Datasets:

TIM0927
/

MedPIC-Bench

instance_id stringlengths 9 18	patient_vignette stringlengths 52 559	question stringlengths 52 139	options dict	answer listlengths 1 5	taxonomy_clinical_department stringclasses 11 values	taxonomy_clinical_system stringclasses 9 values	taxonomy_drug_categories listlengths 1 4	taxonomy_patient_info_type stringclasses 8 values	taxonomy_population_source stringclasses 3 values	taxonomy_reasoning_operation stringclasses 5 values	benchmark_task_family stringclasses 2 values
SS-HF-HFREF-001	A 71-year-old man has heart failure with reduced ejection fraction (LVEF 32%), currently asymptomatic on guideline-directed therapy review. No other significant past medical history; renal and hepatic function normal; not on other prescription medications; no known drug allergies.	For this patient, which of the following drugs should be avoided?	{ "A": "Verapamil", "B": "Dextromethorphan-quinidine", "C": "Diltiazem", "D": "Amlodipine", "E": "Cilostazol" }	[ "A", "B", "C", "E" ]	cardiology	cardiovascular system	[ "calcium-channel blockers", "antiarrhythmics", "pde3 inhibitors/peripheral vascular drugs" ]	disease presence	older adults	static risk identification	guideline_following
SS-HF-HFPEF-001	A 71-year-old man has heart failure with preserved ejection fraction (LVEF 58%), currently asymptomatic. No other significant past medical history; renal and hepatic function normal; not on other prescription medications; no known drug allergies.	Which of the following medications are potentially inappropriate for this patient?	{ "A": "Metformin", "B": "Dextromethorphan-quinidine", "C": "Cilostazol", "D": "Atorvastatin", "E": "None of the above need to be avoided" }	[ "B", "C" ]	cardiology	cardiovascular system	[ "antiarrhythmics", "pde3 inhibitors/peripheral vascular drugs" ]	disease presence	older adults	static risk identification	guideline_following
SS-HF-NOHF-001	A 71-year-old man presents for a routine geriatric review. He has no history of heart failure and a recent echocardiogram showed normal left ventricular function (LVEF 62%). No other pertinent past medical history; kidney and liver function are normal; not on any other prescription drugs; no known drug allergies.	Given this patient's condition, which of the drugs below are unsuitable?	{ "A": "None of the above need to be avoided", "B": "Metformin", "C": "Empagliflozin", "D": "Dextromethorphan-quinidine", "E": "Levothyroxine" }	[ "A" ]	cardiology	cardiovascular system	[ "antidiabetics", "antiarrhythmics", "thyroid hormones" ]	disease presence	older adults	static risk identification	guideline_following
SS-HF-HFREF-002	An 82-year-old woman has heart failure with reduced ejection fraction (LVEF 28%) on stable medical therapy and is currently free of decompensation symptoms. No other significant past medical history; renal and hepatic function normal; not on other prescription medications; no known drug allergies.	Based on safe prescribing principles for older adults, which of these drugs should this patient avoid?	{ "A": "Diltiazem", "B": "Verapamil", "C": "Dextromethorphan-quinidine", "D": "Cilostazol", "E": "None of the above need to be avoided" }	[ "A", "B", "D" ]	cardiology	cardiovascular system	[ "calcium-channel blockers", "antiarrhythmics", "pde3 inhibitors/peripheral vascular drugs" ]	disease presence	older adults	static risk identification	guideline_following
SS-HF-HFPEF-002	An 82-year-old woman has heart failure with preserved ejection fraction (LVEF 55%) and is currently asymptomatic. No other pertinent past medical history; kidney and liver function are normal; not on any other prescription drugs; no known drug allergies.	Which of the following options constitute potentially inappropriate medications for this patient?	{ "A": "Dextromethorphan-quinidine", "B": "Diltiazem", "C": "Verapamil", "D": "None of the above need to be avoided", "E": "Cilostazol" }	[ "A", "E" ]	cardiology	cardiovascular system	[ "antiarrhythmics", "pde3 inhibitors/peripheral vascular drugs" ]	disease presence	older adults	static risk identification	guideline_following
SS-HF-NOHF-002	An 82-year-old woman presents for a wellness visit. She has no history of heart failure and her cardiac function is normal (LVEF 60%). Otherwise unremarkable medical history; normal renal and hepatic function; not taking other prescription drugs; no known allergies.	Looking at this patient, which medications would you not prescribe?	{ "A": "Lisinopril", "B": "Atorvastatin", "C": "None of the above need to be avoided", "D": "Amlodipine", "E": "Cilostazol" }	[ "C" ]	cardiology	cardiovascular system	[ "ras inhibitors", "statins", "calcium-channel blockers", "pde3 inhibitors/peripheral vascular drugs" ]	disease presence	older adults	static risk identification	guideline_following
SS-HF-HFPEF-003	A 76-year-old man with heart failure with preserved ejection fraction (LVEF 62%) is followed in a geriatric clinic. He has no current decompensation. Otherwise unremarkable medical history; normal renal and hepatic function; not taking other prescription drugs; no known allergies.	Considering this patient's history, which drugs below should be avoided?	{ "A": "Amlodipine", "B": "None of the above need to be avoided", "C": "Cilostazol", "D": "Metformin", "E": "Dextromethorphan-quinidine" }	[ "C", "E" ]	cardiology	cardiovascular system	[ "pde3 inhibitors/peripheral vascular drugs", "antiarrhythmics" ]	disease presence	older adults	static risk identification	guideline_following
SS-HF-SYMP-004	A 79-year-old woman has heart failure and is currently symptomatic with NYHA class III symptoms (dyspnea on minimal exertion and lower-extremity edema). Remainder of medical history is unremarkable; renal and hepatic function within normal limits; not on additional prescription medications; no drug allergies reported.	Which of the listed medications poses a concern for this patient?	{ "A": "Dronedarone", "B": "None of the above need to be avoided", "C": "Metformin", "D": "Pioglitazone", "E": "NSAIDs and COX-2 inhibitors" }	[ "A", "D", "E" ]	cardiology	cardiovascular system	[ "antiarrhythmics", "thiazolidinedione antidiabetics", "nsaids/antipyretic analgesics" ]	disease presence	older adults	static risk identification	guideline_following
SS-HF-NOHF-004	A 79-year-old woman presents for a medication review. She has no history of heart failure and her cardiac function is normal. Remainder of medical history is unremarkable; renal and hepatic function within normal limits; not on additional prescription medications; no drug allergies reported.	Reviewing this patient's profile, which of these medications would you avoid?	{ "A": "None of the above need to be avoided", "B": "Bisoprolol", "C": "Pioglitazone", "D": "Metformin", "E": "Empagliflozin" }	[ "C" ]	cardiology	cardiovascular system	[ "thiazolidinedione antidiabetics", "antidiabetics" ]	disease presence	older adults	static risk identification	guideline_following
SS-SY-POS-005	An 80-year-old man has a documented history of recurrent syncope, with episodes attributed to bradycardia. No other significant past medical history; renal and hepatic function normal; not on other prescription medications; no known drug allergies.	Which agents below are potentially inappropriate in this patient?	{ "A": "None of the above need to be avoided", "B": "Acetaminophen", "C": "Donepezil", "D": "Galantamine", "E": "Rivastigmine" }	[ "C", "D", "E" ]	neurology	nervous system	[ "cholinesterase inhibitors" ]	disease presence	older adults	static risk identification	guideline_following
SS-SY-NEG-005	An 80-year-old man has no history of syncope and presents for a routine medication review. Past medical history is otherwise unremarkable; renal and hepatic function are normal; not currently on other prescription medications; no drug allergies.	For this patient, which of the following drugs should be avoided?	{ "A": "Acetaminophen", "B": "None of the above need to be avoided", "C": "Atorvastatin", "D": "Galantamine", "E": "Lisinopril" }	[ "B" ]	neurology	nervous system	[ "antipyretic analgesics", "statins", "cholinesterase inhibitors", "ras inhibitors" ]	disease presence	older adults	static risk identification	guideline_following
SS-SY-POS-006	A 78-year-old woman has a history of recurrent syncope attributed to orthostatic hypotension. No other significant past medical history; renal and hepatic function normal; not on other prescription medications; no known drug allergies.	Which of the following medications are potentially inappropriate for this patient?	{ "A": "Doxazosin", "B": "Prazosin", "C": "Imipramine", "D": "Amitriptyline", "E": "Terazosin" }	[ "A", "B", "C", "D", "E" ]	neurology	nervous system	[ "alpha-1 receptor blockers", "tricyclic antidepressants" ]	disease presence	older adults	static risk identification	guideline_following
SS-SY-NEG-006	A 78-year-old woman presents for medication review with no history of syncope or near-syncope. Remainder of medical history is unremarkable; renal and hepatic function within normal limits; not on additional prescription medications; no drug allergies reported.	Given this patient's condition, which of the drugs below are unsuitable?	{ "A": "Amlodipine", "B": "None of the above need to be avoided", "C": "Metformin", "D": "Levothyroxine", "E": "Lisinopril" }	[ "B" ]	neurology	nervous system	[ "calcium-channel blockers", "antidiabetics", "thyroid hormones", "ras inhibitors" ]	disease presence	older adults	static risk identification	guideline_following
SS-SY-POS-007	A 75-year-old man has a documented history of syncope. No other significant past medical history; renal and hepatic function normal; not on other prescription medications; no known drug allergies.	Based on safe prescribing principles for older adults, which of these drugs should this patient avoid?	{ "A": "Lisinopril", "B": "Chlorpromazine", "C": "None of the above need to be avoided", "D": "Cetirizine", "E": "Olanzapine" }	[ "B", "E" ]	neurology	nervous system	[ "antipsychotics" ]	disease presence	older adults	static risk identification	guideline_following
SS-SY-NEG-007	A 75-year-old man has no history of syncope and presents for an annual review. No other significant past medical history; renal and hepatic function normal; not on other prescription medications; no known drug allergies.	Which of the following options constitute potentially inappropriate medications for this patient?	{ "A": "Empagliflozin", "B": "None of the above need to be avoided", "C": "Metformin", "D": "Lisinopril", "E": "Cetirizine" }	[ "B" ]	neurology	nervous system	[ "antidiabetics", "ras inhibitors", "antihistamines" ]	disease presence	older adults	static risk identification	guideline_following
SS-DE-POS-008	A 78-year-old woman is hospitalized and currently has active delirium. Past medical history is otherwise unremarkable; renal and hepatic function are normal; not currently on other prescription medications; no drug allergies.	Looking at this patient, which medications would you not prescribe?	{ "A": "Hydroxyzine", "B": "Metformin", "C": "Acetaminophen", "D": "None of the above need to be avoided", "E": "Diphenhydramine" }	[ "A", "E" ]	neurology	nervous system	[ "antihistamines" ]	disease presence	older adults	static risk identification	guideline_following
SS-DE-NEG-008	A 78-year-old woman is seen in outpatient clinic; she has no delirium and no risk factors for delirium. Past medical history is otherwise unremarkable; renal and hepatic function are normal; not currently on other prescription medications; no drug allergies.	Among the options below, which are inappropriate for this patient?	{ "A": "Lisinopril", "B": "Metformin", "C": "Atorvastatin", "D": "None of the above need to be avoided", "E": "Loratadine" }	[ "D" ]	neurology	nervous system	[ "ras inhibitors", "antidiabetics", "statins", "antihistamines" ]	disease presence	older adults	static risk identification	guideline_following
SS-DE-POS-009	An 81-year-old man is admitted to the hospital with acute delirium. Otherwise unremarkable medical history; normal renal and hepatic function; not taking other prescription drugs; no known allergies.	Considering this patient's history, which drugs below should be avoided?	{ "A": "Empagliflozin", "B": "Eszopiclone", "C": "Lorazepam", "D": "Zolpidem", "E": "None of the above need to be avoided" }	[ "B", "C", "D" ]	neurology	nervous system	[ "z-drugs", "benzodiazepines" ]	disease presence	older adults	static risk identification	guideline_following
SS-DE-NEG-009	An 81-year-old man attends a geriatric clinic; he is alert, fully oriented, and has no delirium or risk factors for delirium. Past medical history is otherwise unremarkable; renal and hepatic function are normal; not currently on other prescription medications; no drug allergies.	Which of the listed medications poses a concern for this patient?	{ "A": "None of the above need to be avoided", "B": "Atorvastatin", "C": "Acetaminophen", "D": "Metformin", "E": "Lisinopril" }	[ "A" ]	neurology	nervous system	[ "statins", "antipyretic analgesics", "antidiabetics", "ras inhibitors" ]	disease presence	older adults	static risk identification	guideline_following
SS-DE-POS-010	A 73-year-old woman is hospitalized with active delirium following an acute illness. Otherwise unremarkable medical history; normal renal and hepatic function; not taking other prescription drugs; no known allergies.	In this patient, which of the following drugs should not be initiated?	{ "A": "None of the above need to be avoided", "B": "Omeprazole", "C": "Nizatidine", "D": "Famotidine", "E": "Cimetidine" }	[ "C", "D", "E" ]	neurology	nervous system	[ "h2-receptor antagonists" ]	disease presence	older adults	static risk identification	guideline_following
SS-DE-NEG-010	A 73-year-old woman is seen in outpatient clinic; she has no delirium and is not at elevated risk. Past medical history is otherwise unremarkable; renal and hepatic function are normal; not currently on other prescription medications; no drug allergies.	Reviewing this patient's profile, which of these medications would you avoid?	{ "A": "Metformin", "B": "None of the above need to be avoided", "C": "Ondansetron", "D": "Loratadine", "E": "Cetirizine" }	[ "B" ]	neurology	nervous system	[ "antidiabetics", "antihistamines" ]	disease presence	older adults	static risk identification	guideline_following
SS-DE-POS-011	A 76-year-old man is admitted with acute delirium. No other significant past medical history; renal and hepatic function normal; not on other prescription medications; no known drug allergies.	Which agents below are potentially inappropriate in this patient?	{ "A": "None of the above need to be avoided", "B": "Oxycodone", "C": "Empagliflozin", "D": "Prednisone", "E": "Acetaminophen" }	[ "B", "D" ]	neurology	nervous system	[ "opioids" ]	disease presence	older adults	static risk identification	guideline_following
SS-DE-NEG-011	A 76-year-old man is seen in outpatient clinic with no delirium and no risk factors. Otherwise unremarkable medical history; normal renal and hepatic function; not taking other prescription drugs; no known allergies.	For this patient, which of the following drugs should be avoided?	{ "A": "Metformin", "B": "Acetaminophen", "C": "None of the above need to be avoided", "D": "Oxycodone", "E": "Amlodipine" }	[ "C" ]	neurology	nervous system	[ "antidiabetics", "antipyretic analgesics", "opioids", "calcium-channel blockers" ]	disease presence	older adults	static risk identification	guideline_following
SS-DM-POS-012	A 79-year-old woman has mild-to-moderate dementia of the Alzheimer type. Remainder of medical history is unremarkable; renal and hepatic function within normal limits; not on additional prescription medications; no drug allergies reported.	Which of the following medications are potentially inappropriate for this patient?	{ "A": "Empagliflozin", "B": "Lisinopril", "C": "Diphenhydramine", "D": "Oxybutynin", "E": "None of the above need to be avoided" }	[ "C", "D" ]	neurology	nervous system	[ "antihistamines" ]	disease presence	older adults	static risk identification	guideline_following
SS-DM-NEG-012	A 79-year-old woman has no cognitive impairment on formal testing and presents for a routine review. Past medical history is otherwise unremarkable; renal and hepatic function are normal; not currently on other prescription medications; no drug allergies.	Given this patient's condition, which of the drugs below are unsuitable?	{ "A": "Loratadine", "B": "Levothyroxine", "C": "Amlodipine", "D": "None of the above need to be avoided", "E": "Bisoprolol" }	[ "D" ]	neurology	nervous system	[ "antihistamines", "thyroid hormones", "calcium-channel blockers" ]	disease presence	older adults	static risk identification	guideline_following
SS-DM-POS-013	A 84-year-old man has moderate dementia. Otherwise unremarkable medical history; normal renal and hepatic function; not taking other prescription drugs; no known allergies.	Based on safe prescribing principles for older adults, which of these drugs should this patient avoid?	{ "A": "Zolpidem", "B": "Metformin", "C": "Lorazepam", "D": "Eszopiclone", "E": "None of the above need to be avoided" }	[ "A", "C", "D" ]	neurology	nervous system	[ "z-drugs", "benzodiazepines" ]	disease presence	older adults	static risk identification	guideline_following
SS-DM-NEG-013	A 84-year-old man has fully preserved cognition on formal testing and presents for a wellness review. Otherwise unremarkable medical history; normal renal and hepatic function; not taking other prescription drugs; no known allergies.	Which of the following options constitute potentially inappropriate medications for this patient?	{ "A": "Cetirizine", "B": "Loratadine", "C": "None of the above need to be avoided", "D": "Amlodipine", "E": "Acetaminophen" }	[ "C" ]	neurology	nervous system	[ "antihistamines", "calcium-channel blockers", "antipyretic analgesics" ]	disease presence	older adults	static risk identification	guideline_following
SS-FA-POS-014	A 76-year-old woman has a documented history of multiple falls, including a wrist fracture last year. No other significant past medical history; renal and hepatic function normal; not on other prescription medications; no known drug allergies.	Looking at this patient, which medications would you not prescribe?	{ "A": "Diphenhydramine", "B": "Oxybutynin", "C": "Amlodipine", "D": "None of the above need to be avoided", "E": "Mirabegron" }	[ "A", "B" ]	geriatric medicine	skeletal system	[ "antihistamines" ]	disease presence	older adults	static risk identification	guideline_following
SS-FA-NEG-014	A 76-year-old woman has no history of falls or fractures and presents for routine review. Otherwise unremarkable medical history; normal renal and hepatic function; not taking other prescription drugs; no known allergies.	Among the options below, which are inappropriate for this patient?	{ "A": "Loratadine", "B": "Metformin", "C": "Levothyroxine", "D": "None of the above need to be avoided", "E": "Acetaminophen" }	[ "D" ]	geriatric medicine	skeletal system	[ "antihistamines", "antidiabetics", "thyroid hormones", "antipyretic analgesics" ]	disease presence	older adults	static risk identification	guideline_following
SS-FA-POS-015	A 82-year-old man has had two falls in the past year, including a hip fracture six months ago. No other pertinent past medical history; kidney and liver function are normal; not on any other prescription drugs; no known drug allergies.	Considering this patient's history, which drugs below should be avoided?	{ "A": "None of the above need to be avoided", "B": "Sertraline", "C": "Metformin", "D": "Venlafaxine", "E": "Amitriptyline" }	[ "B", "D", "E" ]	geriatric medicine	skeletal system	[ "tricyclic antidepressants" ]	disease presence	older adults	static risk identification	guideline_following
SS-FA-NEG-015	A 82-year-old man has no history of falls or fractures and presents for an annual review. No other significant past medical history; renal and hepatic function normal; not on other prescription medications; no known drug allergies.	Which of the listed medications poses a concern for this patient?	{ "A": "Lisinopril", "B": "Cetirizine", "C": "Metformin", "D": "None of the above need to be avoided", "E": "Levothyroxine" }	[ "D" ]	geriatric medicine	skeletal system	[ "ras inhibitors", "antihistamines", "antidiabetics", "thyroid hormones" ]	disease presence	older adults	static risk identification	guideline_following
SS-FA-POS-016	A 78-year-old woman has a documented history of recurrent falls and a vertebral compression fracture. She has no history of syncope. Remainder of medical history is unremarkable; renal and hepatic function within normal limits; not on additional prescription medications; no drug allergies reported.	In this patient, which of the following drugs should not be initiated?	{ "A": "Cetirizine", "B": "Metformin", "C": "None of the above need to be avoided", "D": "Risperidone", "E": "Haloperidol" }	[ "D", "E" ]	neurology	nervous system	[ "antipsychotics" ]	disease presence	older adults	static risk identification	guideline_following
SS-FA-NEG-016	A 78-year-old woman has no history of falls or fractures and is reviewed for medication safety. She has no history of syncope. Past medical history is otherwise unremarkable; renal and hepatic function are normal; not currently on other prescription medications; no drug allergies.	Reviewing this patient's profile, which of these medications would you avoid?	{ "A": "Cetirizine", "B": "Metformin", "C": "None of the above need to be avoided", "D": "Memantine", "E": "Atorvastatin" }	[ "C" ]	neurology	nervous system	[ "antihistamines", "antidiabetics", "statins" ]	disease presence	older adults	static risk identification	guideline_following
SS-FA-POS-017	An 80-year-old woman has had multiple falls in the past year and one prior hip fracture. Past medical history is otherwise unremarkable; renal and hepatic function are normal; not currently on other prescription medications; no drug allergies.	Which agents below are potentially inappropriate in this patient?	{ "A": "Zolpidem", "B": "Lorazepam", "C": "Levothyroxine", "D": "None of the above need to be avoided", "E": "Eszopiclone" }	[ "A", "B", "E" ]	geriatric medicine	skeletal system	[ "z-drugs", "benzodiazepines" ]	disease presence	older adults	static risk identification	guideline_following
SS-FA-NEG-017	An 80-year-old woman has no history of falls or fractures and is reviewed in clinic. Past medical history is otherwise unremarkable; renal and hepatic function are normal; not currently on other prescription medications; no drug allergies.	For this patient, which of the following drugs should be avoided?	{ "A": "Levothyroxine", "B": "Lisinopril", "C": "None of the above need to be avoided", "D": "Metformin", "E": "Acetaminophen" }	[ "C" ]	geriatric medicine	skeletal system	[ "thyroid hormones", "ras inhibitors", "antidiabetics", "antipyretic analgesics" ]	disease presence	older adults	static risk identification	guideline_following
SS-FA-SEIZMOOD-018	A 73-year-old man has a documented history of falls. He has a diagnosis of epilepsy with seizures controlled on antiepileptic therapy. No other pertinent past medical history; kidney and liver function are normal; not on any other prescription drugs; no known drug allergies.	Which of the following medications are potentially inappropriate for this patient?	{ "A": "None of the above need to be avoided", "B": "Carbamazepine", "C": "Loratadine", "D": "Pregabalin", "E": "Phenytoin" }	[ "A" ]	geriatric medicine	skeletal system	[ "antihistamines", "gabapentinoids", "antiepileptics" ]	disease presence	older adults	static risk identification	guideline_following
SS-FA-OTHERIND-018	A 73-year-old man has a documented history of falls. He is being considered for an antiepileptic agent for chronic peripheral neuropathic pain (not seizures or a mood disorder). Remainder of medical history is unremarkable; renal and hepatic function within normal limits; not on additional prescription medications; no ...	Given this patient's condition, which of the drugs below are unsuitable?	{ "A": "Carbamazepine", "B": "Pregabalin", "C": "None of the above need to be avoided", "D": "Cetirizine", "E": "Gabapentin" }	[ "A", "B", "E" ]	geriatric medicine	skeletal system	[ "gabapentinoids" ]	disease presence	older adults	static risk identification	guideline_following
SS-FA-ACUTE-019	An 81-year-old woman has a documented history of recurrent falls. She presents with a displaced femur fracture causing severe acute pain. Past medical history is otherwise unremarkable; renal and hepatic function are normal; not currently on other prescription medications; no drug allergies.	Based on safe prescribing principles for older adults, which of these drugs should this patient avoid?	{ "A": "Empagliflozin", "B": "None of the above need to be avoided", "C": "Morphine", "D": "Acetaminophen", "E": "Amlodipine" }	[ "B" ]	geriatric medicine	skeletal system	[ "antidiabetics", "opioids", "antipyretic analgesics", "calcium-channel blockers" ]	disease presence	older adults	static risk identification	guideline_following
SS-FA-CHRONIC-019	An 81-year-old woman has a documented history of recurrent falls. She has chronic non-cancer musculoskeletal pain that is not a severe acute pain episode. Otherwise unremarkable medical history; normal renal and hepatic function; not taking other prescription drugs; no known allergies.	Which of the following options constitute potentially inappropriate medications for this patient?	{ "A": "Morphine", "B": "None of the above need to be avoided", "C": "Hydrocodone", "D": "Oxycodone", "E": "Empagliflozin" }	[ "A", "C", "D" ]	geriatric medicine	skeletal system	[ "opioids" ]	disease presence	older adults	static risk identification	guideline_following
SS-PD-POS-020	A 75-year-old man has a confirmed diagnosis of Parkinson disease, currently on dopaminergic therapy. Remainder of medical history is unremarkable; renal and hepatic function within normal limits; not on additional prescription medications; no drug allergies reported.	Looking at this patient, which medications would you not prescribe?	{ "A": "None of the above need to be avoided", "B": "Metoclopramide", "C": "Prochlorperazine", "D": "Acetaminophen", "E": "Promethazine" }	[ "B", "C", "E" ]	neurology	nervous system	[ "multiple drug categories (composite rules)" ]	disease presence	older adults	static risk identification	guideline_following
SS-PD-NEG-020	A 75-year-old man attends a routine geriatric review. He does not have Parkinson disease or any other movement disorder. No other significant past medical history; renal and hepatic function normal; not on other prescription medications; no known drug allergies.	Among the options below, which are inappropriate for this patient?	{ "A": "Metformin", "B": "Levothyroxine", "C": "None of the above need to be avoided", "D": "Atorvastatin", "E": "Acetaminophen" }	[ "C" ]	neurology	nervous system	[ "antidiabetics", "thyroid hormones", "statins", "antipyretic analgesics" ]	disease presence	older adults	static risk identification	guideline_following
SS-UL-POS-021	An 80-year-old woman has a history of a duodenal ulcer confirmed on prior endoscopy. No other significant past medical history; renal and hepatic function normal; not on other prescription medications; no known drug allergies.	Considering this patient's history, which drugs below should be avoided?	{ "A": "Aspirin", "B": "Naproxen", "C": "Ibuprofen", "D": "Lisinopril", "E": "None of the above need to be avoided" }	[ "A", "B", "C" ]	gastroenterology	digestive system	[ "nsaids/antipyretic analgesics" ]	disease presence	older adults	static risk identification	guideline_following
SS-UL-NEG-021	An 80-year-old woman has no history of gastric or duodenal ulcers and presents for routine geriatric review. No other pertinent past medical history; kidney and liver function are normal; not on any other prescription drugs; no known drug allergies.	Which of the listed medications poses a concern for this patient?	{ "A": "None of the above need to be avoided", "B": "Clopidogrel", "C": "Bisoprolol", "D": "Cetirizine", "E": "Acetaminophen" }	[ "A" ]	gastroenterology	digestive system	[ "antihistamines", "antipyretic analgesics" ]	disease presence	older adults	static risk identification	guideline_following
SS-UI-POS-022	A 72-year-old woman has urinary incontinence (mixed type). Past medical history is otherwise unremarkable; renal and hepatic function are normal; not currently on other prescription medications; no drug allergies.	In this patient, which of the following drugs should not be initiated?	{ "A": "Lisinopril", "B": "Oral and transdermal estrogen", "C": "Terazosin", "D": "Prazosin", "E": "Doxazosin" }	[ "B" ]	urology	urinary system	[ "alpha-1 receptor blockers" ]	disease presence	older adults	static risk identification	guideline_following
SS-UI-NEG-022	A 72-year-old woman has no urinary incontinence and presents for a routine health review. Remainder of medical history is unremarkable; renal and hepatic function within normal limits; not on additional prescription medications; no drug allergies reported.	Reviewing this patient's profile, which of these medications would you avoid?	{ "A": "Lisinopril", "B": "Loratadine", "C": "Metformin", "D": "None of the above need to be avoided", "E": "Atorvastatin" }	[ "D" ]	urology	urinary system	[ "ras inhibitors", "antihistamines", "antidiabetics", "statins" ]	disease presence	older adults	static risk identification	guideline_following
SS-BPH-POS-023	A 77-year-old man has lower urinary tract symptoms and a confirmed diagnosis of benign prostatic hyperplasia. Remainder of medical history is unremarkable; renal and hepatic function within normal limits; not on additional prescription medications; no drug allergies reported.	Which agents below are potentially inappropriate in this patient?	{ "A": "Empagliflozin", "B": "Cetirizine", "C": "None of the above need to be avoided", "D": "Strongly anticholinergic drugs", "E": "Lisinopril" }	[ "D" ]	urology	urinary system	[ "multiple drug categories (composite rules)" ]	disease presence	older adults	static risk identification	guideline_following
SS-BPH-NEG-023	A 77-year-old man attends a general geriatric review. He has no lower urinary tract symptoms and no diagnosis of benign prostatic hyperplasia. Past medical history is otherwise unremarkable; renal and hepatic function are normal; not currently on other prescription medications; no drug allergies.	For this patient, which of the following drugs should be avoided?	{ "A": "Levothyroxine", "B": "Metformin", "C": "None of the above need to be avoided", "D": "Loratadine", "E": "Empagliflozin" }	[ "C" ]	urology	urinary system	[ "thyroid hormones", "antidiabetics", "antihistamines" ]	disease presence	older adults	static risk identification	guideline_following
SS-HF-HFREF-005	A 69-year-old man has heart failure with reduced ejection fraction (LVEF 30%) and is currently free of decompensation symptoms on stable therapy. Remainder of medical history is unremarkable; renal and hepatic function within normal limits; not on additional prescription medications; no drug allergies reported.	In this patient, which of the following drugs should not be initiated?	{ "A": "None of the above need to be avoided", "B": "Cilostazol", "C": "Verapamil", "D": "Dextromethorphan-quinidine", "E": "Diltiazem" }	[ "B", "C", "E" ]	cardiology	cardiovascular system	[ "pde3 inhibitors/peripheral vascular drugs", "calcium-channel blockers", "antiarrhythmics" ]	disease presence	older adults	static risk identification	guideline_following
SS-HF-HFPEF-005	A 69-year-old man has heart failure with preserved ejection fraction (LVEF 60%) and is currently asymptomatic. Past medical history is otherwise unremarkable; renal and hepatic function are normal; not currently on other prescription medications; no drug allergies.	Looking at this patient, which medications would you not prescribe?	{ "A": "Dextromethorphan-quinidine", "B": "Cilostazol", "C": "Verapamil", "D": "None of the above need to be avoided", "E": "Diltiazem" }	[ "A", "B" ]	cardiology	cardiovascular system	[ "antiarrhythmics", "pde3 inhibitors/peripheral vascular drugs" ]	disease presence	older adults	static risk identification	guideline_following
SS-SY-POS-025	A 75-year-old man is referred for medication review following two documented episodes of syncope in the past year. No other pertinent past medical history; renal and hepatic function are within normal limits; not taking other prescription medications; no drug allergies.	Which of the following medications are potentially inappropriate for this patient?	{ "A": "Galantamine", "B": "Metoprolol", "C": "Doxazosin", "D": "Lisinopril", "E": "None of the above need to be avoided" }	[ "A", "C" ]	neurology	nervous system	[ "cholinesterase inhibitors", "alpha-1 receptor blockers" ]	disease presence	older adults	static risk identification	guideline_following
SS-SY-NEG-025	A 75-year-old man attends a routine geriatric medication review. He has no history of syncope or near-syncopal episodes. No other pertinent past medical history; renal and hepatic function are within normal limits; not taking other prescription medications; no drug allergies.	For this patient, which of the following drugs should be avoided?	{ "A": "Galantamine", "B": "Metoprolol", "C": "Amlodipine", "D": "Lisinopril", "E": "None of the above need to be avoided" }	[ "E" ]	neurology	nervous system	[ "cholinesterase inhibitors", "calcium-channel blockers", "ras inhibitors" ]	disease presence	older adults	static risk identification	guideline_following
SS-DM-POS-026	A 79-year-old woman has a confirmed diagnosis of mild-to-moderate Alzheimer's dementia and is under outpatient neurology follow-up. She has no history of syncope. Renal and hepatic function are normal; not currently on other prescription medications; no known drug allergies.	Among the options below, which medications would be inappropriate to prescribe for this patient?	{ "A": "Donepezil", "B": "Lorazepam", "C": "None of the above need to be avoided", "D": "Zolpidem", "E": "Acetaminophen" }	[ "B", "D" ]	neurology	nervous system	[ "benzodiazepines", "z-drugs" ]	disease presence	older adults	static risk identification	guideline_following
SS-DM-NEG-026	A 79-year-old woman attends a routine geriatric review. She has no diagnosis of dementia or cognitive impairment and performs within normal limits on cognitive screening. She has no history of syncope. Renal and hepatic function are normal; not currently on other prescription medications; no known drug allergies.	Given this patient's profile, which of these drugs should be avoided?	{ "A": "Atorvastatin", "B": "Metformin", "C": "None of the above need to be avoided", "D": "Lisinopril", "E": "Acetaminophen" }	[ "C" ]	neurology	nervous system	[ "statins", "antidiabetics", "ras inhibitors", "antipyretic analgesics" ]	disease presence	older adults	static risk identification	guideline_following
SS-PD-POS-027	A 71-year-old man with a confirmed diagnosis of Parkinson disease is seen in a neurology clinic for routine follow-up. No other significant past medical history; renal and hepatic function are normal; not currently on other prescription medications; no known drug allergies.	Based on safe prescribing principles for older adults, which of the drugs below should be avoided for this patient?	{ "A": "Prochlorperazine", "B": "None of the above need to be avoided", "C": "Ondansetron", "D": "Levodopa", "E": "Metoclopramide" }	[ "A", "E" ]	neurology	nervous system	[ "multiple drug categories (composite rules)" ]	disease presence	older adults	static risk identification	guideline_following
SS-PD-NEG-027	A 71-year-old man attends a geriatric outpatient clinic for a preventive medication review. He does not have Parkinson disease or any movement disorder. No other significant past medical history; renal and hepatic function are normal; not currently on other prescription medications; no known drug allergies.	Looking at this patient, which of the following drugs are unsuitable?	{ "A": "Prochlorperazine", "B": "None of the above need to be avoided", "C": "Ondansetron", "D": "Metformin", "E": "Bisoprolol" }	[ "A" ]	neurology	nervous system	[ "antidiabetics" ]	disease presence	older adults	static risk identification	guideline_following
SS-PD-POS-028	An 83-year-old woman is being evaluated in a geriatric clinic for medication safety review. She has a diagnosis of Parkinson disease. No other significant past medical history; renal and hepatic function are normal; not on other prescription medications; no known drug allergies.	Which of the following medications are potentially inappropriate for this patient?	{ "A": "Acetaminophen", "B": "Metoclopramide", "C": "Lisinopril", "D": "None of the above need to be avoided", "E": "Ondansetron" }	[ "B" ]	neurology	nervous system	[ "multiple drug categories (composite rules)" ]	disease presence	older adults	static risk identification	guideline_following
SS-PD-NEG-028	An 83-year-old woman is seen in a geriatric outpatient clinic. She does not have Parkinson disease or any other movement disorder. No other significant past medical history; renal and hepatic function are normal; not on other prescription medications; no known drug allergies.	For this patient, which of the following drugs should be avoided?	{ "A": "Acetaminophen", "B": "Metformin", "C": "Lisinopril", "D": "None of the above need to be avoided", "E": "Ondansetron" }	[ "D" ]	neurology	nervous system	[ "antipyretic analgesics", "antidiabetics", "ras inhibitors" ]	disease presence	older adults	static risk identification	guideline_following
SS-UL-POS-029	A 73-year-old man has a documented history of peptic ulcer disease and presents for a medication safety review. Renal and hepatic function are normal; not currently on other prescription medications; no known drug allergies.	Which of the listed drugs should this patient avoid?	{ "A": "Ibuprofen", "B": "None of the above need to be avoided", "C": "Pantoprazole", "D": "Aspirin", "E": "Acetaminophen" }	[ "A", "D" ]	gastroenterology	digestive system	[ "nsaids/antipyretic analgesics" ]	disease presence	older adults	static risk identification	guideline_following
SS-UL-NEG-029	A 73-year-old man presents for a routine geriatric health review. He has no history of peptic ulcer disease or gastrointestinal ulceration. Renal and hepatic function are normal; not currently on other prescription medications; no known drug allergies.	Among these options, which medications pose a concern for this patient?	{ "A": "Clopidogrel", "B": "None of the above need to be avoided", "C": "Loratadine", "D": "Bisoprolol", "E": "Acetaminophen" }	[ "B" ]	gastroenterology	digestive system	[ "antihistamines", "antipyretic analgesics" ]	disease presence	older adults	static risk identification	guideline_following
SS-UL-POS-030	An 80-year-old woman has a confirmed history of duodenal ulcer disease. No other significant past medical history; renal and hepatic function are normal; not on other prescription medications; no known drug allergies.	Reviewing this patient's profile, which of these medications would you not prescribe?	{ "A": "Celecoxib", "B": "Naproxen", "C": "Aspirin", "D": "Lisinopril", "E": "None of the above need to be avoided" }	[ "B", "C" ]	gastroenterology	digestive system	[ "nsaids/antipyretic analgesics" ]	disease presence	older adults	static risk identification	guideline_following
SS-UL-NEG-030	An 80-year-old woman attends a routine geriatric review. She has no history of peptic ulcer disease or gastrointestinal ulceration. No other significant past medical history; renal and hepatic function are normal; not on other prescription medications; no known drug allergies.	For this patient, which of the following drugs should be avoided?	{ "A": "Celecoxib", "B": "Clopidogrel", "C": "Loratadine", "D": "Lisinopril", "E": "None of the above need to be avoided" }	[ "E" ]	gastroenterology	digestive system	[ "nsaids/antipyretic analgesics", "antihistamines", "ras inhibitors" ]	disease presence	older adults	static risk identification	guideline_following
SS-UI-POS-031	A 77-year-old woman has a diagnosis of mixed urinary incontinence and is seen in a urology outpatient clinic. Renal and hepatic function are normal; not currently on other prescription medications; no known drug allergies.	Which of the following options constitute potentially inappropriate medications for this patient?	{ "A": "Prazosin", "B": "Metformin", "C": "None of the above need to be avoided", "D": "Estradiol (oral)", "E": "Lisinopril" }	[ "A", "D" ]	urology	urinary system	[ "alpha-1 receptor blockers" ]	disease presence	older adults	static risk identification	guideline_following
SS-UI-NEG-031	A 77-year-old woman presents for a routine geriatric medication review. She has no history of urinary incontinence. Renal and hepatic function are normal; not currently on other prescription medications; no known drug allergies.	Given this patient's clinical profile, which of these drugs should be avoided?	{ "A": "Amlodipine", "B": "Metformin", "C": "None of the above need to be avoided", "D": "Acetaminophen", "E": "Lisinopril" }	[ "C" ]	urology	urinary system	[ "calcium-channel blockers", "antidiabetics", "antipyretic analgesics", "ras inhibitors" ]	disease presence	older adults	static risk identification	guideline_following
SS-UI-POS-032	A 68-year-old woman presents to her geriatric physician for a medication safety evaluation. She reports bothersome urinary incontinence. Renal and hepatic function are normal; not currently on other prescription medications; no known drug allergies.	For this patient, which of the following drugs should be avoided?	{ "A": "None of the above need to be avoided", "B": "Atorvastatin", "C": "Doxazosin", "D": "Metoprolol", "E": "Amlodipine" }	[ "C" ]	urology	urinary system	[ "alpha-1 receptor blockers" ]	disease presence	older adults	static risk identification	guideline_following
SS-UI-NEG-032	A 68-year-old woman attends a wellness visit with her geriatric physician. She has no history of urinary incontinence. Renal and hepatic function are normal; not currently on other prescription medications; no known drug allergies.	Looking at this patient, which medications would you not prescribe?	{ "A": "None of the above need to be avoided", "B": "Atorvastatin", "C": "Cetirizine", "D": "Metoprolol", "E": "Amlodipine" }	[ "A" ]	urology	urinary system	[ "statins", "antihistamines", "calcium-channel blockers" ]	disease presence	older adults	static risk identification	guideline_following
SS-BPH-POS-033	A 72-year-old man has lower urinary tract symptoms due to benign prostatic hyperplasia and is being seen in a urology outpatient clinic. No other significant past medical history; renal and hepatic function are normal; not on other prescription medications; no known drug allergies.	Among the options below, which are inappropriate for this patient?	{ "A": "Tamsulosin", "B": "Diphenhydramine", "C": "None of the above need to be avoided", "D": "Lisinopril", "E": "Finasteride" }	[ "B" ]	urology	urinary system	[ "antihistamines" ]	disease presence	older adults	static risk identification	guideline_following
SS-BPH-NEG-033	A 72-year-old man presents for a routine geriatric review. He has no lower urinary tract symptoms and no diagnosis of benign prostatic hyperplasia. No other significant past medical history; renal and hepatic function are normal; not on other prescription medications; no known drug allergies.	Which of the following medications are potentially inappropriate for this patient?	{ "A": "Loratadine", "B": "Metformin", "C": "None of the above need to be avoided", "D": "Lisinopril", "E": "Levothyroxine" }	[ "C" ]	urology	urinary system	[ "antihistamines", "antidiabetics", "ras inhibitors", "thyroid hormones" ]	disease presence	older adults	static risk identification	guideline_following
SS-BPH-POS-034	An 80-year-old man attends a urology clinic with worsening lower urinary tract symptoms attributable to benign prostatic hyperplasia. No other significant past medical history; renal and hepatic function are normal; not on other prescription medications; no known drug allergies.	Based on safe prescribing principles for older adults, which of these drugs should this patient avoid?	{ "A": "Hydroxyzine", "B": "None of the above need to be avoided", "C": "Amlodipine", "D": "Tamsulosin", "E": "Atorvastatin" }	[ "A" ]	urology	urinary system	[ "antihistamines" ]	disease presence	older adults	static risk identification	guideline_following
SS-BPH-NEG-034	An 80-year-old man presents for a routine geriatric health review. He has no lower urinary tract symptoms and no history of benign prostatic hyperplasia. No other significant past medical history; renal and hepatic function are normal; not on other prescription medications; no known drug allergies.	For this patient, which of the following medications are unsuitable?	{ "A": "Metformin", "B": "None of the above need to be avoided", "C": "Amlodipine", "D": "Cetirizine", "E": "Atorvastatin" }	[ "B" ]	urology	urinary system	[ "antidiabetics", "calcium-channel blockers", "antihistamines", "statins" ]	disease presence	older adults	static risk identification	guideline_following
CS-HF-001	A 74-year-old man has heart failure with reduced ejection fraction (LVEF 38%), stable on guideline-directed therapy. Renal and hepatic function are normal; not on other prescription medications; no known drug allergies.	Which of the following medications should be avoided in this patient?	{ "A": "Diltiazem", "B": "Bisoprolol", "C": "Metformin", "D": "None of the above need to be avoided", "E": "Cilostazol" }	[ "A", "E" ]	cardiology	cardiovascular system	[ "calcium-channel blockers", "pde3 inhibitors/peripheral vascular drugs" ]	composite clinical context	older adults	static risk identification	guideline_following
CS-HF-002	A 74-year-old man has heart failure with preserved ejection fraction (LVEF 55%), currently asymptomatic. Renal and hepatic function are normal; not on other prescription medications; no known drug allergies.	Which of the following medications should be avoided in this patient?	{ "A": "Cilostazol", "B": "Metformin", "C": "None of the above need to be avoided", "D": "Diltiazem", "E": "Bisoprolol" }	[ "A" ]	cardiology	cardiovascular system	[ "pde3 inhibitors/peripheral vascular drugs" ]	composite clinical context	older adults	static risk identification	guideline_following
CS-HF-003	A 74-year-old man has no history of heart failure; a recent echocardiogram shows normal LVEF (60%). Renal and hepatic function are normal; not on other prescription medications; no known drug allergies.	Which of the following medications should be avoided in this patient?	{ "A": "Dextromethorphan-quinidine", "B": "Bisoprolol", "C": "None of the above need to be avoided", "D": "Metformin", "E": "Cilostazol" }	[ "C" ]	cardiology	cardiovascular system	[ "antiarrhythmics", "antidiabetics", "pde3 inhibitors/peripheral vascular drugs" ]	composite clinical context	older adults	static risk identification	guideline_following
CS-NS-001	An 81-year-old woman is assessed for analgesic safety. She has symptomatic heart failure (LVEF 40%). She has no history of peptic ulcer disease. No other significant past medical history; Renal and hepatic function are normal; not on other prescription medications; no known drug allergies.	Which of the following medications should be avoided in this patient?	{ "A": "Bisoprolol", "B": "Ibuprofen", "C": "Celecoxib", "D": "None of the above need to be avoided", "E": "Acetaminophen" }	[ "B", "C" ]	cardiology	cardiovascular system	[ "nsaids/antipyretic analgesics" ]	composite clinical context	older adults	static risk identification	guideline_following
CS-NS-002	An 81-year-old woman is assessed for analgesic safety. She has symptomatic heart failure (LVEF 40%). She has a documented history of peptic ulcer disease. No other significant past medical history; Renal and hepatic function are normal; not on other prescription medications; no known drug allergies.	Which of the following medications should be avoided in this patient?	{ "A": "None of the above need to be avoided", "B": "Acetaminophen", "C": "Ibuprofen", "D": "Bisoprolol", "E": "Celecoxib" }	[ "C", "E" ]	cardiology	cardiovascular system	[ "nsaids/antipyretic analgesics" ]	composite clinical context	older adults	static risk identification	guideline_following
CS-NS-004	An 81-year-old woman is assessed for analgesic safety. She has no history of heart failure. She has a documented history of peptic ulcer disease. No other significant past medical history; Renal and hepatic function are normal; not on other prescription medications; no known drug allergies.	Which of the following medications should be avoided in this patient?	{ "A": "Bisoprolol", "B": "None of the above need to be avoided", "C": "Celecoxib", "D": "Acetaminophen", "E": "Ibuprofen" }	[ "E" ]	cardiology	cardiovascular system	[ "nsaids/antipyretic analgesics" ]	composite clinical context	older adults	static risk identification	guideline_following
CS-NS-005	An 81-year-old woman is assessed for analgesic safety. She has no history of heart failure. She has no history of peptic ulcer disease. No other significant past medical history; Renal and hepatic function are normal; not on other prescription medications; no known drug allergies.	Which of the following medications should be avoided in this patient?	{ "A": "Acetaminophen", "B": "Bisoprolol", "C": "Loratadine", "D": "None of the above need to be avoided", "E": "Celecoxib" }	[ "D" ]	cardiology	cardiovascular system	[ "antipyretic analgesics", "antihistamines", "nsaids/antipyretic analgesics" ]	composite clinical context	older adults	static risk identification	guideline_following
CS-OP-001	A 79-year-old man is evaluated for pain management. He has active delirium. He has no history of falls or fractures. He presents with chronic lower back pain. No other significant past medical history; Renal and hepatic function are normal; not on other prescription medications; no known drug allergies.	Which of the following medications should be avoided given this patient's clinical status?	{ "A": "Oxycodone", "B": "Bisoprolol", "C": "Celecoxib", "D": "None of the above need to be avoided", "E": "Acetaminophen" }	[ "A" ]	neurology	nervous system	[ "opioids" ]	composite clinical context	older adults	static risk identification	guideline_following
CS-OP-002	A 79-year-old man is evaluated for pain management. He has active delirium. He has no history of falls or fractures. He presents with severe acute pain following a procedure. No other significant past medical history; Renal and hepatic function are normal; not on other prescription medications; no known drug allergies.	Which of the following medications should be avoided given this patient's clinical status?	{ "A": "Bisoprolol", "B": "Celecoxib", "C": "Acetaminophen", "D": "None of the above need to be avoided", "E": "Oxycodone" }	[ "E" ]	neurology	nervous system	[ "opioids" ]	composite clinical context	older adults	static risk identification	guideline_following
CS-OP-003	A 79-year-old man is evaluated for pain management. He has no delirium. He has a history of recurrent falls. He presents with severe acute pain following a rib fracture. No other significant past medical history; Renal and hepatic function are normal; not on other prescription medications; no known drug allergies.	Which of the following medications should be avoided given this patient's clinical status?	{ "A": "Oxycodone", "B": "Bisoprolol", "C": "Acetaminophen", "D": "None of the above need to be avoided", "E": "Celecoxib" }	[ "D" ]	neurology	nervous system	[ "opioids", "antipyretic analgesics", "nsaids/antipyretic analgesics" ]	composite clinical context	older adults	static risk identification	guideline_following
CS-OP-004	A 79-year-old man is evaluated for pain management. He has no delirium. He has a history of recurrent falls. He presents with chronic osteoarthritis pain. No other significant past medical history; Renal and hepatic function are normal; not on other prescription medications; no known drug allergies.	Which of the following medications should be avoided given this patient's clinical status?	{ "A": "Bisoprolol", "B": "Celecoxib", "C": "None of the above need to be avoided", "D": "Acetaminophen", "E": "Oxycodone" }	[ "E" ]	neurology	nervous system	[ "opioids" ]	composite clinical context	older adults	static risk identification	guideline_following
CS-OP-005	A 79-year-old man is evaluated for pain management. He has active delirium. He has a history of recurrent falls. He presents with severe acute pain. No other significant past medical history; Renal and hepatic function are normal; not on other prescription medications; no known drug allergies.	Which of the following medications should be avoided given this patient's clinical status?	{ "A": "Acetaminophen", "B": "Celecoxib", "C": "Bisoprolol", "D": "None of the above need to be avoided", "E": "Oxycodone" }	[ "E" ]	neurology	nervous system	[ "opioids" ]	composite clinical context	older adults	static risk identification	guideline_following
CS-OP-006	A 79-year-old man is evaluated for pain management. He has no delirium. He has no history of falls or fractures. No other significant past medical history; Renal and hepatic function are normal; not on other prescription medications; no known drug allergies.	Which of the following medications should be avoided given this patient's clinical status?	{ "A": "Acetaminophen", "B": "Bisoprolol", "C": "Celecoxib", "D": "None of the above need to be avoided", "E": "Oxycodone" }	[ "D" ]	neurology	nervous system	[ "antipyretic analgesics", "nsaids/antipyretic analgesics", "opioids" ]	composite clinical context	older adults	static risk identification	guideline_following
CS-OP-007	A 79-year-old man is evaluated for pain management. He has active delirium. He has a history of recurrent falls. He presents with chronic lower back pain. No other significant past medical history; Renal and hepatic function are normal; not on other prescription medications; no known drug allergies.	Which of the following medications should be avoided given this patient's clinical status?	{ "A": "Bisoprolol", "B": "Acetaminophen", "C": "Celecoxib", "D": "None of the above need to be avoided", "E": "Oxycodone" }	[ "E" ]	neurology	nervous system	[ "opioids" ]	composite clinical context	older adults	static risk identification	guideline_following
CS-AP-001	An 83-year-old woman is evaluated for medication safety. She has a history of syncope. She has no history of falls and does not have Parkinson disease. No other significant past medical history; Renal and hepatic function are normal; not on other prescription medications; no known drug allergies.	Which of the following medications should be avoided given this patient's conditions?	{ "A": "Bisoprolol", "B": "Chlorpromazine", "C": "None of the above need to be avoided", "D": "Haloperidol", "E": "Metformin" }	[ "B" ]	neurology	nervous system	[ "antipsychotics" ]	composite clinical context	older adults	static risk identification	guideline_following
CS-AP-002	An 83-year-old woman is evaluated for medication safety. She has a history of falls and fractures. She has no syncope and does not have Parkinson disease. No other significant past medical history; Renal and hepatic function are normal; not on other prescription medications; no known drug allergies.	Which of the following medications should be avoided given this patient's conditions?	{ "A": "Metformin", "B": "None of the above need to be avoided", "C": "Bisoprolol", "D": "Quetiapine", "E": "Haloperidol" }	[ "D", "E" ]	neurology	nervous system	[ "antipsychotics" ]	composite clinical context	older adults	static risk identification	guideline_following
CS-AP-003	An 83-year-old woman is evaluated for medication safety. She has Parkinson disease. She has no history of syncope and no falls. No other significant past medical history; Renal and hepatic function are normal; not on other prescription medications; no known drug allergies.	Which of the following medications should be avoided given this patient's conditions?	{ "A": "Quetiapine", "B": "Haloperidol", "C": "None of the above need to be avoided", "D": "Metformin", "E": "Bisoprolol" }	[ "B" ]	neurology	nervous system	[ "antipsychotics" ]	composite clinical context	older adults	static risk identification	guideline_following
CS-AP-004	An 83-year-old woman is evaluated for medication safety. She has a history of syncope and has Parkinson disease. No history of falls. No other significant past medical history; Renal and hepatic function are normal; not on other prescription medications; no known drug allergies.	Which of the following medications should be avoided given this patient's conditions?	{ "A": "None of the above need to be avoided", "B": "Bisoprolol", "C": "Quetiapine", "D": "Metformin", "E": "Chlorpromazine" }	[ "E" ]	neurology	nervous system	[ "antipsychotics" ]	composite clinical context	older adults	static risk identification	guideline_following
CS-AP-005	An 83-year-old woman is evaluated for medication safety. She has a history of syncope and a history of falls. No Parkinson disease. No other significant past medical history; Renal and hepatic function are normal; not on other prescription medications; no known drug allergies.	Which of the following medications should be avoided given this patient's conditions?	{ "A": "Quetiapine", "B": "Metformin", "C": "Chlorpromazine", "D": "Bisoprolol", "E": "None of the above need to be avoided" }	[ "A", "C" ]	neurology	nervous system	[ "antipsychotics" ]	composite clinical context	older adults	static risk identification	guideline_following
CS-AP-006	An 83-year-old woman is evaluated for medication safety. She has a history of falls and has Parkinson disease. No history of syncope. No other significant past medical history; Renal and hepatic function are normal; not on other prescription medications; no known drug allergies.	Which of the following medications should be avoided given this patient's conditions?	{ "A": "None of the above need to be avoided", "B": "Metformin", "C": "Haloperidol", "D": "Bisoprolol", "E": "Quetiapine" }	[ "C", "E" ]	neurology	nervous system	[ "antipsychotics" ]	composite clinical context	older adults	static risk identification	guideline_following
CS-AP-007	An 83-year-old woman is seen for a routine medication safety review. She has no history of syncope, no history of falls, and does not have Parkinson disease. No other significant past medical history; Renal and hepatic function are normal; not on other prescription medications; no known drug allergies.	Which of the following medications should be avoided given this patient's conditions?	{ "A": "Metformin", "B": "Acetaminophen", "C": "Loratadine", "D": "None of the above need to be avoided", "E": "Bisoprolol" }	[ "D" ]	neurology	nervous system	[ "antidiabetics", "antipyretic analgesics", "antihistamines" ]	composite clinical context	older adults	static risk identification	guideline_following
CS-AP-008	An 83-year-old woman is evaluated for medication safety. She has a history of syncope and falls, and has Parkinson disease. No other significant past medical history; Renal and hepatic function are normal; not on other prescription medications; no known drug allergies.	Which of the following medications should be avoided given this patient's conditions?	{ "A": "Quetiapine", "B": "Bisoprolol", "C": "Metformin", "D": "None of the above need to be avoided", "E": "Chlorpromazine" }	[ "A", "E" ]	neurology	nervous system	[ "antipsychotics" ]	composite clinical context	older adults	static risk identification	guideline_following
CS-AD-001	A 76-year-old woman is being considered for antidepressant therapy. She has a history of syncope. She has no history of falls. No other significant past medical history; Renal and hepatic function are normal; not on other prescription medications; no known drug allergies.	Which of the following medications should be avoided in this patient?	{ "A": "Amitriptyline", "B": "None of the above need to be avoided", "C": "Sertraline", "D": "Metformin", "E": "Bisoprolol" }	[ "A" ]	neurology	nervous system	[ "tricyclic antidepressants" ]	composite clinical context	older adults	static risk identification	guideline_following
CS-AD-002	A 76-year-old woman is being considered for antidepressant therapy. She has no history of syncope. She has a history of recurrent falls. No other significant past medical history; Renal and hepatic function are normal; not on other prescription medications; no known drug allergies.	Which of the following medications should be avoided in this patient?	{ "A": "Metformin", "B": "Bisoprolol", "C": "Venlafaxine", "D": "None of the above need to be avoided", "E": "Sertraline" }	[ "C", "E" ]	neurology	nervous system	[ "multiple drug categories (composite rules)" ]	composite clinical context	older adults	static risk identification	guideline_following
CS-AD-003	A 76-year-old woman is being considered for antidepressant therapy. She has a history of syncope. She has a history of recurrent falls. No other significant past medical history; Renal and hepatic function are normal; not on other prescription medications; no known drug allergies.	Which of the following medications should be avoided in this patient?	{ "A": "Sertraline", "B": "Bisoprolol", "C": "Amitriptyline", "D": "Metformin", "E": "None of the above need to be avoided" }	[ "A", "C" ]	neurology	nervous system	[ "tricyclic antidepressants" ]	composite clinical context	older adults	static risk identification	guideline_following
CS-AD-004	A 76-year-old woman is being considered for antidepressant therapy. She has no history of syncope. She has no history of falls. No other significant past medical history; Renal and hepatic function are normal; not on other prescription medications; no known drug allergies.	Which of the following medications should be avoided in this patient?	{ "A": "Loratadine", "B": "Bisoprolol", "C": "Venlafaxine", "D": "Sertraline", "E": "None of the above need to be avoided" }	[ "E" ]	neurology	nervous system	[ "antihistamines" ]	composite clinical context	older adults	static risk identification	guideline_following
CS-A1-001	A 77-year-old woman has a history of syncope and stress urinary incontinence. No other significant past medical history; Renal and hepatic function are normal; not on other prescription medications; no known drug allergies.	Which of the following medications should be avoided in this patient?	{ "A": "Metformin", "B": "None of the above need to be avoided", "C": "Doxazosin", "D": "Bisoprolol", "E": "Prazosin" }	[ "C", "E" ]	neurology	nervous system	[ "alpha-1 receptor blockers" ]	composite clinical context	older adults	static risk identification	guideline_following
CS-A1-002	A 77-year-old woman has a history of syncope. She has no urinary incontinence. No other significant past medical history; Renal and hepatic function are normal; not on other prescription medications; no known drug allergies.	Which of the following medications should be avoided in this patient?	{ "A": "None of the above need to be avoided", "B": "Bisoprolol", "C": "Loratadine", "D": "Terazosin", "E": "Metformin" }	[ "D" ]	neurology	nervous system	[ "alpha-1 receptor blockers" ]	composite clinical context	older adults	static risk identification	guideline_following
CS-A1-003	A 77-year-old woman has stress urinary incontinence. She has no history of syncope. No other significant past medical history; Renal and hepatic function are normal; not on other prescription medications; no known drug allergies.	Which of the following medications should be avoided in this patient?	{ "A": "None of the above need to be avoided", "B": "Prazosin", "C": "Metformin", "D": "Bisoprolol", "E": "Loratadine" }	[ "B" ]	neurology	nervous system	[ "alpha-1 receptor blockers" ]	composite clinical context	older adults	static risk identification	guideline_following
CS-A1-004	A 75-year-old man has a history of syncope. No other significant past medical history; Renal and hepatic function are normal; not on other prescription medications; no known drug allergies.	Which of the following medications should be avoided in this patient?	{ "A": "Metformin", "B": "Bisoprolol", "C": "Doxazosin", "D": "Loratadine", "E": "None of the above need to be avoided" }	[ "C" ]	neurology	nervous system	[ "alpha-1 receptor blockers" ]	composite clinical context	older adults	static risk identification	guideline_following
CS-A1-005	A 75-year-old man has lower urinary tract symptoms. He has no history of syncope. No other significant past medical history; Renal and hepatic function are normal; not on other prescription medications; no known drug allergies.	Which of the following medications should be avoided in this patient?	{ "A": "None of the above need to be avoided", "B": "Bisoprolol", "C": "Famotidine", "D": "Metformin", "E": "Loratadine" }	[ "A" ]	neurology	nervous system	[ "h2-receptor antagonists", "antidiabetics", "antihistamines" ]	composite clinical context	older adults	static risk identification	guideline_following

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MedPIC-Bench

MedPIC-Bench is an English multiple-choice benchmark for evaluating whether large language models apply medication-safety rules to patient-specific clinical contexts. Questions may have one or more correct options.

Dataset overview

The dataset contains 467 questions:

Task family	Questions
Guideline following	284
Counterfactual reasoning	183
Total	467

Loading the dataset

from datasets import load_dataset

dataset = load_dataset("TIM0927/MedPIC-Bench", split="test")

Data fields

Field	Type	Description
`instance_id`	string	Unique question identifier.
`patient_vignette`	string	Patient-specific clinical context.
`question`	string	Medication-safety question.
`options`	object	Mapping from option letters to answer text.
`answer`	list[string]	Correct option letter or letters.
`taxonomy_clinical_department`	string	Clinical department category.
`taxonomy_clinical_system`	string	Organ-system category.
`taxonomy_drug_categories`	list[string]	Drug classes represented in the question.
`taxonomy_patient_info_type`	string	Patient-information or condition type.
`taxonomy_population_source`	string	Population group represented by the question.
`taxonomy_reasoning_operation`	string	Required reasoning operation.
`benchmark_task_family`	string	`guideline_following` or `counterfactual`.

Example:

{
  "instance_id": "SS-HF-HFREF-001",
  "patient_vignette": "A 71-year-old man has heart failure with reduced ejection fraction (LVEF 32%), currently asymptomatic on guideline-directed therapy review. No other significant past medical history; renal and hepatic function normal; not on other prescription medications; no known drug allergies.",
  "question": "For this patient, which of the following drugs should be avoided?",
  "options": {
    "A": "Verapamil",
    "B": "Dextromethorphan-quinidine",
    "C": "Diltiazem",
    "D": "Amlodipine",
    "E": "Cilostazol"
  },
  "answer": [
    "A",
    "B",
    "C",
    "E"
  ],
  "taxonomy_clinical_department": "cardiology",
  "taxonomy_clinical_system": "cardiovascular system",
  "taxonomy_drug_categories": [
    "calcium-channel blockers",
    "antiarrhythmics",
    "pde3 inhibitors/peripheral vascular drugs"
  ],
  "taxonomy_patient_info_type": "disease presence",
  "taxonomy_population_source": "older adults",
  "taxonomy_reasoning_operation": "static risk identification",
  "benchmark_task_family": "guideline_following"
}

Ethical statement and disclaimer

MedPIC-Bench is a research benchmark for evaluating model behavior. It is not a clinical decision-support system, medical device, prescribing reference, or source of medical advice. Benchmark questions and model outputs must not be used to make decisions about diagnosis, treatment, medication selection, or patient care.

The benchmark covers a limited set of medication-safety rules, clinical contexts, and patient populations. It is not an exhaustive representation of clinical practice. Performance on this dataset does not establish that a model is medically accurate, safe, unbiased, or suitable for deployment. Model outputs may contain clinically harmful errors even when aggregate benchmark scores are high.

Users are responsible for appropriate expert review, risk assessment, and compliance with applicable ethical, institutional, and legal requirements.

Acknowledgments

We gratefully acknowledge Yuting Long (龙宇婷) and Xinyao Ma (马馨瑶) for their valuable support in dataset validation. Their careful review helped improve the consistency and reliability of the benchmark.

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