presencesw/mednli · Datasets at Hugging Face

gold_label stringclasses 3 values	sentence1 stringlengths 7 1.07k	sentence2 stringlengths 7 110
entailment	Labs were notable for Cr 1.7 (baseline 0.5 per old records) and lactate 2.4.	Patient has elevated Cr
contradiction	Labs were notable for Cr 1.7 (baseline 0.5 per old records) and lactate 2.4.	Patient has normal Cr
neutral	Labs were notable for Cr 1.7 (baseline 0.5 per old records) and lactate 2.4.	Patient has elevated BUN
entailment	Nystagmus and twiching of R arm was noted.	The patient had abnormal neuro exam.
contradiction	Nystagmus and twiching of R arm was noted.	The patient has a normal neuro exam.
neutral	Nystagmus and twiching of R arm was noted.	The patient has an acute stroke.
entailment	The patient was seen by his primary care physician after he had complained of a one-week history of dyspnea on exertion and jaw tightness.	The patient has symptoms of a CHF exacerbation.
contradiction	The patient was seen by his primary care physician after he had complained of a one-week history of dyspnea on exertion and jaw tightness.	The patient has no symptoms.
neutral	The patient was seen by his primary care physician after he had complained of a one-week history of dyspnea on exertion and jaw tightness.	The patient has has coronary artery disease.
entailment	At [Hospital 1456] Hospital the patient was experiencing 10 out of 10 chest pain and received nitropaste two inches, three sublingual nitroglycerins, morphine 4 mg intravenously, Lopressor 5 mg intravenously.	The patient is being treated with medications used to treat acute coronary syndrome.
contradiction	At [Hospital 1456] Hospital the patient was experiencing 10 out of 10 chest pain and received nitropaste two inches, three sublingual nitroglycerins, morphine 4 mg intravenously, Lopressor 5 mg intravenously.	The patient is asymptomatic.
neutral	At [Hospital 1456] Hospital the patient was experiencing 10 out of 10 chest pain and received nitropaste two inches, three sublingual nitroglycerins, morphine 4 mg intravenously, Lopressor 5 mg intravenously.	The patient is having a myocardial infarction.
entailment	History of nephrolithiasis with hematuria 5.	patient has a history of kidney stones
contradiction	History of nephrolithiasis with hematuria 5.	patient has no history of kidney stones
neutral	History of nephrolithiasis with hematuria 5.	patient has flank pain
entailment	Per patient, he took a combined 100+ pills of Lisinopril, Nifedipine, and Atenolol late yesterday evening.	The patient overdosed on medication.
contradiction	Per patient, he took a combined 100+ pills of Lisinopril, Nifedipine, and Atenolol late yesterday evening.	The patient did not take extra medication.
neutral	Per patient, he took a combined 100+ pills of Lisinopril, Nifedipine, and Atenolol late yesterday evening.	The patient is depressed.
entailment	Temporary pacing wire was placed on [11-7] for persistent complete heart block, but per report the patient was not pacer dependent.	The patient has a heart condition
contradiction	Temporary pacing wire was placed on [11-7] for persistent complete heart block, but per report the patient was not pacer dependent.	The patient has normal cardiac function
neutral	Temporary pacing wire was placed on [11-7] for persistent complete heart block, but per report the patient was not pacer dependent.	The patient has a history of hypertension
entailment	On [8-19], he did finally have his cardiac catheterization which showed no flow limiting coronary artery disease but he did have an ascending aortic aneurysm of approximately six cm.	Cardiac catheterization revealed no blockage
contradiction	On [8-19], he did finally have his cardiac catheterization which showed no flow limiting coronary artery disease but he did have an ascending aortic aneurysm of approximately six cm.	Cardiac catheterization revealed flow limiting blockage
neutral	On [8-19], he did finally have his cardiac catheterization which showed no flow limiting coronary artery disease but he did have an ascending aortic aneurysm of approximately six cm.	The patient has a history of hypertension and smoking
entailment	At [Hospital ] rehab, he was being treated with vanco/flagyl for suspected aspiration pneumonia.	The patient has suspected aspiration pneumonia
contradiction	At [Hospital ] rehab, he was being treated with vanco/flagyl for suspected aspiration pneumonia.	the patient is not on antibiotics
neutral	At [Hospital ] rehab, he was being treated with vanco/flagyl for suspected aspiration pneumonia.	the patient had a stroke
entailment	AROM at delivery yielded clear amniotic fluid.	Patient has delivered a baby
contradiction	AROM at delivery yielded clear amniotic fluid.	Patient has not been pregnant
neutral	AROM at delivery yielded clear amniotic fluid.	Patient has no PMH
entailment	Left dominant, mild left main, 50% left anterior descending and minimal luminal irregularities.	There is 50% blockage in the left anterior descending coronary artery
contradiction	Left dominant, mild left main, 50% left anterior descending and minimal luminal irregularities.	There is no blockage in the coronary arteries
neutral	Left dominant, mild left main, 50% left anterior descending and minimal luminal irregularities.	The patient has a history of high cholesterol and high blood pressure
entailment	The patient began having symptoms of abdominal pain, nausea and vomiting similar to [ Location ]us episodes of diverticulitis three weeks ago and about a week later presented to the [Hospital3 ] when she noted stool draining from her vagina and a CT scan at the outside hospital documented the enterovaginal fistula.	She has a history of digestive disease
contradiction	The patient began having symptoms of abdominal pain, nausea and vomiting similar to [ Location ]us episodes of diverticulitis three weeks ago and about a week later presented to the [Hospital3 ] when she noted stool draining from her vagina and a CT scan at the outside hospital documented the enterovaginal fistula.	She has no gastrointestinal dysfunction
neutral	The patient began having symptoms of abdominal pain, nausea and vomiting similar to [ Location ]us episodes of diverticulitis three weeks ago and about a week later presented to the [Hospital3 ] when she noted stool draining from her vagina and a CT scan at the outside hospital documented the enterovaginal fistula.	She has a history of obesity
entailment	She was started on Dilantin.	The patient has pain.
contradiction	She was started on Dilantin.	The patient has no pain issues.
neutral	She was started on Dilantin.	The patient is hospitalized
entailment	[Known patient firstname ] [Known patient lastname 6979] is a 54-year-old woman with history of CNS lymphoma who presents with increasing seizures and hypotension.	the patient has CNS lymphoma
contradiction	[Known patient firstname ] [Known patient lastname 6979] is a 54-year-old woman with history of CNS lymphoma who presents with increasing seizures and hypotension.	the patient has no neurologic symptoms
neutral	[Known patient firstname ] [Known patient lastname 6979] is a 54-year-old woman with history of CNS lymphoma who presents with increasing seizures and hypotension.	the patient has HIV
entailment	At that time, he characterized his pain as chest tightening and burning, with associated radiation to his neck, jaw and arms.	He has chest pain
contradiction	At that time, he characterized his pain as chest tightening and burning, with associated radiation to his neck, jaw and arms.	He denies pain
neutral	At that time, he characterized his pain as chest tightening and burning, with associated radiation to his neck, jaw and arms.	He has a history of coronary artery disease and hypertension
entailment	Metastatic Renal Cell Carcinoma - diagnosed in [4-/3406] - s/p left radical nephrectomy [5-13] with pathology consistent with clear cell carcinoma - s/p right upper lobe wedge resection for pulmonary metastasis [9-14] - right frontal lobe brain metastasis s/p resection [4-15] with sterotactic radiosurgery to resection site [5-16] - s/p high dose IL-2 [11-15] - s/p right bilobectomy (right upper and right middle lobe) [1-16] - s/p right chest wall resection [11-17] - s/p right lower lobe wedge resection [4-18] - T8 s/p cyberknife [11-18] - s/p sunitinib [8-18] complicated by hand foot syndrome, mucositis - RAD001 trial [1-18] to present - s/p T8 and T9 vetebrectomy and recontruction [3413-8-18] Hypertension Peptic Ulcer Disease (h. pylori positive) Hyperglycemia	History of metastatic cancer
contradiction	Metastatic Renal Cell Carcinoma - diagnosed in [4-/3406] - s/p left radical nephrectomy [5-13] with pathology consistent with clear cell carcinoma - s/p right upper lobe wedge resection for pulmonary metastasis [9-14] - right frontal lobe brain metastasis s/p resection [4-15] with sterotactic radiosurgery to resection site [5-16] - s/p high dose IL-2 [11-15] - s/p right bilobectomy (right upper and right middle lobe) [1-16] - s/p right chest wall resection [11-17] - s/p right lower lobe wedge resection [4-18] - T8 s/p cyberknife [11-18] - s/p sunitinib [8-18] complicated by hand foot syndrome, mucositis - RAD001 trial [1-18] to present - s/p T8 and T9 vetebrectomy and recontruction [3413-8-18] Hypertension Peptic Ulcer Disease (h. pylori positive) Hyperglycemia	No surgical history
neutral	Metastatic Renal Cell Carcinoma - diagnosed in [4-/3406] - s/p left radical nephrectomy [5-13] with pathology consistent with clear cell carcinoma - s/p right upper lobe wedge resection for pulmonary metastasis [9-14] - right frontal lobe brain metastasis s/p resection [4-15] with sterotactic radiosurgery to resection site [5-16] - s/p high dose IL-2 [11-15] - s/p right bilobectomy (right upper and right middle lobe) [1-16] - s/p right chest wall resection [11-17] - s/p right lower lobe wedge resection [4-18] - T8 s/p cyberknife [11-18] - s/p sunitinib [8-18] complicated by hand foot syndrome, mucositis - RAD001 trial [1-18] to present - s/p T8 and T9 vetebrectomy and recontruction [3413-8-18] Hypertension Peptic Ulcer Disease (h. pylori positive) Hyperglycemia	History of hematuria and flank pain
entailment	She had an MRI as part of her metastatic workup which revealed multiple brain metastases, the largest of which was 1.5cm.	Patient has cancer
contradiction	She had an MRI as part of her metastatic workup which revealed multiple brain metastases, the largest of which was 1.5cm.	Patient has no malignancy
neutral	She had an MRI as part of her metastatic workup which revealed multiple brain metastases, the largest of which was 1.5cm.	Patient has disease through her body
entailment	He was able to keep the milk down and at no time vomited or aspirated.	the patient is an infant
contradiction	He was able to keep the milk down and at no time vomited or aspirated.	the patient is aspirating
neutral	He was able to keep the milk down and at no time vomited or aspirated.	the patient is premature
entailment	CXR showed low lung volumes, no focal consolidation or pleural effusion, minimal left basilar atelectasis.	Patient has essentially normal chest X-ray
contradiction	CXR showed low lung volumes, no focal consolidation or pleural effusion, minimal left basilar atelectasis.	Patient has well expanded lungs
neutral	CXR showed low lung volumes, no focal consolidation or pleural effusion, minimal left basilar atelectasis.	Patient has early aspiration
entailment	The patient denied any cough, dysuria, headache, photophobia, stiff neck, or diarrhea.	The patient does not have pain with urination
contradiction	The patient denied any cough, dysuria, headache, photophobia, stiff neck, or diarrhea.	The patient complains of painful urination
neutral	The patient denied any cough, dysuria, headache, photophobia, stiff neck, or diarrhea.	No history of meningitis
entailment	She is currently in stable condition and off of pressors and IABP.	She was treated for a cardiac condition
contradiction	She is currently in stable condition and off of pressors and IABP.	She has no history of cardiac disease
neutral	She is currently in stable condition and off of pressors and IABP.	She has a history of myocardial infarction
entailment	He was given depakote for seizure prevention as well as ativan.	the patient has a history of seizures
contradiction	He was given depakote for seizure prevention as well as ativan.	the patient has no history of seizures
neutral	He was given depakote for seizure prevention as well as ativan.	the patient has a brain tumor
entailment	75 y/o M w/ atrial fibrillation, HTN, dyslipidemia, and DVT (while on coumadin so now on lovenox) who persented with a 1 day history of worsening SOB and cough productive of clear sputum.	the patient has shortness of breath
contradiction	75 y/o M w/ atrial fibrillation, HTN, dyslipidemia, and DVT (while on coumadin so now on lovenox) who persented with a 1 day history of worsening SOB and cough productive of clear sputum.	the patient denies difficulty breathing
neutral	75 y/o M w/ atrial fibrillation, HTN, dyslipidemia, and DVT (while on coumadin so now on lovenox) who persented with a 1 day history of worsening SOB and cough productive of clear sputum.	the patient has pneumonia
entailment	History of TIA [5-/3025] with left hemi[ Location ] that resolved.	Patient has a focal neurological deficit
contradiction	History of TIA [5-/3025] with left hemi[ Location ] that resolved.	Patient has no symptoms
neutral	History of TIA [5-/3025] with left hemi[ Location ] that resolved.	Patient has abnormal brain MRI
entailment	Her abdominal exam was benign.	The patient does not have an abdominal exam concerning for an infection.
contradiction	Her abdominal exam was benign.	The patient has peritoneal signs.
neutral	Her abdominal exam was benign.	The patient does not have an acute intraabdominal process.
entailment	GASTROINTESTINAL: [Known patient lastname 635] was started on Reglan and Zantac on [10-16] to maximize medical therapy that may be contributing to his apneic and bradycardic episodes.	He has had slow heart rate and suspension of breathing
contradiction	GASTROINTESTINAL: [Known patient lastname 635] was started on Reglan and Zantac on [10-16] to maximize medical therapy that may be contributing to his apneic and bradycardic episodes.	His breathing and heart rate have been normal
neutral	GASTROINTESTINAL: [Known patient lastname 635] was started on Reglan and Zantac on [10-16] to maximize medical therapy that may be contributing to his apneic and bradycardic episodes.	He has a history of obesity
entailment	He took some oxycodone without relief.	He had pain
contradiction	He took some oxycodone without relief.	He has no pain
neutral	He took some oxycodone without relief.	He has abdominal pain
entailment	VRE septic thrombophlebitis in IJ ([1-19]) s/p linezolid) 6.	the patient had an infection in the ij
contradiction	VRE septic thrombophlebitis in IJ ([1-19]) s/p linezolid) 6.	the patient has no history of infection
neutral	VRE septic thrombophlebitis in IJ ([1-19]) s/p linezolid) 6.	the patient had a central line
entailment	She was seen by ID at [Hospital1 294] on [6-17] who felt this was less likely an infectious process.	The patient was evaluated by infectious disease specialists
contradiction	She was seen by ID at [Hospital1 294] on [6-17] who felt this was less likely an infectious process.	The patient was suspected to have tuberculosis
neutral	She was seen by ID at [Hospital1 294] on [6-17] who felt this was less likely an infectious process.	The patient has a fever and elevated white count
entailment	Pacemaker for sick sinus syndrome.	Pacemakers are used for symptomatic arrhythmias.
contradiction	Pacemaker for sick sinus syndrome.	Pacemakers are used for pulmonary edema.
neutral	Pacemaker for sick sinus syndrome.	Patients with a pacemakers have atrial fibrillation.
entailment	EMS found her at home where she admitted to ingesting 60mg Cymbalta, 12mg Cyproheptadine, and 22mg Klonopin with an entire bottle of wine (750cc).	She intentionally overdosed on prescription medication
contradiction	EMS found her at home where she admitted to ingesting 60mg Cymbalta, 12mg Cyproheptadine, and 22mg Klonopin with an entire bottle of wine (750cc).	She ingested no medication
neutral	EMS found her at home where she admitted to ingesting 60mg Cymbalta, 12mg Cyproheptadine, and 22mg Klonopin with an entire bottle of wine (750cc).	She has a history of depression
entailment	He underwent partial vertebrectomy, fusion, debridement, and vertebral spacer placement at L3-L4 on [3313-12-1]. .	Patient has had spinal intervention
contradiction	He underwent partial vertebrectomy, fusion, debridement, and vertebral spacer placement at L3-L4 on [3313-12-1]. .	Patient has no PSH
neutral	He underwent partial vertebrectomy, fusion, debridement, and vertebral spacer placement at L3-L4 on [3313-12-1]. .	Patient has back pain
entailment	-Colon CA: T3N2, dx 2 yrs ago, s/p resection ([5-17] LN+), mets to liver and brain, last CEA 7.4 -Chemo: last [11-12] -HTN -GERD	The patient has cancer
contradiction	-Colon CA: T3N2, dx 2 yrs ago, s/p resection ([5-17] LN+), mets to liver and brain, last CEA 7.4 -Chemo: last [11-12] -HTN -GERD	The patient has no history of cancer
neutral	-Colon CA: T3N2, dx 2 yrs ago, s/p resection ([5-17] LN+), mets to liver and brain, last CEA 7.4 -Chemo: last [11-12] -HTN -GERD	History of melena
entailment	Came to ED complaining of vomiting and weakness.	Patient has upper GI pain

entailment

Labs were notable for Cr 1.7 (baseline 0.5 per old records) and lactate 2.4.

Patient has elevated Cr

contradiction

Labs were notable for Cr 1.7 (baseline 0.5 per old records) and lactate 2.4.

Patient has normal Cr

neutral

Labs were notable for Cr 1.7 (baseline 0.5 per old records) and lactate 2.4.

Patient has elevated BUN

entailment

Nystagmus and twiching of R arm was noted.

The patient had abnormal neuro exam.

contradiction

Nystagmus and twiching of R arm was noted.

The patient has a normal neuro exam.

neutral

Nystagmus and twiching of R arm was noted.

The patient has an acute stroke.

entailment

The patient was seen by his primary care physician after he had complained of a one-week history of dyspnea on exertion and jaw tightness.

The patient has symptoms of a CHF exacerbation.

contradiction

The patient was seen by his primary care physician after he had complained of a one-week history of dyspnea on exertion and jaw tightness.

The patient has no symptoms.

neutral

The patient was seen by his primary care physician after he had complained of a one-week history of dyspnea on exertion and jaw tightness.

The patient has has coronary artery disease.

entailment

At [**Hospital 1456**] Hospital the patient was experiencing 10 out of 10 chest pain and received nitropaste two inches, three sublingual nitroglycerins, morphine 4 mg intravenously, Lopressor 5 mg intravenously.

The patient is being treated with medications used to treat acute coronary syndrome.

contradiction

At [**Hospital 1456**] Hospital the patient was experiencing 10 out of 10 chest pain and received nitropaste two inches, three sublingual nitroglycerins, morphine 4 mg intravenously, Lopressor 5 mg intravenously.

The patient is asymptomatic.

neutral

At [**Hospital 1456**] Hospital the patient was experiencing 10 out of 10 chest pain and received nitropaste two inches, three sublingual nitroglycerins, morphine 4 mg intravenously, Lopressor 5 mg intravenously.

The patient is having a myocardial infarction.

entailment

History of nephrolithiasis with hematuria 5.

patient has a history of kidney stones

contradiction

History of nephrolithiasis with hematuria 5.

patient has no history of kidney stones

neutral

History of nephrolithiasis with hematuria 5.

patient has flank pain

entailment

Per patient, he took a combined 100+ pills of Lisinopril, Nifedipine, and Atenolol late yesterday evening.

The patient overdosed on medication.

contradiction

Per patient, he took a combined 100+ pills of Lisinopril, Nifedipine, and Atenolol late yesterday evening.

The patient did not take extra medication.

neutral

Per patient, he took a combined 100+ pills of Lisinopril, Nifedipine, and Atenolol late yesterday evening.

The patient is depressed.

entailment

Temporary pacing wire was placed on [**11-7**] for persistent complete heart block, but per report the patient was not pacer dependent.

The patient has a heart condition

contradiction

Temporary pacing wire was placed on [**11-7**] for persistent complete heart block, but per report the patient was not pacer dependent.

The patient has normal cardiac function

neutral

Temporary pacing wire was placed on [**11-7**] for persistent complete heart block, but per report the patient was not pacer dependent.

The patient has a history of hypertension

entailment

On [**8-19**], he did finally have his cardiac catheterization which showed no flow limiting coronary artery disease but he did have an ascending aortic aneurysm of approximately six cm.

Cardiac catheterization revealed no blockage

contradiction

On [**8-19**], he did finally have his cardiac catheterization which showed no flow limiting coronary artery disease but he did have an ascending aortic aneurysm of approximately six cm.

Cardiac catheterization revealed flow limiting blockage

neutral

On [**8-19**], he did finally have his cardiac catheterization which showed no flow limiting coronary artery disease but he did have an ascending aortic aneurysm of approximately six cm.

The patient has a history of hypertension and smoking

entailment

At [**Hospital **] rehab, he was being treated with vanco/flagyl for suspected aspiration pneumonia.

The patient has suspected aspiration pneumonia

contradiction

At [**Hospital **] rehab, he was being treated with vanco/flagyl for suspected aspiration pneumonia.

the patient is not on antibiotics

neutral

At [**Hospital **] rehab, he was being treated with vanco/flagyl for suspected aspiration pneumonia.

the patient had a stroke

entailment

AROM at delivery yielded clear amniotic fluid.

Patient has delivered a baby

contradiction

AROM at delivery yielded clear amniotic fluid.

Patient has not been pregnant

neutral

AROM at delivery yielded clear amniotic fluid.

Patient has no PMH

entailment

Left dominant, mild left main, 50% left anterior descending and minimal luminal irregularities.

There is 50% blockage in the left anterior descending coronary artery

contradiction

Left dominant, mild left main, 50% left anterior descending and minimal luminal irregularities.

There is no blockage in the coronary arteries

neutral

Left dominant, mild left main, 50% left anterior descending and minimal luminal irregularities.

The patient has a history of high cholesterol and high blood pressure

entailment

The patient began having symptoms of abdominal pain, nausea and vomiting similar to [** Location **]us episodes of diverticulitis three weeks ago and about a week later presented to the [**Hospital3 **] when she noted stool draining from her vagina and a CT scan at the outside hospital documented the enterovaginal fistula.

She has a history of digestive disease

contradiction

The patient began having symptoms of abdominal pain, nausea and vomiting similar to [** Location **]us episodes of diverticulitis three weeks ago and about a week later presented to the [**Hospital3 **] when she noted stool draining from her vagina and a CT scan at the outside hospital documented the enterovaginal fistula.

She has no gastrointestinal dysfunction

neutral

The patient began having symptoms of abdominal pain, nausea and vomiting similar to [** Location **]us episodes of diverticulitis three weeks ago and about a week later presented to the [**Hospital3 **] when she noted stool draining from her vagina and a CT scan at the outside hospital documented the enterovaginal fistula.

She has a history of obesity

entailment

She was started on Dilantin.

The patient has pain.

contradiction

She was started on Dilantin.

The patient has no pain issues.

neutral

She was started on Dilantin.

The patient is hospitalized

entailment

[**Known patient firstname **] [**Known patient lastname 6979**] is a 54-year-old woman with history of CNS lymphoma who presents with increasing seizures and hypotension.

the patient has CNS lymphoma

contradiction

[**Known patient firstname **] [**Known patient lastname 6979**] is a 54-year-old woman with history of CNS lymphoma who presents with increasing seizures and hypotension.

the patient has no neurologic symptoms

neutral

[**Known patient firstname **] [**Known patient lastname 6979**] is a 54-year-old woman with history of CNS lymphoma who presents with increasing seizures and hypotension.

the patient has HIV

entailment

At that time, he characterized his pain as chest tightening and burning, with associated radiation to his neck, jaw and arms.

He has chest pain

contradiction

At that time, he characterized his pain as chest tightening and burning, with associated radiation to his neck, jaw and arms.

He denies pain

neutral

At that time, he characterized his pain as chest tightening and burning, with associated radiation to his neck, jaw and arms.

He has a history of coronary artery disease and hypertension

entailment

Metastatic Renal Cell Carcinoma - diagnosed in [**4-/3406**] - s/p left radical nephrectomy [**5-13**] with pathology consistent with clear cell carcinoma - s/p right upper lobe wedge resection for pulmonary metastasis [**9-14**] - right frontal lobe brain metastasis s/p resection [**4-15**] with sterotactic radiosurgery to resection site [**5-16**] - s/p high dose IL-2 [**11-15**] - s/p right bilobectomy (right upper and right middle lobe) [**1-16**] - s/p right chest wall resection [**11-17**] - s/p right lower lobe wedge resection [**4-18**] - T8 s/p cyberknife [**11-18**] - s/p sunitinib [**8-18**] complicated by hand foot syndrome, mucositis - RAD001 trial [**1-18**] to present - s/p T8 and T9 vetebrectomy and recontruction [**3413-8-18**] Hypertension Peptic Ulcer Disease (h. pylori positive) Hyperglycemia

History of metastatic cancer

contradiction

Metastatic Renal Cell Carcinoma - diagnosed in [**4-/3406**] - s/p left radical nephrectomy [**5-13**] with pathology consistent with clear cell carcinoma - s/p right upper lobe wedge resection for pulmonary metastasis [**9-14**] - right frontal lobe brain metastasis s/p resection [**4-15**] with sterotactic radiosurgery to resection site [**5-16**] - s/p high dose IL-2 [**11-15**] - s/p right bilobectomy (right upper and right middle lobe) [**1-16**] - s/p right chest wall resection [**11-17**] - s/p right lower lobe wedge resection [**4-18**] - T8 s/p cyberknife [**11-18**] - s/p sunitinib [**8-18**] complicated by hand foot syndrome, mucositis - RAD001 trial [**1-18**] to present - s/p T8 and T9 vetebrectomy and recontruction [**3413-8-18**] Hypertension Peptic Ulcer Disease (h. pylori positive) Hyperglycemia

No surgical history

neutral

Metastatic Renal Cell Carcinoma - diagnosed in [**4-/3406**] - s/p left radical nephrectomy [**5-13**] with pathology consistent with clear cell carcinoma - s/p right upper lobe wedge resection for pulmonary metastasis [**9-14**] - right frontal lobe brain metastasis s/p resection [**4-15**] with sterotactic radiosurgery to resection site [**5-16**] - s/p high dose IL-2 [**11-15**] - s/p right bilobectomy (right upper and right middle lobe) [**1-16**] - s/p right chest wall resection [**11-17**] - s/p right lower lobe wedge resection [**4-18**] - T8 s/p cyberknife [**11-18**] - s/p sunitinib [**8-18**] complicated by hand foot syndrome, mucositis - RAD001 trial [**1-18**] to present - s/p T8 and T9 vetebrectomy and recontruction [**3413-8-18**] Hypertension Peptic Ulcer Disease (h. pylori positive) Hyperglycemia

History of hematuria and flank pain

entailment

She had an MRI as part of her metastatic workup which revealed multiple brain metastases, the largest of which was 1.5cm.

Patient has cancer

contradiction

She had an MRI as part of her metastatic workup which revealed multiple brain metastases, the largest of which was 1.5cm.

Patient has no malignancy

neutral

She had an MRI as part of her metastatic workup which revealed multiple brain metastases, the largest of which was 1.5cm.

Patient has disease through her body

entailment

He was able to keep the milk down and at no time vomited or aspirated.

the patient is an infant

contradiction

He was able to keep the milk down and at no time vomited or aspirated.

the patient is aspirating

neutral

He was able to keep the milk down and at no time vomited or aspirated.

the patient is premature

entailment

CXR showed low lung volumes, no focal consolidation or pleural effusion, minimal left basilar atelectasis.

Patient has essentially normal chest X-ray

contradiction

CXR showed low lung volumes, no focal consolidation or pleural effusion, minimal left basilar atelectasis.

Patient has well expanded lungs

neutral

CXR showed low lung volumes, no focal consolidation or pleural effusion, minimal left basilar atelectasis.

Patient has early aspiration

entailment

The patient denied any cough, dysuria, headache, photophobia, stiff neck, or diarrhea.

The patient does not have pain with urination

contradiction

The patient denied any cough, dysuria, headache, photophobia, stiff neck, or diarrhea.

The patient complains of painful urination

neutral

The patient denied any cough, dysuria, headache, photophobia, stiff neck, or diarrhea.

No history of meningitis

entailment

She is currently in stable condition and off of pressors and IABP.

She was treated for a cardiac condition

contradiction

She is currently in stable condition and off of pressors and IABP.

She has no history of cardiac disease

neutral

She is currently in stable condition and off of pressors and IABP.

She has a history of myocardial infarction

entailment

He was given depakote for seizure prevention as well as ativan.

the patient has a history of seizures

contradiction

He was given depakote for seizure prevention as well as ativan.

the patient has no history of seizures

neutral

He was given depakote for seizure prevention as well as ativan.

the patient has a brain tumor

entailment

75 y/o M w/ atrial fibrillation, HTN, dyslipidemia, and DVT (while on coumadin so now on lovenox) who persented with a 1 day history of worsening SOB and cough productive of clear sputum.

the patient has shortness of breath

contradiction

75 y/o M w/ atrial fibrillation, HTN, dyslipidemia, and DVT (while on coumadin so now on lovenox) who persented with a 1 day history of worsening SOB and cough productive of clear sputum.

the patient denies difficulty breathing

neutral

75 y/o M w/ atrial fibrillation, HTN, dyslipidemia, and DVT (while on coumadin so now on lovenox) who persented with a 1 day history of worsening SOB and cough productive of clear sputum.

the patient has pneumonia

entailment

History of TIA [**5-/3025**] with left hemi[** Location **] that resolved.

Patient has a focal neurological deficit

contradiction

History of TIA [**5-/3025**] with left hemi[** Location **] that resolved.

Patient has no symptoms

neutral

History of TIA [**5-/3025**] with left hemi[** Location **] that resolved.

Patient has abnormal brain MRI

entailment

Her abdominal exam was benign.

The patient does not have an abdominal exam concerning for an infection.

contradiction

Her abdominal exam was benign.

The patient has peritoneal signs.

neutral

Her abdominal exam was benign.

The patient does not have an acute intraabdominal process.

entailment

GASTROINTESTINAL: [**Known patient lastname 635**] was started on Reglan and Zantac on [**10-16**] to maximize medical therapy that may be contributing to his apneic and bradycardic episodes.

He has had slow heart rate and suspension of breathing

contradiction

GASTROINTESTINAL: [**Known patient lastname 635**] was started on Reglan and Zantac on [**10-16**] to maximize medical therapy that may be contributing to his apneic and bradycardic episodes.

His breathing and heart rate have been normal

neutral

GASTROINTESTINAL: [**Known patient lastname 635**] was started on Reglan and Zantac on [**10-16**] to maximize medical therapy that may be contributing to his apneic and bradycardic episodes.

He has a history of obesity

entailment

He took some oxycodone without relief.

He had pain

contradiction

He took some oxycodone without relief.

He has no pain

neutral

He took some oxycodone without relief.

He has abdominal pain

entailment

VRE septic thrombophlebitis in IJ ([**1-19**]) s/p linezolid) 6.

the patient had an infection in the ij

contradiction

VRE septic thrombophlebitis in IJ ([**1-19**]) s/p linezolid) 6.

the patient has no history of infection

neutral

VRE septic thrombophlebitis in IJ ([**1-19**]) s/p linezolid) 6.

the patient had a central line

entailment

She was seen by ID at [**Hospital1 294**] on [**6-17**] who felt this was less likely an infectious process.

The patient was evaluated by infectious disease specialists

contradiction

She was seen by ID at [**Hospital1 294**] on [**6-17**] who felt this was less likely an infectious process.

The patient was suspected to have tuberculosis

neutral

She was seen by ID at [**Hospital1 294**] on [**6-17**] who felt this was less likely an infectious process.

The patient has a fever and elevated white count

entailment

Pacemaker for sick sinus syndrome.

Pacemakers are used for symptomatic arrhythmias.

contradiction

Pacemaker for sick sinus syndrome.

Pacemakers are used for pulmonary edema.

neutral

Pacemaker for sick sinus syndrome.

Patients with a pacemakers have atrial fibrillation.

entailment

EMS found her at home where she admitted to ingesting 60mg Cymbalta, 12mg Cyproheptadine, and 22mg Klonopin with an entire bottle of wine (750cc).

She intentionally overdosed on prescription medication

contradiction

EMS found her at home where she admitted to ingesting 60mg Cymbalta, 12mg Cyproheptadine, and 22mg Klonopin with an entire bottle of wine (750cc).

She ingested no medication

neutral

EMS found her at home where she admitted to ingesting 60mg Cymbalta, 12mg Cyproheptadine, and 22mg Klonopin with an entire bottle of wine (750cc).

She has a history of depression

entailment

He underwent partial vertebrectomy, fusion, debridement, and vertebral spacer placement at L3-L4 on [**3313-12-1**]. .

Patient has had spinal intervention

contradiction

He underwent partial vertebrectomy, fusion, debridement, and vertebral spacer placement at L3-L4 on [**3313-12-1**]. .

Patient has no PSH

neutral

He underwent partial vertebrectomy, fusion, debridement, and vertebral spacer placement at L3-L4 on [**3313-12-1**]. .

Patient has back pain

entailment

-Colon CA: T3N2, dx 2 yrs ago, s/p resection ([**5-17**] LN+), mets to liver and brain, last CEA 7.4 -Chemo: last [**11-12**] -HTN -GERD

The patient has cancer

contradiction

-Colon CA: T3N2, dx 2 yrs ago, s/p resection ([**5-17**] LN+), mets to liver and brain, last CEA 7.4 -Chemo: last [**11-12**] -HTN -GERD

The patient has no history of cancer

neutral

-Colon CA: T3N2, dx 2 yrs ago, s/p resection ([**5-17**] LN+), mets to liver and brain, last CEA 7.4 -Chemo: last [**11-12**] -HTN -GERD

History of melena

entailment

Came to ED complaining of vomiting and weakness.

Patient has upper GI pain