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LLM Interoperability Demo

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Round Details

February 15, 2026 at 12:00 PM UTC

Scenario: Chronic Kidney Disease - Multiple Medications

James Brown, 67-year-old male with Stage 3b Chronic Kidney Disease (eGFR 38) secondary to diabetic nephropathy. He also has Type 2 Diabetes and Hypertension. Current medications include: Losartan 50mg daily for renal protection, Metformin 500mg twice daily (reduced dose for CKD), Amlodipine 5mg daily for blood pressure, and Calcitriol 0.25mcg daily for vitamin D deficiency. He requires regular monitoring of renal function and electrolytes. No known drug allergies.

How did the LLMs do?

Same LLM Tests

GeminiGemini

Reconstructed text

James Brown, a male born in 1957, has no known drug allergies. He has active diagnoses of type 2 diabetes mellitus, diabetic nephropathy, chronic kidney disease stage 3B, and hypertension. A recent laboratory observation shows an estimated Glomerular Filtration Rate (eGFR) of 38 mL/min/1.73m2.

To manage his conditions, Mr. Brown is currently prescribed the following medications:

  • Metformin 500mg twice daily (noted as a reduced dose for chronic kidney disease)
  • Losartan 50mg daily for renal protection
  • Amlodipine 5mg daily for hypertension
  • Calcitriol 0.25mcg daily for vitamin D deficiency

Additionally, there is an active service order for a basic metabolic panel to regularly monitor his renal function and electrolytes in relation to his stage 3B chronic kidney disease.

Comparison6 issues

Missing information:

  • age explicitly stated as 67 years old

Hallucinated:

  • birth year 1957 added not stated in the original
  • active service order added reconstructed states there is an active service order for a basic metabolic panel bmp which is not mentioned in the original scenario
  • specific test basic metabolic panel named for monitoring whereas the original only states regular monitoring of renal function and electrolytes without specifying a particular panel
  • birth year addedchanged reconstructed states he was born in 1957 while the original only states he is 67 years old no birth year provided
  • measurement units mlmin173m2 added to egfr
ClaudeClaude

Reconstructed text

James Brown is a 66-year-old male with no known drug allergies (NKDA).

Active Conditions:

Mr. Brown carries a diagnosis of Type 2 diabetes mellitus complicated by diabetic nephropathy, which has progressed to Stage 3b chronic kidney disease (CKD), classified as severe. His most recent estimated glomerular filtration rate (eGFR) is 38 mL/min/1.73m², which is significantly below the normal threshold of ≥90 mL/min/1.73m². He also has active hypertension and vitamin D deficiency.

Current Medications:

  1. Losartan 50 mg orally once daily — prescribed for renal protection in the setting of diabetic nephropathy and CKD.
  2. Metformin 500 mg orally twice daily — for glycemic control of Type 2 diabetes. The dose has been reduced from the standard regimen due to his CKD Stage 3b (eGFR 38), with a note to monitor renal function regularly.
  3. Amlodipine 5 mg orally once daily — for blood pressure control.
  4. Calcitriol 0.25 mcg orally once daily — for treatment of vitamin D deficiency.

Pending Laboratory Orders:

  1. Renal function panel — ordered for regular monitoring of renal function in the context of CKD Stage 3b management and to guide metformin dose adjustment.
  2. Electrolytes panel — ordered for regular electrolyte monitoring due to CKD and concurrent losartan therapy, given the associated risk of hyperkalemia.

Comparison8 issues

Hallucinated:

  • age changed from 67 to 66
  • stage 3b ckd classified as severe not stated in the original stage 3b is generally moderately to severely decreased
  • added pending laboratory orders renal function panel and electrolytes panel as if they were ordered original only states he requires regular monitoring not that labs were ordered
  • added that monitoringlabs are intended to guide metformin dose adjustment not stated in original
  • added rationale that electrolyte monitoring is needed due to losartan therapy and associated risk of hyperkalemia risk statement not included in original
  • added clinical classification of ckd as severe and normal reference threshold of 90 mlmin173m
  • added orally as the route of administration for losartan metformin amlodipine and calcitriol
  • fabricated specific pending laboratory orders for a renal function panel and electrolytes panel including fabricated rationales such as guide metformin dose adjustment and associated risk of hyperkalemia original only noted he requires regular monitoring
MistralMistral

Reconstructed text

James Brown is a 67-year-old male patient with a complex medical history. He has been diagnosed with Stage 3b Chronic Kidney Disease (CKD), which was confirmed in January 2020 and is noted to have an eGFR of 38, secondary to diabetic nephropathy. Additionally, he has active Type 2 Diabetes and Hypertension. Mr. Brown's current medication regimen includes Losartan 50mg daily, Metformin 500mg twice daily (with a note indicating a reduced dose due to his CKD), Amlodipine 5mg daily, and Calcitriol 0.25mcg daily. He has active service requests for renal function monitoring and electrolyte monitoring, both of which are to be performed every three months. Notably, Mr. Brown has no known drug allergies.

Comparison8 issues

Missing information:

  • losartan indication specified as for renal protection
  • amlodipine noted as being prescribed specifically for blood pressure control
  • amlodipine indication for blood pressure
  • calcitriol indication for vitamin d deficiency

Hallucinated:

  • ckd diagnosis date of january 2020 added not present in original
  • monitoring frequency specified as every three months original only states regular monitoring
  • renal function monitoring and electrolyte monitoring specified as active service requests and scheduled every three months frequencyservicerequest details not present in original scenario
  • ckd confirmed in january 2020
ChatGPTChatGPT

Reconstructed text

James Brown (male, born 1959) has no known drug allergies (active, confirmed).

He carries multiple active, confirmed problem-list diagnoses, including chronic kidney disease (CKD) stage 3b (SNOMED 433146000; ICD-10 N18.32) with staging noted as “Stage 3b (eGFR 38)”. Supporting laboratory evidence includes a final estimated GFR (CKD-EPI) of 38 mL/min/1.73 m². The CKD is noted as secondary to diabetic nephropathy. Additional active conditions include diabetic nephropathy, type 2 diabetes mellitus, hypertension, and vitamin D deficiency.

Current active medication orders include:

  • Losartan potassium 50 mg oral tablet: 50 mg by mouth once daily, indicated for renal protection, associated with CKD.
  • Metformin hydrochloride 500 mg oral tablet: 500 mg by mouth twice daily (noted as a reduced dose for CKD), associated with type 2 diabetes and CKD.
  • Amlodipine 5 mg oral tablet: 5 mg by mouth once daily for blood pressure, associated with hypertension.
  • Calcitriol 0.25 mcg oral capsule: 0.25 mcg by mouth once daily for vitamin D deficiency, associated with vitamin D deficiency and CKD.

Two active laboratory service requests have been placed for ongoing monitoring due to CKD stage 3b:

  • Renal function panel (serum/plasma) (LOINC 24362-6) for regular monitoring of renal function, with note indicating monitoring is required due to CKD stage 3b.
  • Electrolytes panel (serum/plasma) (LOINC 24357-6) for regular monitoring of electrolytes, with note indicating monitoring is required due to CKD and antihypertensive therapy.

Comparison15 issues

Missing information:

  • age 67

Hallucinated:

  • electrolyte monitoring note attributes monitoring to ckd and antihypertensive therapy original only states regular monitoring of renal function and electrolytes without specifying antihypertensive therapy as a reason
  • birth year 1959 fabricated original states age 67 which would correspond to birth year 1957 or 1958 not 1959
  • patient birth year listed as 1959 original only states 67yearold no dobbirth year provided
  • inclusion of snomed code 433146000 and icd10 code n1832 for ckd stage 3b not present in original
  • statement of supporting laboratory evidence including a final estimated gfr ckdepi of 38 mlmin173 m original only reports egfr 38 no ckdepi method units or final result status given
  • characterization of diagnoses as active confirmed problemlist diagnoses original does not specify problemlist status or confirmation status
  • addition of two active laboratory service requests being placed renal function panel and electrolytes panel original states monitoring is required but does not state that ordersrequests have been placed
  • specific lab orders and identifiers added renal function panel loinc 243626 and electrolytes panel loinc 243576 not in original
  • birth year 1959 added
  • snomed code 433146000 and icd10 code n1832 added
  • egfr methodology ckdepi and units mlmin173 m added
  • specific medication formulations oral tablet oral capsule added
  • loinc codes 243626 and 243576 added
  • added note that electrolyte monitoring is required due to antihypertensive therapy

Cross LLM Tests

GeminiMistral

Reconstructed text

James Brown, a 66-year-old male, has a complex medical history including chronic kidney disease stage 3B, diabetic nephropathy, type 2 diabetes mellitus, hypertension, and vitamin D deficiency. His glomerular filtration rate is significantly reduced at 38 mL/min/1.73m². He is currently managed on a regimen of losartan potassium 50mg daily for renal protection, metformin hydrochloride 500mg twice daily with a reduced dose for his chronic kidney disease, amlodipine 5mg daily for hypertension, and calcitriol 0.25mcg daily for vitamin D deficiency. Regular monitoring of his renal function and electrolytes has been ordered through basic metabolic panels. Notably, the patient has no known drug allergies.

Comparison3 issues

Hallucinated:

  • age changed from 67 to 66
  • specification of monitoring through basic metabolic panels is fabricated the original only states regular monitoring of renal function and electrolytes without specifying the test type
  • added specific detail that monitoring is ordered through basic metabolic panels which was not in the original
ChatGPTGemini

Reconstructed text

James Brown, a male born in 1959, has no known drug allergies. His active problem list is significant for type 2 diabetes mellitus complicated by diabetic nephropathy, stage 3b chronic kidney disease (CKD), essential hypertension, and vitamin D deficiency. A recent laboratory test on March 9, 2026, revealed a low estimated Glomerular Filtration Rate (eGFR) of 38 mL/min/1.73 m2, which is consistent with his CKD secondary to diabetic nephropathy.

To manage his conditions, Mr. Brown is currently prescribed several oral medications: losartan potassium 50 mg once daily (for his CKD), metformin hydrochloride 500 mg twice daily (a reduced dose for his CKD and diabetes), amlodipine 5 mg once daily (for hypertension), and calcitriol 0.25 mcg once daily (for vitamin D deficiency and CKD).

For ongoing management and regular monitoring of his stage 3b chronic kidney disease, active laboratory orders have been placed for a renal function panel and a basic metabolic panel. Both tests are scheduled to be drawn every 3 months to monitor his overall renal function and electrolytes.

Comparison11 issues

Hallucinated:

  • birth year 1959 fabricated original only states age 67
  • laboratory test date of march 9 2026 fabricated not in original
  • monitoring frequency of every 3 months fabricated original only states regular monitoring without specifying interval
  • basic metabolic panel order fabricated original only mentions regular monitoring of renal function and electrolytes
  • lab timing added recent laboratory test on march 9 2026 no lab datetimeframe provided in original
  • lab order details added active laboratory orders renal function panel and a basic metabolic panel original only states need for regular monitoring of renal function and electrolytes no specific ordered tests named
  • indication expanded calcitriol stated as for vitamin d deficiency and ckd original lists it for vitamin d deficiency only
  • birth year of 1959 added
  • measurement units mlmin173 m2 for egfr added
  • specific active laboratory orders for a renal function panel and a basic metabolic panel added
  • specific frequency of every 3 months for laboratory testing added
MistralClaude

Reconstructed text

James Brown is a 69-year-old male with a complex medical history involving multiple chronic conditions. He has a confirmed diagnosis of hypertension dating back to 2005, type 2 diabetes mellitus with onset in 2010, and stage 3B chronic kidney disease (CKD) of moderate severity, first identified in 2015. His most recent estimated glomerular filtration rate (eGFR), obtained on May 15, 2023, was 38 mL/min/1.73m², consistent with his CKD stage 3B classification.

Mr. Brown is currently on a multi-drug regimen to manage his conditions. For blood pressure control and renal protection, he is prescribed losartan 50 mg orally once daily and amlodipine 5 mg orally once daily. His type 2 diabetes is being managed with metformin 500 mg orally twice daily. Additionally, he is taking calcitriol 0.25 mcg orally once daily, likely to address vitamin D metabolism abnormalities associated with his chronic kidney disease.

Active monitoring orders are in place for both renal function and electrolytes, each scheduled at intervals of every three months, reflecting appropriate surveillance given his stage 3B CKD and concurrent medication use.

Comparison14 issues

Missing information:

  • ckd is secondary to diabetic nephropathy
  • metformin dose is noted as reduced for ckd
  • no known drug allergies

Hallucinated:

  • age changed from 67 to 69
  • type 2 diabetes onset in 2010 fabricated
  • ckd first identified in 2015 fabricated
  • egfr date of may 15 2023 fabricated
  • monitoring interval of every three months fabricated
  • hypertension history added diagnosed in 2005
  • hypertension dating back to 2005 fabricated
  • calcitriol indication changed from vitamin d deficiency to vitamin d metabolism abnormalities associated with ckd
  • specific lab date added for egfr obtained on may 15 2023
  • monitoring frequency addedchanged renal function and electrolytes scheduled every three months
  • ckd identification date of 2015 added
ClaudeChatGPT

Reconstructed text

James Brown is a male born in 1958. He has no known drug allergies (documented as “No known allergy,” active and confirmed).

His active, confirmed problem list includes chronic kidney disease (CKD) stage 3B, described as stage 3b CKD with eGFR 38 and recorded with severe severity. He also has type 2 diabetes mellitus (active/confirmed) with diabetic nephropathy/diabetic chronic kidney disease (renal disorder due to diabetes mellitus; active/confirmed). In addition, he has hypertension (essential/primary; active/confirmed).

A laboratory observation shows an estimated glomerular filtration rate (eGFR, CKD-EPI 2021) of 38 mL/min/1.73 m², interpreted as low, with a referenced normal range of ≥90 mL/min/1.73 m².

Current active medication orders include:

  • Losartan potassium 50 mg oral tablet: 50 mg by mouth once daily, prescribed for renal protection in the context of diabetic nephropathy and CKD stage 3b.
  • Metformin hydrochloride 500 mg oral tablet: 500 mg by mouth twice daily, noted as a reduced dose for CKD; the record specifies it was reduced due to CKD stage 3b (eGFR 38) with instruction to monitor renal function regularly.
  • Amlodipine 5 mg oral tablet: 5 mg by mouth once daily for blood pressure control.
  • Calcitriol 0.25 mcg oral capsule: 0.25 mcg by mouth once daily for vitamin D deficiency, noted as secondary to CKD.

Active ordered laboratory monitoring includes:

  • Renal function panel (serum/plasma) ordered for CKD stage 3B, with a note indicating regular monitoring is needed for CKD management and metformin dose adjustment.
  • Electrolytes panel (serum/plasma) ordered for CKD stage 3B, with a note indicating regular electrolyte monitoring due to CKD and losartan because of risk of hyperkalemia.

No appointment or scheduling details are provided in the available records.

Comparison16 issues

Missing information:

  • age explicitly stated as 67 years old
  • age of 67 years

Hallucinated:

  • electrolyte monitoring rationale of risk of hyperkalemia with losartan fabricated not in original
  • renal function monitoring linked to metformin dose adjustment not stated in original
  • ckd stage 3b severity classified as severe not stated in original
  • egfr test methodology and reporting details added ckdepi 2021 interpretation as low and reference range 90 mlmin173 m not provided in original
  • birth year 1958 fabricated original only states age 67
  • egfr method specified as ckdepi 2021 not mentioned in original
  • egfr normal range 90 mlmin173 m not provided in original
  • hypertension specified as essentialprimary not stated in original
  • date of birthbirth year added born in 1958 not provided in original
  • vitamin d deficiency described as secondary to ckd original states vitamin d deficiency but does not attribute cause
  • specific lab orders added renal function panel and electrolytes panel as active ordered monitoring original only states monitoring is required not that panels were ordered
  • birth year 1958 added
  • ckd recorded with severe severity added
  • calcitriol indication noted as secondary to ckd added