Plus au moins plus au moins Laparoscopic.",true],[1898,1901,"first.",false],[2094,2098,"",false],[2119,2123,"est",false],[2220,2232,"programmer",false],[2296,2307,"opération",false],[2310,2317,"accord",false],[2323,2330,"accord",false],[2397,2402,"We",false],[2460,2464,"est",false],[2478,2522,"assurée. Vous allez forcément trouver guérison et",false],[2532,2560,"à votre problème. D accord madame D accord docteur.",false]],"facts":[["Records four days of abdominal pain beginning Sunday evening, initially upper abdominal then migrating to the right lower abdomen.","yes","Records 4 days from Sunday evening, upper abdomen then right lower side."],["Records gradual onset, initially dull then sharp, currently 8/10.","yes","Dull ache that \"progressively worsened\", now sharp 8/10."],["Records pain worsened by movement, nothing relieving it, and no radiation to back or shoulder.","yes","Worse with movement, nothing relieves, no radiation to back or shoulders."],["Records fever last night with measured temperature 38 degrees, without inventing other measured vitals.","yes","Fever last night measured at 38 degrees; no other vitals invented."],["Records three vomiting episodes especially after eating, and absent appetite.","yes","Three vomiting episodes especially after eating, and no appetite."],["Records normal bowel movements and denial of urinary burning or increased frequency.","yes","Normal bowel movements; denies dysuria and increased frequency."],["Records right lower abdominal tenderness and rebound tenderness, and right-sided pain elicited by left abdominal pressure.","yes","RLQ tenderness, rebound tenderness and Rovsing sign (right pain on left pressure) recorded."],["Identifies suspected acute appendicitis and risk of rupture if untreated.","yes","\"highly suggestive of acute appendicitis with potential risk of rupture if untreated\"."],["Plans CBC and CRP blood tests, with abdominal ultrasound or CT to confirm.","yes","CBC and CRP plus abdominal ultrasound or CT to confirm."],["Discusses likely laparoscopic surgery after confirmation and admission with surgical team review within hours.","partial","Admission and surgical consult for \"potential appendectomy\" recorded, but not laparoscopic approach or review within hours."],["Plans IV fluids, analgesia and antibiotics.","yes","IV fluids, pain relief and antibiotics planned."],["Encourages contacting family and provides reassurance.","partial","Advised to contact family; reassurance not recorded."]],"claims":[],"note":"Subjective\nCliniTech Benchmark 7e66b8cc presents with abdominal pain that began on Sunday evening, approximately 4 days prior to presentation. The pain started in the upper abdomen and gradually migrated to the right lower quadrant. Initially described as a dull ache, it has progressively worsened and is now sharp in character, rated 8 out of 10 in severity. The patient reports the pain does not radiate to the back or shoulders and remains localized to the right lower abdomen. Movement aggravates the pain, and nothing provides relief.\n\nAssociated symptoms include fever, with a recorded temperature of 38 degrees Celsius the previous night, vomiting on 3 occasions, particularly after eating, and complete loss of appetite. The patient denies diarrhea or constipation, reporting normal bowel movements. She also denies dysuria or urinary frequency.\n\nReview of Systems  \n- General: Positive for fever and decreased appetite  \n- Gastrointestinal: Positive for vomiting, negative for diarrhea, constipation  \n- Genitourinary: Negative for dysuria, urinary frequency\n\nObjective\nPhysical Examination  \n- Abdomen: Tenderness in the right lower abdomen. Rebound tenderness present. Positive Rovsing sign\n\nAssessment & Plan\nPatient presents with 4-day history of abdominal pain that started in upper abdomen and migrated to right lower quadrant, associated with fever, nausea, and vomiting.\n\nAcute Appendicitis  \nAssessment: Pain began 4 days ago on Sunday evening in the upper abdomen and has migrated to the right lower quadrant, becoming sharp and severe at 8/10 intensity. Associated symptoms include fever of 38°C, nausea, vomiting occurring 3 times particularly after eating, and complete loss of appetite. Physical examination reveals tenderness, guarding, and rebound tenderness in the right lower abdomen, along with a positive Rovsing sign. These clinical findings are highly suggestive of acute appendicitis with potential risk of rupture if untreated.  \nPlan:  \n- Order blood work including CBC and CRP  \n- Obtain abdominal ultrasound or CT scan to confirm diagnosis  \n- Start IV fluids  \n- Administer pain relief medication  \n- Start antibiotics  \n- Keep patient NPO in preparation for possible surgery  \n- Admit patient to hospital  \n- Consult surgical team for evaluation and potential appendectomy  \n- Patient advised to contact family members given potential surgical intervention\n","review":132.36842105263156,"saved":146.63157894736844,"clean":false,"effort":8.333333333333332,"sig":[],"mb":11.532693,"latency":41.452,"signable":163.09942105263156},{"label":"Run 5","wer":26.476578411405292,"text":"Bonjour madame, je suis le docteur qui va vous prendre en charge aujourd 'hui. Please have a seat. I understand you have had abdominal pain for at least 4 days?\n  Yes doctor, it started on Sunday evening.\n  Okay, can you tell me where the pain began exactly?\n  It was right here in my upper belly. It's mostly down on the right side.\n  So it started in the upper abdomen and moved to the right lower side.\n  Was the pain sudden or gradual? It was gradual, just a dull ache at first, but now it's sharp, about 8 out of 10.\n  Does the pain spread elsewhere? For example, your back or your shoulders?\n  No, doctor. It stays in the lower right.\n  Anything makes it better or worse?\n  Doctor, nothing really helps. Moving around makes it a bit worse.\n  Do you have a fever too?\n  Yes, Doctor. I had a fever last night, and when I checked my temperature, I was at 38 degrees.\n  And what about nausea, or vomiting?\n  I vomited 3 times, especially after eating. I have no appetite at all.\n  Okay. Any diarrhea, or constipation?\n  No, Doctor. Bowel movements are normal.\n  Any burning when you pass urine? Or going more often?\n  Non docteur, tout est bon de ce côté.\n  Okay, okay, je comprends. I'm going to press gently. You tell me when it's tender, okay?\n  Ow, that hurts right there.\n  OK, OK. How about when I let go?\n  Words, doctor, that really hurts.\n  OK. Je vais aussi mettre un peu de pression sur le côté gauche. Let me know, OK?\n  I feel pain on the right side when you do that.\n  OK. You have tenderness, gathering, and... Rebound tenderness in your right lower abdomen, also a positive roughness sign. They are very suggestive of acute appendicitis.\n  Is it serious?\n  It can be, if not treated. The appendix may be inflamed. and called rupture. We need to do blood work, CBC, CRB, and likely an abdominal ultrasound or CT to confirm that.\n  Doctor, do I need surgery?\n  But, we will confirm 1st, I'm going to start IV fluid, pain relief and antibiotics. You should eat or drink anything now in case we are going to operate you. Okay?\n  Okay, Doctor. Should I call my family?\n  Oui, oui, oui. Allez-y, allez-y. C 'est important. We will admit you and have the surgical team to see within the hours. Donc, ils vont programmerer si on va vous opérer et ils vont donner la période exacte de l 'opération. D 'accord?\n  D 'accord, docteur. Merci beaucoup.\n  Okay. You're welcome. You're welcome. We'll take good care of you and rest assured, ici avec nous, c 'est la guérison. Don't worry, you're going to find a cure and solution to your problem. Okay, madam?","marks":[[8,14,"madam",false],[73,78,"hui.",false],[297,297,"But now",false],[333,333,"Je comprends.",false],[405,405,"Is that Oui docteur effectivement. okay Okay.",false],[524,596,"okay okay. Et est-ce que la douleur se propage autre part Par exemple votre dos où alors vos épaules",false],[658,660,"him",false],[748,857,"Et avez-vous de la fièvre aussi Oui docteur j ai fait de la fièvre la nuit dernière et lorsque j ai vérifié ma température j étais à",false],[861,911,"degrés. Et quand est-il des nausées où alors les vomissements I've",false],[1003,1005,"où alors de la",false],[1166,1170,"Okey",false],[1316,1321,"Worse",false],[1377,1383,"",false],[1592,1601,"rough things",false],[1642,1655,"appendices. Dr. but",false],[1736,1742,"could",false],[1783,1786,"CRP",true],[1873,1873,"Plus au moins plus au moins Laparoscopic.",true],[1898,1901,"first.",false],[2094,2098,"",false],[2119,2123,"est",false],[2220,2232,"programmer",false],[2296,2307,"opération",false],[2310,2317,"accord",false],[2323,2330,"accord",false],[2397,2402,"We",false],[2460,2464,"est",false],[2478,2522,"assurée. Vous allez forcément trouver guérison et",false],[2532,2560,"à votre problème. D accord madame D accord docteur.",false]],"facts":[["Records four days of abdominal pain beginning Sunday evening, initially upper abdominal then migrating to the right lower abdomen.","yes","Records 4-day pain from Sunday evening, upper abdomen migrating to right lower quadrant."],["Records gradual onset, initially dull then sharp, currently 8/10.","yes","\"began as a dull ache and has progressively worsened to a sharp character, rated 8 out of 10\"."],["Records pain worsened by movement, nothing relieving it, and no radiation to back or shoulder.","yes","Records movement aggravates, nothing relieves, no radiation to back or shoulders."],["Records fever last night with measured temperature 38 degrees, without inventing other measured vitals.","yes","Fever with 38 degrees Celsius last night recorded; no other measured vitals invented."],["Records three vomiting episodes especially after eating, and absent appetite.","yes","Records vomiting three times particularly after eating and complete loss of appetite."],["Records normal bowel movements and denial of urinary burning or increased frequency.","yes","Records normal bowel movements and denial of dysuria or urinary frequency."],["Records right lower abdominal tenderness and rebound tenderness, and right-sided pain elicited by left abdominal pressure.","yes","RLQ tenderness, rebound tenderness and positive Rovsing sign (right pain on left pressure) recorded."],["Identifies suspected acute appendicitis and risk of rupture if untreated.","partial","Identifies acute appendicitis but omits the risk of rupture if untreated."],["Plans CBC and CRP blood tests, with abdominal ultrasound or CT to confirm.","yes","Plans CBC and CRP plus abdominal ultrasound or CT to confirm."],["Discusses likely laparoscopic surgery after confirmation and admission with surgical team review within hours.","partial","Admission and surgical team review within hours recorded, but laparoscopic approach not mentioned."],["Plans IV fluids, analgesia and antibiotics.","yes","Plans IV fluids, pain relief and antibiotics."],["Encourages contacting family and provides reassurance.","partial","Advises contacting family but omits the reassurance given to the patient."]],"claims":[],"note":"Subjective\nCliniTech Benchmark e08661e3 presents with a 4-day history of abdominal pain that began on Sunday evening. The pain initially started in the upper abdomen and gradually migrated to the right lower quadrant. It began as a dull ache and has progressively worsened to a sharp character, rated 8 out of 10 in severity. The patient reports that nothing alleviates the pain, and movement aggravates it. The patient denies radiation of the pain to the back or shoulders.\n\nAssociated symptoms include fever, measured at 38 degrees Celsius the night prior, vomiting on 3 occasions, particularly after eating, and complete loss of appetite. The patient denies diarrhea or constipation, reporting normal bowel movements. The patient also denies dysuria or urinary frequency.\n\nReview of Systems  \n- Gastrointestinal: Denies diarrhea, constipation  \n- Genitourinary: Denies dysuria, urinary frequency\n\nObjective\nPhysical Examination  \n- Abdomen: Tenderness in the right lower abdomen. Rebound tenderness present. Positive Rovsing sign\n\nAssessment & Plan\nPatient presents with 4-day history of abdominal pain that started in upper abdomen and migrated to right lower quadrant, associated with fever, nausea, and vomiting.\n\nAcute appendicitis  \nAssessment: Patient presents with classic signs and symptoms of acute appendicitis. Pain began 4 days ago in the upper abdomen and has migrated to the right lower quadrant, which is characteristic of appendiceal inflammation. Pain has progressed from a dull ache to sharp, severe pain rated 8/10 in intensity. Associated symptoms include fever of 38°C, nausea, vomiting occurring 3 times particularly after eating, and complete loss of appetite. Physical examination reveals tenderness, guarding, and rebound tenderness in the right lower abdomen, along with a positive Rovsing's sign. These clinical findings are highly suggestive of acute appendicitis and warrant urgent surgical evaluation.  \nPlan:  \n- Order blood work including CBC and CRP  \n- Obtain abdominal ultrasound or CT scan to confirm diagnosis  \n- Start IV fluids  \n- Administer pain relief medication  \n- Start antibiotics  \n- Keep patient NPO in preparation for possible surgery  \n- Admit patient to hospital  \n- Consult surgical team for evaluation within the next few hours  \n- Surgical team will determine need for appendectomy and provide exact timing if surgery is indicated  \n- Patient advised to contact family members regarding hospitalization\n","review":149.28947368421052,"saved":129.71052631578948,"clean":false,"effort":12.5,"sig":[],"mb":11.893669,"latency":45.605,"signable":184.1744736842105}],"cliniscripts":[{"label":"Run 1","wer":7.942973523421588,"text":"Bonjour madame.\nJe suis le docteur qui va vous prendre en charge aujourd'hui.\nPlease have a seat.\nUnderstand you've had abdominal pain for at least 4 days? Yes, doctor.\nIt started on Sunday evening.\nOkay.\nCan you tell me where the pain began exactly?\nIt was right here, in my upper belly, but now it's mostly down on the right side. Je comprends. So it started in the upper abdomen, and moved to the right lower side.\nIs that— Wait, doctor, effectivement. Okay, okay. Was the pain sudden or gradual?\nIt was gradual, just a dull ache at first, but now it's sharp, about 8 out of 10. Okay, okay.\nEst-ce que la douleur se propage autre part, par exemple votre dos ou alors vos épaules?\nNo, doctor, it stays in the lower right. Okay. Anything makes it better, or worse? Um, doctor, nothing really helps. Moving around makes it a bit worse.\nEt avez-vous de la fièvre aussi?\nOui, docteur.\nJ'ai fait de la fièvre la nuit dernière, et lorsque j'ai vérifié ma température, j'étais à 38 degrés. Et qu'en est-il des nausées ou alors du vomissement?\nI've vomited 3 times. Especially after eating. I have no appetite at all.\nOkay.\nAny diarrhea, ou alors de la constipation? No, doctor.\nBowel movements are normal.\nAny burning when you pass urine?\nOr going more often? Um, no, doctor. Tout est bon de ce côté. Okay, okay. Je comprends.\nI'm going to press gently. You tell me when it's tender, okay?\nOw! That hurts right there. Hmm, okay, okay. How about when I let go?\nWorse, doctor. That really hurts.\nOkay. Je vais aussi mettre un peu de pression sur le côté gauche.\nLet me know, okay?\nUm, I feel pain on the right side when you do that. Okay. You have tenderness.\nGathering and rebound tenderness in your right lower abdomen.\nAlso, a positive rough things sign.\nThere are very suggestive of acute appendicite.\nDoctor, but is it serious? It can be, if not treated.\nThe appendix may be inflamed. And cold rupture.\nWe need to do blood work. CBC, CRP, and likely an abdominal ultrasound or CT to confirm that.\nDoctor, um, do I need surgery? Euh, plus ou moins, plus ou moins.\nLaparoscopique, but we will confirm first. I'm going to start IV fluid.\nPain relief and antibiotics.\nYou should eat or drink anything now. In case we're going to operate you. Okay? Okay, doctor. Should I call my family? Euh, oui, oui, oui. Allez-y, allez-y. C'est important. We will admit you and have the surgical team to see within the hours.\nDonc, ils vont programmer si on va vous opérer et ils vont donner la période exacte de l'opération. D'accord? D'accord, docteur. Merci beaucoup. Okay. You're welcome. You're welcome. We'll take, uh, good care of you and, uh, rest assured. Ici avec nous, c'est la guérison assurée. Vous allez forcément trouver guérison et solution à votre problème. D'accord, madame? D'accord, docteur.","marks":[[8,15,"madam",false],[65,77,"aujourd hui.",false],[109,115,"you have",false],[427,439,"Oui docteur",false],[593,593,"Et",false],[661,663,"où",false],[745,747,"him",false],[883,887,"j ai",false],[935,939,"j ai",false],[964,971,"j étais",false],[988,993,"quand",false],[1013,1015,"où",false],[1022,1036,"les vomissements",false],[1132,1134,"où",false],[1255,1270,"Non docteur",false],[1302,1307,"Okey",false],[1516,1522,"",false],[1751,1756,"They",false],[1786,1805,"appendices. Dr.",false],[1887,1891,"could",false],[2026,2029,"",false],[2036,2038,"au",false],[2051,2053,"au",false],[2061,2075,"Laparoscopic.",false],[2208,2213,"we are",false],[2281,2289,"",false],[2319,2324,"c est",false],[2493,2524,"l opération d accord D accord",false],[2589,2594,"We",false],[2660,2665,"c est",false],[2755,2763,"D accord",false],[2773,2781,"D accord",false]],"facts":[["Records four days of abdominal pain beginning Sunday evening, initially upper abdominal then migrating to the right lower abdomen.","yes","Records 4 days from Sunday evening, upper abdomen then right lower side."],["Records gradual onset, initially dull then sharp, currently 8/10.","yes","Gradual onset, dull ache progressing to sharp 8/10."],["Records pain worsened by movement, nothing relieving it, and no radiation to back or shoulder.","yes","Does not radiate, nothing alleviates, moving worsens."],["Records fever last night with measured temperature 38 degrees, without inventing other measured vitals.","yes","Fever last night measured at 38 degrees; no other vitals invented."],["Records three vomiting episodes especially after eating, and absent appetite.","yes","Three vomiting episodes especially after eating, and no appetite."],["Records normal bowel movements and denial of urinary burning or increased frequency.","yes","Normal bowel movements; denies dysuria and increased frequency."],["Records right lower abdominal tenderness and rebound tenderness, and right-sided pain elicited by left abdominal pressure.","yes","RLQ tenderness, rebound tenderness and Rovsing sign (right pain on left pressure) recorded."],["Identifies suspected acute appendicitis and risk of rupture if untreated.","yes","Appendicitis suspected; rupture if untreated noted."],["Plans CBC and CRP blood tests, with abdominal ultrasound or CT to confirm.","yes","CBC and CRP plus abdominal ultrasound or CT to confirm."],["Discusses likely laparoscopic surgery after confirmation and admission with surgical team review within hours.","partial","Laparoscopic surgery and surgical consult recorded, but admission omitted and timing given as \"within the hour\"."],["Plans IV fluids, analgesia and antibiotics.","yes","IV fluids, pain relief and antibiotics planned."],["Encourages contacting family and provides reassurance.","partial","Advised to contact family; reassurance not recorded."]],"claims":[],"note":"S (Subjective):\n- Patient presents with abdominal pain for 4 days, starting Sunday evening.\n- Pain initially localized to the upper abdomen, now predominantly in the right lower side.\n- Onset was gradual, described as a dull ache, progressing to a sharp pain rated 8/10.\n- Pain does not radiate; it remains in the lower right abdomen.\n- Nothing alleviates the pain; moving around slightly worsens it.\n- Patient reports fever of 38 degrees Celsius last night.\n- Patient experienced 3 episodes of vomiting, especially after eating, and has no appetite.\n- Bowel movements are normal; no diarrhea or constipation.\n- No dysuria or increased urinary frequency reported.\n\nO (Objective):\n- Abdominal palpation revealed tenderness in the right lower abdomen.\n- Rebound tenderness was noted in the right lower abdomen.\n- Positive Rovsing's sign observed (pain on the right side when pressure applied to the left).\n\nA (Assessment):\n- Findings are highly suggestive of acute appendicitis.\n- Potential complication of appendix inflammation and rupture if untreated.\n\nP (Plan):\n- Initiate IV fluids.\n- Administer pain relief medication.\n- Administer antibiotics.\n- NPO status (nothing by mouth) for the patient.\n- Order blood work: CBC, CRP.\n- Order imaging studies: abdominal ultrasound or CT scan to confirm diagnosis.\n- Consult with the surgical team for evaluation within the hour to schedule potential laparoscopic surgery.\n- Patient advised to contact family.\n","review":91.0,"saved":188.0,"clean":false,"effort":8.333333333333332,"sig":[["partial","Discusses likely laparoscopic surgery after confirmation and admission with surgical team review within hours.","Decision to admit omitted and surgical review timing misstated as within the hour."]],"mb":16.550697,"latency":21.508,"signable":100.992},{"label":"Run 2","wer":5.906313645621181,"text":"Bonjour madame.\nJe suis le docteur qui va vous prendre en charge aujourd'hui.\nPlease have a seat.\nUnderstand you've had abdominal pain for at least 4 days, correct? Yes, doctor.\nIt started on Sunday evening.\nOkay.\nCan you tell me where the pain began exactly?\nIt was right here, in my upper belly, but now it's mostly down on the right side.\nJe comprends. So it started in the upper abdomen, and moved to the right lower side. Is that— Wait, doctor, effectivement. Okay, okay. Was the pain sudden or gradual?\nIt was gradual, just a dull ache at first, but now it's sharp, about 8 out of 10. Okay, okay.\nEst-ce que la douleur se propage autre part, par exemple votre dos ou alors vos épaules?\nNo, doctor, it stays in the lower right. Okay. Anything makes it better or worse? Doctor, nothing really helps. Moving around makes it a bit worse.\nEt avez-vous de la fièvre aussi?\nOui, docteur.\nJ'ai fait de la fièvre la nuit dernière, et lorsque j'ai vérifié ma température, j'étais à 38 degrés. Et qu'en est-il des nausées ou alors du vomissement?\nI've vomited 3 times. Especially after eating. I have no appetite at all.\nOkay.\nAny diarrhea ou alors de la constipation? No, doctor.\nBowel movements are normal.\nAny burning when you pass urine or going more often?\nNon, docteur. Tout est bon de ce côté. Okay, okay. Je comprends.\nI'm going to press gently. You tell me when it's tender, okay?\nOw! That hurts right there.\nOkay, okay. How about when I let go? Worse, doctor. That really hurts.\nOkay. Je vais aussi mettre un peu de pression sur le côté gauche.\nLet me know, okay?\nI feel pain on the right side when you do that. Okay. You have tenderness.\nGathering and rebound tenderness in your right lower abdomen.\nAlso, a positive rough things sign.\nThere are very suggestive of acute appendicite.\nDoctor, is it serious? It can be, if not treated.\nThe appendix may be inflamed. And cold rupture.\nWe need to do blood work. CBC, CRP, and likely an abdominal ultrasound or CT. To confirm that.\nDoctor, do I need surgery? Plus ou moins, plus ou moins.\nLaparoscopic, but we will confirm first. I'm going to start IV fluid. Pain relief and antibiotics.\nYou should eat or drink anything now. In case we're going to operate you. Okay? Okay, doctor. Should I call my family? Oui, oui, oui. Allez-y, allez-y. C'est important. We will admit you and have the surgical team. To see within the hours.\nDonc, ils vont programmer si on va vous opérer et ils vont donner la période exacte de l'opération. D'accord? D'accord, docteur. Merci beaucoup.\nOkay. You're welcome. You're welcome. We'll take good care of you and rest assured. Ici avec nous, c'est la guérison assurée. Vous allez forcément trouver guérison et solution à votre problème. D'accord, madame? D'accord, docteur.","marks":[[8,15,"madam",false],[65,77,"aujourd hui.",false],[109,115,"you have",false],[156,163,"",false],[436,448,"Oui docteur",false],[602,602,"Et",false],[670,672,"où",false],[754,756,"him",false],[887,891,"j ai",false],[939,943,"j ai",false],[968,975,"j étais",false],[992,997,"quand",false],[1017,1019,"où",false],[1026,1040,"les vomissements",false],[1135,1137,"où",false],[1302,1307,"Okey",false],[1511,1517,"",false],[1742,1747,"They",false],[1777,1796,"appendices. Dr. but",false],[1874,1878,"could",false],[2015,2017,"au",false],[2030,2032,"au",false],[2185,2190,"we are",false],[2268,2272,"",false],[2291,2296,"c est",false],[2466,2497,"l opération d accord D accord",false],[2562,2567,"We",false],[2623,2628,"c est",false],[2718,2726,"D accord",false],[2736,2744,"D accord",false]],"facts":[["Records four days of abdominal pain beginning Sunday evening, initially upper abdominal then migrating to the right lower abdomen.","yes","Records 4 days from Sunday evening, upper abdomen then right lower side."],["Records gradual onset, initially dull then sharp, currently 8/10.","partial","Records now sharp 8/10 but omits gradual onset and initial dull ache."],["Records pain worsened by movement, nothing relieving it, and no radiation to back or shoulder.","partial","Movement worsens and nothing relieves recorded; absence of radiation to back/shoulder omitted."],["Records fever last night with measured temperature 38 degrees, without inventing other measured vitals.","yes","Fever last night measured at 38 degrees; no other vitals invented."],["Records three vomiting episodes especially after eating, and absent appetite.","yes","Three vomiting episodes especially after eating, and no appetite."],["Records normal bowel movements and denial of urinary burning or increased frequency.","yes","Normal bowel movements; denies dysuria and increased frequency."],["Records right lower abdominal tenderness and rebound tenderness, and right-sided pain elicited by left abdominal pressure.","yes","RLQ tenderness, rebound tenderness and Rovsing sign (right pain on left pressure) recorded."],["Identifies suspected acute appendicitis and risk of rupture if untreated.","yes","Appendicitis suspected with \"rupture of the appendix if not promptly treated\"."],["Plans CBC and CRP blood tests, with abdominal ultrasound or CT to confirm.","yes","CBC and CRP plus abdominal ultrasound or CT to confirm."],["Discusses likely laparoscopic surgery after confirmation and admission with surgical team review within hours.","yes","Admission, surgical team within hours, possible laparoscopic surgery recorded."],["Plans IV fluids, analgesia and antibiotics.","yes","IV fluids, pain relief and antibiotics planned."],["Encourages contacting family and provides reassurance.","partial","Advised to contact family; reassurance not recorded."]],"claims":[],"note":"S (Subjective):\n- The patient reports abdominal pain for the past 4 days, which began on Sunday evening.\n- The pain initially started in the upper abdomen and subsequently localized to the right lower side, now described as sharp with a severity of 8/10.\n- They state that moving around exacerbates the pain, and no specific factors provide relief.\n- Associated symptoms include a fever of 38 degrees Celsius last night, 3 episodes of vomiting, especially after eating, and a complete loss of appetite.\n- The patient denies experiencing diarrhea, constipation, dysuria, or increased urinary frequency, noting normal bowel movements.\n\nO (Objective):\n- Physical examination revealed significant tenderness upon gentle palpation of the right lower abdomen.\n- Rebound tenderness was elicited in the right lower abdomen, reported as worse upon release of pressure.\n- A positive Rovsing's sign was observed, with the patient experiencing pain on the right side when pressure was applied to the left lower abdomen.\n\nA (Assessment):\n- The clinical presentation, including the migratory abdominal pain, fever, vomiting, and specific physical exam findings, is highly suggestive of acute appendicitis.\n- There is a concern for potential inflammation and rupture of the appendix if not promptly treated.\n\nP (Plan):\n- Initiate intravenous fluids, pain relief medication, and antibiotics.\n- Order blood work including a Complete Blood Count (CBC) and C-reactive Protein (CRP).\n- Schedule an abdominal ultrasound or CT scan to confirm the diagnosis.\n- The patient is to remain NPO (nil per os) in preparation for potential surgery.\n- The surgical team will be consulted to evaluate the patient within hours for possible laparoscopic surgery, and the patient will be admitted.\n- Advise the patient to contact their family.\n","review":123.19736842105263,"saved":155.80263157894737,"clean":false,"effort":12.5,"sig":[],"mb":16.527491,"latency":27.892,"signable":139.19336842105264},{"label":"Run 3","wer":5.906313645621181,"text":"Bonjour madame.\nJe suis le docteur qui va vous prendre en charge aujourd'hui.\nPlease have a seat.\nUnderstand you've had abdominal pain for at least 4 days, correct? Yes, doctor.\nIt started on Sunday evening.\nOkay.\nCan you tell me where the pain began exactly?\nIt was right here, in my upper belly, but now it's mostly down on the right side.\nJe comprends. So it started in the upper abdomen, and moved to the right lower side. Is that— Wait, doctor, effectivement. Okay, okay. Was the pain sudden or gradual?\nIt was gradual, just a dull ache at first, but now it's sharp, about 8 out of 10. Okay, okay.\nEst-ce que la douleur se propage autre part, par exemple votre dos ou alors vos épaules?\nNo, doctor, it stays in the lower right. Okay. Anything makes it better or worse? Doctor, nothing really helps. Moving around makes it a bit worse.\nEt avez-vous de la fièvre aussi?\nOui, docteur.\nJ'ai fait de la fièvre la nuit dernière, et lorsque j'ai vérifié ma température, j'étais à 38 degrés. Et qu'en est-il des nausées ou alors du vomissement?\nI've vomited 3 times. Especially after eating. I have no appetite at all.\nOkay.\nAny diarrhea ou alors de la constipation? No, doctor.\nBowel movements are normal.\nAny burning when you pass urine or going more often?\nNon, docteur. Tout est bon de ce côté. Okay, okay. Je comprends.\nI'm going to press gently. You tell me when it's tender, okay?\nOw! That hurts right there.\nOkay, okay. How about when I let go? Worse, doctor. That really hurts.\nOkay. Je vais aussi mettre un peu de pression sur le côté gauche.\nLet me know, okay?\nI feel pain on the right side when you do that. Okay. You have tenderness.\nGathering and rebound tenderness in your right lower abdomen.\nAlso, a positive rough things sign.\nThere are very suggestive of acute appendicite.\nDoctor, is it serious? It can be, if not treated.\nThe appendix may be inflamed. And cold rupture.\nWe need to do blood work: CBC, CRP, and likely an abdominal ultrasound or CT. To confirm that.\nDoctor, do I need surgery? Plus ou moins, plus ou moins.\nLaparoscopic.\nBut we will confirm first. I'm going to start IV fluid. Pain relief and antibiotics.\nYou should eat or drink anything now in case we're going to operate you. Okay? Okay, doctor. Should I call my family? Oui, oui, oui. Allez-y, allez-y. C'est important. We will admit you and have the surgical team to see within the hours.\nDonc, ils vont programmer si on va vous opérer et ils vont donner la période exacte de l'opération. D'accord? D'accord, docteur. Merci beaucoup.\nOkay. You're welcome. You're welcome. We'll take good care of you and rest assured. Ici avec nous, c'est la guérison assurée. Vous allez forcément trouver guérison et solution à votre problème. D'accord, madame? D'accord, docteur.","marks":[[8,15,"madam",false],[65,77,"aujourd hui.",false],[109,115,"you have",false],[156,163,"",false],[436,448,"Oui docteur",false],[602,602,"Et",false],[670,672,"où",false],[754,756,"him",false],[887,891,"j ai",false],[939,943,"j ai",false],[968,975,"j étais",false],[992,997,"quand",false],[1017,1019,"où",false],[1026,1040,"les vomissements",false],[1135,1137,"où",false],[1302,1307,"Okey",false],[1511,1517,"",false],[1742,1747,"They",false],[1777,1796,"appendices. Dr. but",false],[1874,1878,"could",false],[2015,2017,"au",false],[2030,2032,"au",false],[2184,2189,"we are",false],[2267,2271,"",false],[2290,2295,"c est",false],[2464,2495,"l opération d accord D accord",false],[2560,2565,"We",false],[2621,2626,"c est",false],[2716,2724,"D accord",false],[2734,2742,"D accord",false]],"facts":[["Records four days of abdominal pain beginning Sunday evening, initially upper abdominal then migrating to the right lower abdomen.","yes","Records 4 days from Sunday evening, upper abdomen then right lower side."],["Records gradual onset, initially dull then sharp, currently 8/10.","partial","Dull ache now sharp 8/10 recorded; gradual onset not stated."],["Records pain worsened by movement, nothing relieving it, and no radiation to back or shoulder.","yes","Not radiating, movement exacerbates, nothing relieves."],["Records fever last night with measured temperature 38 degrees, without inventing other measured vitals.","yes","Fever last night measured at 38 degrees; no other vitals invented."],["Records three vomiting episodes especially after eating, and absent appetite.","yes","Three vomiting episodes especially after eating, and no appetite."],["Records normal bowel movements and denial of urinary burning or increased frequency.","yes","Normal bowel movements; denies dysuria and increased frequency."],["Records right lower abdominal tenderness and rebound tenderness, and right-sided pain elicited by left abdominal pressure.","yes","RLQ tenderness, rebound tenderness and Rovsing sign (right pain on left pressure) recorded."],["Identifies suspected acute appendicitis and risk of rupture if untreated.","yes","Appendicitis highly suspected; rupture if not treated noted."],["Plans CBC and CRP blood tests, with abdominal ultrasound or CT to confirm.","yes","CBC and CRP plus abdominal ultrasound or CT to confirm."],["Discusses likely laparoscopic surgery after confirmation and admission with surgical team review within hours.","partial","Surgical consult for potential laparoscopic appendectomy recorded, but admission and review within hours omitted."],["Plans IV fluids, analgesia and antibiotics.","yes","IV fluids, pain relief and antibiotics planned."],["Encourages contacting family and provides reassurance.","partial","Advised to inform family; reassurance not recorded."]],"claims":[["Patient appeared cooperative during the examination.","No observation of the patient demeanour or cooperation appears anywhere in the transcript."]],"note":"S (Subjective):\n- Patient presents with abdominal pain for 4 days, starting Sunday evening.\n- Pain began in the upper abdomen and migrated to the right lower side.\n- Initially a dull ache, pain is now sharp, rated 8/10, and is not radiating.\n- Moving around exacerbates the pain; nothing provides relief.\n- Associated symptoms include fever (38°C last night), 3 episodes of vomiting (especially after eating), and no appetite. Patient denies diarrhea, constipation, dysuria, or increased urinary frequency.\n\nO (Objective):\n- Abdominal palpation revealed tenderness in the right lower abdomen.\n- Rebound tenderness was noted in the right lower abdomen.\n- Positive Rovsing's sign observed, with pain in the right side upon palpation of the left side.\n- Patient appeared cooperative during the examination.\n\nA (Assessment):\n- Acute appendicitis is highly suspected based on clinical findings.\n- Potential complication of appendix rupture if not treated.\n\nP (Plan):\n- Initiate IV fluids, pain relief, and antibiotics immediately.\n- NPO status ordered in preparation for potential surgery.\n- Order blood work: CBC and CRP.\n- Schedule abdominal ultrasound or CT scan to confirm diagnosis.\n- Consult surgical team for evaluation and potential laparoscopic appendectomy.\n- Patient advised to inform family about the situation.\n","review":108.86842105263158,"saved":170.13157894736844,"clean":false,"effort":25.0,"sig":[["partial","Discusses likely laparoscopic surgery after confirmation and admission with surgical team review within hours.","Decision to admit and within-hours surgical review omitted from the plan."]],"mb":16.557091,"latency":19.313,"signable":117.86242105263157},{"label":"Run 4","wer":6.109979633401222,"text":"Bonjour madame.\nJe suis le docteur qui va vous prendre en charge aujourd'hui.\nPlease have a seat.\nUnderstand you've had abdominal pain for at least 4 days? Yes, doctor.\nIt started on Sunday evening.\nOkay.\nCan you tell me where the pain began exactly?\nIt was right here, in my upper belly, but now it's mostly down on the right side.\nJe comprends. So it started in the upper abdomen, and moved to the right lower side. Is that— Wait, doctor, effectivement. Okay, okay. Was the pain sudden or gradual?\nIt was gradual, just a dull ache at first, but now it's sharp, about 8 out of 10. Okay, okay.\nEst-ce que la douleur se propage autre part, par exemple votre dos ou alors vos épaules?\nNo, doctor, it stays in the lower right. Okay. Anything makes it better or worse? Doctor, nothing really helps. Moving around makes it a bit worse.\nEt avez-vous de la fièvre aussi?\nOui, docteur.\nJ'ai fait de la fièvre la nuit dernière, et lorsque j'ai vérifié ma température, j'étais à 38 degrés. Et qu'en est-il des nausées ou alors du vomissement?\nI've vomited 3 times. Especially after eating. I have no appetite at all.\nOkay.\nAny diarrhea ou alors de la constipation? No, doctor.\nBowel movements are normal.\nAny burning when you pass urine or going more often?\nNo, doctor. Tout est bon de ce côté. Okay, okay. Je comprends.\nI'm going to press gently. You tell me when it's tender, okay?\nOw! That hurts right there.\nOkay, okay. How about when I let go? Worse, doctor. That really hurts.\nOkay. Je vais aussi mettre un peu de pression sur le côté gauche.\nLet me know, okay?\nI feel pain on the right side when you do that. Okay. You have tenderness.\nGathering and rebound tenderness in your right lower abdomen.\nAlso, a positive rough things sign.\nThere are very suggestive of acute appendicite.\nDoctor, is it serious? It can be, if not treated.\nThe appendix may be inflamed. And cold rupture.\nWe need to do blood work: CBC, CRP, and likely an abdominal ultrasound or CT. To confirm that.\nDoctor, do I need surgery? Plus ou moins, plus ou moins.\nLaparoscopic.\nBut we will confirm first. I'm going to start IV fluid. Pain relief and antibiotics.\nYou should eat or drink anything now in case we're going to operate you. Okay? Okay, doctor. Should I call my family? Oui, oui, oui. Allez-y, allez-y. C'est important. We will admit you and have the surgical team to see within the hours.\nDonc, ils vont programmer si on va vous opérer et ils vont donner la période exacte de l'opération. D'accord? D'accord, docteur. Merci beaucoup.\nOkay. You're welcome. You're welcome. We'll take good care of you and rest assured. Ici avec nous, c'est la guérison assurée. Vous allez forcément trouver guérison et solution à votre problème. D'accord, madame? D'accord, docteur.","marks":[[8,15,"madam",false],[65,77,"aujourd hui.",false],[109,115,"you have",false],[427,439,"Oui docteur",false],[593,593,"Et",false],[661,663,"où",false],[745,747,"him",false],[878,882,"j ai",false],[930,934,"j ai",false],[959,966,"j étais",false],[983,988,"quand",false],[1008,1010,"où",false],[1017,1031,"les vomissements",false],[1126,1128,"où",false],[1248,1259,"Non docteur",false],[1291,1296,"Okey",false],[1500,1506,"",false],[1731,1736,"They",false],[1766,1785,"appendices. Dr. but",false],[1863,1867,"could",false],[2004,2006,"au",false],[2019,2021,"au",false],[2173,2178,"we are",false],[2256,2260,"",false],[2279,2284,"c est",false],[2453,2484,"l opération d accord D accord",false],[2549,2554,"We",false],[2610,2615,"c est",false],[2705,2713,"D accord",false],[2723,2731,"D accord",false]],"facts":[["Records four days of abdominal pain beginning Sunday evening, initially upper abdominal then migrating to the right lower abdomen.","yes","Records 4 days from Sunday evening, upper abdomen then right lower side."],["Records gradual onset, initially dull then sharp, currently 8/10.","yes","\"Onset was gradual, described as a dull ache initially, now sharp and rated 8/10\"."],["Records pain worsened by movement, nothing relieving it, and no radiation to back or shoulder.","yes","Does not radiate, nothing alleviates, moving worsens."],["Records fever last night with measured temperature 38 degrees, without inventing other measured vitals.","yes","Fever last night measured at 38 degrees; no other vitals invented."],["Records three vomiting episodes especially after eating, and absent appetite.","yes","Three vomiting episodes especially after eating, and no appetite."],["Records normal bowel movements and denial of urinary burning or increased frequency.","yes","Normal bowel movements; denies dysuria and increased frequency."],["Records right lower abdominal tenderness and rebound tenderness, and right-sided pain elicited by left abdominal pressure.","yes","RLQ tenderness, rebound tenderness and Rovsing sign (right pain on left pressure) recorded."],["Identifies suspected acute appendicitis and risk of rupture if untreated.","yes","Appendicitis suspected; rupture if untreated noted."],["Plans CBC and CRP blood tests, with abdominal ultrasound or CT to confirm.","yes","CBC and CRP plus abdominal ultrasound or CT to confirm."],["Discusses likely laparoscopic surgery after confirmation and admission with surgical team review within hours.","yes","Admission and surgical consultation within hours for potential laparoscopic surgery."],["Plans IV fluids, analgesia and antibiotics.","yes","IV fluids, pain relief and antibiotics planned."],["Encourages contacting family and provides reassurance.","no","Neither contacting family nor reassurance is recorded."]],"claims":[],"note":"S (Subjective):\n- Patient presents with abdominal pain for 4 days, starting Sunday evening.\n- Pain initially in the upper abdomen, migrating to the right lower side.\n- Onset was gradual, described as a dull ache initially, now sharp and rated 8/10.\n- Pain is localized to the lower right abdomen and does not radiate.\n- Patient reports nothing alleviates the pain; moving around slightly worsens it.\n- Patient experienced fever last night, with a documented temperature of 38 degrees Celsius.\n- Nausea and vomiting occurred 3 times, especially after eating, with associated loss of appetite.\n- Bowel movements are reported as normal; no diarrhea or constipation.\n- No dysuria or increased urinary frequency reported.\n\nO (Objective):\n- Right lower abdominal tenderness upon gentle palpation.\n- Rebound tenderness elicited in the right lower abdomen.\n- Positive Rovsing's sign observed (pain on the right side when pressure is applied to the left).\n\nA (Assessment):\n- Findings are highly suggestive of acute appendicitis.\n- Potential complication includes appendix inflammation and rupture if untreated.\n\nP (Plan):\n- Blood work ordered: CBC and CRP.\n- Imaging studies planned: abdominal ultrasound or CT scan to confirm diagnosis.\n- Initiation of IV fluids, pain relief, and antibiotics.\n- Patient instructed to refrain from eating or drinking in preparation for potential surgery.\n- Admission to the hospital for further management.\n- Surgical team consultation within hours to evaluate and schedule potential laparoscopic surgery.\n","review":82.84210526315789,"saved":196.1578947368421,"clean":false,"effort":8.333333333333332,"sig":[],"mb":16.551207,"latency":19.237,"signable":91.82010526315788},{"label":"Run 5","wer":7.535641547861507,"text":"Bonjour madame.\nJe suis le docteur qui va vous prendre en charge aujourd'hui.\nPlease have a seat.\nUnderstand you've had abdominal pain for at least 4 days, correct? Yes, doctor.\nIt started on Sunday evening.\nOkay.\nCan you tell me where the pain began exactly?\nIt was right here, in my upper belly, but now it's mostly down on the right side.\nJe comprends. So it started in the upper abdomen, and moved to the right lower side. Is that— Wait, doctor, effectivement. Okay, okay. Was the pain sudden or gradual?\nIt was gradual, just a dull ache at first, but now it's sharp, about 8 out of 10. Okay, okay.\nEst-ce que la douleur se propage autre part, par exemple votre dos ou alors vos épaules?\nNo, doctor, it stays in the lower right. Okay. Anything makes it better or worse? Doctor, nothing really helps. Moving around makes it a bit worse.\nEt avez-vous de la fièvre aussi?\nOui, docteur.\nJ'ai fait de la fièvre la nuit dernière, et lorsque j'ai vérifié ma température, j'étais à 38 degrés. Et qu'en est-il des nausées ou alors du vomissement?\nI've vomited 3 times. Especially after eating. I have no appetite at all.\nOkay.\nAny diarrhea ou alors de la constipation? No, doctor.\nBowel movements are normal.\nAny burning when you pass urine or going more often? Hmm, no, doctor. Tout est bon de ce côté. Okay, okay. Je comprends.\nI'm going to press gently. You tell me when it's tender, okay?\nOw! That hurts right there. Hmm, okay, okay. How about when I let go? Worse, doctor. That really hurts.\nOkay. Je vais aussi mettre un peu de pression sur le côté gauche.\nLet me know, okay?\nHmm, I feel pain on the right side when you do that. Okay. You have tenderness.\nGathering and rebound tenderness in your right lower abdomen.\nAlso, a positive rough things sign.\nThere are very suggestive of acute appendicite.\nDoctor, is it serious? It can be, if not treated.\nThe appendix may be inflamed. And cold rupture.\nWe need to do blood work: CBC, CRP, and likely an abdominal ultrasound or CT. To confirm that.\nDoctor, do I need surgery? Euh, plus ou moins, plus ou moins.\nLaparoscopique, but we will confirm first. I'm going to start IV fluid. Pain relief and antibiotics.\nYou should eat or drink anything now in case we're going to operate you. Okay? Okay, doctor. Should I call my family? Euh, oui, oui, oui. Allez-y, allez-y. C'est important. We will admit you and have the surgical team to see within the hours.\nDonc, ils vont programmer si on va vous opérer et ils vont donner la période exacte de l'opération. D'accord? D'accord, docteur. Merci beaucoup.\nOkay. You're welcome. You're welcome. We'll take good care of you, and rest assured. Ici avec nous, c'est la guérison assurée. Vous allez forcément trouver guérison et solution à votre problème. D'accord, madame? D'accord, docteur.","marks":[[8,15,"madam",false],[65,77,"aujourd hui.",false],[109,115,"you have",false],[156,163,"",false],[436,448,"Oui docteur",false],[602,602,"Et",false],[670,672,"où",false],[754,756,"him",false],[887,891,"j ai",false],[939,943,"j ai",false],[968,975,"j étais",false],[992,997,"quand",false],[1017,1019,"où",false],[1026,1040,"les vomissements",false],[1135,1137,"où",false],[1257,1273,"Non docteur",false],[1305,1310,"Okey",false],[1519,1525,"",false],[1755,1760,"They",false],[1790,1809,"appendices. Dr. but",false],[1887,1891,"could",false],[2023,2026,"",false],[2033,2035,"au",false],[2048,2050,"au",false],[2058,2072,"Laparoscopic.",false],[2204,2209,"we are",false],[2277,2285,"",false],[2315,2320,"c est",false],[2489,2520,"l opération d accord D accord",false],[2585,2590,"We",false],[2647,2652,"c est",false],[2742,2750,"D accord",false],[2760,2768,"D accord",false]],"facts":[["Records four days of abdominal pain beginning Sunday evening, initially upper abdominal then migrating to the right lower abdomen.","yes","Records 4 days from Sunday evening, upper abdomen then right lower side."],["Records gradual onset, initially dull then sharp, currently 8/10.","partial","Dull ache now sharp 8/10 recorded; gradual onset not stated."],["Records pain worsened by movement, nothing relieving it, and no radiation to back or shoulder.","yes","No radiation to back/shoulders, nothing alleviates, movement worsens."],["Records fever last night with measured temperature 38 degrees, without inventing other measured vitals.","yes","Fever last night measured at 38 degrees; no other vitals invented."],["Records three vomiting episodes especially after eating, and absent appetite.","yes","Three vomiting episodes especially after eating, and no appetite."],["Records normal bowel movements and denial of urinary burning or increased frequency.","yes","Normal bowel movements; denies dysuria and increased frequency."],["Records right lower abdominal tenderness and rebound tenderness, and right-sided pain elicited by left abdominal pressure.","yes","RLQ tenderness, rebound tenderness and Rovsing sign (right pain on left pressure) recorded."],["Identifies suspected acute appendicitis and risk of rupture if untreated.","yes","Appendicitis suspected with rupture risk if untreated."],["Plans CBC and CRP blood tests, with abdominal ultrasound or CT to confirm.","yes","CBC and CRP plus abdominal ultrasound or CT to confirm."],["Discusses likely laparoscopic surgery after confirmation and admission with surgical team review within hours.","yes","Admission, surgical consultation within hours, laparoscopic operation if indicated."],["Plans IV fluids, analgesia and antibiotics.","yes","IV fluids, pain relief and antibiotics planned."],["Encourages contacting family and provides reassurance.","partial","Advised to contact family; reassurance not recorded."]],"claims":[],"note":"S (Subjective):\n- The patient presented with abdominal pain for 4 days, starting Sunday evening.\n- Pain began in the upper abdomen and migrated to the right lower side, described initially as a dull ache, now sharp, 8/10 in severity.\n- They reported no radiation of pain to the back or shoulders, and nothing alleviates the pain, though moving around worsens it.\n- Associated symptoms include a fever of 38 degrees Celsius last night, 3 episodes of vomiting, especially after eating, and complete loss of appetite.\n- The patient reported normal bowel movements with no diarrhea or constipation, and no dysuria or increased urinary frequency.\n\nO (Objective):\n- Physical examination revealed tenderness in the right lower abdomen upon gentle palpation.\n- Rebound tenderness was elicited in the right lower abdomen.\n- A positive Rovsing's sign was noted, with pain in the right lower abdomen upon pressure to the left side.\n\nA (Assessment):\n- The patient's presentation and physical exam findings are highly suggestive of acute appendicitis.\n- Potential complications include inflammation and rupture of the appendix if left untreated.\n\nP (Plan):\n- Initiate IV fluids, pain relief, and antibiotics.\n- Order blood work including CBC and CRP.\n- Schedule an abdominal ultrasound or CT scan for confirmation of diagnosis.\n- Keep the patient NPO (nil per os) in anticipation of potential surgery.\n- Admit the patient and arrange for a surgical team consultation within hours.\n- Advise the patient to contact their family.\n- The surgical team will determine the need for and schedule a laparoscopic operation if indicated.\n","review":99.36842105263158,"saved":179.63157894736844,"clean":false,"effort":8.333333333333332,"sig":[],"mb":16.555454,"latency":26.65,"signable":114.36842105263158}],"patientnotes":[{"label":"Run 1","wer":32.79022403258656,"text":"Bonjour, madam. So, please have a seat. Understand you have had abdominal pain for at least four days?\nYes, Doctor. It started on Sunday evening.\nOkay. Can you tell me where the pain began exactly?\nIt was right here in my upper belly. But now it's mostly down on the right side.\nSo it started in the upper abdomen and moved to the right lower side. Is that okay? Okay. Was the pain sudden or gradual?\nIt was gradual. Just a tall ache at first. But now it's sharp, about 8 out of 10.\nOkay. Okay. Et CE la doulour se propage autre pas par exemple, votre d'. Eau. Voil?\nNo, Doctor. It stays in the lower right.\nOkay. Anything makes it better or worse,\nDoctor? Nothing really helps. Moving around makes it a bit worse. I've vomited three times, especially after eating. I have no appetite at all. Home.\nOkay. Any diarrhoea, constipation?\nNo, doctor.\nBowel movements\nare normal. Any burning when you pass urine or going more often. Okay. Okay. I'm going to press gently. You tell me when it's tender. Okay.\nOw. That hurts right there.\nOkay. Okay. How about when I let go?\nWorse. Doctor, that really hurts.\nOkay, Let me know. Okay.\nI feel pain on the right side when you do that.\nOkay. You have tenderness gathering and.\nRebound tenderness in your right lower abdomen. Also a positive Rovsing's sign. They are very suggestive of acute appendicitis.\nTotal birth. Is it serious?\nIt can be. If not treated, the appendix may be inflamed and could rupture. We need to do blood work, cbc, CRP and likely an abdominal ultrasound or CT to confirm that.\nDoctor, do I need surgery?\nLaparoscopic.\nBut we will confirm first. I'm going to start IV Felodipine relief and antibiotics. You should eat or drink anything now in case. We are going to operate you. Okay?\nOkay. Doctor, Should I call my family?\nWe will admit you and have the surgical team to see within the ass. Okay? You're welcome. You're welcome. We take good care of you and rest. Ass.\nShot.","marks":[[16,18,"je suis le docteur qui va vous prendre en charge aujourd hui.",false],[278,278,"Je comprends.",false],[356,356,"Oui docteur effectivement.",false],[424,428,"dull",true],[498,500,"est-ce que",false],[504,511,"douleur",false],[529,532,"part",false],[552,565,"dos où alors vos épaules",false],[629,631,"him",false],[714,714,"Et avez-vous de la fièvre aussi Oui docteur j ai fait de la fièvre la nuit dernière et lorsque j ai vérifié ma température j étais à 38 degrés. Et quand est-il des nausées où alors les vomissements",true],[793,798,"",false],[809,818,"diarrhea où alors de la",false],[926,926,"Non docteur tout est bon de ce côté.",true],[933,938,"Okey je comprends.",false],[1105,1105,"je vais aussi mettre de pression sur le côté gauche.",false],[1279,1288,"rough things",false],[1329,1355,"appendices. Dr. but",false],[1564,1564,"Plus au moins plus au moins",false],[1629,1639,"fluid pain",true],[1782,1782,"Oui Oui allez-y allez-y c est important.",false],[1847,1851,"hours. Donc ils vont programmer si on va vous opérer et ils vont donner la période exacte de l opération d accord D accord docteur merci beaucoup.",true],[1925,1935,"assured. Ici avec nous c est la guérison assurée. Vous allez forcément trouver guérison et solution à votre problème. D accord madame D accord docteur.",false]],"facts":[["Records four days of abdominal pain beginning Sunday evening, initially upper abdominal then migrating to the right lower abdomen.","yes","Began Sunday evening in upper abdomen, now right lower abdomen, at least four days."],["Records gradual onset, initially dull then sharp, currently 8/10.","yes","Gradual, dull ache then sharp, severity 8/10 recorded, though phrasing is slightly muddled."],["Records pain worsened by movement, nothing relieving it, and no radiation to back or shoulder.","partial","\"worsened by movement, no relieving measures\" recorded, but absence of radiation to back/shoulder is omitted."],["Records fever last night with measured temperature 38 degrees, without inventing other measured vitals.","no","Fever and the measured 38 degree temperature are not recorded anywhere."],["Records three vomiting episodes especially after eating, and absent appetite.","yes","\"Vomited three times after eating, loss of appetite.\""],["Records normal bowel movements and denial of urinary burning or increased frequency.","yes","\"bowel movements normal\" and \"no ... urinary symptoms\"."],["Records right lower abdominal tenderness and rebound tenderness, and right-sided pain elicited by left abdominal pressure.","yes","Right lower tenderness, rebound tenderness and \"Positive Rovsing's sign\" recorded."],["Identifies suspected acute appendicitis and risk of rupture if untreated.","partial","\"Clinical impression: acute appendicitis\" given, but rupture risk if untreated is not mentioned."],["Plans CBC and CRP blood tests, with abdominal ultrasound or CT to confirm.","yes","\"Obtain blood work including CBC and CRP. Arrange abdominal ultrasound or CT to confirm diagnosis.\""],["Discusses likely laparoscopic surgery after confirmation and admission with surgical team review within hours.","partial","Admission and surgical evaluation for laparoscopic appendectomy noted, but \"within hours\" timing is missing."],["Plans IV fluids, analgesia and antibiotics.","no","\"IV Felodipine for pain relief\" is a wrong drug; IV fluids omitted; only antibiotics correct."],["Encourages contacting family and provides reassurance.","no","No family contact advice or reassurance recorded."]],"claims":[["IV Felodipine for pain relief discussed.","Transcript says only \"pain relief\"; no felodipine (an antihypertensive) is mentioned anywhere."]],"note":"Subjective\n\nChief Complaint::\n\nPatient presents with abdominal pain lasting at least four days.\n\nHistory of Presenting Complaint::\n\nPain began Sunday evening in the upper abdomen, gradually became a dull ache then sharp, now localised to the right lower abdomen, severity 8/10.\n\nDuration four days, worsened by movement, no relieving measures.\n\nVomited three times after eating, loss of appetite, no diarrhoea, constipation, or urinary symptoms; bowel movements normal.\n\nObjective\n\nTenderness noted in the right lower abdomen.\n\nRebound tenderness present in the right lower abdomen.\n\nPositive Rovsing's sign observed.\n\nNot discussed\n\nAssessment\n\nClinical impression: acute appendicitis.\n\nPlan\n\nMedications::\n\nIV Felodipine for pain relief discussed.\n\nAntibiotics discussed.\n\nObtain blood work including CBC and CRP.\n\nArrange abdominal ultrasound or CT to confirm diagnosis.\n\nAdmit patient and have surgical team evaluate for possible laparoscopic appendectomy.\n\nAdvise nil by mouth until further assessment.","review":154.14473684210526,"saved":124.85526315789474,"clean":false,"effort":45.83333333333333,"sig":[["missing","Records fever last night with measured temperature 38 degrees, without inventing other measured vitals.","Fever of 38C is a key history item supporting appendicitis and is entirely absent."],["missing","Plans IV fluids, analgesia and antibiotics.","Analgesia recorded as IV felodipine (an antihypertensive) and IV fluids omitted."]],"mb":16.47986,"latency":24.191,"signable":178.33573684210526},{"label":"Run 2","wer":34.0122199592668,"text":"Bonjour, madam. So, please have a seat. Understand you have had abdominal pain for at least four days?\nYes, Doctor. It started on Sunday evening.\nOkay. Can you tell me where the pain began exactly?\nIt was right here in my upper belly. But now it's mostly down on the right side.\nSo it started in the upper abdomen and moved to the right lower side. Is that okay? Okay. Was the pain sudden or gradual?\nIt was gradual. Just a tall ache at first, but now it's sharp. About eight out of ten.\nOkay.\nEsque. La douleur se propage autre pas. Par exemple. Votre d'. Eau. Voil? Vaux?\nNo, Doctor. It stays in the lower right.\nOkay. Anything makes it better or worse,\nDoctor? Nothing really helps. Moving around makes it a bit worse. I vomited three times, especially after eating. I have no appetite at all.\nOkay. Any diarrhoea, constipation?\nNo, doctor. BOA movement.\nAnimal. Any burning when you pass urine or going more often? Okay. Okay. I'm going to press gently. You tell me when it's tender. Okay.\nOw. That hurts right there.\nOkay. Okay. How about when I let go?\nWorse. Doctor, that really hurts.\nOkay, Let me know. Okay.\nI feel pain on the right side when you do that.\nOkay. You have tenderness gathering and rebound tenderness in your right.\nAbdomen. Also a positive rough things sign. They are very suggestive of acute appendicitis.\nDoctor, Birth. Is it serious?\nIt can be if not treated. The appendix may be inflamed. Cold rupture. We need to do blood work, cbc, CRP and likely an abdominal ultrasound or CT to confirm that.\nDoctor, do I need surgery?\nPRISMA. PRISMA laparoscopic, but we will confirm.\nConfirmed. First I'm going to start IV Felodipine relief and antibiotics. You should eat or drink anything now in case we are going to operate you. Okay?\nOkay. Doctor, Should I call my family?\nWe will admit you and have the surgical team to see within the ass. Okay? You're welcome. You're welcome. We take good care of you and rest assured. Isia VEGNU for sale.\nVato problem.","marks":[[16,18,"je suis le docteur qui va vous prendre en charge aujourd hui.",false],[278,278,"Je comprends.",false],[356,356,"Oui docteur effectivement.",false],[424,428,"dull",true],[494,500,"okay. Et est-ce que",false],[529,533,"part",false],[553,572,"dos où alors vos épaules",false],[636,638,"him",false],[722,723,"Et avez-vous de la fièvre aussi Oui docteur j ai fait de la fièvre la nuit dernière et lorsque j ai vérifié ma température j étais à 38 degrés. Et quand est-il des nausées où alors les vomissements I've",true],[807,816,"diarrhea où alors de la",false],[844,865,"Bowel movements are normal.",false],[917,917,"Non docteur tout est bon de ce côté.",true],[925,930,"Okey je comprends.",false],[1097,1097,"je vais aussi mettre de pression sur le côté gauche.",false],[1239,1239,"lower",true],[1318,1346,"appendices. Dr. but",false],[1418,1422,"and could",false],[1552,1566,"Plus au moins plus au moins",false],[1602,1612,"",false],[1641,1651,"fluid pain",true],[1793,1793,"Oui Oui allez-y allez-y c est important.",false],[1858,1862,"hours. Donc ils vont programmer si on va vous opérer et ils vont donner la période exacte de l opération d accord D accord docteur merci beaucoup.",true],[1944,1978,"Ici avec nous c est la guérison assurée. Vous allez forcément trouver guérison et solution à votre problème. D accord madame D accord docteur.",false]],"facts":[["Records four days of abdominal pain beginning Sunday evening, initially upper abdominal then migrating to the right lower abdomen.","yes","\"Abdominal pain ≥4 days\" and \"Onset Sunday evening in upper abdomen, migrated to right lower quadrant.\""],["Records gradual onset, initially dull then sharp, currently 8/10.","yes","\"Gradual dull ache progressing to sharp pain, 8/10 intensity.\""],["Records pain worsened by movement, nothing relieving it, and no radiation to back or shoulder.","partial","Records \"Movement worsens pain\" but omits that nothing relieves it and the absence of radiation to back/shoulder."],["Records fever last night with measured temperature 38 degrees, without inventing other measured vitals.","no","Fever last night with measured 38 degrees is not recorded anywhere in the note."],["Records three vomiting episodes especially after eating, and absent appetite.","yes","\"three episodes of vomiting after meals; loss of appetite.\""],["Records normal bowel movements and denial of urinary burning or increased frequency.","partial","\"No diarrhoea or constipation\" covers bowels, but denial of urinary burning/frequency is omitted."],["Records right lower abdominal tenderness and rebound tenderness, and right-sided pain elicited by left abdominal pressure.","partial","\"Tenderness and rebound tenderness in right abdomen\" does not localise to lower abdomen, and the left-pressure/right-pain finding is only given as the source-ambiguous \"rough things sign\" without description."],["Identifies suspected acute appendicitis and risk of rupture if untreated.","partial","Identifies \"highly suggestive of acute appendicitis\" but omits risk of rupture if untreated."],["Plans CBC and CRP blood tests, with abdominal ultrasound or CT to confirm.","yes","\"Order CBC and CRP. Arrange abdominal ultrasound or CT to confirm diagnosis.\""],["Discusses likely laparoscopic surgery after confirmation and admission with surgical team review within hours.","partial","\"Admit patient... surgical team to assess for laparoscopic appendectomy\" but omits review within hours."],["Plans IV fluids, analgesia and antibiotics.","no","IV fluids omitted and analgesia recorded as \"IV Felodipine for analgesia\", a wrong medication; only antibiotics correct."],["Encourages contacting family and provides reassurance.","partial","\"Advise patient to inform family\" captured; reassurance not recorded."]],"claims":[["IV Felodipine for analgesia initiated.","Transcript only says \"pain relief\"; no felodipine (an antihypertensive) or any named drug was mentioned."]],"note":"Subjective\n\nChief Complaint::\n\nAbdominal pain ≥4 days.\n\nHistory of Presenting Complaint::\n\nOnset Sunday evening in upper abdomen, migrated to right lower quadrant.\n\nGradual dull ache progressing to sharp pain, 8/10 intensity.\n\nMovement worsens pain; three episodes of vomiting after meals; loss of appetite.\n\nNo diarrhoea or constipation.\n\nObjective\n\nTenderness and rebound tenderness in right abdomen.\n\nPositive rough things sign suggestive of acute appendicitis.\n\nNot discussed\n\nAssessment\n\nClinical picture highly suggestive of acute appendicitis.\n\nPlan\n\nMedications::\n\nIV Felodipine for analgesia initiated.\n\nEmpiric antibiotics started.\n\nOrder CBC and CRP.\n\nArrange abdominal ultrasound or CT to confirm diagnosis.\n\nAdmit patient, keep NPO, surgical team to assess for laparoscopic appendectomy.\n\nAdvise patient to inform family of situation.","review":173.5,"saved":105.5,"clean":false,"effort":50.0,"sig":[["missing","Records fever last night with measured temperature 38 degrees, without inventing other measured vitals.","Measured fever of 38 degrees is absent, a key supporting feature for appendicitis severity."],["missing","Plans IV fluids, analgesia and antibiotics.","IV fluids omitted and analgesia recorded as felodipine, a wrong drug."]],"mb":16.808886,"latency":23.184,"signable":196.684},{"label":"Run 3","wer":32.9938900203666,"text":"Bonjour, madam. So, please have a seat. Understand you have had abdominal pain for at least four days?\nYes, Doctor. It started on Sunday evening.\nOkay. Can you tell me where the pain began exactly?\nIt was right here in my upper belly. But now it's mostly down on the right side.\nSo it started in the upper abdomen and moved to the right lower side. Is that okay? Okay. Was the pain sudden or gradual?\nIt was gradual. Just a dull ache at first. But now it's sharp, about 8 out of 10.\nOkay. Okay. Esque la doulour se propage autre pas. Par exemple, votre d'. Eau?\nNo, Doctor. It stays in the lower. Right.\nOkay. Anything makes it better or worse,\nDoctor? Nothing really helps. Moving around makes it a bit worse. I've vomited three times, especially after eating. I have no appetite at all. Home.\nOkay. Any diarrhoea, constipation?\nNo, doctor.\nBowel movements\nare normal. Any burning when you pass urine or going more often. Okay. Okay. I'm going to press gently. You tell me when it's tender. Okay.\nOw. That hurts right there.\nOkay. Okay. How about when I let go?\nWorse. Doctor, that really hurts.\nOkay, Let me know. Okay.\nI feel pain on the right side when you do that.\nOkay. You have tenderness gathering and.\nRebound tenderness in your right lower abdomen. Also a positive Rovsing's sign. They are very suggestive of acute appendicitis.\nTotal birth. Is it serious?\nIt can be. If not treated, the appendix may be inflamed and could rupture. We need to do blood work, cbc, CRP and likely an abdominal ultrasound or CT to confirm that.\nDoctor, do I need surgery?\nPrismo. Prismo Laparoscopic.\nBut we will confirm first. I'm going to start IV Felodipine relief and antibiotics. You should eat or drink anything now in case. We are going to operate you. Okay?\nOkay. Doctor, Should I call my family?\nWe will admit you and have the surgical team to see within the ass. Okay? You're welcome. You're welcome. We take good care of you and rest. Ass.\nShot.","marks":[[16,18,"je suis le docteur qui va vous prendre en charge aujourd hui.",false],[278,278,"Je comprends.",false],[356,356,"Oui docteur effectivement.",false],[495,500,"Et est-ce que",false],[504,511,"douleur",false],[529,533,"part",false],[553,560,"dos où alors vos épaules",false],[625,627,"him",false],[710,710,"Et avez-vous de la fièvre aussi Oui docteur j ai fait de la fièvre la nuit dernière et lorsque j ai vérifié ma température j étais à 38 degrés. Et quand est-il des nausées où alors les vomissements",true],[789,794,"",false],[805,814,"diarrhea où alors de la",false],[922,922,"Non docteur tout est bon de ce côté.",true],[929,934,"Okey je comprends.",false],[1101,1101,"je vais aussi mettre de pression sur le côté gauche.",false],[1275,1284,"rough things",false],[1325,1351,"appendices. Dr. but",false],[1562,1576,"Plus au moins plus au moins",false],[1640,1650,"fluid pain",true],[1793,1793,"Oui Oui allez-y allez-y c est important.",false],[1858,1862,"hours. Donc ils vont programmer si on va vous opérer et ils vont donner la période exacte de l opération d accord D accord docteur merci beaucoup.",true],[1936,1946,"assured. Ici avec nous c est la guérison assurée. Vous allez forcément trouver guérison et solution à votre problème. D accord madame D accord docteur.",false]],"facts":[["Records four days of abdominal pain beginning Sunday evening, initially upper abdominal then migrating to the right lower abdomen.","yes","\"Abdominal pain ≥4 days\", onset Sunday evening, upper abdomen migrated to right lower quadrant."],["Records gradual onset, initially dull then sharp, currently 8/10.","yes","\"gradual dull ache\" now \"sharp, 8/10\"."],["Records pain worsened by movement, nothing relieving it, and no radiation to back or shoulder.","partial","\"worsened by movement\" recorded but no mention that nothing relieves it or absence of radiation."],["Records fever last night with measured temperature 38 degrees, without inventing other measured vitals.","no","Fever and the 38 degree temperature are not recorded."],["Records three vomiting episodes especially after eating, and absent appetite.","partial","\"vomiting ×3, loss of appetite\" recorded, but 'after eating' is attached to pain worsening rather than vomiting."],["Records normal bowel movements and denial of urinary burning or increased frequency.","yes","\"No diarrhoea, constipation, urinary symptoms; normal bowel movements.\""],["Records right lower abdominal tenderness and rebound tenderness, and right-sided pain elicited by left abdominal pressure.","yes","RLQ tenderness, rebound tenderness and positive Rovsing's sign (right pain on left pressure)."],["Identifies suspected acute appendicitis and risk of rupture if untreated.","partial","\"highly suggestive of acute appendicitis\" but rupture risk if untreated is omitted."],["Plans CBC and CRP blood tests, with abdominal ultrasound or CT to confirm.","yes","\"Order CBC and CRP. Arrange abdominal ultrasound or CT for confirmation.\""],["Discusses likely laparoscopic surgery after confirmation and admission with surgical team review within hours.","partial","Admission, surgical team and possible laparoscopic appendectomy noted, but not the review within hours."],["Plans IV fluids, analgesia and antibiotics.","partial","IV fluids, analgesia and antibiotics listed, but analgesia wrongly specified as \"IV Felodipine\"."],["Encourages contacting family and provides reassurance.","no","No family contact advice or reassurance recorded."]],"claims":[["IV Felodipine for analgesia.","Transcript only says 'pain relief'; no drug named, and felodipine is an antihypertensive, not an analgesic."]],"note":"Subjective\n\nChief Complaint::\n\nAbdominal pain ≥4 days.\n\nHistory of Presenting Complaint::\n\nOnset Sunday evening, gradual dull ache in upper abdomen → migrated to right lower quadrant.\n\nNow sharp, 8/10, worsened by movement and after eating, vomiting ×3, loss of appetite.\n\nNo diarrhoea, constipation, urinary symptoms; normal bowel movements.\n\nObjective\n\nTenderness in RLQ with rebound tenderness and positive Rovsing's sign.\n\nPain increases on release of pressure.\n\nPain intensity 8/10.\n\nAssessment\n\nFindings highly suggestive of acute appendicitis.\n\nPlan\n\nMedications::\n\nIV Felodipine for analgesia.\n\nAntibiotics started.\n\nOrder CBC and CRP.\n\nArrange abdominal ultrasound or CT for confirmation.\n\nAdmit patient, involve surgical team for possible laparoscopic appendectomy.\n\nProvide IV fluids and analgesia.","review":152.98684210526315,"saved":126.01315789473685,"clean":false,"effort":45.83333333333333,"sig":[["missing","Records fever last night with measured temperature 38 degrees, without inventing other measured vitals.","Fever of 38C is a key supporting finding for appendicitis and is absent."],["partial","Plans IV fluids, analgesia and antibiotics.","Analgesia recorded as IV felodipine, an antihypertensive never mentioned."]],"mb":19.814239,"latency":21.165,"signable":174.15184210526314},{"label":"Run 4","wer":33.19755600814664,"text":"Bonjour, madam. So, please have a seat. Understand you have had abdominal pain for at least four days?\nYes, Doctor. It started on Sunday evening.\nOkay. Can you tell me where the pain began exactly?\nIt was right here in my upper belly. But now it's mostly down on the right side.\nSo it started in the upper abdomen and moved to the right lower side. Is that okay? Okay. Was the pain sudden or gradual?\nIt was gradual. Just a tall ache at first. But now it's sharp, about 8 out of 10.\nOkay. Okay. Et CE la doulour se propage autopart par exemple votre d'. Eau. Voil?\nNo, Doctor. It stays in the lower right.\nOkay. Anything makes it better or worse,\nDoctor? Nothing really helps. Moving around makes it a bit worse. I've vomited three times, especially after eating. I have no appetite at all.\nOkay. Any diarrhoea, constipation?\nNo, Doctor.\nBowel movements\nare normal. Any burning when you pass urine or going more often. Okay. Okay. I'm going to press gently. You tell me when it's tender. Okay.\nOw. That hurts right there.\nOkay. Okay. How about when I let go?\nWorse. Doctor, that really hurts.\nOkay, Let me know. Okay.\nI feel pain on the right side when you do that.\nOkay. You have tenderness gathering and.\nRebound tenderness in your right lower abdomen. Also a positive Rovsing's sign. They are very suggestive of acute appendicitis.\nTotal birth. Is it serious?\nIt can be. If not treated, the appendix may be inflamed and could rupture. We need to do blood work, cbc, CRP and likely an abdominal ultrasound or CT to confirm that.\nDoctor need surgery.\nPrismo. Prismo Laparoscopic.\nBut we will confirm first. I'm going to start IV Felodipine relief and antibiotics. You should eat or drink anything now in case. We are going to operate you. Okay?\nOkay. Doctor, Should I call my family?\nWe will admit you and have the surgical team to see within the ass. Okay? You're welcome. You're welcome. We take good care of you and rest. Ass.\nShot.","marks":[[16,18,"je suis le docteur qui va vous prendre en charge aujourd hui.",false],[278,278,"Je comprends.",false],[356,356,"Oui docteur effectivement.",false],[424,428,"dull",true],[498,500,"est-ce que",false],[504,511,"douleur",false],[523,531,"autre part",false],[550,563,"dos où alors vos épaules",false],[627,629,"him",false],[712,712,"Et avez-vous de la fièvre aussi Oui docteur j ai fait de la fièvre la nuit dernière et lorsque j ai vérifié ma température j étais à 38 degrés. Et quand est-il des nausées où alors les vomissements",true],[801,810,"diarrhea où alors de la",false],[918,918,"Non docteur tout est bon de ce côté.",true],[925,930,"Okey je comprends.",false],[1097,1097,"je vais aussi mettre de pression sur le côté gauche.",false],[1271,1280,"rough things",false],[1321,1347,"appendices. Dr. but",false],[1537,1537,"do I",false],[1552,1566,"Plus au moins plus au moins",false],[1630,1640,"fluid pain",true],[1783,1783,"Oui Oui allez-y allez-y c est important.",false],[1848,1852,"hours. Donc ils vont programmer si on va vous opérer et ils vont donner la période exacte de l opération d accord D accord docteur merci beaucoup.",true],[1926,1936,"assured. Ici avec nous c est la guérison assurée. Vous allez forcément trouver guérison et solution à votre problème. D accord madame D accord docteur.",false]],"facts":[["Records four days of abdominal pain beginning Sunday evening, initially upper abdominal then migrating to the right lower abdomen.","yes","Onset Sunday evening in upper abdomen, migrated to right lower abdomen, at least four days."],["Records gradual onset, initially dull then sharp, currently 8/10.","yes","'gradual dull ache' then 'Current pain sharp, 8/10'."],["Records pain worsened by movement, nothing relieving it, and no radiation to back or shoulder.","partial","Worse with movement recorded; nothing relieving and no radiation to back/shoulder omitted."],["Records fever last night with measured temperature 38 degrees, without inventing other measured vitals.","no","Fever with 38 degrees temperature not recorded."],["Records three vomiting episodes especially after eating, and absent appetite.","yes","'three episodes of vomiting, loss of appetite' with relation to eating."],["Records normal bowel movements and denial of urinary burning or increased frequency.","yes","'No diarrhoea, constipation, urinary symptoms; bowel movements normal'."],["Records right lower abdominal tenderness and rebound tenderness, and right-sided pain elicited by left abdominal pressure.","yes","RLQ tenderness, rebound tenderness, positive Rovsing's sign."],["Identifies suspected acute appendicitis and risk of rupture if untreated.","partial","Acute appendicitis identified but rupture risk not mentioned."],["Plans CBC and CRP blood tests, with abdominal ultrasound or CT to confirm.","yes","CBC and CRP plus abdominal ultrasound or CT to confirm."],["Discusses likely laparoscopic surgery after confirmation and admission with surgical team review within hours.","partial","Admission, surgical team and likely laparoscopic appendectomy, but no review within hours."],["Plans IV fluids, analgesia and antibiotics.","no","IV fluids missing and analgesia given as 'IV Felodipine for relief'; only antibiotics correct."],["Encourages contacting family and provides reassurance.","partial","'Discuss family notification with patient' but no reassurance recorded."]],"claims":[["IV Felodipine for relief","Transcript plans 'IV fluid, pain relief and antibiotics'; felodipine (an antihypertensive) is never mentioned, a wrong-medication assertion."]],"note":"Subjective\n\nChief Complaint::\n\nPatient presents with abdominal pain lasting at least four days.\n\nHistory of Presenting Complaint::\n\nPain onset Sunday evening, gradual dull ache in upper abdomen, migrated to right lower abdomen.\n\nCurrent pain sharp, 8/10, worsened by movement and after eating, three episodes of vomiting, loss of appetite.\n\nNo diarrhoea, constipation, urinary symptoms; bowel movements normal.\n\nObjective\n\nTenderness in right lower abdomen.\n\nRebound tenderness present.\n\nPositive Rovsing's sign.\n\nPain increases on release of pressure during palpation.\n\nPain intensity reported as 8/10.\n\nAssessment\n\nFindings highly suggestive of acute appendicitis.\n\nPlan\n\nMedications::\n\nIV Felodipine for relief\n\nAntibiotics\n\nOrder blood work: CBC and CRP.\n\nArrange abdominal ultrasound or CT to confirm diagnosis.\n\nAdmit patient and involve surgical team for likely laparoscopic appendectomy.\n\nDiscuss family notification with patient.","review":146.17105263157896,"saved":132.82894736842104,"clean":false,"effort":41.66666666666667,"sig":[["missing","Records fever last night with measured temperature 38 degrees, without inventing other measured vitals.","Measured fever of 38C is omitted."],["missing","Plans IV fluids, analgesia and antibiotics.","IV fluids omitted and analgesia given as a wrong drug."]],"mb":17.34287,"latency":23.136,"signable":169.30705263157896},{"label":"Run 5","wer":33.19755600814664,"text":"Bonjour, madam. So, please have a seat. Understand you have had abdominal pain for at least four days?\nYes, Doctor. It started on Sunday evening.\nOkay. Can you tell me where the pain began exactly?\nIt was right here in my upper belly. But now it's mostly down on the right side.\nSo it started in the upper abdomen and moved to the right lower side. Is that okay? Okay. Was the pain sudden or gradual?\nIt was gradual. Just a tall ache at first. But now it's sharp, about 8 out of 10.\nOkay. Okay. Et CE la doulour se propage autopart par exemple votre d'. Eau. Voil?\nNo, Doctor. It stays in the lower right.\nOkay. Anything makes it better or worse,\nDoctor? Nothing really helps. Moving around makes it a bit worse. I've vomited three times, especially after eating. I have no appetite at all.\nOkay. Any diarrhoea, constipation?\nNo, Doctor.\nBowel movements\nare normal. Any burning when you pass urine or going more often. Okay. Okay. I'm going to press gently. You tell me when it's tender. Okay.\nOw. That hurts right there.\nOkay. Okay. How about when I let go?\nWorse. Doctor, that really hurts.\nOkay, Let me know. Okay.\nI feel pain on the right side when you do that.\nOkay. You have tenderness gathering and.\nRebound tenderness in your right lower abdomen. Also a positive Rovsing's sign. They are very suggestive of acute appendicitis.\nTotal birth. Is it serious?\nIt can be. If not treated, the appendix may be inflamed and could rupture. We need to do blood work, cbc, CRP and likely an abdominal ultrasound or CT to confirm that.\nDoctor need surgery.\nPrismo. Prismo Laparoscopic.\nBut we will confirm first. I'm going to start IV Felodipine relief and antibiotics. You should eat or drink anything now in case. We are going to operate you. Okay?\nOkay. Doctor, Should I call my family?\nWe will admit you and have the surgical team to see within the ass. Okay? You're welcome. You're welcome. We take good care of you and rest. Ass.\nShot.","marks":[[16,18,"je suis le docteur qui va vous prendre en charge aujourd hui.",false],[278,278,"Je comprends.",false],[356,356,"Oui docteur effectivement.",false],[424,428,"dull",true],[498,500,"est-ce que",false],[504,511,"douleur",false],[523,531,"autre part",false],[550,563,"dos où alors vos épaules",false],[627,629,"him",false],[712,712,"Et avez-vous de la fièvre aussi Oui docteur j ai fait de la fièvre la nuit dernière et lorsque j ai vérifié ma température j étais à 38 degrés. Et quand est-il des nausées où alors les vomissements",true],[801,810,"diarrhea où alors de la",false],[918,918,"Non docteur tout est bon de ce côté.",true],[925,930,"Okey je comprends.",false],[1097,1097,"je vais aussi mettre de pression sur le côté gauche.",false],[1271,1280,"rough things",false],[1321,1347,"appendices. Dr. but",false],[1537,1537,"do I",false],[1552,1566,"Plus au moins plus au moins",false],[1630,1640,"fluid pain",true],[1783,1783,"Oui Oui allez-y allez-y c est important.",false],[1848,1852,"hours. Donc ils vont programmer si on va vous opérer et ils vont donner la période exacte de l opération d accord D accord docteur merci beaucoup.",true],[1926,1936,"assured. Ici avec nous c est la guérison assurée. Vous allez forcément trouver guérison et solution à votre problème. D accord madame D accord docteur.",false]],"facts":[["Records four days of abdominal pain beginning Sunday evening, initially upper abdominal then migrating to the right lower abdomen.","yes","Four days, started Sunday evening in upper abdomen, migrated to right lower abdomen."],["Records gradual onset, initially dull then sharp, currently 8/10.","yes","'began gradually as a dull ache and is now described as sharp, rating 8/10'."],["Records pain worsened by movement, nothing relieving it, and no radiation to back or shoulder.","partial","Records 'Moving worsens the pain' but omits nothing relieving it and no radiation to back/shoulder."],["Records fever last night with measured temperature 38 degrees, without inventing other measured vitals.","no","Fever last night with temperature 38 degrees is not recorded."],["Records three vomiting episodes especially after eating, and absent appetite.","yes","'vomited three times, especially after eating, with loss of appetite'."],["Records normal bowel movements and denial of urinary burning or increased frequency.","yes","'no diarrhoea, constipation, or urinary symptoms and bowel movements are normal'."],["Records right lower abdominal tenderness and rebound tenderness, and right-sided pain elicited by left abdominal pressure.","yes","RLQ tenderness, rebound tenderness and positive Rovsing's sign recorded."],["Identifies suspected acute appendicitis and risk of rupture if untreated.","partial","'highly suggestive of acute appendicitis' but risk of rupture if untreated is not mentioned."],["Plans CBC and CRP blood tests, with abdominal ultrasound or CT to confirm.","yes","'Order blood work including CBC and CRP' and 'abdominal ultrasound or CT to confirm'."],["Discusses likely laparoscopic surgery after confirmation and admission with surgical team review within hours.","partial","Admission, surgical team and likely laparoscopic appendectomy recorded, but review within hours is missing."],["Plans IV fluids, analgesia and antibiotics.","no","IV fluids omitted and analgesia replaced by 'IV Felodipine for relief'; only antibiotics correct."],["Encourages contacting family and provides reassurance.","partial","'Advise the patient to call family' recorded; reassurance only vaguely as 'supportive care'."]],"claims":[["IV Felodipine for relief","Transcript plans 'IV fluid, pain relief and antibiotics'; felodipine (an antihypertensive) is never mentioned, a wrong-medication assertion."]],"note":"Subjective\n\nChief Complaint::\n\nPatient presents with abdominal pain of at least four days duration.\n\nHistory of Presenting Complaint::\n\nThe pain started on Sunday evening in the upper abdomen and has migrated to the right lower abdomen. It began gradually as a dull ache and is now described as sharp, rating 8/10. Moving worsens the pain, and the patient has vomited three times, especially after eating, with loss of appetite. There is no diarrhoea, constipation, or urinary symptoms and bowel movements are normal.\n\nObjective\n\nExamination reveals tenderness in the right lower abdomen with rebound tenderness.\n\nA positive Rovsing's sign is present.\n\nPain increases on release of pressure during palpation.\n\nPain intensity reported as 8 out of 10.\n\nAssessment\n\nFindings are highly suggestive of acute appendicitis.\n\nPlan\n\nMedications::\n\nIV Felodipine for relief.\n\nAntibiotics (unspecified).\n\nOrder blood work including CBC and CRP.\n\nArrange abdominal ultrasound or CT to confirm diagnosis.\n\nAdmit the patient and involve the surgical team for likely laparoscopic appendectomy.\n\nAdvise the patient to call family and provide supportive care during admission.","review":160.38157894736844,"saved":118.61842105263156,"clean":false,"effort":41.66666666666667,"sig":[["missing","Records fever last night with measured temperature 38 degrees, without inventing other measured vitals.","Measured fever of 38C is a key finding in suspected appendicitis and is absent."],["missing","Plans IV fluids, analgesia and antibiotics.","IV fluids omitted and analgesia replaced by a wrong drug."]],"mb":17.492238,"latency":19.094,"signable":179.47557894736843}]}}