× smfs.
Star on GitHub
← Back to runs
Claude Code Claude Code Codex Codex
dp_003 q08 20 files format_spanning Claude Code

Using the HEART score component table in Hugo Marchetti's ED admission note, provide the individual component scores and explain what value was assigned for the 'Troponin' component and why.

Gold answer

From the HEART score table in the ED admission note: History = 1, ECG = 2, Age = 1, Risk factors = 2, Troponin = 2, total = 7. The Troponin component was scored 2 because the initial troponin was 0.21 ng/mL (more than 3× the 99th-percentile cutoff of 0.04 ng/mL), placing it in the highest HEART troponin tier.

Filesystem View raw JSON
Input
208k
Output
304
Steps
7
Tools
4
Latency
27.1s
Cost
$3.15
#2 Ran ls /Users/prasanna/Documents/supermemoryai/supermemoryfs/.scratch/eval/eval/workspace/fs/dp_003/agent_memory/ 36 chars
Command Bash 
ls /Users/prasanna/Documents/supermemoryai/supermemoryfs/.scratch/eval/eval/workspace/fs/dp_003/agent_memory/

{
  "description": "List agent_memory directory contents"
}
Result 4 lines 
clinical
correspondence
memory
tests
#3 Read /Users/prasanna/Documents/supermemoryai/supermemoryfs/.scratch/eval/eval/workspace/fs/dp_003/agent_memory/ 730 chars
Command Grep 
{
  "pattern": "HEART",
  "path": "/Users/prasanna/Documents/supermemoryai/supermemoryfs/.scratch/eval/eval/workspace/fs/dp_003/agent_memory/",
  "output_mode": "files_with_matches"
}
Result 7 lines 
Found 11 files
agent_memory/correspondence/provider/pcp-handoff-letter-2025-11-12.md
agent_memory/correspondence/provider/cohort-followup-velasquez-personal.md
agent_memory/clinical/specialty/cardiology-followup-clinic-2025-11-17.md
agent_memory/clinical/specialty/cardiology-cath-report-2025-11-09.md
agent_memory/clinical/admission/hospitalist-admit-note-2025-11-08.md
agent_memory/clinical/admissi…
#4 Read /Users/prasanna/Documents/supermemoryai/supermemoryfs/.scratch/eval/eval/workspace/fs/dp_003/agent_memory/ 1,135 chars
Command Grep 
{
  "pattern": "Marchetti",
  "path": "/Users/prasanna/Documents/supermemoryai/supermemoryfs/.scratch/eval/eval/workspace/fs/dp_003/agent_memory/",
  "output_mode": "files_with_matches"
}
Result 7 lines 
Found 18 files
agent_memory/correspondence/patient/patient-portal-messages.md
agent_memory/correspondence/patient/patient-symptom-journal-hugo.md
agent_memory/correspondence/provider/pcp-handoff-letter-2025-11-12.md
agent_memory/clinical/specialty/cardiology-followup-clinic-2025-11-17.md
agent_memory/clinical/specialty/cardiology-cath-report-2025-11-09.md
agent_memory/clinical/specialty/gi-consult…
#5 Read agent_memory/clinical/admission/er-admission-note-2025-11-08.md 6,957 chars
Command Grep 
{
  "pattern": "HEART",
  "path": "/Users/prasanna/Documents/supermemoryai/supermemoryfs/.scratch/eval/eval/workspace/fs/dp_003/agent_memory/clinical/admission/er-admission-note-2025-11-08.md",
  "output_mode": "content",
  "-n": true,
  "-C": 30
}
Result 9 lines 
257-## Laboratory Interpretation
258-
259-(See `labs-day0-troponins-cbc-bmp.md` for full printout.)
260-
261-- **Troponin I (Architect, 99th percentile cutoff 0.04 ng/mL):**
262-  - Initial (10:14 draw, result 10:18): **0.21 ng/mL**
263-  - 3-hour (11:18 draw): **0.84 ng/mL**
264-  - 6-hour (13:00 draw): **1.32 ng/mL**
265-  - Trajectory: clearly rising, well above the 99th-percentile cutoff, with…
#7 Reasoning 1,427 chars 
## HEART Score — Hugo Marchetti, ED admission 2025-11-08

From `agent_memory/clinical/admission/er-admission-note-2025-11-08.md` (lines 287–298):

| Component | Patient finding | Score |
|---|---|---|
| **H**istory | Moderately suspicious — sub-sternal pressure, jaw radiation, diaphoresis, but onset at rest and somewhat atypical | 1 |
| **E**CG | 1 mm horizontal ST depression V4–V6, new from prior | 2 |
| **A**ge | 52 (45–64 range) | 1 |
| **R**isk factors | HTN, HLD, prediabetes, former heavy smoker, family Hx premature CAD → ≥3 risk factors | 2 |
| **T**roponin | Initial 0.21 ng/mL (>3× cutoff of 0.04); rising | **2** |
| **Sum (computed)** | | **8** |

(Note: the arithmetic sums to 8, but the documented hand-off number is **HEART 7**, per the cardiology consult's age-component rounding convention. Both 7 and 8 land in the high-risk band → early invasive strategy.)

## Troponin component = 2

The Troponin sub-score was assigned **2** because the initial troponin I value of **0.21 ng/mL** was greater than 3× the assay's 99th-percentile cutoff of **0.04 ng/mL** (3× cutoff = 0.12 ng/mL; 0.21 is ~5× cutoff), and was on a clearly rising trajectory (0.21 → 0.84 → 1.32 ng/mL across the 0/3/6-hour draws). The HEART scoring rubric awards 2 points whenever the initial troponin exceeds 3× the upper reference limit, which this value did on the first draw alone — so the maximum troponin sub-score of 2 was assigned.
Answer
## HEART Score — Hugo Marchetti, ED admission 2025-11-08 From `agent_memory/clinical/admission/er-admission-note-2025-11-08.md` (lines 287–298): | Component | Patient finding | Score | |---|---|---| | **H**istory | Moderately suspicious — sub-sternal pressure, jaw radiation, diaphoresis, but onset at rest and somewhat atypical | 1 | | **E**CG | 1 mm horizontal ST depression V4–V6, new from prior | 2 | | **A**ge | 52 (45–64 range) | 1 | | **R**isk factors | HTN, HLD, prediabetes, former heavy s…
Judge: covers all asked facts
SMFS Won View raw JSON
Input
93k
Output
18
Steps
3
Tools
1
Latency
13.0s
Cost
$1.39
#2 Ran smfs grep "HEART score Hugo Marchetti ED admission troponin" /Users/prasanna/Documents/supermemoryai/supermemoryfs/.scratch/eval/eval/worksp… 4,943 chars
Command Bash 
smfs grep "HEART score Hugo Marchetti ED admission troponin" /Users/prasanna/Documents/supermemoryai/supermemoryfs/.scratch/eval/eval/workspace/smfs/dp_003/agent_memory/

{
  "description": "Search agent memory for HEART score in Hugo Marchetti's ED note"
}
Result 7 lines 
# supermemory semantic search — 10 results for "HEART score Hugo Marchetti ED admission troponin"
# searches by meaning across files in this container. usage:
#   grep "natural language query"          search all files
#   grep "query" path/to/dir/              search within directory
# output: <filepath>:<line_start>-<line_end>:<chunk> (chunk text is verbatim from the file)

/memory/profiles/hugo…
#3 Reasoning 1,315 chars 
Found it. Here are the HEART score component values from Hugo Marchetti's ED admission note (2025-11-08):

## HEART Score Components

| Component | Patient finding | Score |
|---|---|---|
| **H**istory | Moderately suspicious — sub-sternal pressure, jaw radiation, diaphoresis, but onset at rest and somewhat atypical | 1 |
| **E**CG | 1 mm horizontal ST depression V4–V6, new from prior | 2 |
| **A**ge | 52 (45–64 range) | 1 |
| **R**isk factors | HTN, HLD, prediabetes, former heavy smoker, family Hx premature CAD → ≥3 risk factors | 2 |
| **T**roponin | Initial 0.21 ng/mL (>3× cutoff of 0.04); rising | **2** |
| **Sum (computed)** | | **8** |

## Troponin component: 2

The Troponin component was assigned **2** points because the initial troponin was **0.21 ng/mL**, which is **more than 3× the institutional 99th-percentile cutoff of 0.04 ng/mL**, and it was already rising on serial measurement. In HEART scoring, a troponin >3× the upper reference limit scores the maximum of 2 points (vs. 1 for 1–3× cutoff, 0 for ≤ cutoff).

Note: although the arithmetic sum of components is **8**, the note documents a final HEART score of **7** "to align with the cards consult convention" on rounding the age component. Either way, the patient lands in the high-risk band (≥7) supporting an early invasive strategy.
Answer
Found it. Here are the HEART score component values from Hugo Marchetti's ED admission note (2025-11-08): ## HEART Score Components | Component | Patient finding | Score | |---|---|---| | **H**istory | Moderately suspicious — sub-sternal pressure, jaw radiation, diaphoresis, but onset at rest and somewhat atypical | 1 | | **E**CG | 1 mm horizontal ST depression V4–V6, new from prior | 2 | | **A**ge | 52 (45–64 range) | 1 | | **R**isk factors | HTN, HLD, prediabetes, former heavy smoker, family…
Judge: covers all asked facts