feature: Medication Tracking & Vital Sign Correlation
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voltsrage
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{
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"scenario": {
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"id": "medication-false-alarm-01",
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"name": "Post-Metoprolol BP Drop — Expected Pharmacology",
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"description": "68-year-old man admitted for hypertension management. Receives metoprolol for high BP. BP and HR drop into warning range afterward — this is the expected drug effect, not deterioration. Tests whether clinicians rate the post-medication alerts as false positives.",
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"durationMinutes": 180,
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"tags": ["medication", "false-positive", "hypertension", "expected-response"]
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},
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"patient": {
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"firstName": "David",
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"lastName": "Huang",
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"dateOfBirth": "1958-11-03",
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"gender": "Male",
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"mrn": "SIM-004"
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},
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"encounter": {
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"department": "Medical",
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"room": "MED-7A",
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"bed": "2",
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"encounterType": "Inpatient",
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"chiefComplaint": "Uncontrolled hypertension, headache"
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},
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"events": [
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{ "offsetMinutes": 0, "type": "observation", "data": { "code": "HEART_RATE", "value": 92, "unit": "bpm", "source": "monitor" } },
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{ "offsetMinutes": 0, "type": "observation", "data": { "code": "RESP_RATE", "value": 16, "unit": "/min", "source": "manual" } },
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{ "offsetMinutes": 0, "type": "observation", "data": { "code": "SYSTOLIC_BP", "value": 168, "unit": "mmHg", "source": "manual" } },
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{ "offsetMinutes": 0, "type": "observation", "data": { "code": "DIASTOLIC_BP", "value": 98, "unit": "mmHg", "source": "manual" } },
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{ "offsetMinutes": 0, "type": "observation", "data": { "code": "TEMP_C", "value": 36.9, "unit": "°C", "source": "manual" } },
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{ "offsetMinutes": 0, "type": "observation", "data": { "code": "SPO2", "value": 97, "unit": "%", "source": "monitor" } },
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{ "offsetMinutes": 0, "type": "observation", "data": { "code": "AVPU", "value": 0, "unit": "score", "source": "manual" } },
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{ "offsetMinutes": 30, "type": "medication", "data": { "drugName": "metoprolol", "dose": 50, "doseUnit": "mg", "route": "PO", "administeredBy": "nurse-rn-2" }, "note": "Metoprolol administered for BP control" },
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{ "offsetMinutes": 60, "type": "observation", "data": { "code": "HEART_RATE", "value": 78, "unit": "bpm", "source": "monitor" } },
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{ "offsetMinutes": 60, "type": "observation", "data": { "code": "RESP_RATE", "value": 15, "unit": "/min", "source": "manual" } },
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{ "offsetMinutes": 60, "type": "observation", "data": { "code": "SYSTOLIC_BP", "value": 142, "unit": "mmHg", "source": "manual" } },
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{ "offsetMinutes": 60, "type": "observation", "data": { "code": "DIASTOLIC_BP", "value": 88, "unit": "mmHg", "source": "manual" } },
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{ "offsetMinutes": 60, "type": "observation", "data": { "code": "TEMP_C", "value": 36.8, "unit": "°C", "source": "manual" } },
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{ "offsetMinutes": 60, "type": "observation", "data": { "code": "SPO2", "value": 97, "unit": "%", "source": "monitor" } },
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{ "offsetMinutes": 60, "type": "observation", "data": { "code": "AVPU", "value": 0, "unit": "score", "source": "manual" } },
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{ "offsetMinutes": 90, "type": "observation", "data": { "code": "HEART_RATE", "value": 64, "unit": "bpm", "source": "monitor" }, "note": "HR dropping — expected metoprolol effect" },
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{ "offsetMinutes": 90, "type": "observation", "data": { "code": "RESP_RATE", "value": 14, "unit": "/min", "source": "manual" } },
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{ "offsetMinutes": 90, "type": "observation", "data": { "code": "SYSTOLIC_BP", "value": 118, "unit": "mmHg", "source": "manual" } },
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{ "offsetMinutes": 90, "type": "observation", "data": { "code": "DIASTOLIC_BP", "value": 76, "unit": "mmHg", "source": "manual" } },
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{ "offsetMinutes": 90, "type": "observation", "data": { "code": "TEMP_C", "value": 36.8, "unit": "°C", "source": "manual" } },
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{ "offsetMinutes": 90, "type": "observation", "data": { "code": "SPO2", "value": 98, "unit": "%", "source": "monitor" } },
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{ "offsetMinutes": 90, "type": "observation", "data": { "code": "AVPU", "value": 0, "unit": "score", "source": "manual" } },
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{ "offsetMinutes": 120, "type": "observation", "data": { "code": "HEART_RATE", "value": 56, "unit": "bpm", "source": "monitor" }, "note": "HR in low range — metoprolol peak effect" },
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{ "offsetMinutes": 120, "type": "observation", "data": { "code": "RESP_RATE", "value": 14, "unit": "/min", "source": "manual" } },
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{ "offsetMinutes": 120, "type": "observation", "data": { "code": "SYSTOLIC_BP", "value": 106, "unit": "mmHg", "source": "manual" }, "note": "SBP approaching warning range" },
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{ "offsetMinutes": 120, "type": "observation", "data": { "code": "DIASTOLIC_BP", "value": 68, "unit": "mmHg", "source": "manual" } },
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{ "offsetMinutes": 120, "type": "observation", "data": { "code": "TEMP_C", "value": 36.7, "unit": "°C", "source": "manual" } },
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{ "offsetMinutes": 120, "type": "observation", "data": { "code": "SPO2", "value": 97, "unit": "%", "source": "monitor" } },
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{ "offsetMinutes": 120, "type": "observation", "data": { "code": "AVPU", "value": 0, "unit": "score", "source": "manual" } },
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{ "offsetMinutes": 150, "type": "observation", "data": { "code": "HEART_RATE", "value": 52, "unit": "bpm", "source": "monitor" }, "note": "HR 52 — warning range but expected" },
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{ "offsetMinutes": 150, "type": "observation", "data": { "code": "RESP_RATE", "value": 13, "unit": "/min", "source": "manual" } },
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{ "offsetMinutes": 150, "type": "observation", "data": { "code": "SYSTOLIC_BP", "value": 102, "unit": "mmHg", "source": "manual" }, "note": "SBP 102 — warning range but expected" },
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{ "offsetMinutes": 150, "type": "observation", "data": { "code": "DIASTOLIC_BP", "value": 64, "unit": "mmHg", "source": "manual" } },
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{ "offsetMinutes": 150, "type": "observation", "data": { "code": "TEMP_C", "value": 36.7, "unit": "°C", "source": "manual" } },
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{ "offsetMinutes": 150, "type": "observation", "data": { "code": "SPO2", "value": 98, "unit": "%", "source": "monitor" } },
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{ "offsetMinutes": 150, "type": "observation", "data": { "code": "AVPU", "value": 0, "unit": "score", "source": "manual" } },
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{ "offsetMinutes": 180, "type": "observation", "data": { "code": "HEART_RATE", "value": 58, "unit": "bpm", "source": "monitor" }, "note": "Stabilizing — effect wearing off slightly" },
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{ "offsetMinutes": 180, "type": "observation", "data": { "code": "RESP_RATE", "value": 14, "unit": "/min", "source": "manual" } },
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{ "offsetMinutes": 180, "type": "observation", "data": { "code": "SYSTOLIC_BP", "value": 110, "unit": "mmHg", "source": "manual" } },
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{ "offsetMinutes": 180, "type": "observation", "data": { "code": "DIASTOLIC_BP", "value": 70, "unit": "mmHg", "source": "manual" } },
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{ "offsetMinutes": 180, "type": "observation", "data": { "code": "TEMP_C", "value": 36.8, "unit": "°C", "source": "manual" } },
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{ "offsetMinutes": 180, "type": "observation", "data": { "code": "SPO2", "value": 97, "unit": "%", "source": "monitor" } },
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{ "offsetMinutes": 180, "type": "observation", "data": { "code": "AVPU", "value": 0, "unit": "score", "source": "manual" } }
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],
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"expectedOutcomes": [
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{ "afterOffsetMinutes": 120, "type": "alert", "alertType": "WARNING_SYSTOLIC_BP", "description": "SBP 106 enters warning range — should be annotated with metoprolol context if Phase 15 active" },
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{ "afterOffsetMinutes": 150, "type": "alert", "alertType": "WARNING_HEART_RATE", "description": "HR 52 enters low warning range — expected metoprolol effect" },
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{ "afterOffsetMinutes": 150, "type": "alert", "alertType": "RAPID_DETERIORATION", "description": "HR dropped 92→52 and SBP dropped 168→102 — trajectory alert, but pharmacologically expected" }
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]
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}
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