Round Details
March 9, 2026 at 12:00 AM UTC
Scenario: Type 2 Diabetes - Metformin
Patient John Smith is a 45-year-old male who was diagnosed with Type 2 Diabetes Mellitus last month. His physician prescribed Metformin 500mg to be taken twice daily with meals. His latest HbA1c was 7.8%. He has no known drug allergies and his BMI is 28.
How did the LLMs do?
Same LLM Tests
Reconstructed text
John Smith is a 45-year-old male (born in 1979) with no known drug allergies. He has an active diagnosis of Type 2 diabetes mellitus. Recent clinical observations indicate a Hemoglobin A1c of 7.8% and a Body Mass Index (BMI) of 28 kg/m2. To manage his condition, he is prescribed Metformin hydrochloride 500 mg oral tablets, with instructions to take the medication twice daily with meals.
Comparison5 issues
Missing information:
- diagnosis was made last month timing of diagnosis is absent from reconstruction
- timing of diagnosis original states type 2 diabetes mellitus was diagnosed last month
- time of diagnosis last month
Hallucinated:
- birth year born in 1979 was fabricated and not present in the original
- birth year added born in 1979
Reconstructed text
John Smith is a male patient born in 1981. He has an active, confirmed diagnosis of type 2 diabetes mellitus, documented as type 2 diabetes mellitus without complications, with onset in February 2026. He has an active medication order for metformin hydrochloride 500 mg oral tablet for treatment of his diabetes. The prescribed instructions are to take 500 mg by mouth twice daily with meals via the oral route. Recent observations include a final laboratory HbA1c of 7.8% and a final BMI of 28 kg/m². Allergy documentation indicates confirmed no known drug allergies.
Comparison9 issues
Missing information:
- patient age of 45 years
Hallucinated:
- birth year 1981 added not stated in original
- diagnosis specified as without complications not stated in original
- onset date of february 2026 fabricated original only states last month
- medication specified as metformin hydrochloride 500 mg oral tablet original only states metformin 500mg
- birth year 1981 was added the original only states that the patient is 45 years old
- diagnosis timing was changed from diagnosed last month to a specific onset date of february 2026
- the diagnosis was made more specific as type 2 diabetes mellitus without complications but the original only states type 2 diabetes mellitus and does not mention complication status
- onset date of february 2026 added
Reconstructed text
Clinical Narrative for John Smith
John Smith, a 45-year-old male (DOB: 05/15/1978), was diagnosed with Type 2 Diabetes Mellitus (E11.9) on April 1, 2023, which remains active and confirmed. His most recent HbA1c, measured on April 15, 2023, was 7.8% (elevated), and his BMI was 28 kg/m², classifying him as overweight.
For diabetes management, Dr. Physician prescribed metformin 500mg orally, to be taken twice daily with meals, starting April 1, 2023. The patient has no known drug allergies (confirmed as inactive).
This summary reflects his current clinical status, including active diabetes, elevated HbA1c, overweight BMI, and ongoing metformin therapy.
Comparison12 issues
Hallucinated:
- specific diagnosis date of april 1 2023 fabricated original states last month
- icd10 code e119 added not in original
- date of birth 05151978 fabricated not in original
- prescriber name dr physician fabricated original only refers to his physician
- specific hba1c measurement date april 15 2023 was added the original only gives the latest hba1c value of 78
- date of birth 05151978 was added no dob was provided in the original
- diagnosis status active and confirmed was added this status was not stated in the original
- bmi unit kgm and interpretation classifying him as overweight were added the original only states bmi is 28
- medication route orally was added the original only states metformin 500mg twice daily with meals
- allergy status described as confirmed as inactive was added the original only states no known drug allergies
- physician name dr physician added
- metformin start date april 1 2023 added
Reconstructed text
John Smith is a 45-year-old male with no known drug allergies. He has a confirmed, active diagnosis of Type 2 diabetes mellitus without complications, with an onset date of May 1, 2025.
Laboratory and vital sign data obtained on June 1, 2025, revealed a hemoglobin A1c (HbA1c) of 7.8%, which is elevated above the normal reference range of less than 5.7%. His body mass index (BMI) was recorded at 28 kg/m², classified as high relative to the normal range of 18.5–24.9 kg/m², consistent with overweight status.
For management of his Type 2 diabetes, Mr. Smith has been prescribed metformin hydrochloride 500 mg oral tablet, to be taken at a dose of 500 mg twice daily with meals. This medication order is currently active.
Comparison14 issues
Missing information:
- diagnosed last month
- prescribed by his physician
Hallucinated:
- specific onset date of may 1 2025 fabricated original only states last month
- without complications qualifier added to type 2 diabetes mellitus diagnosis not stated in original
- specific lab data date of june 1 2025 fabricated no date provided in original
- formulation specified as oral tablet not stated in original
- specific labvital date added june 1 2025 for the hba1c and bmi no date is provided in the original
- medication status added the metformin order is described as currently active this status is not stated in the original
- diabetes described as without complications
- onset date of may 1 2025 added
- laboratory and vital sign data date of june 1 2025 added
- hemoglobin a1c normal reference range of less than 57 added
- bmi normal range of 185249 kgm and overweight status classification added
- metformin specified as hydrochloride and oral tablet
Cross LLM Tests
Reconstructed text
John Smith is a 45-year-old male (born in 1981) who has no known drug allergies. In February 2026, he was confirmed to have an active diagnosis of Type 2 diabetes mellitus without complications. His recent clinical observations include a Body Mass Index (BMI) of 28 kg/m2 and a high Hemoglobin A1c laboratory result of 7.8%. To manage his diabetes, he was prescribed metformin hydrochloride 500 mg oral tablets, with instructions to take 500 mg by mouth twice daily with meals.
Comparison5 issues
Hallucinated:
- birth year 1981 added not present in original
- type 2 diabetes mellitus described as without complications not stated in original
- specific date february 2026 fabricated original only states last month
- diagnosis timing changed from diagnosed last month to in february 2026
- diagnosis date february 2026 added
Reconstructed text
Clinical Narrative for John Smith
John Smith is a 43-year-old male with a diagnosis of type 2 diabetes mellitus (T2DM), currently active. His most recent hemoglobin A1c (HbA1c) is 7.8%, indicating suboptimal glycemic control. His body mass index (BMI) is 28 kg/m², placing him in the overweight category. He has no known drug allergies documented.
For diabetes management, Mr. Smith is prescribed metformin hydrochloride 500 mg oral tablets, with instructions to take 500 mg twice daily with meals. The medication order remains active. No additional complications or comorbidities are noted in the available records.
Comparison6 issues
Missing information:
- diagnosis was made last month
- timing of diagnosis the original states he was diagnosed with type 2 diabetes mellitus last month
- diagnosed last month
Hallucinated:
- age changed from 45 to 43
- diagnosis status added as currently active which was not stated in the original
- statement that no additional complications or comorbidities are noted was added but this was not provided in the original
Reconstructed text
John Smith is a male patient born in 1980. He has an active, confirmed diagnosis of type 2 diabetes mellitus (SNOMED CT 44054006; ICD-10-CM E11), with onset documented on 2025-05-01 and recorded on 2025-05-01. For treatment of his type 2 diabetes mellitus, an active medication order was authored on 2025-05-01 for metformin hydrochloride 500 mg oral tablet (Metformin 500 mg). The prescribed dosage is 500 mg by mouth twice daily with meals. Laboratory testing on 2025-06-01 showed an HbA1c of 7.8%, which was interpreted as high; the stated normal reference range is less than 5.7%. On the same date, his BMI was 28 kg/m2, also interpreted as high, compared with a reference range of 18.5 to 24.9 kg/m2. Allergy documentation recorded on 2025-06-01 indicates active, confirmed no known drug allergies.
Comparison14 issues
Missing information:
- age 45
Hallucinated:
- birth year 1980 fabricated original only states age 45
- specific diagnosis onset date 20250501 fabricated original only states last month
- specific medication order date 20250501 fabricated not in original
- hba1c reference range of less than 57 added not in original
- interpretation of bmi as high added not in original
- specific metformin medication order author date 20250501 was added no prescription date is given in the original
- specific hba1c test date 20250601 was added the original only states the latest hba1c was 78
- diagnosis coding details snomed ct 44054006 and icd10cm e11 were added but are not present in the original
- normalreference ranges and interpretations hba1c high with normal 57 bmi high with reference range 185 to 249 kgm2 were added but are not present in the original
- birth year 1980 added
- snomed ct 44054006 and icd10cm e11 codes added
- specific lab bmi and allergy recording date of 20250601 added
- bmi interpretation high and reference range 185 to 249 kgm2 added
Reconstructed text
John Smith is a 46-year-old male (date of birth: May 15, 1978) with no known drug allergies (confirmed, currently inactive).
He carries a confirmed, active diagnosis of Type 2 Diabetes Mellitus without complications (ICD-10: E11.9), with onset and recording date of April 1, 2023. On that same date, Dr. Physician ordered Metformin 500 mg oral tablet, to be taken 500 mg twice daily with meals (before breakfast and before lunch) by oral route. This medication order remains active.
Laboratory and clinical data obtained on May 10, 2023, include a Hemoglobin A1c of 7.8%, which is elevated above the normal reference range of 4.0–5.6%, and a body mass index (BMI) of 28 kg/m², placing him in the overweight category. The elevated HbA1c is consistent with his diabetes diagnosis and suggests suboptimal glycemic control at the time of measurement.
Comparison17 issues
Hallucinated:
- age changed from 45 to 46
- without complications added to type 2 diabetes mellitus diagnosis
- date of birth may 15 1978 fabricated
- specific diagnosis onset date of april 1 2023 fabricated
- hba1c normal reference range of 4056 fabricated
- prescriber name dr physician fabricated from generic reference to his physician
- meal specification before breakfast and before lunch fabricated original only states with meals
- icd10 code e119 fabricated
- date of birth may 15 1978 was added the original did not provide a dob
- diabetes diagnosis timing was changed from diagnosed last month to a specific onsetrecording date of april 1 2023
- icd10 code e119 was added no diagnosis code was provided in the original
- metformin instructions were altered to specify dosing before breakfast and before lunch the original only said twice daily with meals
- medication order status remains active was added this was not stated in the original
- allergy status was expanded to confirmed currently inactive the original only stated no known drug allergies
- prescribing physician name dr physician added
- specific meal instructions before breakfast and before lunch added
- laboratory and clinical data date of may 10 2023 added