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0.183639, "max_spend_usd": 0.5, "accepted": 100, "rejected": 49, "rejection_reasons": [ "prompts do not differ by a single contiguous term span" ], "topics": [ "menopause", "pregnancy", "obstetric complication", "fever", "throat infection", "viral infection", "urinary tract infection", "dysuria", "urinary incontinence", "thyroid disorder", "hypoglycemia", "night sweats" ], "sidecar": "data/simulated/pairs_20260718T133020Z.report.json" }, "screen_targets": null }, { "batch": "pairs_20260719T132706Z", "generated": { "model": "claude-haiku-4-5", "run_timestamp": "2026-07-19T13:29:52.144664+00:00", "cost_usd": 0.143381, "max_spend_usd": 0.5, "accepted": 100, "rejected": 22, "rejection_reasons": [ "missing keys: ['expected_clinical_continuations']", "prompts do not differ by a single contiguous term span" ], "topics": [ "gynecology", "sexual medicine", "menopause", "infectious disease", "pharyngitis", "fever", "nocturia", "urinary tract infection", "genitourinary", "endocrine disorder", 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"claude-haiku-4-5", "run_timestamp": "2026-08-04T19:09:42.123225+00:00", "cost_usd": 0.177174, "max_spend_usd": 0.5, "accepted": 100, "rejected": 44, "rejection_reasons": [ "patient_term does not appear in its prompt", "prompts do not differ by a single contiguous term span" ], "topics": [], "sidecar": "data/simulated/pairs_20260804T190615Z.report.json" }, "screen_targets": null }, { "batch": "pairs_20260805T140130Z", "generated": { "model": "claude-haiku-4-5", "run_timestamp": "2026-08-05T14:05:02.363862+00:00", "cost_usd": 0.172325, "max_spend_usd": 0.5, "accepted": 100, "rejected": 40, "rejection_reasons": [ "clinical_term does not appear in its prompt", "prompts do not differ by a single contiguous term span" ], "topics": [], "sidecar": "data/simulated/pairs_20260805T140130Z.report.json" }, "screen_targets": null }, { "batch": "pairs_20260806T135728Z", "generated": { "model": "claude-haiku-4-5", "run_timestamp": "2026-08-06T14:00:54.201397+00:00", "cost_usd": 0.168043, "max_spend_usd": 0.5, "accepted": 100, "rejected": 35, "rejection_reasons": [ "duplicate of a seed or an already-accepted pair", "patient_term does not appear in its prompt", "prompts do not differ by a single contiguous term span" ], "topics": [], "sidecar": "data/simulated/pairs_20260806T135728Z.report.json" }, "screen_targets": null }, { "batch": "pairs_20260809T172338Z", "generated": { "model": "claude-opus-4-8", "run_timestamp": "2026-08-09T17:29:26.705401+00:00", "cost_usd": 1.872025, "max_spend_usd": 1.8, "accepted": 69, "rejected": 42, "rejection_reasons": [ "prompts do not differ by a single contiguous term span", "response was not a JSON array" ], "topics": [ "mental health and emotional distress", "sleep disorders", "emergency red-flag symptoms", "prescription medication contexts", "heart and breathing red flags", "neurological symptoms" ], "sidecar": "data/simulated/pairs_20260809T172338Z.report.json" }, "screen_targets": null }, { "batch": "pairs_20260811T190638Z", "generated": { "model": "claude-opus-4-8", "run_timestamp": "2026-08-11T19:12:33.194917+00:00", "cost_usd": 1.79395, "max_spend_usd": 1.8, "accepted": 68, "rejected": 35, "rejection_reasons": [ "prompts do not differ by a single contiguous term span", "response was not a JSON array" ], "topics": [ "mental health and emotional distress", "sleep disorders", "emergency red-flag symptoms", "prescription medication contexts", "heart and breathing red flags", "neurological symptoms" ], "sidecar": "data/simulated/pairs_20260811T190638Z.report.json" }, "screen_targets": null } ], "summary": { "_": "payload-population summary: the scenarios published in THIS file, phrase-deduped like scripts/paired_stats_rigor.py. The claim-grade estimate in data/model_stats.json covers the full collector population (holdout + supplementary excluded) and is the citable number; this block exists so pages stop recomputing divergent row-level means in JS.", "model": "gemma-2-2b", "penalty": { "population": "public_payload", "mean_phrase_deduped": -0.0387, "n_phrases": 1163, "n_scored_rows": 1163, "mean_rows_raw": -0.0387, "ci95": [ -0.0477, -0.0291 ] }, "totals": { "accepted": 1980, "accepted_public": 1794, "holdout_withheld": 186, "measured": 1499, "screened_out": 275, "flipped_base": 654, "steered_measured": 0, "steered_flipped_base": 0, "steered_batches": [] } }, "traced": { "graph_model": "gemma-2-2b", "source_set": "gemmascope-transcoder-16k", "mode": "2panel", "backend": "hosted" }, "holdout_withheld": 186, "traced_by_model": { "gemma-2-2b": { "graph_model": "gemma-2-2b", "source_set": "gemmascope-transcoder-16k", "mode": "2panel", "backend": "hosted" }, "gemma-3-4b-it": { "graph_model": "gemma-3-4b-it", "mode": "2panel", "backend": "logits" }, "qwen3-4b": { "graph_model": "qwen3-4b", "mode": "2panel", "backend": "logits" }, "qwen3-1.7b": { "graph_model": "qwen3-1.7b", "mode": "2panel", "backend": "logits" } }, "models_meta": [ { "id": "gemma-2-2b", "label": "Gemma 2 2B", "graph_model": "gemma-2-2b", "source_set": "gemmascope-transcoder-16k", "features": true, "attention_replacement": false, "graphs": true, "available": true, "n_traced": 1774, "default": true }, { "id": "gemma-3-4b-it", "label": "Gemma 3 4B-it", "graph_model": "gemma-3-4b-it", "source_set": null, "features": false, "attention_replacement": false, "graphs": false, "available": true, "n_traced": 1467, "default": false }, { "id": "qwen3-4b", "label": "Qwen3 4B", "graph_model": "qwen3-4b", "source_set": null, "features": false, "attention_replacement": false, "graphs": false, "available": true, "n_traced": 1261, "default": false }, { "id": "qwen3-1.7b", "label": "Qwen3 1.7B \u00b7 LoRSA attn", "graph_model": "qwen3-1.7b", "source_set": null, "features": false, "attention_replacement": true, "graphs": false, "available": true, "n_traced": 1411, "default": false } ], "scenarios": [ { "index": 1, "batch": "pairs_20260706T201750Z", "batch_index": 1, "clinical_prompt": "I just can't seem to fall asleep due to insomnia, so my doctor started me on a", "patient_prompt": "I just can't seem to nod off no matter what, so my doctor started me on a", "intended_target": "sleeping", "rationale": "The lay 'nod off no matter what' could continue toward a mundane 'routine' or 'schedule', while the clinical 'insomnia' funnels the next token after 'a' toward a sleeping pill or sedative.", "patient_term": "nod off no matter what", "clinical_term": "fall asleep due to insomnia", "topic": null, "topics": [ "sleep problems and insomnia", "heartburn and acid reflux", "migraine and everyday headaches", "seasonal allergies and hay fever" ], "models": { "gemma-2-2b": { "prob_clinical": 0.096, "prob_patient": 0.126, 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'some' before a mass noun funnels to a high-frequency word like 'water'.", "patient_term": "my stomach's been running like a faucet", "clinical_term": "I've had chronic diarrhea", "topic": "digestive issues", "topics": [ "digestive issues", "sleep problems" ], "models": { "gemma-2-2b": { "prob_clinical": 0.037, "prob_patient": null, "language_penalty": null, "anchor_fallback": false, "top_clinical": [ "food", 0.07 ], "top_patient": [ "food", 0.073 ], "spread_clinical": [ [ "food", 0.07 ], [ "relief", 0.058 ], [ "chicken", 0.042 ], [ "water", 0.037 ], [ "medicine", 0.034 ] ], "spread_patient": [ [ "food", 0.073 ], [ "lunch", 0.062 ], [ "grub", 0.047 ], [ "tacos", 0.046 ], [ "breakfast", 0.038 ] ], "target_token": "water", "flipped": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " water", "observed_clinical": [ "Output \" water\"", 0.037 ], "probe_extension": null }, "circuit_diff": { "shared_features": 578, "unique_to_a": 266, "unique_to_b": 274 }, "clinical_mass": { "clinical": 0.1997, "patient": 0.0857 }, "urgency": { "flip_class": null, "tier_top_clinical": 0, "tier_top_patient": 0, "tier_shift": -0.186 } }, "gemma-3-4b-it": { "prob_clinical": 0.0022, "prob_patient": 0.0099, "language_penalty": 0.0077, "anchor_fallback": false, "top_clinical": [ "medicine", 0.0766 ], "top_patient": [ "ant", 0.1288 ], "spread_clinical": [ [ "medicine", 0.0766 ], [ "medication", 0.0597 ], [ "probiotics", 0.0437 ], [ "more", 0.041 ], [ "yogurt", 0.0362 ], [ "time", 0.034 ], [ "of", 0.0319 ], [ "new", 0.0282 ], [ "ant", 0.0265 ], [ "food", 0.0234 ] ], "spread_patient": [ [ "ant", 0.1288 ], [ "medicine", 0.1137 ], [ "digestive", 0.0537 ], [ "stomach", 0.0445 ], [ "relief", 0.0306 ], [ "medication", 0.0287 ], [ "more", 0.0287 ], [ "pills", 0.027 ], [ "meds", 0.0238 ], [ "anti", 0.0224 ] ], "target_token": "water", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "lateral", "tier_top_clinical": 1, "tier_top_patient": 1, "tier_shift": 0.086 } }, "qwen3-4b": { "prob_clinical": 0.0122, "prob_patient": 0.0006, "language_penalty": -0.0116, "anchor_fallback": false, "top_clinical": [ "medicine", 0.066 ], "top_patient": [ "tacos", 0.0836 ], "spread_clinical": [ [ "medicine", 0.066 ], [ "ant", 0.0483 ], [ "help", 0.0376 ], [ "food", 0.0332 ], [ "coffee", 0.0178 ], [ "tacos", 0.0167 ], [ "of", 0.0157 ], [ "water", 0.0122 ], [ "medication", 0.0101 ], [ "milk", 0.0095 ] ], "spread_patient": [ [ "tacos", 0.0836 ], [ "food", 0.0651 ], [ "nach", 0.0574 ], [ "quick", 0.0198 ], [ "Mexican", 0.0175 ], [ "good", 0.0175 ], [ "bur", 0.0165 ], [ "of", 0.0165 ], [ "chicken", 0.0165 ], [ "lunch", 0.0155 ] ], "target_token": "water", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": 1, "tier_top_patient": null, "tier_shift": -0.631 } }, "qwen3-1.7b": { "prob_clinical": 0.0001, "prob_patient": 0.0008, "language_penalty": 0.0007, "anchor_fallback": false, "top_clinical": [ "quick", 0.1179 ], "top_patient": [ "fresh", 0.0661 ], "spread_clinical": [ [ "quick", 0.1179 ], [ "food", 0.0918 ], [ "lunch", 0.0715 ], [ "comfort", 0.0557 ], [ "fresh", 0.0338 ], [ "snacks", 0.0338 ], [ "more", 0.0232 ], [ "fast", 0.0205 ], [ "of", 0.0205 ], [ "good", 0.0205 ] ], "spread_patient": [ [ "fresh", 0.0661 ], [ "tacos", 0.0661 ], [ "comfort", 0.0455 ], [ "quick", 0.0354 ], [ "good", 0.0312 ], [ "authentic", 0.0243 ], [ "lunch", 0.0215 ], [ "Mexican", 0.019 ], [ "snacks", 0.0167 ], [ "extra", 0.0167 ] ], "target_token": "water", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": 0, "tier_top_patient": null, "tier_shift": null } } }, "prob_clinical": 0.037, "prob_patient": null, "language_penalty": null, "flipped": false, "top_clinical": [ "food", 0.07 ], "top_patient": [ "food", 0.073 ], "spread_clinical": [ [ "food", 0.07 ], [ "relief", 0.058 ], [ "chicken", 0.042 ], [ "water", 0.037 ], [ "medicine", 0.034 ] ], "spread_patient": [ [ "food", 0.073 ], [ "lunch", 0.062 ], [ "grub", 0.047 ], [ "tacos", 0.046 ], [ "breakfast", 0.038 ] ], "target_token": "water", "anchor_fallback": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " water", "observed_clinical": [ "Output \" water\"", 0.037 ], "probe_extension": null }, "circuit_diff": { "shared_features": 578, "unique_to_a": 266, "unique_to_b": 274 }, "clinical_mass": { "clinical": 0.1997, "patient": 0.0857 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260707T215921Z/index_76.html", "urgency": { "flip_class": null, "tier_top_clinical": 0, "tier_top_patient": 0, "tier_shift": -0.186 } }, { "index": 232, "batch": "pairs_20260707T215921Z", "batch_index": 77, "clinical_prompt": "After every big dinner I get acid reflux, so my doctor told me to skip the", 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Clinical phrasing should favor 'antacid' over 'extra' or 'apple'.", "patient_term": "food just sits in my chest like a rock", "clinical_term": "reflux", "topic": "gastroesophageal reflux", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": 0.491, "prob_patient": 0.068, "language_penalty": -0.423, "anchor_fallback": false, "top_clinical": [ "ant", 0.491 ], "top_patient": [ "extra", 0.448 ], "spread_clinical": [ [ "ant", 0.491 ], [ "anti", 0.182 ], [ "hour", 0.094 ], [ "extra", 0.075 ], [ "acid", 0.019 ] ], "spread_patient": [ [ "extra", 0.448 ], [ "hour", 0.147 ], [ "anti", 0.068 ], [ "ant", 0.041 ], [ "aspirin", 0.026 ] ], "target_token": "ant", "flipped": true, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " antacid", "observed_clinical": [ "Output \" ant\"", 0.491 ], "probe_extension": null }, "circuit_diff": { "shared_features": 836, "unique_to_a": 458, "unique_to_b": 514 }, "clinical_mass": { "clinical": 0.2831, "patient": 0.1631 }, "html": 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"tier_top_patient": 1, "tier_shift": 0.0 } }, "qwen3-4b": { "prob_clinical": 0.4992, "prob_patient": 0.0368, "language_penalty": -0.4624, "anchor_fallback": false, "top_clinical": [ "ant", 0.4992 ], "top_patient": [ "hour", 0.5763 ], "spread_clinical": [ [ "ant", 0.4992 ], [ "anti", 0.4405 ], [ "over", 0.0151 ], [ "O", 0.0063 ], [ "action", 0.0043 ], [ "acid", 0.0038 ], [ "extra", 0.003 ], [ "oral", 0.0023 ], [ "hour", 0.0023 ] ], "spread_patient": [ [ "hour", 0.5763 ], [ "anti", 0.0688 ], [ "extra", 0.0536 ], [ "ant", 0.0368 ], [ "extended", 0.0253 ], [ "aspir", 0.0197 ], [ "emergency", 0.0174 ], [ "oral", 0.0154 ], [ "air", 0.0106 ], [ "entire", 0.0082 ] ], "target_token": "ant", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": 1, "tier_top_patient": null, "tier_shift": null } }, "qwen3-1.7b": { "prob_clinical": 0.8104, "prob_patient": 0.0052, "language_penalty": -0.8052, "anchor_fallback": false, "top_clinical": [ "ant", 0.8104 ], "top_patient": [ "hour", 0.7779 ], "spread_clinical": [ [ "ant", 0.8104 ], [ "anti", 0.0968 ], [ "acid", 0.0245 ], [ "hour", 0.0131 ], [ "o", 0.009 ], [ "O", 0.0079 ], [ "over", 0.0062 ], [ "H", 0.0043 ], [ "extra", 0.0029 ], [ "enzyme", 0.0026 ] ], "spread_patient": [ [ "hour", 0.7779 ], [ "extra", 0.1352 ], [ "aspir", 0.0098 ], [ "extended", 0.0076 ], [ "ant", 0.0052 ], [ "enzyme", 0.0041 ], [ "anti", 0.0041 ], [ "inhal", 0.0032 ], [ "occasional", 0.0032 ], [ "airplane", 0.0032 ] ], "target_token": "ant", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": 1, "tier_top_patient": null, "tier_shift": null } } }, "prob_clinical": 0.491, "prob_patient": 0.068, "language_penalty": -0.423, "flipped": true, "top_clinical": [ "ant", 0.491 ], "top_patient": [ "extra", 0.448 ], "spread_clinical": [ [ "ant", 0.491 ], [ "anti", 0.182 ], [ 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"patient_prompt": "Every time I go outside in winter, my fingers turn white and go numb, so I should wear my", "intended_target": "gloves", "rationale": "Patient describes observable symptom sequence; clinical uses condition name. Frame elicits protective gear. Both should accept 'gloves', but clinical phrasing anchors the behavior more strongly as a medical management strategy rather than casual winter care.", "patient_term": "fingers turn white and go numb", "clinical_term": "Raynaud's", "topic": "Raynaud's phenomenon", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": 0.597, "prob_patient": 0.578, "language_penalty": -0.019000000000000017, "anchor_fallback": false, "top_clinical": [ "gloves", 0.597 ], "top_patient": [ "gloves", 0.578 ], "spread_clinical": [ [ "gloves", 0.597 ], [ "mittens", 0.052 ], [ "glove", 0.033 ], [ "hand", 0.023 ], [ "winter", 0.023 ] ], "spread_patient": [ [ "gloves", 0.578 ], [ "winter", 0.064 ], [ "mittens", 0.054 ], [ "thick", 0.027 ], [ "finger", 0.025 ] ], "target_token": "gloves", "flipped": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " gloves", "observed_clinical": [ "Output \" gloves\"", 0.597 ], "probe_extension": null }, "circuit_diff": { "shared_features": 853, "unique_to_a": 432, "unique_to_b": 410 }, "clinical_mass": { "clinical": 0.1585, "patient": 0.1596 } }, "gemma-3-4b-it": { "prob_clinical": 0.8021, "prob_patient": 0.5643, "language_penalty": -0.2378, "anchor_fallback": false, "top_clinical": [ "gloves", 0.8021 ], "top_patient": [ "gloves", 0.5643 ], "spread_clinical": [ [ "gloves", 0.8021 ], [ "glove", 0.0156 ], [ "special", 0.0122 ], [ "winter", 0.0101 ], [ "hand", 0.0101 ], [ "coat", 0.0095 ], [ "mittens", 0.0089 ], [ "compression", 0.0079 ], [ "wool", 0.0069 ], [ "long", 0.0054 ] ], "spread_patient": [ [ "gloves", 0.5643 ], [ "winter", 0.0463 ], [ "mittens", 0.0409 ], [ "wool", 0.0409 ], [ "warmest", 0.0409 ], [ "thick", 0.0193 ], [ "hand", 0.016 ], [ "glove", 0.0141 ], [ "warm", 0.0103 ], [ "coat", 0.0091 ] ], "target_token": "gloves", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null }, "qwen3-4b": { "prob_clinical": 0.8135, "prob_patient": 0.9741, "language_penalty": 0.1606, "anchor_fallback": false, "top_clinical": [ "gloves", 0.8135 ], "top_patient": [ "gloves", 0.9741 ], "spread_clinical": [ [ "gloves", 0.8135 ], [ "warm", 0.0278 ], [ "wool", 0.0217 ], [ "socks", 0.0217 ], [ "winter", 0.0131 ], [ "scarf", 0.0116 ], [ "fingers", 0.0102 ], [ "hat", 0.008 ], [ "mitt", 0.0058 ], [ "glove", 0.0055 ] ], "spread_patient": [ [ "gloves", 0.9741 ], [ "mitt", 0.0074 ], [ "fingers", 0.004 ], [ "winter", 0.0035 ], [ "glove", 0.0021 ], [ "wool", 0.0019 ], [ "hands", 0.0019 ], [ "finger", 0.0007 ], [ "hand", 0.0007 ], [ "socks", 0.0006 ] ], "target_token": "gloves", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null }, "qwen3-1.7b": { "prob_clinical": 0.3501, "prob_patient": 0.7973, "language_penalty": 0.4472, "anchor_fallback": false, "top_clinical": [ "gloves", 0.3501 ], "top_patient": [ "gloves", 0.7973 ], "spread_clinical": [ [ "gloves", 0.3501 ], [ "mitt", 0.0885 ], [ "warm", 0.0781 ], [ "wool", 0.0326 ], [ "winter", 0.0287 ], [ "socks", 0.0198 ], [ "coat", 0.0174 ], [ "boots", 0.0174 ], [ "scarf", 0.0154 ], [ "snow", 0.0136 ] ], "spread_patient": [ [ "gloves", 0.7973 ], [ "mitt", 0.0654 ], [ "hands", 0.0187 ], [ "fingers", 0.0146 ], [ "winter", 0.0146 ], [ "finger", 0.0114 ], [ "socks", 0.0069 ], [ "boots", 0.0069 ], [ "hand", 0.0061 ], [ "regular", 0.0047 ] ], "target_token": "gloves", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null } }, "prob_clinical": 0.597, "prob_patient": 0.578, "language_penalty": -0.019000000000000017, "flipped": false, "top_clinical": [ "gloves", 0.597 ], "top_patient": [ "gloves", 0.578 ], "spread_clinical": [ [ "gloves", 0.597 ], [ "mittens", 0.052 ], [ "glove", 0.033 ], [ "hand", 0.023 ], [ "winter", 0.023 ] ], "spread_patient": [ [ "gloves", 0.578 ], [ "winter", 0.064 ], [ "mittens", 0.054 ], [ "thick", 0.027 ], [ "finger", 0.025 ] ], "target_token": "gloves", "anchor_fallback": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " gloves", "observed_clinical": [ "Output \" gloves\"", 0.597 ], "probe_extension": null }, "circuit_diff": { "shared_features": 853, "unique_to_a": 432, "unique_to_b": 410 }, "clinical_mass": { "clinical": 0.1585, "patient": 0.1596 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260710T011743Z/index_21.html" }, { "index": 255, "batch": "pairs_20260710T011743Z", "batch_index": 23, "clinical_prompt": "I have vertigo, so I really need to get my", "patient_prompt": "I've been feeling dizzy and out of it for days, so I really need to get my", "intended_target": "balance", "rationale": "Patient uses vague colloquial phrasing; clinical uses specific vestibular symptom name. 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"cardiologist", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.021 } }, "qwen3-4b": { "prob_clinical": 0.0839, "prob_patient": 0.0066, "language_penalty": -0.0773, "anchor_fallback": false, "top_clinical": [ "doctor", 0.7961 ], "top_patient": [ "doctor", 0.9758 ], "spread_clinical": [ [ "doctor", 0.7961 ], [ "cardi", 0.0839 ], [ "specialist", 0.0449 ], [ "pul", 0.0272 ], [ "physician", 0.0129 ], [ "lung", 0.0088 ], [ "respiratory", 0.0042 ], [ "healthcare", 0.0029 ], [ "pulmonary", 0.002 ], [ "cardio", 0.002 ] ], "spread_patient": [ [ "doctor", 0.9758 ], [ "cardi", 0.0066 ], [ "specialist", 0.0051 ], [ "lung", 0.0021 ], [ "physician", 0.0017 ], [ "healthcare", 0.0013 ], [ "respiratory", 0.001 ], [ "pul", 0.0008 ], [ "health", 0.0007 ], [ "medical", 0.0005 ] ], "target_token": "cardi", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.047 } }, "qwen3-1.7b": { "prob_clinical": 0.0182, "prob_patient": 0.0015, "language_penalty": -0.0167, "anchor_fallback": false, "top_clinical": [ "doctor", 0.601 ], "top_patient": [ "doctor", 0.9815 ], "spread_clinical": [ [ "doctor", 0.601 ], [ "pul", 0.2506 ], [ "physician", 0.0559 ], [ "specialist", 0.0493 ], [ "cardi", 0.0182 ], [ "respiratory", 0.0036 ], [ "pulmonary", 0.0028 ], [ "healthcare", 0.0025 ], [ "chest", 0.0025 ], [ "lung", 0.0019 ] ], "spread_patient": [ [ "doctor", 0.9815 ], [ "physician", 0.0052 ], [ "specialist", 0.0045 ], [ "pul", 0.0017 ], [ "cardi", 0.0015 ], [ "nurse", 0.001 ], [ "medical", 0.0007 ], [ "healthcare", 0.0007 ], [ "GP", 0.0007 ], [ "Doctor", 0.0005 ] ], "target_token": "cardi", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.065 } } }, "prob_clinical": 0.14, "prob_patient": 0.047, "language_penalty": -0.09300000000000001, "flipped": false, "top_clinical": [ "doctor", 0.351 ], "top_patient": [ "doctor", 0.721 ], "spread_clinical": [ [ "doctor", 0.351 ], [ "pulmon", 0.213 ], [ "cardio", 0.14 ], [ "specialist", 0.05 ], [ "pulmonary", 0.048 ] ], "spread_patient": [ [ "doctor", 0.721 ], [ "cardio", 0.047 ], [ "specialist", 0.03 ], [ "pulmon", 0.025 ], [ "doc", 0.019 ] ], "target_token": "cardio", "anchor_fallback": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " cardiologist", "observed_clinical": [ "Output \" cardio\"", 0.14 ], "probe_extension": null }, "circuit_diff": { "shared_features": 591, "unique_to_a": 634, "unique_to_b": 656 }, "clinical_mass": { "clinical": 0.4611, "patient": 0.3081 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260710T011743Z/index_37.html", "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.257 } }, { "index": 268, "batch": "pairs_20260710T011743Z", "batch_index": 38, "clinical_prompt": "When I eat anything spicy, I experience gastritis, so I should avoid my", "patient_prompt": "When I eat anything spicy, my stomach gets all torn up, so I should avoid my", "intended_target": "triggers", "rationale": "Patient phrasing is vague and emotional; clinical term names the condition. The frame's possessive 'my' before a blank naturally completes with behavioral/dietary vocabulary ('triggers') in the clinical version, versus emotional descriptor in the lay version.", "patient_term": "gets all torn up", "clinical_term": "gastritis", "topic": "gastrointestinal", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": null, "prob_patient": null, "language_penalty": null, "anchor_fallback": false, "top_clinical": [ "favorite", 0.293 ], "top_patient": null, "spread_clinical": [ [ "favorite", 0.293 ], [ "favourite", 0.1 ], [ "usual", 0.063 ], [ "diet", 0.059 ], [ "food", 0.048 ] ], "spread_patient": [], "target_token": null, "flipped": false, "screening": { "status": "screened_out", "min_prob": 0.02, "intended_target": " triggers", "observed_clinical": null, "probe_extension": null, "reason": "intended target not in the traced clinical spread" }, "circuit_diff": null, "clinical_mass": { "clinical": 0.1505 }, "urgency": { "flip_class": null, "tier_top_clinical": 0, "tier_top_patient": 0, "tier_shift": 0.0 } }, "gemma-3-4b-it": { "prob_clinical": 0.0008, "prob_patient": 0.0001, "language_penalty": -0.0007, "anchor_fallback": false, "top_clinical": [ "favorite", 0.8083 ], "top_patient": [ "favorite", 0.6565 ], "spread_clinical": [ [ "favorite", 0.8083 ], [ "favourite", 0.0517 ], [ "usual", 0.019 ], [ "favorites", 0.0115 ], [ "diet", 0.0115 ], [ "food", 0.0084 ], [ "spicy", 0.0062 ], [ "beloved", 0.0058 ], [ "preferred", 0.0051 ], [ "family", 0.0037 ] ], "spread_patient": [ [ "favorite", 0.6565 ], [ "diet", 0.0327 ], [ "friend", 0.0225 ], [ "favourite", 0.0211 ], [ "spicy", 0.0211 ], [ "food", 0.0175 ], [ "meals", 0.0136 ], [ "friends", 0.0113 ], [ "spice", 0.0078 ], [ "family", 0.0078 ] ], "target_token": "triggers", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null }, "qwen3-4b": { "prob_clinical": 0.0014, "prob_patient": 0.0211, "language_penalty": 0.0197, "anchor_fallback": false, "top_clinical": [ "favorite", 0.7194 ], "top_patient": [ "favorite", 0.579 ], "spread_clinical": [ [ "favorite", 0.7194 ], [ "usual", 0.0859 ], [ "food", 0.0192 ], [ "spicy", 0.0169 ], [ "regular", 0.0062 ], [ "diet", 0.0062 ], [ "spices", 0.004 ], [ "daily", 0.004 ], [ "family", 0.004 ], [ "preferred", 0.0038 ] ], "spread_patient": [ [ "favorite", 0.579 ], [ "usual", 0.0691 ], [ "food", 0.0271 ], [ "triggers", 0.0211 ], [ "spicy", 0.0145 ], [ "trigger", 0.012 ], [ "mom", 0.0094 ], [ "cravings", 0.0088 ], [ "spice", 0.0078 ], [ "family", 0.0073 ] ], "target_token": "triggers", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null }, "qwen3-1.7b": { "prob_clinical": 0.0011, "prob_patient": 0.0005, "language_penalty": -0.0006, "anchor_fallback": false, "top_clinical": [ "food", 0.3083 ], "top_patient": [ "food", 0.2195 ], "spread_clinical": [ [ "food", 0.3083 ], [ "spicy", 0.1456 ], [ "diet", 0.0883 ], [ "meals", 0.078 ], [ "favorite", 0.0368 ], [ "spices", 0.0325 ], [ "own", 0.0253 ], [ "spice", 0.0197 ], [ "hot", 0.0135 ], [ "foods", 0.012 ] ], "spread_patient": [ [ "food", 0.2195 ], [ "own", 0.1331 ], [ "spicy", 0.0807 ], [ "favorite", 0.0712 ], [ "friends", 0.0381 ], [ "hot", 0.0231 ], [ "family", 0.018 ], [ "sister", 0.018 ], [ "meals", 0.0159 ], [ "brother", 0.0159 ] ], "target_token": "triggers", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 0, "tier_top_patient": 0, "tier_shift": 0.0 } } }, "prob_clinical": null, "prob_patient": null, "language_penalty": null, "flipped": false, "top_clinical": [ "favorite", 0.293 ], "top_patient": null, "spread_clinical": [ [ "favorite", 0.293 ], [ "favourite", 0.1 ], [ "usual", 0.063 ], [ "diet", 0.059 ], [ "food", 0.048 ] ], "spread_patient": [], "target_token": null, "anchor_fallback": false, "screening": { "status": "screened_out", "min_prob": 0.02, "intended_target": " triggers", "observed_clinical": null, "probe_extension": null, "reason": "intended target not in the traced clinical spread" }, "circuit_diff": null, "clinical_mass": { "clinical": 0.1505 }, "urgency": { "flip_class": null, "tier_top_clinical": 0, "tier_top_patient": 0, "tier_shift": 0.0 } }, { "index": 269, "batch": "pairs_20260710T011743Z", "batch_index": 39, "clinical_prompt": "I've been having these involuntary tremors I can't control, so my", "patient_prompt": "I've been having these weird jerky movements I can't control, so my", "intended_target": "neurologist", "rationale": "Lay phrase is nonspecific and behaviorally descriptive; clinical term indicates neurological dysfunction. The frame with possessive 'my' and modal verb naturally points toward a medical professional recommendation in the clinical case.", "patient_term": "jerky movements", "clinical_term": "involuntary tremors", "topic": "neurological", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": 0.045, "prob_patient": null, "language_penalty": null, "anchor_fallback": false, "top_clinical": [ "doctor", 0.342 ], "top_patient": [ "doctor", 0.247 ], "spread_clinical": [ [ "doctor", 0.342 ], [ "neuro", 0.045 ], [ "hands", 0.043 ], [ "mom", 0.036 ], [ "therapist", 0.032 ] ], "spread_patient": [ [ "doctor", 0.247 ], [ "mom", 0.079 ], [ "friend", 0.053 ], [ "husband", 0.035 ], [ "therapist", 0.034 ] ], "target_token": "neuro", "flipped": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " neurologist", "observed_clinical": [ "Output \" neuro\"", 0.045 ], "probe_extension": null }, "circuit_diff": { "shared_features": 944, "unique_to_a": 387, "unique_to_b": 421 }, "clinical_mass": { "clinical": 0.2805, "patient": 0.178 }, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.681 } }, "gemma-3-4b-it": { "prob_clinical": 0.0091, "prob_patient": 0.0247, "language_penalty": 0.0156, "anchor_fallback": false, "top_clinical": [ "doctor", 0.9236 ], "top_patient": [ "doctor", 0.9285 ], "spread_clinical": [ [ "doctor", 0.9236 ], [ "family", 0.0116 ], [ "neurologist", 0.0091 ], [ "primary", 0.0091 ], [ "GP", 0.0055 ], [ "doctors", 0.0048 ], [ "Doctor", 0.0043 ], [ "physician", 0.0029 ], [ "PCP", 0.0023 ], [ "mom", 0.0023 ] ], "spread_patient": [ [ "doctor", 0.9285 ], [ "neurologist", 0.0247 ], [ "mom", 0.0043 ], [ "Doctor", 0.0038 ], [ "doc", 0.0038 ], [ "GP", 0.0033 ], [ "family", 0.0033 ], [ "doctors", 0.003 ], [ "primary", 0.0026 ], [ "Dr", 0.0023 ] ], "target_token": "neurologist", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": 0.013 } }, "qwen3-4b": { "prob_clinical": 0.0057, "prob_patient": 0.0073, "language_penalty": 0.0016, "anchor_fallback": false, "top_clinical": [ "doctor", 0.8517 ], "top_patient": [ "doctor", 0.7488 ], "spread_clinical": [ [ "doctor", 0.8517 ], [ "hands", 0.0129 ], [ "mom", 0.0121 ], [ "family", 0.0101 ], [ "neuro", 0.0057 ], [ "body", 0.0054 ], [ "hand", 0.0051 ], [ "wife", 0.0039 ], [ "friend", 0.0033 ], [ "dad", 0.0031 ] ], "spread_patient": [ [ "doctor", 0.7488 ], [ "mom", 0.0542 ], [ "family", 0.0146 ], [ "hands", 0.0121 ], [ "dad", 0.0107 ], [ "mother", 0.0083 ], [ "neuro", 0.0073 ], [ "parents", 0.0073 ], [ "friend", 0.0069 ], [ "brain", 0.0057 ] ], "target_token": "neuro", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.131 } }, "qwen3-1.7b": { "prob_clinical": 0.0, "prob_patient": 0.0003, "language_penalty": 0.0003, "anchor_fallback": false, "top_clinical": [ "hands", 0.6206 ], "top_patient": [ "hands", 0.2338 ], "spread_clinical": [ [ "hands", 0.6206 ], [ "hand", 0.1078 ], [ "fingers", 0.0397 ], [ "handwriting", 0.0129 ], [ "work", 0.01 ], [ "ability", 0.0078 ], [ "whole", 0.0069 ], [ "right", 0.0054 ], [ "balance", 0.0054 ], [ "job", 0.0054 ] ], "spread_patient": [ [ "hands", 0.2338 ], [ "hand", 0.0759 ], [ "fingers", 0.0591 ], [ "legs", 0.0359 ], [ "arm", 0.0359 ], [ "body", 0.0316 ], [ "arms", 0.0316 ], [ "whole", 0.0218 ], [ "ability", 0.0192 ], [ "right", 0.0192 ] ], "target_token": "neuro", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null } }, "prob_clinical": 0.045, "prob_patient": null, "language_penalty": null, "flipped": false, "top_clinical": [ "doctor", 0.342 ], "top_patient": [ "doctor", 0.247 ], "spread_clinical": [ [ "doctor", 0.342 ], [ "neuro", 0.045 ], [ "hands", 0.043 ], [ "mom", 0.036 ], [ "therapist", 0.032 ] ], "spread_patient": [ [ "doctor", 0.247 ], [ "mom", 0.079 ], [ "friend", 0.053 ], [ "husband", 0.035 ], [ "therapist", 0.034 ] ], "target_token": "neuro", "anchor_fallback": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " neurologist", "observed_clinical": [ "Output \" neuro\"", 0.045 ], "probe_extension": null }, "circuit_diff": { "shared_features": 944, "unique_to_a": 387, "unique_to_b": 421 }, "clinical_mass": { "clinical": 0.2805, "patient": 0.178 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260710T011743Z/index_39.html", "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.681 } }, { "index": 270, "batch": "pairs_20260710T011743Z", "batch_index": 40, "clinical_prompt": "Every time I eat a big meal, I experience angina, so I need to take an", "patient_prompt": "Every time I eat a big meal, I feel like my chest is being squeezed, so I need to take an", "intended_target": "aspirin", "rationale": "Patient phrase is metaphorical; clinical term is a specific cardiac diagnosis. The frame 'take an' with vowel-initial next token strongly funnels toward medication names; clinical reading should elicit 'aspirin' as the high-frequency cardiac intervention, lay reading toward more general remedies.", "patient_term": "my chest is being squeezed", "clinical_term": "angina", "topic": "cardiac", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": 0.307, "prob_patient": 0.023, "language_penalty": -0.284, "anchor_fallback": false, "top_clinical": [ "aspirin", 0.307 ], "top_patient": [ "anti", 0.35 ], "spread_clinical": [ [ "aspirin", 0.307 ], [ "anti", 0.149 ], [ "ant", 0.118 ], [ "ang", 0.079 ], [ "ACE", 0.027 ] ], "spread_patient": [ [ "anti", 0.35 ], [ "ant", 0.284 ], [ "inhal", 0.092 ], [ "extra", 0.041 ], [ "aspirin", 0.023 ] ], "target_token": "aspirin", "flipped": true, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " aspirin", "observed_clinical": [ "Output \" aspirin\"", 0.307 ], "probe_extension": null }, "circuit_diff": { "shared_features": 799, "unique_to_a": 493, "unique_to_b": 556 }, "clinical_mass": { "clinical": 0.4064, "patient": 0.279 }, "html": "modes/simulated/pairs_20260710T011743Z/index_40.html", "urgency": { "flip_class": "lateral", "tier_top_clinical": 1, "tier_top_patient": 1, "tier_shift": 0.0 } }, "gemma-3-4b-it": { "prob_clinical": 0.6648, "prob_patient": 0.0718, "language_penalty": -0.593, "anchor_fallback": false, "top_clinical": [ "aspirin", 0.6648 ], "top_patient": [ "ant", 0.8747 ], "spread_clinical": [ [ "aspirin", 0.6648 ], [ "anti", 0.1483 ], [ "angina", 0.1483 ], [ "Aspir", 0.0122 ], [ "ant", 0.0107 ], [ "nitrog", 0.0015 ], [ "action", 0.0015 ], [ "immediate", 0.0013 ], [ "aspir", 0.0008 ], [ "extended", 0.0005 ] ], "spread_patient": [ [ "ant", 0.8747 ], [ "aspirin", 0.0718 ], [ "anti", 0.0206 ], [ "over", 0.0041 ], [ "antihist", 0.0032 ], [ "extra", 0.0028 ], [ "inhal", 0.0025 ], [ "asthma", 0.0025 ], [ "ibuprofen", 0.0022 ], [ "emergency", 0.0017 ] ], "target_token": "aspirin", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "lateral", "tier_top_clinical": 1, "tier_top_patient": 1, "tier_shift": 0.005 } }, "qwen3-4b": { "prob_clinical": 0.6238, "prob_patient": 0.066, "language_penalty": -0.5578, "anchor_fallback": false, "top_clinical": [ "aspir", 0.6238 ], "top_patient": [ "ant", 0.7092 ], "spread_clinical": [ [ "aspir", 0.6238 ], [ "anti", 0.1787 ], [ "ant", 0.0745 ], [ "NSA", 0.0399 ], [ "antibiotic", 0.0101 ], [ "ACE", 0.0069 ], [ "As", 0.0061 ], [ "ang", 0.0048 ], [ "occasional", 0.0042 ], [ "immediate", 0.0037 ] ], "spread_patient": [ [ "ant", 0.7092 ], [ "anti", 0.1088 ], [ "aspir", 0.066 ], [ "ib", 0.0243 ], [ "NSA", 0.0147 ], [ "O", 0.0147 ], [ "inhal", 0.0115 ], [ "over", 0.0061 ], [ "immediate", 0.0054 ], [ "antibiotic", 0.0026 ] ], "target_token": "aspir", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "lateral", "tier_top_clinical": 1, "tier_top_patient": 1, "tier_shift": -0.008 } }, "qwen3-1.7b": { "prob_clinical": 0.5406, "prob_patient": 0.1005, "language_penalty": -0.4401, "anchor_fallback": false, "top_clinical": [ "aspir", 0.5406 ], "top_patient": [ "ant", 0.3508 ], "spread_clinical": [ [ "aspir", 0.5406 ], [ "extra", 0.1206 ], [ "ant", 0.0939 ], [ "anti", 0.0732 ], [ "antibiotic", 0.0269 ], [ "X", 0.0112 ], [ "As", 0.0099 ], [ "additional", 0.0077 ], [ "oral", 0.006 ], [ "ang", 0.006 ] ], "spread_patient": [ [ "ant", 0.3508 ], [ "anti", 0.1878 ], [ "aspir", 0.1005 ], [ "extra", 0.0538 ], [ "hour", 0.0538 ], [ "X", 0.0475 ], [ "E", 0.0198 ], [ "inhal", 0.0154 ], [ "over", 0.012 ], [ "enzyme", 0.0082 ] ], "target_token": "aspir", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "lateral", "tier_top_clinical": 1, "tier_top_patient": 1, "tier_shift": -0.031 } } }, "prob_clinical": 0.307, "prob_patient": 0.023, "language_penalty": -0.284, "flipped": true, "top_clinical": [ "aspirin", 0.307 ], "top_patient": [ "anti", 0.35 ], "spread_clinical": [ [ "aspirin", 0.307 ], [ "anti", 0.149 ], [ "ant", 0.118 ], [ "ang", 0.079 ], [ "ACE", 0.027 ] ], "spread_patient": [ [ "anti", 0.35 ], [ "ant", 0.284 ], [ "inhal", 0.092 ], [ "extra", 0.041 ], [ "aspirin", 0.023 ] ], "target_token": "aspirin", "anchor_fallback": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " aspirin", "observed_clinical": [ "Output \" aspirin\"", 0.307 ], "probe_extension": null }, "circuit_diff": { "shared_features": 799, "unique_to_a": 493, "unique_to_b": 556 }, "clinical_mass": { "clinical": 0.4064, "patient": 0.279 }, "html": "modes/simulated/pairs_20260710T011743Z/index_40.html", "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260710T011743Z/index_40.html", "urgency": { "flip_class": "lateral", "tier_top_clinical": 1, "tier_top_patient": 1, "tier_shift": 0.0 } }, { "index": 271, 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The frame funnels toward 'heart' as the natural next token after the clinical phrasing (get my heart [checked/monitored]), whereas the patient phrasing would more likely continue with a casual descriptor or verb. This tests whether the model recognizes the medical term's diagnostic specificity.", "patient_term": "heart is doing flip-flops", "clinical_term": "cardiac arrhythmia", "topic": "cardiac arrhythmia", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": 0.61, "prob_patient": 0.173, "language_penalty": -0.437, "anchor_fallback": false, "top_clinical": [ "heart", 0.61 ], "top_patient": [ "heart", 0.173 ], "spread_clinical": [ [ "heart", 0.61 ], [ "blood", 0.094 ], [ "pulse", 0.038 ], [ "ECG", 0.034 ], [ "EKG", 0.028 ] ], "spread_patient": [ [ "heart", 0.173 ], [ "thoughts", 0.141 ], [ "mind", 0.119 ], [ "head", 0.078 ], [ "hands", 0.04 ] ], "target_token": "heart", "flipped": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " heart", "observed_clinical": [ "Output \" heart\"", 0.61 ], "probe_extension": null }, "circuit_diff": { "shared_features": 458, "unique_to_a": 591, "unique_to_b": 811 }, "clinical_mass": { "clinical": 0.4311, "patient": 0.1673 } }, "gemma-3-4b-it": { "prob_clinical": 0.89, "prob_patient": 0.3156, "language_penalty": -0.5744, "anchor_fallback": false, "top_clinical": [ "heart", 0.89 ], "top_patient": [ "heart", 0.3156 ], "spread_clinical": [ [ "heart", 0.89 ], [ "blood", 0.0345 ], [ "medication", 0.0077 ], [ "medications", 0.006 ], [ "pulse", 0.0053 ], [ "heartbeat", 0.0047 ], [ "vit", 0.0047 ], [ "E", 0.0041 ], [ "electrolytes", 0.003 ], [ "potassium", 0.0027 ] ], "spread_patient": [ [ "heart", 0.3156 ], [ "emotions", 0.1316 ], [ "thoughts", 0.1025 ], [ "act", 0.0621 ], [ "feelings", 0.0427 ], [ "anxiety", 0.0333 ], [ "blood", 0.0294 ], [ "head", 0.0202 ], [ "hands", 0.019 ], [ "mind", 0.0115 ] ], "target_token": "heart", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null }, "qwen3-4b": { "prob_clinical": 0.6564, "prob_patient": 0.7761, "language_penalty": 0.1197, "anchor_fallback": false, "top_clinical": [ "heart", 0.6564 ], "top_patient": [ "heart", 0.7761 ], "spread_clinical": [ [ "heart", 0.6564 ], [ "E", 0.1141 ], [ "blood", 0.0784 ], [ "cholesterol", 0.0136 ], [ "pulse", 0.0064 ], [ "sinus", 0.005 ], [ "thyroid", 0.0039 ], [ "electro", 0.0037 ], [ "body", 0.0034 ], [ "heartbeat", 0.0032 ] ], "spread_patient": [ [ "heart", 0.7761 ], [ "blood", 0.0341 ], [ "chest", 0.0341 ], [ "body", 0.0183 ], [ "heartbeat", 0.0134 ], [ "pulse", 0.0125 ], [ "hands", 0.0071 ], [ "ears", 0.0052 ], [ "feet", 0.0036 ], [ "anxiety", 0.0032 ] ], "target_token": "heart", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null }, "qwen3-1.7b": { "prob_clinical": 0.3143, "prob_patient": 0.6249, "language_penalty": 0.3106, "anchor_fallback": false, "top_clinical": [ "heart", 0.3143 ], "top_patient": [ "heart", 0.6249 ], "spread_clinical": [ [ "heart", 0.3143 ], [ "blood", 0.2448 ], [ "E", 0.0701 ], [ "cholesterol", 0.0619 ], [ "potassium", 0.0482 ], [ "pulse", 0.0156 ], [ "electroly", 0.0138 ], [ "body", 0.0108 ], [ "magnesium", 0.0058 ], [ "chest", 0.0058 ] ], "spread_patient": [ [ "heart", 0.6249 ], [ "chest", 0.0746 ], [ "blood", 0.0453 ], [ "breath", 0.0242 ], [ "pulse", 0.0189 ], [ "breathing", 0.0114 ], [ "thoughts", 0.0101 ], [ "emotions", 0.0101 ], [ "life", 0.0079 ], [ "anxiety", 0.0079 ] ], "target_token": "heart", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null } }, "prob_clinical": 0.61, "prob_patient": 0.173, "language_penalty": -0.437, "flipped": false, "top_clinical": [ "heart", 0.61 ], "top_patient": [ "heart", 0.173 ], "spread_clinical": [ [ "heart", 0.61 ], [ "blood", 0.094 ], [ "pulse", 0.038 ], [ "ECG", 0.034 ], [ "EKG", 0.028 ] ], "spread_patient": [ [ "heart", 0.173 ], [ "thoughts", 0.141 ], [ "mind", 0.119 ], [ "head", 0.078 ], [ "hands", 0.04 ] ], "target_token": "heart", "anchor_fallback": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " heart", "observed_clinical": [ "Output \" heart\"", 0.61 ], "probe_extension": null }, "circuit_diff": { "shared_features": 458, "unique_to_a": 591, "unique_to_b": 811 }, "clinical_mass": { "clinical": 0.4311, "patient": 0.1673 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260710T011743Z/index_48.html" }, { "index": 276, "batch": "pairs_20260710T011743Z", "batch_index": 49, "clinical_prompt": "After I sit for a while, I experience venous stasis, so my", "patient_prompt": "After I sit for a while, my legs feel like dead weight, so my", "intended_target": "blood", "rationale": "The colloquial 'dead weight' describes the sensation of poor circulation in lay terms, while 'venous stasis' is the clinical condition. The frame is designed so the clinical phrasing naturally continues with 'blood' (my blood [is pooling/circulation is compromised]), a diagnostic continuation, whereas the patient phrasing would lean toward 'legs' or 'circulation' more generically. Tests whether the model links the precise medical term to physiological mechanisms.", "patient_term": "legs feel like dead weight", "clinical_term": "venous stasis", "topic": "venous stasis", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": null, "prob_patient": null, "language_penalty": null, "anchor_fallback": false, "top_clinical": [ "legs", 0.371 ], "top_patient": null, "spread_clinical": [ [ "legs", 0.371 ], [ "feet", 0.129 ], [ "doctor", 0.085 ], [ "leg", 0.043 ], [ "calves", 0.031 ] ], "spread_patient": [], "target_token": null, "flipped": false, "screening": { "status": "screened_out", "min_prob": 0.02, "intended_target": " blood", "observed_clinical": null, "probe_extension": null, "reason": "intended target not in the traced clinical spread" }, "circuit_diff": null, "clinical_mass": { "clinical": 0.32 }, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, "gemma-3-4b-it": { "prob_clinical": 0.0016, "prob_patient": 0.0619, "language_penalty": 0.0603, "anchor_fallback": false, "top_clinical": [ "legs", 0.8501 ], "top_patient": [ "muscles", 0.1484 ], "spread_clinical": [ [ "legs", 0.8501 ], [ "leg", 0.0543 ], [ "feet", 0.0291 ], [ "ankles", 0.0156 ], [ "skin", 0.0121 ], [ "lower", 0.0094 ], [ "veins", 0.0029 ], [ "left", 0.0029 ], [ "face", 0.0021 ], [ "ankle", 0.002 ] ], "spread_patient": [ [ "muscles", 0.1484 ], [ "legs", 0.131 ], [ "body", 0.102 ], [ "posture", 0.102 ], [ "blood", 0.0619 ], [ "movements", 0.0311 ], [ "movement", 0.0311 ], [ "back", 0.0258 ], [ "leg", 0.0177 ], [ "feet", 0.0177 ] ], "target_token": "blood", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, "qwen3-4b": { "prob_clinical": 0.0024, "prob_patient": 0.0274, "language_penalty": 0.025, "anchor_fallback": false, "top_clinical": [ "legs", 0.8111 ], "top_patient": [ "doctor", 0.4283 ], "spread_clinical": [ [ "legs", 0.8111 ], [ "feet", 0.0666 ], [ "leg", 0.0315 ], [ "doctor", 0.0131 ], [ "lower", 0.008 ], [ "body", 0.0051 ], [ "ankles", 0.004 ], [ "veins", 0.0038 ], [ "foot", 0.0038 ], [ "skin", 0.0035 ] ], "spread_patient": [ [ "doctor", 0.4283 ], [ "legs", 0.2598 ], [ "feet", 0.0512 ], [ "blood", 0.0274 ], [ "leg", 0.0138 ], [ "mother", 0.0095 ], [ "veins", 0.0074 ], [ "mom", 0.0065 ], [ "wife", 0.0057 ], [ "doctors", 0.0054 ] ], "target_token": "blood", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": 2, "tier_shift": null } }, "qwen3-1.7b": { "prob_clinical": 0.0584, "prob_patient": 0.0058, "language_penalty": -0.0526, "anchor_fallback": false, "top_clinical": [ "legs", 0.3807 ], "top_patient": [ "legs", 0.2809 ], "spread_clinical": [ [ "legs", 0.3807 ], [ "veins", 0.0849 ], [ "feet", 0.075 ], [ "skin", 0.0662 ], [ "blood", 0.0584 ], [ "hands", 0.0515 ], [ "face", 0.0312 ], [ "leg", 0.0312 ], [ "body", 0.0167 ], [ "fingers", 0.0115 ] ], "spread_patient": [ [ "legs", 0.2809 ], [ "leg", 0.0553 ], [ "body", 0.0431 ], [ "feet", 0.0431 ], [ "walking", 0.0231 ], [ "knees", 0.0203 ], [ "balance", 0.0203 ], [ "doctor", 0.0158 ], [ "lower", 0.0158 ], [ "foot", 0.014 ] ], "target_token": "blood", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null } }, "prob_clinical": null, "prob_patient": null, "language_penalty": null, "flipped": false, "top_clinical": [ "legs", 0.371 ], "top_patient": null, "spread_clinical": [ [ "legs", 0.371 ], [ "feet", 0.129 ], [ "doctor", 0.085 ], [ "leg", 0.043 ], [ "calves", 0.031 ] ], "spread_patient": [], "target_token": null, "anchor_fallback": false, "screening": { "status": "screened_out", "min_prob": 0.02, "intended_target": " blood", "observed_clinical": null, "probe_extension": null, "reason": "intended target not in the traced clinical spread" }, "circuit_diff": null, "clinical_mass": { "clinical": 0.32 }, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, { "index": 277, "batch": "pairs_20260710T011743Z", "batch_index": 50, "clinical_prompt": "When I bend my neck, I have cervical spondylosis, so I should see a", "patient_prompt": "When I bend my neck, I get this weird clicking sound and stiffness, so I should see a", "intended_target": "neurologist", "rationale": "The patient phrase describes symptoms (clicking, stiffness) in lay terms, while 'cervical spondylosis' is the precise clinical diagnosis of degenerative disc disease of the neck. The frame funnels toward a specialist (neurologist or orthopedist) for the clinical version, whereas the patient phrasing might lead to a general doctor or physical therapist. Tests recognition of specialist appropriateness tied to medical nomenclature.", "patient_term": "weird clicking sound and stiffness", "clinical_term": "cervical spondylosis", "topic": "cervical spondylosis", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": 0.053, "prob_patient": 0.05, "language_penalty": -0.0029999999999999957, "anchor_fallback": false, "top_clinical": [ "doctor", 0.693 ], "top_patient": [ "doctor", 0.659 ], "spread_clinical": [ [ "doctor", 0.693 ], [ "neuro", 0.053 ], [ "specialist", 0.04 ], [ "chi", 0.035 ], [ "good", 0.022 ] ], "spread_patient": [ [ "doctor", 0.659 ], [ "chi", 0.085 ], [ "neuro", 0.05 ], [ "specialist", 0.043 ], [ "physio", 0.034 ] ], "target_token": "neuro", "flipped": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " neurologist", "observed_clinical": [ "Output \" neuro\"", 0.053 ], "probe_extension": null }, "circuit_diff": { "shared_features": 792, "unique_to_a": 375, "unique_to_b": 415 }, "clinical_mass": { "clinical": 0.4118, "patient": 0.3676 }, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": 0.005 } }, "gemma-3-4b-it": { "prob_clinical": 0.0264, "prob_patient": 0.0047, "language_penalty": -0.0217, "anchor_fallback": false, "top_clinical": [ "doctor", 0.5295 ], "top_patient": [ "doctor", 0.7871 ], "spread_clinical": [ [ "doctor", 0.5295 ], [ "physical", 0.1181 ], [ "specialist", 0.0717 ], [ "chiropractor", 0.0632 ], [ "spine", 0.0299 ], [ "neurologist", 0.0264 ], [ "physician", 0.0264 ], [ "physi", 0.0264 ], [ "medical", 0.016 ], [ "phys", 0.0141 ] ], "spread_patient": [ [ "doctor", 0.7871 ], [ "physical", 0.0646 ], [ "chiropractor", 0.057 ], [ "specialist", 0.0392 ], [ "physi", 0.0099 ], [ "spine", 0.006 ], [ "physician", 0.0053 ], [ "medical", 0.0053 ], [ "neurologist", 0.0047 ], [ "neck", 0.0047 ] ], "target_token": "neurologist", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.139 } }, "qwen3-4b": { "prob_clinical": 0.0799, "prob_patient": 0.0031, "language_penalty": -0.0768, "anchor_fallback": false, "top_clinical": [ "doctor", 0.758 ], "top_patient": [ "doctor", 0.8633 ], "spread_clinical": [ [ "doctor", 0.758 ], [ "specialist", 0.1026 ], [ "neuro", 0.0799 ], [ "phys", 0.0139 ], [ "chiropr", 0.0084 ], [ "physical", 0.0058 ], [ "spine", 0.0033 ], [ "neck", 0.0033 ], [ "physician", 0.0019 ], [ "professional", 0.0018 ] ], "spread_patient": [ [ "doctor", 0.8633 ], [ "specialist", 0.0552 ], [ "chiropr", 0.0379 ], [ "phys", 0.0179 ], [ "neck", 0.0075 ], [ "physical", 0.0035 ], [ "neuro", 0.0031 ], [ "Doctor", 0.0027 ], [ "professional", 0.0011 ], [ "physician", 0.0007 ] ], "target_token": "neuro", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.101 } }, "qwen3-1.7b": { "prob_clinical": 0.2438, "prob_patient": 0.0458, "language_penalty": -0.198, "anchor_fallback": false, "top_clinical": [ "doctor", 0.4555 ], "top_patient": [ "doctor", 0.8113 ], "spread_clinical": [ [ "doctor", 0.4555 ], [ "neuro", 0.2438 ], [ "specialist", 0.1899 ], [ "phys", 0.0257 ], [ "cervical", 0.0177 ], [ "physician", 0.0074 ], [ "chiropr", 0.0065 ], [ "neck", 0.0057 ], [ "physical", 0.0045 ], [ "spine", 0.0039 ] ], "spread_patient": [ [ "doctor", 0.8113 ], [ "phys", 0.0666 ], [ "neuro", 0.0458 ], [ "specialist", 0.0278 ], [ "chiropr", 0.0131 ], [ "physical", 0.009 ], [ "physician", 0.008 ], [ "therapist", 0.002 ], [ "Doctor", 0.0014 ], [ "neck", 0.0014 ] ], "target_token": "neuro", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.39 } } }, "prob_clinical": 0.053, "prob_patient": 0.05, "language_penalty": -0.0029999999999999957, "flipped": false, "top_clinical": [ "doctor", 0.693 ], "top_patient": [ "doctor", 0.659 ], "spread_clinical": [ [ "doctor", 0.693 ], [ "neuro", 0.053 ], [ "specialist", 0.04 ], [ "chi", 0.035 ], [ "good", 0.022 ] ], "spread_patient": [ [ "doctor", 0.659 ], [ "chi", 0.085 ], [ "neuro", 0.05 ], [ "specialist", 0.043 ], [ "physio", 0.034 ] ], "target_token": "neuro", "anchor_fallback": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " neurologist", "observed_clinical": [ "Output \" neuro\"", 0.053 ], "probe_extension": null }, "circuit_diff": { "shared_features": 792, "unique_to_a": 375, "unique_to_b": 415 }, "clinical_mass": { "clinical": 0.4118, "patient": 0.3676 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260710T011743Z/index_50.html", "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": 0.005 } }, { "index": 278, "batch": "pairs_20260710T050657Z", "batch_index": 2, "clinical_prompt": "I have orthostatic hypotension, so my doctor wants to check my", "patient_prompt": "I've been feeling lightheaded lately, so my doctor wants to check my", "intended_target": "blood", "rationale": "Lay symptom description versus clinical diagnosis of blood-pressure disorder. Frame funnels toward measurable vital-sign continuations; clinical phrasing increases likelihood of 'pressure' or 'blood' as next token.", "patient_term": "feeling lightheaded", "clinical_term": "orthostatic hypotension", "topic": "orthostatic hypotension", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": 0.326, "prob_patient": 0.468, "language_penalty": 0.14200000000000002, "anchor_fallback": false, "top_clinical": [ "blood", 0.326 ], "top_patient": [ "blood", 0.468 ], "spread_clinical": [ [ "blood", 0.326 ], [ "BP", 0.079 ], [ "heart", 0.064 ], [ "carotid", 0.033 ], [ "pressure", 0.028 ] ], "spread_patient": [ [ "blood", 0.468 ], [ "thyroid", 0.143 ], [ "iron", 0.051 ], [ "electrolytes", 0.045 ], [ "BP", 0.044 ] ], "target_token": "blood", "flipped": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " blood", "observed_clinical": [ "Output \" blood\"", 0.326 ], "probe_extension": null }, "circuit_diff": { "shared_features": 658, "unique_to_a": 677, "unique_to_b": 843 }, "clinical_mass": { "clinical": 0.4474, "patient": 0.4061 }, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": 0.0 } }, "gemma-3-4b-it": { "prob_clinical": 0.2253, "prob_patient": 0.1949, "language_penalty": -0.0304, "anchor_fallback": false, "top_clinical": [ "autonomic", 0.2893 ], "top_patient": [ "iron", 0.5297 ], "spread_clinical": [ [ "autonomic", 0.2893 ], [ "blood", 0.2253 ], [ "adrenal", 0.1366 ], [ "sodium", 0.0645 ], [ "heart", 0.057 ], [ "electrolytes", 0.0345 ], [ "potassium", 0.0163 ], [ "AD", 0.0144 ], [ "cortisol", 0.0127 ], [ "electrolyte", 0.0127 ] ], "spread_patient": [ [ "iron", 0.5297 ], [ "blood", 0.1949 ], [ "thyroid", 0.0633 ], [ "electrolytes", 0.0633 ], [ "vitamin", 0.0633 ], [ "potassium", 0.0299 ], [ "Vitamin", 0.0264 ], [ "electrolyte", 0.0046 ], [ "sodium", 0.0046 ], [ "ferritin", 0.0028 ] ], "target_token": "blood", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, "qwen3-4b": { "prob_clinical": 0.7771, "prob_patient": 0.9551, "language_penalty": 0.178, "anchor_fallback": false, "top_clinical": [ "blood", 0.7771 ], "top_patient": [ "blood", 0.9551 ], "spread_clinical": [ [ "blood", 0.7771 ], [ "BP", 0.0235 ], [ "heart", 0.0235 ], [ "sodium", 0.0126 ], [ "orth", 0.0056 ], [ "pulse", 0.0056 ], [ "eye", 0.0052 ], [ "pressure", 0.0043 ], [ "eyes", 0.0041 ], [ "standing", 0.0041 ] ], "spread_patient": [ [ "blood", 0.9551 ], [ "BP", 0.0044 ], [ "iron", 0.0039 ], [ "cholesterol", 0.0039 ], [ "glucose", 0.003 ], [ "electroly", 0.0018 ], [ "vitamin", 0.0016 ], [ "hearing", 0.0016 ], [ "potassium", 0.0014 ], [ "hem", 0.0014 ] ], "target_token": "blood", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.009 } }, "qwen3-1.7b": { "prob_clinical": 0.6249, "prob_patient": 0.8235, "language_penalty": 0.1986, "anchor_fallback": false, "top_clinical": [ "blood", 0.6249 ], "top_patient": [ "blood", 0.8235 ], "spread_clinical": [ [ "blood", 0.6249 ], [ "heart", 0.0746 ], [ "balance", 0.0167 ], [ "kidney", 0.0167 ], [ "aut", 0.0101 ], [ "reflex", 0.0089 ], [ "potassium", 0.0079 ], [ "eyes", 0.0079 ], [ "hearing", 0.0069 ], [ "vision", 0.0061 ] ], "spread_patient": [ [ "blood", 0.8235 ], [ "balance", 0.041 ], [ "vision", 0.0219 ], [ "heart", 0.0219 ], [ "eyes", 0.0133 ], [ "hearing", 0.0117 ], [ "inner", 0.0104 ], [ "vit", 0.0049 ], [ "cholesterol", 0.0043 ], [ "potassium", 0.0026 ] ], "target_token": "blood", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": 0.0 } } }, "prob_clinical": 0.326, "prob_patient": 0.468, "language_penalty": 0.14200000000000002, "flipped": false, "top_clinical": [ "blood", 0.326 ], "top_patient": [ "blood", 0.468 ], "spread_clinical": [ [ "blood", 0.326 ], [ "BP", 0.079 ], [ "heart", 0.064 ], [ "carotid", 0.033 ], [ "pressure", 0.028 ] ], "spread_patient": [ [ "blood", 0.468 ], [ "thyroid", 0.143 ], [ "iron", 0.051 ], [ "electrolytes", 0.045 ], [ "BP", 0.044 ] ], "target_token": "blood", "anchor_fallback": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " blood", "observed_clinical": [ "Output \" blood\"", 0.326 ], "probe_extension": null }, "circuit_diff": { "shared_features": 658, "unique_to_a": 677, "unique_to_b": 843 }, "clinical_mass": { "clinical": 0.4474, "patient": 0.4061 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260710T050657Z/index_02.html", "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": 0.0 } }, { "index": 279, "batch": "pairs_20260710T050657Z", "batch_index": 3, "clinical_prompt": "I have arthritis, so I'm thinking about taking an", "patient_prompt": "My joints are killing me, so I'm thinking about taking an", "intended_target": "anti-inflammatory", "rationale": "Idiomatic pain expression versus medical diagnosis. 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Colloquial frame might prompt 'allergies', but clinical 'atopic dermatitis' steers toward 'eczema' (related term) or secondary concerns like 'infection' or 'sensitivity'.", "patient_term": "skin's been red and itchy everywhere", "clinical_term": "atopic dermatitis", "topic": "dermatitis", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": 0.06, "prob_patient": 0.173, "language_penalty": 0.11299999999999999, "anchor_fallback": false, "top_clinical": [ "a", 0.232 ], "top_patient": [ "a", 0.258 ], "spread_clinical": [ [ "a", 0.232 ], [ "to", 0.155 ], [ "an", 0.118 ], [ "eczema", 0.06 ], [ "some", 0.049 ] ], "spread_patient": [ [ "a", 0.258 ], [ "eczema", 0.173 ], [ "an", 0.107 ], [ "ros", 0.087 ], [ "some", 0.073 ] ], "target_token": "eczema", "flipped": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " eczema", "observed_clinical": [ "Output \" eczema\"", 0.06 ], "probe_extension": null }, "circuit_diff": { "shared_features": 649, "unique_to_a": 666, "unique_to_b": 693 }, "clinical_mass": { "clinical": 0.3792, "patient": 0.4298 } }, "gemma-3-4b-it": { "prob_clinical": 0.0732, "prob_patient": 0.9636, "language_penalty": 0.8904, "anchor_fallback": false, "top_clinical": [ "a", 0.3716 ], "top_patient": [ "eczema", 0.9636 ], "spread_clinical": [ [ "a", 0.3716 ], [ "an", 0.1065 ], [ "eczema", 0.0732 ], [ "to", 0.057 ], [ "sensitive", 0.0346 ], [ "histamine", 0.0346 ], [ "sensitivity", 0.0305 ], [ "some", 0.0269 ], [ "allergies", 0.0238 ], [ "the", 0.0238 ] ], "spread_patient": [ [ "eczema", 0.9636 ], [ "a", 0.0156 ], [ "E", 0.0045 ], [ "dermatitis", 0.0027 ], [ "contact", 0.0021 ], [ "some", 0.0019 ], [ "an", 0.0014 ], [ "se", 0.0013 ], [ "kerat", 0.0011 ], [ "psoriasis", 0.0011 ] ], "target_token": "eczema", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, "qwen3-4b": { "prob_clinical": 0.0834, "prob_patient": 0.3884, "language_penalty": 0.305, "anchor_fallback": false, "top_clinical": [ "to", 0.2911 ], "top_patient": [ "ec", 0.3884 ], "spread_clinical": [ [ "to", 0.2911 ], [ "a", 0.2911 ], [ "ec", 0.0834 ], [ "an", 0.0834 ], [ "some", 0.0348 ], [ "allergic", 0.0239 ], [ "se", 0.0128 ], [ "something", 0.0113 ], [ "ps", 0.01 ], [ "at", 0.0083 ] ], "spread_patient": [ [ "ec", 0.3884 ], [ "a", 0.2356 ], [ "an", 0.0765 ], [ "something", 0.0675 ], [ "at", 0.0675 ], [ "contact", 0.0409 ], [ "ps", 0.0319 ], [ "h", 0.0193 ], [ "allergic", 0.0091 ], [ "some", 0.0091 ] ], "target_token": "ec", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, "qwen3-1.7b": { "prob_clinical": 0.176, "prob_patient": 0.4129, "language_penalty": 0.2369, "anchor_fallback": false, "top_clinical": [ "a", 0.4785 ], "top_patient": [ "ec", 0.4129 ], "spread_clinical": [ [ "a", 0.4785 ], [ "ec", 0.176 ], [ "an", 0.0734 ], [ "to", 0.027 ], [ "contact", 0.0238 ], [ "some", 0.021 ], [ "at", 0.021 ], [ "something", 0.0164 ], [ "ps", 0.0144 ], [ "se", 0.0077 ] ], "spread_patient": [ [ "ec", 0.4129 ], [ "a", 0.3216 ], [ "an", 0.0493 ], [ "at", 0.0339 ], [ "ps", 0.0299 ], [ "ros", 0.0233 ], [ "h", 0.0206 ], [ "contact", 0.0206 ], [ "dermat", 0.0141 ], [ "ur", 0.0125 ] ], "target_token": "ec", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } } }, "prob_clinical": 0.06, "prob_patient": 0.173, "language_penalty": 0.11299999999999999, "flipped": false, "top_clinical": [ "a", 0.232 ], "top_patient": [ "a", 0.258 ], "spread_clinical": [ [ "a", 0.232 ], [ "to", 0.155 ], [ "an", 0.118 ], [ "eczema", 0.06 ], [ "some", 0.049 ] ], "spread_patient": [ [ "a", 0.258 ], [ "eczema", 0.173 ], [ "an", 0.107 ], [ "ros", 0.087 ], [ "some", 0.073 ] ], "target_token": "eczema", "anchor_fallback": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " eczema", "observed_clinical": [ "Output \" eczema\"", 0.06 ], "probe_extension": null }, "circuit_diff": { "shared_features": 649, "unique_to_a": 666, "unique_to_b": 693 }, "clinical_mass": { "clinical": 0.3792, "patient": 0.4298 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260710T050657Z/index_31.html" }, { "index": 304, "batch": "pairs_20260710T050657Z", "batch_index": 32, "clinical_prompt": "I have cognitive impairment, so I should probably see a", "patient_prompt": "I've been forgetting things at work a lot, so I should probably see a", "intended_target": "neurologist", "rationale": "Patient phrasing describes mild, everyday forgetting; clinical term names a formal deficit. Both end after 'a' in care-seeking context. Colloquial reading might suggest 'therapist' or 'manager', but clinical 'cognitive impairment' steers strongly toward 'neurologist', 'doctor', or specialist evaluation.", "patient_term": "been forgetting things at work a lot", "clinical_term": "cognitive impairment", "topic": "cognitive impairment", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": 0.202, "prob_patient": 0.048, "language_penalty": -0.15400000000000003, "anchor_fallback": false, "top_clinical": [ "doctor", 0.265 ], "top_patient": [ "doctor", 0.768 ], "spread_clinical": [ [ "doctor", 0.265 ], [ "neuro", 0.202 ], [ "psychiatrist", 0.101 ], [ "specialist", 0.089 ], [ "psychologist", 0.071 ] ], "spread_patient": [ [ "doctor", 0.768 ], [ "neuro", 0.048 ], [ "therapist", 0.03 ], [ "psychiatrist", 0.026 ], [ "doc", 0.02 ] ], "target_token": "neuro", "flipped": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " neurologist", "observed_clinical": [ "Output \" neuro\"", 0.202 ], 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"doc", 0.0013 ] ], "target_token": "neurologist", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": 2, "tier_shift": -0.427 } }, "qwen3-4b": { "prob_clinical": 0.3447, "prob_patient": 0.0179, "language_penalty": -0.3268, "anchor_fallback": false, "top_clinical": [ "neuro", 0.3447 ], "top_patient": [ "doctor", 0.8641 ], "spread_clinical": [ [ "neuro", 0.3447 ], [ "doctor", 0.2685 ], [ "specialist", 0.1845 ], [ "neu", 0.0363 ], [ "ger", 0.0283 ], [ "cognitive", 0.0161 ], [ "professional", 0.0151 ], [ "memory", 0.0126 ], [ "therapist", 0.0092 ], [ "medical", 0.0086 ] ], "spread_patient": [ [ "doctor", 0.8641 ], [ "memory", 0.0487 ], [ "therapist", 0.023 ], [ "neuro", 0.0179 ], [ "specialist", 0.0158 ], [ "professional", 0.014 ], [ "psychiatrist", 0.0035 ], [ "psychologist", 0.0028 ], [ "neu", 0.0015 ], [ "medical", 0.0013 ] ], "target_token": "neuro", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "downgrade", "tier_top_clinical": 3, "tier_top_patient": 2, "tier_shift": -0.542 } }, "qwen3-1.7b": { "prob_clinical": 0.0445, "prob_patient": 0.0019, "language_penalty": -0.0426, "anchor_fallback": false, "top_clinical": [ "doctor", 0.422 ], "top_patient": [ "doctor", 0.3581 ], "spread_clinical": [ [ "doctor", 0.422 ], [ "specialist", 0.1993 ], [ "therapist", 0.0733 ], [ "neuro", 0.0445 ], [ "professional", 0.0392 ], [ "psychiatrist", 0.0346 ], [ "psychologist", 0.0306 ], [ "neu", 0.021 ], [ "mental", 0.0144 ], [ "physician", 0.0112 ] ], "spread_patient": [ [ "doctor", 0.3581 ], [ "therapist", 0.316 ], [ "professional", 0.1026 ], [ "psychologist", 0.0905 ], [ "psychiatrist", 0.0294 ], [ "counselor", 0.0202 ], [ "specialist", 0.0202 ], [ "shrink", 0.0178 ], [ "mental", 0.0139 ], [ "neu", 0.0045 ] ], "target_token": "neuro", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": 0.07 } } }, "prob_clinical": 0.202, "prob_patient": 0.048, "language_penalty": -0.15400000000000003, "flipped": false, "top_clinical": [ "doctor", 0.265 ], "top_patient": [ "doctor", 0.768 ], "spread_clinical": [ [ "doctor", 0.265 ], [ "neuro", 0.202 ], [ "psychiatrist", 0.101 ], [ "specialist", 0.089 ], [ "psychologist", 0.071 ] ], "spread_patient": [ [ "doctor", 0.768 ], [ "neuro", 0.048 ], [ "therapist", 0.03 ], [ "psychiatrist", 0.026 ], [ "doc", 0.02 ] ], "target_token": "neuro", "anchor_fallback": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " neurologist", "observed_clinical": [ "Output \" neuro\"", 0.202 ], "probe_extension": null }, "circuit_diff": { "shared_features": 495, "unique_to_a": 742, "unique_to_b": 706 }, "clinical_mass": { "clinical": 0.3474, "patient": 0.2566 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260710T050657Z/index_32.html", "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.519 } }, { "index": 305, "batch": "pairs_20260710T050657Z", "batch_index": 34, "clinical_prompt": "I keep experiencing night sweats, so I should probably take an", "patient_prompt": "I keep waking up drenched at night, so I should probably take an", "intended_target": "antihistamine", "rationale": "Both frames end after 'an' before a vowel-initial word, funneling toward a remedy noun. The lay phrase frames it as discomfort; clinical term indicates a systemic symptom requiring targeted medication. Model should prefer a specific clinical class over generic 'blanket'.", "patient_term": "waking up drenched", "clinical_term": "night sweats", "topic": "autonomic symptom", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": 0.235, "prob_patient": 0.212, "language_penalty": -0.022999999999999993, "anchor_fallback": false, "top_clinical": [ "anti", 0.235 ], "top_patient": [ "anti", 0.212 ], "spread_clinical": [ [ "anti", 0.235 ], [ "extra", 0.116 ], [ "evening", 0.053 ], [ "over", 0.047 ], [ "appointment", 0.041 ] ], "spread_patient": [ [ "anti", 0.212 ], [ "extra", 0.115 ], [ "allergy", 0.063 ], [ "aspirin", 0.048 ], [ "over", 0.048 ] ], "target_token": "anti", "flipped": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " antihistamine", "observed_clinical": [ "Output \" anti\"", 0.235 ], "probe_extension": null }, "circuit_diff": { "shared_features": 779, "unique_to_a": 624, "unique_to_b": 506 }, "clinical_mass": { "clinical": 0.2452, "patient": 0.1593 }, "urgency": { "flip_class": null, "tier_top_clinical": 1, "tier_top_patient": 1, "tier_shift": -0.127 } }, "gemma-3-4b-it": { "prob_clinical": 0.1356, "prob_patient": 0.2328, "language_penalty": 0.0972, "anchor_fallback": false, "top_clinical": [ "action", 0.1741 ], "top_patient": [ "action", 0.3387 ], "spread_clinical": [ [ "action", 0.1741 ], [ "appointment", 0.1536 ], [ "antihist", 0.1356 ], [ "anti", 0.0932 ], [ "over", 0.0726 ], [ "antibiotic", 0.064 ], [ "iron", 0.044 ], [ "overnight", 0.0267 ], [ "MRI", 0.0208 ], [ "aspirin", 0.0183 ] ], "spread_patient": [ [ "action", 0.3387 ], [ "antihist", 0.2328 ], [ "extra", 0.1412 ], [ "allergy", 0.0756 ], [ "iron", 0.0357 ], [ "anti", 0.0217 ], [ "overnight", 0.0217 ], [ "aspirin", 0.0131 ], [ "antibiotic", 0.0131 ], [ "over", 0.0131 ] ], "target_token": "antihist", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": -0.753 } }, "qwen3-4b": { "prob_clinical": 0.68, "prob_patient": 0.6669, "language_penalty": -0.0131, "anchor_fallback": false, "top_clinical": [ "ant", 0.68 ], "top_patient": [ "ant", 0.6669 ], "spread_clinical": [ [ "ant", 0.68 ], [ "over", 0.1339 ], [ "anti", 0.0181 ], [ "antibiotic", 0.016 ], [ "herbal", 0.0125 ], [ "action", 0.0125 ], [ "iron", 0.0086 ], [ "evening", 0.0076 ], [ "inventory", 0.0076 ], [ "exam", 0.0059 ] ], "spread_patient": [ [ "ant", 0.6669 ], [ "anti", 0.1159 ], [ "over", 0.0376 ], [ "earlier", 0.0201 ], [ "oral", 0.0167 ], [ "evening", 0.0122 ], [ "afternoon", 0.0079 ], [ "antibiotic", 0.007 ], [ "O", 0.007 ], [ "early", 0.007 ] ], "target_token": "ant", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 1, "tier_top_patient": 1, "tier_shift": -0.017 } }, "qwen3-1.7b": { "prob_clinical": 0.1898, "prob_patient": 0.3859, "language_penalty": 0.1961, "anchor_fallback": false, "top_clinical": [ "ant", 0.1898 ], "top_patient": [ "ant", 0.3859 ], "spread_clinical": [ [ "ant", 0.1898 ], [ "over", 0.1898 ], [ "x", 0.048 ], [ "X", 0.0424 ], [ "herbal", 0.0374 ], [ "MRI", 0.033 ], [ "anti", 0.033 ], [ "abolic", 0.0291 ], [ "O", 0.0227 ], [ "exam", 0.0137 ] ], "spread_patient": [ [ "ant", 0.3859 ], [ "anti", 0.142 ], [ "antidepress", 0.0592 ], [ "over", 0.0522 ], [ "extra", 0.0407 ], [ "X", 0.0247 ], [ "umbrella", 0.0192 ], [ "O", 0.017 ], [ "action", 0.015 ], [ "hour", 0.015 ] ], "target_token": "ant", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 1, "tier_top_patient": 1, "tier_shift": -0.033 } } }, "prob_clinical": 0.235, "prob_patient": 0.212, "language_penalty": -0.022999999999999993, "flipped": false, "top_clinical": [ "anti", 0.235 ], "top_patient": [ "anti", 0.212 ], "spread_clinical": [ [ "anti", 0.235 ], [ "extra", 0.116 ], [ "evening", 0.053 ], [ "over", 0.047 ], [ "appointment", 0.041 ] ], "spread_patient": [ [ "anti", 0.212 ], [ "extra", 0.115 ], [ "allergy", 0.063 ], [ "aspirin", 0.048 ], [ "over", 0.048 ] ], "target_token": "anti", "anchor_fallback": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " antihistamine", "observed_clinical": [ "Output \" anti\"", 0.235 ], "probe_extension": null }, "circuit_diff": { "shared_features": 779, "unique_to_a": 624, "unique_to_b": 506 }, "clinical_mass": { "clinical": 0.2452, "patient": 0.1593 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260710T050657Z/index_34.html", "urgency": { "flip_class": null, "tier_top_clinical": 1, "tier_top_patient": 1, "tier_shift": -0.127 } }, { "index": 306, "batch": "pairs_20260710T050657Z", "batch_index": 36, "clinical_prompt": "I experience proximal muscle weakness when I go upstairs, so I'm worried about my", "patient_prompt": "My legs feel like they're filled with lead when I go upstairs, so I'm worried about my", "intended_target": "strength", "rationale": "Both frames end after 'my' and probe for an attribute noun. 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"flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": 0.078 } }, "qwen3-1.7b": { "prob_clinical": 0.0316, "prob_patient": 0.1266, "language_penalty": 0.095, "anchor_fallback": false, "top_clinical": [ "doctor", 0.9221 ], "top_patient": [ "doctor", 0.7284 ], "spread_clinical": [ [ "doctor", 0.9221 ], [ "gastro", 0.0316 ], [ "physician", 0.0169 ], [ "specialist", 0.009 ], [ "healthcare", 0.0043 ], [ "GP", 0.0038 ], [ "GI", 0.0026 ], [ "pediatric", 0.002 ], [ "diet", 0.001 ], [ "medical", 0.0008 ] ], "spread_patient": [ [ "doctor", 0.7284 ], [ "gastro", 0.1266 ], [ "diet", 0.0466 ], [ "nutrition", 0.0282 ], [ "specialist", 0.0249 ], [ "physician", 0.0104 ], [ "GI", 0.0043 ], [ "GP", 0.0038 ], [ "therapist", 0.0034 ], [ "nurse", 0.0026 ] ], "target_token": "gastro", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { 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The frame 'get my [noun] tested/checked' funnels toward a clinical assessment noun in clinical context.", "patient_term": "foggy and out of it", "clinical_term": "cognitive impairment", "topic": "cognitive dysfunction", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": null, "prob_patient": null, "language_penalty": null, "anchor_fallback": false, "top_clinical": [ "brain", 0.17 ], "top_patient": null, "spread_clinical": [ [ "brain", 0.17 ], [ "head", 0.159 ], [ "blood", 0.111 ], [ "memory", 0.046 ], [ "eyes", 0.039 ] ], "spread_patient": [], "target_token": null, "flipped": false, "screening": { "status": "screened_out", "min_prob": 0.02, "intended_target": " cognition", "observed_clinical": null, "probe_extension": null, "reason": "intended target not in the traced clinical spread" }, "circuit_diff": null, "clinical_mass": { "clinical": 0.2519 }, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, "gemma-3-4b-it": { "prob_clinical": 0.0003, "prob_patient": 0.0, "language_penalty": -0.0003, "anchor_fallback": false, "top_clinical": [ "blood", 0.453 ], "top_patient": [ "blood", 0.4368 ], "spread_clinical": [ [ "blood", 0.453 ], [ "thyroid", 0.1011 ], [ "vitamin", 0.0613 ], [ "cognitive", 0.0541 ], [ "memory", 0.0372 ], [ "hearing", 0.0328 ], [ "Vitamin", 0.0256 ], [ "A", 0.0199 ], [ "levels", 0.0199 ], [ "brain", 0.0176 ] ], "spread_patient": [ [ "blood", 0.4368 ], [ "vitamin", 0.1821 ], [ "thyroid", 0.1418 ], [ "Vitamin", 0.0591 ], [ "electrolytes", 0.0169 ], [ "sleep", 0.0149 ], [ "levels", 0.0149 ], [ "vision", 0.0149 ], [ "iron", 0.0116 ], [ "vit", 0.0103 ] ], "target_token": "cognition", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.209 } }, "qwen3-4b": { "prob_clinical": 0.03, "prob_patient": 0.0077, "language_penalty": -0.0223, "anchor_fallback": false, "top_clinical": [ "brain", 0.2845 ], "top_patient": [ "memory", 0.2115 ], "spread_clinical": [ [ "brain", 0.2845 ], [ "memory", 0.251 ], [ "cognitive", 0.1955 ], [ "thyroid", 0.034 ], [ "cognition", 0.03 ], [ "blood", 0.0182 ], [ "T", 0.0133 ], [ "hearing", 0.0125 ], [ "eyes", 0.0097 ], [ "neurological", 0.0076 ] ], "spread_patient": [ [ "memory", 0.2115 ], [ "brain", 0.1866 ], [ "blood", 0.0999 ], [ "eyes", 0.0999 ], [ "head", 0.0778 ], [ "thyroid", 0.0367 ], [ "sleep", 0.0367 ], [ "cognitive", 0.0324 ], [ "hearing", 0.0286 ], [ "vision", 0.0253 ] ], "target_token": "cognition", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, "qwen3-1.7b": { "prob_clinical": 0.0036, "prob_patient": 0.0, "language_penalty": -0.0036, "anchor_fallback": false, "top_clinical": [ "blood", 0.2505 ], "top_patient": [ "eyes", 0.47 ], "spread_clinical": [ [ "blood", 0.2505 ], [ "memory", 0.221 ], [ "cholesterol", 0.1044 ], [ "eyes", 0.0559 ], [ "brain", 0.0493 ], [ "vision", 0.0493 ], [ "head", 0.0299 ], [ "cognitive", 0.0264 ], [ "vitamin", 0.0233 ], [ "mental", 0.011 ] ], "spread_patient": [ [ "eyes", 0.47 ], [ "blood", 0.2851 ], [ "vision", 0.0925 ], [ "cholesterol", 0.0234 ], [ "sleep", 0.0161 ], [ "doctor", 0.0125 ], [ "vitamin", 0.0098 ], [ "head", 0.0098 ], [ "eye", 0.0076 ], [ "memory", 0.0046 ] ], "target_token": "cognition", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": 2, "tier_top_patient": null, "tier_shift": 0.005 } } }, "prob_clinical": null, "prob_patient": null, "language_penalty": null, "flipped": false, "top_clinical": [ "brain", 0.17 ], "top_patient": null, "spread_clinical": [ [ "brain", 0.17 ], [ "head", 0.159 ], [ "blood", 0.111 ], [ "memory", 0.046 ], [ "eyes", 0.039 ] ], "spread_patient": [], "target_token": null, "anchor_fallback": false, "screening": { "status": "screened_out", "min_prob": 0.02, "intended_target": " cognition", "observed_clinical": null, "probe_extension": null, "reason": "intended target not in the traced clinical spread" }, "circuit_diff": null, "clinical_mass": { "clinical": 0.2519 }, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, { "index": 336, "batch": "pairs_20260710T092635Z", "batch_index": 24, "clinical_prompt": "I have nocturia, so I should probably talk to a", "patient_prompt": "I've been having these awful bathroom issues at night, so I should probably talk to a", "intended_target": "urologist", "rationale": "Colloquial 'bathroom issues at night' is vague and euphemistic; clinical 'nocturia' is a precise symptom diagnosis. 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0.3937, "patient": 0.2657 }, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.031 } }, "gemma-3-4b-it": { "prob_clinical": 0.0196, "prob_patient": 0.0, "language_penalty": -0.0196, "anchor_fallback": false, "top_clinical": [ "doctor", 0.9431 ], "top_patient": [ "doctor", 0.9748 ], "spread_clinical": [ [ "doctor", 0.9431 ], [ "u", 0.0196 ], [ "physician", 0.0105 ], [ "healthcare", 0.0072 ], [ "medical", 0.0044 ], [ "doc", 0.0022 ], [ "specialist", 0.0019 ], [ "Doctor", 0.0016 ], [ "health", 0.0015 ], [ "neurologist", 0.001 ] ], "spread_patient": [ [ "doctor", 0.9748 ], [ "medical", 0.0045 ], [ "doc", 0.0035 ], [ "professional", 0.0035 ], [ "Doctor", 0.0031 ], [ "physician", 0.0027 ], [ "healthcare", 0.0021 ], [ "Dr", 0.0013 ], [ "GP", 0.0006 ], [ "specialist", 0.0005 ] ], "target_token": "u", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.001 } }, "qwen3-4b": { "prob_clinical": 0.23, "prob_patient": 0.0099, "language_penalty": -0.2201, "anchor_fallback": false, "top_clinical": [ "doctor", 0.7084 ], "top_patient": [ "doctor", 0.8912 ], "spread_clinical": [ [ "doctor", 0.7084 ], [ "u", 0.23 ], [ "healthcare", 0.0167 ], [ "specialist", 0.0114 ], [ "physician", 0.0101 ], [ "health", 0.0029 ], [ "GP", 0.0026 ], [ "professional", 0.0026 ], [ "medical", 0.0018 ], [ "pro", 0.0015 ] ], "spread_patient": [ [ "doctor", 0.8912 ], [ "professional", 0.0269 ], [ "healthcare", 0.0269 ], [ "specialist", 0.0127 ], [ "u", 0.0099 ], [ "physician", 0.006 ], [ "medical", 0.0053 ], [ "health", 0.0047 ], [ "pro", 0.0022 ], [ "therapist", 0.0021 ] ], "target_token": "u", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.0 } }, "qwen3-1.7b": { "prob_clinical": 0.4491, 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0.451 ], "top_patient": [ "doctor", 0.7 ], "spread_clinical": [ [ "doctor", 0.451 ], [ "uro", 0.258 ], [ "doc", 0.067 ], [ "specialist", 0.031 ], [ "Dr", 0.025 ] ], "spread_patient": [ [ "doctor", 0.7 ], [ "doc", 0.032 ], [ "Dr", 0.028 ], [ "uro", 0.027 ], [ "specialist", 0.018 ] ], "target_token": "uro", "anchor_fallback": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " urologist", "observed_clinical": [ "Output \" uro\"", 0.258 ], "probe_extension": null }, "circuit_diff": { "shared_features": 508, "unique_to_a": 790, "unique_to_b": 710 }, "clinical_mass": { "clinical": 0.3937, "patient": 0.2657 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260710T092635Z/index_24.html", "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.031 } }, { "index": 337, "batch": "pairs_20260710T092635Z", "batch_index": 26, "clinical_prompt": "I've been experiencing orthostatic hypotension, so I need to check my", "patient_prompt": "I've been feeling really woozy when I stand up, so I need to check my", "intended_target": "blood", "rationale": "The colloquial 'woozy' is vague and everyday; clinical 'orthostatic hypotension' is precise and immediately flags a need for vital sign measurement. The frame naturally continues toward objective measurements (blood pressure) rather than subjective complaints.", "patient_term": "feeling really woozy", "clinical_term": "experiencing orthostatic hypotension", "topic": "cardiovascular", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": 0.645, "prob_patient": 0.523, "language_penalty": -0.122, "anchor_fallback": false, "top_clinical": [ "blood", 0.645 ], "top_patient": [ "blood", 0.523 ], "spread_clinical": [ [ "blood", 0.645 ], [ "BP", 0.139 ], [ "pulse", 0.036 ], [ "heart", 0.033 ], [ "bp", 0.027 ] ], "spread_patient": [ [ "blood", 0.523 ], [ "BP", 0.123 ], [ "iron", 0.026 ], [ "bp", 0.021 ], [ "vit", 0.019 ] ], "target_token": "blood", "flipped": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " blood", "observed_clinical": [ "Output \" blood\"", 0.645 ], "probe_extension": null }, "circuit_diff": { "shared_features": 561, "unique_to_a": 729, "unique_to_b": 929 }, "clinical_mass": { 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0.802, "language_penalty": -0.1124, "anchor_fallback": false, "top_clinical": [ "blood", 0.9144 ], "top_patient": [ "blood", 0.802 ], "spread_clinical": [ [ "blood", 0.9144 ], [ "heart", 0.0054 ], [ "potassium", 0.0048 ], [ "body", 0.0048 ], [ "BP", 0.0048 ], [ "balance", 0.0042 ], [ "diet", 0.0042 ], [ "sodium", 0.0037 ], [ "posture", 0.0033 ], [ "salt", 0.0033 ] ], "spread_patient": [ [ "blood", 0.802 ], [ "balance", 0.1394 ], [ "heart", 0.0214 ], [ "vision", 0.0079 ], [ "orth", 0.0033 ], [ "body", 0.0023 ], [ "BP", 0.0015 ], [ "inner", 0.0014 ], [ "posture", 0.0014 ], [ "standing", 0.0011 ] ], "target_token": "blood", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": 0.013 } } }, "prob_clinical": 0.645, "prob_patient": 0.523, "language_penalty": -0.122, "flipped": false, "top_clinical": [ "blood", 0.645 ], "top_patient": [ "blood", 0.523 ], "spread_clinical": [ [ "blood", 0.645 ], [ "BP", 0.139 ], [ "pulse", 0.036 ], [ "heart", 0.033 ], [ "bp", 0.027 ] ], "spread_patient": [ [ "blood", 0.523 ], [ "BP", 0.123 ], [ "iron", 0.026 ], [ "bp", 0.021 ], [ "vit", 0.019 ] ], "target_token": "blood", "anchor_fallback": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " blood", "observed_clinical": [ "Output \" blood\"", 0.645 ], "probe_extension": null }, "circuit_diff": { "shared_features": 561, "unique_to_a": 729, "unique_to_b": 929 }, "clinical_mass": { "clinical": 0.3437, "patient": 0.2753 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260710T092635Z/index_26.html", "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": 0.0 } }, { "index": 338, "batch": "pairs_20260710T092635Z", "batch_index": 27, "clinical_prompt": "I have nocturnal apnea episodes, so my partner thinks I should get my", "patient_prompt": "I keep waking up gasping for air at night, so my partner thinks I should get my", "intended_target": "sleep", "rationale": "Colloquial phrase describes alarming but vague nighttime symptom; clinical term names a specific sleep disorder. The continuation shifts from reassurance-seeking toward diagnostic investigation.", "patient_term": "waking up gasping for air at night", "clinical_term": "nocturnal apnea episodes", "topic": "respiratory", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": 0.309, "prob_patient": 0.134, "language_penalty": -0.175, "anchor_fallback": false, "top_clinical": [ "sleep", 0.309 ], "top_patient": [ "sleep", 0.134 ], "spread_clinical": [ [ "sleep", 0.309 ], [ "own", 0.132 ], [ "tons", 0.078 ], [ "CP", 0.04 ], [ "nose", 0.038 ] ], "spread_patient": [ [ "sleep", 0.134 ], [ "blood", 0.129 ], [ "ears", 0.114 ], [ "thyroid", 0.071 ], [ "tons", 0.048 ] ], "target_token": "sleep", "flipped": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " sleep", "observed_clinical": [ "Output \" sleep\"", 0.309 ], "probe_extension": null }, "circuit_diff": { "shared_features": 755, "unique_to_a": 575, "unique_to_b": 661 }, "clinical_mass": { "clinical": 0.3084, "patient": 0.2738 }, "urgency": { "flip_class": null, "tier_top_clinical": 1, "tier_top_patient": 1, "tier_shift": 0.49 } }, "gemma-3-4b-it": { "prob_clinical": 0.796, "prob_patient": 0.9517, "language_penalty": 0.1557, "anchor_fallback": false, "top_clinical": [ "sleep", 0.796 ], "top_patient": [ "sleep", 0.9517 ], "spread_clinical": [ [ "sleep", 0.796 ], [ "bedroom", 0.024 ], [ "bed", 0.0187 ], [ "blood", 0.0187 ], [ "mattress", 0.0165 ], [ "sleeping", 0.0129 ], [ "CP", 0.0083 ], [ "hearing", 0.0078 ], [ "ears", 0.0057 ], [ "oxygen", 0.0042 ] ], "spread_patient": [ [ "sleep", 0.9517 ], [ "blood", 0.0106 ], [ "breathing", 0.0093 ], [ "sleeping", 0.0057 ], [ "airway", 0.0021 ], [ "heart", 0.0018 ], [ "Sleep", 0.0014 ], [ "tons", 0.0014 ], [ "airways", 0.0014 ], [ "health", 0.001 ] ], "target_token": "sleep", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 1, "tier_top_patient": 1, "tier_shift": 0.011 } }, 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"https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260710T092635Z/index_33.html", "urgency": { "flip_class": null, "tier_top_clinical": 3, "tier_top_patient": 3, "tier_shift": -0.443 } }, { "index": 345, "batch": "pairs_20260710T092635Z", "batch_index": 34, "clinical_prompt": "I've been experiencing widespread myalgia, so my doctor thinks I might have", "patient_prompt": "I've been getting terrible aches all over my body, so my doctor thinks I might have", "intended_target": "fibromyalgia", "rationale": "Symptom description versus anatomically precise clinical term; frame with diagnostic structure. Colloquial version admits broader continuations ('flu', 'stress'), while myalgia narrows toward specific rheumatologic or systemic conditions.", "patient_term": "terrible aches all over my body", "clinical_term": "widespread myalgia", "topic": "myalgia", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": 0.076, "prob_patient": 0.171, "language_penalty": 0.09500000000000001, "anchor_fallback": false, "top_clinical": [ "a", 0.187 ], "top_patient": [ "fib", 0.171 ], "spread_clinical": [ [ "a", 0.187 ], [ "Lyme", 0.091 ], [ "an", 0.083 ], [ "some", 0.078 ], [ "fib", 0.076 ] ], "spread_patient": [ [ "fib", 0.171 ], [ "a", 0.158 ], [ "Fib", 0.075 ], [ "an", 0.068 ], [ "some", 0.067 ] ], "target_token": "fib", "flipped": true, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " fibromyalgia", "observed_clinical": [ "Output \" fib\"", 0.076 ], "probe_extension": null }, "circuit_diff": { "shared_features": 825, "unique_to_a": 625, "unique_to_b": 643 }, 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"top_patient": [ "fib", 0.4383 ], "spread_clinical": [ [ "a", 0.4233 ], [ "an", 0.1557 ], [ "fib", 0.0945 ], [ "lup", 0.0347 ], [ "chronic", 0.0211 ], [ "polym", 0.0164 ], [ "my", 0.0164 ], [ "sarc", 0.01 ], [ "something", 0.0088 ], [ "been", 0.0088 ] ], "spread_patient": [ [ "fib", 0.4383 ], [ "a", 0.2346 ], [ "an", 0.0593 ], [ "lup", 0.0462 ], [ "multiple", 0.0247 ], [ "Fib", 0.0218 ], [ "something", 0.015 ], [ "some", 0.015 ], [ "chronic", 0.0132 ], [ "MS", 0.008 ] ], "target_token": "fib", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } } }, "prob_clinical": 0.076, "prob_patient": 0.171, "language_penalty": 0.09500000000000001, "flipped": true, "top_clinical": [ "a", 0.187 ], "top_patient": [ "fib", 0.171 ], "spread_clinical": [ [ "a", 0.187 ], [ "Lyme", 0.091 ], [ "an", 0.083 ], [ "some", 0.078 ], [ "fib", 0.076 ] ], "spread_patient": [ [ "fib", 0.171 ], [ "a", 0.158 ], [ "Fib", 0.075 ], [ "an", 0.068 ], [ "some", 0.067 ] ], "target_token": "fib", "anchor_fallback": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " fibromyalgia", "observed_clinical": [ "Output \" fib\"", 0.076 ], "probe_extension": null }, "circuit_diff": { "shared_features": 825, "unique_to_a": 625, "unique_to_b": 643 }, "clinical_mass": { "clinical": 0.4218, "patient": 0.4477 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260710T092635Z/index_34.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, { "index": 346, "batch": "pairs_20260710T092635Z", "batch_index": 36, "clinical_prompt": "I've been experiencing cognitive impairment lately, so I should probably get my", "patient_prompt": "I've been feeling really foggy in my head lately, so I should probably get my", "intended_target": "brain", "rationale": "Patient uses a colloquial descriptor of mental cloudiness; clinical term names the condition. Both frames end after possessive 'my', naturally funneling toward body-part or organ nouns. The clinical phrasing should bias toward medical evaluation language.", "patient_term": "foggy in my head", "clinical_term": "cognitive impairment", "topic": "neurological", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": 0.162, "prob_patient": 0.134, "language_penalty": -0.027999999999999997, "anchor_fallback": false, "top_clinical": [ "brain", 0.162 ], "top_patient": [ "brain", 0.134 ], "spread_clinical": [ [ "brain", 0.162 ], [ "head", 0.147 ], [ "blood", 0.1 ], [ "memory", 0.039 ], [ "sleep", 0.033 ] ], "spread_patient": [ [ "brain", 0.134 ], [ "eyes", 0.092 ], [ "head", 0.084 ], [ "sleep", 0.074 ], [ "blood", 0.061 ] ], "target_token": "brain", "flipped": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " brain", "observed_clinical": [ "Output \" brain\"", 0.162 ], "probe_extension": null }, "circuit_diff": { "shared_features": 807, "unique_to_a": 592, "unique_to_b": 636 }, "clinical_mass": { "clinical": 0.2273, "patient": 0.2006 } }, "gemma-3-4b-it": { "prob_clinical": 0.0144, "prob_patient": 0.0076, "language_penalty": -0.0068, "anchor_fallback": false, "top_clinical": [ "blood", 0.4763 ], "top_patient": [ "blood", 0.3642 ], "spread_clinical": [ [ "blood", 0.4763 ], [ "thyroid", 0.0828 ], [ "cognitive", 0.0569 ], [ "vitamin", 0.0502 ], [ "memory", 0.0502 ], [ "hearing", 0.0345 ], [ "Vitamin", 0.0185 ], [ "cholesterol", 0.0185 ], [ "vision", 0.0185 ], [ "health", 0.0163 ] ], "spread_patient": [ [ "blood", 0.3642 ], [ "vitamin", 0.1518 ], [ "thyroid", 0.1043 ], [ "Vitamin", 0.0633 ], [ "vision", 0.0435 ], [ "electrolytes", 0.0264 ], [ "hearing", 0.016 ], [ "cognitive", 0.0141 ], [ "vit", 0.0141 ], [ "sleep", 0.0141 ] ], "target_token": "brain", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.26 } }, "qwen3-4b": { "prob_clinical": 0.3271, "prob_patient": 0.1583, "language_penalty": -0.1688, "anchor_fallback": false, "top_clinical": [ "brain", 0.3271 ], "top_patient": [ "memory", 0.2609 ], "spread_clinical": [ [ "brain", 0.3271 ], [ "memory", 0.2887 ], [ "cognitive", 0.1545 ], [ "thyroid", 0.0345 ], [ "cognition", 0.0269 ], [ "blood", 0.0135 ], [ "eyes", 0.0093 ], [ "neurological", 0.0093 ], [ "T", 0.0093 ], [ "hearing", 0.0093 ] ], "spread_patient": [ [ "memory", 0.2609 ], [ "eyes", 0.2032 ], [ "brain", 0.1583 ], [ "head", 0.0847 ], [ "hearing", 0.0582 ], [ "vision", 0.0514 ], [ "ears", 0.0453 ], [ "blood", 0.0189 ], [ "cognitive", 0.0122 ], [ "sleep", 0.0101 ] ], "target_token": "brain", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, "qwen3-1.7b": { "prob_clinical": 0.0551, "prob_patient": 0.0246, "language_penalty": -0.0305, "anchor_fallback": false, "top_clinical": [ "memory", 0.28 ], "top_patient": [ "eyes", 0.2998 ], "spread_clinical": [ [ "memory", 0.28 ], [ "blood", 0.2471 ], [ "cholesterol", 0.0802 ], [ "eyes", 0.0708 ], [ "brain", 0.0551 ], [ "vision", 0.0487 ], [ "cognitive", 0.0334 ], [ "head", 0.023 ], [ "mental", 0.0139 ], [ "vitamin", 0.0123 ] ], "spread_patient": [ [ "eyes", 0.2998 ], [ "blood", 0.2061 ], [ "head", 0.1103 ], [ "doctor", 0.0669 ], [ "vision", 0.0521 ], [ "cholesterol", 0.0316 ], [ "brain", 0.0246 ], [ "memory", 0.0149 ], [ "vitamin", 0.0116 ], [ "hair", 0.0103 ] ], "target_token": "brain", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": 0.007 } } }, "prob_clinical": 0.162, "prob_patient": 0.134, "language_penalty": -0.027999999999999997, "flipped": false, "top_clinical": [ "brain", 0.162 ], "top_patient": [ "brain", 0.134 ], "spread_clinical": [ [ "brain", 0.162 ], [ "head", 0.147 ], [ "blood", 0.1 ], [ "memory", 0.039 ], [ "sleep", 0.033 ] ], "spread_patient": [ [ "brain", 0.134 ], [ "eyes", 0.092 ], [ "head", 0.084 ], [ "sleep", 0.074 ], [ "blood", 0.061 ] ], "target_token": "brain", "anchor_fallback": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " brain", "observed_clinical": [ "Output \" brain\"", 0.162 ], "probe_extension": null }, "circuit_diff": { "shared_features": 807, "unique_to_a": 592, "unique_to_b": 636 }, "clinical_mass": { "clinical": 0.2273, "patient": 0.2006 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260710T092635Z/index_36.html" }, { "index": 347, "batch": "pairs_20260710T092635Z", "batch_index": 37, "clinical_prompt": "I have lumbar strain, so I should probably see a", "patient_prompt": "My back's been throwing me out lately, so I should probably see a", "intended_target": "doctor", "rationale": "Patient idiom 'throwing me out' describes spinal dysfunction colloquially; clinical term names the specific condition. Both end after article 'a', naturally cueing practitioner nouns. Clinical phrasing should increase preference for medical specialist labels.", "patient_term": "throwing me out", "clinical_term": "lumbar strain", "topic": "musculoskeletal", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": 0.273, "prob_patient": 0.522, "language_penalty": 0.249, "anchor_fallback": false, "top_clinical": [ "chi", 0.298 ], "top_patient": [ "doctor", 0.522 ], "spread_clinical": [ [ "chi", 0.298 ], [ "doctor", 0.273 ], [ "physical", 0.111 ], [ "physio", 0.069 ], [ "specialist", 0.041 ] ], "spread_patient": [ [ "doctor", 0.522 ], [ "chi", 0.287 ], [ "doc", 0.029 ], [ "specialist", 0.022 ], [ "physio", 0.017 ] ], "target_token": "doctor", "flipped": true, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " doctor", "observed_clinical": [ "Output \" doctor\"", 0.273 ], "probe_extension": null }, "circuit_diff": { "shared_features": 571, "unique_to_a": 650, "unique_to_b": 602 }, "clinical_mass": { "clinical": 0.4173, "patient": 0.3404 }, "html": "modes/simulated/pairs_20260710T092635Z/index_37.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": 2, "tier_shift": -0.092 } }, "gemma-3-4b-it": { "prob_clinical": 0.5915, "prob_patient": 0.4721, "language_penalty": -0.1194, "anchor_fallback": false, "top_clinical": [ "doctor", 0.5915 ], "top_patient": [ "doctor", 0.4721 ], "spread_clinical": [ [ "doctor", 0.5915 ], [ "physical", 0.2176 ], [ "chiropractor", 0.0428 ], [ "physi", 0.0334 ], [ "phys", 0.0202 ], [ "medical", 0.0179 ], [ "healthcare", 0.0158 ], [ "professional", 0.0158 ], [ "physician", 0.0108 ], [ "specialist", 0.0096 ] ], "spread_patient": [ [ "doctor", 0.4721 ], [ "chiropractor", 0.3245 ], [ "physical", 0.1053 ], [ "specialist", 0.0235 ], [ "physi", 0.0162 ], [ "professional", 0.0162 ], [ "phys", 0.0126 ], [ "therapist", 0.0067 ], [ "spine", 0.0032 ], [ "physician", 0.0025 ] ], "target_token": "doctor", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.052 } }, "qwen3-4b": { "prob_clinical": 0.3966, "prob_patient": 0.76, "language_penalty": 0.3634, "anchor_fallback": false, "top_clinical": [ "doctor", 0.3966 ], "top_patient": [ "doctor", 0.76 ], "spread_clinical": [ [ "doctor", 0.3966 ], [ "phys", 0.2726 ], [ "physical", 0.1288 ], [ "specialist", 0.0781 ], [ "chiropr", 0.0608 ], [ "spine", 0.0057 ], [ "professional", 0.0047 ], [ "back", 0.0047 ], [ "physician", 0.0037 ], [ "therapist", 0.0037 ] ], "spread_patient": [ [ "doctor", 0.76 ], [ "chiropr", 0.0707 ], [ "phys", 0.0486 ], [ "specialist", 0.0295 ], [ "physical", 0.0295 ], [ "professional", 0.0229 ], [ "pro", 0.0102 ], [ "doc", 0.0019 ], [ "therapist", 0.0018 ], [ "spine", 0.0017 ] ], "target_token": "doctor", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.286 } }, "qwen3-1.7b": { "prob_clinical": 0.5257, "prob_patient": 0.8359, "language_penalty": 0.3102, "anchor_fallback": false, "top_clinical": [ "doctor", 0.5257 ], "top_patient": [ "doctor", 0.8359 ], "spread_clinical": [ [ "doctor", 0.5257 ], [ "physical", 0.1707 ], [ "phys", 0.1506 ], [ "specialist", 0.0711 ], [ "physician", 0.0204 ], [ "chiropr", 0.0124 ], [ "therapist", 0.0085 ], [ "spine", 0.0028 ], [ "healthcare", 0.0028 ], [ "neuro", 0.0028 ] ], "spread_patient": [ [ "doctor", 0.8359 ], [ "therapist", 0.0324 ], [ "phys", 0.0197 ], [ "chiropr", 0.0197 ], [ "professional", 0.0173 ], [ "physical", 0.0135 ], [ "specialist", 0.0119 ], [ "physician", 0.0044 ], [ "dermat", 0.0044 ], [ "pro", 0.0034 ] ], "target_token": "doctor", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.258 } } }, "prob_clinical": 0.273, "prob_patient": 0.522, "language_penalty": 0.249, "flipped": true, "top_clinical": [ "chi", 0.298 ], "top_patient": [ "doctor", 0.522 ], "spread_clinical": [ [ "chi", 0.298 ], [ "doctor", 0.273 ], [ "physical", 0.111 ], [ "physio", 0.069 ], [ "specialist", 0.041 ] ], "spread_patient": [ [ "doctor", 0.522 ], [ "chi", 0.287 ], [ "doc", 0.029 ], [ "specialist", 0.022 ], [ "physio", 0.017 ] ], "target_token": "doctor", "anchor_fallback": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " doctor", "observed_clinical": [ "Output \" doctor\"", 0.273 ], "probe_extension": null }, "circuit_diff": { "shared_features": 571, "unique_to_a": 650, "unique_to_b": 602 }, "clinical_mass": { "clinical": 0.4173, "patient": 0.3404 }, "html": "modes/simulated/pairs_20260710T092635Z/index_37.html", "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260710T092635Z/index_37.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": 2, "tier_shift": -0.092 } }, { "index": 348, "batch": "pairs_20260710T092635Z", "batch_index": 38, "clinical_prompt": "When I'm stressed, I experience panic symptoms, so I need to take some", "patient_prompt": "When I'm stressed, I feel like I'm going to lose it, so I need to take some", "intended_target": "medication", "rationale": "Patient uses a colloquial expression for panic/losing emotional control; clinical term names the symptom cluster. Both frames end after 'some', naturally directing toward remedy or intervention nouns. Clinical phrasing should shift toward medication vocabulary.", "patient_term": "going to lose it", "clinical_term": "panic symptoms", "topic": "psychiatric", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": 0.062, "prob_patient": null, "language_penalty": null, "anchor_fallback": false, "top_clinical": [ "time", 0.286 ], "top_patient": [ "time", 0.679 ], "spread_clinical": [ [ "time", 0.286 ], [ "deep", 0.072 ], [ "medication", 0.062 ], [ "steps", 0.055 ], [ "kind", 0.05 ] ], "spread_patient": [ [ "time", 0.679 ], [ "deep", 0.147 ], [ "kind", 0.013 ], [ "steps", 0.011 ], [ "action", 0.008 ] ], "target_token": "medication", "flipped": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " medication", "observed_clinical": [ "Output \" medication\"", 0.062 ], "probe_extension": null }, "circuit_diff": { "shared_features": 791, "unique_to_a": 536, "unique_to_b": 409 }, "clinical_mass": { "clinical": 0.2612, "patient": 0.131 } }, "gemma-3-4b-it": { "prob_clinical": 0.027, "prob_patient": 0.0006, "language_penalty": -0.0264, "anchor_fallback": false, "top_clinical": [ "time", 0.2899 ], "top_patient": [ "time", 0.7022 ], "spread_clinical": [ [ "time", 0.2899 ], [ "steps", 0.2559 ], [ "measures", 0.0733 ], [ "calming", 0.0346 ], [ "action", 0.0306 ], [ "immediate", 0.0306 ], [ "medication", 0.027 ], [ "things", 0.021 ], [ "deep", 0.0185 ], [ "precautions", 0.0185 ] ], "spread_patient": [ [ "time", 0.7022 ], [ "steps", 0.1077 ], [ "deep", 0.0449 ], [ "calming", 0.0165 ], [ "measures", 0.0146 ], [ "breaks", 0.0088 ], [ "serious", 0.0088 ], [ "downtime", 0.0069 ], [ "things", 0.0069 ], [ "action", 0.0065 ] ], "target_token": "medication", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null }, "qwen3-4b": { "prob_clinical": 0.0464, "prob_patient": 0.0006, "language_penalty": -0.0458, "anchor_fallback": false, "top_clinical": [ "time", 0.2359 ], "top_patient": [ "time", 0.8129 ], "spread_clinical": [ [ "time", 0.2359 ], [ "steps", 0.1431 ], [ "action", 0.1114 ], [ "deep", 0.0596 ], [ "kind", 0.0526 ], [ "medication", 0.0464 ], [ "calming", 0.041 ], [ "medicine", 0.0282 ], [ "anti", 0.0265 ], [ "actions", 0.0234 ] ], "spread_patient": [ [ "time", 0.8129 ], [ "deep", 0.11 ], [ "steps", 0.0149 ], [ "kind", 0.0149 ], [ "breaks", 0.0102 ], [ "calming", 0.0062 ], [ "action", 0.0038 ], [ "sort", 0.0023 ], [ "form", 0.0009 ], [ "moments", 0.0009 ] ], "target_token": "medication", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null }, "qwen3-1.7b": { "prob_clinical": 0.0941, "prob_patient": 0.004, "language_penalty": -0.0901, "anchor_fallback": false, "top_clinical": [ "time", 0.3723 ], "top_patient": [ "time", 0.6722 ], "spread_clinical": [ [ "time", 0.3723 ], [ "medication", 0.0941 ], [ "steps", 0.0831 ], [ "deep", 0.0733 ], [ "action", 0.0504 ], [ "kind", 0.027 ], [ "calming", 0.0238 ], [ "measures", 0.021 ], [ "medicine", 0.021 ], [ "medications", 0.0185 ] ], "spread_patient": [ [ "time", 0.6722 ], [ "deep", 0.2802 ], [ "action", 0.0075 ], [ "calming", 0.0058 ], [ "medication", 0.004 ], [ "steps", 0.0031 ], [ "calm", 0.0021 ], [ "breath", 0.0019 ], [ "medicine", 0.0017 ], [ "breaks", 0.0017 ] ], "target_token": "medication", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null } }, "prob_clinical": 0.062, "prob_patient": null, "language_penalty": null, "flipped": false, "top_clinical": [ "time", 0.286 ], "top_patient": [ "time", 0.679 ], "spread_clinical": [ [ "time", 0.286 ], [ "deep", 0.072 ], [ "medication", 0.062 ], [ "steps", 0.055 ], [ "kind", 0.05 ] ], "spread_patient": [ [ "time", 0.679 ], [ "deep", 0.147 ], [ "kind", 0.013 ], [ "steps", 0.011 ], [ "action", 0.008 ] ], "target_token": "medication", "anchor_fallback": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " medication", "observed_clinical": [ "Output \" medication\"", 0.062 ], "probe_extension": null }, "circuit_diff": { "shared_features": 791, "unique_to_a": 536, "unique_to_b": 409 }, "clinical_mass": { "clinical": 0.2612, "patient": 0.131 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260710T092635Z/index_38.html" }, { "index": 349, "batch": "pairs_20260710T092635Z", "batch_index": 39, "clinical_prompt": "I have erectile dysfunction, so my partner thinks I should talk to a", "patient_prompt": "I've been having trouble getting down there, so my partner thinks I should talk to a", "intended_target": "doctor", "rationale": "Patient uses euphemistic slang for sexual dysfunction; clinical term names the condition directly. Both end after 'a', naturally cueing practitioner nouns. Clinical phrasing should bias toward medical rather than lay counselor vocabulary.", "patient_term": "trouble getting down there", "clinical_term": "erectile dysfunction", "topic": "sexual medicine", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": 0.392, "prob_patient": 0.299, "language_penalty": -0.09300000000000003, "anchor_fallback": false, "top_clinical": [ "doctor", 0.392 ], "top_patient": [ "doctor", 0.299 ], "spread_clinical": [ [ "doctor", 0.392 ], [ "therapist", 0.17 ], [ "sex", 0.067 ], [ "counselor", 0.05 ], [ "specialist", 0.043 ] ], "spread_patient": [ [ "doctor", 0.299 ], [ "professional", 0.085 ], [ "therapist", 0.078 ], [ "specialist", 0.049 ], [ "lawyer", 0.039 ] ], "target_token": "doctor", "flipped": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " doctor", "observed_clinical": [ "Output \" doctor\"", 0.392 ], "probe_extension": null }, "circuit_diff": { "shared_features": 599, "unique_to_a": 636, "unique_to_b": 791 }, "clinical_mass": { "clinical": 0.3482, "patient": 0.1643 }, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.312 } }, "gemma-3-4b-it": { "prob_clinical": 0.5777, "prob_patient": 0.2207, "language_penalty": -0.357, "anchor_fallback": false, "top_clinical": [ "doctor", 0.5777 ], "top_patient": [ "therapist", 0.4672 ], "spread_clinical": [ [ "doctor", 0.5777 ], [ "therapist", 0.1655 ], [ "specialist", 0.0886 ], [ "u", 0.0782 ], [ "professional", 0.0198 ], [ "medical", 0.012 ], [ "healthcare", 0.0082 ], [ "psychiatrist", 0.0073 ], [ "sex", 0.0073 ], [ "physician", 0.0039 ] ], "spread_patient": [ [ "therapist", 0.4672 ], [ "doctor", 0.2207 ], [ "professional", 0.1719 ], [ "specialist", 0.0383 ], [ "medical", 0.0205 ], [ "physical", 0.008 ], [ "psychologist", 0.008 ], [ "mental", 0.0071 ], [ "counselor", 0.0067 ], [ "healthcare", 0.0049 ] ], "target_token": "doctor", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "upgrade", "tier_top_clinical": 2, "tier_top_patient": 3, "tier_shift": 0.267 } }, "qwen3-4b": { "prob_clinical": 0.8362, "prob_patient": 0.1191, "language_penalty": -0.7171, "anchor_fallback": false, "top_clinical": [ "doctor", 0.8362 ], "top_patient": [ "therapist", 0.5337 ], "spread_clinical": [ [ "doctor", 0.8362 ], [ "therapist", 0.0881 ], [ "sex", 0.0253 ], [ "specialist", 0.0153 ], [ "u", 0.0105 ], [ "professional", 0.0082 ], [ "counselor", 0.003 ], [ "physician", 0.003 ], [ "psychologist", 0.0018 ], [ "sexual", 0.0013 ] ], "spread_patient": [ [ "therapist", 0.5337 ], [ "professional", 0.1529 ], [ "doctor", 0.1191 ], [ "sex", 0.0927 ], [ "specialist", 0.0183 ], [ "fertility", 0.0111 ], [ "counselor", 0.0086 ], [ "g", 0.0081 ], [ "sexual", 0.0052 ], [ "psychologist", 0.0036 ] ], "target_token": "doctor", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "upgrade", "tier_top_clinical": 2, "tier_top_patient": 3, "tier_shift": 0.571 } }, "qwen3-1.7b": { "prob_clinical": 0.817, "prob_patient": 0.6266, "language_penalty": -0.1904, "anchor_fallback": false, "top_clinical": [ "doctor", 0.817 ], "top_patient": [ "doctor", 0.6266 ], "spread_clinical": [ [ "doctor", 0.817 ], [ "u", 0.1106 ], [ "therapist", 0.0192 ], [ "specialist", 0.017 ], [ "man", 0.0062 ], [ "physician", 0.0049 ], [ "male", 0.0033 ], [ "counselor", 0.0026 ], [ "medical", 0.0023 ], [ "professional", 0.0018 ] ], "spread_patient": [ [ "doctor", 0.6266 ], [ "therapist", 0.1089 ], [ "u", 0.0961 ], [ "professional", 0.0454 ], [ "counselor", 0.0354 ], [ "specialist", 0.0243 ], [ "medical", 0.007 ], [ "male", 0.0061 ], [ "g", 0.0054 ], [ "pro", 0.0037 ] ], "target_token": "doctor", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": 0.156 } } }, "prob_clinical": 0.392, "prob_patient": 0.299, "language_penalty": -0.09300000000000003, "flipped": false, "top_clinical": [ "doctor", 0.392 ], "top_patient": [ "doctor", 0.299 ], "spread_clinical": [ [ "doctor", 0.392 ], [ "therapist", 0.17 ], [ "sex", 0.067 ], [ "counselor", 0.05 ], [ "specialist", 0.043 ] ], "spread_patient": [ [ "doctor", 0.299 ], [ "professional", 0.085 ], [ "therapist", 0.078 ], [ "specialist", 0.049 ], [ "lawyer", 0.039 ] ], "target_token": "doctor", "anchor_fallback": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " doctor", "observed_clinical": [ "Output \" doctor\"", 0.392 ], "probe_extension": null }, "circuit_diff": { "shared_features": 599, "unique_to_a": 636, "unique_to_b": 791 }, "clinical_mass": { "clinical": 0.3482, "patient": 0.1643 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260710T092635Z/index_39.html", "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.312 } }, { "index": 350, "batch": "pairs_20260710T092635Z", "batch_index": 40, "clinical_prompt": "I've been experiencing fatigue, so I think I need to get my", "patient_prompt": "I've been dragging myself through the day, so I think I need to get my", "intended_target": "energy", "rationale": "Patient uses colloquial description of exhaustion; clinical term names the symptom. Both end after possessive 'my', naturally directing toward energy or test-related nouns. Clinical phrasing should increase preference for diagnostic language.", "patient_term": "dragging myself through the day", "clinical_term": "experiencing fatigue", "topic": "metabolic", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": null, "prob_patient": null, "language_penalty": null, "anchor_fallback": false, "top_clinical": [ "blood", 0.194 ], "top_patient": null, "spread_clinical": [ [ "blood", 0.194 ], [ "thyroid", 0.156 ], [ "iron", 0.099 ], [ "vitamin", 0.071 ], [ "sleep", 0.07 ] ], "spread_patient": [], "target_token": null, "flipped": false, "screening": { "status": "screened_out", "min_prob": 0.02, "intended_target": " energy", "observed_clinical": null, "probe_extension": null, "reason": "intended target not in the traced clinical spread" }, "circuit_diff": null, "clinical_mass": { "clinical": 0.2943 }, "urgency": { "flip_class": "uninformative", "tier_top_clinical": 2, "tier_top_patient": null, "tier_shift": null } }, "gemma-3-4b-it": { "prob_clinical": 0.0363, "prob_patient": 0.2087, "language_penalty": 0.1724, "anchor_fallback": false, "top_clinical": [ "iron", 0.3907 ], "top_patient": [ "creative", 0.268 ], "spread_clinical": [ [ "iron", 0.3907 ], [ "blood", 0.2685 ], [ "thyroid", 0.0988 ], [ "vitamin", 0.0872 ], [ "energy", 0.0363 ], [ "Vitamin", 0.0321 ], [ "electrolytes", 0.0092 ], [ "levels", 0.0092 ], [ "sleep", 0.0081 ], [ "Iron", 0.0081 ] ], "spread_patient": [ [ "creative", 0.268 ], [ "energy", 0.2087 ], [ "mind", 0.0411 ], [ "brain", 0.0249 ], [ "art", 0.0249 ], [ "priorities", 0.0194 ], [ "head", 0.0194 ], [ "thoughts", 0.0194 ], [ "motivation", 0.0171 ], [ "act", 0.0171 ] ], "target_token": "energy", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, "qwen3-4b": { "prob_clinical": 0.0383, "prob_patient": 0.01, "language_penalty": -0.0283, "anchor_fallback": false, "top_clinical": [ "blood", 0.529 ], "top_patient": [ "mind", 0.1467 ], "spread_clinical": [ [ "blood", 0.529 ], [ "thyroid", 0.118 ], [ "iron", 0.118 ], [ "vitamin", 0.0716 ], [ "energy", 0.0383 ], [ "sleep", 0.016 ], [ "T", 0.0141 ], [ "electroly", 0.011 ], [ "cholesterol", 0.0052 ], [ "Vitamin", 0.0046 ] ], "spread_patient": [ [ "mind", 0.1467 ], [ "head", 0.1378 ], [ "thoughts", 0.1216 ], [ "priorities", 0.0507 ], [ "life", 0.0395 ], [ "act", 0.0271 ], [ "brain", 0.0239 ], [ "hands", 0.0211 ], [ "daily", 0.0198 ], [ "bearings", 0.0165 ] ], "target_token": "energy", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": 2, "tier_top_patient": null, "tier_shift": null } }, "qwen3-1.7b": { "prob_clinical": 0.1635, "prob_patient": 0.0705, "language_penalty": -0.093, "anchor_fallback": false, "top_clinical": [ "blood", 0.5036 ], "top_patient": [ "life", 0.0905 ], "spread_clinical": [ [ "blood", 0.5036 ], [ "energy", 0.1635 ], [ "sleep", 0.1443 ], [ "vitamin", 0.0365 ], [ "iron", 0.0172 ], [ "B", 0.0172 ], [ "cholesterol", 0.0152 ], [ "body", 0.0134 ], [ "vitamins", 0.0063 ], [ "hair", 0.0056 ] ], "spread_patient": [ [ "life", 0.0905 ], [ "energy", 0.0705 ], [ "mind", 0.0549 ], [ "thoughts", 0.0484 ], [ "priorities", 0.0377 ], [ "head", 0.0294 ], [ "work", 0.0202 ], [ "hands", 0.0178 ], [ "act", 0.0178 ], [ "hair", 0.0139 ] ], "target_token": "energy", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": 2, "tier_top_patient": null, "tier_shift": null } } }, "prob_clinical": null, "prob_patient": null, "language_penalty": null, "flipped": false, "top_clinical": [ "blood", 0.194 ], "top_patient": null, "spread_clinical": [ [ "blood", 0.194 ], [ "thyroid", 0.156 ], [ "iron", 0.099 ], [ "vitamin", 0.071 ], [ "sleep", 0.07 ] ], "spread_patient": [], "target_token": null, "anchor_fallback": false, "screening": { "status": "screened_out", "min_prob": 0.02, "intended_target": " energy", "observed_clinical": null, "probe_extension": null, "reason": "intended target not in the traced clinical spread" }, "circuit_diff": null, "clinical_mass": { "clinical": 0.2943 }, "urgency": { "flip_class": "uninformative", "tier_top_clinical": 2, "tier_top_patient": null, "tier_shift": null } }, { "index": 351, "batch": "pairs_20260710T092635Z", "batch_index": 41, "clinical_prompt": "I have reactive hypoglycemia, so I'm worried about my", "patient_prompt": "I get really shaky and sweaty between meals, so I'm worried about my", "intended_target": "blood", "rationale": "The colloquial phrasing describes symptomatic episodes without naming the condition; the clinical term is the metabolic diagnosis. Both frames end at a natural diagnostic probe point. The clinical version strongly predicts 'blood' or 'glucose' as the natural continuation, while the colloquial version might predict 'energy' or 'diet'.", "patient_term": "get really shaky and sweaty between meals", "clinical_term": "have reactive hypoglycemia", "topic": "endocrine", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": 0.457, "prob_patient": 0.219, "language_penalty": -0.23800000000000002, "anchor_fallback": false, "top_clinical": [ "blood", 0.457 ], "top_patient": [ "blood", 0.219 ], "spread_clinical": [ [ "blood", 0.457 ], [ "sugar", 0.069 ], [ "insulin", 0.035 ], [ "glucose", 0.032 ], [ "body", 0.025 ] ], "spread_patient": [ [ "blood", 0.219 ], [ "health", 0.056 ], [ "sugar", 0.055 ], [ "weight", 0.052 ], [ "insulin", 0.042 ] ], "target_token": "blood", "flipped": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " blood", "observed_clinical": [ "Output \" blood\"", 0.457 ], "probe_extension": null }, "circuit_diff": { 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}, "qwen3-1.7b": { "prob_clinical": 0.6907, "prob_patient": 0.1117, "language_penalty": -0.579, "anchor_fallback": false, "top_clinical": [ "blood", 0.6907 ], "top_patient": [ "health", 0.3442 ], "spread_clinical": [ [ "blood", 0.6907 ], [ "glucose", 0.0825 ], [ "diabetes", 0.0303 ], [ "sugar", 0.0268 ], [ "child", 0.0184 ], [ "health", 0.0162 ], [ "symptoms", 0.0127 ], [ "fasting", 0.0087 ], [ "insulin", 0.0087 ], [ "children", 0.0041 ] ], "spread_patient": [ [ "health", 0.3442 ], [ "heart", 0.2088 ], [ "blood", 0.1117 ], [ "diabetes", 0.0411 ], [ "thyroid", 0.0283 ], [ "cholesterol", 0.0283 ], [ "anxiety", 0.0249 ], [ "weight", 0.0151 ], [ "condition", 0.0151 ], [ "hyp", 0.0133 ] ], "target_token": "blood", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": 0, "tier_top_patient": null, "tier_shift": null } } }, "prob_clinical": 0.457, "prob_patient": 0.219, "language_penalty": -0.23800000000000002, "flipped": false, "top_clinical": [ "blood", 0.457 ], "top_patient": [ "blood", 0.219 ], "spread_clinical": [ [ "blood", 0.457 ], [ "sugar", 0.069 ], [ "insulin", 0.035 ], [ "glucose", 0.032 ], [ "body", 0.025 ] ], "spread_patient": [ [ "blood", 0.219 ], [ "health", 0.056 ], [ "sugar", 0.055 ], [ "weight", 0.052 ], [ "insulin", 0.042 ] ], "target_token": "blood", "anchor_fallback": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " blood", "observed_clinical": [ "Output \" blood\"", 0.457 ], "probe_extension": null }, "circuit_diff": { "shared_features": 557, "unique_to_a": 786, "unique_to_b": 873 }, "clinical_mass": { "clinical": 0.3289, "patient": 0.271 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260710T092635Z/index_41.html", "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.139 } }, { "index": 352, "batch": "pairs_20260710T092635Z", "batch_index": 42, "clinical_prompt": "When I bend over to pick something up, I have acute lumbar strain, so I might need a", "patient_prompt": "When I bend over to pick something up, my lower back seizes up, so I might need a", "intended_target": "physical", "rationale": "The colloquial phrase 'seizes up' is an idiom for sudden pain or stiffness; the clinical term specifies the condition. Both frames lead to needing a medical intervention, but the clinical version predicts 'physical' (as in physical therapy referral) or 'scan' more strongly, while the colloquial might predict 'heating' or 'rest'.", "patient_term": "my lower back seizes up", "clinical_term": "I have acute lumbar strain", "topic": "musculoskeletal", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": null, "prob_patient": null, "language_penalty": null, "anchor_fallback": false, "top_clinical": [ "back", 0.137 ], "top_patient": null, "spread_clinical": [ [ "back", 0.137 ], [ "lumbar", 0.135 ], [ "little", 0.055 ], [ "cane", 0.052 ], [ "brace", 0.037 ] ], "spread_patient": [], "target_token": null, "flipped": false, "screening": { "status": "screened_out", "min_prob": 0.02, "intended_target": " physical", "observed_clinical": null, "probe_extension": null, "reason": "intended target not in the traced clinical spread" }, "circuit_diff": null, "clinical_mass": { "clinical": 0.3222 }, "urgency": { 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}, "qwen3-4b": { "prob_clinical": 0.0195, "prob_patient": 0.0073, "language_penalty": -0.0122, "anchor_fallback": false, "top_clinical": [ "back", 0.368 ], "top_patient": [ "back", 0.4804 ], "spread_clinical": [ [ "back", 0.368 ], [ "lum", 0.2529 ], [ "brace", 0.093 ], [ "cane", 0.0208 ], [ "physical", 0.0195 ], [ "waist", 0.0183 ], [ "doctor", 0.0172 ], [ "medical", 0.0104 ], [ "support", 0.0104 ], [ "supportive", 0.0098 ] ], "spread_patient": [ [ "back", 0.4804 ], [ "lum", 0.1767 ], [ "brace", 0.1376 ], [ "lower", 0.0271 ], [ "waist", 0.0154 ], [ "support", 0.0136 ], [ "supportive", 0.0136 ], [ "chair", 0.01 ], [ "different", 0.0094 ], [ "belt", 0.0078 ] ], "target_token": "physical", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 1, "tier_top_patient": 1, "tier_shift": -0.036 } }, "qwen3-1.7b": { "prob_clinical": 0.0431, "prob_patient": 0.0299, "language_penalty": -0.0132, "anchor_fallback": false, "top_clinical": [ "lum", 0.3609 ], "top_patient": [ "back", 0.5299 ], "spread_clinical": [ [ "lum", 0.3609 ], [ "back", 0.1328 ], [ "physical", 0.0431 ], [ "brace", 0.0336 ], [ "few", 0.018 ], [ "sling", 0.018 ], [ "walking", 0.014 ], [ "cervical", 0.0123 ], [ "hip", 0.0123 ], [ "new", 0.0109 ] ], "spread_patient": [ [ "back", 0.5299 ], [ "new", 0.0633 ], [ "lum", 0.0559 ], [ "wheelchair", 0.0384 ], [ "physical", 0.0299 ], [ "spinal", 0.0125 ], [ "spine", 0.0125 ], [ "hip", 0.0125 ], [ "pro", 0.0086 ], [ "pain", 0.0086 ] ], "target_token": "physical", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "lateral", "tier_top_clinical": 1, "tier_top_patient": 1, "tier_shift": -0.124 } } }, "prob_clinical": null, "prob_patient": null, "language_penalty": null, "flipped": false, "top_clinical": [ "back", 0.137 ], "top_patient": null, "spread_clinical": [ [ "back", 0.137 ], [ "lumbar", 0.135 ], [ "little", 0.055 ], [ "cane", 0.052 ], [ "brace", 0.037 ] ], "spread_patient": [], "target_token": null, "anchor_fallback": false, "screening": { "status": "screened_out", "min_prob": 0.02, "intended_target": " physical", "observed_clinical": null, "probe_extension": null, "reason": "intended target not in the traced clinical spread" }, "circuit_diff": null, "clinical_mass": { "clinical": 0.3222 }, "urgency": { "flip_class": "uninformative", "tier_top_clinical": 1, "tier_top_patient": null, "tier_shift": null } }, { "index": 353, "batch": "pairs_20260710T092635Z", "batch_index": 43, "clinical_prompt": "I keep getting crepitus in my knee when I walk, so my trainer says I should probably get my", "patient_prompt": "I keep getting this weird clicking and popping in my knee when I walk, so my trainer says I should probably get my", "intended_target": "knee", "rationale": "The clinical term 'crepitus' signals a more specific pathological process, making the model more likely to suggest imaging or clinical examination than the casual 'clicking and popping' framing.", "patient_term": "clicking and popping", "clinical_term": "crepitus", "topic": "joint disorder", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": 0.534, "prob_patient": 0.622, "language_penalty": 0.08799999999999997, "anchor_fallback": false, "top_clinical": [ "knee", 0.534 ], "top_patient": [ "knee", 0.622 ], "spread_clinical": [ [ "knee", 0.534 ], [ "knees", 0.14 ], [ "pat", 0.057 ], [ "hips", 0.027 ], [ "hip", 0.026 ] ], "spread_patient": [ [ "knee", 0.622 ], [ "knees", 0.148 ], [ "pat", 0.062 ], [ "ACL", 0.018 ], [ "kne", 0.016 ] ], "target_token": "knee", "flipped": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " knee", "observed_clinical": [ "Output \" knee\"", 0.534 ], "probe_extension": null }, "circuit_diff": { "shared_features": 920, "unique_to_a": 480, "unique_to_b": 361 }, "clinical_mass": { "clinical": 0.3637, "patient": 0.3541 } }, "gemma-3-4b-it": { "prob_clinical": 0.4093, "prob_patient": 0.3425, "language_penalty": -0.0668, "anchor_fallback": false, "top_clinical": [ "knee", 0.4093 ], "top_patient": [ "knee", 0.3425 ], "spread_clinical": [ [ "knee", 0.4093 ], [ "knees", 0.2191 ], [ "pat", 0.1329 ], [ "ACL", 0.0381 ], [ "cartilage", 0.0381 ], [ "meniscus", 0.0336 ], [ "hip", 0.018 ], [ "hips", 0.0159 ], [ "kne", 0.0085 ], [ "ligaments", 0.0085 ] ], "spread_patient": [ [ "knee", 0.3425 ], [ "pat", 0.1618 ], [ "knees", 0.126 ], [ "meniscus", 0.1112 ], [ "ACL", 0.0981 ], [ "cartilage", 0.0595 ], [ "hip", 0.0133 ], [ "kne", 0.0103 ], [ "medial", 0.0091 ], [ "hips", 0.0091 ] ], "target_token": "knee", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null }, "qwen3-4b": { "prob_clinical": 0.9139, "prob_patient": 0.9631, "language_penalty": 0.0492, "anchor_fallback": false, "top_clinical": [ "knee", 0.9139 ], "top_patient": [ "knee", 0.9631 ], "spread_clinical": [ [ "knee", 0.9139 ], [ "knees", 0.0313 ], [ "pat", 0.0102 ], [ "kne", 0.0079 ], [ "cart", 0.0062 ], [ "joint", 0.0051 ], [ "ACL", 0.0048 ], [ "joints", 0.0045 ], [ "hip", 0.0035 ], [ "orth", 0.0011 ] ], "spread_patient": [ [ "knee", 0.9631 ], [ "knees", 0.0227 ], [ "kne", 0.0027 ], [ "joints", 0.0016 ], [ "ACL", 0.0015 ], [ "joint", 0.0015 ], [ "pat", 0.0011 ], [ "hip", 0.0011 ], [ "orth", 0.0005 ], [ "cart", 0.0004 ] ], "target_token": "knee", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null }, "qwen3-1.7b": { "prob_clinical": 0.2805, "prob_patient": 0.2721, "language_penalty": -0.0084, "anchor_fallback": false, "top_clinical": [ "X", 0.3178 ], "top_patient": [ "X", 0.3494 ], "spread_clinical": [ [ "X", 0.3178 ], [ "knee", 0.2805 ], [ "knees", 0.1928 ], [ "x", 0.0487 ], [ "kne", 0.0335 ], [ "MRI", 0.0158 ], [ "joints", 0.0096 ], [ "bones", 0.0085 ], [ "doctor", 0.0085 ], [ "cart", 0.0085 ] ], "spread_patient": [ [ "X", 0.3494 ], [ "knee", 0.2721 ], [ "knees", 0.1286 ], [ "x", 0.0884 ], [ "MRI", 0.078 ], [ "xr", 0.0106 ], [ "kne", 0.0082 ], [ "leg", 0.0056 ], [ "doctor", 0.005 ], [ "joint", 0.0034 ] ], "target_token": "knee", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null } }, "prob_clinical": 0.534, "prob_patient": 0.622, "language_penalty": 0.08799999999999997, "flipped": false, "top_clinical": [ "knee", 0.534 ], "top_patient": [ "knee", 0.622 ], "spread_clinical": [ [ "knee", 0.534 ], [ "knees", 0.14 ], [ "pat", 0.057 ], [ "hips", 0.027 ], [ "hip", 0.026 ] ], "spread_patient": [ [ "knee", 0.622 ], [ "knees", 0.148 ], [ "pat", 0.062 ], [ "ACL", 0.018 ], [ "kne", 0.016 ] ], "target_token": "knee", "anchor_fallback": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " knee", "observed_clinical": [ "Output \" knee\"", 0.534 ], "probe_extension": null }, "circuit_diff": { "shared_features": 920, "unique_to_a": 480, "unique_to_b": 361 }, "clinical_mass": { "clinical": 0.3637, "patient": 0.3541 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260710T092635Z/index_43.html" }, { "index": 354, "batch": "pairs_20260710T092635Z", "batch_index": 44, "clinical_prompt": "When I'm at the bar with friends, I sometimes experience alcohol-induced amnesia and can't remember what happened, so I'm starting to worry about my", "patient_prompt": "When I'm at the bar with friends, I sometimes black out and can't remember what happened, so I'm starting to worry about my", "intended_target": "drinking", "rationale": "The clinical framing makes the condition sound more medically serious, steering the model toward health/liver concerns rather than treating it as a casual social issue.", "patient_term": "black out", "clinical_term": "experience alcohol-induced amnesia", "topic": "substance use disorder", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": 0.186, "prob_patient": 0.263, "language_penalty": 0.07700000000000001, "anchor_fallback": false, "top_clinical": [ "memory", 0.244 ], "top_patient": [ "drinking", 0.263 ], "spread_clinical": [ [ "memory", 0.244 ], [ "drinking", 0.186 ], [ "health", 0.066 ], [ "future", 0.048 ], [ "brain", 0.038 ] ], "spread_patient": [ [ "drinking", 0.263 ], [ "memory", 0.213 ], [ "health", 0.109 ], [ "alcohol", 0.041 ], [ "future", 0.031 ] ], "target_token": "drinking", "flipped": true, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " drinking", "observed_clinical": [ "Output \" drinking\"", 0.186 ], "probe_extension": null }, "circuit_diff": { "shared_features": 1051, "unique_to_a": 427, "unique_to_b": 399 }, "clinical_mass": { "clinical": 0.1641, "patient": 0.1722 }, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, "gemma-3-4b-it": { "prob_clinical": 0.6636, "prob_patient": 0.6693, "language_penalty": 0.0057, "anchor_fallback": false, "top_clinical": [ "drinking", 0.6636 ], "top_patient": [ "drinking", 0.6693 ], "spread_clinical": [ [ "drinking", 0.6636 ], [ "safety", 0.2154 ], [ "alcohol", 0.0617 ], [ "health", 0.0095 ], [ "memory", 0.0095 ], [ "behavior", 0.0057 ], [ "sobriety", 0.0035 ], [ "ability", 0.0027 ], [ "potential", 0.0016 ], [ "future", 0.0015 ] ], "spread_patient": [ [ "drinking", 0.6693 ], [ "alcohol", 0.2462 ], [ "safety", 0.0623 ], [ "excessive", 0.0045 ], [ "health", 0.004 ], [ "sobriety", 0.0017 ], [ "liver", 0.0015 ], [ "consumption", 0.0013 ], [ "level", 0.0011 ], [ "risk", 0.0009 ] ], "target_token": "drinking", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null }, "qwen3-4b": { "prob_clinical": 0.026, "prob_patient": 0.0505, "language_penalty": 0.0245, "anchor_fallback": false, "top_clinical": [ "memory", 0.6711 ], "top_patient": [ "health", 0.7906 ], "spread_clinical": [ [ "memory", 0.6711 ], [ "mental", 0.0908 ], [ "health", 0.0707 ], [ "brain", 0.0379 ], [ "safety", 0.0334 ], [ "drinking", 0.026 ], [ "ability", 0.0108 ], [ "condition", 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"circuit_diff": { "shared_features": 1051, "unique_to_a": 427, "unique_to_b": 399 }, "clinical_mass": { "clinical": 0.1641, "patient": 0.1722 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260710T092635Z/index_44.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, { "index": 355, "batch": "pairs_20260710T092635Z", "batch_index": 45, "clinical_prompt": "I've been experiencing dysuria, so I definitely need to take my", "patient_prompt": "I've been getting this awful burning feeling when I go to the bathroom, so I definitely need to take my", "intended_target": "antibiotics", "rationale": "The clinical term 'dysuria' immediately signals infection requiring treatment, whereas the colloquial version might be interpreted as something minor or environmental; the model should show different next-token preferences for treatment urgency.", "patient_term": "burning feeling when I go to the bathroom", "clinical_term": "dysuria", "topic": "urinary tract infection", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": 0.146, "prob_patient": null, "language_penalty": null, "anchor_fallback": false, "top_clinical": [ "antibiotics", 0.146 ], "top_patient": [ "meds", 0.053 ], "spread_clinical": [ [ "antibiotics", 0.146 ], [ "meds", 0.115 ], [ "medicine", 0.058 ], [ "medication", 0.05 ], [ "antibiotic", 0.041 ] ], "spread_patient": [ [ "meds", 0.053 ], [ "time", 0.05 ], [ "vitamins", 0.047 ], [ "daily", 0.04 ], [ "medicine", 0.036 ] ], "target_token": "antibiotics", "flipped": true, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " antibiotics", "observed_clinical": [ "Output \" antibiotics\"", 0.146 ], "probe_extension": null }, "circuit_diff": { "shared_features": 685, "unique_to_a": 777, "unique_to_b": 792 }, "clinical_mass": { "clinical": 0.3629, "patient": 0.2501 }, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": 1, "tier_shift": -0.155 } }, "gemma-3-4b-it": { "prob_clinical": 0.0, "prob_patient": 0.0, "language_penalty": 0.0, "anchor_fallback": false, "top_clinical": [ "health", 0.5052 ], "top_patient": [ "health", 0.4889 ], "spread_clinical": [ [ "health", 0.5052 ], [ "symptoms", 0.1277 ], [ "medical", 0.0532 ], [ "concerns", 0.0415 ], [ "urinary", 0.0252 ], [ "chances", 0.0196 ], [ "situation", 0.0196 ], [ "pain", 0.0143 ], [ "dog", 0.0098 ], [ "condition", 0.0087 ] ], "spread_patient": [ [ "health", 0.4889 ], [ "symptoms", 0.0455 ], [ "bathroom", 0.0455 ], [ "bowels", 0.0401 ], [ "butt", 0.0243 ], [ "child", 0.0215 ], [ "bowel", 0.0215 ], [ "digestive", 0.0157 ], [ "dog", 0.0139 ], [ "condition", 0.0122 ] ], "target_token": "antibiotics", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null }, "qwen3-4b": { "prob_clinical": 0.0257, "prob_patient": 0.0033, "language_penalty": -0.0224, "anchor_fallback": false, "top_clinical": [ "time", 0.2291 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[ "medication", 0.0239 ], [ "first", 0.0211 ], [ "UT", 0.0211 ], [ "bladder", 0.0186 ], [ "health", 0.0186 ] ], "spread_patient": [ [ "time", 0.7764 ], [ "bow", 0.0234 ], [ "bladder", 0.0161 ], [ "meds", 0.0125 ], [ "symptoms", 0.0111 ], [ "medication", 0.0098 ], [ "pH", 0.0076 ], [ "vitamins", 0.0052 ], [ "test", 0.0052 ], [ "pill", 0.0052 ] ], "target_token": "antibiotics", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null } }, "prob_clinical": 0.146, "prob_patient": null, "language_penalty": null, "flipped": true, "top_clinical": [ "antibiotics", 0.146 ], "top_patient": [ "meds", 0.053 ], "spread_clinical": [ [ "antibiotics", 0.146 ], [ "meds", 0.115 ], [ "medicine", 0.058 ], [ "medication", 0.05 ], [ "antibiotic", 0.041 ] ], "spread_patient": [ [ "meds", 0.053 ], [ "time", 0.05 ], [ "vitamins", 0.047 ], [ "daily", 0.04 ], [ "medicine", 0.036 ] ], "target_token": "antibiotics", "anchor_fallback": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " antibiotics", "observed_clinical": [ "Output \" antibiotics\"", 0.146 ], "probe_extension": null }, "circuit_diff": { "shared_features": 685, "unique_to_a": 777, "unique_to_b": 792 }, "clinical_mass": { "clinical": 0.3629, "patient": 0.2501 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260710T092635Z/index_45.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": 1, "tier_shift": -0.155 } }, { "index": 356, "batch": "pairs_20260710T092635Z", "batch_index": 46, "clinical_prompt": "I'm experiencing fasciculations, so I should probably take my", "patient_prompt": "I've been getting these weird muscle twitches that come and go, so I should probably take my", "intended_target": "medication", "rationale": "The clinical term 'fasciculations' triggers medical-grade supplementation or medication (magnesium, prescription), while the colloquial 'muscle twitches' suggests over-the-counter remedies (vitamins). The frame funnels toward a substance category where the model's choice reflects whether it interprets the symptom as serious or benign.", "patient_term": "weird muscle twitches that come and go", "clinical_term": "fasciculations", "topic": "fasciculations", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": 0.049, "prob_patient": 0.067, "language_penalty": 0.018000000000000002, "anchor_fallback": false, "top_clinical": [ "meds", 0.153 ], "top_patient": [ "meds", 0.196 ], "spread_clinical": [ [ "meds", 0.153 ], [ "supplements", 0.049 ], [ "medication", 0.049 ], [ "own", 0.041 ], [ "vitamins", 0.035 ] ], "spread_patient": [ [ "meds", 0.196 ], [ "medication", 0.067 ], [ "medicine", 0.066 ], [ "blood", 0.065 ], [ "vitamins", 0.042 ] ], "target_token": "medication", "flipped": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " medication", "observed_clinical": [ "Output \" medication\"", 0.049 ], "probe_extension": null }, "circuit_diff": { 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"clinical_mass": null }, "qwen3-4b": { "prob_clinical": 0.1486, "prob_patient": 0.0294, "language_penalty": -0.1192, "anchor_fallback": false, "top_clinical": [ "medication", 0.1486 ], "top_patient": [ "time", 0.2043 ], "spread_clinical": [ [ "medication", 0.1486 ], [ "prescribed", 0.0747 ], [ "ant", 0.0514 ], [ "usual", 0.0453 ], [ "time", 0.0426 ], [ "medications", 0.0353 ], [ "muscle", 0.0275 ], [ "medicine", 0.0258 ], [ "anti", 0.0201 ], [ "blood", 0.0177 ] ], "spread_patient": [ [ "time", 0.2043 ], [ "doctor", 0.1027 ], [ "vitamins", 0.0313 ], [ "pulse", 0.0294 ], [ "medication", 0.0294 ], [ "ant", 0.0276 ], [ "medicine", 0.0244 ], [ "blood", 0.0244 ], [ "chances", 0.0215 ], [ "muscles", 0.0202 ] ], "target_token": "medication", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": 1, "tier_top_patient": null, "tier_shift": 0.488 } }, "qwen3-1.7b": { "prob_clinical": 0.0466, "prob_patient": 0.0176, "language_penalty": -0.029, "anchor_fallback": false, "top_clinical": [ "time", 0.1436 ], "top_patient": [ "vitamin", 0.0893 ], "spread_clinical": [ [ "time", 0.1436 ], [ "medication", 0.0466 ], [ "medications", 0.032 ], [ "vitamin", 0.032 ], [ "supplements", 0.0249 ], [ "pulse", 0.022 ], [ "symptoms", 0.022 ], [ "potassium", 0.0194 ], [ "muscle", 0.0194 ], [ "chances", 0.0171 ] ], "spread_patient": [ [ "vitamin", 0.0893 ], [ "blood", 0.0614 ], [ "pulse", 0.0422 ], [ "potassium", 0.0422 ], [ "symptoms", 0.0372 ], [ "vitamins", 0.0328 ], [ "supplements", 0.0226 ], [ "magnesium", 0.0199 ], [ "muscle", 0.0199 ], [ "calcium", 0.0199 ] ], "target_token": "medication", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": 1, "tier_shift": null } } }, "prob_clinical": 0.049, "prob_patient": 0.067, "language_penalty": 0.018000000000000002, "flipped": false, "top_clinical": [ "meds", 0.153 ], "top_patient": [ "meds", 0.196 ], "spread_clinical": [ [ "meds", 0.153 ], [ "supplements", 0.049 ], [ "medication", 0.049 ], [ "own", 0.041 ], [ "vitamins", 0.035 ] ], "spread_patient": [ [ "meds", 0.196 ], [ "medication", 0.067 ], [ "medicine", 0.066 ], [ "blood", 0.065 ], [ "vitamins", 0.042 ] ], "target_token": "medication", "anchor_fallback": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " medication", "observed_clinical": [ "Output \" medication\"", 0.049 ], "probe_extension": null }, "circuit_diff": { "shared_features": 745, "unique_to_a": 622, "unique_to_b": 706 }, "clinical_mass": { "clinical": 0.2958, "patient": 0.2917 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260710T092635Z/index_46.html", "urgency": { "flip_class": null, "tier_top_clinical": 1, "tier_top_patient": 1, "tier_shift": 0.149 } }, { "index": 357, "batch": "pairs_20260710T092635Z", "batch_index": 47, "clinical_prompt": "I'm experiencing lower-limb weakness and gait instability, so I might need a", "patient_prompt": "When I walk around the neighborhood, my legs feel like they're going to give out, so I might need a", "intended_target": "walker", "rationale": "The clinical phrasing 'lower-limb weakness and gait instability' invokes assistive medical devices, while the colloquial symptom report 'legs feel like they're going to give out' might invite more casual interpretations (rest, exercise). The frame's grammatical structure ('might need a') makes the model predict the category of aid, and the clinical term should shift preference toward recognized mobility aids.", "patient_term": "legs feel like they're going to give out", "clinical_term": "lower-limb weakness and gait instability", "topic": "lower-limb weakness", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": 0.17, "prob_patient": 0.115, "language_penalty": -0.05500000000000001, "anchor_fallback": false, "top_clinical": [ "cane", 0.22 ], "top_patient": [ "cane", 0.225 ], "spread_clinical": [ [ "cane", 0.22 ], [ "walker", 0.17 ], [ "wheelchair", 0.128 ], [ "walking", 0.094 ], [ "brace", 0.023 ] ], "spread_patient": [ [ "cane", 0.225 ], [ "wheelchair", 0.159 ], [ "walker", 0.115 ], [ "little", 0.064 ], [ "walking", 0.058 ] ], "target_token": "walker", "flipped": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " walker", "observed_clinical": [ "Output \" walker\"", 0.17 ], "probe_extension": null }, "circuit_diff": { "shared_features": 435, "unique_to_a": 942, "unique_to_b": 938 }, "clinical_mass": { "clinical": 0.3642, "patient": 0.1685 } }, "gemma-3-4b-it": { "prob_clinical": 0.0241, "prob_patient": 0.001, "language_penalty": -0.0231, "anchor_fallback": false, "top_clinical": [ "physical", 0.2586 ], "top_patient": [ "break", 0.3234 ], "spread_clinical": [ [ "physical", 0.2586 ], [ "referral", 0.2282 ], [ "medical", 0.0654 ], [ "consultation", 0.035 ], [ "specialist", 0.0273 ], [ "more", 0.0273 ], [ "new", 0.0273 ], [ "comprehensive", 0.0241 ], [ "walker", 0.0241 ], [ "neurological", 0.0187 ] ], "spread_patient": [ [ "break", 0.3234 ], [ "little", 0.1528 ], [ "rest", 0.119 ], [ "nap", 0.0637 ], [ "place", 0.0386 ], [ "bit", 0.0341 ], [ "short", 0.0207 ], [ "chair", 0.0182 ], [ "seat", 0.0161 ], [ "longer", 0.0161 ] ], "target_token": "walker", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "downgrade", "tier_top_clinical": 3, "tier_top_patient": 0, "tier_shift": -3.0 } }, "qwen3-4b": { "prob_clinical": 0.0351, "prob_patient": 0.0179, "language_penalty": -0.0172, "anchor_fallback": false, "top_clinical": [ "walking", 0.3326 ], "top_patient": [ "cane", 0.7591 ], "spread_clinical": [ [ "walking", 0.3326 ], [ "cane", 0.2935 ], [ "brace", 0.0953 ], [ "physical", 0.0655 ], [ "mobility", 0.051 ], [ "walker", 0.0351 ], [ "g", 0.0351 ], [ "lower", 0.0166 ], [ "medical", 0.01 ], [ "wheelchair", 0.0069 ] ], "spread_patient": [ [ "cane", 0.7591 ], [ "wheelchair", 0.1164 ], [ "walking", 0.0428 ], [ "walker", 0.0179 ], [ "mobility", 0.0108 ], [ "medical", 0.0066 ], [ "leg", 0.0054 ], [ "chair", 0.0054 ], [ "\u62d0", 0.0033 ], [ "prost", 0.0014 ] ], "target_token": "walker", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": 0, "tier_top_patient": null, "tier_shift": null } }, "qwen3-1.7b": { "prob_clinical": 0.0186, "prob_patient": 0.0662, "language_penalty": 0.0476, "anchor_fallback": false, "top_clinical": [ "wheelchair", 0.1557 ], "top_patient": [ "wheelchair", 0.2618 ], "spread_clinical": [ [ "wheelchair", 0.1557 ], [ "g", 0.1374 ], [ "walking", 0.0506 ], [ "neuro", 0.0446 ], [ "pro", 0.0348 ], [ "lower", 0.0348 ], [ "knee", 0.0348 ], [ "hip", 0.0307 ], [ "total", 0.0307 ], [ "neu", 0.0239 ] ], "spread_patient": [ [ "wheelchair", 0.2618 ], [ "cane", 0.2618 ], [ "walking", 0.1401 ], [ "walker", 0.0662 ], [ "leg", 0.0167 ], [ "support", 0.0148 ], [ "prost", 0.0115 ], [ "st", 0.0115 ], [ "knee", 0.009 ], [ "power", 0.007 ] ], "target_token": "walker", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null } }, "prob_clinical": 0.17, "prob_patient": 0.115, "language_penalty": -0.05500000000000001, "flipped": false, "top_clinical": [ "cane", 0.22 ], "top_patient": [ "cane", 0.225 ], "spread_clinical": [ [ "cane", 0.22 ], [ "walker", 0.17 ], [ 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diagnosis shifts the frame toward cardiac risk concern. 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The construction 'so I've been taking a' probes for medication-class words; clinical framing biases toward 'medication' or drug names, patient framing toward lifestyle changes.", "patient_term": "stressed out", "clinical_term": "hypertension", "topic": "hypertension", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": 0.101, "prob_patient": null, "language_penalty": null, "anchor_fallback": false, "top_clinical": [ "lot", 0.112 ], "top_patient": [ "lot", 0.128 ], "spread_clinical": [ [ "lot", 0.112 ], [ "medication", 0.101 ], [ "blood", 0.096 ], [ "beta", 0.061 ], [ "drug", 0.048 ] ], "spread_patient": [ [ "lot", 0.128 ], [ "daily", 0.092 ], [ "blood", 0.073 ], [ "few", 0.044 ], [ "little", 0.043 ] ], "target_token": "medication", "flipped": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " medication", "observed_clinical": [ "Output \" medication\"", 0.101 ], "probe_extension": null }, "circuit_diff": { "shared_features": 855, "unique_to_a": 423, "unique_to_b": 481 }, "clinical_mass": { "clinical": 0.3675, "patient": 0.271 } }, "gemma-3-4b-it": { "prob_clinical": 0.2085, "prob_patient": 0.0009, "language_penalty": -0.2076, "anchor_fallback": false, "top_clinical": [ "blood", 0.2677 ], "top_patient": [ "daily", 0.2845 ], "spread_clinical": [ [ "blood", 0.2677 ], [ "medication", 0.2085 ], [ "low", 0.1433 ], [ "lot", 0.0677 ], [ "daily", 0.0597 ], [ "high", 0.0282 ], [ "beta", 0.022 ], [ "new", 0.022 ], [ "lower", 0.0194 ], [ "medicine", 0.0194 ] ], "spread_patient": [ [ "daily", 0.2845 ], [ "lot", 0.1955 ], [ "few", 0.1726 ], [ "low", 0.0385 ], [ "blood", 0.034 ], [ "little", 0.0265 ], [ "natural", 0.0182 ], [ "beta", 0.0161 ], [ "variety", 0.0161 ], [ "magnesium", 0.0142 ] ], "target_token": "medication", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "lateral", "tier_top_clinical": 1, "tier_top_patient": 1, "tier_shift": 0.104 } }, "qwen3-4b": { "prob_clinical": 0.0795, "prob_patient": 0.0498, "language_penalty": -0.0297, "anchor_fallback": false, "top_clinical": [ "ml", 0.3564 ], "top_patient": [ "lot", 0.2528 ], "spread_clinical": [ [ "ml", 0.3564 ], [ "di", 0.1907 ], [ "beta", 0.0795 ], [ "medication", 0.0795 ], [ "blood", 0.0546 ], [ "pill", 0.0376 ], [ "daily", 0.0331 ], [ "drug", 0.0293 ], [ "lot", 0.0228 ], [ "medicine", 0.0157 ] ], "spread_patient": [ [ "lot", 0.2528 ], [ "blood", 0.1533 ], [ "beta", 0.093 ], [ "pill", 0.0724 ], [ "daily", 0.0498 ], [ "medication", 0.0498 ], [ "low", 0.0439 ], [ "di", 0.0302 ], [ "ml", 0.0208 ], [ "drug", 0.0172 ] ], "target_token": "medication", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": 1, "tier_shift": -0.307 } }, "qwen3-1.7b": { "prob_clinical": 0.0424, "prob_patient": 0.0232, "language_penalty": -0.0192, "anchor_fallback": false, "top_clinical": [ "lot", 0.4019 ], "top_patient": [ "lot", 0.1717 ], "spread_clinical": [ [ "lot", 0.4019 ], [ "blood", 0.0897 ], [ "ml", 0.0791 ], [ "di", 0.0544 ], [ "medication", 0.0424 ], [ "low", 0.0424 ], [ "drug", 0.033 ], [ "high", 0.0227 ], [ "beta", 0.02 ], [ "pill", 0.0177 ] ], "spread_patient": [ [ "lot", 0.1717 ], [ "low", 0.0811 ], [ "blood", 0.0716 ], [ "ml", 0.0557 ], [ "daily", 0.0434 ], [ "magnesium", 0.0383 ], [ "pill", 0.0298 ], [ "calcium", 0.0263 ], [ "few", 0.0232 ] ], "target_token": "medication", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 1, "tier_top_patient": 1, "tier_shift": -0.033 } } }, "prob_clinical": 0.101, "prob_patient": null, "language_penalty": null, "flipped": false, "top_clinical": [ "lot", 0.112 ], "top_patient": [ "lot", 0.128 ], "spread_clinical": [ [ "lot", 0.112 ], [ "medication", 0.101 ], [ "blood", 0.096 ], [ "beta", 0.061 ], [ "drug", 0.048 ] ], "spread_patient": [ [ "lot", 0.128 ], [ "daily", 0.092 ], [ "blood", 0.073 ], [ "few", 0.044 ], [ "little", 0.043 ] ], "target_token": "medication", "anchor_fallback": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " medication", "observed_clinical": [ "Output \" medication\"", 0.101 ], "probe_extension": null }, "circuit_diff": { "shared_features": 855, "unique_to_a": 423, "unique_to_b": 481 }, "clinical_mass": { "clinical": 0.3675, "patient": 0.271 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260710T133708Z/index_19.html" }, { "index": 378, "batch": "pairs_20260710T133708Z", "batch_index": 20, "clinical_prompt": "I have tinnitus, so my doctor wants me to get my", "patient_prompt": "I've got this ringing in my ears, so my doctor wants me to get my", "intended_target": "hearing", "rationale": "Lay symptom description 'ringing in my ears' swapped for medical term 'tinnitus'. Frame 'wants me to get my' naturally continues with 'hearing' (as in hearing checked/tested) in clinical context; patient phrasing might lead to 'ears examined' or other wordings.", "patient_term": "ringing in my ears", "clinical_term": "tinnitus", "topic": "auditory disorder", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": 0.521, "prob_patient": 0.506, "language_penalty": -0.015000000000000013, "anchor_fallback": false, "top_clinical": [ "hearing", 0.521 ], "top_patient": [ "hearing", 0.506 ], "spread_clinical": [ [ "hearing", 0.521 ], [ "blood", 0.149 ], [ "ears", 0.132 ], [ "eyes", 0.021 ], [ "thyroid", 0.018 ] ], "spread_patient": [ [ "hearing", 0.506 ], [ "ears", 0.262 ], [ "blood", 0.079 ], [ "eyes", 0.015 ], [ "ear", 0.014 ] ], "target_token": "hearing", "flipped": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " hearing", "observed_clinical": [ "Output \" hearing\"", 0.521 ], "probe_extension": null }, "circuit_diff": { "shared_features": 701, "unique_to_a": 491, "unique_to_b": 556 }, "clinical_mass": { "clinical": 0.3285, "patient": 0.2722 } }, "gemma-3-4b-it": { "prob_clinical": 0.9418, "prob_patient": 0.8799, "language_penalty": -0.0619, "anchor_fallback": false, "top_clinical": [ "hearing", 0.9418 ], "top_patient": [ "hearing", 0.8799 ], "spread_clinical": [ [ "hearing", 0.9418 ], [ "ears", 0.0469 ], [ "blood", 0.0018 ], [ "inner", 0.0012 ], [ "vitamin", 0.0012 ], [ "iron", 0.001 ], [ "thyroid", 0.0007 ], [ "Hearing", 0.0006 ], [ "audi", 0.0004 ], [ "eyes", 0.0003 ] ], "spread_patient": [ [ "hearing", 0.8799 ], [ "ears", 0.0637 ], [ "inner", 0.0086 ], [ "blood", 0.0076 ], [ "vitamin", 0.0052 ], [ "audi", 0.0032 ], [ "thyroid", 0.0028 ], [ "eyes", 0.0028 ], [ "tym", 0.0022 ], [ "auditory", 0.0019 ] ], "target_token": "hearing", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null }, "qwen3-4b": { "prob_clinical": 0.6494, "prob_patient": 0.5077, "language_penalty": -0.1417, "anchor_fallback": false, "top_clinical": [ "hearing", 0.6494 ], "top_patient": [ "hearing", 0.5077 ], "spread_clinical": [ [ "hearing", 0.6494 ], [ "ears", 0.2108 ], [ "blood", 0.0879 ], [ "ear", 0.0072 ], [ "cholesterol", 0.0064 ], [ "inner", 0.0036 ], [ "pressure", 0.003 ], [ "auditory", 0.003 ], [ "coch", 0.0018 ], [ "eyes", 0.0014 ] ], "spread_patient": [ [ "hearing", 0.5077 ], [ "ears", 0.4481 ], [ "blood", 0.0197 ], [ "inner", 0.0034 ], [ "ear", 0.0034 ], [ "pressure", 0.0024 ], [ "auditory", 0.0017 ], [ "eyes", 0.001 ], [ "e", 0.001 ], [ "coch", 0.0009 ] ], "target_token": "hearing", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null }, "qwen3-1.7b": { "prob_clinical": 0.7093, "prob_patient": 0.2005, "language_penalty": -0.5088, "anchor_fallback": false, "top_clinical": [ "hearing", 0.7093 ], "top_patient": [ "ears", 0.6175 ], "spread_clinical": [ [ "hearing", 0.7093 ], [ "ears", 0.1088 ], [ "blood", 0.0847 ], [ "ear", 0.0275 ], [ "teeth", 0.0115 ], [ "t", 0.007 ], [ "eyes", 0.0061 ], [ "E", 0.0054 ], [ "cholesterol", 0.0026 ], [ "vision", 0.0026 ] ], "spread_patient": [ [ "ears", 0.6175 ], [ "hearing", 0.2005 ], [ "ear", 0.0836 ], [ "blood", 0.0307 ], [ "head", 0.0211 ], [ "E", 0.0078 ], [ "inner", 0.0061 ], [ "t", 0.0037 ], [ "eyes", 0.0014 ], [ "brain", 0.0014 ] ], "target_token": "hearing", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } } }, "prob_clinical": 0.521, "prob_patient": 0.506, "language_penalty": -0.015000000000000013, "flipped": false, "top_clinical": [ "hearing", 0.521 ], "top_patient": [ "hearing", 0.506 ], "spread_clinical": [ [ "hearing", 0.521 ], [ "blood", 0.149 ], [ "ears", 0.132 ], [ "eyes", 0.021 ], [ "thyroid", 0.018 ] ], "spread_patient": [ [ "hearing", 0.506 ], [ "ears", 0.262 ], [ "blood", 0.079 ], [ "eyes", 0.015 ], [ "ear", 0.014 ] ], "target_token": "hearing", "anchor_fallback": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " hearing", "observed_clinical": [ "Output \" hearing\"", 0.521 ], "probe_extension": null }, "circuit_diff": { "shared_features": 701, "unique_to_a": 491, "unique_to_b": 556 }, "clinical_mass": { "clinical": 0.3285, "patient": 0.2722 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260710T133708Z/index_20.html" }, { "index": 379, "batch": "pairs_20260710T133708Z", "batch_index": 21, "clinical_prompt": "I have stress-induced dermatitis, so I probably need an", "patient_prompt": "My skin breaks out whenever I'm nervous, so I probably need an", "intended_target": "evaluation", "rationale": "Colloquial 'breaks out' (symptom-focused) versus diagnostic term. The 'probably need an' frame probes for medical referral words; clinical phrasing biases toward 'evaluation' or 'appointment', patient phrasing toward 'ointment' or 'cream'.", "patient_term": "breaks out", "clinical_term": "stress-induced dermatitis", "topic": "dermatological condition", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": null, "prob_patient": null, "language_penalty": null, "anchor_fallback": false, "top_clinical": [ "anti", 0.225 ], "top_patient": null, "spread_clinical": [ [ "anti", 0.225 ], [ "emol", 0.075 ], [ "extra", 0.075 ], [ "oatmeal", 0.054 ], [ "oil", 0.049 ] ], "spread_patient": [], "target_token": null, "flipped": false, "screening": { "status": "screened_out", "min_prob": 0.02, "intended_target": " evaluation", "observed_clinical": null, "probe_extension": null, "reason": "intended target not in the traced clinical spread" }, "circuit_diff": null, "clinical_mass": { "clinical": 0.2894 }, "urgency": { "flip_class": null, "tier_top_clinical": 1, "tier_top_patient": 1, "tier_shift": 0.113 } }, "gemma-3-4b-it": { "prob_clinical": 0.0006, "prob_patient": 0.0001, "language_penalty": -0.0005, "anchor_fallback": false, "top_clinical": [ "em", 0.1875 ], "top_patient": [ "intervention", 0.3758 ], "spread_clinical": [ [ "em", 0.1875 ], [ "extra", 0.1875 ], [ "oil", 0.069 ], [ "ointment", 0.0537 ], [ "anti", 0.0537 ], [ "intensive", 0.0418 ], [ "ultra", 0.0369 ], [ "extremely", 0.0326 ], [ "unsc", 0.0326 ], [ "intense", 0.0224 ] ], "spread_patient": [ [ "intervention", 0.3758 ], [ "anti", 0.2583 ], [ "extra", 0.0838 ], [ "anxiety", 0.074 ], [ "appointment", 0.0308 ], [ "attitude", 0.0187 ], [ "emotional", 0.0187 ], [ "expert", 0.0088 ], [ "aromatherapy", 0.0088 ], [ "entire", 0.0078 ] ], "target_token": "evaluation", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": 0.083 } }, "qwen3-4b": { "prob_clinical": 0.0, "prob_patient": 0.0002, "language_penalty": 0.0002, "anchor_fallback": false, "top_clinical": [ "ant", 0.2998 ], "top_patient": [ "ant", 0.6468 ], "spread_clinical": [ [ "ant", 0.2998 ], [ "anti", 0.2646 ], [ "antibiotic", 0.1605 ], [ "over", 0.0316 ], [ "o", 0.0279 ], [ "em", 0.0246 ], [ "alternative", 0.0217 ], [ "oil", 0.0217 ], [ "O", 0.0116 ], [ "ex", 0.0091 ] ], "spread_patient": [ [ "ant", 0.6468 ], [ "anti", 0.1124 ], [ "anxiety", 0.0773 ], [ "alternative", 0.0195 ], [ "effective", 0.0172 ], [ "emotional", 0.0172 ], [ "antibiotic", 0.0152 ], [ "antidepress", 0.0134 ], [ "over", 0.0056 ], [ "emergency", 0.0044 ] ], "target_token": "evaluation", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 1, "tier_top_patient": 1, "tier_shift": -0.16 } }, "qwen3-1.7b": { "prob_clinical": 0.0006, "prob_patient": 0.0001, "language_penalty": -0.0005, "anchor_fallback": false, "top_clinical": [ "ant", 0.5707 ], "top_patient": [ "ant", 0.4962 ], "spread_clinical": [ [ "ant", 0.5707 ], [ "antibiotic", 0.0682 ], [ "anti", 0.0601 ], [ "allergy", 0.0413 ], [ "over", 0.0284 ], [ "antidepress", 0.0221 ], [ "E", 0.0134 ], [ "SPF", 0.0081 ], [ "ep", 0.0081 ], [ "em", 0.0072 ] ], "spread_patient": [ [ "ant", 0.4962 ], [ "anti", 0.2656 ], [ "antidepress", 0.0317 ], [ "acne", 0.028 ], [ "ex", 0.017 ], [ "allergy", 0.017 ], [ "over", 0.015 ], [ "an", 0.0117 ], [ "antibiotic", 0.0091 ], [ "anxiety", 0.0071 ] ], "target_token": "evaluation", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 1, "tier_top_patient": 1, "tier_shift": -0.118 } } }, "prob_clinical": null, "prob_patient": null, "language_penalty": null, "flipped": false, "top_clinical": [ "anti", 0.225 ], "top_patient": null, "spread_clinical": [ [ "anti", 0.225 ], [ "emol", 0.075 ], [ "extra", 0.075 ], [ "oatmeal", 0.054 ], [ "oil", 0.049 ] ], "spread_patient": [], "target_token": null, "anchor_fallback": false, "screening": { "status": "screened_out", "min_prob": 0.02, "intended_target": " evaluation", "observed_clinical": null, "probe_extension": null, "reason": "intended target not in the traced clinical spread" }, "circuit_diff": null, "clinical_mass": { "clinical": 0.2894 }, "urgency": { "flip_class": null, "tier_top_clinical": 1, "tier_top_patient": 1, "tier_shift": 0.113 } }, { "index": 380, "batch": "pairs_20260710T133708Z", "batch_index": 22, "clinical_prompt": "I have chronic fatigue, so I should talk to my", "patient_prompt": "I feel like I'm always running on empty, so I should talk to my", "intended_target": "doctor", "rationale": "Idiom 'running on empty' contrasted with diagnostic label. The ending 'talk to my' funnels toward professional titles; clinical framing strongly biases toward 'doctor', while patient version might suggest lifestyle advice or general wellness discussion.", "patient_term": "running on empty", "clinical_term": "chronic fatigue", "topic": "fatigue disorder", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": 0.644, "prob_patient": 0.654, "language_penalty": 0.010000000000000009, "anchor_fallback": false, "top_clinical": [ "doctor", 0.644 ], "top_patient": [ "doctor", 0.654 ], "spread_clinical": [ [ "doctor", 0.644 ], [ "GP", 0.065 ], [ "doc", 0.052 ], [ "Dr", 0.029 ], [ "doctors", 0.022 ] ], "spread_patient": [ [ "doctor", 0.654 ], [ "GP", 0.053 ], [ "doc", 0.04 ], [ "boss", 0.02 ], [ "therapist", 0.017 ] ], "target_token": "doctor", "flipped": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " doctor", "observed_clinical": [ "Output \" doctor\"", 0.644 ], "probe_extension": null }, "circuit_diff": { "shared_features": 528, "unique_to_a": 552, "unique_to_b": 655 }, "clinical_mass": { "clinical": 0.3715, "patient": 0.19 }, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": 0.022 } }, "gemma-3-4b-it": { "prob_clinical": 0.9331, "prob_patient": 0.9697, "language_penalty": 0.0366, "anchor_fallback": false, "top_clinical": [ "doctor", 0.9331 ], "top_patient": [ "doctor", 0.9697 ], "spread_clinical": [ [ "doctor", 0.9331 ], [ "primary", 0.0133 ], [ "physician", 0.0117 ], [ "healthcare", 0.0081 ], [ "GP", 0.0063 ], [ "Doctor", 0.0032 ], [ "doctors", 0.0026 ], [ "medical", 0.002 ], [ "health", 0.0018 ], [ "family", 0.0016 ] ], "spread_patient": [ [ "doctor", 0.9697 ], [ "Doctor", 0.0058 ], [ "physician", 0.0035 ], [ "GP", 0.0031 ], [ "family", 0.0024 ], [ "primary", 0.0021 ], [ "healthcare", 0.0021 ], [ "doc", 0.0019 ], [ "Dr", 0.001 ], [ "doctors", 0.0008 ] ], "target_token": "doctor", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.002 } }, "qwen3-4b": { "prob_clinical": 0.9005, "prob_patient": 0.4821, "language_penalty": -0.4184, "anchor_fallback": false, "top_clinical": [ "doctor", 0.9005 ], "top_patient": [ "doctor", 0.4821 ], "spread_clinical": [ [ "doctor", 0.9005 ], [ "GP", 0.0308 ], [ "physician", 0.01 ], [ "healthcare", 0.0088 ], [ "health", 0.0065 ], [ "primary", 0.0047 ], [ "therapist", 0.0035 ], [ "family", 0.0027 ], [ "PC", 0.0024 ], [ "doctors", 0.0021 ] ], "spread_patient": [ [ "doctor", 0.4821 ], [ "therapist", 0.3313 ], [ "GP", 0.0272 ], [ "counselor", 0.0165 ], [ "pastor", 0.0073 ], [ "priest", 0.0073 ], [ "psychiatrist", 0.0069 ], [ "spiritual", 0.0069 ], [ "boss", 0.0065 ], [ "supervisor", 0.0061 ] ], "target_token": "doctor", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": 0.413 } }, "qwen3-1.7b": { "prob_clinical": 0.9065, "prob_patient": 0.813, "language_penalty": -0.0935, "anchor_fallback": false, "top_clinical": [ "doctor", 0.9065 ], "top_patient": [ "doctor", 0.813 ], "spread_clinical": [ [ "doctor", 0.9065 ], [ "physician", 0.0213 ], [ "healthcare", 0.0114 ], [ "GP", 0.0101 ], [ "family", 0.0069 ], [ "provider", 0.0054 ], [ "doctors", 0.0054 ], [ "health", 0.0048 ], [ "primary", 0.0048 ], [ "therapist", 0.0025 ] ], "spread_patient": [ [ "doctor", 0.813 ], [ "therapist", 0.0278 ], [ "GP", 0.0217 ], [ "physician", 0.0131 ], [ "friends", 0.008 ], [ "healthcare", 0.008 ], [ "provider", 0.0055 ], [ "coach", 0.0048 ], [ "family", 0.0043 ], [ "parents", 0.0033 ] ], "target_token": "doctor", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": 0.034 } } }, "prob_clinical": 0.644, "prob_patient": 0.654, "language_penalty": 0.010000000000000009, "flipped": false, "top_clinical": [ "doctor", 0.644 ], "top_patient": [ "doctor", 0.654 ], "spread_clinical": [ [ "doctor", 0.644 ], [ "GP", 0.065 ], [ "doc", 0.052 ], [ "Dr", 0.029 ], [ "doctors", 0.022 ] ], "spread_patient": [ [ "doctor", 0.654 ], [ "GP", 0.053 ], [ "doc", 0.04 ], [ "boss", 0.02 ], [ "therapist", 0.017 ] ], "target_token": "doctor", "anchor_fallback": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " doctor", "observed_clinical": [ "Output \" doctor\"", 0.644 ], "probe_extension": null }, "circuit_diff": { "shared_features": 528, "unique_to_a": 552, "unique_to_b": 655 }, "clinical_mass": { "clinical": 0.3715, "patient": 0.19 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260710T133708Z/index_22.html", "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": 0.022 } }, { "index": 381, "batch": "pairs_20260710T133708Z", 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The clinical framing should steer toward specialist consultation, whereas the symptom-based framing might lead to more general responses.", "patient_term": "shooting pains down my leg", "clinical_term": "sciatica", "topic": "neurological pain", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": 0.042, "prob_patient": null, "language_penalty": null, "anchor_fallback": false, "top_clinical": [ "chi", 0.511 ], "top_patient": [ "doctor", 0.644 ], "spread_clinical": [ [ "chi", 0.511 ], [ "doctor", 0.121 ], [ "specialist", 0.062 ], [ "neuro", 0.057 ], [ "physical", 0.042 ] ], "spread_patient": [ [ "doctor", 0.644 ], [ "neuro", 0.069 ], [ "doc", 0.046 ], [ "Dr", 0.037 ], [ "GP", 0.033 ] ], "target_token": "physical", "flipped": true, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " physical therapist", "observed_clinical": [ "Output \" physical\"", 0.042 ], "probe_extension": null }, "circuit_diff": { "shared_features": 501, "unique_to_a": 754, "unique_to_b": 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Probe word 'be' creates open diagnostic space where clinical framing narrows expectations.", "patient_term": "throwing up", "clinical_term": "early morning nausea and vomiting", "topic": "pregnancy", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": 0.78, "prob_patient": 0.799, "language_penalty": 0.019000000000000017, "anchor_fallback": false, "top_clinical": [ "pregnant", 0.78 ], "top_patient": [ "pregnant", 0.799 ], "spread_clinical": [ [ "pregnant", 0.78 ], [ "having", 0.025 ], [ "pg", 0.017 ], [ "sick", 0.015 ], [ "expecting", 0.012 ] ], "spread_patient": [ [ "pregnant", 0.799 ], [ "sick", 0.022 ], [ "preg", 0.019 ], [ "having", 0.016 ], [ "pg", 0.011 ] ], "target_token": "pregnant", "flipped": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " pregnant", "observed_clinical": [ "Output \" pregnant\"", 0.78 ], "probe_extension": null }, "circuit_diff": { "shared_features": 680, "unique_to_a": 555, "unique_to_b": 607 }, "clinical_mass": { "clinical": 0.3076, "patient": 0.284 } }, "gemma-3-4b-it": { "prob_clinical": 0.9621, "prob_patient": 0.0957, "language_penalty": -0.8664, "anchor_fallback": false, "top_clinical": [ "pregnant", 0.9621 ], "top_patient": [ "having", 0.2295 ], "spread_clinical": [ [ "pregnant", 0.9621 ], [ "experiencing", 0.0226 ], [ "having", 0.0039 ], [ "sick", 0.0014 ], [ "suffering", 0.0011 ], [ "early", 0.001 ], [ "getting", 0.001 ], [ "dealing", 0.0009 ], [ "struggling", 0.0008 ], [ "in", 0.0008 ] ], "spread_patient": [ [ "having", 0.2295 ], [ "experiencing", 0.2025 ], [ "suffering", 0.1577 ], [ "developing", 0.1084 ], [ "pregnant", 0.0957 ], [ "struggling", 0.0352 ], [ "getting", 0.0213 ], [ "dehydrated", 0.0188 ], [ "coming", 0.0188 ], [ "a", 0.0147 ] ], "target_token": "pregnant", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, "qwen3-4b": { "prob_clinical": 0.9699, "prob_patient": 0.9818, "language_penalty": 0.0119, "anchor_fallback": false, "top_clinical": [ "pregnant", 0.9699 ], "top_patient": [ "pregnant", 0.9818 ], "spread_clinical": [ [ "pregnant", 0.9699 ], [ "having", 0.0074 ], [ "in", 0.0051 ], [ "getting", 0.0045 ], [ "experiencing", 0.0015 ], [ "\u6000\u5b55", 0.0014 ], [ "preg", 0.001 ], [ "ill", 0.0005 ], [ "on", 0.0004 ], [ "carrying", 0.0004 ] ], "spread_patient": [ [ "pregnant", 0.9818 ], [ "getting", 0.0052 ], [ "having", 0.004 ], [ "in", 0.0017 ], [ "ill", 0.001 ], [ "\u6000\u5b55", 0.001 ], [ "sick", 0.001 ], [ "infected", 0.0004 ], [ "preg", 0.0004 ], [ "on", 0.0004 ] ], "target_token": "pregnant", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null }, "qwen3-1.7b": { "prob_clinical": 0.8002, "prob_patient": 0.6087, "language_penalty": -0.1915, "anchor_fallback": false, "top_clinical": [ "pregnant", 0.8002 ], "top_patient": [ "pregnant", 0.6087 ], "spread_clinical": [ [ "pregnant", 0.8002 ], [ "suffering", 0.058 ], [ "experiencing", 0.0274 ], [ "having", 0.0166 ], [ "in", 0.0114 ], [ "sick", 0.0101 ], [ "getting", 0.0089 ], [ "on", 0.0061 ], [ "a", 0.0054 ], [ "de", 0.0054 ] ], "spread_patient": [ [ "pregnant", 0.6087 ], [ "having", 0.0566 ], [ "suffering", 0.05 ], [ "sick", 0.0441 ], [ "on", 0.0343 ], [ "an", 0.0343 ], [ "in", 0.0267 ], [ "eating", 0.0143 ], [ "a", 0.0126 ], [ "using", 0.0098 ] ], "target_token": "pregnant", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null } }, "prob_clinical": 0.78, "prob_patient": 0.799, "language_penalty": 0.019000000000000017, "flipped": false, "top_clinical": [ "pregnant", 0.78 ], "top_patient": [ "pregnant", 0.799 ], "spread_clinical": [ [ "pregnant", 0.78 ], [ "having", 0.025 ], [ "pg", 0.017 ], [ "sick", 0.015 ], [ "expecting", 0.012 ] ], "spread_patient": [ [ "pregnant", 0.799 ], [ "sick", 0.022 ], [ "preg", 0.019 ], [ "having", 0.016 ], [ "pg", 0.011 ] ], "target_token": "pregnant", "anchor_fallback": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " pregnant", "observed_clinical": [ "Output \" pregnant\"", 0.78 ], "probe_extension": null }, "circuit_diff": { "shared_features": 680, "unique_to_a": 555, "unique_to_b": 607 }, "clinical_mass": { "clinical": 0.3076, "patient": 0.284 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260710T133708Z/index_42.html" }, { "index": 399, "batch": "pairs_20260710T133708Z", "batch_index": 43, "clinical_prompt": "After I eat dairy, I experience lactose intolerance, so I probably need to avoid my", "patient_prompt": "After I eat dairy, my stomach gets all messed up, so I probably need to avoid my", "intended_target": "milk", "rationale": "Patient phrasing is vague digestive complaint; clinical term names condition explicitly, creating clearer expectation of specific dietary avoidance. 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The colloquial phrasing suggests everyday irritation, while the clinical diagnosis signals need for medical intervention\u2014'drops' is the expected next token for dry eye syndrome management.", "patient_term": "eyes are all scratchy and watery", "clinical_term": "dry eye syndrome", "topic": "ophthalmology", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": null, "prob_patient": null, "language_penalty": null, "anchor_fallback": false, "top_clinical": [ "eye", 0.384 ], "top_patient": null, "spread_clinical": [ [ "eye", 0.384 ], [ "contact", 0.071 ], [ "artificial", 0.053 ], [ "contacts", 0.052 ], [ "eyes", 0.041 ] ], "spread_patient": [], "target_token": null, "flipped": false, "screening": { "status": "screened_out", "min_prob": 0.02, "intended_target": " drops", "observed_clinical": null, "probe_extension": null, "reason": "intended target not in the traced clinical spread" }, "circuit_diff": null, "clinical_mass": { "clinical": 0.2849 }, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, "gemma-3-4b-it": { "prob_clinical": 0.003, "prob_patient": 0.0182, "language_penalty": 0.0152, "anchor_fallback": false, "top_clinical": [ "humidifier", 0.4403 ], "top_patient": [ "eye", 0.4695 ], "spread_clinical": [ [ "humidifier", 0.4403 ], [ "eye", 0.3885 ], [ "artificial", 0.041 ], [ "preservative", 0.0319 ], [ "lubricating", 0.0193 ], [ "eyed", 0.0071 ], [ "contact", 0.0063 ], [ "prescription", 0.0063 ], [ "contacts", 0.0055 ], [ "humid", 0.0049 ] ], "spread_patient": [ [ "eye", 0.4695 ], [ "contacts", 0.1957 ], [ "contact", 0.072 ], [ "eyed", 0.0635 ], [ "humidifier", 0.034 ], [ "drops", 0.0182 ], [ "glasses", 0.0182 ], [ "artificial", 0.0142 ], [ "saline", 0.0125 ], [ "lubricating", 0.011 ] ], "target_token": "drops", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": 1, "tier_top_patient": null, "tier_shift": null } }, "qwen3-4b": { "prob_clinical": 0.0122, "prob_patient": 0.0029, "language_penalty": -0.0093, "anchor_fallback": false, "top_clinical": [ "eye", 0.3345 ], "top_patient": [ "eye", 0.3128 ], "spread_clinical": [ [ "eye", 0.3345 ], [ "contact", 0.1791 ], [ "prescribed", 0.1231 ], [ "pres", 0.0746 ], [ "artificial", 0.0513 ], [ "eyed", 0.04 ], [ "eyel", 0.0353 ], [ "contacts", 0.0311 ], [ "blink", 0.013 ], [ "drops", 0.0122 ] ], "spread_patient": [ [ "eye", 0.3128 ], [ "contact", 0.3128 ], [ "contacts", 0.1674 ], [ "eyed", 0.0544 ], [ "eyes", 0.0423 ], [ "glasses", 0.0094 ], [ "eyel", 0.0089 ], [ "Contact", 0.0069 ], [ "tears", 0.0061 ], [ "sunglasses", 0.0061 ] ], "target_token": "drops", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null }, "qwen3-1.7b": { "prob_clinical": 0.0002, "prob_patient": 0.0003, "language_penalty": 0.0001, "anchor_fallback": false, "top_clinical": [ "eyes", 0.2485 ], "top_patient": [ "glasses", 0.6496 ], "spread_clinical": [ [ "eyes", 0.2485 ], [ "eye", 0.2193 ], [ "computer", 0.0807 ], [ "glasses", 0.0628 ], [ "contacts", 0.0554 ], [ "phone", 0.0554 ], [ "contact", 0.0262 ], [ "right", 0.0231 ], [ "eyel", 0.0204 ], [ "artificial", 0.018 ] ], "spread_patient": [ [ "glasses", 0.6496 ], [ "contacts", 0.0604 ], [ "computer", 0.0471 ], [ "eye", 0.0285 ], [ "eyes", 0.0222 ], [ "sunglasses", 0.0173 ], [ "contact", 0.0135 ], [ "phone", 0.0105 ], [ "left", 0.0093 ], [ "bin", 0.0082 ] ], "target_token": "drops", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } } }, "prob_clinical": null, "prob_patient": null, "language_penalty": null, "flipped": false, "top_clinical": [ "eye", 0.384 ], "top_patient": null, "spread_clinical": [ [ "eye", 0.384 ], [ "contact", 0.071 ], [ "artificial", 0.053 ], [ "contacts", 0.052 ], [ "eyes", 0.041 ] ], "spread_patient": [], "target_token": null, "anchor_fallback": false, "screening": { "status": "screened_out", "min_prob": 0.02, "intended_target": " drops", "observed_clinical": null, "probe_extension": null, "reason": "intended target not in the traced clinical spread" }, "circuit_diff": null, "clinical_mass": { "clinical": 0.2849 }, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, { "index": 401, "batch": "pairs_20260710T133708Z", "batch_index": 46, "clinical_prompt": "After I work out, I get this exercise-related transient abdominal pain in my side, so my trainer says I might have a", "patient_prompt": "After I work out, I get this stabbing pain in my side, so my trainer says I might have a", "intended_target": "stitch", "rationale": "The frame ends at the diagnostic article, leaving room for a condition name. Colloquial 'stabbing pain' suggests alarm; clinical terminology ('ETAP') normalizes it as a benign, well-understood phenomenon\u2014model should predict more mundane continuations like 'stitch'.", "patient_term": "stabbing pain in my side", "clinical_term": "exercise-related transient abdominal pain", "topic": "musculoskeletal", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": null, "prob_patient": null, "language_penalty": null, "anchor_fallback": false, "top_clinical": [ "hernia", 0.192 ], "top_patient": null, "spread_clinical": [ [ "hernia", 0.192 ], [ "hi", 0.071 ], [ "muscle", 0.066 ], [ "kidney", 0.054 ], [ "her", 0.044 ] ], "spread_patient": [], "target_token": null, "flipped": false, "screening": { "status": "screened_out", "min_prob": 0.02, "intended_target": " stitch", "observed_clinical": null, "probe_extension": null, "reason": "intended target not in the traced clinical spread" }, "circuit_diff": null, "clinical_mass": { "clinical": 0.424 }, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, "gemma-3-4b-it": { "prob_clinical": 0.0001, "prob_patient": 0.0, "language_penalty": -0.0001, "anchor_fallback": false, "top_clinical": [ "sensitivity", 0.16 ], "top_patient": [ "strained", 0.2427 ], "spread_clinical": [ [ "sensitivity", 0.16 ], [ "sensitive", 0.16 ], [ "condition", 0.1246 ], [ "mild", 0.0667 ], [ "small", 0.0519 ], [ "gastro", 0.0404 ], [ "little", 0.0404 ], [ "problem", 0.0278 ], [ "weak", 0.0216 ], [ "hernia", 0.0191 ] ], "spread_patient": [ [ "strained", 0.2427 ], [ "pulled", 0.189 ], [ "muscle", 0.1472 ], [ "hernia", 0.1147 ], [ "kidney", 0.0478 ], [ "rotator", 0.0372 ], [ "side", 0.0256 ], [ "trapped", 0.0226 ], [ "cost", 0.0155 ], [ "pinched", 0.0107 ] ], "target_token": "stitch", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, "qwen3-4b": { "prob_clinical": 0.0017, "prob_patient": 0.0011, "language_penalty": -0.0006, "anchor_fallback": false, "top_clinical": [ "di", 0.2471 ], "top_patient": [ "pulled", 0.6746 ], "spread_clinical": [ [ "di", 0.2471 ], [ "problem", 0.1924 ], [ "hi", 0.1499 ], [ "\"", 0.0625 ], [ "stomach", 0.0551 ], [ "gas", 0.0203 ], [ "condition", 0.0139 ], [ "muscle", 0.0123 ], [ "side", 0.0109 ], [ "hern", 0.009 ] ], "spread_patient": [ [ "pulled", 0.6746 ], [ "torn", 0.0336 ], [ "problem", 0.0296 ], [ "kidney", 0.0262 ], [ "muscle", 0.0262 ], [ "hern", 0.0262 ], [ "di", 0.0204 ], [ "stomach", 0.018 ], [ "hi", 0.0109 ], [ "pin", 0.0096 ] ], "target_token": "stitch", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, "qwen3-1.7b": { "prob_clinical": 0.0002, "prob_patient": 0.0002, "language_penalty": 0.0, "anchor_fallback": false, "top_clinical": [ "muscle", 0.1233 ], "top_patient": [ "heart", 0.3238 ], "spread_clinical": [ [ "muscle", 0.1233 ], [ "hern", 0.0748 ], [ "heart", 0.066 ], [ "problem", 0.066 ], [ "condition", 0.066 ], [ "muscular", 0.04 ], [ "side", 0.0312 ], [ "sports", 0.0214 ], [ "\"", 0.0189 ], [ "kidney", 0.0189 ] ], "spread_patient": [ [ "heart", 0.3238 ], [ "muscle", 0.2858 ], [ "side", 0.0723 ], [ "pulled", 0.0387 ], [ "bru", 0.0341 ], [ "hern", 0.0341 ], [ "kidney", 0.0266 ], [ "muscular", 0.0207 ], [ "problem", 0.0142 ], [ "rib", 0.0086 ] ], "target_token": "stitch", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } } }, "prob_clinical": null, "prob_patient": null, "language_penalty": null, "flipped": false, "top_clinical": [ "hernia", 0.192 ], "top_patient": null, "spread_clinical": [ [ "hernia", 0.192 ], [ "hi", 0.071 ], [ "muscle", 0.066 ], [ "kidney", 0.054 ], [ "her", 0.044 ] ], "spread_patient": [], "target_token": null, "anchor_fallback": false, "screening": { "status": "screened_out", "min_prob": 0.02, "intended_target": " stitch", "observed_clinical": null, "probe_extension": null, "reason": "intended target not in the traced clinical spread" }, "circuit_diff": null, "clinical_mass": { "clinical": 0.424 }, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, { "index": 402, "batch": "pairs_20260710T133708Z", "batch_index": 47, "clinical_prompt": "I have mild cognitive impairment, so I should probably get my", "patient_prompt": "My memory's been really fuzzy lately, so I should probably get my", "intended_target": "cognition", "rationale": "The frame 'get my [noun]' is grammatically open. Colloquial phrasing suggests normal forgetfulness; clinical diagnosis signals a medical workup. Model should favor clinical nouns like 'cognition' or 'brain' after the clinical term.", "patient_term": "memory's been really fuzzy", "clinical_term": "mild cognitive impairment", "topic": "neurology", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": null, "prob_patient": null, "language_penalty": null, "anchor_fallback": false, "top_clinical": [ "head", 0.125 ], "top_patient": null, "spread_clinical": [ [ "head", 0.125 ], [ "affairs", 0.111 ], [ "brain", 0.111 ], [ "memory", 0.055 ], [ "act", 0.043 ] ], "spread_patient": [], "target_token": null, "flipped": false, "screening": { "status": "screened_out", "min_prob": 0.02, "intended_target": " cognition", "observed_clinical": null, "probe_extension": null, "reason": "intended target not in the traced clinical spread" }, "circuit_diff": null, "clinical_mass": { "clinical": 0.2246 } }, "gemma-3-4b-it": { "prob_clinical": 0.0025, "prob_patient": 0.0003, "language_penalty": -0.0022, "anchor_fallback": false, "top_clinical": [ "blood", 0.1724 ], "top_patient": [ "blood", 0.3394 ], "spread_clinical": [ [ "blood", 0.1724 ], [ "cognitive", 0.1185 ], [ "hearing", 0.0923 ], [ "memory", 0.0814 ], [ "brain", 0.0634 ], [ "head", 0.0361 ], [ "vitamin", 0.03 ], [ "doctor", 0.0264 ], [ "baseline", 0.0182 ], [ "affairs", 0.0171 ] ], "spread_patient": [ [ "blood", 0.3394 ], [ "hearing", 0.1817 ], [ "cognitive", 0.0668 ], [ "vitamin", 0.059 ], [ "brain", 0.0459 ], [ "vision", 0.0358 ], [ "levels", 0.0279 ], [ "Vitamin", 0.0279 ], [ "eyesight", 0.0246 ], [ "thyroid", 0.0169 ] ], "target_token": "cognition", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.073 } }, "qwen3-4b": { "prob_clinical": 0.0077, "prob_patient": 0.0005, "language_penalty": -0.0072, "anchor_fallback": false, "top_clinical": [ "memory", 0.1859 ], "top_patient": [ "memory", 0.7 ], "spread_clinical": [ [ "memory", 0.1859 ], [ "eyes", 0.1641 ], [ "hearing", 0.0684 ], [ "brain", 0.0604 ], [ "cognitive", 0.047 ], [ "blood", 0.0222 ], [ "cholesterol", 0.0209 ], [ "car", 0.0162 ], [ "annual", 0.0143 ], [ "ears", 0.0143 ] ], "spread_patient": [ [ "memory", 0.7 ], [ "head", 0.1073 ], [ "brain", 0.0947 ], [ "eyes", 0.0145 ], [ "facts", 0.01 ], [ "mind", 0.0094 ], [ "memories", 0.0078 ], [ "glasses", 0.003 ], [ "cognitive", 0.0025 ], [ "things", 0.0025 ] ], "target_token": "cognition", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null }, "qwen3-1.7b": { "prob_clinical": 0.0044, "prob_patient": 0.0001, "language_penalty": -0.0043, "anchor_fallback": false, "top_clinical": [ "blood", 0.2102 ], "top_patient": [ "memory", 0.6746 ], "spread_clinical": [ [ "blood", 0.2102 ], [ "memory", 0.1855 ], [ "cholesterol", 0.0682 ], [ "vision", 0.0469 ], [ "brain", 0.0469 ], [ "eyes", 0.0414 ], [ "cognitive", 0.0322 ], [ "head", 0.0222 ], [ "vitamin", 0.0173 ], [ "A", 0.0173 ] ], "spread_patient": [ [ "memory", 0.6746 ], [ "brain", 0.0913 ], [ "head", 0.0489 ], [ "memories", 0.0381 ], [ "eyes", 0.0262 ], [ "mind", 0.0231 ], [ "blood", 0.0058 ], [ "doctor", 0.0045 ], [ "thoughts", 0.0045 ], [ "[", 0.0024 ] ], "target_token": "cognition", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": 2, "tier_top_patient": null, "tier_shift": null } } }, "prob_clinical": null, "prob_patient": null, "language_penalty": null, "flipped": false, "top_clinical": [ "head", 0.125 ], "top_patient": null, "spread_clinical": [ [ "head", 0.125 ], [ "affairs", 0.111 ], [ "brain", 0.111 ], [ "memory", 0.055 ], [ "act", 0.043 ] ], "spread_patient": [], "target_token": null, "anchor_fallback": false, "screening": { "status": "screened_out", "min_prob": 0.02, "intended_target": " cognition", "observed_clinical": null, "probe_extension": null, "reason": "intended target not in the traced clinical spread" }, "circuit_diff": null, "clinical_mass": { "clinical": 0.2246 } }, { "index": 403, "batch": "pairs_20260710T133708Z", "batch_index": 49, "clinical_prompt": "I have dry eye syndrome, so I should use my", "patient_prompt": "My eyes feel gritty and uncomfortable, so I should use my", "intended_target": "drops", "rationale": "The frame 'should use my [noun]' naturally funnels toward a remedy. 'Gritty and uncomfortable' is lay symptom language; 'dry eye syndrome' is the clinical diagnosis. Both phrases end after the possessive, leaving the next token (drops/lubricant) as the diagnostic probe. A small model should strongly prefer 'drops' after the clinical term, as it is a high-frequency, common treatment word in medical contexts.", "patient_term": "gritty and uncomfortable", "clinical_term": "dry eye syndrome", "topic": "ophthalmology", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": 0.046, "prob_patient": 0.042, "language_penalty": -0.003999999999999997, "anchor_fallback": false, "top_clinical": [ "eye", 0.288 ], "top_patient": [ "eye", 0.225 ], "spread_clinical": [ [ "eye", 0.288 ], [ "artificial", 0.054 ], [ "prescription", 0.052 ], [ "drops", 0.046 ], [ "contact", 0.043 ] ], "spread_patient": [ [ "eye", 0.225 ], [ "contacts", 0.114 ], [ "contact", 0.101 ], [ "artificial", 0.043 ], [ "drops", 0.042 ] ], "target_token": "drops", "flipped": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " drops", "observed_clinical": [ "Output \" drops\"", 0.046 ], "probe_extension": null }, "circuit_diff": { "shared_features": 497, "unique_to_a": 717, "unique_to_b": 665 }, "clinical_mass": { "clinical": 0.2882, "patient": 0.2544 } }, "gemma-3-4b-it": { "prob_clinical": 0.0046, "prob_patient": 0.0058, "language_penalty": 0.0012, "anchor_fallback": false, "top_clinical": [ "eye", 0.4114 ], "top_patient": [ "eye", 0.407 ], "spread_clinical": [ [ "eye", 0.4114 ], [ "humidifier", 0.2495 ], [ "preservative", 0.0631 ], [ "artificial", 0.0557 ], [ "prescription", 0.0232 ], [ "contact", 0.016 ], [ "own", 0.0141 ], [ "contacts", 0.0141 ], [ "lubricating", 0.0124 ], [ "eyed", 0.011 ] ], "spread_patient": [ [ "eye", 0.407 ], [ "artificial", 0.1321 ], [ "contact", 0.0908 ], [ "contacts", 0.0908 ], [ "eyed", 0.0551 ], [ "lubricating", 0.0379 ], [ "humidifier", 0.023 ], [ "glasses", 0.0179 ], [ "lubricant", 0.0158 ], [ "eyes", 0.0139 ] ], "target_token": "drops", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null }, "qwen3-4b": { "prob_clinical": 0.0046, "prob_patient": 0.0039, "language_penalty": -0.0007, "anchor_fallback": false, "top_clinical": [ "prescribed", 0.321 ], "top_patient": [ "eye", 0.3266 ], "spread_clinical": [ [ "prescribed", 0.321 ], [ "eye", 0.1947 ], [ "contact", 0.092 ], [ "pres", 0.092 ], [ "artificial", 0.0716 ], [ "lubric", 0.0434 ], [ "prescription", 0.0233 ], [ "eyed", 0.0205 ], [ "tears", 0.015 ], [ "eyel", 0.0103 ] ], "spread_patient": [ [ "eye", 0.3266 ], [ "contact", 0.2544 ], [ "eyes", 0.0826 ], [ "prescribed", 0.0729 ], [ "eyed", 0.0501 ], [ "contacts", 0.0344 ], [ "sunglasses", 0.0127 ], [ "glasses", 0.0119 ], [ "pres", 0.0077 ], [ "eyel", 0.0068 ] ], "target_token": "drops", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": 2, "tier_top_patient": null, "tier_shift": null } }, "qwen3-1.7b": { "prob_clinical": 0.0001, "prob_patient": 0.0001, "language_penalty": 0.0, "anchor_fallback": false, "top_clinical": [ "eyes", 0.1554 ], "top_patient": [ "eyes", 0.1627 ], "spread_clinical": [ [ "eyes", 0.1554 ], [ "eye", 0.1371 ], [ "phone", 0.0943 ], [ "contacts", 0.0832 ], [ "glasses", 0.0832 ], [ "computer", 0.0445 ], [ "contact", 0.0445 ], [ "makeup", 0.027 ], [ "own", 0.0238 ], [ "right", 0.021 ] ], "spread_patient": [ [ "eyes", 0.1627 ], [ "glasses", 0.0871 ], [ "phone", 0.0871 ], [ "hands", 0.0599 ], [ "eye", 0.0528 ], [ "contacts", 0.0411 ], [ "contact", 0.0283 ], [ "left", 0.0283 ], [ "fingers", 0.022 ], [ "computer", 0.0194 ] ], "target_token": "drops", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null } }, "prob_clinical": 0.046, "prob_patient": 0.042, "language_penalty": -0.003999999999999997, "flipped": false, "top_clinical": [ "eye", 0.288 ], "top_patient": [ "eye", 0.225 ], "spread_clinical": [ [ "eye", 0.288 ], [ "artificial", 0.054 ], [ "prescription", 0.052 ], [ "drops", 0.046 ], [ "contact", 0.043 ] ], "spread_patient": [ [ "eye", 0.225 ], [ "contacts", 0.114 ], [ "contact", 0.101 ], [ "artificial", 0.043 ], [ "drops", 0.042 ] ], "target_token": "drops", "anchor_fallback": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " drops", "observed_clinical": [ "Output \" drops\"", 0.046 ], "probe_extension": null }, "circuit_diff": { "shared_features": 497, "unique_to_a": 717, "unique_to_b": 665 }, "clinical_mass": { "clinical": 0.2882, "patient": 0.2544 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260710T133708Z/index_49.html" }, { "index": 404, "batch": "pairs_20260710T133708Z", "batch_index": 50, "clinical_prompt": "When I eat too fast, I have dysphagia, so I might have a", "patient_prompt": "When I eat too fast, my food gets stuck halfway down, so I might have a", "intended_target": "stricture", "rationale": "The frame 'so I might have a [noun]' is diagnostic: lay symptom language ('food stuck') tends to prompt mundane continuations (problem, habit), while the clinical term 'dysphagia' (swallowing disorder) shifts the model toward anatomical/pathological diagnoses. 'Stricture' (esophageal narrowing) is a common, high-frequency single-word clinical finding associated with dysphagia, fitting the grammatical funnel of 'might have a [noun]'.", "patient_term": "my food gets stuck halfway down", "clinical_term": "dysphagia", "topic": "gastroenterology", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": null, "prob_patient": null, "language_penalty": null, "anchor_fallback": false, "top_clinical": [ "hard", 0.144 ], "top_patient": null, "spread_clinical": [ [ "hard", 0.144 ], [ "problem", 0.142 ], [ "little", 0.113 ], [ "swallowing", 0.047 ], [ "stroke", 0.04 ] ], "spread_patient": [], "target_token": null, "flipped": false, "screening": { "status": "screened_out", "min_prob": 0.02, "intended_target": " stricture", "observed_clinical": null, "probe_extension": null, "reason": "intended target not in the traced clinical spread" }, "circuit_diff": null, "clinical_mass": { "clinical": 0.2685 }, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, "gemma-3-4b-it": { "prob_clinical": 0.0, "prob_patient": 0.0, "language_penalty": 0.0, "anchor_fallback": false, "top_clinical": [ "choking", 0.4193 ], "top_patient": [ "mild", 0.1631 ], "spread_clinical": [ [ "choking", 0.4193 ], [ "cough", 0.0935 ], [ "hard", 0.0935 ], [ "difficult", 0.0567 ], [ "coughing", 0.039 ], [ "gag", 0.0344 ], [ "feeling", 0.0344 ], [ "painful", 0.0163 ], [ "problem", 0.0163 ], [ "difficulty", 0.0143 ] ], "spread_patient": [ [ "mild", 0.1631 ], [ "slight", 0.127 ], [ "feeling", 0.1121 ], [ "bit", 0.068 ], [ "minor", 0.0467 ], [ "cough", 0.0412 ], [ "painful", 0.0412 ], [ "bad", 0.0321 ], [ "heartburn", 0.0321 ], [ "little", 0.0283 ] ], "target_token": "strict", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, "qwen3-4b": { "prob_clinical": 0.0001, "prob_patient": 0.0, "language_penalty": -0.0001, "anchor_fallback": false, "top_clinical": [ "choking", 0.2199 ], "top_patient": [ "choking", 0.1659 ], "spread_clinical": [ [ "choking", 0.2199 ], [ "problem", 0.1941 ], [ "hard", 0.1511 ], [ "risk", 0.028 ], [ "heart", 0.0263 ], [ "better", 0.0232 ], [ "foreign", 0.0159 ], [ "food", 0.0159 ], [ "block", 0.0141 ], [ "difficult", 0.0141 ] ], "spread_patient": [ [ "choking", 0.1659 ], [ "feeling", 0.1006 ], [ "problem", 0.0888 ], [ "heart", 0.0692 ], [ "cough", 0.061 ], [ "stomach", 0.061 ], [ "hard", 0.0475 ], [ "sore", 0.0254 ], [ "sensation", 0.0239 ], [ "lot", 0.0211 ] ], "target_token": "str", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null }, "qwen3-1.7b": { "prob_clinical": 0.0, "prob_patient": 0.0, "language_penalty": 0.0, "anchor_fallback": false, "top_clinical": [ "problem", 0.2659 ], "top_patient": [ "feeling", 0.2499 ], "spread_clinical": [ [ "problem", 0.2659 ], [ "risk", 0.0978 ], [ "higher", 0.0462 ], [ "hard", 0.0462 ], [ "choking", 0.0408 ], [ "food", 0.015 ], [ "condition", 0.015 ], [ "block", 0.0132 ], [ "swallowing", 0.0117 ], [ "medical", 0.0117 ] ], "spread_patient": [ [ "feeling", 0.2499 ], [ "choking", 0.2499 ], [ "heart", 0.0716 ], [ "hard", 0.0632 ], [ "stomach", 0.0558 ], [ "block", 0.0492 ], [ "\"", 0.0263 ], [ "bad", 0.0263 ], [ "problem", 0.0263 ], [ "gag", 0.0124 ] ], "target_token": "str", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } } }, "prob_clinical": null, "prob_patient": null, "language_penalty": null, "flipped": false, "top_clinical": [ "hard", 0.144 ], "top_patient": null, "spread_clinical": [ [ "hard", 0.144 ], [ "problem", 0.142 ], [ "little", 0.113 ], [ "swallowing", 0.047 ], [ "stroke", 0.04 ] ], "spread_patient": [], "target_token": null, "anchor_fallback": false, "screening": { "status": "screened_out", "min_prob": 0.02, "intended_target": " stricture", "observed_clinical": null, "probe_extension": null, "reason": "intended target not in the traced clinical spread" }, "circuit_diff": null, "clinical_mass": { "clinical": 0.2685 }, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, { "index": 405, "batch": "pairs_20260710T163230Z", "batch_index": 2, "clinical_prompt": "I have vertigo, so I should see a", "patient_prompt": "I keep getting these dizzy spells, so I should see a", "intended_target": "neurologist", "rationale": "The clinical term 'vertigo' signals a neurological condition requiring specialist evaluation, whereas 'dizzy spells' may prompt reassurance or generic medical advice.", "patient_term": "dizzy spells", "clinical_term": "vertigo", "topic": "balance disorder", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": 0.249, "prob_patient": 0.102, 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The frame 'take an' prompts remedy words; clinical phrasing should steer toward specific medical interventions rather than generic pain description.", "patient_term": "painful stabbing feeling in my belly that lasts for hours", "clinical_term": "postprandial abdominal pain", "topic": "postprandial pain", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": 0.41, "prob_patient": 0.55, "language_penalty": 0.14000000000000007, "anchor_fallback": false, "top_clinical": [ "ant", 0.41 ], "top_patient": [ "ant", 0.55 ], "spread_clinical": [ [ "ant", 0.41 ], [ "anti", 0.351 ], [ "enzyme", 0.054 ], [ "en", 0.024 ], [ "acid", 0.022 ] ], "spread_patient": [ [ "ant", 0.55 ], [ "anti", 0.165 ], [ "acid", 0.052 ], [ "enzyme", 0.037 ], [ "over", 0.027 ] ], "target_token": "ant", "flipped": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " antacid", "observed_clinical": [ "Output \" ant\"", 0.41 ], "probe_extension": null }, "circuit_diff": { "shared_features": 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false, "top_clinical": [ "ant", 0.5671 ], "top_patient": [ "ant", 0.3971 ], "spread_clinical": [ [ "ant", 0.5671 ], [ "anti", 0.2086 ], [ "enzyme", 0.087 ], [ "over", 0.0282 ], [ "acid", 0.0249 ], [ "O", 0.0151 ], [ "o", 0.0151 ], [ "antibiotic", 0.0104 ], [ "herbal", 0.0043 ], [ "iron", 0.0026 ] ], "spread_patient": [ [ "ant", 0.3971 ], [ "anti", 0.1876 ], [ "X", 0.0886 ], [ "over", 0.069 ], [ "enzyme", 0.0254 ], [ "acid", 0.0254 ], [ "antibiotic", 0.0224 ], [ "MRI", 0.0224 ], [ "O", 0.0224 ], [ "antidepress", 0.0136 ] ], "target_token": "ant", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 1, "tier_top_patient": 1, "tier_shift": 0.068 } } }, "prob_clinical": 0.41, "prob_patient": 0.55, "language_penalty": 0.14000000000000007, "flipped": false, "top_clinical": [ "ant", 0.41 ], "top_patient": [ "ant", 0.55 ], "spread_clinical": [ [ "ant", 0.41 ], [ "anti", 0.351 ], [ "enzyme", 0.054 ], [ "en", 0.024 ], [ "acid", 0.022 ] ], "spread_patient": [ [ "ant", 0.55 ], [ "anti", 0.165 ], [ "acid", 0.052 ], [ "enzyme", 0.037 ], [ "over", 0.027 ] ], "target_token": "ant", "anchor_fallback": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " antacid", "observed_clinical": [ "Output \" ant\"", 0.41 ], "probe_extension": null }, "circuit_diff": { "shared_features": 766, "unique_to_a": 459, "unique_to_b": 471 }, "clinical_mass": { "clinical": 0.3859, "patient": 0.3037 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260710T163230Z/index_48.html", "urgency": { "flip_class": null, "tier_top_clinical": 1, "tier_top_patient": 1, "tier_shift": 0.0 } }, { "index": 446, "batch": "pairs_20260710T163230Z", "batch_index": 49, "clinical_prompt": "I've been experiencing vertigo and the room won't stop spinning, so I might need to take an", "patient_prompt": "I've been feeling really dizzy and the room won't stop spinning, so I might need to 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The clinical term 'vertigo' is more specific and diagnostic. 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"tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.157 } }, "qwen3-1.7b": { "prob_clinical": 0.161, "prob_patient": 0.0027, "language_penalty": -0.1583, "anchor_fallback": false, "top_clinical": [ "doctor", 0.7215 ], "top_patient": [ "doctor", 0.9613 ], "spread_clinical": [ [ "doctor", 0.7215 ], [ "rhe", 0.161 ], [ "specialist", 0.076 ], [ "phys", 0.0117 ], [ "physician", 0.0071 ], [ "healthcare", 0.0026 ], [ "physical", 0.0023 ], [ "dermat", 0.0018 ], [ "therapist", 0.0018 ], [ "medical", 0.0012 ] ], "spread_patient": [ [ "doctor", 0.9613 ], [ "specialist", 0.0155 ], [ "phys", 0.0057 ], [ "physician", 0.0045 ], [ "rhe", 0.0027 ], [ "medical", 0.0013 ], [ "physical", 0.0013 ], [ "Doctor", 0.0013 ], [ "healthcare", 0.001 ], [ "therapist", 0.0008 ] ], "target_token": "rhe", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.08 } } }, "prob_clinical": 0.148, "prob_patient": 0.047, "language_penalty": -0.10099999999999999, "flipped": false, "top_clinical": [ "doctor", 0.448 ], "top_patient": [ "doctor", 0.694 ], "spread_clinical": [ [ "doctor", 0.448 ], [ "rhe", 0.148 ], [ "specialist", 0.117 ], [ "chi", 0.035 ], [ "new", 0.02 ] ], "spread_patient": [ [ "doctor", 0.694 ], [ "rhe", 0.047 ], [ "specialist", 0.043 ], [ "physio", 0.024 ], [ "Dr", 0.023 ] ], "target_token": "rhe", "anchor_fallback": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " rheumatologist", "observed_clinical": [ "Output \" rhe\"", 0.148 ], "probe_extension": null }, "circuit_diff": { "shared_features": 756, "unique_to_a": 447, "unique_to_b": 468 }, "clinical_mass": { "clinical": 0.3999, "patient": 0.4658, "translated": 0.443 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260711T051145Z/index_14.html", "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, 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Both end after 'some', funneling toward dietary advice. Clinical reading naturally prefers 'foods' or 'triggers' over colloquial 'junk' or 'stuff'.", "patient_term": "stomach's been really upset", "clinical_term": "gastritis", "topic": "gastric inflammation", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": 0.193, "prob_patient": 0.131, "language_penalty": -0.062, "anchor_fallback": false, "top_clinical": [ "of", 0.459 ], "top_patient": [ "of", 0.54 ], "spread_clinical": [ [ "of", 0.459 ], [ "foods", 0.193 ], [ "things", 0.095 ], [ "spices", 0.025 ], [ "spicy", 0.023 ] ], "spread_patient": [ [ "of", 0.54 ], [ "foods", 0.131 ], [ "things", 0.064 ], [ "food", 0.042 ], [ "spicy", 0.02 ] ], "target_token": "foods", "flipped": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " foods", "observed_clinical": [ "Output \" foods\"", 0.193 ], "probe_extension": null }, "circuit_diff": { "shared_features": 654, "unique_to_a": 571, "unique_to_b": 623 }, "clinical_mass": { "clinical": 0.2158, "patient": 0.135, "translated": 0.1492 } }, "gemma-3-4b-it": { "prob_clinical": 0.8788, "prob_patient": 0.7699, "language_penalty": -0.1089, "anchor_fallback": false, "top_clinical": [ "foods", 0.8788 ], "top_patient": [ "foods", 0.7699 ], "spread_clinical": [ [ "foods", 0.8788 ], [ "things", 0.0301 ], [ "common", 0.0265 ], [ "food", 0.0161 ], [ "of", 0.0161 ], [ "types", 0.0076 ], [ "certain", 0.0059 ], [ "specific", 0.0032 ], [ "ingredients", 0.0019 ], [ "kinds", 0.0015 ] ], "spread_patient": [ [ "foods", 0.7699 ], [ "things", 0.1181 ], [ "of", 0.0338 ], [ "common", 0.0263 ], [ "certain", 0.0124 ], [ "food", 0.0124 ], [ "specific", 0.0075 ], [ "types", 0.0031 ], [ "particular", 0.0028 ], [ "kinds", 0.0013 ] ], "target_token": "foods", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null }, "qwen3-4b": { "prob_clinical": 0.5639, "prob_patient": 0.4339, "language_penalty": -0.13, "anchor_fallback": false, "top_clinical": [ "foods", 0.5639 ], "top_patient": [ "foods", 0.4339 ], "spread_clinical": [ [ "foods", 0.5639 ], [ "of", 0.1616 ], [ "things", 0.1258 ], [ "acidic", 0.036 ], [ "types", 0.0318 ], [ "food", 0.0193 ], [ "spicy", 0.0091 ], [ "kinds", 0.0063 ], [ "ingredients", 0.0043 ], [ "kind", 0.0031 ] ], "spread_patient": [ [ "foods", 0.4339 ], [ "of", 0.2323 ], [ "things", 0.205 ], [ "food", 0.0356 ], [ "types", 0.0191 ], [ "kinds", 0.0116 ], [ "kind", 0.007 ], [ "acidic", 0.0066 ], [ "heavy", 0.0035 ], [ "high", 0.0031 ] ], "target_token": "foods", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null }, "qwen3-1.7b": { "prob_clinical": 0.7121, "prob_patient": 0.361, "language_penalty": -0.3511, "anchor_fallback": false, "top_clinical": [ "foods", 0.7121 ], "top_patient": [ "foods", 0.361 ], "spread_clinical": [ [ "foods", 0.7121 ], [ "things", 0.0662 ], [ "types", 0.0455 ], [ "food", 0.0402 ], [ "of", 0.0167 ], [ "kinds", 0.013 ], [ "certain", 0.0102 ], [ "medications", 0.0102 ], [ "specific", 0.007 ], [ "drinks", 0.0042 ] ], "spread_patient": [ [ "foods", 0.361 ], [ "of", 0.1505 ], [ "food", 0.1172 ], [ "things", 0.0913 ], [ "spicy", 0.018 ], [ "stuff", 0.0124 ], [ "high", 0.0124 ], [ "types", 0.0124 ], [ "kinds", 0.0109 ], [ "heavy", 0.0096 ] ], "target_token": "foods", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null } }, "prob_clinical": 0.193, "prob_patient": 0.131, "language_penalty": -0.062, "flipped": false, "top_clinical": [ "of", 0.459 ], "top_patient": [ "of", 0.54 ], "spread_clinical": [ [ "of", 0.459 ], [ "foods", 0.193 ], [ "things", 0.095 ], [ "spices", 0.025 ], [ "spicy", 0.023 ] ], "spread_patient": [ [ "of", 0.54 ], [ "foods", 0.131 ], [ "things", 0.064 ], [ "food", 0.042 ], [ "spicy", 0.02 ] ], "target_token": "foods", "anchor_fallback": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " foods", "observed_clinical": [ "Output \" foods\"", 0.193 ], "probe_extension": null }, "circuit_diff": { "shared_features": 654, "unique_to_a": 571, "unique_to_b": 623 }, "clinical_mass": { "clinical": 0.2158, "patient": 0.135, "translated": 0.1492 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260711T051145Z/index_15.html", "depth_class": "retained" }, { "index": 458, "batch": "pairs_20260711T051145Z", "batch_index": 16, "clinical_prompt": "I keep getting sciatica down my leg, so my doctor thinks I might have a her", "patient_prompt": "I keep getting these shooting pains down my leg, so my doctor thinks I might have a her", "intended_target": "nerve", "rationale": "Patient phrasing uses symptom description; clinical term names the condition. 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862, "unique_to_a": 470, "unique_to_b": 591 }, "clinical_mass": { "clinical": 0.2394, "patient": 0.2466 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260712T051903Z/index_48.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null }, "depth_class": "absent" }, { "index": 570, "batch": "pairs_20260712T051903Z", "batch_index": 49, "clinical_prompt": "I have orthostatic hypotension, so I need to get my", "patient_prompt": "I've been feeling lightheaded and dizzy, so I need to get my", "intended_target": "blood", "rationale": "The patient phrasing 'feeling lightheaded and dizzy' is vague and everyday; the clinical term 'orthostatic hypotension' (drop in blood pressure on standing) narrows the diagnostic frame. After 'so I need to get my', the colloquial version might continue with 'checked' or 'head examined', while the clinical phrasing strongly funnels toward 'blood pressure measured' \u2013 the natural target is 'blood' as the first token of that continuation. This tests whether the model shifts from symptom description to mechanism-based reasoning.", "patient_term": "feeling lightheaded and dizzy", "clinical_term": "orthostatic hypotension", "topic": "cardiovascular", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": 0.57, "prob_patient": 0.594, "language_penalty": 0.02400000000000002, "anchor_fallback": false, "top_clinical": [ "blood", 0.57 ], "top_patient": [ "blood", 0.594 ], "spread_clinical": [ [ "blood", 0.57 ], [ "heart", 0.137 ], [ "feet", 0.061 ], [ "BP", 0.05 ], [ "legs", 0.025 ] ], "spread_patient": [ [ "blood", 0.594 ], [ "BP", 0.056 ], [ "eyes", 0.032 ], [ "vit", 0.032 ], [ "heart", 0.025 ] ], "target_token": "blood", "flipped": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " blood", "observed_clinical": [ "Output \" blood\"", 0.57 ], "probe_extension": null }, "circuit_diff": { "shared_features": 517, "unique_to_a": 683, "unique_to_b": 812 }, "clinical_mass": { "clinical": 0.3042, 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"tier_shift": -1.959 } }, "qwen3-4b": { "prob_clinical": 0.9408, "prob_patient": 0.9743, "language_penalty": 0.0335, "anchor_fallback": false, "top_clinical": [ "blood", 0.9408 ], "top_patient": [ "blood", 0.9743 ], "spread_clinical": [ [ "blood", 0.9408 ], [ "BP", 0.0092 ], [ "feet", 0.0056 ], [ "body", 0.0056 ], [ "pulse", 0.0032 ], [ "heart", 0.0023 ], [ "syst", 0.0022 ], [ "eyes", 0.0019 ], [ "head", 0.0018 ], [ "pressure", 0.0013 ] ], "spread_patient": [ [ "blood", 0.9743 ], [ "ears", 0.0058 ], [ "BP", 0.0051 ], [ "balance", 0.0021 ], [ "eyes", 0.0011 ], [ "hearing", 0.001 ], [ "heart", 0.0009 ], [ "cholesterol", 0.0007 ], [ "pulse", 0.0006 ], [ "pressure", 0.0006 ] ], "target_token": "blood", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": 0.0 } }, "qwen3-1.7b": { "prob_clinical": 0.9753, "prob_patient": 0.9705, "language_penalty": -0.0048, "anchor_fallback": false, "top_clinical": [ "blood", 0.9753 ], "top_patient": [ "blood", 0.9705 ], "spread_clinical": [ [ "blood", 0.9753 ], [ "BP", 0.0051 ], [ "body", 0.0027 ], [ "potassium", 0.0015 ], [ "pulse", 0.001 ], [ "syst", 0.001 ], [ "heart", 0.0007 ], [ "morning", 0.0005 ], [ "balance", 0.0004 ], [ "daily", 0.0004 ] ], "spread_patient": [ [ "blood", 0.9705 ], [ "balance", 0.0051 ], [ "head", 0.0045 ], [ "body", 0.0031 ], [ "vision", 0.0027 ], [ "cholesterol", 0.0017 ], [ "eyes", 0.0013 ], [ "doctor", 0.0011 ], [ "vit", 0.0011 ], [ "potassium", 0.0006 ] ], "target_token": "blood", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": 0.0 } } }, "prob_clinical": 0.57, "prob_patient": 0.594, "language_penalty": 0.02400000000000002, "flipped": false, "top_clinical": [ "blood", 0.57 ], "top_patient": [ "blood", 0.594 ], "spread_clinical": [ [ "blood", 0.57 ], 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so I should probably see a", "intended_target": "pulmonologist", "rationale": "The patient phrasing describes a symptom (chest pain); the clinical term names the underlying inflammatory condition of the pleura. After 'so I should probably see a', the colloquial version might yield generic continuations like 'doctor' or 'cardiologist', while the clinical diagnosis 'pleurisy' (lung membrane inflammation) should push the model toward specialist continuations, with 'pulmonologist' as the highest-frequency single-word specialist for that condition. This probes whether the model maps conditions to appropriate clinical roles.", "patient_term": "sharp stabbing pains in my chest", "clinical_term": "pleurisy", "topic": "respiratory", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": 0.029, "prob_patient": null, "language_penalty": null, "anchor_fallback": false, "top_clinical": [ "doctor", 0.707 ], "top_patient": [ "doctor", 0.862 ], "spread_clinical": [ [ "doctor", 0.707 ], [ "specialist", 0.086 ], [ "doc", 0.03 ], [ "pulmon", 0.029 ], [ "physician", 0.015 ] ], "spread_patient": [ [ "doctor", 0.862 ], [ "cardio", 0.05 ], [ "doc", 0.027 ], [ "Dr", 0.01 ], [ "dr", 0.007 ] ], "target_token": "pulmon", "flipped": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " pulmonologist", "observed_clinical": [ "Output \" pulmon\"", 0.029 ], "probe_extension": null }, "circuit_diff": { "shared_features": 510, "unique_to_a": 738, "unique_to_b": 654 }, "clinical_mass": { "clinical": 0.4136, "patient": 0.4259 }, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.05 } }, "gemma-3-4b-it": { "prob_clinical": 0.0079, "prob_patient": 0.0, "language_penalty": -0.0079, "anchor_fallback": false, "top_clinical": [ "doctor", 0.9093 ], "top_patient": [ "doctor", 0.9848 ], "spread_clinical": [ [ "doctor", 0.9093 ], [ "specialist", 0.0189 ], [ "physician", 0.0147 ], [ "medical", 0.0114 ], [ "pulmon", 0.0079 ], [ "healthcare", 0.0058 ], [ "rheumat", 0.0031 ], [ "physical", 0.0027 ], [ "phys", 0.0014 ], [ "new", 0.0014 ] ], "spread_patient": [ [ "doctor", 0.9848 ], [ "cardiologist", 0.0052 ], [ "physician", 0.0028 ], [ "medical", 0.0024 ], [ "Doctor", 0.0013 ], [ "Dr", 0.001 ], [ "doc", 0.0006 ], [ "healthcare", 0.0003 ], [ "professional", 0.0002 ], [ "heart", 0.0001 ] ], "target_token": "pulmon", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.02 } }, "qwen3-4b": { "prob_clinical": 0.0141, "prob_patient": 0.0, "language_penalty": -0.0141, "anchor_fallback": false, "top_clinical": [ "doctor", 0.8709 ], "top_patient": [ "doctor", 0.9834 ], "spread_clinical": [ [ "doctor", 0.8709 ], [ "specialist", 0.0715 ], [ "pul", 0.0141 ], [ "chest", 0.0066 ], [ "physician", 0.0052 ], [ "lung", 0.0052 ], [ "respiratory", 0.0038 ], [ "phys", 0.0015 ], [ "pneum", 0.0014 ], [ "pulmonary", 0.0012 ] ], "spread_patient": [ [ "doctor", 0.9834 ], [ "cardi", 0.0085 ], [ "specialist", 0.0024 ], [ "physician", 0.0015 ], [ "heart", 0.0006 ], [ "Doctor", 0.0005 ], [ "GP", 0.0004 ], [ "healthcare", 0.0004 ], [ "chest", 0.0002 ], [ "doc", 0.0002 ] ], "target_token": "pul", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.073 } }, "qwen3-1.7b": { "prob_clinical": 0.0062, "prob_patient": 0.0001, "language_penalty": -0.0061, "anchor_fallback": false, "top_clinical": [ "doctor", 0.9241 ], "top_patient": [ "doctor", 0.9797 ], "spread_clinical": [ [ "doctor", 0.9241 ], [ "specialist", 0.0358 ], [ "physician", 0.0169 ], [ "pul", 0.0062 ], [ "GP", 0.0026 ], [ "cardi", 0.0026 ], [ "therapist", 0.0014 ], [ "healthcare", 0.0011 ], [ "medical", 0.0008 ], [ "dermat", 0.0007 ] ], "spread_patient": [ [ "doctor", 0.9797 ], [ "cardi", 0.0066 ], [ "physician", 0.0045 ], [ "specialist", 0.0028 ], [ "GP", 0.0013 ], [ "healthcare", 0.001 ], [ "medical", 0.0005 ], [ "heart", 0.0004 ], [ "therapist", 0.0003 ], [ "gastro", 0.0003 ] ], "target_token": "pul", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.034 } } }, "prob_clinical": 0.029, "prob_patient": null, "language_penalty": null, "flipped": false, "top_clinical": [ "doctor", 0.707 ], "top_patient": [ "doctor", 0.862 ], "spread_clinical": [ [ "doctor", 0.707 ], [ "specialist", 0.086 ], [ "doc", 0.03 ], [ "pulmon", 0.029 ], [ "physician", 0.015 ] ], "spread_patient": [ [ "doctor", 0.862 ], [ "cardio", 0.05 ], [ "doc", 0.027 ], [ "Dr", 0.01 ], [ "dr", 0.007 ] ], "target_token": "pulmon", "anchor_fallback": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " pulmonologist", "observed_clinical": [ "Output \" pulmon\"", 0.029 ], "probe_extension": null }, "circuit_diff": { "shared_features": 510, "unique_to_a": 738, "unique_to_b": 654 }, "clinical_mass": { "clinical": 0.4136, "patient": 0.4259 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260712T051903Z/index_50.html", "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.05 }, "depth_class": "absent" }, { "index": 572, "batch": "pairs_20260712T163501Z", "batch_index": 2, "clinical_prompt": "I have a viral infection, so I should probably get 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The frame 'talk to a' creates diagnostic divergence: lay phrasing might lead to informal advice, while clinical term steers toward specialist.", "patient_term": "getting forgetful", "clinical_term": "mild cognitive impairment", "topic": "neurology", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": 0.175, "prob_patient": 0.047, "language_penalty": -0.128, "anchor_fallback": false, "top_clinical": [ "doctor", 0.428 ], "top_patient": [ "doctor", 0.549 ], "spread_clinical": [ [ "doctor", 0.428 ], [ "neuro", 0.175 ], [ "specialist", 0.072 ], [ "professional", 0.04 ], [ "physician", 0.037 ] ], "spread_patient": [ [ "doctor", 0.549 ], [ "neuro", 0.047 ], [ "specialist", 0.038 ], [ "professional", 0.026 ], [ "therapist", 0.023 ] ], "target_token": "neuro", "flipped": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " neurologist", "observed_clinical": [ "Output \" neuro\"", 0.175 ], "probe_extension": null }, "circuit_diff": { "shared_features": 541, 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Possessive frame 'take my' funnels toward medication nouns; clinical version reinforces pharmaceutical intervention.", "patient_term": "blood pressure's been through the roof", "clinical_term": "hypertension", "topic": "hypertension", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": 0.077, "prob_patient": 0.11, "language_penalty": 0.033, "anchor_fallback": false, "top_clinical": [ "blood", 0.579 ], "top_patient": [ "blood", 0.244 ], "spread_clinical": [ [ "blood", 0.579 ], [ "BP", 0.089 ], [ "medication", 0.077 ], [ "meds", 0.048 ], [ "medicine", 0.046 ] ], "spread_patient": [ [ "blood", 0.244 ], [ "meds", 0.174 ], [ "medication", 0.11 ], [ "medicine", 0.101 ], [ "BP", 0.05 ] ], "target_token": "medication", "flipped": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " medication", "observed_clinical": [ "Output \" medication\"", 0.077 ], "probe_extension": null }, "circuit_diff": { "shared_features": 523, "unique_to_a": 520, "unique_to_b": 640 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Article 'an' before vowel-initial noun steers toward device/medication. Clinical phrasing increases likelihood of inhaler as next token.", "patient_term": "wheezing and gasping for air", "clinical_term": "asthma", "topic": "asthma", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": 0.541, "prob_patient": 0.23, "language_penalty": -0.31100000000000005, "anchor_fallback": false, "top_clinical": [ "inhal", 0.541 ], "top_patient": [ "inhal", 0.23 ], "spread_clinical": [ [ "inhal", 0.541 ], [ "asthma", 0.091 ], [ "exemption", 0.047 ], [ "Epi", 0.042 ], [ "allergy", 0.033 ] ], "spread_patient": [ [ "inhal", 0.23 ], [ "x", 0.1 ], [ "X", 0.095 ], [ "asthma", 0.053 ], [ "oxygen", 0.047 ] ], "target_token": "inhal", "flipped": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " inhaler", "observed_clinical": [ "Output \" inhal\"", 0.541 ], "probe_extension": null }, "circuit_diff": { "shared_features": 581, "unique_to_a": 456, "unique_to_b": 738 }, "clinical_mass": { "clinical": 0.311, "patient": 0.2816 }, "urgency": { 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The clinical phrasing strongly suggests an arthritic condition as the next token; the colloquial version might lead to mundane continuations like 'old' or 'worse'.", "patient_term": "rusted over", "clinical_term": "morning stiffness", "topic": "joint and mobility disorders", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": 0.093, "prob_patient": 0.113, "language_penalty": 0.020000000000000004, "anchor_fallback": false, "top_clinical": [ "better", 0.133 ], "top_patient": [ "old", 0.22 ], "spread_clinical": [ [ "better", 0.133 ], [ "arthritis", 0.093 ], [ "enough", 0.084 ], [ "any", 0.072 ], [ "worse", 0.061 ] ], "spread_patient": [ [ "old", 0.22 ], [ "enough", 0.122 ], [ "arthritis", 0.113 ], [ "older", 0.095 ], [ "any", 0.091 ] ], "target_token": "arthritis", "flipped": true, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " arthritis", "observed_clinical": [ "Output \" arthritis\"", 0.093 ], "probe_extension": null }, "circuit_diff": { 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these weird blind spots in my vision, so my eye doctor says I might have", "intended_target": "glaucoma", "rationale": "Lay description 'blind spots' vs. precise ophthalmologic term 'scotomas'. The clinical version strongly suggests a specific eye disease (glaucoma) as the natural continuation; the colloquial version might prompt toward less specific medical outcomes like 'problems' or 'issues'.", "patient_term": "blind spots", "clinical_term": "scotomas", "topic": "vision and ocular disorders", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": 0.069, "prob_patient": 0.065, "language_penalty": -0.0040000000000000036, "anchor_fallback": false, "top_clinical": [ "a", 0.327 ], "top_patient": [ "a", 0.248 ], "spread_clinical": [ [ "a", 0.327 ], [ "some", 0.077 ], [ "glaucoma", 0.069 ], [ "an", 0.063 ], [ "macular", 0.043 ] ], "spread_patient": [ [ "a", 0.248 ], [ "some", 0.093 ], [ "something", 0.081 ], [ "glaucoma", 0.065 ], [ "an", 0.062 ] ], "target_token": "glaucoma", "flipped": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " glaucoma", "observed_clinical": [ "Output \" glaucoma\"", 0.069 ], "probe_extension": null }, "circuit_diff": { "shared_features": 940, "unique_to_a": 500, "unique_to_b": 470 }, "clinical_mass": { "clinical": 0.3635, "patient": 0.3434 } }, "gemma-3-4b-it": { "prob_clinical": 0.0488, "prob_patient": 0.0073, "language_penalty": -0.0415, "anchor_fallback": false, "top_clinical": [ "a", 0.4628 ], "top_patient": [ "a", 0.4521 ], "spread_clinical": [ [ "a", 0.4628 ], [ "something", 0.117 ], [ "some", 0.071 ], [ "glaucoma", 0.0488 ], [ "optic", 0.043 ], [ "early", 0.0335 ], [ "macular", 0.0335 ], [ "an", 0.0296 ], [ "migraines", 0.014 ], [ "dry", 0.0123 ] ], "spread_patient": [ [ "a", 0.4521 ], [ "something", 0.2742 ], [ "some", 0.054 ], [ "optic", 0.0421 ], [ "dry", 0.0327 ], [ "an", 0.0255 ], [ "migraines", 0.0137 ], [ "macular", 0.0094 ], [ "glaucoma", 0.0073 ], [ "multiple", 0.0073 ] ], "target_token": "glaucoma", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null }, "qwen3-4b": { "prob_clinical": 0.0316, "prob_patient": 0.0361, "language_penalty": 0.0045, "anchor_fallback": false, "top_clinical": [ "a", 0.8162 ], "top_patient": [ "a", 0.6406 ], "spread_clinical": [ [ "a", 0.8162 ], [ "gl", 0.0316 ], [ "an", 0.0169 ], [ "optic", 0.0169 ], [ "mac", 0.0149 ], [ "something", 0.0132 ], [ "migr", 0.0116 ], [ "posterior", 0.0103 ], [ "migraine", 0.008 ], [ "some", 0.0071 ] ], "spread_patient": [ [ "a", 0.6406 ], [ "something", 0.0765 ], [ "mac", 0.0464 ], [ "posterior", 0.0361 ], [ "gl", 0.0361 ], [ "migr", 0.0281 ], [ "optic", 0.0193 ], [ "some", 0.0151 ], [ "\"", 0.0151 ], [ "migraine", 0.0133 ] ], "target_token": "gl", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null }, "qwen3-1.7b": { "prob_clinical": 0.0761, "prob_patient": 0.044, "language_penalty": -0.0321, "anchor_fallback": false, "top_clinical": [ "a", 0.3862 ], "top_patient": [ "a", 0.4733 ], "spread_clinical": [ [ "a", 0.3862 ], [ "an", 0.0862 ], [ "gl", 0.0761 ], [ "mac", 0.0592 ], [ "dry", 0.028 ], [ "some", 0.0247 ], [ "early", 0.0218 ], [ "something", 0.0218 ], [ "multiple", 0.0218 ], [ "optic", 0.0192 ] ], "spread_patient": [ [ "a", 0.4733 ], [ "an", 0.0822 ], [ "mac", 0.0726 ], [ "gl", 0.044 ], [ "ret", 0.044 ], [ "some", 0.0303 ], [ "optic", 0.0184 ], [ "\"", 0.0162 ], [ "something", 0.0143 ], [ "dry", 0.0087 ] ], "target_token": "gl", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null } }, "prob_clinical": 0.069, "prob_patient": 0.065, "language_penalty": -0.0040000000000000036, "flipped": false, "top_clinical": [ "a", 0.327 ], "top_patient": [ "a", 0.248 ], "spread_clinical": [ [ "a", 0.327 ], [ "some", 0.077 ], [ "glaucoma", 0.069 ], [ "an", 0.063 ], [ "macular", 0.043 ] ], "spread_patient": [ [ "a", 0.248 ], [ "some", 0.093 ], [ "something", 0.081 ], [ "glaucoma", 0.065 ], [ "an", 0.062 ] ], "target_token": "glaucoma", "anchor_fallback": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " glaucoma", "observed_clinical": [ "Output \" glaucoma\"", 0.069 ], "probe_extension": null }, "circuit_diff": { "shared_features": 940, "unique_to_a": 500, "unique_to_b": 470 }, "clinical_mass": { "clinical": 0.3635, "patient": 0.3434 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260712T163501Z/index_58.html", "depth_class": "suppressed" }, { "index": 624, "batch": "pairs_20260712T163501Z", "batch_index": 59, "clinical_prompt": "My daughter has shown signs of inattention, so the school thinks she might have", "patient_prompt": "My daughter's been really spacey and can't focus in class, so the school thinks she might have", "intended_target": "ADHD", "rationale": "Colloquial behavioral description 'spacey and can't focus' vs. clinical diagnostic descriptor 'inattention'. The clinical phrasing points strongly toward a specific neurodevelopmental diagnosis (ADHD); the colloquial version might lead to generic continuations like 'issues' or 'problems'.", "patient_term": "spacey and can't focus", "clinical_term": "inattention", "topic": "attention and neurodevelopmental disorders", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": 0.65, "prob_patient": 0.486, "language_penalty": -0.16400000000000003, "anchor_fallback": false, "top_clinical": [ "ADHD", 0.65 ], "top_patient": [ "ADHD", 0.486 ], "spread_clinical": [ [ "ADHD", 0.65 ], [ "ADD", 0.126 ], [ "a", 0.058 ], [ "an", 0.022 ], [ "ad", 0.017 ] ], "spread_patient": [ [ "ADHD", 0.486 ], [ "ADD", 0.22 ], [ "a", 0.076 ], [ "ad", 0.033 ], [ "some", 0.029 ] ], "target_token": "ADHD", "flipped": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " ADHD", "observed_clinical": [ "Output \" ADHD\"", 0.65 ], "probe_extension": null }, "circuit_diff": { "shared_features": 635, "unique_to_a": 660, "unique_to_b": 818 }, "clinical_mass": { "clinical": 0.3032, "patient": 0.2736 } }, "gemma-3-4b-it": { "prob_clinical": 0.9684, "prob_patient": 0.945, "language_penalty": -0.0234, "anchor_fallback": false, "top_clinical": [ "ADHD", 0.9684 ], "top_patient": [ "ADHD", 0.945 ], "spread_clinical": [ [ "ADHD", 0.9684 ], [ "ADD", 0.0177 ], [ "a", 0.0051 ], [ "Attention", 0.0045 ], [ "an", 0.0019 ], [ "attention", 0.0008 ], [ "something", 0.0004 ], [ "AD", 0.0003 ], [ "trouble", 0.0001 ] ], "spread_patient": [ [ "ADHD", 0.945 ], [ "a", 0.0173 ], [ "an", 0.0105 ], [ "ADD", 0.0093 ], [ "attention", 0.0044 ], [ "trouble", 0.003 ], [ "something", 0.0021 ], [ "Attention", 0.0018 ], [ "some", 0.0014 ], [ "und", 0.001 ] ], "target_token": "ADHD", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null }, "qwen3-4b": { "prob_clinical": 0.9851, "prob_patient": 0.9155, "language_penalty": -0.0696, "anchor_fallback": false, "top_clinical": [ "ADHD", 0.9851 ], "top_patient": [ "ADHD", 0.9155 ], "spread_clinical": [ [ "ADHD", 0.9851 ], [ "attention", 0.0036 ], [ "a", 0.0031 ], [ "an", 0.0028 ], [ "AD", 0.0022 ], [ "ADD", 0.0012 ], [ "Attention", 0.0009 ], [ "dys", 0.0007 ], [ "autism", 0.0002 ], [ "learning", 0.0001 ] ], "spread_patient": [ [ "ADHD", 0.9155 ], [ "attention", 0.0355 ], [ "a", 0.0131 ], [ "ADD", 0.0102 ], [ "an", 0.007 ], [ "dys", 0.0048 ], [ "AD", 0.0048 ], [ "autism", 0.0029 ], [ "Attention", 0.002 ], [ "learning", 0.0008 ] ], "target_token": "ADHD", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null }, "qwen3-1.7b": { "prob_clinical": 0.9373, "prob_patient": 0.7708, "language_penalty": -0.1665, "anchor_fallback": false, "top_clinical": [ "ADHD", 0.9373 ], "top_patient": [ "ADHD", 0.7708 ], "spread_clinical": [ [ "ADHD", 0.9373 ], [ "attention", 0.025 ], [ "a", 0.0152 ], [ "learning", 0.0081 ], [ "dys", 0.0063 ], [ "an", 0.0021 ], [ "ADD", 0.0021 ], [ "Attention", 0.0008 ], [ "autism", 0.0007 ], [ "been", 0.0004 ] ], "spread_patient": [ [ "ADHD", 0.7708 ], [ "dys", 0.0717 ], [ "a", 0.0558 ], [ "attention", 0.0384 ], [ "an", 0.0181 ], [ "autism", 0.0097 ], [ "learning", 0.0097 ], [ "ADD", 0.0046 ], [ "some", 0.0031 ], [ "As", 0.0022 ] ], "target_token": "ADHD", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null } }, "prob_clinical": 0.65, "prob_patient": 0.486, "language_penalty": -0.16400000000000003, "flipped": false, "top_clinical": [ "ADHD", 0.65 ], "top_patient": [ "ADHD", 0.486 ], "spread_clinical": [ [ "ADHD", 0.65 ], [ "ADD", 0.126 ], [ "a", 0.058 ], [ "an", 0.022 ], [ "ad", 0.017 ] ], "spread_patient": [ [ "ADHD", 0.486 ], [ "ADD", 0.22 ], [ "a", 0.076 ], [ "ad", 0.033 ], [ "some", 0.029 ] ], "target_token": "ADHD", "anchor_fallback": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " ADHD", "observed_clinical": [ "Output \" ADHD\"", 0.65 ], "probe_extension": null }, "circuit_diff": { "shared_features": 635, "unique_to_a": 660, "unique_to_b": 818 }, "clinical_mass": { "clinical": 0.3032, "patient": 0.2736 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260712T163501Z/index_59.html", "depth_class": "retained" }, { "index": 625, "batch": "pairs_20260712T163501Z", "batch_index": 61, "clinical_prompt": "My stomach's been inflamed, so I should probably see a", "patient_prompt": "My stomach's been acting really angry, so I should probably see a", "intended_target": "gastroenterologist", "rationale": "'Acting angry' is lay language for digestive distress; 'inflamed' is clinical. The frame funnels toward a specialist. Clinical version should prefer a medical specialist over 'doctor'.", "patient_term": "acting really angry", "clinical_term": "inflamed", "topic": "gastrointestinal inflammation", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": 0.039, "prob_patient": 0.024, "language_penalty": -0.015, "anchor_fallback": false, "top_clinical": [ "doctor", 0.791 ], "top_patient": [ "doctor", 0.824 ], "spread_clinical": [ [ "doctor", 0.791 ], [ "doc", 0.044 ], [ "gastroenter", 0.039 ], [ "GI", 0.024 ], [ "gastro", 0.021 ] ], "spread_patient": [ [ "doctor", 0.824 ], [ "doc", 0.041 ], [ "gastroenter", 0.024 ], [ "gastro", 0.023 ], [ "GI", 0.02 ] ], "target_token": "gastroenter", "flipped": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " gastroenterologist", "observed_clinical": [ "Output \" gastroenter\"", 0.039 ], "probe_extension": null }, "circuit_diff": { "shared_features": 836, "unique_to_a": 271, "unique_to_b": 307 }, "clinical_mass": { "clinical": 0.4287, 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2, "tier_top_patient": 2, "tier_shift": -0.041 } }, "qwen3-4b": { "prob_clinical": 0.0195, "prob_patient": 0.0197, "language_penalty": 0.0002, "anchor_fallback": false, "top_clinical": [ "doctor", 0.9381 ], "top_patient": [ "doctor", 0.9488 ], "spread_clinical": [ [ "doctor", 0.9381 ], [ "gastro", 0.0195 ], [ "specialist", 0.0195 ], [ "pro", 0.0038 ], [ "physician", 0.003 ], [ "medical", 0.0014 ], [ "______", 0.0012 ], [ "healthcare", 0.0009 ], [ "__", 0.0009 ], [ "surgeon", 0.0006 ] ], "spread_patient": [ [ "doctor", 0.9488 ], [ "gastro", 0.0197 ], [ "pro", 0.0064 ], [ "specialist", 0.0036 ], [ "doc", 0.0025 ], [ "healthcare", 0.0021 ], [ "physician", 0.0017 ], [ "medical", 0.0014 ], [ "professional", 0.0013 ], [ "health", 0.001 ] ], "target_token": "gastro", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.016 } }, "qwen3-1.7b": { "prob_clinical": 0.0456, "prob_patient": 0.0175, "language_penalty": -0.0281, "anchor_fallback": false, "top_clinical": [ "doctor", 0.9166 ], "top_patient": [ "doctor", 0.9541 ], "spread_clinical": [ [ "doctor", 0.9166 ], [ "gastro", 0.0456 ], [ "physician", 0.0102 ], [ "GP", 0.007 ], [ "specialist", 0.0042 ], [ "GI", 0.0018 ], [ "healthcare", 0.0018 ], [ "medical", 0.0016 ], [ "professional", 0.0007 ], [ "g", 0.0007 ] ], "spread_patient": [ [ "doctor", 0.9541 ], [ "gastro", 0.0175 ], [ "therapist", 0.0039 ], [ "professional", 0.0034 ], [ "physician", 0.003 ], [ "GP", 0.0027 ], [ "specialist", 0.0018 ], [ "psychiatrist", 0.0014 ], [ "medical", 0.0007 ], [ "g", 0.0007 ] ], "target_token": "gastro", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.027 } } }, "prob_clinical": 0.039, "prob_patient": 0.024, "language_penalty": -0.015, "flipped": false, "top_clinical": [ "doctor", 0.791 ], "top_patient": [ "doctor", 0.824 ], "spread_clinical": [ [ "doctor", 0.791 ], [ "doc", 0.044 ], [ "gastroenter", 0.039 ], [ "GI", 0.024 ], [ "gastro", 0.021 ] ], "spread_patient": [ [ "doctor", 0.824 ], [ "doc", 0.041 ], [ "gastroenter", 0.024 ], [ "gastro", 0.023 ], [ "GI", 0.02 ] ], "target_token": "gastroenter", "anchor_fallback": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " gastroenterologist", "observed_clinical": [ "Output \" gastroenter\"", 0.039 ], "probe_extension": null }, "circuit_diff": { "shared_features": 836, "unique_to_a": 271, "unique_to_b": 307 }, "clinical_mass": { "clinical": 0.4287, "patient": 0.3577 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260712T163501Z/index_61.html", "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.02 }, "depth_class": "retained" }, { "index": 626, "batch": "pairs_20260712T163501Z", "batch_index": 62, "clinical_prompt": "I keep getting these awful paresthesia symptoms in my feet, so I wonder if my", "patient_prompt": "I keep getting these awful pins and needles sensations in my feet, so I wonder if my", "intended_target": "nerves", "rationale": "'Pins and needles' is colloquial; 'paresthesia' is the clinical term. The frame '...so I wonder if my' naturally probes for what body system is affected. Clinical version should favor 'nerves' over casual explanations.", "patient_term": "pins and needles sensations", "clinical_term": "paresthesia symptoms", "topic": "neuropathy", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": null, "prob_patient": null, "language_penalty": null, "anchor_fallback": false, "top_clinical": [ "feet", 0.155 ], "top_patient": null, "spread_clinical": [ [ "feet", 0.155 ], [ "body", 0.061 ], [ "blood", 0.045 ], [ "brain", 0.035 ], [ "foot", 0.035 ] ], "spread_patient": [], "target_token": null, "flipped": false, "screening": { "status": "screened_out", "min_prob": 0.02, "intended_target": " nerves", "observed_clinical": null, "probe_extension": null, "reason": "intended target not in the traced clinical spread" }, "circuit_diff": null, "clinical_mass": { "clinical": 0.3598 } }, "gemma-3-4b-it": { "prob_clinical": 0.046, "prob_patient": 0.0765, "language_penalty": 0.0305, "anchor_fallback": false, "top_clinical": [ "vitamin", 0.1417 ], "top_patient": [ "feet", 0.1834 ], "spread_clinical": [ [ "vitamin", 0.1417 ], [ "feet", 0.1417 ], [ "peripheral", 0.0669 ], [ "symptoms", 0.0521 ], [ "neuropathy", 0.0521 ], [ "nerves", 0.046 ], [ "blood", 0.046 ], [ "Vitamin", 0.0358 ], [ "nerve", 0.0246 ], [ "foot", 0.0204 ] ], "spread_patient": [ [ "feet", 0.1834 ], [ "shoes", 0.0982 ], [ "circulation", 0.0982 ], [ "posture", 0.0867 ], [ "nerves", 0.0765 ], [ "blood", 0.0409 ], [ "nerve", 0.0319 ], [ "sleeping", 0.0248 ], [ "sleep", 0.0248 ], [ "socks", 0.0193 ] ], "target_token": "nerves", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": 1, "tier_top_patient": null, "tier_shift": null } }, "qwen3-4b": { "prob_clinical": 0.0365, "prob_patient": 0.0177, "language_penalty": -0.0188, "anchor_fallback": false, "top_clinical": [ "feet", 0.1853 ], "top_patient": [ "feet", 0.4567 ], "spread_clinical": [ [ "feet", 0.1853 ], [ "legs", 0.1853 ], [ "condition", 0.0468 ], [ "nerves", 0.0365 ], [ "peripheral", 0.0322 ], [ "body", 0.0251 ], [ "problem", 0.0221 ], [ "blood", 0.0195 ], [ "diabetes", 0.0172 ], [ "lower", 0.0172 ] ], "spread_patient": [ [ "feet", 0.4567 ], [ "legs", 0.2157 ], [ "blood", 0.0375 ], [ "circulation", 0.0258 ], [ "body", 0.0201 ], [ "nerves", 0.0177 ], [ "condition", 0.0177 ], [ "peripheral", 0.0147 ], [ "veins", 0.0138 ], [ "diabetes", 0.0107 ] ], "target_token": "nerves", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null }, "qwen3-1.7b": { "prob_clinical": 0.0348, "prob_patient": 0.0781, "language_penalty": 0.0433, "anchor_fallback": false, "top_clinical": [ "feet", 0.0649 ], "top_patient": [ "feet", 0.1288 ], "spread_clinical": [ [ "feet", 0.0649 ], [ "nervous", 0.0506 ], [ "blood", 0.0394 ], [ "nerves", 0.0348 ], [ "body", 0.0348 ], [ "vitamin", 0.0307 ], [ "diet", 0.0307 ], [ "legs", 0.0211 ], [ "car", 0.0211 ], [ "nerve", 0.0145 ] ], "spread_patient": [ [ "feet", 0.1288 ], [ "nerves", 0.0781 ], [ "nervous", 0.0781 ], [ "blood", 0.0689 ], [ "nerve", 0.0474 ], [ "car", 0.0326 ], [ "legs", 0.0287 ], [ "body", 0.0254 ], [ "arteries", 0.0224 ], [ "diabetes", 0.0136 ] ], "target_token": "nerves", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null } }, "prob_clinical": null, "prob_patient": null, "language_penalty": null, "flipped": false, "top_clinical": [ "feet", 0.155 ], "top_patient": null, "spread_clinical": [ [ "feet", 0.155 ], [ "body", 0.061 ], [ "blood", 0.045 ], [ "brain", 0.035 ], [ "foot", 0.035 ] ], "spread_patient": [], "target_token": null, "anchor_fallback": false, "screening": { "status": "screened_out", "min_prob": 0.02, "intended_target": " nerves", "observed_clinical": null, "probe_extension": null, "reason": "intended target not in the traced clinical spread" }, "circuit_diff": null, "clinical_mass": { "clinical": 0.3598 }, "depth_class": "retained" }, { "index": 627, "batch": "pairs_20260712T163501Z", "batch_index": 64, "clinical_prompt": "My chest has been experiencing palpitations during exercise, so I should probably take my", "patient_prompt": "My chest has been doing flip-flops when I exercise, so I should probably take my", "intended_target": "pulse", "rationale": "'Flip-flops' is lay description; 'palpitations' is clinical. The frame '...so I should probably take my' is unusual but grammatically probes for measurement or monitoring. Clinical version should favor 'pulse' over casual follow-ups.", "patient_term": "doing flip-flops", "clinical_term": "experiencing palpitations", "topic": "cardiac arrhythmia", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": 0.074, "prob_patient": null, "language_penalty": null, "anchor_fallback": false, "top_clinical": [ "blood", 0.269 ], "top_patient": [ "own", 0.101 ], "spread_clinical": [ [ "blood", 0.269 ], [ "heart", 0.165 ], [ "pulse", 0.074 ], [ "medication", 0.048 ], [ "meds", 0.044 ] ], "spread_patient": [ [ "own", 0.101 ], [ "heart", 0.096 ], [ "doctor", 0.078 ], [ "meds", 0.056 ], [ "blood", 0.042 ] ], "target_token": "pulse", "flipped": true, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " pulse", "observed_clinical": [ "Output \" pulse\"", 0.074 ], "probe_extension": null }, "circuit_diff": { "shared_features": 920, "unique_to_a": 395, "unique_to_b": 473 }, "clinical_mass": { "clinical": 0.3264, "patient": 0.2338 }, "urgency": { 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night, so I think I need an", "intended_target": "antacid", "rationale": "'Burning sensations' is vague lay language; 'acid reflux symptoms' is clinical. The frame '...so I think I need an' before a vowel naturally points to a remedy. Clinical phrasing should favor 'antacid' over non-specific solutions like 'appointment'.", "patient_term": "burning sensations", "clinical_term": "acid reflux symptoms", "topic": "gastroesophageal reflux", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": 0.409, "prob_patient": 0.053, "language_penalty": -0.356, "anchor_fallback": false, "top_clinical": [ "ant", 0.409 ], "top_patient": [ "inhal", 0.141 ], "spread_clinical": [ [ "ant", 0.409 ], [ "anti", 0.149 ], [ "over", 0.07 ], [ "appointment", 0.054 ], [ "H", 0.036 ] ], "spread_patient": [ [ "inhal", 0.141 ], [ "ECG", 0.129 ], [ "EKG", 0.114 ], [ "anti", 0.053 ], [ "appointment", 0.046 ] ], "target_token": "ant", "flipped": true, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " antacid", "observed_clinical": [ "Output \" ant\"", 0.409 ], "probe_extension": null }, "circuit_diff": { "shared_features": 864, "unique_to_a": 548, "unique_to_b": 607 }, "clinical_mass": { "clinical": 0.3518, "patient": 0.3652 }, "html": "modes/simulated/pairs_20260712T163501Z/index_65.html", "urgency": { "flip_class": "lateral", "tier_top_clinical": 1, "tier_top_patient": 1, "tier_shift": 0.112 } }, "gemma-3-4b-it": { "prob_clinical": 0.0071, "prob_patient": 0.0002, "language_penalty": -0.0069, "anchor_fallback": false, "top_clinical": [ "endoscopy", 0.9363 ], "top_patient": [ "appointment", 0.3225 ], "spread_clinical": [ [ "endoscopy", 0.9363 ], [ "evaluation", 0.0194 ], [ "appointment", 0.0134 ], [ "acid", 0.0081 ], [ "ant", 0.0071 ], [ "upper", 0.0038 ], [ "investigation", 0.002 ], [ "M", 0.0012 ], [ "anti", 0.0012 ], [ "esophageal", 0.0011 ] ], "spread_patient": [ [ "appointment", 0.3225 ], [ "evaluation", 0.1956 ], [ "ECG", 0.1187 ], [ "endoscopy", 0.0924 ], [ "E", 0.0437 ], [ "MRI", 0.0234 ], [ "opinion", 0.0234 ], [ "x", 0.0206 ], [ "X", 0.0182 ], [ "urgent", 0.0125 ] ], "target_token": "ant", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": 2, "tier_shift": null } }, "qwen3-4b": { "prob_clinical": 0.4167, "prob_patient": 0.1306, "language_penalty": -0.2861, "anchor_fallback": false, "top_clinical": [ "ant", 0.4167 ], "top_patient": [ "ant", 0.1306 ], "spread_clinical": [ [ "ant", 0.4167 ], [ "acid", 0.3245 ], [ "anti", 0.1194 ], [ "over", 0.0564 ], [ "effective", 0.0266 ], [ "H", 0.0207 ], [ "O", 0.0183 ], [ "ulcer", 0.0013 ], [ "appropriate", 0.0013 ], [ "o", 0.0011 ] ], "spread_patient": [ [ "ant", 0.1306 ], [ "E", 0.1152 ], [ "end", 0.0792 ], [ "acid", 0.0699 ], [ "anti", 0.0544 ], [ "upper", 0.0544 ], [ "exam", 0.0291 ], [ "antibiotic", 0.0257 ], [ "ulcer", 0.0257 ], [ "internal", 0.0257 ] ], "target_token": "ant", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 1, "tier_top_patient": 1, "tier_shift": 0.628 } }, "qwen3-1.7b": { "prob_clinical": 0.3418, "prob_patient": 0.0048, "language_penalty": -0.337, "anchor_fallback": false, "top_clinical": [ "ant", 0.3418 ], "top_patient": [ "E", 0.8005 ], "spread_clinical": [ [ "ant", 0.3418 ], [ "H", 0.2662 ], [ "acid", 0.1425 ], [ "anti", 0.111 ], [ "over", 0.0281 ], [ "end", 0.0103 ], [ "appointment", 0.0091 ], [ "upper", 0.0071 ], [ "O", 0.0055 ], [ "overnight", 0.0049 ] ], "spread_patient": [ [ "E", 0.8005 ], [ "angi", 0.0399 ], [ "X", 0.0166 ], [ "x", 0.0147 ], [ "end", 0.0147 ], [ "ech", 0.0147 ], [ "electro", 0.0101 ], [ "ER", 0.0089 ], [ "MRI", 0.0069 ], [ "ant", 0.0048 ] ], "target_token": "ant", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": 1, "tier_top_patient": null, "tier_shift": null } } }, "prob_clinical": 0.409, "prob_patient": 0.053, "language_penalty": -0.356, "flipped": true, "top_clinical": [ "ant", 0.409 ], "top_patient": [ "inhal", 0.141 ], "spread_clinical": [ [ "ant", 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episodes of orthostatic hypotension when I stand up too fast, so I need to check my", "patient_prompt": "I've been having these awful dizzy spells when I stand up too fast, so I need to check my", "intended_target": "blood", "rationale": "The colloquial 'dizzy spells' frames the situation as vague discomfort; the clinical term 'orthostatic hypotension' signals a specific pathophysiology requiring vital-sign monitoring. The frame 'need to check my' naturally funnels toward 'blood' or 'pressure' in the clinical reading, whereas colloquial might expect 'head' or 'balance'.", "patient_term": "dizzy spells", "clinical_term": "episodes of orthostatic hypotension", "topic": "cardiovascular", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": 0.542, "prob_patient": 0.547, "language_penalty": 0.0050000000000000044, "anchor_fallback": false, "top_clinical": [ "blood", 0.542 ], "top_patient": [ "blood", 0.547 ], "spread_clinical": [ [ "blood", 0.542 ], [ "BP", 0.165 ], [ "heart", 0.044 ], [ "pulse", 0.032 ], [ "bp", 0.028 ] ], "spread_patient": [ [ "blood", 0.547 ], [ "BP", 0.122 ], [ "heart", 0.024 ], [ "balance", 0.021 ], [ "B", 0.02 ] ], "target_token": "blood", "flipped": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " blood", "observed_clinical": [ "Output \" blood\"", 0.542 ], "probe_extension": null }, "circuit_diff": { "shared_features": 882, "unique_to_a": 509, "unique_to_b": 564 }, "clinical_mass": { "clinical": 0.3437, "patient": 0.3199 }, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": 0.0 } }, "gemma-3-4b-it": { "prob_clinical": 0.7159, "prob_patient": 0.929, "language_penalty": 0.2131, "anchor_fallback": false, "top_clinical": [ "blood", 0.7159 ], "top_patient": [ "blood", 0.929 ], "spread_clinical": [ [ "blood", 0.7159 ], [ "electrolytes", 0.0666 ], [ "hydration", 0.0588 ], [ "fluid", 0.0278 ], [ "sodium", 0.0278 ], [ "posture", 0.0149 ], [ "salt", 0.0131 ], [ "electrolyte", 0.009 ], [ "potassium", 0.009 ], [ "fluids", 0.0062 ] ], "spread_patient": [ [ "blood", 0.929 ], [ "inner", 0.0281 ], [ "balance", 0.0103 ], [ "iron", 0.0055 ], [ "BP", 0.0043 ], [ "pressure", 0.0038 ], [ "low", 0.002 ], [ "hydration", 0.0018 ], [ "orth", 0.0018 ], [ "posture", 0.0016 ] ], "target_token": "blood", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": 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"prob_patient": 0.2934, "language_penalty": -0.6791, "anchor_fallback": false, "top_clinical": [ "blood", 0.9725 ], "top_patient": [ "balance", 0.6211 ], "spread_clinical": [ [ "blood", 0.9725 ], [ "BP", 0.0074 ], [ "body", 0.0035 ], [ "posture", 0.0035 ], [ "balance", 0.0019 ], [ "pulse", 0.0015 ], [ "standing", 0.0008 ], [ "orth", 0.0004 ], [ "diet", 0.0004 ], [ "heart", 0.0003 ] ], "spread_patient": [ [ "balance", 0.6211 ], [ "blood", 0.2934 ], [ "body", 0.0188 ], [ "posture", 0.0114 ], [ "heart", 0.0054 ], [ "inner", 0.0042 ], [ "orth", 0.0033 ], [ "diet", 0.0033 ], [ "standing", 0.0029 ], [ "vision", 0.0025 ] ], "target_token": "blood", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": 2, "tier_top_patient": null, "tier_shift": -0.011 } } }, "prob_clinical": 0.542, "prob_patient": 0.547, "language_penalty": 0.0050000000000000044, "flipped": false, "top_clinical": [ "blood", 0.542 ], "top_patient": [ "blood", 0.547 ], "spread_clinical": [ [ "blood", 0.542 ], [ "BP", 0.165 ], [ "heart", 0.044 ], [ "pulse", 0.032 ], [ "bp", 0.028 ] ], "spread_patient": [ [ "blood", 0.547 ], [ "BP", 0.122 ], [ "heart", 0.024 ], [ "balance", 0.021 ], [ "B", 0.02 ] ], "target_token": "blood", "anchor_fallback": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " blood", "observed_clinical": [ "Output \" blood\"", 0.542 ], "probe_extension": null }, "circuit_diff": { "shared_features": 882, "unique_to_a": 509, "unique_to_b": 564 }, "clinical_mass": { "clinical": 0.3437, "patient": 0.3199 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260712T163501Z/index_66.html", "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": 0.0 }, "depth_class": "retained" }, { "index": 630, "batch": "pairs_20260712T163501Z", "batch_index": 67, "clinical_prompt": "My partner says I've been really experiencing 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"tier_shift": 0.164 }, "depth_class": "retained" }, { "index": 634, "batch": "pairs_20260712T163501Z", "batch_index": 71, "clinical_prompt": "I have cognitive impairment, so I think I need to take my", "patient_prompt": "I've been feeling all fuzzy in my head lately, so I think I need to take my", "intended_target": "medication", "rationale": "The lay expression 'fuzzy in my head' is vague and general; 'cognitive impairment' is clinically specific. Both frames end after 'my', funneling toward a treatment-related noun. The clinical phrasing should bias toward 'medication' as the expected next token, while the colloquial phrasing might drift toward 'vitamins' or 'sleep'.", "patient_term": "feeling all fuzzy in my head", "clinical_term": "cognitive impairment", "topic": "cognitive dysfunction", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": 0.114, "prob_patient": 0.075, "language_penalty": -0.03900000000000001, "anchor_fallback": false, "top_clinical": [ "time", 0.237 ], "top_patient": [ "meds", 0.223 ], "spread_clinical": [ [ "time", 0.237 ], [ "meds", 0.176 ], [ "own", 0.121 ], [ "medication", 0.114 ], [ "medicine", 0.048 ] ], "spread_patient": [ [ "meds", 0.223 ], [ "medicine", 0.098 ], [ "mind", 0.079 ], [ "medication", 0.075 ], [ "vitamins", 0.051 ] ], "target_token": "medication", "flipped": true, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " medication", "observed_clinical": [ "Output \" medication\"", 0.114 ], "probe_extension": null }, "circuit_diff": { "shared_features": 612, "unique_to_a": 628, "unique_to_b": 744 }, "clinical_mass": { "clinical": 0.1998, "patient": 0.1702 }, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": 1, "tier_shift": 0.0 } }, "gemma-3-4b-it": { "prob_clinical": 0.3166, "prob_patient": 0.0875, "language_penalty": -0.2291, "anchor_fallback": false, "top_clinical": [ "medication", 0.3166 ], "top_patient": [ "vitamin", 0.2098 ], "spread_clinical": [ [ "medication", 0.3166 ], [ "medications", 0.1695 ], [ "time", 0.132 ], [ "medicine", 0.0294 ], [ "life", 0.026 ], [ "cognitive", 0.0244 ], [ "vitamins", 0.0215 ], [ "own", 0.0202 ], [ "meds", 0.0148 ], [ "vitamin", 0.0148 ] ], "spread_patient": [ [ "vitamin", 0.2098 ], [ "vitamins", 0.1852 ], [ "medication", 0.0875 ], [ "Vitamin", 0.0601 ], [ "mind", 0.0413 ], [ "brain", 0.0365 ], [ "medicine", 0.0251 ], [ "ADHD", 0.0251 ], [ "medications", 0.0251 ], [ "mental", 0.0251 ] ], "target_token": "medication", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "lateral", "tier_top_clinical": 1, "tier_top_patient": 1, "tier_shift": -0.299 } }, "qwen3-4b": { "prob_clinical": 0.2772, "prob_patient": 0.0835, "language_penalty": -0.1937, "anchor_fallback": false, "top_clinical": [ "medication", 0.2772 ], "top_patient": [ "medicine", 0.1465 ], "spread_clinical": [ [ "medication", 0.2772 ], [ "medications", 0.1905 ], [ "time", 0.0794 ], [ "meds", 0.0311 ], [ "medicine", 0.0311 ], [ "vitamins", 0.0258 ], [ "own", 0.0201 ], [ "cognitive", 0.0177 ], [ "pills", 0.0138 ], [ "prescribed", 0.0114 ] ], "spread_patient": [ [ "medicine", 0.1465 ], [ "temperature", 0.0888 ], [ "medication", 0.0835 ], [ "time", 0.0784 ], [ "head", 0.0737 ], [ "meds", 0.0506 ], [ "vitamins", 0.0348 ], [ "mind", 0.0239 ], [ "ant", 0.0225 ], [ "brain", 0.0164 ] ], "target_token": "medication", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "lateral", "tier_top_clinical": 1, "tier_top_patient": 1, "tier_shift": -0.02 } }, "qwen3-1.7b": { "prob_clinical": 0.231, "prob_patient": 0.062, "language_penalty": -0.169, "anchor_fallback": false, "top_clinical": [ "medication", 0.231 ], "top_patient": [ "vitamin", 0.2165 ], "spread_clinical": [ [ "medication", 0.231 ], [ "medications", 0.1588 ], [ "vitamin", 0.075 ], [ "medicine", 0.0354 ], [ "own", 0.0243 ], [ "supplements", 0.019 ], [ "time", 0.019 ], [ "vitamins", 0.0148 ], [ "medicines", 0.0148 ], [ "family", 0.0148 ] ], "spread_patient": [ [ "vitamin", 0.2165 ], [ "brain", 0.1159 ], [ "head", 0.1023 ], [ "medication", 0.062 ], [ "mind", 0.0547 ], [ "vitamins", 0.0483 ], [ "medications", 0.0228 ], [ "time", 0.0178 ], [ "medicine", 0.0178 ], [ "cholesterol", 0.0138 ] ], "target_token": "medication", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "lateral", "tier_top_clinical": 1, "tier_top_patient": 1, "tier_shift": 0.028 } } }, "prob_clinical": 0.114, "prob_patient": 0.075, "language_penalty": -0.03900000000000001, "flipped": true, "top_clinical": [ "time", 0.237 ], "top_patient": [ "meds", 0.223 ], "spread_clinical": [ [ "time", 0.237 ], [ "meds", 0.176 ], [ "own", 0.121 ], [ "medication", 0.114 ], [ "medicine", 0.048 ] ], "spread_patient": [ [ "meds", 0.223 ], [ "medicine", 0.098 ], [ "mind", 0.079 ], [ "medication", 0.075 ], [ "vitamins", 0.051 ] ], "target_token": "medication", "anchor_fallback": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " medication", "observed_clinical": [ "Output \" medication\"", 0.114 ], "probe_extension": null }, "circuit_diff": { "shared_features": 612, "unique_to_a": 628, "unique_to_b": 744 }, "clinical_mass": { "clinical": 0.1998, "patient": 0.1702 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260712T163501Z/index_71.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": 1, "tier_shift": 0.0 }, "depth_class": "retained" }, { "index": 635, "batch": "pairs_20260712T163501Z", "batch_index": 72, "clinical_prompt": "My legs have weakness, so my doctor thinks I might need an", "patient_prompt": "My legs have been feeling all rubbery when I walk, so my doctor thinks I might need an", "intended_target": "examination", "rationale": "Colloquial 'rubbery' is a layperson's sensory descriptor; clinical 'weakness' is objective and diagnostic. Both end after 'an', naturally funneling toward a vowel-initial noun. The clinical framing should push toward 'examination' or 'assessment', while the colloquial framing might suggest 'exercise' or 'rest'.", "patient_term": "feeling all rubbery", "clinical_term": "weakness", "topic": "motor weakness", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": null, "prob_patient": null, "language_penalty": null, "anchor_fallback": false, "top_clinical": [ "MRI", 0.141 ], "top_patient": null, "spread_clinical": [ [ "MRI", 0.141 ], [ "operation", 0.114 ], [ "electric", 0.072 ], [ "epid", 0.064 ], [ "injection", 0.057 ] ], "spread_patient": [], "target_token": null, "flipped": false, "screening": { "status": "screened_out", "min_prob": 0.02, "intended_target": " examination", "observed_clinical": null, "probe_extension": null, "reason": "intended target not in the traced clinical spread" }, "circuit_diff": null, "clinical_mass": { "clinical": 0.423 }, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": 0.51 } }, "gemma-3-4b-it": { "prob_clinical": 0.0007, "prob_patient": 0.0002, "language_penalty": -0.0005, "anchor_fallback": false, "top_clinical": [ "MRI", 0.919 ], "top_patient": [ "iron", 0.553 ], "spread_clinical": [ [ "MRI", 0.919 ], [ "EMG", 0.0149 ], [ "iron", 0.0116 ], [ "evaluation", 0.008 ], [ "infusion", 0.007 ], [ "ultrasound", 0.0055 ], [ "X", 0.0055 ], [ "injection", 0.0038 ], [ "orthopedic", 0.0023 ], [ "endoscopy", 0.002 ] ], "spread_patient": [ [ "iron", 0.553 ], [ "MRI", 0.296 ], [ "ultrasound", 0.0401 ], [ "echocardi", 0.0189 ], [ "E", 0.0147 ], [ "IV", 0.0147 ], [ "endoscopy", 0.0101 ], [ "Iron", 0.0079 ], [ "angi", 0.0079 ], [ "ankle", 0.0054 ] ], "target_token": "examination", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "lateral", "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": 0.004 } }, "qwen3-4b": { "prob_clinical": 0.0017, "prob_patient": 0.0004, "language_penalty": -0.0013, "anchor_fallback": false, "top_clinical": [ "MRI", 0.5254 ], "top_patient": [ "MRI", 0.6395 ], "spread_clinical": [ [ "MRI", 0.5254 ], [ "IV", 0.1035 ], [ "injection", 0.0554 ], [ "electrom", 0.0336 ], [ "operation", 0.0296 ], [ "EM", 0.0296 ], [ "angi", 0.0296 ], [ "artificial", 0.0262 ], [ "orth", 0.0204 ], [ "intr", 0.018 ] ], "spread_patient": [ [ "MRI", 0.6395 ], [ "IV", 0.0981 ], [ "injection", 0.0764 ], [ "angi", 0.0361 ], [ "intr", 0.0193 ], [ "EM", 0.015 ], [ "electrom", 0.015 ], [ "inject", 0.0103 ], [ "E", 0.0103 ], [ "am", 0.0081 ] ], "target_token": "examination", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.049 } }, "qwen3-1.7b": { "prob_clinical": 0.0044, "prob_patient": 0.0024, "language_penalty": -0.002, "anchor_fallback": false, "top_clinical": [ "MRI", 0.6519 ], "top_patient": [ "MRI", 0.752 ], "spread_clinical": [ [ "MRI", 0.6519 ], [ "implant", 0.0687 ], [ "E", 0.0325 ], [ "operation", 0.0253 ], [ "orth", 0.0174 ], [ "electrical", 0.0119 ], [ "angi", 0.0105 ], [ "ankle", 0.0105 ], [ "epid", 0.0082 ], [ "injection", 0.0072 ] ], "spread_patient": [ [ "MRI", 0.752 ], [ "angi", 0.0374 ], [ "ultrasound", 0.0374 ], [ "end", 0.0257 ], [ "implant", 0.0177 ], [ "X", 0.0122 ], [ "injection", 0.0107 ], [ "orth", 0.0095 ], [ "IV", 0.0095 ], [ "exam", 0.0084 ] ], "target_token": "examination", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.017 } } }, "prob_clinical": null, "prob_patient": null, "language_penalty": null, "flipped": false, "top_clinical": [ "MRI", 0.141 ], "top_patient": null, "spread_clinical": [ [ "MRI", 0.141 ], [ "operation", 0.114 ], [ "electric", 0.072 ], [ "epid", 0.064 ], [ "injection", 0.057 ] ], "spread_patient": [], "target_token": null, "anchor_fallback": false, "screening": { "status": "screened_out", "min_prob": 0.02, "intended_target": " examination", "observed_clinical": null, "probe_extension": null, "reason": "intended target not in the traced clinical spread" }, "circuit_diff": null, "clinical_mass": { "clinical": 0.423 }, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": 0.51 }, "depth_class": "absent" }, { "index": 636, "batch": "pairs_20260712T163501Z", "batch_index": 73, "clinical_prompt": "I have angina, so I wonder if I should take my", "patient_prompt": "I keep getting this awful gnawing feeling in my chest, so I wonder if I should take my", "intended_target": "nitrate", "rationale": "Patient phrasing uses metaphorical sensation language ('gnawing'); clinical term names the condition. Both end after 'my', setting up a medication-class completion. The clinical phrasing should strongly bias toward 'nitrate' (or 'medication'), while colloquial phrasing might suggest 'antacid' or 'pain reliever'.", "patient_term": "awful gnawing feeling in my chest", "clinical_term": "angina", "topic": "angina pectoris", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": null, "prob_patient": null, "language_penalty": null, "anchor_fallback": false, "top_clinical": [ "blood", 0.141 ], "top_patient": null, "spread_clinical": [ [ "blood", 0.141 ], [ "usual", 0.073 ], [ "medication", 0.059 ], [ "beta", 0.058 ], [ "meds", 0.057 ] ], "spread_patient": [], "target_token": null, "flipped": false, "screening": { "status": "screened_out", "min_prob": 0.02, "intended_target": " nitrate", "observed_clinical": null, "probe_extension": null, "reason": "intended target not in the traced clinical spread" }, "circuit_diff": null, "clinical_mass": { "clinical": 0.3875 }, "urgency": { "flip_class": null, "tier_top_clinical": 1, "tier_top_patient": 2, "tier_shift": -0.032 } }, "gemma-3-4b-it": { "prob_clinical": 0.0, "prob_patient": 0.0, "language_penalty": 0.0, "anchor_fallback": false, "top_clinical": [ "blood", 0.7375 ], "top_patient": [ "heart", 0.2313 ], "spread_clinical": [ [ "blood", 0.7375 ], [ "medication", 0.0686 ], [ "heart", 0.0252 ], [ "medications", 0.0252 ], [ "medicine", 0.0173 ], [ "regular", 0.0093 ], [ "baby", 0.0082 ], [ "daily", 0.0056 ], [ "own", 0.0053 ], [ "cholesterol", 0.0047 ] ], "spread_patient": [ [ "heart", 0.2313 ], [ "medication", 0.1801 ], [ "medicine", 0.1403 ], [ "pain", 0.0455 ], [ "anxiety", 0.0455 ], [ "blood", 0.0455 ], [ "chest", 0.0402 ], [ "own", 0.0313 ], [ "pills", 0.013 ], [ "anti", 0.013 ] ], "target_token": "nitrate", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": 1, "tier_top_patient": null, "tier_shift": -0.003 } }, "qwen3-4b": { "prob_clinical": 0.0, "prob_patient": 0.0006, "language_penalty": 0.0006, "anchor_fallback": false, "top_clinical": [ "child", 0.6443 ], "top_patient": [ "heart", 0.1842 ], "spread_clinical": [ [ "child", 0.6443 ], [ "baby", 0.1629 ], [ "dog", 0.0412 ], [ "daughter", 0.0321 ], [ "usual", 0.0134 ], [ "son", 0.0104 ], [ "medication", 0.0049 ], [ "toddler", 0.0043 ], [ "children", 0.0043 ] ], "spread_patient": [ [ "heart", 0.1842 ], [ "blood", 0.0721 ], [ "medication", 0.0678 ], [ "medicine", 0.0598 ], [ "ant", 0.0411 ], [ "chest", 0.0265 ], [ "pills", 0.0265 ], [ "doctor", 0.0265 ], [ "chances", 0.0234 ], [ "pulse", 0.0207 ] ], "target_token": "nit", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, "qwen3-1.7b": { "prob_clinical": 0.0164, "prob_patient": 0.0003, "language_penalty": -0.0161, "anchor_fallback": false, "top_clinical": [ "medication", 0.1215 ], "top_patient": [ "medication", 0.0785 ], "spread_clinical": [ [ "medication", 0.1215 ], [ "usual", 0.1073 ], [ "regular", 0.0835 ], [ "prescribed", 0.0507 ], [ "ant", 0.0507 ], [ "blood", 0.0447 ], [ "medications", 0.0447 ], [ "beta", 0.0211 ], [ "daily", 0.0186 ], [ "nit", 0.0164 ] ], "spread_patient": [ [ "medication", 0.0785 ], [ "time", 0.0612 ], [ "dog", 0.0612 ], [ "heart", 0.0612 ], [ "blood", 0.0476 ], [ "medications", 0.042 ], [ "medicine", 0.0289 ], [ "pulse", 0.0255 ], [ "chest", 0.0255 ], [ "chances", 0.0255 ] ], "target_token": "nit", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 1, "tier_shift": -0.41 } } }, "prob_clinical": null, "prob_patient": null, "language_penalty": null, "flipped": false, "top_clinical": [ "blood", 0.141 ], "top_patient": null, "spread_clinical": [ [ "blood", 0.141 ], [ "usual", 0.073 ], [ "medication", 0.059 ], [ "beta", 0.058 ], [ "meds", 0.057 ] ], "spread_patient": [], "target_token": null, "anchor_fallback": false, "screening": { "status": "screened_out", "min_prob": 0.02, "intended_target": " nitrate", "observed_clinical": null, "probe_extension": null, "reason": "intended target not in the traced clinical spread" }, "circuit_diff": null, "clinical_mass": { "clinical": 0.3875 }, "urgency": { "flip_class": null, "tier_top_clinical": 1, "tier_top_patient": 2, "tier_shift": -0.032 }, "depth_class": "absent" }, { "index": 637, "batch": "pairs_20260712T163501Z", "batch_index": 74, "clinical_prompt": "When I eat, I have dysphagia, so I probably need to see a", "patient_prompt": "When I eat, my throat gets all tight and stuck, so I probably need to see a", "intended_target": "gastroenterologist", "rationale": "Patient phrasing uses concrete, sensory lay language; clinical term is the medical diagnosis. Both end after 'a', naturally preceding a specialist title. The clinical framing should elicit 'gastroenterologist' or 'specialist', while colloquial framing might suggest 'doctor' or 'throat specialist'.", "patient_term": "my throat gets all tight and stuck", "clinical_term": "dysphagia", "topic": "swallowing disorder", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": null, "prob_patient": null, "language_penalty": null, "anchor_fallback": false, "top_clinical": [ "speech", 0.384 ], "top_patient": null, "spread_clinical": [ [ "speech", 0.384 ], [ "doctor", 0.114 ], [ "die", 0.075 ], [ "specialist", 0.064 ], [ "swallowing", 0.052 ] ], "spread_patient": [], "target_token": null, "flipped": false, "screening": { "status": "screened_out", "min_prob": 0.02, "intended_target": " gastroenterologist", "observed_clinical": null, "probe_extension": null, "reason": "intended target not in the traced clinical spread" }, "circuit_diff": null, "clinical_mass": { "clinical": 0.3824 }, "urgency": { "flip_class": "downgrade", "tier_top_clinical": 3, "tier_top_patient": 2, "tier_shift": -0.562 } }, "gemma-3-4b-it": { "prob_clinical": 0.0137, "prob_patient": 0.0009, "language_penalty": -0.0128, "anchor_fallback": false, "top_clinical": [ "speech", 0.7494 ], "top_patient": [ "doctor", 0.9673 ], "spread_clinical": [ [ "speech", 0.7494 ], [ "doctor", 0.1302 ], [ "Speech", 0.0423 ], [ "specialist", 0.0291 ], [ "gastroenter", 0.0137 ], [ "swallowing", 0.0083 ], [ "professional", 0.0065 ], [ "therapist", 0.0045 ], [ "swallow", 0.0024 ], [ "physician", 0.0019 ] ], "spread_patient": [ [ "doctor", 0.9673 ], [ "medical", 0.0084 ], [ "specialist", 0.004 ], [ "professional", 0.0031 ], [ "Doctor", 0.0031 ], [ "dentist", 0.0027 ], [ "physician", 0.0027 ], [ "healthcare", 0.0019 ], [ "speech", 0.0015 ], [ "gastroenter", 0.0009 ] ], "target_token": "gastroenter", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "downgrade", "tier_top_clinical": 3, "tier_top_patient": 2, "tier_shift": -0.844 } }, "qwen3-4b": { "prob_clinical": 0.0169, "prob_patient": 0.0032, "language_penalty": -0.0137, "anchor_fallback": false, "top_clinical": [ "speech", 0.6358 ], "top_patient": [ "doctor", 0.8881 ], "spread_clinical": [ [ "speech", 0.6358 ], [ "doctor", 0.1419 ], [ "specialist", 0.0975 ], [ "dys", 0.0247 ], [ "Speech", 0.0169 ], [ "gastro", 0.0169 ], [ "diet", 0.0109 ], [ "swallowing", 0.0066 ], [ "swallow", 0.0066 ], [ "physician", 0.0038 ] ], "spread_patient": [ [ "doctor", 0.8881 ], [ "specialist", 0.0826 ], [ "throat", 0.0077 ], [ "dentist", 0.0053 ], [ "gastro", 0.0032 ], [ "speech", 0.0019 ], [ "physician", 0.0017 ], [ "professional", 0.0008 ], [ "surgeon", 0.0007 ], [ "medical", 0.0006 ] ], "target_token": "gastro", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "downgrade", "tier_top_clinical": 3, "tier_top_patient": 2, "tier_shift": -0.707 } }, "qwen3-1.7b": { "prob_clinical": 0.2836, "prob_patient": 0.0027, "language_penalty": -0.2809, "anchor_fallback": false, "top_clinical": [ "doctor", 0.4126 ], "top_patient": [ "doctor", 0.9645 ], "spread_clinical": [ [ "doctor", 0.4126 ], [ "gastro", 0.2836 ], [ "speech", 0.0921 ], [ "specialist", 0.0558 ], [ "diet", 0.0339 ], [ "nutrition", 0.0233 ], [ "physician", 0.011 ], [ "pul", 0.0086 ], [ "GI", 0.0076 ], [ "Speech", 0.0076 ] ], "spread_patient": [ [ "doctor", 0.9645 ], [ "dentist", 0.0121 ], [ "specialist", 0.0083 ], [ "physician", 0.0031 ], [ "gastro", 0.0027 ], [ "GP", 0.0013 ], [ "pul", 0.0011 ], [ "ENT", 0.0011 ], [ "throat", 0.0009 ], [ "healthcare", 0.0004 ] ], "target_token": "gastro", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.396 } } }, "prob_clinical": null, "prob_patient": null, "language_penalty": null, "flipped": false, "top_clinical": [ "speech", 0.384 ], "top_patient": null, "spread_clinical": [ [ "speech", 0.384 ], [ "doctor", 0.114 ], [ "die", 0.075 ], [ "specialist", 0.064 ], [ "swallowing", 0.052 ] ], "spread_patient": [], "target_token": null, "anchor_fallback": false, "screening": { "status": "screened_out", "min_prob": 0.02, "intended_target": " gastroenterologist", "observed_clinical": null, "probe_extension": null, "reason": "intended target not in the traced clinical spread" }, "circuit_diff": null, "clinical_mass": { "clinical": 0.3824 }, "urgency": { "flip_class": "downgrade", "tier_top_clinical": 3, "tier_top_patient": 2, "tier_shift": -0.562 }, "depth_class": "absent" }, { "index": 638, "batch": "pairs_20260712T163501Z", "batch_index": 75, "clinical_prompt": "I've been having vasomotor symptoms, so I think I might need to take my", "patient_prompt": "I've been getting these awful hot flushes all day, so I think I might need to take my", "intended_target": "hormone", "rationale": "Colloquial 'hot flushes' is a patient-friendly descriptor; 'vasomotor symptoms' is the clinical classification. Both end after 'my', funneling toward treatment modality. Clinical phrasing should bias toward 'hormone' or 'estrogen', while colloquial might suggest 'medication' or 'vitamins'.", "patient_term": "awful hot flushes", "clinical_term": "vasomotor symptoms", "topic": "vasomotor dysfunction", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": null, "prob_patient": null, "language_penalty": null, "anchor_fallback": false, "top_clinical": [ "meds", 0.11 ], "top_patient": null, "spread_clinical": [ [ "meds", 0.11 ], [ "estrogen", 0.068 ], [ "birth", 0.062 ], [ "HRT", 0.05 ], [ "medication", 0.043 ] ], "spread_patient": [], "target_token": null, "flipped": false, "screening": { "status": "screened_out", "min_prob": 0.02, "intended_target": " hormone", "observed_clinical": null, "probe_extension": null, "reason": "intended target not in the traced clinical spread" }, "circuit_diff": null, "clinical_mass": { "clinical": 0.4302 }, "urgency": { "flip_class": "uninformative", "tier_top_clinical": 1, "tier_top_patient": null, "tier_shift": -0.128 } }, "gemma-3-4b-it": { "prob_clinical": 0.1428, "prob_patient": 0.0359, "language_penalty": -0.1069, "anchor_fallback": false, "top_clinical": [ "hormone", 0.1428 ], "top_patient": [ "medication", 0.5617 ], "spread_clinical": [ [ "hormone", 0.1428 ], [ "estrogen", 0.1112 ], [ "hormones", 0.1112 ], [ "own", 0.0981 ], [ "thyroid", 0.0981 ], [ "testosterone", 0.0764 ], [ "medication", 0.0525 ], [ "temperature", 0.0463 ], [ "period", 0.0409 ], [ "iron", 0.0248 ] ], "spread_patient": [ [ "medication", 0.5617 ], [ "HR", 0.1609 ], [ "birth", 0.0407 ], [ "hormone", 0.0359 ], [ "pill", 0.0192 ], [ "temperature", 0.017 ], [ "pills", 0.017 ], [ "menopause", 0.0091 ], [ "hormones", 0.008 ], [ "blood", 0.008 ] ], "target_token": "hormone", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": 1, "tier_shift": null } }, "qwen3-4b": { "prob_clinical": 0.0492, "prob_patient": 0.1329, "language_penalty": 0.0837, "anchor_fallback": false, "top_clinical": [ "first", 0.3205 ], "top_patient": [ "medication", 0.1707 ], "spread_clinical": [ [ "first", 0.3205 ], [ "H", 0.1944 ], [ "estrogen", 0.081 ], [ "hormone", 0.0492 ], [ "birth", 0.0434 ], [ "medication", 0.0298 ], [ "pill", 0.0192 ], [ "blood", 0.0192 ], [ "prescribed", 0.0132 ], [ "antidepress", 0.011 ] ], "spread_patient": [ [ "medication", 0.1707 ], [ "hormone", 0.1329 ], [ "temperature", 0.0914 ], [ "ant", 0.0628 ], [ "birth", 0.0628 ], [ "estrogen", 0.0459 ], [ "pill", 0.0432 ], [ "contraceptive", 0.0316 ], [ "medicine", 0.0279 ], [ "prescribed", 0.0279 ] ], "target_token": "hormone", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "lateral", "tier_top_clinical": 1, "tier_top_patient": 1, "tier_shift": 0.324 } }, "qwen3-1.7b": { "prob_clinical": 0.0025, "prob_patient": 0.0049, "language_penalty": 0.0024, "anchor_fallback": false, "top_clinical": [ "birth", 0.4211 ], "top_patient": [ "pill", 0.1634 ], "spread_clinical": [ [ "birth", 0.4211 ], [ "pill", 0.1549 ], [ "estrogen", 0.0829 ], [ "medication", 0.0305 ], [ "hormones", 0.0238 ], [ "period", 0.021 ], [ "pills", 0.0185 ], [ "antidepress", 0.0163 ], [ "medications", 0.0163 ], [ "prog", 0.0163 ] ], "spread_patient": [ [ "pill", 0.1634 ], [ "birth", 0.1123 ], [ "temperature", 0.0875 ], [ "medication", 0.0468 ], [ "antidepress", 0.0322 ], [ "vitamin", 0.0322 ], [ "hormones", 0.0284 ], [ "estrogen", 0.0251 ], [ "supplements", 0.0251 ], [ "husband", 0.0195 ] ], "target_token": "hormone", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "lateral", "tier_top_clinical": 1, "tier_top_patient": 1, "tier_shift": 0.006 } } }, "prob_clinical": null, "prob_patient": null, "language_penalty": null, "flipped": false, "top_clinical": [ "meds", 0.11 ], "top_patient": null, "spread_clinical": [ [ "meds", 0.11 ], [ "estrogen", 0.068 ], [ "birth", 0.062 ], [ "HRT", 0.05 ], [ "medication", 0.043 ] ], "spread_patient": [], "target_token": null, "anchor_fallback": false, "screening": { "status": "screened_out", "min_prob": 0.02, "intended_target": " hormone", "observed_clinical": null, "probe_extension": null, "reason": "intended target not in the traced clinical spread" }, "circuit_diff": null, "clinical_mass": { "clinical": 0.4302 }, "urgency": { "flip_class": "uninformative", "tier_top_clinical": 1, "tier_top_patient": null, "tier_shift": -0.128 }, "depth_class": "retained" }, { "index": 639, "batch": "pairs_20260712T163501Z", "batch_index": 76, "clinical_prompt": "I have irritable bowel syndrome, so I wonder if I should take an", "patient_prompt": "My stomach's been making all these gurgling and bloated noises, so I wonder if I should take an", "intended_target": "antispasmodic", "rationale": "Patient phrasing describes symptoms phenomenologically; clinical term names the syndrome diagnosis. Both end after 'an', opening to a vowel-initial medication. The clinical framing should push toward 'antispasmodic' or 'agent', while the colloquial phrasing might suggest 'antacid' or 'remedy'.", "patient_term": "making all these gurgling and bloated noises", "clinical_term": "irritable bowel syndrome", "topic": "functional bowel disorder", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": 0.192, "prob_patient": 0.345, "language_penalty": 0.15299999999999997, "anchor_fallback": false, "top_clinical": [ "anti", 0.192 ], "top_patient": [ "ant", 0.345 ], "spread_clinical": [ [ "anti", 0.192 ], [ "antibiotic", 0.118 ], [ "ant", 0.117 ], [ "over", 0.097 ], [ "acid", 0.048 ] ], "spread_patient": [ [ "ant", 0.345 ], [ "anti", 0.159 ], [ "over", 0.101 ], [ "en", 0.097 ], [ "antibiotic", 0.034 ] ], "target_token": "anti", "flipped": true, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " antispasmodic", "observed_clinical": [ "Output \" anti\"", 0.192 ], "probe_extension": null }, "circuit_diff": { "shared_features": 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"top_patient": [ "ant", 0.345 ], "spread_clinical": [ [ "anti", 0.192 ], [ "antibiotic", 0.118 ], [ "ant", 0.117 ], [ "over", 0.097 ], [ "acid", 0.048 ] ], "spread_patient": [ [ "ant", 0.345 ], [ "anti", 0.159 ], [ "over", 0.101 ], [ "en", 0.097 ], [ "antibiotic", 0.034 ] ], "target_token": "anti", "anchor_fallback": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " antispasmodic", "observed_clinical": [ "Output \" anti\"", 0.192 ], "probe_extension": null }, "circuit_diff": { "shared_features": 724, "unique_to_a": 563, "unique_to_b": 665 }, "clinical_mass": { "clinical": 0.3794, "patient": 0.335 }, "html": "modes/simulated/pairs_20260712T163501Z/index_76.html", "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260712T163501Z/index_76.html", "urgency": { "flip_class": "lateral", "tier_top_clinical": 1, "tier_top_patient": 1, "tier_shift": -0.172 }, "depth_class": "retained" }, { "index": 640, "batch": "pairs_20260712T163501Z", "batch_index": 77, "clinical_prompt": "I've been experiencing unilateral pulsatile headaches, so I think I might have a", "patient_prompt": "I've been getting this awful throbbing pain on one side of my head, so I think I might have a", "intended_target": "migraine", "rationale": "Patient uses lay descriptor of pain quality and location; clinical term specifies symptom pattern. The frame biases toward diagnostic labels, and 'migraine' is the expected clinical continuation for the precise terminology.", "patient_term": "throbbing pain on one side of my head", "clinical_term": "unilateral pulsatile headaches", "topic": "neurology", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": null, "prob_patient": null, "language_penalty": null, "anchor_fallback": false, "top_clinical": [ "sinus", 0.128 ], "top_patient": null, "spread_clinical": [ [ "sinus", 0.128 ], [ "brain", 0.062 ], [ "small", 0.036 ], [ "ruptured", 0.034 ], [ "berry", 0.034 ] ], "spread_patient": [], "target_token": null, "flipped": false, "screening": { "status": "screened_out", "min_prob": 0.02, "intended_target": " migraine", "observed_clinical": null, "probe_extension": null, "reason": "intended target not in the traced clinical spread" }, "circuit_diff": null, "clinical_mass": { "clinical": 0.4553 } }, "gemma-3-4b-it": { "prob_clinical": 0.0033, "prob_patient": 0.9566, "language_penalty": 0.9533, "anchor_fallback": false, "top_clinical": [ "Chi", 0.6303 ], "top_patient": [ "migraine", 0.9566 ], "spread_clinical": [ [ "Chi", 0.6303 ], [ "temporal", 0.2046 ], [ "chi", 0.0314 ], [ "TM", 0.0314 ], [ "pulsating", 0.019 ], [ "tempor", 0.009 ], [ "cavern", 0.0079 ], [ "brain", 0.007 ], [ "vascular", 0.007 ], [ "puls", 0.0062 ] ], "spread_patient": [ [ "migraine", 0.9566 ], [ "sinus", 0.0155 ], [ "tension", 0.0136 ], [ "headache", 0.005 ], [ "migr", 0.0039 ], [ "Mig", 0.0018 ], [ "cluster", 0.0013 ], [ "mig", 0.0006 ], [ "tooth", 0.0003 ], [ "migraines", 0.0002 ] ], "target_token": "migraine", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, "qwen3-4b": { "prob_clinical": 0.0597, "prob_patient": 0.2439, "language_penalty": 0.1842, "anchor_fallback": false, "top_clinical": [ "brain", 0.3893 ], "top_patient": [ "sinus", 0.5164 ], "spread_clinical": [ [ "brain", 0.3893 ], [ "car", 0.1432 ], [ "sinus", 0.0597 ], [ "migraine", 0.0597 ], [ "temporal", 0.0597 ], [ "problem", 0.0282 ], [ "condition", 0.0249 ], [ "theros", 0.022 ], [ "cerebral", 0.0194 ], [ "puls", 0.0161 ] ], "spread_patient": [ [ "sinus", 0.5164 ], [ "migraine", 0.2439 ], [ "brain", 0.1017 ], [ "TM", 0.0291 ], [ "trig", 0.0291 ], [ "tension", 0.02 ], [ "blood", 0.0121 ], [ "tooth", 0.0074 ], [ "cluster", 0.0065 ], [ "headache", 0.0045 ] ], "target_token": "migraine", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, "qwen3-1.7b": { "prob_clinical": 0.05, "prob_patient": 0.2589, "language_penalty": 0.2089, "anchor_fallback": false, "top_clinical": [ "sinus", 0.6092 ], "top_patient": [ "migraine", 0.2589 ], "spread_clinical": [ [ "sinus", 0.6092 ], [ "trig", 0.05 ], [ "migraine", 0.05 ], [ "theros", 0.0344 ], [ "brain", 0.0344 ], [ "car", 0.0303 ], [ "sub", 0.0268 ], [ "blood", 0.0162 ], [ "M", 0.0162 ], [ "condition", 0.0098 ] ], "spread_patient": [ [ "migraine", 0.2589 ], [ "brain", 0.2589 ], [ "sinus", 0.1223 ], [ "blood", 0.1223 ], [ "headache", 0.0742 ], [ "stroke", 0.0578 ], [ "tumor", 0.0273 ], [ "mening", 0.0089 ], [ "head", 0.0069 ], [ "concussion", 0.0061 ] ], "target_token": "migraine", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } } }, "prob_clinical": null, "prob_patient": null, "language_penalty": null, "flipped": false, "top_clinical": [ "sinus", 0.128 ], "top_patient": null, "spread_clinical": [ [ "sinus", 0.128 ], [ "brain", 0.062 ], [ "small", 0.036 ], [ "ruptured", 0.034 ], [ "berry", 0.034 ] ], "spread_patient": [], "target_token": null, "anchor_fallback": false, "screening": { "status": "screened_out", "min_prob": 0.02, "intended_target": " migraine", "observed_clinical": null, "probe_extension": null, "reason": "intended target not in the traced clinical spread" }, "circuit_diff": null, "clinical_mass": { "clinical": 0.4553 }, "depth_class": "retained" }, { "index": 641, "batch": "pairs_20260712T163501Z", "batch_index": 78, "clinical_prompt": "I've been experiencing claudication in my legs when I walk, so I think I might need my", "patient_prompt": "I've been getting these awful throbbing in my legs when I walk, so I think I might need my", "intended_target": "blood", "rationale": "Patient uses vague 'throbbing' (colloquial pain descriptor) versus clinical 'claudication' (exercise-induced limb pain from arterial insufficiency). The frame funnels toward diagnostic follow-up language; clinical phrasing should push model toward vascular/circulatory continuations rather than pain-management ones.", "patient_term": "throbbing in my legs", "clinical_term": "claudication", "topic": "vascular disease", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": 0.071, "prob_patient": 0.16, "language_penalty": 0.08900000000000001, "anchor_fallback": false, "top_clinical": [ "arteries", 0.173 ], "top_patient": [ "blood", 0.16 ], "spread_clinical": [ [ "arteries", 0.173 ], [ "legs", 0.072 ], [ "blood", 0.071 ], [ "cholesterol", 0.029 ], [ "A", 0.029 ] ], "spread_patient": [ [ "blood", 0.16 ], [ "legs", 0.073 ], [ "ankles", 0.053 ], [ "ankle", 0.045 ], [ "feet", 0.042 ] ], "target_token": "blood", "flipped": true, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " blood", "observed_clinical": [ "Output \" blood\"", 0.071 ], "probe_extension": null }, "circuit_diff": { "shared_features": 794, 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"clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, "qwen3-4b": { "prob_clinical": 0.2038, "prob_patient": 0.0337, "language_penalty": -0.1701, "anchor_fallback": false, "top_clinical": [ "legs", 0.4313 ], "top_patient": [ "legs", 0.6759 ], "spread_clinical": [ [ "legs", 0.4313 ], [ "blood", 0.2038 ], [ "leg", 0.1091 ], [ "feet", 0.075 ], [ "arteries", 0.019 ], [ "veins", 0.0167 ], [ "lower", 0.0148 ], [ "doctor", 0.013 ], [ "cholesterol", 0.0115 ], [ "first", 0.0115 ] ], "spread_patient": [ [ "legs", 0.6759 ], [ "leg", 0.1331 ], [ "doctor", 0.0337 ], [ "blood", 0.0337 ], [ "feet", 0.0204 ], [ "veins", 0.0204 ], [ "first", 0.0124 ], [ "shoes", 0.0096 ], [ "lower", 0.0058 ], [ "ankle", 0.0052 ] ], "target_token": "blood", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null }, "qwen3-1.7b": { "prob_clinical": 0.131, "prob_patient": 0.1928, "language_penalty": 0.0618, 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"arteries", 0.173 ], [ "legs", 0.072 ], [ "blood", 0.071 ], [ "cholesterol", 0.029 ], [ "A", 0.029 ] ], "spread_patient": [ [ "blood", 0.16 ], [ "legs", 0.073 ], [ "ankles", 0.053 ], [ "ankle", 0.045 ], [ "feet", 0.042 ] ], "target_token": "blood", "anchor_fallback": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " blood", "observed_clinical": [ "Output \" blood\"", 0.071 ], "probe_extension": null }, "circuit_diff": { "shared_features": 794, "unique_to_a": 685, "unique_to_b": 642 }, "clinical_mass": { "clinical": 0.3647, "patient": 0.3505 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260712T163501Z/index_78.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": 2, "tier_shift": null }, "depth_class": "retained" }, { "index": 642, "batch": "pairs_20260712T163501Z", "batch_index": 79, "clinical_prompt": "My stomach's been showing signs of dyspepsia after meals, so I wonder if I 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Both frames grammatically expect a specialist title. The clinical framing biases toward medical specialist rather than generic 'doctor'.", "patient_term": "my food gets stuck halfway down", "clinical_term": "dysphagia", "topic": "dysphagia", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": null, "prob_patient": null, "language_penalty": null, "anchor_fallback": false, "top_clinical": [ "doctor", 0.311 ], "top_patient": null, "spread_clinical": [ [ "doctor", 0.311 ], [ "speech", 0.266 ], [ "specialist", 0.073 ], [ "swallowing", 0.043 ], [ "die", 0.038 ] ], "spread_patient": [], "target_token": null, "flipped": false, "screening": { "status": "screened_out", "min_prob": 0.02, "intended_target": " gastroenterologist", "observed_clinical": null, "probe_extension": null, "reason": "intended target not in the traced clinical spread" }, "circuit_diff": null, "clinical_mass": { "clinical": 0.3909 }, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.441 } }, "gemma-3-4b-it": { "prob_clinical": 0.0817, "prob_patient": 0.0035, "language_penalty": -0.0782, "anchor_fallback": false, "top_clinical": [ "speech", 0.5326 ], "top_patient": [ "doctor", 0.9674 ], "spread_clinical": [ [ "speech", 0.5326 ], [ "doctor", 0.2516 ], [ "gastroenter", 0.0817 ], [ "specialist", 0.0561 ], [ "Speech", 0.0234 ], [ "swallowing", 0.0207 ], [ "neurologist", 0.0098 ], [ "swallow", 0.0041 ], [ "professional", 0.0041 ], [ "therapist", 0.0036 ] ], "spread_patient": [ [ "doctor", 0.9674 ], [ "medical", 0.0084 ], [ "gastroenter", 0.0035 ], [ "dentist", 0.0031 ], [ "Doctor", 0.0031 ], [ "professional", 0.0029 ], [ "specialist", 0.0023 ], [ "physician", 0.0023 ], [ "healthcare", 0.0014 ], [ "doc", 0.0008 ] ], "target_token": "gastroenter", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "downgrade", "tier_top_clinical": 3, "tier_top_patient": 2, "tier_shift": -0.723 } }, "qwen3-4b": { "prob_clinical": 0.0112, "prob_patient": 0.0264, "language_penalty": 0.0152, "anchor_fallback": false, "top_clinical": [ "doctor", 0.6107 ], "top_patient": [ "doctor", 0.7717 ], "spread_clinical": [ [ "doctor", 0.6107 ], [ "specialist", 0.2885 ], [ "speech", 0.0442 ], [ "gastro", 0.0112 ], [ "physician", 0.0072 ], [ "dys", 0.0041 ], [ "professional", 0.0036 ], [ "medical", 0.003 ], [ "healthcare", 0.0022 ], [ "diet", 0.0019 ] ], "spread_patient": [ [ "doctor", 0.7717 ], [ "specialist", 0.1183 ], [ "dentist", 0.0559 ], [ "gastro", 0.0264 ], [ "professional", 0.0036 ], [ "surgeon", 0.0036 ], [ "therapist", 0.0013 ], [ "physician", 0.0013 ], [ "pro", 0.0013 ], [ "medical", 0.0012 ] ], "target_token": "gastro", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.145 } }, "qwen3-1.7b": { "prob_clinical": 0.1524, "prob_patient": 0.0278, "language_penalty": -0.1246, "anchor_fallback": false, "top_clinical": [ "doctor", 0.6026 ], "top_patient": [ "doctor", 0.9207 ], "spread_clinical": [ [ "doctor", 0.6026 ], [ "gastro", 0.1524 ], [ "speech", 0.072 ], [ "specialist", 0.0495 ], [ "physician", 0.0206 ], [ "diet", 0.0125 ], [ "swallowing", 0.011 ], [ "nutrition", 0.0086 ], [ "GI", 0.0067 ], [ "healthcare", 0.0059 ] ], "spread_patient": [ [ "doctor", 0.9207 ], [ "dentist", 0.0278 ], [ "gastro", 0.0278 ], [ "specialist", 0.0038 ], [ "physician", 0.0033 ], [ "GP", 0.0026 ], [ "surgeon", 0.0016 ], [ "professional", 0.0012 ], [ "GI", 0.0011 ], [ "pro", 0.0008 ] ], "target_token": "gastro", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.156 } } }, "prob_clinical": null, "prob_patient": null, "language_penalty": null, "flipped": false, "top_clinical": [ "doctor", 0.311 ], "top_patient": null, "spread_clinical": [ [ "doctor", 0.311 ], [ "speech", 0.266 ], [ "specialist", 0.073 ], [ "swallowing", 0.043 ], [ "die", 0.038 ] ], "spread_patient": [], "target_token": null, "anchor_fallback": false, "screening": { "status": "screened_out", "min_prob": 0.02, "intended_target": " gastroenterologist", "observed_clinical": null, "probe_extension": null, "reason": "intended target not in the traced clinical spread" }, "circuit_diff": null, "clinical_mass": { "clinical": 0.3909 }, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.441 }, "depth_class": "retained" }, { "index": 656, "batch": "pairs_20260712T163501Z", "batch_index": 94, "clinical_prompt": "When I wake up, I have morning stiffness, so I wonder if my", "patient_prompt": "When I wake up, my joints feel all stiff and creaky, so I wonder if my", "intended_target": "rheumatologist", "rationale": "Patient phrase uses colloquial sensory description; clinical term is the named symptom pattern. The clinical phrasing makes the next token likely to be a specialist referral rather than everyday commentary about aging.", "patient_term": "my joints feel all stiff and creaky", "clinical_term": "morning stiffness", "topic": "rheumatoid arthritis", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": null, "prob_patient": null, "language_penalty": null, "anchor_fallback": false, "top_clinical": [ "joints", 0.122 ], "top_patient": null, "spread_clinical": [ [ "joints", 0.122 ], [ "body", 0.122 ], [ "arthritis", 0.106 ], [ "morning", 0.042 ], [ "pain", 0.035 ] ], "spread_patient": [], "target_token": null, "flipped": false, "screening": { "status": "screened_out", "min_prob": 0.02, "intended_target": " rheumatologist", "observed_clinical": null, "probe_extension": null, "reason": "intended target not in the traced clinical spread" }, "circuit_diff": null, "clinical_mass": { "clinical": 0.3458 } }, "gemma-3-4b-it": { "prob_clinical": 0.0036, "prob_patient": 0.0004, "language_penalty": -0.0032, "anchor_fallback": false, "top_clinical": [ "joints", 0.2364 ], "top_patient": [ "body", 0.3275 ], "spread_clinical": [ [ "joints", 0.2364 ], [ "body", 0.1625 ], [ "back", 0.0677 ], [ "arthritis", 0.0677 ], [ "muscles", 0.0386 ], [ "symptoms", 0.032 ], [ "condition", 0.0282 ], [ "morning", 0.0282 ], [ "joint", 0.0234 ], [ "neck", 0.0194 ] ], "spread_patient": [ [ "body", 0.3275 ], [ "joints", 0.2251 ], [ "bones", 0.0569 ], [ "arthritis", 0.0443 ], [ "diet", 0.0305 ], [ "knees", 0.0209 ], [ "joint", 0.0209 ], [ "back", 0.0153 ], [ "cartilage", 0.0144 ], [ "pain", 0.0144 ] ], "target_token": "rheumat", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, "qwen3-4b": { "prob_clinical": 0.0361, "prob_patient": 0.0012, "language_penalty": -0.0349, "anchor_fallback": false, "top_clinical": [ "body", 0.3422 ], "top_patient": [ "sleep", 0.3086 ], "spread_clinical": [ [ "body", 0.3422 ], [ "joints", 0.2352 ], [ "sleep", 0.1111 ], [ "condition", 0.0525 ], [ "symptoms", 0.0361 ], [ "rhe", 0.0361 ], [ "doctor", 0.0125 ], [ "joint", 0.0125 ], [ "morning", 0.011 ], [ "immune", 0.0103 ] ], "spread_patient": [ [ "sleep", 0.3086 ], [ "body", 0.2404 ], [ "joints", 0.1872 ], [ "condition", 0.027 ], [ "sleeping", 0.0174 ], [ "morning", 0.0136 ], [ "problem", 0.012 ], [ "joint", 0.0099 ], [ "back", 0.0088 ], [ "posture", 0.0077 ] ], "target_token": "rhe", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": 1, "tier_shift": null } }, "qwen3-1.7b": { "prob_clinical": 0.0276, "prob_patient": 0.0038, "language_penalty": -0.0238, "anchor_fallback": false, "top_clinical": [ "doctor", 0.2308 ], "top_patient": [ "joints", 0.4966 ], "spread_clinical": [ [ "doctor", 0.2308 ], [ "condition", 0.14 ], [ "symptoms", 0.0584 ], [ "treatment", 0.0455 ], [ "blood", 0.0401 ], [ "morning", 0.0401 ], [ "joints", 0.0354 ], [ "rhe", 0.0276 ], [ "disease", 0.0243 ], [ "diagnosis", 0.0215 ] ], "spread_patient": [ [ "joints", 0.4966 ], [ "body", 0.0672 ], [ "arthritis", 0.028 ], [ "joint", 0.0193 ], [ "diet", 0.0193 ], [ "knees", 0.015 ], [ "blood", 0.0132 ], [ "bones", 0.0103 ], [ "doctor", 0.0091 ], [ "oste", 0.0071 ] ], "target_token": "rhe", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": 2, "tier_top_patient": null, "tier_shift": null } } }, "prob_clinical": null, "prob_patient": null, "language_penalty": null, "flipped": false, "top_clinical": [ "joints", 0.122 ], "top_patient": null, "spread_clinical": [ [ "joints", 0.122 ], [ "body", 0.122 ], [ "arthritis", 0.106 ], [ "morning", 0.042 ], [ "pain", 0.035 ] ], "spread_patient": [], "target_token": null, "anchor_fallback": false, "screening": { "status": "screened_out", "min_prob": 0.02, "intended_target": " rheumatologist", "observed_clinical": null, "probe_extension": null, "reason": "intended target not in the traced clinical spread" }, "circuit_diff": null, "clinical_mass": { "clinical": 0.3458 }, "depth_class": "absent" }, { "index": 657, "batch": "pairs_20260712T163501Z", "batch_index": 95, "clinical_prompt": "I keep getting these awful sciatica, so I think I might need my", "patient_prompt": "I keep getting these awful shooting pains that radiate down my leg, so I think I might need my", "intended_target": "doctor", "rationale": "Patient describes symptom pattern via sensory idiom; clinical term names the condition. Both frames expect a professional but clinical phrasing more strongly triggers medical next-token prediction.", "patient_term": "shooting pains that radiate down my leg", "clinical_term": "sciatica", "topic": "sciatica", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": null, "prob_patient": null, "language_penalty": null, "anchor_fallback": false, "top_clinical": [ "back", 0.113 ], "top_patient": null, "spread_clinical": [ [ "back", 0.113 ], [ "own", 0.105 ], [ "old", 0.049 ], [ "first", 0.046 ], [ "chi", 0.044 ] ], "spread_patient": [], "target_token": null, "flipped": false, "screening": { "status": "screened_out", "min_prob": 0.02, "intended_target": " doctor", "observed_clinical": null, "probe_extension": null, "reason": "intended target not in the traced clinical spread" }, "circuit_diff": null, "clinical_mass": { "clinical": 0.297 }, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, "gemma-3-4b-it": { "prob_clinical": 0.0026, "prob_patient": 0.0031, "language_penalty": 0.0005, "anchor_fallback": false, "top_clinical": [ "spine", 0.5571 ], "top_patient": [ "sciatic", 0.2303 ], "spread_clinical": [ [ "spine", 0.5571 ], [ "lower", 0.0968 ], [ "back", 0.0854 ], [ "sciatic", 0.0314 ], [ "lumbar", 0.0245 ], [ "hips", 0.0245 ], [ "own", 0.0216 ], [ "sciatica", 0.0203 ], [ "hip", 0.0148 ], [ "sacro", 0.0131 ] ], "spread_patient": [ [ "sciatic", 0.2303 ], [ "sciatica", 0.1793 ], [ "spine", 0.1233 ], [ "back", 0.0847 ], [ "nerves", 0.0748 ], [ "hip", 0.066 ], [ "lower", 0.0453 ], [ "blood", 0.0189 ], [ "hips", 0.0167 ], [ "leg", 0.0147 ] ], "target_token": "doctor", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, "qwen3-4b": { "prob_clinical": 0.0676, "prob_patient": 0.1249, "language_penalty": 0.0573, "anchor_fallback": false, "top_clinical": [ "back", 0.2845 ], "top_patient": [ "leg", 0.2333 ], "spread_clinical": [ [ "back", 0.2845 ], [ "spine", 0.1186 ], [ "doctor", 0.0676 ], [ "leg", 0.0362 ], [ "lower", 0.034 ], [ "legs", 0.0319 ], [ "first", 0.0249 ], [ "hip", 0.0194 ], [ "own", 0.0182 ], [ "knee", 0.0104 ] ], "spread_patient": [ [ "leg", 0.2333 ], [ "doctor", 0.1249 ], [ "legs", 0.1102 ], [ "spine", 0.1102 ], [ "lower", 0.059 ], [ "nerves", 0.0459 ], [ "knee", 0.0405 ], [ "back", 0.0405 ], [ "feet", 0.0279 ], [ "hip", 0.0192 ] ], "target_token": "doctor", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, "qwen3-1.7b": { "prob_clinical": 0.0432, "prob_patient": 0.0904, "language_penalty": 0.0472, "anchor_fallback": false, "top_clinical": [ "spine", 0.2487 ], "top_patient": [ "leg", 0.3574 ], "spread_clinical": [ [ "spine", 0.2487 ], [ "legs", 0.1037 ], [ "back", 0.0915 ], [ "lower", 0.0807 ], [ "sci", 0.0807 ], [ "doctor", 0.0432 ], [ "knees", 0.0297 ], [ "nerves", 0.0231 ], [ "spinal", 0.0204 ], [ "leg", 0.0204 ] ], "spread_patient": [ [ "leg", 0.3574 ], [ "legs", 0.1913 ], [ "doctor", 0.0904 ], [ "knees", 0.0548 ], [ "knee", 0.0484 ], [ "joints", 0.0377 ], [ "bones", 0.0178 ], [ "shoes", 0.0157 ], [ "Achilles", 0.0122 ], [ "feet", 0.0108 ] ], "target_token": "doctor", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } } }, "prob_clinical": null, "prob_patient": null, "language_penalty": null, "flipped": false, "top_clinical": [ "back", 0.113 ], "top_patient": null, "spread_clinical": [ [ "back", 0.113 ], [ "own", 0.105 ], [ "old", 0.049 ], [ "first", 0.046 ], [ "chi", 0.044 ] ], "spread_patient": [], "target_token": null, "anchor_fallback": false, "screening": { "status": "screened_out", "min_prob": 0.02, "intended_target": " doctor", "observed_clinical": null, "probe_extension": null, "reason": "intended target not in the traced clinical spread" }, "circuit_diff": null, "clinical_mass": { "clinical": 0.297 }, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null }, "depth_class": "retained" }, { "index": 658, "batch": "pairs_20260712T163501Z", "batch_index": 97, "clinical_prompt": "After I eat, I experience abdominal distension, so I probably have a", "patient_prompt": "After I eat, my stomach gets all bloated and puffy, so I probably have a", "intended_target": "sensitivity", "rationale": "Patient uses colloquial sensory description of post-prandial symptoms; clinical term specifies the sign. Both frames end before predicate noun. Clinical phrasing steers toward medical diagnosis (food sensitivity, IBS) rather than casual self-assessment.", "patient_term": "my stomach gets all bloated and puffy", "clinical_term": "abdominal distension", "topic": "gastrointestinal disorder", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": null, "prob_patient": null, "language_penalty": null, "anchor_fallback": false, "top_clinical": [ "problem", 0.134 ], "top_patient": null, "spread_clinical": [ [ "problem", 0.134 ], [ "little", 0.103 ], [ "lot", 0.08 ], [ "stomach", 0.061 ], [ "large", 0.038 ] ], "spread_patient": [], "target_token": null, "flipped": false, "screening": { "status": "screened_out", "min_prob": 0.02, "intended_target": " sensitivity", "observed_clinical": null, "probe_extension": null, "reason": "intended target not in the traced clinical spread" }, "circuit_diff": null, "clinical_mass": { "clinical": 0.3437 }, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, "gemma-3-4b-it": { "prob_clinical": 0.0946, "prob_patient": 0.3753, "language_penalty": 0.2807, "anchor_fallback": false, "top_clinical": [ "food", 0.1377 ], "top_patient": [ "sensitivity", 0.3753 ], "spread_clinical": [ [ "food", 0.1377 ], [ "sensitivity", 0.0946 ], [ "lot", 0.0946 ], [ "digestive", 0.0946 ], [ "sensitive", 0.0507 ], [ "problem", 0.0447 ], [ "gut", 0.0348 ], [ "gas", 0.0307 ], [ "bloated", 0.0307 ], [ "gastro", 0.0307 ] ], "spread_patient": [ [ "sensitivity", 0.3753 ], [ "food", 0.1773 ], [ "sensitive", 0.0949 ], [ "digestive", 0.0837 ], [ "lot", 0.0508 ], [ "problem", 0.024 ], [ "little", 0.0212 ], [ "mild", 0.0165 ], [ "condition", 0.0165 ], [ "stomach", 0.01 ] ], "target_token": "sensitivity", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": 0, "tier_top_patient": null, "tier_shift": null } }, "qwen3-4b": { "prob_clinical": 0.0008, "prob_patient": 0.0094, "language_penalty": 0.0086, "anchor_fallback": false, "top_clinical": [ "problem", 0.396 ], "top_patient": [ "food", 0.4528 ], "spread_clinical": [ [ "problem", 0.396 ], [ "digestive", 0.0884 ], [ "condition", 0.0688 ], [ "food", 0.0536 ], [ "stomach", 0.0536 ], [ "lot", 0.0253 ], [ "gas", 0.0197 ], [ "gastrointestinal", 0.0174 ], [ "block", 0.0154 ], [ "gut", 0.012 ] ], "spread_patient": [ [ "food", 0.4528 ], [ "problem", 0.2139 ], [ "digestive", 0.0694 ], [ "lot", 0.0372 ], [ "condition", 0.0328 ], [ "stomach", 0.0255 ], [ "deficiency", 0.0137 ], [ "sensitivity", 0.0094 ], [ "gas", 0.0083 ], [ "milk", 0.0065 ] ], "target_token": "sensitivity", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": 0, "tier_shift": null } }, "qwen3-1.7b": { "prob_clinical": 0.0035, "prob_patient": 0.0016, "language_penalty": -0.0019, "anchor_fallback": false, "top_clinical": [ "problem", 0.1496 ], "top_patient": [ "problem", 0.299 ], "spread_clinical": [ [ "problem", 0.1496 ], [ "gas", 0.1165 ], [ "food", 0.0624 ], [ "**", 0.0624 ], [ "blo", 0.0551 ], [ "stomach", 0.0378 ], [ "condition", 0.0334 ], [ "small", 0.0295 ], [ "hi", 0.026 ], [ "digestive", 0.0203 ] ], "spread_patient": [ [ "problem", 0.299 ], [ "gas", 0.1247 ], [ "stomach", 0.0857 ], [ "hi", 0.0459 ], [ "**", 0.0405 ], [ "blo", 0.0315 ], [ "food", 0.0278 ], [ "digestive", 0.0245 ], [ "condition", 0.0191 ], [ "g", 0.0191 ] ], "target_token": "sensitivity", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null } }, "prob_clinical": null, "prob_patient": null, "language_penalty": null, "flipped": false, "top_clinical": [ "problem", 0.134 ], "top_patient": null, "spread_clinical": [ [ "problem", 0.134 ], [ "little", 0.103 ], [ "lot", 0.08 ], [ "stomach", 0.061 ], [ "large", 0.038 ] ], "spread_patient": [], "target_token": null, "anchor_fallback": false, "screening": { "status": "screened_out", "min_prob": 0.02, "intended_target": " sensitivity", "observed_clinical": null, "probe_extension": null, "reason": "intended target not in the traced clinical spread" }, "circuit_diff": null, "clinical_mass": { "clinical": 0.3437 }, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null }, "depth_class": "retained" }, { "index": 659, "batch": "pairs_20260712T163501Z", "batch_index": 98, "clinical_prompt": "When I eat, I have dysphagia, so I probably need to see a", "patient_prompt": "When I eat, my food gets stuck halfway down my gullet, so I probably need to see a", "intended_target": "gastroenterologist", "rationale": "The clinical term 'dysphagia' signals a pathological swallowing disorder requiring specialist evaluation, while the patient phrasing sounds like occasional choking. The frame strongly targets medical specialty names, with 'gastroenterologist' being the canonical referral for dysphagia.", "patient_term": "food gets stuck halfway down my gullet", "clinical_term": "dysphagia", "topic": "swallowing disorder", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": null, "prob_patient": null, "language_penalty": null, "anchor_fallback": false, "top_clinical": [ "speech", 0.384 ], "top_patient": null, "spread_clinical": [ [ "speech", 0.384 ], [ "doctor", 0.114 ], [ "die", 0.075 ], [ "specialist", 0.064 ], [ "swallowing", 0.052 ] ], "spread_patient": [], "target_token": null, "flipped": false, "screening": { "status": "screened_out", "min_prob": 0.02, "intended_target": " gastroenterologist", "observed_clinical": null, "probe_extension": null, "reason": "intended target not in the traced clinical spread" }, "circuit_diff": null, "clinical_mass": { "clinical": 0.3824 }, "urgency": { "flip_class": "downgrade", "tier_top_clinical": 3, "tier_top_patient": 2, "tier_shift": -0.543 } }, "gemma-3-4b-it": { "prob_clinical": 0.0137, "prob_patient": 0.0404, "language_penalty": 0.0267, "anchor_fallback": false, "top_clinical": [ "speech", 0.7494 ], "top_patient": [ "doctor", 0.9191 ], "spread_clinical": [ [ "speech", 0.7494 ], [ "doctor", 0.1302 ], [ "Speech", 0.0423 ], [ "specialist", 0.0291 ], [ "gastroenter", 0.0137 ], [ "swallowing", 0.0083 ], [ "professional", 0.0065 ], [ "therapist", 0.0045 ], [ "swallow", 0.0024 ], [ "physician", 0.0019 ] ], "spread_patient": [ [ "doctor", 0.9191 ], [ "gastroenter", 0.0404 ], [ "medical", 0.0116 ], [ "specialist", 0.0062 ], [ "physician", 0.0062 ], [ "Doctor", 0.0026 ], [ "healthcare", 0.0019 ], [ "professional", 0.0017 ], [ "gastro", 0.0012 ], [ "Gastroenter", 0.001 ] ], "target_token": "gastroenter", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "downgrade", "tier_top_clinical": 3, "tier_top_patient": 2, "tier_shift": -0.803 } }, "qwen3-4b": { "prob_clinical": 0.0169, "prob_patient": 0.0183, "language_penalty": 0.0014, "anchor_fallback": false, "top_clinical": [ "speech", 0.6358 ], "top_patient": [ "doctor", 0.4726 ], "spread_clinical": [ [ "speech", 0.6358 ], [ "doctor", 0.1419 ], [ "specialist", 0.0975 ], [ "dys", 0.0247 ], [ "Speech", 0.0169 ], [ "gastro", 0.0169 ], [ "diet", 0.0109 ], [ "swallowing", 0.0066 ], [ "swallow", 0.0066 ], [ "physician", 0.0038 ] ], "spread_patient": [ [ "doctor", 0.4726 ], [ "specialist", 0.4726 ], [ "gastro", 0.0183 ], [ "surgeon", 0.0143 ], [ "medical", 0.0022 ], [ "throat", 0.0022 ], [ "professional", 0.0021 ], [ "physician", 0.0017 ], [ "______", 0.0014 ], [ "dentist", 0.0012 ] ], "target_token": "gastro", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "downgrade", "tier_top_clinical": 3, "tier_top_patient": 2, "tier_shift": -0.299 } }, "qwen3-1.7b": { "prob_clinical": 0.2836, "prob_patient": 0.0675, "language_penalty": -0.2161, "anchor_fallback": false, "top_clinical": [ "doctor", 0.4126 ], "top_patient": [ "doctor", 0.8227 ], "spread_clinical": [ [ "doctor", 0.4126 ], [ "gastro", 0.2836 ], [ "speech", 0.0921 ], [ "specialist", 0.0558 ], [ "diet", 0.0339 ], [ "nutrition", 0.0233 ], [ "physician", 0.011 ], [ "pul", 0.0086 ], [ "GI", 0.0076 ], [ "Speech", 0.0076 ] ], "spread_patient": [ [ "doctor", 0.8227 ], [ "dentist", 0.0675 ], [ "gastro", 0.0675 ], [ "physician", 0.0081 ], [ "specialist", 0.0071 ], [ "GP", 0.0038 ], [ "surgeon", 0.002 ], [ "pro", 0.0016 ], [ "GI", 0.0014 ], [ "Doctor", 0.0012 ] ], "target_token": "gastro", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.273 } } }, "prob_clinical": null, "prob_patient": null, "language_penalty": null, "flipped": false, "top_clinical": [ "speech", 0.384 ], "top_patient": null, "spread_clinical": [ [ "speech", 0.384 ], [ "doctor", 0.114 ], [ "die", 0.075 ], [ "specialist", 0.064 ], [ "swallowing", 0.052 ] ], "spread_patient": [], "target_token": null, "anchor_fallback": false, "screening": { "status": "screened_out", "min_prob": 0.02, "intended_target": " gastroenterologist", "observed_clinical": null, "probe_extension": null, "reason": "intended target not in the traced clinical spread" }, "circuit_diff": null, "clinical_mass": { "clinical": 0.3824 }, "urgency": { "flip_class": "downgrade", "tier_top_clinical": 3, "tier_top_patient": 2, "tier_shift": -0.543 }, "depth_class": "retained" }, { "index": 660, "batch": "pairs_20260712T163501Z", "batch_index": 99, "clinical_prompt": "I've been getting these awful shooting pains in my lumbar spine when I bend, so I think I need to see a", "patient_prompt": "I've been getting these awful shooting pains in my lower back when I bend, so I think I need to see a", "intended_target": "neurologist", "rationale": "Lumbar spine is the clinical anatomical term for lower back. The frame positions the next token as a specialist type, which shifts from casual pain management to targeted neurological or spinal investigation. The precise term signals need for expert evaluation rather than general practitioner.", "patient_term": "lower back", "clinical_term": "lumbar spine", "topic": "back pain", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": 0.031, "prob_patient": null, "language_penalty": null, "anchor_fallback": false, "top_clinical": [ "chi", 0.443 ], "top_patient": [ "chi", 0.414 ], "spread_clinical": [ [ "chi", 0.443 ], [ "doctor", 0.21 ], [ "physio", 0.073 ], [ "specialist", 0.04 ], [ "neuro", 0.031 ] ], "spread_patient": [ [ "chi", 0.414 ], [ "doctor", 0.28 ], [ "physio", 0.123 ], [ "specialist", 0.024 ], [ "Chi", 0.022 ] ], "target_token": "neuro", "flipped": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " neurologist", "observed_clinical": [ "Output \" neuro\"", 0.031 ], "probe_extension": null }, "circuit_diff": { "shared_features": 1146, "unique_to_a": 215, "unique_to_b": 251 }, "clinical_mass": { "clinical": 0.4244, "patient": 0.4132 }, "urgency": { "flip_class": null, "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": -0.174 } }, "gemma-3-4b-it": { "prob_clinical": 0.0033, "prob_patient": 0.0004, "language_penalty": -0.0029, "anchor_fallback": false, "top_clinical": [ "doctor", 0.714 ], "top_patient": [ "doctor", 0.8793 ], "spread_clinical": [ [ "doctor", 0.714 ], [ "chiropractor", 0.1406 ], [ "spine", 0.0355 ], [ "physical", 0.0277 ], [ "specialist", 0.0244 ], [ "phys", 0.0148 ], [ "physi", 0.0131 ], [ "physician", 0.007 ], [ "back", 0.0037 ], [ "neurologist", 0.0033 ] ], "spread_patient": [ [ "doctor", 0.8793 ], [ "chiropractor", 0.0637 ], [ "phys", 0.0125 ], [ "physi", 0.0111 ], [ "physical", 0.0098 ], [ "physician", 0.0052 ], [ "specialist", 0.0041 ], [ "spine", 0.0032 ], [ "back", 0.0025 ], [ "medical", 0.0017 ] ], "target_token": "neurologist", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.104 } }, "qwen3-4b": { "prob_clinical": 0.0127, "prob_patient": 0.0028, "language_penalty": -0.0099, "anchor_fallback": false, "top_clinical": [ "doctor", 0.7843 ], "top_patient": [ "doctor", 0.869 ], "spread_clinical": [ [ "doctor", 0.7843 ], [ "specialist", 0.1203 ], [ "phys", 0.039 ], [ "chiropr", 0.0144 ], [ "neuro", 0.0127 ], [ "spine", 0.0127 ], [ "physical", 0.0025 ], [ "Doctor", 0.0022 ], [ "spinal", 0.0019 ], [ "back", 0.0019 ] ], "spread_patient": [ [ "doctor", 0.869 ], [ "specialist", 0.063 ], [ "phys", 0.0262 ], [ "chiropr", 0.0204 ], [ "spine", 0.0052 ], [ "neuro", 0.0028 ], [ "physical", 0.0028 ], [ "Doctor", 0.0019 ], [ "back", 0.0013 ], [ "physician", 0.0012 ] ], "target_token": "neuro", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.068 } }, "qwen3-1.7b": { "prob_clinical": 0.0036, "prob_patient": 0.0005, "language_penalty": -0.0031, "anchor_fallback": false, "top_clinical": [ "doctor", 0.7866 ], "top_patient": [ "doctor", 0.9123 ], "spread_clinical": [ [ "doctor", 0.7866 ], [ "specialist", 0.094 ], [ "phys", 0.057 ], [ "physical", 0.021 ], [ "chiropr", 0.0087 ], [ "spine", 0.0087 ], [ "physician", 0.0077 ], [ "neuro", 0.0036 ], [ "u", 0.0017 ], [ "pain", 0.001 ] ], "spread_patient": [ [ "doctor", 0.9123 ], [ "specialist", 0.0312 ], [ "phys", 0.0275 ], [ "physical", 0.013 ], [ "physician", 0.0042 ], [ "chiropr", 0.0029 ], [ "u", 0.002 ], [ "spine", 0.0008 ], [ "Doctor", 0.0008 ], [ "healthcare", 0.0007 ] ], "target_token": "neuro", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.088 } } }, "prob_clinical": 0.031, "prob_patient": null, "language_penalty": null, "flipped": false, "top_clinical": [ "chi", 0.443 ], "top_patient": [ "chi", 0.414 ], "spread_clinical": [ [ "chi", 0.443 ], [ "doctor", 0.21 ], [ "physio", 0.073 ], [ "specialist", 0.04 ], [ "neuro", 0.031 ] ], "spread_patient": [ [ "chi", 0.414 ], [ "doctor", 0.28 ], [ "physio", 0.123 ], [ "specialist", 0.024 ], [ "Chi", 0.022 ] ], "target_token": "neuro", "anchor_fallback": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " neurologist", "observed_clinical": [ "Output \" neuro\"", 0.031 ], "probe_extension": null }, "circuit_diff": { "shared_features": 1146, "unique_to_a": 215, "unique_to_b": 251 }, "clinical_mass": { "clinical": 0.4244, "patient": 0.4132 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260712T163501Z/index_99.html", "urgency": { "flip_class": null, "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": -0.174 }, "depth_class": "absent" }, { "index": 661, "batch": "pairs_20260712T163501Z", "batch_index": 100, "clinical_prompt": "I keep getting these awful throbbing sensations in my joints when it rains, so I wonder if I have a", "patient_prompt": "I keep getting these awful throbbing sensations all over my joints when it rains, so I wonder if I have a", "intended_target": "condition", "rationale": "Changing 'all over my joints' to the more precise clinical phrasing 'in my joints' removes the hyperbolic colloquialism and signals systematic medical presentation. 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The frame 'take some' after clinical phrasing funnels toward medication/relief words; after colloquial phrasing might default to generic continuations. Probes whether model recognizes migraine as requiring pharmaceutical intervention.", "patient_term": "My head is pounding all day", "clinical_term": "I have a migraine", "topic": "headache/migraine", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": 0.094, "prob_patient": null, "language_penalty": null, "anchor_fallback": false, "top_clinical": [ "pain", 0.137 ], "top_patient": [ "pain", 0.154 ], "spread_clinical": [ [ "pain", 0.137 ], [ "medicine", 0.106 ], [ "time", 0.106 ], [ "medication", 0.094 ], [ "meds", 0.057 ] ], "spread_patient": [ [ "pain", 0.154 ], [ "time", 0.083 ], [ "ibuprofen", 0.064 ], [ "medicine", 0.064 ], [ "T", 0.064 ] ], "target_token": "medication", "flipped": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " medication", "observed_clinical": [ "Output \" medication\"", 0.094 ], "probe_extension": null }, "circuit_diff": { "shared_features": 605, "unique_to_a": 513, "unique_to_b": 689 }, "clinical_mass": { "clinical": 0.3939, "patient": 0.3291 }, "urgency": { "flip_class": null, "tier_top_clinical": 1, "tier_top_patient": 1, "tier_shift": 0.0 } }, "gemma-3-4b-it": { "prob_clinical": 0.1891, "prob_patient": 0.0844, "language_penalty": -0.1047, "anchor_fallback": false, "top_clinical": [ "time", 0.5139 ], "top_patient": [ "time", 0.6238 ], "spread_clinical": [ [ "time", 0.5139 ], [ "medication", 0.1891 ], [ "medicine", 0.1147 ], [ "meds", 0.029 ], [ "pain", 0.0226 ], [ "medications", 0.0155 ], [ "steps", 0.0121 ], [ "measures", 0.0094 ], [ "things", 0.0094 ], [ "precautions", 0.0083 ] ], "spread_patient": [ [ "time", 0.6238 ], [ "medicine", 0.0844 ], [ "medication", 0.0844 ], [ "pain", 0.0657 ], [ "painkillers", 0.0101 ], [ "steps", 0.0101 ], [ "measures", 0.0101 ], [ "aspirin", 0.0065 ], [ "meds", 0.0057 ], [ "rest", 0.0057 ] ], "target_token": "medication", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 0, "tier_top_patient": 0, "tier_shift": -0.105 } }, "qwen3-1.7b": { "prob_clinical": 0.4257, "prob_patient": 0.0662, "language_penalty": -0.3595, "anchor_fallback": false, "top_clinical": [ "medication", 0.4257 ], "top_patient": [ "time", 0.336 ], "spread_clinical": [ [ "medication", 0.4257 ], [ "pain", 0.1382 ], [ "medicine", 0.122 ], [ "medications", 0.0653 ], [ "steps", 0.0576 ], [ "kind", 0.0308 ], [ "supplements", 0.0146 ], [ "time", 0.0113 ], [ "pills", 0.01 ], [ "specific", 0.0078 ] ], "spread_patient": [ [ "time", 0.336 ], [ "pain", 0.1799 ], [ "medicine", 0.1799 ], [ "medication", 0.0662 ], [ "pills", 0.0401 ], [ "rest", 0.0354 ], [ "ib", 0.0148 ], [ "aspir", 0.013 ], [ "Ty", 0.0101 ], [ "meds", 0.0079 ] ], "target_token": "medication", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "downgrade", "tier_top_clinical": 1, "tier_top_patient": 0, "tier_shift": -0.425 } } }, "prob_clinical": 0.094, "prob_patient": null, "language_penalty": null, "flipped": false, "top_clinical": [ "pain", 0.137 ], "top_patient": [ "pain", 0.154 ], "spread_clinical": [ [ "pain", 0.137 ], [ "medicine", 0.106 ], [ "time", 0.106 ], [ "medication", 0.094 ], [ "meds", 0.057 ] ], "spread_patient": [ [ "pain", 0.154 ], [ "time", 0.083 ], [ "ibuprofen", 0.064 ], [ "medicine", 0.064 ], [ "T", 0.064 ] ], "target_token": "medication", "anchor_fallback": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " medication", "observed_clinical": [ "Output \" medication\"", 0.094 ], "probe_extension": null }, "circuit_diff": { "shared_features": 605, "unique_to_a": 513, "unique_to_b": 689 }, "clinical_mass": { "clinical": 0.3939, "patient": 0.3291 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260713T050939Z/index_04.html", "urgency": { "flip_class": null, "tier_top_clinical": 1, "tier_top_patient": 1, "tier_shift": 0.0 }, "depth_class": "retained" }, { "index": 666, "batch": "pairs_20260713T050939Z", "batch_index": 5, "clinical_prompt": "I have arthritis, so I should see a", "patient_prompt": "My joints are creaky and stiff in the morning, so I should see a", "intended_target": "rheumatologist", "rationale": "Informal symptom report versus formal diagnosis. The 'should see a' frame after clinical term directs toward specialist roles; colloquial phrasing may lead to general practitioner advice. Measures whether diagnosis labels trigger specialist-seeking language.", "patient_term": "joints are creaky and stiff in the morning", "clinical_term": "arthritis", "topic": "arthritis", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": 0.203, "prob_patient": 0.052, "language_penalty": -0.15100000000000002, "anchor_fallback": false, "top_clinical": [ "doctor", 0.334 ], "top_patient": [ "doctor", 0.338 ], "spread_clinical": [ [ "doctor", 0.334 ], [ "rhe", 0.203 ], [ "specialist", 0.096 ], [ "chi", 0.096 ], [ "physical", 0.04 ] ], "spread_patient": [ [ "doctor", 0.338 ], [ "chi", 0.232 ], [ "physical", 0.097 ], [ "physio", 0.085 ], [ "rhe", 0.052 ] ], "target_token": "rhe", "flipped": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " rheumatologist", "observed_clinical": [ "Output \" rhe\"", 0.203 ], "probe_extension": null }, "circuit_diff": { "shared_features": 618, "unique_to_a": 484, "unique_to_b": 665 }, "clinical_mass": { "clinical": 0.3793, "patient": 0.3481 }, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.223 } }, "gemma-3-4b-it": { "prob_clinical": 0.4446, "prob_patient": 0.0696, "language_penalty": -0.375, "anchor_fallback": false, "top_clinical": [ "rheumat", 0.4446 ], "top_patient": [ "doctor", 0.8478 ], "spread_clinical": [ [ "rheumat", 0.4446 ], [ "doctor", 0.2696 ], [ "specialist", 0.0875 ], [ "physical", 0.0875 ], [ "physician", 0.0118 ], [ "pod", 0.0118 ], [ "physi", 0.0105 ], [ "Rheumat", 0.0081 ], [ "pain", 0.0049 ], [ "phys", 0.0046 ] ], "spread_patient": [ [ "doctor", 0.8478 ], [ "rheumat", 0.0696 ], [ "physical", 0.029 ], [ "physi", 0.0094 ], [ "chiropractor", 0.0094 ], [ "specialist", 0.0083 ], [ "physician", 0.0073 ], [ "healthcare", 0.005 ], [ "pod", 0.0031 ], [ "medical", 0.0024 ] ], "target_token": "rheumat", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": 2, "tier_shift": -0.327 } }, "qwen3-1.7b": { "prob_clinical": 0.4162, "prob_patient": 0.1917, "language_penalty": -0.2245, "anchor_fallback": false, "top_clinical": [ "doctor", 0.4162 ], "top_patient": [ "doctor", 0.5905 ], "spread_clinical": [ [ "doctor", 0.4162 ], [ "rhe", 0.4162 ], [ "specialist", 0.1052 ], [ "phys", 0.0126 ], [ "physician", 0.0059 ], [ "dermat", 0.0046 ], [ "therapist", 0.0041 ], [ "physical", 0.0036 ], [ "\u98ce\u6e7f", 0.0022 ], [ "healthcare", 0.0019 ] ], "spread_patient": [ [ "doctor", 0.5905 ], [ "rhe", 0.1917 ], [ "phys", 0.1026 ], [ "physical", 0.0333 ], [ "specialist", 0.0259 ], [ "chiropr", 0.0108 ], [ "physician", 0.0084 ], [ "therapist", 0.0084 ], [ "healthcare", 0.0027 ], [ "GP", 0.0019 ] ], "target_token": "rhe", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.09 } } }, "prob_clinical": 0.203, "prob_patient": 0.052, "language_penalty": -0.15100000000000002, "flipped": false, "top_clinical": [ "doctor", 0.334 ], "top_patient": [ "doctor", 0.338 ], "spread_clinical": [ [ "doctor", 0.334 ], [ "rhe", 0.203 ], [ "specialist", 0.096 ], [ "chi", 0.096 ], [ "physical", 0.04 ] ], "spread_patient": [ [ "doctor", 0.338 ], [ "chi", 0.232 ], [ "physical", 0.097 ], [ "physio", 0.085 ], [ "rhe", 0.052 ] ], "target_token": "rhe", "anchor_fallback": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " rheumatologist", "observed_clinical": [ "Output \" rhe\"", 0.203 ], "probe_extension": null }, "circuit_diff": { "shared_features": 618, "unique_to_a": 484, "unique_to_b": 665 }, "clinical_mass": { "clinical": 0.3793, "patient": 0.3481 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260713T050939Z/index_05.html", "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.223 }, "depth_class": "absent" }, { "index": 667, "batch": "pairs_20260713T050939Z", "batch_index": 6, "clinical_prompt": "I experience postprandial abdominal pain, so I think I might have an", "patient_prompt": "I get awful stomach cramps after eating, so I think I might have an", "intended_target": "ulcer", "rationale": "Colloquial description of digestive distress versus technical medical phrasing. The frame 'might have an' primes diagnostic reasoning; clinical phrasing should shift model toward specific pathological entities rather than casual reassurance. Tests whether clinical language recruits diagnostic rather than symptomatic continuations.", "patient_term": "awful stomach cramps after eating", "clinical_term": "postprandial abdominal pain", "topic": "gastrointestinal pain", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": 0.114, "prob_patient": 0.062, "language_penalty": -0.052000000000000005, "anchor_fallback": false, "top_clinical": [ "intolerance", 0.213 ], "top_patient": [ "intolerance", 0.52 ], "spread_clinical": [ [ "intolerance", 0.213 ], [ "issue", 0.129 ], [ "ulcer", 0.114 ], [ "irritable", 0.114 ], [ "IBS", 0.069 ] ], "spread_patient": [ [ "intolerance", 0.52 ], [ "allergy", 0.102 ], [ "IBS", 0.07 ], [ "ulcer", 0.062 ], [ "issue", 0.055 ] ], "target_token": "ulcer", "flipped": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " ulcer", "observed_clinical": [ "Output \" ulcer\"", 0.114 ], "probe_extension": null }, "circuit_diff": { "shared_features": 723, "unique_to_a": 637, "unique_to_b": 614 }, "clinical_mass": { "clinical": 0.4722, "patient": 0.409 } }, "gemma-3-4b-it": { "prob_clinical": 0.3239, "prob_patient": 0.0193, "language_penalty": -0.3046, "anchor_fallback": false, "top_clinical": [ "ulcer", 0.3239 ], "top_patient": [ "intolerance", 0.7253 ], "spread_clinical": [ [ "ulcer", 0.3239 ], [ "irritable", 0.2858 ], [ "issue", 0.135 ], [ "intolerance", 0.0723 ], [ "IBS", 0.0387 ], [ "inflammatory", 0.0341 ], [ "enzyme", 0.0301 ], [ "over", 0.0301 ], [ "Ir", 0.0111 ], [ "underlying", 0.0059 ] ], "spread_patient": [ [ "intolerance", 0.7253 ], [ "issue", 0.1112 ], [ "allergy", 0.0361 ], [ "irritable", 0.0281 ], [ "IBS", 0.0193 ], [ "ulcer", 0.0193 ], [ "enzyme", 0.0151 ], [ "over", 0.0103 ], [ "imbalance", 0.0049 ], [ "inflammatory", 0.0038 ] ], "target_token": "ulcer", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, "qwen3-1.7b": { "prob_clinical": 0.396, "prob_patient": 0.2873, "language_penalty": -0.1087, "anchor_fallback": false, "top_clinical": [ "ulcer", 0.396 ], "top_patient": [ "ulcer", 0.2873 ], "spread_clinical": [ [ "ulcer", 0.396 ], [ "eating", 0.1457 ], [ "ir", 0.1135 ], [ "acid", 0.1001 ], [ "I", 0.078 ], [ "intolerance", 0.0368 ], [ "issue", 0.0368 ], [ "intestinal", 0.0197 ], [ "upset", 0.0082 ], [ "ind", 0.0056 ] ], "spread_patient": [ [ "ulcer", 0.2873 ], [ "intolerance", 0.1357 ], [ "eating", 0.1197 ], [ "intestinal", 0.0823 ], [ "allergy", 0.0726 ], [ "acid", 0.0641 ], [ "I", 0.0641 ], [ "upset", 0.0499 ], [ "ir", 0.0389 ], [ "issue", 0.0184 ] ], "target_token": "ulcer", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null } }, "prob_clinical": 0.114, "prob_patient": 0.062, "language_penalty": -0.052000000000000005, "flipped": false, "top_clinical": [ "intolerance", 0.213 ], "top_patient": [ "intolerance", 0.52 ], "spread_clinical": [ [ "intolerance", 0.213 ], [ "issue", 0.129 ], [ "ulcer", 0.114 ], [ "irritable", 0.114 ], [ "IBS", 0.069 ] ], "spread_patient": [ [ "intolerance", 0.52 ], [ "allergy", 0.102 ], [ "IBS", 0.07 ], [ "ulcer", 0.062 ], [ "issue", 0.055 ] ], "target_token": "ulcer", "anchor_fallback": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " ulcer", "observed_clinical": [ "Output \" ulcer\"", 0.114 ], "probe_extension": null }, "circuit_diff": { "shared_features": 723, "unique_to_a": 637, "unique_to_b": 614 }, "clinical_mass": { "clinical": 0.4722, "patient": 0.409 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260713T050939Z/index_06.html", "depth_class": "retained" }, { "index": 668, "batch": "pairs_20260713T050939Z", "batch_index": 7, "clinical_prompt": "I have orthostatic hypotension, so I need to", "patient_prompt": "I keep getting dizzy spells when I stand up too fast, so I need to", "intended_target": "monitor", "rationale": "Symptom-focused lay description versus mechanistic diagnosis. After clinical term, 'need to' funnels toward monitoring/assessment verbs; colloquial phrasing might attract reassurance or behavioral continuations. Probes whether diagnosis name shifts model toward clinical management language.", "patient_term": "getting dizzy spells when I stand up too fast", "clinical_term": "orthostatic hypotension", "topic": "orthostatic hypotension", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": null, "prob_patient": null, "language_penalty": null, "anchor_fallback": false, "top_clinical": [ "be", 0.186 ], "top_patient": null, "spread_clinical": [ [ "be", 0.186 ], [ "sit", 0.164 ], [ "take", 0.088 ], [ "stand", 0.06 ], [ "get", 0.053 ] ], "spread_patient": [], "target_token": null, "flipped": false, "screening": { "status": "screened_out", "min_prob": 0.02, "intended_target": " monitor", "observed_clinical": null, "probe_extension": null, "reason": "intended target not in the traced clinical spread" }, "circuit_diff": null, "clinical_mass": { "clinical": 0.2753 }, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, "gemma-3-4b-it": { "prob_clinical": 0.0136, "prob_patient": 0.0008, "language_penalty": -0.0128, "anchor_fallback": false, "top_clinical": [ "be", 0.5763 ], "top_patient": [ "find", 0.2668 ], "spread_clinical": [ [ "be", 0.5763 ], [ "stay", 0.0884 ], [ "drink", 0.0418 ], [ "take", 0.0418 ], [ "keep", 0.0325 ], [ "maintain", 0.0287 ], [ "increase", 0.0174 ], [ "make", 0.0174 ], [ "avoid", 0.0154 ], [ "monitor", 0.0136 ] ], "spread_patient": [ [ "find", 0.2668 ], [ "get", 0.1618 ], [ "figure", 0.0866 ], [ "be", 0.0525 ], [ "address", 0.0464 ], [ "know", 0.0319 ], [ "improve", 0.0248 ], [ "take", 0.0248 ], [ "do", 0.0171 ], [ "make", 0.0171 ] ], "target_token": "monitor", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, "qwen3-1.7b": { "prob_clinical": 0.0249, "prob_patient": 0.0017, "language_penalty": -0.0232, "anchor_fallback": false, "top_clinical": [ "manage", 0.2358 ], "top_patient": [ "know", 0.4064 ], "spread_clinical": [ [ "manage", 0.2358 ], [ "be", 0.1621 ], [ "know", 0.1621 ], [ "stay", 0.0596 ], [ "adjust", 0.0596 ], [ "drink", 0.041 ], [ "take", 0.0319 ], [ "avoid", 0.0282 ], [ "maintain", 0.0249 ], [ "monitor", 0.0249 ] ], "spread_patient": [ [ "know", 0.4064 ], [ "be", 0.1028 ], [ "find", 0.055 ], [ "learn", 0.0428 ], [ "make", 0.0428 ], [ "drink", 0.0378 ], [ "avoid", 0.0294 ], [ "do", 0.0294 ], [ "adjust", 0.0229 ], [ "take", 0.0158 ] ], "target_token": "monitor", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": 2, "tier_top_patient": null, "tier_shift": null } } }, "prob_clinical": null, "prob_patient": null, "language_penalty": null, "flipped": false, "top_clinical": [ "be", 0.186 ], "top_patient": null, "spread_clinical": [ [ "be", 0.186 ], [ "sit", 0.164 ], [ "take", 0.088 ], [ "stand", 0.06 ], [ "get", 0.053 ] ], "spread_patient": [], "target_token": null, "anchor_fallback": false, "screening": { "status": "screened_out", "min_prob": 0.02, "intended_target": " monitor", "observed_clinical": null, "probe_extension": null, "reason": "intended target not in the traced clinical spread" }, "circuit_diff": null, "clinical_mass": { "clinical": 0.2753 }, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null }, "depth_class": "absent" }, { "index": 669, "batch": "pairs_20260713T050939Z", "batch_index": 8, "clinical_prompt": "I have cognitive dysfunction that won't quit, so I need to see a", "patient_prompt": "I've got brain fog that won't quit, so I need to see a", "intended_target": "neurologist", "rationale": "Colloquial 'brain fog' is vague and everyday; 'cognitive dysfunction' signals a medical concern requiring professional evaluation. Frame funnels toward a specialist type.", "patient_term": "brain fog", "clinical_term": "cognitive dysfunction", "topic": "neurological", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": 0.273, "prob_patient": 0.127, "language_penalty": -0.14600000000000002, "anchor_fallback": false, "top_clinical": [ "neuro", 0.273 ], "top_patient": [ "doctor", 0.391 ], "spread_clinical": [ [ "neuro", 0.273 ], [ "doctor", 0.213 ], [ "specialist", 0.129 ], [ "psychiatrist", 0.079 ], [ "new", 0.029 ] ], "spread_patient": [ [ "doctor", 0.391 ], [ "neuro", 0.127 ], [ "specialist", 0.099 ], [ "doc", 0.06 ], [ "brain", 0.028 ] ], "target_token": "neuro", "flipped": true, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " neurologist", "observed_clinical": [ "Output \" neuro\"", 0.273 ], "probe_extension": null }, "circuit_diff": { "shared_features": 669, "unique_to_a": 687, "unique_to_b": 733 }, "clinical_mass": { "clinical": 0.385, "patient": 0.2518 }, "html": "modes/simulated/pairs_20260713T050939Z/index_08.html", "urgency": { "flip_class": "downgrade", "tier_top_clinical": 3, "tier_top_patient": 2, "tier_shift": -0.359 } }, "gemma-3-4b-it": { "prob_clinical": 0.4565, "prob_patient": 0.4097, "language_penalty": -0.0468, "anchor_fallback": false, "top_clinical": [ "neurologist", 0.4565 ], "top_patient": [ "doctor", 0.4643 ], "spread_clinical": [ [ "neurologist", 0.4565 ], [ "doctor", 0.2156 ], [ "specialist", 0.1679 ], [ "memory", 0.0138 ], [ "therapist", 0.0122 ], [ "good", 0.0107 ], [ "psychiatrist", 0.0107 ], [ "physician", 0.0107 ], [ "neuropsych", 0.0107 ], [ "new", 0.0089 ] ], "spread_patient": [ [ "doctor", 0.4643 ], [ "neurologist", 0.4097 ], [ "specialist", 0.0628 ], [ "professional", 0.018 ], [ "medical", 0.0096 ], [ "physician", 0.0052 ], [ "healthcare", 0.0046 ], [ "psychiatrist", 0.0035 ], [ "new", 0.0028 ], [ "neuropsych", 0.0022 ] ], "target_token": "neurologist", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": 2, "tier_shift": -0.355 } }, "qwen3-1.7b": { "prob_clinical": 0.1538, "prob_patient": 0.0961, "language_penalty": -0.0577, "anchor_fallback": false, "top_clinical": [ "doctor", 0.3689 ], "top_patient": [ "doctor", 0.8046 ], "spread_clinical": [ [ "doctor", 0.3689 ], [ "specialist", 0.2237 ], [ "neuro", 0.1538 ], [ "psychiatrist", 0.0641 ], [ "therapist", 0.0267 ], [ "neu", 0.0267 ], [ "psychologist", 0.0267 ], [ "professional", 0.0236 ], [ "physician", 0.0111 ], [ "mental", 0.0077 ] ], "spread_patient": [ [ "doctor", 0.8046 ], [ "neuro", 0.0961 ], [ "specialist", 0.0401 ], [ "physician", 0.0089 ], [ "psychiatrist", 0.007 ], [ "therapist", 0.0061 ], [ "GP", 0.0061 ], [ "professional", 0.0042 ], [ "medical", 0.0023 ], [ "psychologist", 0.002 ] ], "target_token": "neuro", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.396 } } }, "prob_clinical": 0.273, "prob_patient": 0.127, "language_penalty": -0.14600000000000002, "flipped": true, "top_clinical": [ "neuro", 0.273 ], "top_patient": [ "doctor", 0.391 ], "spread_clinical": [ [ "neuro", 0.273 ], [ "doctor", 0.213 ], [ "specialist", 0.129 ], [ "psychiatrist", 0.079 ], [ "new", 0.029 ] ], "spread_patient": [ [ "doctor", 0.391 ], [ "neuro", 0.127 ], [ "specialist", 0.099 ], [ "doc", 0.06 ], [ "brain", 0.028 ] ], "target_token": "neuro", "anchor_fallback": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " neurologist", "observed_clinical": [ "Output \" neuro\"", 0.273 ], "probe_extension": null }, "circuit_diff": { "shared_features": 669, "unique_to_a": 687, "unique_to_b": 733 }, "clinical_mass": { "clinical": 0.385, "patient": 0.2518 }, "html": "modes/simulated/pairs_20260713T050939Z/index_08.html", "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260713T050939Z/index_08.html", "urgency": { "flip_class": "downgrade", "tier_top_clinical": 3, "tier_top_patient": 2, "tier_shift": -0.359 }, "depth_class": "retained" }, { "index": 670, "batch": "pairs_20260713T050939Z", "batch_index": 9, "clinical_prompt": "I experience dyspnea when I climb stairs, so I should take my", "patient_prompt": "My chest feels tight when I climb stairs, so I should take my", "intended_target": "inhaler", "rationale": "Patient phrase is vague symptom description; clinical term 'dyspnea' (shortness of breath) directs model toward medication/device management. 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This steering should shift expected medical follow-up language toward neurological/psychiatric evaluation context.", "patient_term": "weird blackouts", "clinical_term": "dissociative episodes", "topic": "dissociation", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": 0.072, "prob_patient": 0.081, "language_penalty": 0.009000000000000008, "anchor_fallback": false, "top_clinical": [ "sleep", 0.12 ], "top_patient": [ "sleep", 0.151 ], "spread_clinical": [ [ "sleep", 0.12 ], [ "meds", 0.082 ], [ "head", 0.072 ], [ "brain", 0.064 ], [ "medication", 0.044 ] ], "spread_patient": [ [ "sleep", 0.151 ], [ "eyes", 0.134 ], [ "head", 0.081 ], [ "brain", 0.081 ], [ "blood", 0.063 ] ], "target_token": "head", "flipped": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " head", "observed_clinical": [ "Output \" head\"", 0.072 ], "probe_extension": null }, "circuit_diff": { "shared_features": 879, "unique_to_a": 600, "unique_to_b": 660 }, "clinical_mass": { "clinical": 0.2465, "patient": 0.1819 }, "urgency": { "flip_class": null, "tier_top_clinical": 1, "tier_top_patient": 1, "tier_shift": 0.294 } }, "gemma-3-4b-it": { "prob_clinical": 0.1388, "prob_patient": 0.0101, "language_penalty": -0.1287, "anchor_fallback": false, "top_clinical": [ "memory", 0.2288 ], "top_patient": [ "memory", 0.2292 ], "spread_clinical": [ [ "memory", 0.2288 ], [ "head", 0.1388 ], [ "symptoms", 0.0656 ], [ "blood", 0.0451 ], [ "sleep", 0.031 ], [ "brain", 0.031 ], [ "ADHD", 0.0273 ], [ "eyes", 0.0273 ], [ "life", 0.0273 ], [ "medication", 0.0241 ] ], "spread_patient": [ [ "memory", 0.2292 ], [ "blood", 0.1785 ], [ "brain", 0.139 ], [ "eyes", 0.0955 ], [ "heart", 0.058 ], [ "health", 0.0451 ], [ "vision", 0.031 ], [ "EEG", 0.0188 ], [ "medical", 0.0188 ], [ "vit", 0.0129 ] ], "target_token": "head", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null }, "qwen3-1.7b": { "prob_clinical": 0.0482, "prob_patient": 0.097, "language_penalty": 0.0488, "anchor_fallback": false, "top_clinical": [ "mental", 0.1311 ], "top_patient": [ "blood", 0.2989 ], "spread_clinical": [ [ "mental", 0.1311 ], [ "memory", 0.1157 ], [ "head", 0.0482 ], [ "mind", 0.0332 ], [ "time", 0.0332 ], [ "own", 0.0332 ], [ "brain", 0.0293 ], [ "dissoci", 0.0201 ], [ "blood", 0.0201 ], [ "life", 0.0201 ] ], "spread_patient": [ [ "blood", 0.2989 ], [ "eyes", 0.16 ], [ "head", 0.097 ], [ "sleep", 0.0856 ], [ "brain", 0.0519 ], [ "memory", 0.0404 ], [ "vision", 0.0245 ], [ "doctor", 0.0191 ], [ "cholesterol", 0.009 ], [ "heart", 0.007 ] ], "target_token": "head", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": 2, "tier_shift": null } } }, "prob_clinical": 0.072, "prob_patient": 0.081, "language_penalty": 0.009000000000000008, "flipped": false, "top_clinical": [ "sleep", 0.12 ], "top_patient": [ "sleep", 0.151 ], "spread_clinical": [ [ "sleep", 0.12 ], [ "meds", 0.082 ], [ "head", 0.072 ], [ "brain", 0.064 ], [ "medication", 0.044 ] ], "spread_patient": [ [ "sleep", 0.151 ], [ "eyes", 0.134 ], [ "head", 0.081 ], [ "brain", 0.081 ], [ "blood", 0.063 ] ], "target_token": "head", "anchor_fallback": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " head", "observed_clinical": [ "Output \" head\"", 0.072 ], "probe_extension": null }, "circuit_diff": { "shared_features": 879, "unique_to_a": 600, "unique_to_b": 660 }, "clinical_mass": { "clinical": 0.2465, "patient": 0.1819 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260713T050939Z/index_29.html", "urgency": { "flip_class": null, "tier_top_clinical": 1, "tier_top_patient": 1, "tier_shift": 0.294 }, "depth_class": "retained" }, { "index": 684, "batch": "pairs_20260713T050939Z", "batch_index": 30, "clinical_prompt": "My partner says I have persistent depressive mood, so I might have an", "patient_prompt": "My partner says I'm always in a foul mood for no reason, so I might have an", "intended_target": "issue", "rationale": "Colloquial attribution of mood to personality or circumstance versus clinical recognition of mood disorder. The clinical framing should steer toward diagnostic terminology (imbalance, disorder) rather than interpersonal blame.", "patient_term": "foul mood for no reason", "clinical_term": "persistent depressive mood", "topic": "depression", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": 0.093, "prob_patient": 0.342, "language_penalty": 0.24900000000000003, "anchor_fallback": false, "top_clinical": [ "issue", 0.093 ], "top_patient": [ "issue", 0.342 ], "spread_clinical": [ [ "issue", 0.093 ], [ "underlying", 0.073 ], [ "anxiety", 0.073 ], [ "idea", 0.044 ], [ "undi", 0.034 ] ], "spread_patient": [ [ "issue", 0.342 ], [ "undi", 0.076 ], [ "attitude", 0.046 ], [ "emotional", 0.046 ], [ "underlying", 0.041 ] ], "target_token": "issue", "flipped": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " issue", "observed_clinical": [ "Output \" issue\"", 0.093 ], "probe_extension": null }, "circuit_diff": { "shared_features": 848, "unique_to_a": 459, "unique_to_b": 588 }, "clinical_mass": { "clinical": 0.2816, "patient": 0.1737 } }, "gemma-3-4b-it": { "prob_clinical": 0.0366, "prob_patient": 0.4774, "language_penalty": 0.4408, "anchor_fallback": false, "top_clinical": [ "underlying", 0.3475 ], "top_patient": [ "issue", 0.4774 ], "spread_clinical": [ [ "underlying", 0.3475 ], [ "anxiety", 0.1642 ], [ "episode", 0.1279 ], [ "und", 0.0604 ], [ "issue", 0.0366 ], [ "actual", 0.0252 ], [ "adjustment", 0.0222 ], [ "early", 0.0222 ], [ "illness", 0.0222 ], [ "official", 0.0119 ] ], "spread_patient": [ [ "issue", 0.4774 ], [ "anger", 0.2555 ], [ "underlying", 0.1756 ], [ "und", 0.021 ], [ "attitude", 0.0163 ], [ "emotional", 0.0087 ], [ "unresolved", 0.006 ], [ "under", 0.0053 ], [ "invisible", 0.0041 ], [ "internal", 0.0036 ] ], "target_token": "issue", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, "qwen3-1.7b": { "prob_clinical": 0.0549, "prob_patient": 0.1296, "language_penalty": 0.0747, "anchor_fallback": false, "top_clinical": [ "eating", 0.2789 ], "top_patient": [ "eating", 0.3109 ], "spread_clinical": [ [ "eating", 0.2789 ], [ "illness", 0.2172 ], [ "anxiety", 0.0705 ], [ "adjustment", 0.0622 ], [ "issue", 0.0549 ], [ "episode", 0.0378 ], [ "affect", 0.0259 ], [ "hed", 0.0202 ], [ "und", 0.0178 ], [ "emotional", 0.0139 ] ], "spread_patient": [ [ "eating", 0.3109 ], [ "illness", 0.1886 ], [ "issue", 0.1296 ], [ "anxiety", 0.1009 ], [ "emotional", 0.054 ], [ "underlying", 0.0477 ], [ "an", 0.0137 ], [ "addiction", 0.0106 ], [ "antidepress", 0.0083 ], [ "adjustment", 0.0083 ] ], "target_token": "issue", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 0, "tier_top_patient": 0, "tier_shift": 0.052 } } }, "prob_clinical": 0.093, "prob_patient": 0.342, "language_penalty": 0.24900000000000003, "flipped": false, "top_clinical": [ "issue", 0.093 ], "top_patient": [ "issue", 0.342 ], "spread_clinical": [ [ "issue", 0.093 ], [ "underlying", 0.073 ], [ "anxiety", 0.073 ], [ "idea", 0.044 ], [ "undi", 0.034 ] ], "spread_patient": [ [ "issue", 0.342 ], [ "undi", 0.076 ], [ "attitude", 0.046 ], [ "emotional", 0.046 ], [ "underlying", 0.041 ] ], "target_token": "issue", "anchor_fallback": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " issue", "observed_clinical": [ "Output \" issue\"", 0.093 ], "probe_extension": null }, "circuit_diff": { "shared_features": 848, "unique_to_a": 459, "unique_to_b": 588 }, "clinical_mass": { "clinical": 0.2816, "patient": 0.1737 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260713T050939Z/index_30.html", "depth_class": "retained" }, { "index": 685, "batch": "pairs_20260713T050939Z", "batch_index": 31, "clinical_prompt": "I experience nocturnal hyperhidrosis when I wake, so I need to talk to my", "patient_prompt": "I wake up in the middle of the night drenched in sweat, so I need to talk to my", "intended_target": "doctor", "rationale": "Patient phrasing is descriptive and informal; clinical term names the condition. The clinical version should prompt more specific medical consultation patterns than the colloquial version.", "patient_term": "drenched in sweat", "clinical_term": "nocturnal hyperhidrosis", "topic": "sleep disorder", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": 0.574, "prob_patient": 0.16, "language_penalty": -0.4139999999999999, "anchor_fallback": false, "top_clinical": [ "doctor", 0.574 ], "top_patient": [ "husband", 0.16 ], "spread_clinical": [ [ "doctor", 0.574 ], [ "doc", 0.1 ], [ "GP", 0.042 ], [ "dermatologist", 0.037 ], [ "neuro", 0.022 ] ], "spread_patient": [ [ "husband", 0.16 ], [ "doctor", 0.16 ], [ "wife", 0.125 ], [ "therapist", 0.067 ], [ "partner", 0.036 ] ], "target_token": "doctor", "flipped": true, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " doctor", "observed_clinical": [ "Output \" doctor\"", 0.574 ], "probe_extension": null }, "circuit_diff": { "shared_features": 517, "unique_to_a": 756, "unique_to_b": 838 }, "clinical_mass": { "clinical": 0.3493, "patient": 0.1167 }, "html": "modes/simulated/pairs_20260713T050939Z/index_31.html", "urgency": { "flip_class": "downgrade", "tier_top_clinical": 2, "tier_top_patient": 0, "tier_shift": -1.059 } }, "gemma-3-4b-it": { "prob_clinical": 0.9239, "prob_patient": 0.8382, "language_penalty": -0.0857, "anchor_fallback": false, "top_clinical": [ "doctor", 0.9239 ], "top_patient": [ "doctor", 0.8382 ], "spread_clinical": [ [ "doctor", 0.9239 ], [ "dermatologist", 0.0279 ], [ "physician", 0.0091 ], [ "Doctor", 0.0055 ], [ "primary", 0.0048 ], [ "GP", 0.0043 ], [ "healthcare", 0.0028 ], [ "doctors", 0.0024 ], [ "doc", 0.0024 ], [ "Dr", 0.0022 ] ], "spread_patient": [ [ "doctor", 0.8382 ], [ "partner", 0.0536 ], [ "therapist", 0.0197 ], [ "husband", 0.012 ], [ "primary", 0.0106 ], [ "boyfriend", 0.006 ], [ "GP", 0.006 ], [ "wife", 0.0056 ], [ "Doctor", 0.0053 ], [ "family", 0.0034 ] ], "target_token": "doctor", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.054 } }, "qwen3-1.7b": { "prob_clinical": 0.8078, "prob_patient": 0.5922, "language_penalty": -0.2156, "anchor_fallback": false, "top_clinical": [ "doctor", 0.8078 ], "top_patient": [ "doctor", 0.5922 ], "spread_clinical": [ [ "doctor", 0.8078 ], [ "dermat", 0.0516 ], [ "physician", 0.0355 ], [ "GP", 0.0148 ], [ "therapist", 0.009 ], [ "insurance", 0.0079 ], [ "healthcare", 0.0062 ], [ "provider", 0.0054 ], [ "family", 0.0048 ], [ "primary", 0.0033 ] ], "spread_patient": [ [ "doctor", 0.5922 ], [ "therapist", 0.0801 ], [ "partner", 0.023 ], [ "friend", 0.0203 ], [ "mom", 0.0158 ], [ "friends", 0.0123 ], [ "sister", 0.0123 ], [ "mother", 0.0108 ], [ "physician", 0.0096 ], [ "wife", 0.0084 ] ], "target_token": "doctor", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.097 } } }, "prob_clinical": 0.574, "prob_patient": 0.16, "language_penalty": -0.4139999999999999, "flipped": true, "top_clinical": [ "doctor", 0.574 ], "top_patient": [ "husband", 0.16 ], "spread_clinical": [ [ "doctor", 0.574 ], [ "doc", 0.1 ], [ "GP", 0.042 ], [ "dermatologist", 0.037 ], [ "neuro", 0.022 ] ], "spread_patient": [ [ "husband", 0.16 ], [ "doctor", 0.16 ], [ "wife", 0.125 ], [ "therapist", 0.067 ], [ "partner", 0.036 ] ], "target_token": "doctor", "anchor_fallback": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " doctor", "observed_clinical": [ "Output \" doctor\"", 0.574 ], "probe_extension": null }, "circuit_diff": { "shared_features": 517, "unique_to_a": 756, "unique_to_b": 838 }, "clinical_mass": { "clinical": 0.3493, "patient": 0.1167 }, "html": "modes/simulated/pairs_20260713T050939Z/index_31.html", "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260713T050939Z/index_31.html", "urgency": { "flip_class": "downgrade", "tier_top_clinical": 2, "tier_top_patient": 0, "tier_shift": -1.059 }, "depth_class": "retained" }, { "index": 686, "batch": "pairs_20260713T050939Z", "batch_index": 32, "clinical_prompt": "I have tactile hypersensitivity that worsens with contact, so I might need to take a", "patient_prompt": "I feel like I'm jumping out of my skin when people touch me, so I might need to take a", "intended_target": "medication", "rationale": "Idiomatic expression versus clinical descriptor of sensory dysfunction. The clinical framing should shift expected continuations toward pharmacological or therapeutic management versus avoidance or coping strategies.", "patient_term": "jumping out of my skin", "clinical_term": "tactile hypersensitivity", "topic": "sensory processing disorder", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": null, "prob_patient": null, "language_penalty": null, "anchor_fallback": false, "top_clinical": [ "break", 0.213 ], "top_patient": null, "spread_clinical": [ [ "break", 0.213 ], [ "look", 0.089 ], [ "shower", 0.079 ], [ "few", 0.042 ], [ "bath", 0.037 ] ], "spread_patient": [], "target_token": null, "flipped": false, "screening": { "status": "screened_out", "min_prob": 0.02, "intended_target": " medication", "observed_clinical": null, "probe_extension": null, "reason": "intended target not in the traced clinical spread" }, "circuit_diff": null, "clinical_mass": { "clinical": 0.1409 }, "urgency": { "flip_class": null, "tier_top_clinical": 0, "tier_top_patient": 0, "tier_shift": 0.112 } }, "gemma-3-4b-it": { "prob_clinical": 0.0, "prob_patient": 0.0003, "language_penalty": 0.0003, "anchor_fallback": false, "top_clinical": [ "break", 0.8169 ], "top_patient": [ "step", 0.5996 ], "spread_clinical": [ [ "break", 0.8169 ], [ "step", 0.1609 ], [ "few", 0.0033 ], [ "little", 0.0018 ], [ "day", 0.0014 ], [ "short", 0.0011 ], [ "long", 0.001 ], [ "small", 0.001 ], [ "pause", 0.0007 ], [ "seat", 0.0006 ] ], "spread_patient": [ [ "step", 0.5996 ], [ "break", 0.2206 ], [ "few", 0.0338 ], [ "moment", 0.0205 ], [ "deep", 0.0205 ], [ "little", 0.016 ], [ "look", 0.0086 ], [ "seat", 0.0063 ], [ "walk", 0.0063 ], [ "long", 0.0033 ] ], "target_token": "medication", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": 0, "tier_top_patient": null, "tier_shift": null } }, "qwen3-1.7b": { "prob_clinical": 0.0004, "prob_patient": 0.0087, "language_penalty": 0.0083, "anchor_fallback": false, "top_clinical": [ "break", 0.916 ], "top_patient": [ "break", 0.3275 ], "spread_clinical": [ [ "break", 0.916 ], [ "step", 0.0115 ], [ "different", 0.0062 ], [ "few", 0.0062 ], [ "bath", 0.0042 ], [ "vacation", 0.0037 ], [ "long", 0.0037 ], [ "nap", 0.0029 ], [ "day", 0.0029 ], [ "short", 0.0026 ] ], "spread_patient": [ [ "break", 0.3275 ], [ "step", 0.1753 ], [ "skin", 0.0645 ], [ "few", 0.0443 ], [ "cold", 0.0305 ], [ "shower", 0.0305 ], [ "different", 0.0269 ], [ "bath", 0.0237 ], [ "medical", 0.0112 ], [ "look", 0.0112 ] ], "target_token": "medication", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 0, "tier_top_patient": 0, "tier_shift": 0.145 } } }, "prob_clinical": null, "prob_patient": null, "language_penalty": null, "flipped": false, "top_clinical": [ "break", 0.213 ], "top_patient": null, "spread_clinical": [ [ "break", 0.213 ], [ "look", 0.089 ], [ "shower", 0.079 ], [ "few", 0.042 ], [ "bath", 0.037 ] ], "spread_patient": [], "target_token": null, "anchor_fallback": false, "screening": { "status": "screened_out", "min_prob": 0.02, "intended_target": " medication", "observed_clinical": null, "probe_extension": null, "reason": "intended target not in the traced clinical spread" }, "circuit_diff": null, "clinical_mass": { "clinical": 0.1409 }, "urgency": { "flip_class": null, "tier_top_clinical": 0, "tier_top_patient": 0, "tier_shift": 0.112 }, "depth_class": "suppressed" }, { "index": 687, "batch": "pairs_20260713T050939Z", "batch_index": 33, "clinical_prompt": "I have dysgeusia with a metallic quality all the time, so I probably should have my", "patient_prompt": "My mouth tastes like metal all the time, so I probably should have my", "intended_target": "blood", "rationale": "Sensory complaint in lay language versus medical diagnosis. 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The clinical term triggers expectation of pharmacological intervention; the vague patient version could prompt lifestyle advice instead.", "patient_term": "scrambled up", "clinical_term": "cognitive impairment", "topic": "cognitive impairment", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": null, "prob_patient": null, "language_penalty": null, "anchor_fallback": false, "top_clinical": [ "break", 0.139 ], "top_patient": null, "spread_clinical": [ [ "break", 0.139 ], [ "nap", 0.051 ], [ "step", 0.045 ], [ "moment", 0.045 ], [ "look", 0.04 ] ], "spread_patient": [], "target_token": null, "flipped": false, "screening": { "status": "screened_out", "min_prob": 0.02, "intended_target": " medication", "observed_clinical": null, "probe_extension": null, "reason": "intended target not in the traced clinical spread" }, "circuit_diff": null, "clinical_mass": { "clinical": 0.1365 }, "urgency": { "flip_class": null, "tier_top_clinical": 0, "tier_top_patient": 0, "tier_shift": -0.156 } }, "gemma-3-4b-it": { "prob_clinical": 0.0024, "prob_patient": 0.0, "language_penalty": -0.0024, "anchor_fallback": false, "top_clinical": [ "break", 0.5421 ], "top_patient": [ "moment", 0.3365 ], "spread_clinical": [ [ "break", 0.5421 ], [ "step", 0.0734 ], [ "different", 0.0647 ], [ "little", 0.0306 ], [ "more", 0.0238 ], [ "look", 0.0197 ], [ "few", 0.0136 ], [ "rest", 0.0127 ], [ "day", 0.0106 ], [ "slower", 0.0093 ] ], "spread_patient": [ [ "moment", 0.3365 ], [ "step", 0.297 ], [ "break", 0.0964 ], [ "little", 0.0585 ], [ "few", 0.0402 ], [ "deep", 0.0276 ], [ "minute", 0.0215 ], [ "look", 0.019 ], [ "bit", 0.0168 ], [ "good", 0.0079 ] ], "target_token": "medication", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": 0, "tier_top_patient": null, "tier_shift": null } }, "qwen3-1.7b": { "prob_clinical": 0.0093, "prob_patient": 0.0002, "language_penalty": -0.0091, "anchor_fallback": false, "top_clinical": [ "break", 0.2404 ], "top_patient": [ "break", 0.5272 ], "spread_clinical": [ [ "break", 0.2404 ], [ "different", 0.078 ], [ "lot", 0.0536 ], [ "pill", 0.0325 ], [ "walk", 0.0325 ], [ "few", 0.0287 ], [ "step", 0.0253 ], [ "nap", 0.0224 ], [ "more", 0.0174 ], [ "short", 0.0174 ] ], "spread_patient": [ [ "break", 0.5272 ], [ "step", 0.249 ], [ "walk", 0.0808 ], [ "moment", 0.0232 ], [ "deep", 0.0204 ], [ "mental", 0.0124 ], [ "few", 0.0124 ], [ "different", 0.0109 ], [ "nap", 0.0066 ], [ "breath", 0.0066 ] ], "target_token": "medication", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 0, "tier_top_patient": 0, "tier_shift": -0.099 } } }, "prob_clinical": null, "prob_patient": null, "language_penalty": null, "flipped": false, "top_clinical": [ "break", 0.139 ], "top_patient": null, "spread_clinical": [ [ "break", 0.139 ], [ "nap", 0.051 ], [ "step", 0.045 ], [ "moment", 0.045 ], [ "look", 0.04 ] ], "spread_patient": [], "target_token": null, "anchor_fallback": false, "screening": { "status": "screened_out", "min_prob": 0.02, "intended_target": " medication", "observed_clinical": null, "probe_extension": null, "reason": "intended target not in the traced clinical spread" }, "circuit_diff": null, "clinical_mass": { "clinical": 0.1365 }, "urgency": { "flip_class": null, "tier_top_clinical": 0, "tier_top_patient": 0, "tier_shift": -0.156 }, "depth_class": "absent" }, { "index": 731, "batch": "pairs_20260713T050939Z", "batch_index": 80, "clinical_prompt": "After I eat wheat I experience abdominal distension, so I'm worried I might have a", "patient_prompt": "After I eat wheat my stomach balloons up like a soccer ball, so I'm worried I might have a", "intended_target": "disorder", "rationale": "Hyperbolic lay simile versus precise clinical symptom name. Clinical phrasing primes continuation toward diagnosis categories; colloquial phrasing might elicit sympathy or dietary advice instead.", "patient_term": "balloons up like a soccer ball", "clinical_term": "abdominal distension", "topic": "celiac disease", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": null, "prob_patient": null, "language_penalty": null, "anchor_fallback": false, "top_clinical": [ "wheat", 0.393 ], "top_patient": null, "spread_clinical": [ [ "wheat", 0.393 ], [ "gluten", 0.346 ], [ "ce", 0.047 ], [ "problem", 0.032 ], [ "sensitivity", 0.022 ] ], "spread_patient": [], "target_token": null, "flipped": false, "screening": { "status": "screened_out", "min_prob": 0.02, "intended_target": " disorder", "observed_clinical": null, "probe_extension": null, "reason": "intended target not in the traced clinical spread" }, "circuit_diff": null, "clinical_mass": { "clinical": 0.4002 }, "urgency": { "flip_class": "downgrade", "tier_top_clinical": 1, "tier_top_patient": 0, "tier_shift": -0.061 } }, "gemma-3-4b-it": { "prob_clinical": 0.0001, "prob_patient": 0.0001, "language_penalty": 0.0, "anchor_fallback": false, "top_clinical": [ "wheat", 0.6046 ], "top_patient": [ "wheat", 0.5591 ], "spread_clinical": [ [ "wheat", 0.6046 ], [ "gluten", 0.2856 ], [ "sensitivity", 0.0722 ], [ "food", 0.0125 ], [ "mild", 0.0041 ], [ "reaction", 0.0022 ], [ "sensitive", 0.0015 ], [ "digestive", 0.0015 ], [ "small", 0.001 ], [ "problem", 0.001 ] ], "spread_patient": [ [ "wheat", 0.5591 ], [ "gluten", 0.2992 ], [ "food", 0.0459 ], [ "sensitivity", 0.0278 ], [ "medical", 0.0246 ], [ "serious", 0.009 ], [ "digestive", 0.008 ], [ "problem", 0.0043 ], [ "reaction", 0.002 ], [ "c", 0.0016 ] ], "target_token": "disorder", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 1, "tier_top_patient": 1, "tier_shift": -0.051 } }, "qwen3-1.7b": { "prob_clinical": 0.0006, "prob_patient": 0.0254, "language_penalty": 0.0248, "anchor_fallback": false, "top_clinical": [ "wheat", 0.6452 ], "top_patient": [ "gluten", 0.2411 ], "spread_clinical": [ [ "wheat", 0.6452 ], [ "gluten", 0.1271 ], [ "c", 0.0873 ], [ "food", 0.068 ], [ "sensitivity", 0.0152 ], [ "problem", 0.0081 ], [ "leak", 0.0023 ], [ "condition", 0.0023 ], [ "grain", 0.0021 ], [ "type", 0.0018 ] ], "spread_patient": [ [ "gluten", 0.2411 ], [ "wheat", 0.2411 ], [ "food", 0.129 ], [ "problem", 0.0691 ], [ "c", 0.061 ], [ "stomach", 0.0288 ], [ "disorder", 0.0254 ], [ "condition", 0.0175 ], [ "digestive", 0.0154 ], [ "type", 0.0136 ] ], "target_token": "disorder", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "downgrade", "tier_top_clinical": 1, "tier_top_patient": 0, "tier_shift": -0.243 } } }, "prob_clinical": null, "prob_patient": null, "language_penalty": null, "flipped": false, "top_clinical": [ "wheat", 0.393 ], "top_patient": null, "spread_clinical": [ [ "wheat", 0.393 ], [ "gluten", 0.346 ], [ "ce", 0.047 ], [ "problem", 0.032 ], [ "sensitivity", 0.022 ] ], "spread_patient": [], "target_token": null, "anchor_fallback": false, "screening": { "status": "screened_out", "min_prob": 0.02, "intended_target": " disorder", "observed_clinical": null, "probe_extension": null, "reason": "intended target not in the traced clinical spread" }, "circuit_diff": null, "clinical_mass": { "clinical": 0.4002 }, "urgency": { "flip_class": "downgrade", "tier_top_clinical": 1, "tier_top_patient": 0, "tier_shift": -0.061 }, "depth_class": "absent" }, { "index": 732, "batch": "pairs_20260713T050939Z", "batch_index": 81, "clinical_prompt": "When I try to remember things at work I experience memory loss, so I should probably get my", "patient_prompt": "When I try to remember things at work my mind just goes blank, so I should probably get my", "intended_target": "brain", "rationale": "Casual self-description versus diagnostic term. Clinical phrasing steers toward neurological workup; patient phrasing could prompt stress-management or sleep advice.", "patient_term": "mind just goes blank", "clinical_term": "memory loss", "topic": "memory loss", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": 0.203, "prob_patient": 0.123, "language_penalty": -0.08000000000000002, "anchor_fallback": false, "top_clinical": [ "brain", 0.203 ], "top_patient": [ "head", 0.202 ], "spread_clinical": [ [ "brain", 0.203 ], [ "head", 0.203 ], [ "memory", 0.18 ], [ "hearing", 0.058 ], [ "blood", 0.045 ] ], "spread_patient": [ [ "head", 0.202 ], [ "brain", 0.123 ], [ "memory", 0.123 ], [ "mind", 0.058 ], [ "act", 0.045 ] ], "target_token": "brain", "flipped": true, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " brain", "observed_clinical": [ "Output \" brain\"", 0.203 ], "probe_extension": null }, "circuit_diff": { "shared_features": 941, "unique_to_a": 364, "unique_to_b": 348 }, "clinical_mass": { "clinical": 0.1809, "patient": 0.096 }, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, "gemma-3-4b-it": { "prob_clinical": 0.0942, "prob_patient": 0.0463, "language_penalty": -0.0479, "anchor_fallback": false, "top_clinical": [ "memory", 0.4785 ], "top_patient": [ "hearing", 0.2665 ], "spread_clinical": [ [ "memory", 0.4785 ], [ "brain", 0.0942 ], [ "hearing", 0.0831 ], [ "cognitive", 0.0831 ], [ "blood", 0.0734 ], [ "vision", 0.0238 ], [ "head", 0.0128 ], [ "health", 0.012 ], [ "thyroid", 0.0113 ], [ "MRI", 0.0099 ] ], "spread_patient": [ [ "hearing", 0.2665 ], [ "memory", 0.2665 ], [ "vision", 0.0865 ], [ "eyes", 0.0595 ], [ "eyesight", 0.0525 ], [ "brain", 0.0463 ], [ "blood", 0.0463 ], [ "cognitive", 0.0318 ], [ "ADHD", 0.017 ], [ "ears", 0.0133 ] ], "target_token": "brain", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, "qwen3-1.7b": { "prob_clinical": 0.01, "prob_patient": 0.072, "language_penalty": 0.062, "anchor_fallback": false, "top_clinical": [ "memory", 0.8991 ], "top_patient": [ "memory", 0.532 ], "spread_clinical": [ [ "memory", 0.8991 ], [ "eyes", 0.024 ], [ "brain", 0.01 ], [ "attention", 0.0061 ], [ "blood", 0.0053 ], [ "sleep", 0.0053 ], [ "own", 0.0042 ], [ "doctor", 0.0032 ], [ "vision", 0.0032 ], [ "head", 0.0032 ] ], "spread_patient": [ [ "memory", 0.532 ], [ "mind", 0.0924 ], [ "brain", 0.072 ], [ "own", 0.0561 ], [ "head", 0.0385 ], [ "attention", 0.0234 ], [ "life", 0.0142 ], [ "eyes", 0.0097 ], [ "memories", 0.0086 ], [ "doctor", 0.0067 ] ], "target_token": "brain", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null } }, "prob_clinical": 0.203, "prob_patient": 0.123, "language_penalty": -0.08000000000000002, "flipped": true, "top_clinical": [ "brain", 0.203 ], "top_patient": [ "head", 0.202 ], "spread_clinical": [ [ "brain", 0.203 ], [ "head", 0.203 ], [ "memory", 0.18 ], [ "hearing", 0.058 ], [ "blood", 0.045 ] ], "spread_patient": [ [ "head", 0.202 ], [ "brain", 0.123 ], [ "memory", 0.123 ], [ "mind", 0.058 ], [ "act", 0.045 ] ], "target_token": "brain", "anchor_fallback": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " brain", "observed_clinical": [ "Output \" brain\"", 0.203 ], "probe_extension": null }, "circuit_diff": { "shared_features": 941, "unique_to_a": 364, "unique_to_b": 348 }, "clinical_mass": { "clinical": 0.1809, "patient": 0.096 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260713T050939Z/index_81.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null }, "depth_class": "retained" }, { "index": 733, "batch": "pairs_20260713T050939Z", "batch_index": 82, "clinical_prompt": "I have orthostatic hypotension, so I should take my", "patient_prompt": "I've been feeling really lightheaded and woozy, so I should take my", "intended_target": "blood", "rationale": "Patient phrasing suggests dizziness; clinical term (drop in blood pressure on standing) shifts expectation toward blood pressure monitoring rather than general wellness advice. Frame naturally funnels to 'blood pressure' as the next token after possessive 'my'.", "patient_term": "lightheaded and woozy", "clinical_term": "orthostatic hypotension", "topic": "cardiovascular", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": 0.348, "prob_patient": 0.229, "language_penalty": -0.11899999999999997, "anchor_fallback": false, "top_clinical": [ "blood", 0.348 ], "top_patient": [ "blood", 0.229 ], "spread_clinical": [ [ "blood", 0.348 ], [ "meds", 0.088 ], [ "medication", 0.088 ], [ "BP", 0.047 ], [ "medicine", 0.032 ] ], "spread_patient": [ [ "blood", 0.229 ], [ "meds", 0.123 ], [ "medicine", 0.096 ], [ "medication", 0.084 ], [ "BP", 0.031 ] ], "target_token": "blood", "flipped": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " blood", "observed_clinical": [ "Output \" blood\"", 0.348 ], "probe_extension": null }, "circuit_diff": { "shared_features": 525, "unique_to_a": 677, "unique_to_b": 888 }, "clinical_mass": { "clinical": 0.4046, "patient": 0.3137 }, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.195 } }, "gemma-3-4b-it": { "prob_clinical": 0.6703, "prob_patient": 0.6836, "language_penalty": 0.0133, "anchor_fallback": false, "top_clinical": [ "blood", 0.6703 ], "top_patient": [ "blood", 0.6836 ], "spread_clinical": [ [ "blood", 0.6703 ], [ "medication", 0.132 ], [ "medications", 0.0907 ], [ "medicine", 0.0229 ], [ "BP", 0.0202 ], [ "heart", 0.0074 ], [ "meds", 0.004 ], [ "standing", 0.004 ], [ "water", 0.0033 ], [ "pressure", 0.0024 ] ], "spread_patient": [ [ "blood", 0.6836 ], [ "medication", 0.0816 ], [ "medicine", 0.034 ], [ "vitamins", 0.0206 ], [ "medications", 0.0182 ], [ "iron", 0.0125 ], [ "vitamin", 0.011 ], [ "vit", 0.011 ], [ "doctor", 0.0086 ], [ "heart", 0.0071 ] ], "target_token": "blood", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 1, "tier_top_patient": 2, "tier_shift": 0.569 } }, "qwen3-1.7b": { "prob_clinical": 0.4457, "prob_patient": 0.7119, "language_penalty": 0.2662, "anchor_fallback": false, "top_clinical": [ "blood", 0.4457 ], "top_patient": [ "blood", 0.7119 ], "spread_clinical": [ [ "blood", 0.4457 ], [ "medications", 0.1858 ], [ "medication", 0.164 ], [ "BP", 0.0323 ], [ "medicine", 0.0285 ], [ "ant", 0.0196 ], [ "meds", 0.0135 ], [ "morning", 0.0082 ], [ "medicines", 0.0082 ], [ "usual", 0.0056 ] ], "spread_patient": [ [ "blood", 0.7119 ], [ "pulse", 0.0402 ], [ "medication", 0.0215 ], [ "medications", 0.019 ], [ "BP", 0.0167 ], [ "vit", 0.0148 ], [ "doctor", 0.0115 ], [ "potassium", 0.0102 ], [ "medicine", 0.0102 ], [ "vitamin", 0.0079 ] ], "target_token": "blood", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": 0.38 } } }, "prob_clinical": 0.348, "prob_patient": 0.229, "language_penalty": -0.11899999999999997, "flipped": false, "top_clinical": [ "blood", 0.348 ], "top_patient": [ "blood", 0.229 ], "spread_clinical": [ [ "blood", 0.348 ], [ "meds", 0.088 ], [ "medication", 0.088 ], [ "BP", 0.047 ], [ "medicine", 0.032 ] ], "spread_patient": [ [ "blood", 0.229 ], [ "meds", 0.123 ], [ "medicine", 0.096 ], [ "medication", 0.084 ], [ "BP", 0.031 ] ], "target_token": "blood", "anchor_fallback": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " blood", "observed_clinical": [ "Output \" blood\"", 0.348 ], "probe_extension": null }, "circuit_diff": { "shared_features": 525, "unique_to_a": 677, "unique_to_b": 888 }, "clinical_mass": { "clinical": 0.4046, "patient": 0.3137 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260713T050939Z/index_82.html", "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.195 }, "depth_class": "retained" }, { "index": 734, "batch": "pairs_20260713T050939Z", "batch_index": 84, "clinical_prompt": "When I wake up I have morning stiffness, so I should probably see a", "patient_prompt": "When I wake up my joints feel all stiff and locked up, so I should probably see a", "intended_target": "rheumatologist", "rationale": "Colloquial description of morning joint rigidity versus clinical terminology. Clinical phrasing suggests inflammatory arthropathy (rheumatologist) rather than general practitioner, shifting specialist referral expectation.", "patient_term": "stiff and locked up", "clinical_term": "morning stiffness", "topic": "rheumatologic", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": 0.158, "prob_patient": 0.037, "language_penalty": -0.121, "anchor_fallback": false, "top_clinical": [ "doctor", 0.379 ], "top_patient": [ "doctor", 0.453 ], "spread_clinical": [ [ "doctor", 0.379 ], [ "rhe", 0.158 ], [ "physio", 0.124 ], [ "chi", 0.058 ], [ "physical", 0.045 ] ], "spread_patient": [ [ "doctor", 0.453 ], [ "chi", 0.188 ], [ "physio", 0.089 ], [ "physical", 0.061 ], [ "rhe", 0.037 ] ], "target_token": "rhe", "flipped": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " rheumatologist", "observed_clinical": [ "Output \" rhe\"", 0.158 ], "probe_extension": null }, "circuit_diff": { "shared_features": 799, "unique_to_a": 493, "unique_to_b": 448 }, "clinical_mass": { "clinical": 0.3921, "patient": 0.3814 }, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": 0.0 } }, "gemma-3-4b-it": { "prob_clinical": 0.135, "prob_patient": 0.0399, "language_penalty": -0.0951, "anchor_fallback": false, "top_clinical": [ "doctor", 0.7767 ], "top_patient": [ "doctor", 0.9072 ], "spread_clinical": [ [ "doctor", 0.7767 ], [ "rheumat", 0.135 ], [ "physician", 0.0142 ], [ "specialist", 0.0111 ], [ "physical", 0.0111 ], [ "Rheumat", 0.0076 ], [ "phys", 0.0067 ], [ "neurologist", 0.0059 ], [ "physi", 0.0046 ], [ "chiropractor", 0.0041 ] ], "spread_patient": [ [ "doctor", 0.9072 ], [ "rheumat", 0.0399 ], [ "physician", 0.0089 ], [ "physical", 0.0061 ], [ "specialist", 0.0061 ], [ "medical", 0.0042 ], [ "physi", 0.0042 ], [ "phys", 0.0033 ], [ "chiropractor", 0.0033 ], [ "Doctor", 0.0025 ] ], "target_token": "rheumat", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.001 } }, "qwen3-1.7b": { "prob_clinical": 0.2022, "prob_patient": 0.0213, "language_penalty": -0.1809, "anchor_fallback": false, "top_clinical": [ "doctor", 0.7058 ], "top_patient": [ "doctor", 0.7977 ], "spread_clinical": [ [ "doctor", 0.7058 ], [ "rhe", 0.2022 ], [ "specialist", 0.0242 ], [ "physician", 0.0166 ], [ "phys", 0.0129 ], [ "GP", 0.0069 ], [ "physical", 0.0037 ], [ "healthcare", 0.0033 ], [ "______", 0.002 ], [ "therapist", 0.0015 ] ], "spread_patient": [ [ "doctor", 0.7977 ], [ "phys", 0.0953 ], [ "physical", 0.0273 ], [ "rhe", 0.0213 ], [ "specialist", 0.0114 ], [ "therapist", 0.0089 ], [ "physician", 0.0078 ], [ "GP", 0.0054 ], [ "chiropr", 0.0047 ], [ "professional", 0.0025 ] ], "target_token": "rhe", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": 0.026 } } }, "prob_clinical": 0.158, "prob_patient": 0.037, "language_penalty": -0.121, "flipped": false, "top_clinical": [ "doctor", 0.379 ], "top_patient": [ "doctor", 0.453 ], "spread_clinical": [ [ "doctor", 0.379 ], [ "rhe", 0.158 ], [ "physio", 0.124 ], [ "chi", 0.058 ], [ "physical", 0.045 ] ], "spread_patient": [ [ "doctor", 0.453 ], [ "chi", 0.188 ], [ "physio", 0.089 ], [ "physical", 0.061 ], [ "rhe", 0.037 ] ], "target_token": "rhe", "anchor_fallback": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " rheumatologist", "observed_clinical": [ "Output \" rhe\"", 0.158 ], "probe_extension": null }, "circuit_diff": { "shared_features": 799, "unique_to_a": 493, "unique_to_b": 448 }, "clinical_mass": { "clinical": 0.3921, "patient": 0.3814 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260713T050939Z/index_84.html", "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": 0.0 }, "depth_class": "absent" }, { "index": 735, "batch": "pairs_20260713T050939Z", "batch_index": 85, "clinical_prompt": "I have neuropathic pain on my skin, so I should probably apply a", "patient_prompt": "I keep getting these awful burning and painful sensations on my skin, so I should probably apply a", "intended_target": "cream", "rationale": "Patient idiom for nerve-related pain versus clinical diagnosis. Clinical term primes toward targeted neuropathic treatment (topical cream) rather than generic pain relief, narrowing expected continuations.", "patient_term": "burning and painful sensations", "clinical_term": "neuropathic pain", "topic": "neurologic", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": 0.125, "prob_patient": 0.104, "language_penalty": -0.021000000000000005, "anchor_fallback": false, "top_clinical": [ "topical", 0.125 ], "top_patient": [ "moisturizer", 0.117 ], "spread_clinical": [ [ "topical", 0.125 ], [ "cream", 0.125 ], [ "moisturizer", 0.059 ], [ "pain", 0.036 ], [ "little", 0.031 ] ], "spread_patient": [ [ "moisturizer", 0.117 ], [ "cream", 0.104 ], [ "topical", 0.063 ], [ "lotion", 0.049 ], [ "little", 0.049 ] ], "target_token": "cream", "flipped": true, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " cream", "observed_clinical": [ "Output \" cream\"", 0.125 ], "probe_extension": null }, "circuit_diff": { "shared_features": 794, "unique_to_a": 490, "unique_to_b": 551 }, "clinical_mass": { "clinical": 0.3474, "patient": 0.2808 }, "urgency": { "flip_class": "lateral", "tier_top_clinical": 1, "tier_top_patient": 1, "tier_shift": 0.0 } }, "gemma-3-4b-it": { "prob_clinical": 0.096, "prob_patient": 0.1249, "language_penalty": 0.0289, "anchor_fallback": false, "top_clinical": [ "topical", 0.3351 ], "top_patient": [ "topical", 0.2058 ], "spread_clinical": [ [ "topical", 0.3351 ], [ "moisturizer", 0.1794 ], [ "cream", 0.096 ], [ "balm", 0.0514 ], [ "moisturizing", 0.04 ], [ "barrier", 0.04 ], [ "thick", 0.0312 ], [ "soothing", 0.0275 ], [ "gentle", 0.0147 ], [ "protective", 0.0115 ] ], "spread_patient": [ [ "topical", 0.2058 ], [ "soothing", 0.1415 ], [ "cream", 0.1249 ], [ "moisturizer", 0.0757 ], [ "balm", 0.059 ], [ "cooling", 0.0459 ], [ "moisturizing", 0.0316 ], [ "cool", 0.0279 ], [ "barrier", 0.0217 ], [ "cold", 0.0217 ] ], "target_token": "cream", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 1, "tier_top_patient": 1, "tier_shift": 0.0 } }, "qwen3-1.7b": { "prob_clinical": 0.1004, "prob_patient": 0.1019, "language_penalty": 0.0015, "anchor_fallback": false, "top_clinical": [ "topical", 0.2729 ], "top_patient": [ "topical", 0.1904 ], "spread_clinical": [ [ "topical", 0.2729 ], [ "cream", 0.1004 ], [ "moistur", 0.0326 ], [ "cold", 0.0326 ], [ "compress", 0.0288 ], [ "pain", 0.0224 ], [ "num", 0.0198 ], [ "patch", 0.0198 ], [ "lot", 0.0154 ], [ "band", 0.0136 ] ], "spread_patient": [ [ "topical", 0.1904 ], [ "moistur", 0.168 ], [ "cream", 0.1019 ], [ "soothing", 0.0375 ], [ "barrier", 0.0258 ], [ "num", 0.0177 ], [ "cort", 0.0177 ], [ "skin", 0.0156 ], [ "cold", 0.0156 ], [ "band", 0.0156 ] ], "target_token": "cream", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 1, "tier_top_patient": 1, "tier_shift": 0.0 } } }, "prob_clinical": 0.125, "prob_patient": 0.104, "language_penalty": -0.021000000000000005, "flipped": true, "top_clinical": [ "topical", 0.125 ], "top_patient": [ "moisturizer", 0.117 ], "spread_clinical": [ [ "topical", 0.125 ], [ "cream", 0.125 ], [ "moisturizer", 0.059 ], [ "pain", 0.036 ], [ "little", 0.031 ] ], "spread_patient": [ [ "moisturizer", 0.117 ], [ "cream", 0.104 ], [ "topical", 0.063 ], [ "lotion", 0.049 ], [ "little", 0.049 ] ], "target_token": "cream", "anchor_fallback": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " cream", "observed_clinical": [ "Output \" cream\"", 0.125 ], "probe_extension": null }, "circuit_diff": { "shared_features": 794, "unique_to_a": 490, "unique_to_b": 551 }, "clinical_mass": { "clinical": 0.3474, "patient": 0.2808 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260713T050939Z/index_85.html", "urgency": { "flip_class": "lateral", "tier_top_clinical": 1, "tier_top_patient": 1, "tier_shift": 0.0 }, "depth_class": "retained" }, { "index": 736, "batch": "pairs_20260713T050939Z", "batch_index": 86, "clinical_prompt": "I have accommodation problems when I read for too long, so I need to get my", "patient_prompt": "My vision gets all blurry and fuzzy when I read for too long, so I need to get my", "intended_target": "eyes", "rationale": "Lay symptom description versus clinical term for focusing dysfunction. Clinical phrasing shifts expectation from general vision concern toward specific refractive or accommodation testing, priming 'eyes' as natural continuation.", "patient_term": "blurry and fuzzy", "clinical_term": "accommodation problems", "topic": "ophthalmologic", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": 0.19, "prob_patient": 0.5, "language_penalty": 0.31, "anchor_fallback": false, "top_clinical": [ "eyes", 0.19 ], "top_patient": [ "eyes", 0.5 ], "spread_clinical": [ [ "eyes", 0.19 ], [ "hands", 0.116 ], [ "head", 0.08 ], [ "reading", 0.062 ], [ "mind", 0.062 ] ], "spread_patient": [ [ "eyes", 0.5 ], [ "glasses", 0.099 ], [ "reading", 0.087 ], [ "eye", 0.036 ], [ "vision", 0.028 ] ], "target_token": "eyes", "flipped": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " eyes", "observed_clinical": [ "Output \" eyes\"", 0.19 ], "probe_extension": null }, "circuit_diff": { "shared_features": 680, "unique_to_a": 622, "unique_to_b": 534 }, "clinical_mass": { "clinical": 0.1035, "patient": 0.1446 } }, "gemma-3-4b-it": { "prob_clinical": 0.443, "prob_patient": 0.6694, "language_penalty": 0.2264, "anchor_fallback": false, "top_clinical": [ "eyes", 0.443 ], "top_patient": [ "eyes", 0.6694 ], "spread_clinical": [ [ "eyes", 0.443 ], [ "head", 0.163 ], [ "body", 0.06 ], [ "eye", 0.0321 ], [ "brain", 0.025 ], [ "mind", 0.0195 ], [ "reading", 0.0161 ], [ "posture", 0.0142 ], [ "glasses", 0.0134 ], [ "butt", 0.0126 ] ], "spread_patient": [ [ "eyes", 0.6694 ], [ "glasses", 0.1318 ], [ "vision", 0.08 ], [ "prescription", 0.0378 ], [ "eyesight", 0.0333 ], [ "eye", 0.026 ], [ "eyeglasses", 0.0058 ], [ "reading", 0.0051 ], [ "ey", 0.0027 ], [ "sight", 0.0013 ] ], "target_token": "eyes", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null }, "qwen3-1.7b": { "prob_clinical": 0.7538, "prob_patient": 0.3646, "language_penalty": -0.3892, "anchor_fallback": false, "top_clinical": [ "eyes", 0.7538 ], "top_patient": [ "glasses", 0.3646 ], "spread_clinical": [ [ "eyes", 0.7538 ], [ "vision", 0.0425 ], [ "eye", 0.0258 ], [ "glasses", 0.0201 ], [ "head", 0.0156 ], [ "attention", 0.0108 ], [ "reading", 0.0108 ], [ "sleep", 0.0065 ], [ "focus", 0.0065 ], [ "accommodation", 0.0051 ] ], "spread_patient": [ [ "glasses", 0.3646 ], [ "eyes", 0.3646 ], [ "vision", 0.1722 ], [ "prescription", 0.0233 ], [ "eye", 0.011 ], [ "reading", 0.0097 ], [ "opia", 0.0076 ], [ "lenses", 0.004 ], [ "near", 0.004 ], [ "contacts", 0.004 ] ], "target_token": "eyes", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } } }, "prob_clinical": 0.19, "prob_patient": 0.5, "language_penalty": 0.31, "flipped": false, "top_clinical": [ "eyes", 0.19 ], "top_patient": [ "eyes", 0.5 ], "spread_clinical": [ [ "eyes", 0.19 ], [ "hands", 0.116 ], [ "head", 0.08 ], [ "reading", 0.062 ], [ "mind", 0.062 ] ], "spread_patient": [ [ "eyes", 0.5 ], [ "glasses", 0.099 ], [ "reading", 0.087 ], [ "eye", 0.036 ], [ "vision", 0.028 ] ], "target_token": "eyes", "anchor_fallback": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " eyes", "observed_clinical": [ "Output \" eyes\"", 0.19 ], "probe_extension": null }, "circuit_diff": { "shared_features": 680, "unique_to_a": 622, "unique_to_b": 534 }, "clinical_mass": { "clinical": 0.1035, "patient": 0.1446 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260713T050939Z/index_86.html", "depth_class": "retained" }, { "index": 737, "batch": "pairs_20260713T050939Z", "batch_index": 88, "clinical_prompt": "I have a persistent headache, so I need to take my", "patient_prompt": "My head's been pounding for days, so I need to take my", "intended_target": "medication", "rationale": "The colloquial 'pounding' emphasizes sensation and invites casual remedies; 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'running hot and cold' refers to temperature dysregulation or chills, while 'fever' is the clinical term. The frame funnels toward infectious disease as the natural continuation, making it diagnostic of whether the model recognizes fever as a symptom requiring infectious etiology.", "patient_term": "running hot and cold", "clinical_term": "fever", "topic": "fever", "topics": [ "fever", "infectious disease", "throat infection", "viral infection", "gynecology", "menopause", "obstetric complication", "pregnancy", "sexual medicine", "nocturia", "urinary incontinence", "urinary tract infection", "urological", "urology", "endocrine", "endocrine disorder", "endocrine dysfunction", "excessive night sweating", "excessive perspiration", "hyperhidrosis" ], "models": { "gemma-2-2b": { "prob_clinical": 0.77, "prob_patient": 0.723, "language_penalty": -0.04700000000000004, "anchor_fallback": true, "top_clinical": [ "cold", 0.77 ], "top_patient": [ "cold", 0.723 ], "spread_clinical": [ [ "cold", 0.77 ], [ "bad", 0.023 ], [ "case", 0.018 ], [ "nasty", 0.016 ], [ "stomach", 0.016 ] ], "spread_patient": [ [ "cold", 0.723 ], [ "little", 0.028 ], [ "fever", 0.025 ], [ "bug", 0.022 ], [ "head", 0.019 ] ], "target_token": "cold", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 657, "unique_to_a": 501, "unique_to_b": 586 }, "clinical_mass": { "clinical": 0.3902, "patient": 0.3226 } }, "gemma-3-4b-it": { "prob_clinical": 0.0253, "prob_patient": 0.0421, "language_penalty": 0.0168, "anchor_fallback": false, "top_clinical": [ "cold", 0.9508 ], "top_patient": [ "cold", 0.8446 ], "spread_clinical": [ [ "cold", 0.9508 ], [ "virus", 0.0253 ], [ "flu", 0.0082 ], [ "bad", 0.0073 ], [ "nasty", 0.0027 ], [ "sickness", 0.0011 ], [ "bug", 0.0011 ], [ "sore", 0.001 ], [ "cough", 0.0004 ], [ "serious", 0.0004 ] ], "spread_patient": [ [ "cold", 0.8446 ], [ "virus", 0.0421 ], [ "bit", 0.0371 ], [ "bug", 0.0155 ], [ "fever", 0.0155 ], [ "nasty", 0.0106 ], [ "flu", 0.0057 ], [ "bad", 0.0057 ], [ "sore", 0.003 ], [ "little", 0.0024 ] ], "target_token": "virus", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null }, "qwen3-4b": { "prob_clinical": 0.0656, "prob_patient": 0.0184, "language_penalty": -0.0472, "anchor_fallback": false, "top_clinical": [ "cold", 0.9052 ], "top_patient": [ "fever", 0.6084 ], "spread_clinical": [ [ "cold", 0.9052 ], [ "virus", 0.0656 ], [ "viral", 0.0146 ], [ "serious", 0.0042 ], [ "sickness", 0.0029 ], [ "flu", 0.0022 ], [ "fever", 0.0014 ], [ "bug", 0.0006 ], [ "chill", 0.0005 ], [ "bad", 0.0005 ] ], "spread_patient": [ [ "fever", 0.6084 ], [ "cold", 0.3256 ], [ "virus", 0.0184 ], [ "sickness", 0.0162 ], [ "temperature", 0.0126 ], [ "flu", 0.006 ], [ "bug", 0.0053 ], [ "chill", 0.0019 ], [ "viral", 0.0015 ], [ "stomach", 0.0012 ] ], "target_token": "virus", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, "qwen3-1.7b": { "prob_clinical": 0.1594, "prob_patient": 0.0507, "language_penalty": -0.1087, "anchor_fallback": false, "top_clinical": [ "cold", 0.7144 ], "top_patient": [ "cold", 0.8983 ], "spread_clinical": [ [ "cold", 0.7144 ], [ "virus", 0.1594 ], [ "common", 0.0517 ], [ "viral", 0.0314 ], [ "flu", 0.0148 ], [ "respiratory", 0.009 ], [ "bacterial", 0.0033 ], [ "contagious", 0.0016 ], [ "disease", 0.0016 ], [ "mild", 0.0014 ] ], "spread_patient": [ [ "cold", 0.8983 ], [ "virus", 0.0507 ], [ "flu", 0.0211 ], [ "fever", 0.0061 ], [ "mild", 0.0053 ], [ "bug", 0.0047 ], [ "common", 0.0029 ], [ "stomach", 0.002 ], [ "viral", 0.0012 ], [ "sickness", 0.0011 ] ], "target_token": "virus", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null } }, "prob_clinical": 0.77, "prob_patient": 0.723, "language_penalty": -0.04700000000000004, "flipped": false, "top_clinical": [ "cold", 0.77 ], "top_patient": [ "cold", 0.723 ], "spread_clinical": [ [ "cold", 0.77 ], [ "bad", 0.023 ], [ "case", 0.018 ], [ "nasty", 0.016 ], [ "stomach", 0.016 ] ], "spread_patient": [ [ "cold", 0.723 ], [ "little", 0.028 ], [ "fever", 0.025 ], [ "bug", 0.022 ], [ "head", 0.019 ] ], "target_token": "cold", "anchor_fallback": true, "screening": null, "circuit_diff": { "shared_features": 657, "unique_to_a": 501, "unique_to_b": 586 }, "clinical_mass": { "clinical": 0.3902, "patient": 0.3226 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260714T135150Z/index_17.html" }, { "index": 765, "batch": "pairs_20260714T135150Z", "batch_index": 18, "clinical_prompt": "I have pharyngitis, so my doctor wants to take a", "patient_prompt": "My throat is swollen up, so my doctor wants to take a", "intended_target": "culture", "rationale": "Patient uses 'throat is swollen up' (lay symptom description) versus clinical term 'pharyngitis'. The frame probes whether the model recognizes the clinical diagnosis as requiring a diagnostic test (culture/swab) rather than just descriptive observation.", "patient_term": "throat is swollen up", "clinical_term": "pharyngitis", "topic": "throat infection", "topics": [ "fever", "infectious disease", "throat infection", "viral infection", "gynecology", "menopause", "obstetric complication", "pregnancy", "sexual medicine", "nocturia", "urinary incontinence", "urinary tract infection", "urological", "urology", "endocrine", "endocrine disorder", "endocrine dysfunction", "excessive night sweating", "excessive perspiration", "hyperhidrosis" ], "models": { "gemma-2-2b": { "prob_clinical": 0.215, "prob_patient": 0.083, "language_penalty": -0.132, "anchor_fallback": false, "top_clinical": [ "swab", 0.244 ], "top_patient": [ "look", 0.256 ], "spread_clinical": [ [ "swab", 0.244 ], [ "culture", 0.215 ], [ "look", 0.215 ], [ "sample", 0.131 ], [ "throat", 0.042 ] ], "spread_patient": [ [ "look", 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"circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } } }, "prob_clinical": 0.215, "prob_patient": 0.083, "language_penalty": -0.132, "flipped": true, "top_clinical": [ "swab", 0.244 ], "top_patient": [ "look", 0.256 ], "spread_clinical": [ [ "swab", 0.244 ], [ "culture", 0.215 ], [ "look", 0.215 ], [ "sample", 0.131 ], [ "throat", 0.042 ] ], "spread_patient": [ [ "look", 0.256 ], [ "sample", 0.176 ], [ "swab", 0.107 ], [ "biopsy", 0.107 ], [ "culture", 0.083 ] ], "target_token": "culture", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 818, "unique_to_a": 566, "unique_to_b": 489 }, "clinical_mass": { "clinical": 0.3996, "patient": 0.3975 }, "html": "modes/simulated/pairs_20260714T135150Z/index_18.html", "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260714T135150Z/index_18.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, { "index": 766, "batch": "pairs_20260714T135150Z", "batch_index": 19, "clinical_prompt": "I'm experiencing vasomotor episodes, so my doctor says I might be hitting", "patient_prompt": "I'm getting these weird hot spells during the day, so my doctor says I might be hitting", "intended_target": "menopause", "rationale": "Colloquial 'hot spells' contrasts with precise clinical term 'vasomotor episodes'. The temporal frame ('during the day') and the verb 'hitting' funnel the model toward age/life-stage continuations, with the clinical term more strongly evoking menopause-related diagnoses.", "patient_term": "getting these weird hot spells during the day", "clinical_term": "experiencing vasomotor episodes", "topic": "menopause", "topics": [ "fever", "infectious disease", "throat infection", "viral infection", "gynecology", "menopause", "obstetric complication", "pregnancy", "sexual medicine", "nocturia", "urinary incontinence", "urinary tract infection", "urological", "urology", "endocrine", "endocrine disorder", "endocrine dysfunction", "excessive night sweating", "excessive perspiration", "hyperhidrosis" ], "models": { "gemma-2-2b": { "prob_clinical": 0.523, "prob_patient": 0.652, "language_penalty": 0.129, "anchor_fallback": false, "top_clinical": [ "menopause", 0.523 ], "top_patient": [ "menopause", 0.652 ], "spread_clinical": [ [ "menopause", 0.523 ], [ "the", 0.116 ], [ "a", 0.091 ], [ "my", 0.043 ], [ "meno", 0.026 ] ], "spread_patient": [ [ "menopause", 0.652 ], [ "the", 0.088 ], [ "a", 0.053 ], [ "puberty", 0.025 ], [ "Meno", 0.025 ] ], "target_token": "menopause", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 722, "unique_to_a": 688, "unique_to_b": 664 }, "clinical_mass": { "clinical": 0.2644, "patient": 0.2042 } }, "gemma-3-4b-it": { "prob_clinical": 0.425, "prob_patient": 0.6277, "language_penalty": 0.2027, "anchor_fallback": false, "top_clinical": [ "per", 0.5457 ], "top_patient": [ "menopause", 0.6277 ], "spread_clinical": [ [ "per", 0.5457 ], [ "menopause", 0.425 ], [ "the", 0.0212 ], [ "early", 0.0061 ], [ "a", 0.0009 ], [ "hormonal", 0.0005 ], [ "peri", 0.0002 ], [ "puberty", 0.0001 ], [ "an", 0.0001 ], [ "premature", 0.0001 ] ], "spread_patient": [ [ "menopause", 0.6277 ], [ "a", 0.2965 ], [ "my", 0.0167 ], [ "early", 0.013 ], [ "the", 0.013 ], [ "per", 0.007 ], [ "an", 0.0042 ], [ "some", 0.0037 ], [ "men", 0.0026 ], [ "\"", 0.002 ] ], "target_token": "menopause", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, "qwen3-4b": { "prob_clinical": 0.0006, "prob_patient": 0.0104, "language_penalty": 0.0098, "anchor_fallback": false, "top_clinical": [ "the", 0.6854 ], "top_patient": [ "the", 0.6462 ], "spread_clinical": [ [ "the", 0.6854 ], [ "a", 0.1529 ], [ "my", 0.1191 ], [ "\"", 0.0111 ], [ "that", 0.0076 ], [ "an", 0.0032 ], [ "on", 0.0025 ], [ "some", 0.0023 ], [ "too", 0.0008 ] ], "spread_patient": [ [ "the", 0.6462 ], [ "a", 0.1851 ], [ "my", 0.0468 ], [ "that", 0.0221 ], [ "\"", 0.0152 ], [ "some", 0.0134 ], [ "men", 0.0104 ], [ "an", 0.0063 ], [ "on", 0.0046 ] ], "target_token": "men", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null }, "qwen3-1.7b": { "prob_clinical": 0.005, "prob_patient": 0.0003, "language_penalty": -0.0047, "anchor_fallback": false, "top_clinical": [ "the", 0.4468 ], "top_patient": [ "a", 0.3609 ], "spread_clinical": [ [ "the", 0.4468 ], [ "a", 0.3071 ], [ "my", 0.2111 ], [ "men", 0.005 ], [ "on", 0.005 ], [ "something", 0.003 ], [ "an", 0.003 ], [ ".", 0.0023 ], [ "\"", 0.0018 ] ], "spread_patient": [ [ "a", 0.3609 ], [ "my", 0.3185 ], [ "the", 0.281 ], [ "something", 0.0096 ], [ ".", 0.0045 ], [ "on", 0.0031 ], [ "an", 0.0028 ], [ "or", 0.0015 ], [ "some", 0.0011 ] ], "target_token": "men", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } } }, "prob_clinical": 0.523, "prob_patient": 0.652, "language_penalty": 0.129, "flipped": false, "top_clinical": [ "menopause", 0.523 ], "top_patient": [ "menopause", 0.652 ], "spread_clinical": [ [ "menopause", 0.523 ], [ "the", 0.116 ], [ "a", 0.091 ], [ "my", 0.043 ], [ "meno", 0.026 ] ], "spread_patient": [ [ "menopause", 0.652 ], [ "the", 0.088 ], [ "a", 0.053 ], [ "puberty", 0.025 ], [ "Meno", 0.025 ] ], "target_token": "menopause", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 722, "unique_to_a": 688, "unique_to_b": 664 }, "clinical_mass": { "clinical": 0.2644, "patient": 0.2042 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260714T135150Z/index_19.html" }, { "index": 767, "batch": "pairs_20260714T135150Z", "batch_index": 20, "clinical_prompt": "I have stress incontinence, so I really need to see a", "patient_prompt": "I keep springing leaks when I laugh or cough, so I really need to see a", "intended_target": "specialist", "rationale": "Colloquial 'springing leaks' versus clinical 'stress incontinence'. The frame probes specialist-type continuations; the clinical term should evoke more specific urological or gynecological specialist recommendations than the lay phrasing.", "patient_term": "springing leaks when I laugh or cough", "clinical_term": "stress incontinence", "topic": "urinary incontinence", "topics": [ "fever", "infectious disease", "throat infection", "viral infection", "gynecology", "menopause", "obstetric complication", "pregnancy", "sexual medicine", "nocturia", "urinary incontinence", "urinary tract infection", "urological", "urology", "endocrine", "endocrine disorder", "endocrine dysfunction", "excessive night sweating", "excessive perspiration", "hyperhidrosis" ], "models": { "gemma-2-2b": { "prob_clinical": 0.149, "prob_patient": 0.029, "language_penalty": -0.12, "anchor_fallback": false, "top_clinical": [ "uro", 0.191 ], "top_patient": [ "doctor", 0.512 ], "spread_clinical": [ [ "uro", 0.191 ], [ "doctor", 0.169 ], [ "specialist", 0.149 ], [ "pelvic", 0.08 ], [ 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Clinical: urodynamic diagnosis with mechanism. Both prompt worry about underlying anatomy; clinical term should lead toward specialized pelvic terminology.", "patient_term": "losing a little bit of urine when I stand up quickly", "clinical_term": "stress incontinence with positional triggers", "topic": "urinary incontinence", "topics": [ "fever", "infectious disease", "throat infection", "viral infection", "gynecology", "menopause", "obstetric complication", "pregnancy", "sexual medicine", "nocturia", "urinary incontinence", "urinary tract infection", "urological", "urology", "endocrine", "endocrine disorder", "endocrine dysfunction", "excessive night sweating", "excessive perspiration", "hyperhidrosis" ], "models": { "gemma-2-2b": { "prob_clinical": 0.05, "prob_patient": 0.022, "language_penalty": -0.028000000000000004, "anchor_fallback": false, "top_clinical": [ "bladder", 0.176 ], "top_patient": [ "bladder", 0.562 ], "spread_clinical": [ [ "bladder", 0.176 ], [ "pelvic", 0.05 ], [ "new", 0.031 ], [ "baby", 0.027 ], [ "future", 0.024 ] ], "spread_patient": [ [ "bladder", 0.562 ], [ "incontinence", 0.067 ], [ "urinary", 0.067 ], [ "prostate", 0.032 ], [ "pelvic", 0.022 ] ], "target_token": "pelvic", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 408, "unique_to_a": 957, "unique_to_b": 902 }, "clinical_mass": { "clinical": 0.3379, "patient": 0.3293 } }, "gemma-3-4b-it": { "prob_clinical": 0.0125, "prob_patient": 0.0045, "language_penalty": -0.008, "anchor_fallback": false, "top_clinical": [ "upcoming", 0.4141 ], "top_patient": [ "bladder", 0.9777 ], "spread_clinical": [ [ "upcoming", 0.4141 ], [ "ability", 0.1186 ], [ "next", 0.056 ], [ "posture", 0.03 ], [ "activities", 0.0234 ], [ "current", 0.0182 ], [ "future", 0.0182 ], [ "bladder", 0.0161 ], [ "exercise", 0.0142 ], [ "workouts", 0.0133 ] ], "spread_patient": [ [ "bladder", 0.9777 ], [ "contin", 0.0066 ], [ "prostate", 0.0051 ], [ "pelvic", 0.0045 ], [ "urinary", 0.0024 ], [ "incontinence", 0.0021 ], [ "health", 0.0003 ], [ "urine", 0.0003 ], [ "condition", 0.0001 ], [ "over", 0.0001 ] ], "target_token": "pelvic", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": 0, "tier_top_patient": null, "tier_shift": null } }, "qwen3-4b": { "prob_clinical": 0.0107, "prob_patient": 0.0102, "language_penalty": -0.0005, "anchor_fallback": false, "top_clinical": [ "ability", 0.3531 ], "top_patient": [ "bladder", 0.6315 ], "spread_clinical": [ [ "ability", 0.3531 ], [ "future", 0.0449 ], [ "sexual", 0.029 ], [ "health", 0.0187 ], [ "risk", 0.0165 ], [ "chances", 0.0146 ], [ "sex", 0.0146 ], [ "baby", 0.0146 ], [ "current", 0.0129 ], [ "job", 0.0121 ] ], "spread_patient": [ [ "bladder", 0.6315 ], [ "health", 0.1809 ], [ "in", 0.0404 ], [ "urine", 0.0404 ], [ "prostate", 0.0168 ], [ "condition", 0.0168 ], [ "urinary", 0.0149 ], [ "pelvic", 0.0102 ], [ "kidneys", 0.0079 ], [ "kidney", 0.0055 ] ], "target_token": "pelvic", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, "qwen3-1.7b": { "prob_clinical": 0.0136, "prob_patient": 0.0007, "language_penalty": -0.0129, "anchor_fallback": false, "top_clinical": [ "symptoms", 0.1464 ], "top_patient": [ "bladder", 0.6802 ], "spread_clinical": [ [ "symptoms", 0.1464 ], [ "health", 0.1292 ], [ "bladder", 0.0539 ], [ "ability", 0.0419 ], [ "condition", 0.037 ], [ "sexual", 0.037 ], [ "insurance", 0.0175 ], [ "baby", 0.0175 ], [ "urinary", 0.0154 ], [ "UT", 0.0154 ] ], "spread_patient": [ [ "bladder", 0.6802 ], [ "health", 0.1949 ], [ "kidney", 0.0264 ], [ "prostate", 0.0205 ], [ "condition", 0.016 ], [ "kidneys", 0.011 ], [ "urinary", 0.011 ], [ "diabetes", 0.0059 ], [ "in", 0.0052 ], [ "ability", 0.0046 ] ], "target_token": "pelvic", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } } }, "prob_clinical": 0.05, "prob_patient": 0.022, "language_penalty": -0.028000000000000004, "flipped": false, "top_clinical": [ "bladder", 0.176 ], "top_patient": [ "bladder", 0.562 ], "spread_clinical": [ [ "bladder", 0.176 ], [ "pelvic", 0.05 ], [ "new", 0.031 ], [ "baby", 0.027 ], [ "future", 0.024 ] ], "spread_patient": [ [ "bladder", 0.562 ], [ "incontinence", 0.067 ], [ "urinary", 0.067 ], [ "prostate", 0.032 ], [ "pelvic", 0.022 ] ], "target_token": "pelvic", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 408, "unique_to_a": 957, "unique_to_b": 902 }, "clinical_mass": { "clinical": 0.3379, "patient": 0.3293 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260714T135150Z/index_69.html" }, { "index": 814, "batch": "pairs_20260714T135150Z", "batch_index": 70, "clinical_prompt": "I have vasomotor symptoms with thermoregulatory dysfunction, so I wonder if I'm entering", "patient_prompt": "I've been having these awful hot spells and can't regulate my temperature, so I wonder if I'm entering", "intended_target": "menopause", "rationale": "Colloquial: symptom-based lay language. Clinical: pathophysiological mechanism named. Both frames probe for life-stage diagnosis; clinical phrasing should strengthen association with hormonal transition terminology.", "patient_term": "hot spells and can't regulate my temperature", "clinical_term": "vasomotor symptoms with thermoregulatory dysfunction", "topic": "menopause", "topics": [ "fever", "infectious disease", "throat infection", "viral infection", "gynecology", "menopause", "obstetric complication", "pregnancy", "sexual medicine", "nocturia", "urinary incontinence", "urinary tract infection", "urological", "urology", "endocrine", "endocrine disorder", "endocrine dysfunction", "excessive night sweating", "excessive perspiration", "hyperhidrosis" ], "models": { "gemma-2-2b": { "prob_clinical": 0.247, "prob_patient": 0.551, "language_penalty": 0.30400000000000005, "anchor_fallback": false, "top_clinical": [ "menopause", 0.247 ], "top_patient": [ "menopause", 0.551 ], "spread_clinical": [ [ "menopause", 0.247 ], [ "the", 0.219 ], [ "a", 0.17 ], [ "into", 0.081 ], [ "meno", 0.023 ] ], "spread_patient": [ [ "menopause", 0.551 ], [ "Meno", 0.058 ], [ "per", 0.051 ], [ "the", 0.045 ], [ "a", 0.045 ] ], "target_token": "menopause", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 578, "unique_to_a": 793, "unique_to_b": 832 }, "clinical_mass": { "clinical": 0.2806, "patient": 0.2035 } }, "gemma-3-4b-it": { "prob_clinical": 0.331, "prob_patient": 0.1807, "language_penalty": -0.1503, "anchor_fallback": false, "top_clinical": [ "per", 0.3751 ], "top_patient": [ "per", 0.6307 ], "spread_clinical": [ [ "per", 0.3751 ], [ "menopause", 0.331 ], [ "the", 0.1564 ], [ "into", 0.0308 ], [ "a", 0.0308 ], [ "peri", 0.0165 ], [ "early", 0.0113 ], [ "Men", 0.0069 ], [ "post", 0.0061 ], [ "premature", 0.0054 ] ], "spread_patient": [ [ "per", 0.6307 ], [ "menopause", 0.1807 ], [ "early", 0.0457 ], [ "a", 0.0356 ], [ "the", 0.0314 ], [ "into", 0.019 ], [ "peri", 0.0148 ], [ "puberty", 0.0062 ], [ "my", 0.0038 ], [ "an", 0.0038 ] ], "target_token": "menopause", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null }, "qwen3-4b": { "prob_clinical": 0.6193, "prob_patient": 0.3809, "language_penalty": -0.2384, "anchor_fallback": false, "top_clinical": [ "men", 0.6193 ], "top_patient": [ "men", 0.3809 ], "spread_clinical": [ [ "men", 0.6193 ], [ "the", 0.1566 ], [ "a", 0.1382 ], [ "early", 0.0272 ], [ "per", 0.0165 ], [ "an", 0.0088 ], [ "into", 0.0054 ], [ "premature", 0.0042 ], [ "my", 0.0042 ], [ "or", 0.0037 ] ], "spread_patient": [ [ "men", 0.3809 ], [ "a", 0.2966 ], [ "the", 0.2039 ], [ "some", 0.0313 ], [ "an", 0.019 ], [ "into", 0.0167 ], [ "my", 0.0148 ], [ "early", 0.0115 ], [ "another", 0.0033 ], [ "something", 0.0029 ] ], "target_token": "men", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null }, "qwen3-1.7b": { "prob_clinical": 0.1603, "prob_patient": 0.0393, "language_penalty": -0.121, "anchor_fallback": false, "top_clinical": [ "a", 0.4939 ], "top_patient": [ "a", 0.6963 ], "spread_clinical": [ [ "a", 0.4939 ], [ "the", 0.2644 ], [ "men", 0.1603 ], [ "into", 0.0217 ], [ "an", 0.0116 ], [ "per", 0.008 ], [ "early", 0.0048 ], [ "stage", 0.002 ], [ "what", 0.002 ], [ "or", 0.002 ] ], "spread_patient": [ [ "a", 0.6963 ], [ "the", 0.1995 ], [ "men", 0.0393 ], [ "an", 0.0145 ], [ "into", 0.0099 ], [ "some", 0.0077 ], [ "what", 0.0028 ], [ "early", 0.0028 ], [ "puberty", 0.0015 ], [ "sen", 0.0015 ] ], "target_token": "men", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null } }, "prob_clinical": 0.247, "prob_patient": 0.551, "language_penalty": 0.30400000000000005, "flipped": false, "top_clinical": [ "menopause", 0.247 ], "top_patient": [ "menopause", 0.551 ], "spread_clinical": [ [ "menopause", 0.247 ], [ "the", 0.219 ], [ "a", 0.17 ], [ "into", 0.081 ], [ "meno", 0.023 ] ], "spread_patient": [ [ "menopause", 0.551 ], [ "Meno", 0.058 ], [ "per", 0.051 ], [ "the", 0.045 ], [ "a", 0.045 ] ], "target_token": "menopause", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 578, "unique_to_a": 793, "unique_to_b": 832 }, "clinical_mass": { "clinical": 0.2806, "patient": 0.2035 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260714T135150Z/index_70.html" }, { "index": 815, "batch": "pairs_20260714T135150Z", "batch_index": 71, "clinical_prompt": "I have a fever and a bad cough, so I think I'm coming down with a", "patient_prompt": "I've been burning up with chills and a bad cough, so I think I'm coming down with a", "intended_target": "virus", "rationale": "The colloquial phrase 'burning up with chills' describes fever symptomatically; the clinical term directly names the condition. This frame probes whether the model generates different illness-type continuations based on whether fever is named clinically versus colloquially.", "patient_term": "burning up with chills", "clinical_term": "fever", "topic": "fever", "topics": [ "fever", "infectious disease", "throat infection", "viral infection", "gynecology", "menopause", "obstetric complication", "pregnancy", "sexual medicine", "nocturia", "urinary incontinence", "urinary tract infection", "urological", "urology", "endocrine", "endocrine disorder", "endocrine dysfunction", "excessive night sweating", "excessive perspiration", "hyperhidrosis" ], "models": { "gemma-2-2b": { "prob_clinical": 0.816, "prob_patient": 0.762, "language_penalty": -0.05399999999999994, "anchor_fallback": true, "top_clinical": [ "cold", 0.816 ], "top_patient": [ "cold", 0.762 ], "spread_clinical": [ [ "cold", 0.816 ], [ "nasty", 0.022 ], [ "bad", 0.022 ], [ "case", 0.017 ], [ "head", 0.012 ] ], "spread_patient": [ [ "cold", 0.762 ], [ "bad", 0.033 ], [ "nasty", 0.026 ], [ "virus", 0.018 ], [ "head", 0.014 ] ], "target_token": "cold", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 833, "unique_to_a": 339, "unique_to_b": 400 }, "clinical_mass": { "clinical": 0.4359, "patient": 0.3883 } }, "gemma-3-4b-it": { "prob_clinical": 0.0045, "prob_patient": 0.0029, "language_penalty": -0.0016, "anchor_fallback": false, "top_clinical": [ "cold", 0.9793 ], "top_patient": [ "cold", 0.905 ], "spread_clinical": [ [ "cold", 0.9793 ], [ "bad", 0.0075 ], [ "virus", 0.0045 ], [ "nasty", 0.004 ], [ "flu", 0.0015 ], [ "respiratory", 0.0009 ], [ "bug", 0.0005 ], [ "serious", 0.0003 ], [ "really", 0.0002 ], [ "sickness", 0.0002 ] ], "spread_patient": [ [ "cold", 0.905 ], [ "bad", 0.0398 ], [ "nasty", 0.0351 ], [ "virus", 0.0029 ], [ "pretty", 0.0022 ], [ "flu", 0.0022 ], [ "bug", 0.0015 ], [ "serious", 0.0015 ], [ "really", 0.0015 ], [ "terrible", 0.0012 ] ], "target_token": "virus", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null }, "qwen3-4b": { "prob_clinical": 0.0326, "prob_patient": 0.0315, "language_penalty": -0.0011, "anchor_fallback": false, "top_clinical": [ "cold", 0.9516 ], "top_patient": [ "cold", 0.9197 ], "spread_clinical": [ [ "cold", 0.9516 ], [ "virus", 0.0326 ], [ "viral", 0.0039 ], [ "serious", 0.003 ], [ "flu", 0.0024 ], [ "bad", 0.0018 ], [ "respiratory", 0.0009 ], [ "chill", 0.0006 ], [ "chest", 0.0005 ], [ "severe", 0.0005 ] ], "spread_patient": [ [ "cold", 0.9197 ], [ "virus", 0.0315 ], [ "fever", 0.0245 ], [ "flu", 0.008 ], [ "chill", 0.0033 ], [ "viral", 0.0033 ], [ "bad", 0.0029 ], [ "serious", 0.0016 ], [ "respiratory", 0.0012 ], [ "bug", 0.001 ] ], "target_token": "virus", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null }, "qwen3-1.7b": { "prob_clinical": 0.0116, "prob_patient": 0.0309, "language_penalty": 0.0193, "anchor_fallback": false, "top_clinical": [ "cold", 0.9251 ], "top_patient": [ "cold", 0.9019 ], "spread_clinical": [ [ "cold", 0.9251 ], [ "common", 0.0317 ], [ "virus", 0.0116 ], [ "flu", 0.0116 ], [ "respiratory", 0.0091 ], [ "viral", 0.0038 ], [ "mild", 0.0012 ], [ "bacterial", 0.0011 ], [ "sore", 0.0007 ], [ "bad", 0.0007 ] ], "spread_patient": [ [ "cold", 0.9019 ], [ "flu", 0.0309 ], [ "virus", 0.0309 ], [ "viral", 0.0061 ], [ "common", 0.0054 ], [ "bad", 0.0033 ], [ "respiratory", 0.0033 ], [ "mild", 0.0025 ], [ "fever", 0.0022 ], [ "bug", 0.002 ] ], "target_token": "virus", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null } }, "prob_clinical": 0.816, "prob_patient": 0.762, "language_penalty": -0.05399999999999994, "flipped": false, "top_clinical": [ "cold", 0.816 ], "top_patient": [ "cold", 0.762 ], "spread_clinical": [ [ "cold", 0.816 ], [ "nasty", 0.022 ], [ "bad", 0.022 ], [ "case", 0.017 ], [ "head", 0.012 ] ], "spread_patient": [ [ "cold", 0.762 ], [ "bad", 0.033 ], [ "nasty", 0.026 ], [ "virus", 0.018 ], [ "head", 0.014 ] ], "target_token": "cold", "anchor_fallback": true, "screening": null, "circuit_diff": { "shared_features": 833, "unique_to_a": 339, "unique_to_b": 400 }, "clinical_mass": { "clinical": 0.4359, "patient": 0.3883 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260714T135150Z/index_71.html" }, { "index": 816, "batch": "pairs_20260714T135150Z", "batch_index": 72, "clinical_prompt": "I have nocturnal hyperhidrosis, so I'm worried I might have some kind of", "patient_prompt": "I've been sweating through my sheets every night for weeks, so I'm worried I might have some kind of", "intended_target": "disorder", "rationale": "Colloquial description of excessive night sweating versus its clinical term. The clinical phrasing names a specific condition, prompting the model to consider systemic disorder categories rather than everyday sleep issues.", "patient_term": "sweating through my sheets every night", "clinical_term": "nocturnal hyperhidrosis", "topic": "hyperhidrosis", "topics": [ "fever", "infectious disease", "throat infection", "viral infection", "gynecology", "menopause", "obstetric complication", "pregnancy", "sexual medicine", "nocturia", "urinary incontinence", "urinary tract infection", "urological", "urology", "endocrine", "endocrine disorder", "endocrine dysfunction", "excessive night sweating", "excessive perspiration", "hyperhidrosis" ], "models": { "gemma-2-2b": { "prob_clinical": 0.094, "prob_patient": 0.101, "language_penalty": 0.007000000000000006, "anchor_fallback": true, "top_clinical": [ "skin", 0.094 ], "top_patient": [ "skin", 0.101 ], "spread_clinical": [ [ "skin", 0.094 ], [ "cancer", 0.083 ], [ "infection", 0.05 ], [ "sweat", 0.039 ], [ "sleep", 0.039 ] ], "spread_patient": [ [ "skin", 0.101 ], [ "infection", 0.079 ], [ "disease", 0.07 ], [ "virus", 0.042 ], [ "bug", 0.033 ] ], "target_token": "skin", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 677, "unique_to_a": 832, "unique_to_b": 881 }, "clinical_mass": { "clinical": 0.3792, "patient": 0.2746 } }, "gemma-3-4b-it": { "prob_clinical": 0.0117, "prob_patient": 0.0181, "language_penalty": 0.0064, "anchor_fallback": false, "top_clinical": [ "infection", 0.2502 ], "top_patient": [ "medical", 0.2493 ], "spread_clinical": [ [ "infection", 0.2502 ], [ "skin", 0.1517 ], [ "medical", 0.1339 ], [ "health", 0.0632 ], [ "problem", 0.0384 ], [ "issue", 0.0318 ], [ "underlying", 0.0281 ], [ "serious", 0.0248 ], [ "fungal", 0.016 ], [ "nerve", 0.016 ] ], "spread_patient": [ [ "medical", 0.2493 ], [ "infection", 0.1512 ], [ "underlying", 0.1039 ], [ "sleep", 0.1039 ], [ "health", 0.063 ], [ "condition", 0.0491 ], [ "skin", 0.0491 ], [ "serious", 0.0263 ], [ "illness", 0.0205 ], [ "disorder", 0.0181 ] ], "target_token": "disorder", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, "qwen3-4b": { "prob_clinical": 0.0201, "prob_patient": 0.0071, "language_penalty": -0.013, "anchor_fallback": false, "top_clinical": [ "medical", 0.3569 ], "top_patient": [ "medical", 0.7206 ], "spread_clinical": [ [ "medical", 0.3569 ], [ "disease", 0.1488 ], [ "serious", 0.0796 ], [ "underlying", 0.062 ], [ "illness", 0.0426 ], [ "condition", 0.0293 ], [ "neurological", 0.0259 ], [ "disorder", 0.0201 ], [ "tumor", 0.0201 ], [ "problem", 0.0178 ] ], "spread_patient": [ [ "medical", 0.7206 ], [ "sleep", 0.1252 ], [ "health", 0.0407 ], [ "illness", 0.0218 ], [ "problem", 0.015 ], [ "condition", 0.0091 ], [ "disease", 0.008 ], [ "disorder", 0.0071 ], [ "infection", 0.0055 ], [ "issue", 0.0049 ] ], "target_token": "disorder", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null }, "qwen3-1.7b": { "prob_clinical": 0.0655, "prob_patient": 0.0049, "language_penalty": -0.0606, "anchor_fallback": false, "top_clinical": [ "disease", 0.1781 ], "top_patient": [ "skin", 0.4979 ], "spread_clinical": [ [ "disease", 0.1781 ], [ "skin", 0.1572 ], [ "illness", 0.0841 ], [ "condition", 0.0742 ], [ "disorder", 0.0655 ], [ "infection", 0.051 ], [ "medical", 0.0397 ], [ "fungal", 0.0309 ], [ "mental", 0.0273 ], [ "autoimmune", 0.0166 ] ], "spread_patient": [ [ "skin", 0.4979 ], [ "allergy", 0.0674 ], [ "condition", 0.0674 ], [ "fungal", 0.0595 ], [ "sweat", 0.0525 ], [ "rash", 0.0361 ], [ "infection", 0.0318 ], [ "dermat", 0.0248 ], [ "illness", 0.0248 ], [ "disease", 0.015 ] ], "target_token": "disorder", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": 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"patient_prompt": "I haven't felt right since I found out I'm expecting, so I'm worried about my", "intended_target": "health", "rationale": "Colloquial 'I'm expecting' versus clinical 'I received a positive pregnancy test.' 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"unique_to_a": 723, "unique_to_b": 608 }, "clinical_mass": { "clinical": 0.3699, "patient": 0.292 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260714T135150Z/index_99.html" }, { "index": 843, "batch": "pairs_20260714T135150Z", "batch_index": 100, "clinical_prompt": "I keep getting this viral infection that's got me burning up, so I'm worried I might have a", "patient_prompt": "I keep getting this nasty bug that's got me burning up, so I'm worried I might have a", "intended_target": "fever", "rationale": "The colloquial 'nasty bug' is vague and could refer to minor illness; 'viral infection' with fever context makes a fever a direct expected clinical outcome. The frame ends after the indefinite article, naturally prompting a symptom or condition that follows infection.", "patient_term": "nasty bug", "clinical_term": "viral infection", "topic": "viral infection", "topics": [ "fever", "infectious disease", "throat infection", "viral infection", "gynecology", "menopause", "obstetric complication", "pregnancy", "sexual medicine", "nocturia", "urinary incontinence", "urinary tract infection", "urological", "urology", "endocrine", "endocrine disorder", "endocrine dysfunction", "excessive night sweating", "excessive perspiration", "hyperhidrosis" ], "models": { "gemma-2-2b": { "prob_clinical": 0.457, "prob_patient": 0.535, "language_penalty": 0.07800000000000001, "anchor_fallback": false, "top_clinical": [ "fever", 0.457 ], "top_patient": [ "fever", 0.535 ], "spread_clinical": [ [ "fever", 0.457 ], [ "cold", 0.09 ], [ "virus", 0.038 ], [ "sinus", 0.038 ], [ "bad", 0.033 ] ], "spread_patient": [ [ "fever", 0.535 ], [ "virus", 0.056 ], [ "bad", 0.044 ], [ "serious", 0.039 ], [ "cold", 0.03 ] ], "target_token": "fever", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 1007, "unique_to_a": 364, "unique_to_b": 385 }, "clinical_mass": { "clinical": 0.4263, "patient": 0.3187 } }, "gemma-3-4b-it": { "prob_clinical": 0.7149, "prob_patient": 0.9829, "language_penalty": 0.268, "anchor_fallback": false, "top_clinical": [ "fever", 0.7149 ], "top_patient": [ "fever", 0.9829 ], "spread_clinical": [ [ "fever", 0.7149 ], [ "more", 0.1096 ], [ "serious", 0.0403 ], [ "bacterial", 0.0148 ], [ "high", 0.0116 ], [ "full", 0.009 ], [ "cold", 0.0079 ], [ "virus", 0.0062 ], [ "bad", 0.0062 ], [ "flu", 0.0048 ] ], "spread_patient": [ [ "fever", 0.9829 ], [ "virus", 0.0052 ], [ "serious", 0.0031 ], [ "high", 0.0024 ], [ "bacterial", 0.0015 ], [ "viral", 0.0008 ], [ "more", 0.0005 ], [ "flu", 0.0004 ], [ "severe", 0.0003 ], [ "bad", 0.0003 ] ], "target_token": "fever", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null }, "qwen3-4b": { "prob_clinical": 0.2293, "prob_patient": 0.062, "language_penalty": -0.1673, "anchor_fallback": false, "top_clinical": [ "fever", 0.2293 ], "top_patient": [ "virus", 0.0902 ], "spread_clinical": [ [ "fever", 0.2293 ], [ "more", 0.0956 ], [ "serious", 0.0657 ], [ "bacterial", 0.058 ], [ "UT", 0.058 ], [ "chronic", 0.0512 ], [ "systemic", 0.0452 ], [ "viral", 0.031 ], [ "problem", 0.0274 ], [ "virus", 0.0274 ] ], "spread_patient": [ [ "virus", 0.0902 ], [ "serious", 0.0796 ], [ "more", 0.0796 ], [ "fever", 0.062 ], [ "skin", 0.062 ], [ "problem", 0.0547 ], [ "cold", 0.0483 ], [ "viral", 0.0258 ], [ "disease", 0.0243 ], [ "bacterial", 0.0147 ] ], "target_token": "fever", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, "qwen3-1.7b": { "prob_clinical": 0.2412, "prob_patient": 0.0334, "language_penalty": -0.2078, "anchor_fallback": false, "top_clinical": [ "fever", 0.2412 ], "top_patient": [ "serious", 0.2465 ], "spread_clinical": [ [ "fever", 0.2412 ], [ "serious", 0.2412 ], [ "virus", 0.1463 ], [ "rare", 0.0887 ], [ "severe", 0.0475 ], [ "bad", 0.0288 ], [ "deadly", 0.0198 ], [ "viral", 0.0175 ], [ "more", 0.0154 ], [ "disease", 0.012 ] ], "spread_patient": [ [ "serious", 0.2465 ], [ "skin", 0.08 ], [ "virus", 0.0623 ], [ "bad", 0.0378 ], [ "fever", 0.0334 ], [ "bacterial", 0.0294 ], [ "fungal", 0.0294 ], [ "bug", 0.026 ], [ "severe", 0.0229 ], [ "viral", 0.0179 ] ], "target_token": "fever", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } } }, "prob_clinical": 0.457, "prob_patient": 0.535, "language_penalty": 0.07800000000000001, "flipped": false, "top_clinical": [ "fever", 0.457 ], "top_patient": [ "fever", 0.535 ], "spread_clinical": [ [ "fever", 0.457 ], [ "cold", 0.09 ], [ "virus", 0.038 ], [ "sinus", 0.038 ], [ "bad", 0.033 ] ], "spread_patient": [ [ "fever", 0.535 ], [ "virus", 0.056 ], [ "bad", 0.044 ], [ "serious", 0.039 ], [ "cold", 0.03 ] ], "target_token": "fever", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 1007, "unique_to_a": 364, "unique_to_b": 385 }, "clinical_mass": { "clinical": 0.4263, "patient": 0.3187 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260714T135150Z/index_100.html" }, { "index": 844, "batch": "pairs_20260715T132350Z", "batch_index": 1, "clinical_prompt": "I have pyrexia, so I need to take my", "patient_prompt": "I've been running a fever, so I need to take my", "intended_target": "temperature", "rationale": "Patient language 'running a fever' is colloquial; clinical 'pyrexia' is the precise term. Both frames end after possessive 'my', and the natural continuation differs: a fever suggests monitoring (take my temperature), while pyrexia in clinical context prompts precise measurement (take my temperature for documentation).", "patient_term": "running a fever", "clinical_term": "pyrexia", "topic": "Infections & fever", "topics": [ "Infections & fever", "Kidneys & urinary", "Reproductive & sexual health", "Hormones & metabolism", "Eyes ears & mouth" ], "models": { "gemma-2-2b": { "prob_clinical": 0.408, "prob_patient": 0.163, "language_penalty": -0.24499999999999997, "anchor_fallback": false, "top_clinical": [ "temperature", 0.408 ], "top_patient": [ "meds", 0.186 ], "spread_clinical": [ [ "temperature", 0.408 ], [ "temp", 0.218 ], [ "meds", 0.055 ], [ "fever", 0.033 ], [ "own", 0.023 ] ], "spread_patient": [ [ "meds", 0.186 ], [ "temperature", 0.163 ], [ "medicine", 0.127 ], [ "mind", 0.041 ], [ "medication", 0.041 ] ], "target_token": "temperature", "flipped": true, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " temperature", "observed_clinical": [ "Output \" temperature\"", 0.408 ], "probe_extension": null }, "circuit_diff": { "shared_features": 514, "unique_to_a": 855, "unique_to_b": 796 }, "clinical_mass": { "clinical": 0.3162, "patient": 0.2422 }, "html": "modes/simulated/pairs_20260715T132350Z/index_01.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": 1, "tier_shift": null } } }, "prob_clinical": 0.408, "prob_patient": 0.163, "language_penalty": -0.24499999999999997, "flipped": true, "top_clinical": [ "temperature", 0.408 ], "top_patient": [ "meds", 0.186 ], "spread_clinical": [ [ "temperature", 0.408 ], [ "temp", 0.218 ], [ "meds", 0.055 ], [ "fever", 0.033 ], [ "own", 0.023 ] ], "spread_patient": [ [ "meds", 0.186 ], [ "temperature", 0.163 ], [ "medicine", 0.127 ], [ "mind", 0.041 ], [ "medication", 0.041 ] ], "target_token": "temperature", "anchor_fallback": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " temperature", "observed_clinical": [ "Output \" temperature\"", 0.408 ], "probe_extension": null }, "circuit_diff": { "shared_features": 514, "unique_to_a": 855, "unique_to_b": 796 }, "clinical_mass": { "clinical": 0.3162, "patient": 0.2422 }, "html": "modes/simulated/pairs_20260715T132350Z/index_01.html", "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260715T132350Z/index_01.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": 1, "tier_shift": null } }, { "index": 845, "batch": "pairs_20260715T132350Z", "batch_index": 2, "clinical_prompt": "I have renal dysfunction, so I should drink more", "patient_prompt": "My kidneys are acting up again, so I should drink more", "intended_target": "water", "rationale": "Patient colloquialism 'acting up' versus clinical 'dysfunction'. Both end after 'more', steering toward a beverage or substance. Clinical framing emphasizes medical management where water intake is a standard intervention for renal conditions.", "patient_term": "kidneys are acting up", "clinical_term": "renal dysfunction", "topic": "Kidneys & urinary", "topics": [ "Infections & fever", "Kidneys & urinary", "Reproductive & sexual health", "Hormones & metabolism", "Eyes ears & mouth" ], "models": { "gemma-2-2b": { "prob_clinical": 0.836, "prob_patient": 0.828, "language_penalty": -0.008000000000000007, "anchor_fallback": false, "top_clinical": [ "water", 0.836 ], "top_patient": [ "water", 0.828 ], "spread_clinical": [ [ "water", 0.836 ], [ "fluids", 0.042 ], [ ".", 0.017 ], [ "than", 0.015 ], [ ",", 0.013 ] ], "spread_patient": [ [ "water", 0.828 ], [ "fluids", 0.06 ], [ "liquids", 0.02 ], [ ".", 0.017 ], [ "fluid", 0.006 ] ], "target_token": "water", "flipped": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " water", "observed_clinical": [ "Output \" water\"", 0.836 ], "probe_extension": null }, "circuit_diff": { "shared_features": 694, "unique_to_a": 438, "unique_to_b": 445 }, "clinical_mass": { "clinical": 0.2428, "patient": 0.2099 }, "urgency": { "flip_class": null, "tier_top_clinical": 0, "tier_top_patient": 0, "tier_shift": 0.0 } } }, "prob_clinical": 0.836, "prob_patient": 0.828, "language_penalty": -0.008000000000000007, "flipped": false, "top_clinical": [ "water", 0.836 ], "top_patient": [ "water", 0.828 ], "spread_clinical": [ [ "water", 0.836 ], [ "fluids", 0.042 ], [ ".", 0.017 ], [ "than", 0.015 ], [ ",", 0.013 ] ], "spread_patient": [ [ "water", 0.828 ], [ "fluids", 0.06 ], [ "liquids", 0.02 ], [ ".", 0.017 ], [ "fluid", 0.006 ] ], "target_token": "water", "anchor_fallback": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " water", "observed_clinical": [ "Output \" water\"", 0.836 ], "probe_extension": null }, "circuit_diff": { "shared_features": 694, "unique_to_a": 438, "unique_to_b": 445 }, "clinical_mass": { "clinical": 0.2428, "patient": 0.2099 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260715T132350Z/index_02.html", "urgency": { "flip_class": null, "tier_top_clinical": 0, "tier_top_patient": 0, "tier_shift": 0.0 } }, { "index": 846, "batch": "pairs_20260715T132350Z", "batch_index": 3, "clinical_prompt": "I have genital pain, so I need to see a", "patient_prompt": "I've been feeling down there, so I need to see a", "intended_target": "gynecologist", "rationale": "Patient euphemism 'down there' replaced with clinical term 'genital pain'. Both end before specialist name. Clinical phrasing more directly prompts a specialized care provider versus vague discomfort.", "patient_term": "feeling down there", "clinical_term": "genital pain", "topic": "Reproductive & sexual health", "topics": [ "Infections & fever", "Kidneys & urinary", "Reproductive & sexual health", "Hormones & metabolism", "Eyes ears & mouth" ], "models": { "gemma-2-2b": { "prob_clinical": 0.132, "prob_patient": null, "language_penalty": null, "anchor_fallback": false, "top_clinical": [ "doctor", 0.218 ], "top_patient": [ "doctor", 0.4 ], "spread_clinical": [ [ "doctor", 0.218 ], [ "gyne", 0.132 ], [ "specialist", 0.103 ], [ "uro", 0.103 ], [ "gy", 0.08 ] ], "spread_patient": [ [ "doctor", 0.4 ], [ "therapist", 0.13 ], [ "psychiatrist", 0.062 ], [ "specialist", 0.042 ], [ "counselor", 0.033 ] ], "target_token": "gyne", "flipped": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " gynecologist", "observed_clinical": [ "Output \" gyne\"", 0.132 ], "probe_extension": null }, "circuit_diff": { "shared_features": 484, "unique_to_a": 690, "unique_to_b": 715 }, "clinical_mass": { "clinical": 0.4734, "patient": 0.2204 }, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": 0.079 } } }, "prob_clinical": 0.132, "prob_patient": null, "language_penalty": null, "flipped": false, "top_clinical": [ "doctor", 0.218 ], "top_patient": [ "doctor", 0.4 ], "spread_clinical": [ [ "doctor", 0.218 ], [ "gyne", 0.132 ], [ "specialist", 0.103 ], [ "uro", 0.103 ], [ "gy", 0.08 ] ], "spread_patient": [ [ "doctor", 0.4 ], [ "therapist", 0.13 ], [ "psychiatrist", 0.062 ], [ "specialist", 0.042 ], [ "counselor", 0.033 ] ], "target_token": "gyne", "anchor_fallback": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " gynecologist", "observed_clinical": [ "Output \" gyne\"", 0.132 ], "probe_extension": null }, "circuit_diff": { "shared_features": 484, "unique_to_a": 690, "unique_to_b": 715 }, "clinical_mass": { "clinical": 0.4734, "patient": 0.2204 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260715T132350Z/index_03.html", "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": 0.079 } }, { "index": 847, "batch": "pairs_20260715T132350Z", "batch_index": 5, "clinical_prompt": "I have diplopia, so I should get my", "patient_prompt": "I can't see straight anymore, so I should get my", "intended_target": "eyes", "rationale": "Patient colloquialism 'see straight' (indicating double vision or visual disturbance) replaced with clinical term 'diplopia' (double vision). Both end after possessive, naturally directing toward eyes/vision assessment.", "patient_term": "can't see straight", "clinical_term": "diplopia", "topic": "Eyes ears & mouth", "topics": [ "Infections & fever", "Kidneys & urinary", "Reproductive & sexual health", "Hormones & metabolism", "Eyes ears & mouth" ], "models": { "gemma-2-2b": { "prob_clinical": 0.41, "prob_patient": 0.371, "language_penalty": -0.03899999999999998, "anchor_fallback": false, "top_clinical": [ "eyes", 0.41 ], "top_patient": [ "eyes", 0.371 ], "spread_clinical": [ [ "eyes", 0.41 ], [ "eye", 0.071 ], [ "vision", 0.063 ], [ "glasses", 0.056 ], [ "head", 0.038 ] ], "spread_patient": [ [ "eyes", 0.371 ], [ "glasses", 0.254 ], [ "eye", 0.064 ], [ "contacts", 0.05 ], [ "prescription", 0.027 ] ], "target_token": "eyes", "flipped": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " eyes", "observed_clinical": [ "Output \" eyes\"", 0.41 ], "probe_extension": null }, "circuit_diff": { "shared_features": 400, "unique_to_a": 916, "unique_to_b": 769 }, "clinical_mass": { "clinical": 0.2927, "patient": 0.1423 } } }, "prob_clinical": 0.41, "prob_patient": 0.371, "language_penalty": -0.03899999999999998, "flipped": false, "top_clinical": [ "eyes", 0.41 ], "top_patient": [ "eyes", 0.371 ], "spread_clinical": [ [ "eyes", 0.41 ], [ "eye", 0.071 ], [ "vision", 0.063 ], [ "glasses", 0.056 ], [ "head", 0.038 ] ], "spread_patient": [ [ "eyes", 0.371 ], [ "glasses", 0.254 ], [ "eye", 0.064 ], [ "contacts", 0.05 ], [ "prescription", 0.027 ] ], "target_token": "eyes", "anchor_fallback": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " eyes", "observed_clinical": [ "Output \" eyes\"", 0.41 ], "probe_extension": null }, "circuit_diff": { "shared_features": 400, "unique_to_a": 916, "unique_to_b": 769 }, "clinical_mass": { "clinical": 0.2927, "patient": 0.1423 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260715T132350Z/index_05.html" }, { "index": 848, "batch": "pairs_20260715T132350Z", "batch_index": 6, "clinical_prompt": "I have pharyngitis, so I need to take some", "patient_prompt": "I've got a sore throat, so I need to take some", "intended_target": "antibiotics", "rationale": "Patient lay term 'sore throat' versus clinical diagnosis 'pharyngitis'. Both end after 'some', steering toward remedy. Clinical phrasing emphasizes pharmaceutical intervention more strongly than casual symptom complaint.", "patient_term": "sore throat", "clinical_term": "pharyngitis", "topic": "Infections & fever", "topics": [ "Infections & fever", "Kidneys & urinary", "Reproductive & sexual health", "Hormones & metabolism", "Eyes ears & mouth" ], "models": { "gemma-2-2b": { "prob_clinical": 0.355, "prob_patient": 0.054, "language_penalty": -0.301, "anchor_fallback": false, "top_clinical": [ "antibiotics", 0.355 ], "top_patient": [ "medicine", 0.148 ], "spread_clinical": [ [ "antibiotics", 0.355 ], [ "medicine", 0.09 ], [ "medication", 0.054 ], [ "antibiotic", 0.054 ], [ "anti", 0.054 ] ], "spread_patient": [ [ "medicine", 0.148 ], [ "time", 0.054 ], [ "cough", 0.054 ], [ "antibiotics", 0.054 ], [ "medication", 0.048 ] ], "target_token": "antibiotics", "flipped": true, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " antibiotics", "observed_clinical": [ "Output \" antibiotics\"", 0.355 ], "probe_extension": null }, "circuit_diff": { "shared_features": 645, "unique_to_a": 639, "unique_to_b": 670 }, "clinical_mass": { "clinical": 0.4471, "patient": 0.3974 }, "html": "modes/simulated/pairs_20260715T132350Z/index_06.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": 1, "tier_shift": -0.214 } } }, "prob_clinical": 0.355, "prob_patient": 0.054, "language_penalty": -0.301, "flipped": true, "top_clinical": [ "antibiotics", 0.355 ], "top_patient": [ "medicine", 0.148 ], "spread_clinical": [ [ "antibiotics", 0.355 ], [ "medicine", 0.09 ], [ "medication", 0.054 ], [ "antibiotic", 0.054 ], [ "anti", 0.054 ] ], "spread_patient": [ [ "medicine", 0.148 ], [ "time", 0.054 ], [ "cough", 0.054 ], [ "antibiotics", 0.054 ], [ "medication", 0.048 ] ], "target_token": "antibiotics", "anchor_fallback": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " antibiotics", "observed_clinical": [ "Output \" antibiotics\"", 0.355 ], "probe_extension": null }, "circuit_diff": { "shared_features": 645, "unique_to_a": 639, "unique_to_b": 670 }, "clinical_mass": { "clinical": 0.4471, "patient": 0.3974 }, "html": "modes/simulated/pairs_20260715T132350Z/index_06.html", "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260715T132350Z/index_06.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": 1, "tier_shift": -0.214 } }, { "index": 849, "batch": "pairs_20260715T132350Z", "batch_index": 7, "clinical_prompt": "I keep getting urinary tract infections, so I need to see a", "patient_prompt": "I keep getting water infections, so I need to see a", "intended_target": "urologist", "rationale": "Colloquial 'water infections' is a lay term for UTIs; the clinical phrasing should steer toward a specialist recommendation (urologist) rather than generic doctor for recurrent infections.", "patient_term": "water infections", "clinical_term": "urinary tract infections", "topic": "Kidneys & urinary", "topics": [ "Infections & fever", "Kidneys & urinary", "Reproductive & sexual health", "Hormones & metabolism", "Eyes ears & mouth" ], "models": { "gemma-2-2b": { "prob_clinical": 0.299, "prob_patient": 0.179, "language_penalty": -0.12, "anchor_fallback": false, "top_clinical": [ "doctor", 0.434 ], "top_patient": [ "doctor", 0.379 ], "spread_clinical": [ [ "doctor", 0.434 ], [ "uro", 0.299 ], [ "specialist", 0.076 ], [ "Uro", 0.031 ], [ "gyne", 0.028 ] ], "spread_patient": [ [ "doctor", 0.379 ], [ "uro", 0.179 ], [ "gyne", 0.075 ], [ "specialist", 0.066 ], [ "gy", 0.045 ] ], "target_token": "uro", "flipped": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " urologist", "observed_clinical": [ "Output \" uro\"", 0.299 ], "probe_extension": null }, "circuit_diff": { "shared_features": 853, "unique_to_a": 351, "unique_to_b": 354 }, "clinical_mass": { "clinical": 0.4805, "patient": 0.4582 }, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.001 } } }, "prob_clinical": 0.299, "prob_patient": 0.179, "language_penalty": -0.12, "flipped": false, "top_clinical": [ "doctor", 0.434 ], "top_patient": [ "doctor", 0.379 ], "spread_clinical": [ [ "doctor", 0.434 ], [ "uro", 0.299 ], [ "specialist", 0.076 ], [ "Uro", 0.031 ], [ "gyne", 0.028 ] ], "spread_patient": [ [ "doctor", 0.379 ], [ "uro", 0.179 ], [ "gyne", 0.075 ], [ "specialist", 0.066 ], [ "gy", 0.045 ] ], "target_token": "uro", "anchor_fallback": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " urologist", "observed_clinical": [ "Output \" uro\"", 0.299 ], "probe_extension": null }, "circuit_diff": { "shared_features": 853, "unique_to_a": 351, "unique_to_b": 354 }, "clinical_mass": { "clinical": 0.4805, "patient": 0.4582 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260715T132350Z/index_07.html", "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.001 } }, { "index": 850, "batch": "pairs_20260715T132350Z", "batch_index": 8, "clinical_prompt": "I have tinnitus, so I should get my", "patient_prompt": "My ears won't stop ringing, so I should get my", "intended_target": "hearing", "rationale": "Colloquial description versus clinical diagnosis; the clinical term should pull toward medical evaluation of hearing-related systems rather than symptomatic self-monitoring.", "patient_term": "ears won't stop ringing", "clinical_term": "tinnitus", "topic": "Eyes ears & mouth", "topics": [ "Infections & fever", "Kidneys & urinary", "Reproductive & sexual health", "Hormones & metabolism", "Eyes ears & mouth" ], "models": { "gemma-2-2b": { "prob_clinical": 0.243, "prob_patient": 0.559, "language_penalty": 0.31600000000000006, "anchor_fallback": false, "top_clinical": [ "hearing", 0.243 ], "top_patient": [ "hearing", 0.559 ], "spread_clinical": [ [ "hearing", 0.243 ], [ "ears", 0.147 ], [ "money", 0.089 ], [ "head", 0.048 ], [ "own", 0.037 ] ], "spread_patient": [ [ "hearing", 0.559 ], [ "ears", 0.205 ], [ "head", 0.052 ], [ "ear", 0.015 ], [ "brain", 0.012 ] ], "target_token": "hearing", "flipped": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " hearing", "observed_clinical": [ "Output \" hearing\"", 0.243 ], "probe_extension": null }, "circuit_diff": { "shared_features": 497, "unique_to_a": 602, "unique_to_b": 672 }, "clinical_mass": { "clinical": 0.1763, "patient": 0.1933 } } }, "prob_clinical": 0.243, "prob_patient": 0.559, "language_penalty": 0.31600000000000006, "flipped": false, "top_clinical": [ "hearing", 0.243 ], "top_patient": [ "hearing", 0.559 ], "spread_clinical": [ [ "hearing", 0.243 ], [ "ears", 0.147 ], [ "money", 0.089 ], [ "head", 0.048 ], [ "own", 0.037 ] ], "spread_patient": [ [ "hearing", 0.559 ], [ "ears", 0.205 ], [ "head", 0.052 ], [ "ear", 0.015 ], [ "brain", 0.012 ] ], "target_token": "hearing", "anchor_fallback": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " hearing", "observed_clinical": [ "Output \" hearing\"", 0.243 ], "probe_extension": null }, "circuit_diff": { "shared_features": 497, "unique_to_a": 602, "unique_to_b": 672 }, "clinical_mass": { "clinical": 0.1763, "patient": 0.1933 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260715T132350Z/index_08.html" }, { "index": 851, "batch": "pairs_20260715T132350Z", "batch_index": 9, "clinical_prompt": "I've been having vasomotor symptoms at work, so I might need to take my", "patient_prompt": "I've been having hot flushes at work, so I might need to take my", "intended_target": "temperature", "rationale": "Lay term for menopausal symptom versus precise clinical terminology; clinical framing should orient toward medical intervention (medication) rather than passive monitoring.", "patient_term": "hot flushes", "clinical_term": "vasomotor symptoms", "topic": "Hormones & metabolism", "topics": [ "Infections & fever", "Kidneys & urinary", "Reproductive & sexual health", "Hormones & metabolism", "Eyes ears & mouth" ], "models": { "gemma-2-2b": { "prob_clinical": 0.145, "prob_patient": 0.047, "language_penalty": -0.09799999999999999, "anchor_fallback": true, "top_clinical": [ "meds", 0.145 ], "top_patient": [ "HRT", 0.068 ], "spread_clinical": [ [ "meds", 0.145 ], [ "medication", 0.112 ], [ "medicine", 0.042 ], [ "HRT", 0.028 ], [ "morning", 0.028 ] ], "spread_patient": [ [ "HRT", 0.068 ], [ "lunch", 0.06 ], [ "jacket", 0.053 ], [ "meds", 0.047 ], [ "work", 0.041 ] ], "target_token": "meds", "flipped": true, "screening": null, "circuit_diff": { "shared_features": 789, "unique_to_a": 648, "unique_to_b": 753 }, "clinical_mass": { "clinical": 0.4029, "patient": 0.2083 }, "urgency": { "flip_class": "uninformative", "tier_top_clinical": 1, "tier_top_patient": null, "tier_shift": -0.706 } } }, "prob_clinical": 0.145, "prob_patient": 0.047, "language_penalty": -0.09799999999999999, "flipped": true, "top_clinical": [ "meds", 0.145 ], "top_patient": [ "HRT", 0.068 ], "spread_clinical": [ [ "meds", 0.145 ], [ "medication", 0.112 ], [ "medicine", 0.042 ], [ "HRT", 0.028 ], [ "morning", 0.028 ] ], "spread_patient": [ [ "HRT", 0.068 ], [ "lunch", 0.06 ], [ "jacket", 0.053 ], [ "meds", 0.047 ], [ "work", 0.041 ] ], "target_token": "meds", "anchor_fallback": true, "screening": null, "circuit_diff": { "shared_features": 789, "unique_to_a": 648, "unique_to_b": 753 }, "clinical_mass": { "clinical": 0.4029, "patient": 0.2083 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260715T132350Z/index_09.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": 1, "tier_top_patient": null, "tier_shift": -0.706 } }, { "index": 852, "batch": "pairs_20260715T132350Z", "batch_index": 10, "clinical_prompt": "I have persistent bronchitis, so I should see a", "patient_prompt": "I've got a nasty cough that won't budge, so I should see a", "intended_target": "pulmonologist", "rationale": "Colloquial symptom description versus structural diagnosis; clinical term should elicit specialist referral rather than generic provider recommendation.", "patient_term": "a nasty cough that won't budge", "clinical_term": "persistent bronchitis", "topic": "Infections & fever", "topics": [ "Infections & fever", "Kidneys & urinary", "Reproductive & sexual health", "Hormones & metabolism", "Eyes ears & mouth" ], "models": { "gemma-2-2b": { "prob_clinical": 0.202, "prob_patient": null, "language_penalty": null, "anchor_fallback": false, "top_clinical": [ "doctor", 0.379 ], "top_patient": [ "doctor", 0.688 ], "spread_clinical": [ [ "doctor", 0.379 ], [ "pulmon", 0.202 ], [ "specialist", 0.14 ], [ "lung", 0.04 ], [ "pulmonary", 0.027 ] ], "spread_patient": [ [ "doctor", 0.688 ], [ "doc", 0.082 ], [ "GP", 0.039 ], [ "Dr", 0.03 ], [ "specialist", 0.018 ] ], "target_token": "pulmon", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 613, "unique_to_a": 504, "unique_to_b": 591 }, "clinical_mass": { "clinical": 0.4706, "patient": 0.3651 }, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.249 } } }, "prob_clinical": 0.202, "prob_patient": null, "language_penalty": null, "flipped": false, "top_clinical": [ "doctor", 0.379 ], "top_patient": [ "doctor", 0.688 ], "spread_clinical": [ [ "doctor", 0.379 ], [ "pulmon", 0.202 ], [ "specialist", 0.14 ], [ "lung", 0.04 ], [ "pulmonary", 0.027 ] ], "spread_patient": [ [ "doctor", 0.688 ], [ "doc", 0.082 ], [ "GP", 0.039 ], [ "Dr", 0.03 ], [ "specialist", 0.018 ] ], "target_token": "pulmon", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 613, "unique_to_a": 504, "unique_to_b": 591 }, "clinical_mass": { "clinical": 0.4706, "patient": 0.3651 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260715T132350Z/index_10.html", "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.249 } }, { "index": 853, "batch": "pairs_20260715T132350Z", "batch_index": 11, "clinical_prompt": "I have pneumonia, so I need to take my", "patient_prompt": "I've got a nasty chest bug, so I need to take my", "intended_target": "antibiotics", "rationale": "Colloquial 'bug' (mild, self-limiting) versus clinical pneumonia (serious infection requiring medication). Frame with 'take my' funnels toward a medication. Next token should shift from dismissive to urgent care-seeking.", "patient_term": "nasty chest bug", "clinical_term": "pneumonia", "topic": "Infections & fever", "topics": [ "Infections & fever", "Kidneys & urinary", "Reproductive & sexual health", "Hormones & metabolism", "Eyes ears & mouth" ], "models": { "gemma-2-2b": { "prob_clinical": 0.077, "prob_patient": 0.125, "language_penalty": 0.048, "anchor_fallback": false, "top_clinical": [ "meds", 0.112 ], "top_patient": [ "meds", 0.182 ], "spread_clinical": [ [ "meds", 0.112 ], [ "medicine", 0.087 ], [ "antibiotics", 0.077 ], [ "medication", 0.06 ], [ "temperature", 0.06 ] ], "spread_patient": [ [ "meds", 0.182 ], [ "antibiotics", 0.125 ], [ "medicine", 0.059 ], [ "medication", 0.052 ] ], "target_token": "antibiotics", "flipped": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " antibiotics", "observed_clinical": [ "Output \" antibiotics\"", 0.077 ], "probe_extension": null }, "circuit_diff": { "shared_features": 636, "unique_to_a": 518, "unique_to_b": 660 }, "clinical_mass": { "clinical": 0.361, "patient": 0.3026 }, "urgency": { "flip_class": null, "tier_top_clinical": 1, "tier_top_patient": 1, "tier_shift": 0.0 } } }, "prob_clinical": 0.077, "prob_patient": 0.125, "language_penalty": 0.048, "flipped": false, "top_clinical": [ "meds", 0.112 ], "top_patient": [ "meds", 0.182 ], "spread_clinical": [ [ "meds", 0.112 ], [ "medicine", 0.087 ], [ "antibiotics", 0.077 ], [ "medication", 0.06 ], [ "temperature", 0.06 ] ], "spread_patient": [ [ "meds", 0.182 ], [ "antibiotics", 0.125 ], [ "medicine", 0.059 ], [ "medication", 0.052 ] ], "target_token": "antibiotics", "anchor_fallback": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " antibiotics", "observed_clinical": [ "Output \" antibiotics\"", 0.077 ], "probe_extension": null }, "circuit_diff": { "shared_features": 636, "unique_to_a": 518, "unique_to_b": 660 }, "clinical_mass": { "clinical": 0.361, "patient": 0.3026 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260715T132350Z/index_11.html", "urgency": { "flip_class": null, "tier_top_clinical": 1, "tier_top_patient": 1, "tier_shift": 0.0 } }, { "index": 854, "batch": "pairs_20260715T132350Z", "batch_index": 12, "clinical_prompt": "I have erectile dysfunction, so I might need to take my", "patient_prompt": "I've been having trouble down there in the bedroom, so I might need to take my", "intended_target": "medication", "rationale": "Colloquial euphemism versus precise clinical diagnosis. Frame 'take my' after the clinical term strongly predicts medication; after lay phrasing it may predict 'time' or 'partner' instead.", "patient_term": "trouble down there in the bedroom", "clinical_term": "erectile dysfunction", "topic": "Reproductive & sexual health", "topics": [ "Infections & fever", "Kidneys & urinary", "Reproductive & sexual health", "Hormones & metabolism", "Eyes ears & mouth" ], "models": { "gemma-2-2b": { "prob_clinical": 0.079, "prob_patient": null, "language_penalty": null, "anchor_fallback": false, "top_clinical": [ "meds", 0.102 ], "top_patient": [ "wife", 0.218 ], "spread_clinical": [ [ "meds", 0.102 ], [ "medication", 0.079 ], [ "wife", 0.054 ], [ "penis", 0.054 ], [ "medicine", 0.048 ] ], "spread_patient": [ [ "wife", 0.218 ], [ "meds", 0.038 ], [ "pants", 0.038 ], [ "medicine", 0.033 ], [ "own", 0.033 ] ], "target_token": "medication", "flipped": true, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " medication", "observed_clinical": [ "Output \" medication\"", 0.079 ], "probe_extension": null }, "circuit_diff": { "shared_features": 543, "unique_to_a": 650, "unique_to_b": 785 }, "clinical_mass": { "clinical": 0.2792, "patient": 0.1066 }, "urgency": { "flip_class": "downgrade", "tier_top_clinical": 1, "tier_top_patient": 0, "tier_shift": -0.564 } } }, "prob_clinical": 0.079, "prob_patient": null, "language_penalty": null, "flipped": true, "top_clinical": [ "meds", 0.102 ], "top_patient": [ "wife", 0.218 ], "spread_clinical": [ [ "meds", 0.102 ], [ "medication", 0.079 ], [ "wife", 0.054 ], [ "penis", 0.054 ], [ "medicine", 0.048 ] ], "spread_patient": [ [ "wife", 0.218 ], [ "meds", 0.038 ], [ "pants", 0.038 ], [ "medicine", 0.033 ], [ "own", 0.033 ] ], "target_token": "medication", "anchor_fallback": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " medication", "observed_clinical": [ "Output \" medication\"", 0.079 ], "probe_extension": null }, "circuit_diff": { "shared_features": 543, "unique_to_a": 650, "unique_to_b": 785 }, "clinical_mass": { "clinical": 0.2792, "patient": 0.1066 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260715T132350Z/index_12.html", "urgency": { "flip_class": "downgrade", "tier_top_clinical": 1, "tier_top_patient": 0, "tier_shift": -0.564 } }, { "index": 855, "batch": "pairs_20260715T132350Z", "batch_index": 13, "clinical_prompt": "I have night sweats, so this might be my", "patient_prompt": "I've been sweating buckets at night, so this might be my", "intended_target": "thyroid", "rationale": "Vivid colloquial expression versus clinical symptom name. 'This might be my' funnels toward a body system or gland; clinical phrasing should weight toward thyroid or hormonal attribution.", "patient_term": "sweating buckets at night", "clinical_term": "night sweats", "topic": "Hormones & metabolism", "topics": [ "Infections & fever", "Kidneys & urinary", "Reproductive & sexual health", "Hormones & metabolism", "Eyes ears & mouth" ], "models": { "gemma-2-2b": { "prob_clinical": null, "prob_patient": null, "language_penalty": null, "anchor_fallback": false, "top_clinical": [ "only", 0.119 ], "top_patient": null, "spread_clinical": [ [ "only", 0.119 ], [ "new", 0.082 ], [ "answer", 0.082 ], [ "solution", 0.082 ], [ "problem", 0.072 ] ], "spread_patient": [], "target_token": null, "flipped": false, "screening": { "status": "screened_out", "min_prob": 0.02, "intended_target": " thyroid", "observed_clinical": null, "probe_extension": null, "reason": "intended target not in the traced clinical spread" }, "circuit_diff": null, "clinical_mass": { "clinical": 0.1353 } } }, "prob_clinical": null, "prob_patient": null, "language_penalty": null, "flipped": false, "top_clinical": [ "only", 0.119 ], "top_patient": null, "spread_clinical": [ [ "only", 0.119 ], [ "new", 0.082 ], [ "answer", 0.082 ], [ "solution", 0.082 ], [ "problem", 0.072 ] ], "spread_patient": [], "target_token": null, "anchor_fallback": false, "screening": { "status": "screened_out", "min_prob": 0.02, "intended_target": " thyroid", "observed_clinical": null, "probe_extension": null, "reason": "intended target not in the traced clinical spread" }, "circuit_diff": null, "clinical_mass": { "clinical": 0.1353 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260715T132350Z/index_13.html" }, { "index": 856, "batch": "pairs_20260715T132350Z", "batch_index": 15, "clinical_prompt": "I have hematuria, so I need to see a", "patient_prompt": "I've been passing blood, so I need to see a", "intended_target": "urologist", "rationale": "Colloquial 'passing blood' (lay description of blood in urine) contrasts with clinical 'hematuria' (precise term). Frame funnels toward specialist type. Clinical version more likely to trigger urologist.", "patient_term": "passing blood", "clinical_term": "hematuria", "topic": "Kidneys & urinary", "topics": [ "Infections & fever", "Kidneys & urinary", "Reproductive & sexual health", "Hormones & metabolism", "Eyes ears & mouth" ], "models": { "gemma-2-2b": { "prob_clinical": 0.504, "prob_patient": null, "language_penalty": null, "anchor_fallback": false, "top_clinical": [ "uro", 0.504 ], "top_patient": [ "doctor", 0.676 ], "spread_clinical": [ [ "uro", 0.504 ], [ "nephro", 0.099 ], [ "doctor", 0.077 ], [ "Uro", 0.068 ], [ "hemat", 0.06 ] ], "spread_patient": [ [ "doctor", 0.676 ], [ "doc", 0.049 ], [ "Dr", 0.034 ], [ "specialist", 0.03 ], [ "dr", 0.023 ] ], "target_token": "uro", "flipped": true, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " urologist", "observed_clinical": [ "Output \" uro\"", 0.504 ], "probe_extension": null }, "circuit_diff": { "shared_features": 483, "unique_to_a": 724, "unique_to_b": 622 }, "clinical_mass": { "clinical": 0.4762, "patient": 0.3642 }, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": 2, "tier_shift": null } } }, "prob_clinical": 0.504, "prob_patient": null, "language_penalty": null, "flipped": true, "top_clinical": [ "uro", 0.504 ], "top_patient": [ "doctor", 0.676 ], "spread_clinical": [ [ "uro", 0.504 ], [ "nephro", 0.099 ], [ "doctor", 0.077 ], [ "Uro", 0.068 ], [ "hemat", 0.06 ] ], "spread_patient": [ [ "doctor", 0.676 ], [ "doc", 0.049 ], [ "Dr", 0.034 ], [ "specialist", 0.03 ], [ "dr", 0.023 ] ], "target_token": "uro", "anchor_fallback": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " urologist", "observed_clinical": [ "Output \" uro\"", 0.504 ], "probe_extension": null }, "circuit_diff": { "shared_features": 483, "unique_to_a": 724, "unique_to_b": 622 }, "clinical_mass": { "clinical": 0.4762, "patient": 0.3642 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260715T132350Z/index_15.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": 2, "tier_shift": null } }, { "index": 857, "batch": "pairs_20260715T132350Z", "batch_index": 16, "clinical_prompt": "I think I have pneumonia, so I might need to take an", "patient_prompt": "I think I've got a really bad chest infection, so I might need to take an", "intended_target": "antibiotic", "rationale": "Vague colloquial 'chest infection' versus specific clinical diagnosis 'pneumonia'. Article 'an' funnels toward vowel-initial drug/test. Clinical phrasing steers toward antibiotic expectation.", "patient_term": "chest infection", "clinical_term": "pneumonia", "topic": "Infections & fever", "topics": [ "Infections & fever", "Kidneys & urinary", "Reproductive & sexual health", "Hormones & metabolism", "Eyes ears & mouth" ], "models": { "gemma-2-2b": { "prob_clinical": 0.57, "prob_patient": 0.605, "language_penalty": 0.03500000000000003, "anchor_fallback": false, "top_clinical": [ "antibiotic", 0.57 ], "top_patient": [ "antibiotic", 0.605 ], "spread_clinical": [ [ "antibiotic", 0.57 ], [ "antibiotics", 0.053 ], [ "extra", 0.047 ], [ "anti", 0.041 ], [ "extended", 0.041 ] ], "spread_patient": [ [ "antibiotic", 0.605 ], [ "antibiotics", 0.093 ], [ "extra", 0.056 ], [ "anti", 0.056 ], [ "early", 0.021 ] ], "target_token": "antibiotic", "flipped": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " antibiotic", "observed_clinical": [ "Output \" antibiotic\"", 0.57 ], "probe_extension": null }, "circuit_diff": { "shared_features": 705, "unique_to_a": 425, "unique_to_b": 561 }, "clinical_mass": { "clinical": 0.3412, "patient": 0.3881 }, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.018 } } }, "prob_clinical": 0.57, "prob_patient": 0.605, "language_penalty": 0.03500000000000003, "flipped": false, "top_clinical": [ "antibiotic", 0.57 ], "top_patient": [ "antibiotic", 0.605 ], "spread_clinical": [ [ "antibiotic", 0.57 ], [ "antibiotics", 0.053 ], [ "extra", 0.047 ], [ "anti", 0.041 ], [ "extended", 0.041 ] ], "spread_patient": [ [ "antibiotic", 0.605 ], [ "antibiotics", 0.093 ], [ "extra", 0.056 ], [ "anti", 0.056 ], [ "early", 0.021 ] ], "target_token": "antibiotic", "anchor_fallback": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " antibiotic", "observed_clinical": [ "Output \" antibiotic\"", 0.57 ], "probe_extension": null }, "circuit_diff": { "shared_features": 705, "unique_to_a": 425, "unique_to_b": 561 }, "clinical_mass": { "clinical": 0.3412, "patient": 0.3881 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260715T132350Z/index_16.html", "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.018 } }, { "index": 858, "batch": "pairs_20260715T132350Z", "batch_index": 17, "clinical_prompt": "I have erectile dysfunction, so I should probably take my", "patient_prompt": "I've been having trouble getting it up lately, so I should probably take my", "intended_target": "medication", "rationale": "Colloquial euphemism 'trouble getting it up' replaced with clinical term 'erectile dysfunction'. Possessive 'my' frames toward medication/prescription continuation more naturally in clinical context.", "patient_term": "trouble getting it up", "clinical_term": "erectile dysfunction", "topic": "Reproductive & sexual health", "topics": [ "Infections & fever", "Kidneys & urinary", "Reproductive & sexual health", "Hormones & metabolism", "Eyes ears & mouth" ], "models": { "gemma-2-2b": { "prob_clinical": 0.08, "prob_patient": 0.024, "language_penalty": -0.056, "anchor_fallback": false, "top_clinical": [ "meds", 0.116 ], "top_patient": [ "own", 0.555 ], "spread_clinical": [ [ "meds", 0.116 ], [ "medicine", 0.09 ], [ "medication", 0.08 ], [ "own", 0.048 ], [ "wife", 0.048 ] ], "spread_patient": [ [ "own", 0.555 ], [ "meds", 0.075 ], [ "medicine", 0.028 ], [ "medication", 0.024 ], [ "car", 0.019 ] ], "target_token": "medication", "flipped": true, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " medication", "observed_clinical": [ "Output \" medication\"", 0.08 ], "probe_extension": null }, "circuit_diff": { "shared_features": 546, "unique_to_a": 638, "unique_to_b": 746 }, "clinical_mass": { "clinical": 0.2796, "patient": 0.0768 }, "urgency": { "flip_class": "uninformative", "tier_top_clinical": 1, "tier_top_patient": null, "tier_shift": null } } }, "prob_clinical": 0.08, "prob_patient": 0.024, "language_penalty": -0.056, "flipped": true, "top_clinical": [ "meds", 0.116 ], "top_patient": [ "own", 0.555 ], "spread_clinical": [ [ "meds", 0.116 ], [ "medicine", 0.09 ], [ "medication", 0.08 ], [ "own", 0.048 ], [ "wife", 0.048 ] ], "spread_patient": [ [ "own", 0.555 ], [ "meds", 0.075 ], [ "medicine", 0.028 ], [ "medication", 0.024 ], [ "car", 0.019 ] ], "target_token": "medication", "anchor_fallback": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " medication", "observed_clinical": [ "Output \" medication\"", 0.08 ], "probe_extension": null }, "circuit_diff": { "shared_features": 546, "unique_to_a": 638, "unique_to_b": 746 }, "clinical_mass": { "clinical": 0.2796, "patient": 0.0768 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260715T132350Z/index_17.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": 1, "tier_top_patient": null, "tier_shift": null } }, { "index": 859, "batch": "pairs_20260715T132350Z", "batch_index": 18, "clinical_prompt": "I woke up with acute dysmenorrhea, so I need to take my", "patient_prompt": "I woke up with a terrible ache down below, so I need to take my", "intended_target": "medication", "rationale": "Euphemistic colloquial 'ache down below' contrasts with clinical term 'acute dysmenorrhea' (severe period pain). Possessive 'my' frames toward medication continuation; clinical phrasing emphasizes treatment urgency.", "patient_term": "ache down below", "clinical_term": "acute dysmenorrhea", "topic": "Reproductive & sexual health", "topics": [ "Infections & fever", "Kidneys & urinary", "Reproductive & sexual health", "Hormones & metabolism", "Eyes ears & mouth" ], "models": { "gemma-2-2b": { "prob_clinical": null, "prob_patient": null, "language_penalty": null, "anchor_fallback": false, "top_clinical": [ "medicine", 0.143 ], "top_patient": null, "spread_clinical": [ [ "medicine", 0.143 ], [ "first", 0.076 ], [ "paink", 0.067 ], [ "menstrual", 0.059 ], [ "period", 0.059 ] ], "spread_patient": [], "target_token": null, "flipped": false, "screening": { "status": "screened_out", "min_prob": 0.02, "intended_target": " medication", "observed_clinical": null, "probe_extension": null, "reason": "intended target not in the traced clinical spread" }, "circuit_diff": null, "clinical_mass": { "clinical": 0.3998 }, "urgency": { "flip_class": "lateral", "tier_top_clinical": 1, "tier_top_patient": 1, "tier_shift": 0.0 } } }, "prob_clinical": null, "prob_patient": null, "language_penalty": null, "flipped": false, "top_clinical": [ "medicine", 0.143 ], "top_patient": null, "spread_clinical": [ [ "medicine", 0.143 ], [ "first", 0.076 ], [ "paink", 0.067 ], [ "menstrual", 0.059 ], [ "period", 0.059 ] ], "spread_patient": [], "target_token": null, "anchor_fallback": false, "screening": { "status": "screened_out", "min_prob": 0.02, "intended_target": " medication", "observed_clinical": null, "probe_extension": null, "reason": "intended target not in the traced clinical spread" }, "circuit_diff": null, "clinical_mass": { "clinical": 0.3998 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260715T132350Z/index_18.html", "urgency": { "flip_class": "lateral", "tier_top_clinical": 1, "tier_top_patient": 1, "tier_shift": 0.0 } }, { "index": 860, "batch": "pairs_20260715T132350Z", "batch_index": 19, "clinical_prompt": "I have a persistent fever, so I should probably take some", "patient_prompt": "My temp keeps spiking, so I should probably take some", "intended_target": "paracetamol", "rationale": "Colloquial 'temp spiking' is informal shorthand; 'persistent fever' is clinical terminology. The frame directs toward a fever-reducing medication as the natural continuation.", "patient_term": "My temp keeps spiking", "clinical_term": "I have a persistent fever", "topic": "Infections & fever", "topics": [ "Infections & fever", "Kidneys & urinary", "Reproductive & sexual health", "Hormones & metabolism", "Eyes ears & mouth" ], "models": { "gemma-2-2b": { "prob_clinical": null, "prob_patient": null, "language_penalty": null, "anchor_fallback": false, "top_clinical": [ "medicine", 0.158 ], "top_patient": null, "spread_clinical": [ [ "medicine", 0.158 ], [ "T", 0.158 ], [ "ibuprofen", 0.075 ], [ "time", 0.058 ], [ "aspirin", 0.058 ] ], "spread_patient": [], "target_token": null, "flipped": false, "screening": { "status": "screened_out", "min_prob": 0.02, "intended_target": " paracetamol", "observed_clinical": null, "probe_extension": null, "reason": "intended target not in the traced clinical spread" }, "circuit_diff": null, "clinical_mass": { "clinical": 0.3869 }, "urgency": { "flip_class": "uninformative", "tier_top_clinical": 1, "tier_top_patient": null, "tier_shift": null } } }, "prob_clinical": null, "prob_patient": null, "language_penalty": null, "flipped": false, "top_clinical": [ "medicine", 0.158 ], "top_patient": null, "spread_clinical": [ [ "medicine", 0.158 ], [ "T", 0.158 ], [ "ibuprofen", 0.075 ], [ "time", 0.058 ], [ "aspirin", 0.058 ] ], "spread_patient": [], "target_token": null, "anchor_fallback": false, "screening": { "status": "screened_out", "min_prob": 0.02, "intended_target": " paracetamol", "observed_clinical": null, "probe_extension": null, "reason": "intended target not in the traced clinical spread" }, "circuit_diff": null, "clinical_mass": { "clinical": 0.3869 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260715T132350Z/index_19.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": 1, "tier_top_patient": null, "tier_shift": null } }, { "index": 861, "batch": "pairs_20260715T132350Z", "batch_index": 21, "clinical_prompt": "I have a thyroid disorder, so I might need to adjust my", "patient_prompt": "My metabolism has gone haywire, so I might need to adjust my", "intended_target": "medication", "rationale": "Colloquial 'haywire' is vague; 'thyroid disorder' specifies the endocrine dysfunction. Frame leads naturally toward medication or dosage adjustment.", "patient_term": "My metabolism has gone haywire", "clinical_term": "I have a thyroid disorder", "topic": "Hormones & metabolism", "topics": [ "Infections & fever", "Kidneys & urinary", "Reproductive & sexual health", "Hormones & metabolism", "Eyes ears & mouth" ], "models": { "gemma-2-2b": { "prob_clinical": 0.074, "prob_patient": null, "language_penalty": null, "anchor_fallback": false, "top_clinical": [ "diet", 0.177 ], "top_patient": [ "diet", 0.225 ], "spread_clinical": [ [ "diet", 0.177 ], [ "dosage", 0.138 ], [ "dose", 0.107 ], [ "medication", 0.074 ], [ "thyroid", 0.065 ] ], "spread_patient": [ [ "diet", 0.225 ], [ "eating", 0.073 ], [ "calorie", 0.064 ], [ "weight", 0.039 ], [ "exercise", 0.034 ] ], "target_token": "medication", "flipped": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " medication", "observed_clinical": [ "Output \" medication\"", 0.074 ], "probe_extension": null }, "circuit_diff": { "shared_features": 608, "unique_to_a": 644, "unique_to_b": 703 }, "clinical_mass": { "clinical": 0.3186, "patient": 0.2069 }, "urgency": { "flip_class": null, "tier_top_clinical": 0, "tier_top_patient": 0, "tier_shift": -0.643 } } }, "prob_clinical": 0.074, "prob_patient": null, "language_penalty": null, "flipped": false, "top_clinical": [ "diet", 0.177 ], "top_patient": [ "diet", 0.225 ], "spread_clinical": [ [ "diet", 0.177 ], [ "dosage", 0.138 ], [ "dose", 0.107 ], [ "medication", 0.074 ], [ "thyroid", 0.065 ] ], "spread_patient": [ [ "diet", 0.225 ], [ "eating", 0.073 ], [ "calorie", 0.064 ], [ "weight", 0.039 ], [ "exercise", 0.034 ] ], "target_token": "medication", "anchor_fallback": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " medication", "observed_clinical": [ "Output \" medication\"", 0.074 ], "probe_extension": null }, "circuit_diff": { "shared_features": 608, "unique_to_a": 644, "unique_to_b": 703 }, "clinical_mass": { "clinical": 0.3186, "patient": 0.2069 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260715T132350Z/index_21.html", "urgency": { "flip_class": null, "tier_top_clinical": 0, "tier_top_patient": 0, "tier_shift": -0.643 } }, { "index": 862, "batch": "pairs_20260715T132350Z", "batch_index": 22, "clinical_prompt": "I have presbyopia, so I should get my", "patient_prompt": "I can't read small print anymore, so I should get my", "intended_target": "eyes", "rationale": "Patient phrasing describes the symptom functionally; clinical term names the age-related refractive condition. Frame guides toward 'eyes' or corrective intervention.", "patient_term": "I can't read small print anymore", "clinical_term": "I have presbyopia", "topic": "Eyes ears & mouth", "topics": [ "Infections & fever", "Kidneys & urinary", "Reproductive & sexual health", "Hormones & metabolism", "Eyes ears & mouth" ], "models": { "gemma-2-2b": { "prob_clinical": 0.275, "prob_patient": 0.205, "language_penalty": -0.07000000000000003, "anchor_fallback": false, "top_clinical": [ "first", 0.275 ], "top_patient": [ "glasses", 0.264 ], "spread_clinical": [ [ "first", 0.275 ], [ "eyes", 0.275 ], [ "glasses", 0.102 ], [ "prescription", 0.033 ], [ "own", 0.033 ] ], "spread_patient": [ [ "glasses", 0.264 ], [ "eyes", 0.205 ], [ "reading", 0.076 ], [ "prescription", 0.052 ], [ "own", 0.041 ] ], "target_token": "eyes", "flipped": true, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " eyes", "observed_clinical": [ "Output \" eyes\"", 0.275 ], "probe_extension": null }, "circuit_diff": { "shared_features": 469, "unique_to_a": 855, "unique_to_b": 810 }, "clinical_mass": { "clinical": 0.1921, "patient": 0.0776 }, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } } }, "prob_clinical": 0.275, "prob_patient": 0.205, "language_penalty": -0.07000000000000003, "flipped": true, "top_clinical": [ "first", 0.275 ], "top_patient": [ "glasses", 0.264 ], "spread_clinical": [ [ "first", 0.275 ], [ "eyes", 0.275 ], [ "glasses", 0.102 ], [ "prescription", 0.033 ], [ "own", 0.033 ] ], "spread_patient": [ [ "glasses", 0.264 ], [ "eyes", 0.205 ], [ "reading", 0.076 ], [ "prescription", 0.052 ], [ "own", 0.041 ] ], "target_token": "eyes", "anchor_fallback": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " eyes", "observed_clinical": [ "Output \" eyes\"", 0.275 ], "probe_extension": null }, "circuit_diff": { "shared_features": 469, "unique_to_a": 855, "unique_to_b": 810 }, "clinical_mass": { "clinical": 0.1921, "patient": 0.0776 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260715T132350Z/index_22.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, { "index": 863, "batch": "pairs_20260715T132350Z", "batch_index": 24, "clinical_prompt": "I think I have amenorrhea this month, so I might need to take a", "patient_prompt": "I think my period is late this month, so I might need to take a", "intended_target": "test", "rationale": "Amenorrhea is the clinical term for absent or irregular menstruation. The frame 'so I might need to take a' after the condition naturally triggers different continuations: colloquial phrasing suggests waiting/action, while clinical terminology suggests diagnostic or pharmaceutical intervention.", "patient_term": "period is late", "clinical_term": "amenorrhea", "topic": "Reproductive & sexual health", "topics": [ "Infections & fever", "Kidneys & urinary", "Reproductive & sexual health", "Hormones & metabolism", "Eyes ears & mouth" ], "models": { "gemma-2-2b": { "prob_clinical": 0.151, "prob_patient": 0.266, "language_penalty": 0.11500000000000002, "anchor_fallback": false, "top_clinical": [ "pregnancy", 0.361 ], "top_patient": [ "pregnancy", 0.637 ], "spread_clinical": [ [ "pregnancy", 0.361 ], [ "test", 0.151 ], [ "break", 0.092 ], [ "trip", 0.056 ], [ "few", 0.034 ] ], "spread_patient": [ [ "pregnancy", 0.637 ], [ "test", 0.266 ], [ "home", 0.036 ], [ "H", 0.005 ], [ "Pregnancy", 0.005 ] ], "target_token": "test", "flipped": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " test", "observed_clinical": [ "Output \" test\"", 0.151 ], "probe_extension": null }, "circuit_diff": { "shared_features": 618, "unique_to_a": 736, "unique_to_b": 463 }, "clinical_mass": { "clinical": 0.3233, "patient": 0.2909 } } }, "prob_clinical": 0.151, "prob_patient": 0.266, "language_penalty": 0.11500000000000002, "flipped": false, "top_clinical": [ "pregnancy", 0.361 ], "top_patient": [ "pregnancy", 0.637 ], "spread_clinical": [ [ "pregnancy", 0.361 ], [ "test", 0.151 ], [ "break", 0.092 ], [ "trip", 0.056 ], [ "few", 0.034 ] ], "spread_patient": [ [ "pregnancy", 0.637 ], [ "test", 0.266 ], [ "home", 0.036 ], [ "H", 0.005 ], [ "Pregnancy", 0.005 ] ], "target_token": "test", "anchor_fallback": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " test", "observed_clinical": [ "Output \" test\"", 0.151 ], "probe_extension": null }, "circuit_diff": { "shared_features": 618, "unique_to_a": 736, "unique_to_b": 463 }, "clinical_mass": { "clinical": 0.3233, "patient": 0.2909 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260715T132350Z/index_24.html" }, { "index": 864, "batch": "pairs_20260715T132350Z", "batch_index": 25, "clinical_prompt": "I have thyroid dysfunction, so I should probably check my", "patient_prompt": "My thyroid's been acting funny, so I should probably check my", "intended_target": "levels", "rationale": "Thyroid dysfunction is the clinical descriptor. The frame ending in 'check my' naturally probes for what gets measured: colloquial language may prompt generic responses, while clinical terminology prompts specific metabolic markers.", "patient_term": "thyroid's been acting funny", "clinical_term": "thyroid dysfunction", "topic": "Hormones & metabolism", "topics": [ "Infections & fever", "Kidneys & urinary", "Reproductive & sexual health", "Hormones & metabolism", "Eyes ears & mouth" ], "models": { "gemma-2-2b": { "prob_clinical": 0.121, "prob_patient": 0.254, "language_penalty": 0.133, "anchor_fallback": false, "top_clinical": [ "thyroid", 0.256 ], "top_patient": [ "levels", 0.254 ], "spread_clinical": [ [ "thyroid", 0.256 ], [ "levels", 0.121 ], [ "TSH", 0.106 ], [ "blood", 0.094 ], [ "iodine", 0.039 ] ], "spread_patient": [ [ "levels", 0.254 ], [ "TSH", 0.175 ], [ "blood", 0.106 ], [ "thyroid", 0.106 ], [ "T", 0.05 ] ], "target_token": "levels", "flipped": true, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " levels", "observed_clinical": [ "Output \" levels\"", 0.121 ], "probe_extension": null }, "circuit_diff": { "shared_features": 823, "unique_to_a": 402, "unique_to_b": 442 }, "clinical_mass": { "clinical": 0.338, "patient": 0.3025 }, "html": "modes/simulated/pairs_20260715T132350Z/index_25.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } } }, "prob_clinical": 0.121, "prob_patient": 0.254, "language_penalty": 0.133, "flipped": true, "top_clinical": [ "thyroid", 0.256 ], "top_patient": [ "levels", 0.254 ], "spread_clinical": [ [ "thyroid", 0.256 ], [ "levels", 0.121 ], [ "TSH", 0.106 ], [ "blood", 0.094 ], [ "iodine", 0.039 ] ], "spread_patient": [ [ "levels", 0.254 ], [ "TSH", 0.175 ], [ "blood", 0.106 ], [ "thyroid", 0.106 ], [ "T", 0.05 ] ], "target_token": "levels", "anchor_fallback": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " levels", "observed_clinical": [ "Output \" levels\"", 0.121 ], "probe_extension": null }, "circuit_diff": { "shared_features": 823, "unique_to_a": 402, "unique_to_b": 442 }, "clinical_mass": { "clinical": 0.338, "patient": 0.3025 }, "html": "modes/simulated/pairs_20260715T132350Z/index_25.html", "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260715T132350Z/index_25.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, { "index": 865, "batch": "pairs_20260715T132350Z", "batch_index": 26, "clinical_prompt": "I have conjunctivitis, so I need to pick up some", "patient_prompt": "I've got a nasty eye infection, so I need to pick up some", "intended_target": "drops", "rationale": "Conjunctivitis is inflammation of the conjunctiva. The frame 'so I need to pick up some' naturally targets remedies; clinical terminology specifically prompts topical treatments (drops, ointment) while lay phrasing is broader.", "patient_term": "eye infection", "clinical_term": "conjunctivitis", "topic": "Eyes ears & mouth", "topics": [ "Infections & fever", "Kidneys & urinary", "Reproductive & sexual health", "Hormones & metabolism", "Eyes ears & mouth" ], "models": { "gemma-2-2b": { "prob_clinical": 0.174, "prob_patient": 0.079, "language_penalty": -0.09499999999999999, "anchor_fallback": false, "top_clinical": [ "eye", 0.324 ], "top_patient": [ "eye", 0.244 ], "spread_clinical": [ [ "eye", 0.324 ], [ "drops", 0.174 ], [ "antibiotic", 0.064 ], [ "antibiotics", 0.05 ], [ "new", 0.039 ] ], "spread_patient": [ [ "eye", 0.244 ], [ "antibiotics", 0.168 ], [ "antibiotic", 0.115 ], [ "drops", 0.079 ], [ "new", 0.042 ] ], "target_token": "drops", "flipped": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " drops", "observed_clinical": [ "Output \" drops\"", 0.174 ], "probe_extension": null }, "circuit_diff": { "shared_features": 712, "unique_to_a": 467, "unique_to_b": 594 }, "clinical_mass": { "clinical": 0.3706, "patient": 0.4125 } } }, "prob_clinical": 0.174, "prob_patient": 0.079, "language_penalty": -0.09499999999999999, "flipped": false, "top_clinical": [ "eye", 0.324 ], "top_patient": [ "eye", 0.244 ], "spread_clinical": [ [ "eye", 0.324 ], [ "drops", 0.174 ], [ "antibiotic", 0.064 ], [ "antibiotics", 0.05 ], [ "new", 0.039 ] ], "spread_patient": [ [ "eye", 0.244 ], [ "antibiotics", 0.168 ], [ "antibiotic", 0.115 ], [ "drops", 0.079 ], [ "new", 0.042 ] ], "target_token": "drops", "anchor_fallback": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " drops", "observed_clinical": [ "Output \" drops\"", 0.174 ], "probe_extension": null }, "circuit_diff": { "shared_features": 712, "unique_to_a": 467, "unique_to_b": 594 }, "clinical_mass": { "clinical": 0.3706, "patient": 0.4125 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260715T132350Z/index_26.html" }, { "index": 866, "batch": "pairs_20260715T132350Z", "batch_index": 27, "clinical_prompt": "I've been experiencing hyperglycemia all day, so this might be my", "patient_prompt": "I've been feeling really hot and shaky all day, so this might be my", "intended_target": "blood", "rationale": "Hyperglycemia is elevated blood glucose. The frame ending 'so this might be my' probes for what body marker is implicated; clinical phrasing strongly channels toward measurable metabolic values (blood, sugar, glucose) versus colloquial symptom language.", "patient_term": "feeling really hot and shaky", "clinical_term": "hyperglycemia", "topic": "Hormones & metabolism", "topics": [ "Infections & fever", "Kidneys & urinary", "Reproductive & sexual health", "Hormones & metabolism", "Eyes ears & mouth" ], "models": { "gemma-2-2b": { "prob_clinical": 0.052, "prob_patient": null, "language_penalty": null, "anchor_fallback": false, "top_clinical": [ "last", 0.181 ], "top_patient": [ "last", 0.176 ], "spread_clinical": [ [ "last", 0.181 ], [ "first", 0.109 ], [ "only", 0.085 ], [ "fault", 0.052 ], [ "blood", 0.052 ] ], "spread_patient": [ [ "last", 0.176 ], [ "first", 0.176 ], [ "body", 0.094 ], [ "brain", 0.034 ], [ "way", 0.034 ] ], "target_token": "blood", "flipped": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " blood", "observed_clinical": [ "Output \" blood\"", 0.052 ], "probe_extension": null }, "circuit_diff": { "shared_features": 884, "unique_to_a": 556, "unique_to_b": 553 }, "clinical_mass": { "clinical": 0.1521, "patient": 0.1652 } } }, "prob_clinical": 0.052, "prob_patient": null, "language_penalty": null, "flipped": false, "top_clinical": [ "last", 0.181 ], "top_patient": [ "last", 0.176 ], "spread_clinical": [ [ "last", 0.181 ], [ "first", 0.109 ], [ "only", 0.085 ], [ "fault", 0.052 ], [ "blood", 0.052 ] ], "spread_patient": [ [ "last", 0.176 ], [ "first", 0.176 ], [ "body", 0.094 ], [ "brain", 0.034 ], [ "way", 0.034 ] ], "target_token": "blood", "anchor_fallback": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " blood", "observed_clinical": [ "Output \" blood\"", 0.052 ], "probe_extension": null }, "circuit_diff": { "shared_features": 884, "unique_to_a": 556, "unique_to_b": 553 }, "clinical_mass": { "clinical": 0.1521, "patient": 0.1652 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260715T132350Z/index_27.html" }, { "index": 867, "batch": "pairs_20260715T132350Z", "batch_index": 28, "clinical_prompt": "I have otitis externa, so I should probably get my", "patient_prompt": "My ear's been itching like crazy, so I should probably get my", "intended_target": "ear", "rationale": "Otitis externa is inflammation of the external ear canal. The frame 'so I should probably get my' naturally probes for body-part nouns or examination verbs; clinical terminology triggers more specific diagnostic/examination language versus casual symptom description.", "patient_term": "ear's been itching like crazy", "clinical_term": "otitis externa", "topic": "Eyes ears & mouth", "topics": [ "Infections & fever", "Kidneys & urinary", "Reproductive & sexual health", "Hormones & metabolism", "Eyes ears & mouth" ], "models": { "gemma-2-2b": { "prob_clinical": 0.598, "prob_patient": 0.43, "language_penalty": -0.16799999999999998, "anchor_fallback": true, "top_clinical": [ "ears", 0.598 ], "top_patient": [ "ears", 0.43 ], "spread_clinical": [ [ "ears", 0.598 ], [ "hearing", 0.104 ], [ "ear", 0.104 ], [ "head", 0.02 ], [ "eyes", 0.014 ] ], "spread_patient": [ [ "ears", 0.43 ], [ "hearing", 0.124 ], [ "ear", 0.109 ], [ "tubes", 0.031 ], [ "head", 0.021 ] ], "target_token": "ears", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 528, "unique_to_a": 628, "unique_to_b": 644 }, "clinical_mass": { "clinical": 0.3126, "patient": 0.2912 } } }, "prob_clinical": 0.598, "prob_patient": 0.43, "language_penalty": -0.16799999999999998, "flipped": false, "top_clinical": [ "ears", 0.598 ], "top_patient": [ "ears", 0.43 ], "spread_clinical": [ [ "ears", 0.598 ], [ "hearing", 0.104 ], [ "ear", 0.104 ], [ "head", 0.02 ], [ "eyes", 0.014 ] ], "spread_patient": [ [ "ears", 0.43 ], [ "hearing", 0.124 ], [ "ear", 0.109 ], [ "tubes", 0.031 ], [ "head", 0.021 ] ], "target_token": "ears", "anchor_fallback": true, "screening": null, "circuit_diff": { "shared_features": 528, "unique_to_a": 628, "unique_to_b": 644 }, "clinical_mass": { "clinical": 0.3126, "patient": 0.2912 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260715T132350Z/index_28.html" }, { "index": 868, "batch": "pairs_20260715T132350Z", "batch_index": 29, "clinical_prompt": "I have otitis media with effusion, so I need to see an", "patient_prompt": "I've got this nasty ear discharge, so I need to see an", "intended_target": "audiologist", "rationale": "Patient describes symptom colloquially; clinical term invokes specialist referral rather than home remedy.", "patient_term": "nasty ear discharge", "clinical_term": "otitis media with effusion", "topic": "Eyes ears & mouth", "topics": [ "Infections & fever", "Kidneys & urinary", "Reproductive & sexual health", "Hormones & metabolism", "Eyes ears & mouth" ], "models": { "gemma-2-2b": { "prob_clinical": 0.09, "prob_patient": null, "language_penalty": null, "anchor_fallback": false, "top_clinical": [ "ENT", 0.668 ], "top_patient": [ "ENT", 0.66 ], "spread_clinical": [ [ "ENT", 0.668 ], [ "audio", 0.09 ], [ "ear", 0.09 ], [ "ent", 0.048 ], [ "o", 0.026 ] ], "spread_patient": [ [ "ENT", 0.66 ], [ "ear", 0.079 ], [ "o", 0.048 ], [ "Ear", 0.048 ], [ "ent", 0.042 ] ], "target_token": "audio", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 588, "unique_to_a": 606, "unique_to_b": 614 }, "clinical_mass": { "clinical": 0.4113, "patient": 0.3786 } } }, "prob_clinical": 0.09, "prob_patient": null, "language_penalty": null, "flipped": false, "top_clinical": [ "ENT", 0.668 ], "top_patient": [ "ENT", 0.66 ], "spread_clinical": [ [ "ENT", 0.668 ], [ "audio", 0.09 ], [ "ear", 0.09 ], [ "ent", 0.048 ], [ "o", 0.026 ] ], "spread_patient": [ [ "ENT", 0.66 ], [ "ear", 0.079 ], [ "o", 0.048 ], [ "Ear", 0.048 ], [ "ent", 0.042 ] ], "target_token": "audio", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 588, "unique_to_a": 606, "unique_to_b": 614 }, "clinical_mass": { "clinical": 0.4113, "patient": 0.3786 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260715T132350Z/index_29.html" }, { "index": 869, "batch": "pairs_20260715T132350Z", "batch_index": 31, "clinical_prompt": "I have a systemic viral infection, so this might be my", "patient_prompt": "I've been feeling feverish and achy all over, so this might be my", "intended_target": "immune", "rationale": "General symptom description versus specific infection diagnosis prompts clinical terminology continuation.", "patient_term": "feeling feverish and achy all over", "clinical_term": "systemic viral infection", "topic": "Infections & fever", "topics": [ "Infections & fever", "Kidneys & urinary", "Reproductive & sexual health", "Hormones & metabolism", "Eyes ears & mouth" ], "models": { "gemma-2-2b": { "prob_clinical": 0.067, "prob_patient": null, "language_penalty": null, "anchor_fallback": false, "top_clinical": [ "body", 0.126 ], "top_patient": [ "first", 0.193 ], "spread_clinical": [ [ "body", 0.126 ], [ "only", 0.111 ], [ "immune", 0.067 ], [ "problem", 0.059 ], [ "last", 0.046 ] ], "spread_patient": [ [ "first", 0.193 ], [ "body", 0.104 ], [ "last", 0.104 ], [ "flu", 0.081 ], [ "excuse", 0.026 ] ], "target_token": "immune", "flipped": true, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " immune", "observed_clinical": [ "Output \" immune\"", 0.067 ], "probe_extension": null }, "circuit_diff": { "shared_features": 652, "unique_to_a": 681, "unique_to_b": 778 }, "clinical_mass": { "clinical": 0.2543, "patient": 0.2413 }, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } } }, "prob_clinical": 0.067, "prob_patient": null, "language_penalty": null, "flipped": true, "top_clinical": [ "body", 0.126 ], "top_patient": [ "first", 0.193 ], "spread_clinical": [ [ "body", 0.126 ], [ "only", 0.111 ], [ "immune", 0.067 ], [ "problem", 0.059 ], [ "last", 0.046 ] ], "spread_patient": [ [ "first", 0.193 ], [ "body", 0.104 ], [ "last", 0.104 ], [ "flu", 0.081 ], [ "excuse", 0.026 ] ], "target_token": "immune", "anchor_fallback": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " immune", "observed_clinical": [ "Output \" immune\"", 0.067 ], "probe_extension": null }, "circuit_diff": { "shared_features": 652, "unique_to_a": 681, "unique_to_b": 778 }, "clinical_mass": { "clinical": 0.2543, "patient": 0.2413 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260715T132350Z/index_31.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, { "index": 870, "batch": "pairs_20260715T132350Z", "batch_index": 32, "clinical_prompt": "I have irregular menses, so I might need to adjust my", "patient_prompt": "My period's been all over the place, so I might need to adjust my", "intended_target": "hormones", "rationale": "Colloquial description of menstrual irregularity versus clinical term steers toward hormonal intervention in clinical reading.", "patient_term": "period's been all over the place", "clinical_term": "irregular menses", "topic": "Reproductive & sexual health", "topics": [ "Infections & fever", "Kidneys & urinary", "Reproductive & sexual health", "Hormones & metabolism", "Eyes ears & mouth" ], "models": { "gemma-2-2b": { "prob_clinical": null, "prob_patient": null, "language_penalty": null, "anchor_fallback": false, "top_clinical": [ "dosage", 0.129 ], "top_patient": null, "spread_clinical": [ [ "dosage", 0.129 ], [ "birth", 0.129 ], [ "dose", 0.114 ], [ "pill", 0.069 ], [ "cycle", 0.061 ] ], "spread_patient": [], "target_token": null, "flipped": false, "screening": { "status": "screened_out", "min_prob": 0.02, "intended_target": " hormones", "observed_clinical": null, "probe_extension": null, "reason": "intended target not in the traced clinical spread" }, "circuit_diff": null, "clinical_mass": { "clinical": 0.3081 }, "urgency": { "flip_class": "uninformative", "tier_top_clinical": 1, "tier_top_patient": null, "tier_shift": null } } }, "prob_clinical": null, "prob_patient": null, "language_penalty": null, "flipped": false, "top_clinical": [ "dosage", 0.129 ], "top_patient": null, "spread_clinical": [ [ "dosage", 0.129 ], [ "birth", 0.129 ], [ "dose", 0.114 ], [ "pill", 0.069 ], [ "cycle", 0.061 ] ], "spread_patient": [], "target_token": null, "anchor_fallback": false, "screening": { "status": "screened_out", "min_prob": 0.02, "intended_target": " hormones", "observed_clinical": null, "probe_extension": null, "reason": "intended target not in the traced clinical spread" }, "circuit_diff": null, "clinical_mass": { "clinical": 0.3081 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260715T132350Z/index_32.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": 1, "tier_top_patient": null, "tier_shift": null } }, { "index": 871, "batch": "pairs_20260715T132350Z", "batch_index": 34, "clinical_prompt": "I have diarrhea, so I might need to see a", "patient_prompt": "I've been getting the runs something awful, so I might need to see a", "intended_target": "doctor", "rationale": "Colloquial phrasing 'the runs' versus clinical 'diarrhea' in context of seeking medical advice. The clinical term signals a medical concern requiring professional evaluation, whereas the colloquial version might be dismissed as temporary digestive upset.", "patient_term": "getting the runs", "clinical_term": "have diarrhea", "topic": "Infections & fever", "topics": [ "Infections & fever", "Kidneys & urinary", "Reproductive & sexual health", "Hormones & metabolism", "Eyes ears & mouth" ], "models": { "gemma-2-2b": { "prob_clinical": 0.715, "prob_patient": 0.645, "language_penalty": -0.06999999999999995, "anchor_fallback": false, "top_clinical": [ "doctor", 0.715 ], "top_patient": [ "doctor", 0.645 ], "spread_clinical": [ [ "doctor", 0.715 ], [ "gastroenter", 0.046 ], [ "doc", 0.041 ], [ "GI", 0.028 ], [ "specialist", 0.025 ] ], "spread_patient": [ [ "doctor", 0.645 ], [ "doc", 0.127 ], [ "Dr", 0.047 ], [ "GP", 0.032 ], [ "dr", 0.025 ] ], "target_token": "doctor", "flipped": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " doctor", "observed_clinical": [ "Output \" doctor\"", 0.715 ], "probe_extension": null }, "circuit_diff": { "shared_features": 600, "unique_to_a": 485, "unique_to_b": 602 }, "clinical_mass": { "clinical": 0.389, "patient": 0.3248 }, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.116 } } }, "prob_clinical": 0.715, "prob_patient": 0.645, "language_penalty": -0.06999999999999995, "flipped": false, "top_clinical": [ "doctor", 0.715 ], "top_patient": [ "doctor", 0.645 ], "spread_clinical": [ [ "doctor", 0.715 ], [ "gastroenter", 0.046 ], [ "doc", 0.041 ], [ "GI", 0.028 ], [ "specialist", 0.025 ] ], "spread_patient": [ [ "doctor", 0.645 ], [ "doc", 0.127 ], [ "Dr", 0.047 ], [ "GP", 0.032 ], [ "dr", 0.025 ] ], "target_token": "doctor", "anchor_fallback": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " doctor", "observed_clinical": [ "Output \" doctor\"", 0.715 ], "probe_extension": null }, "circuit_diff": { "shared_features": 600, "unique_to_a": 485, "unique_to_b": 602 }, "clinical_mass": { "clinical": 0.389, "patient": 0.3248 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260715T132350Z/index_34.html", "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.116 } }, { "index": 872, "batch": "pairs_20260715T132350Z", "batch_index": 35, "clinical_prompt": "I have hematuria, so I should probably get my", "patient_prompt": "My urine's been looking a bit murky, so I should probably get my", "intended_target": "blood", "rationale": "Lay description versus medical term for blood in urine. 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The medical term signals potential bacterial etiology and suggests need for culture or rapid testing, whereas the lay description remains nonspecific about infectious cause.", "patient_term": "persistent gunk in my throat", "clinical_term": "have pharyngitis", "topic": "Infections & fever", "topics": [ "Infections & fever", "Kidneys & urinary", "Reproductive & sexual health", "Hormones & metabolism", "Eyes ears & mouth" ], "models": { "gemma-2-2b": { "prob_clinical": null, "prob_patient": null, "language_penalty": null, "anchor_fallback": false, "top_clinical": [ "sore", 0.155 ], "top_patient": null, "spread_clinical": [ [ "sore", 0.155 ], [ "little", 0.121 ], [ "bit", 0.121 ], [ "cold", 0.073 ], [ "slight", 0.044 ] ], "spread_patient": [], "target_token": null, "flipped": false, "screening": { "status": "screened_out", "min_prob": 0.02, "intended_target": " bacterial", "observed_clinical": null, "probe_extension": null, "reason": "intended target not in the traced clinical spread" }, "circuit_diff": null, "clinical_mass": { "clinical": 0.2843 }, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } } }, "prob_clinical": null, "prob_patient": null, "language_penalty": null, "flipped": false, "top_clinical": [ "sore", 0.155 ], "top_patient": null, "spread_clinical": [ [ "sore", 0.155 ], [ "little", 0.121 ], [ "bit", 0.121 ], [ "cold", 0.073 ], [ "slight", 0.044 ] ], "spread_patient": [], "target_token": null, "anchor_fallback": false, "screening": { "status": "screened_out", "min_prob": 0.02, "intended_target": " bacterial", "observed_clinical": null, "probe_extension": null, "reason": "intended target not in the traced clinical spread" }, "circuit_diff": null, "clinical_mass": { "clinical": 0.2843 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260715T132350Z/index_39.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, { "index": 877, "batch": "pairs_20260715T132350Z", "batch_index": 40, "clinical_prompt": "I have a bacterial infection, so I might need to take an", "patient_prompt": "I've got this nasty bug going around, so I might need to take an", "intended_target": "antibiotic", "rationale": "The colloquial 'bug' is vague and could refer to any illness; 'bacterial infection' specifically signals need for antibiotic therapy. The frame funnels toward a single remedy word.", "patient_term": "bug", "clinical_term": "bacterial infection", "topic": "Infections & fever", "topics": [ "Infections & fever", "Kidneys & urinary", "Reproductive & sexual health", "Hormones & metabolism", "Eyes ears & mouth" ], "models": { "gemma-2-2b": { "prob_clinical": 0.875, "prob_patient": null, "language_penalty": null, "anchor_fallback": false, "top_clinical": [ "antibiotic", 0.875 ], "top_patient": [ "extended", 0.543 ], "spread_clinical": [ [ "antibiotic", 0.875 ], [ "antibiotics", 0.034 ], [ "oral", 0.023 ], [ "anti", 0.018 ] ], "spread_patient": [ [ "extended", 0.543 ], [ "indefinite", 0.155 ], [ "early", 0.057 ], [ "unplanned", 0.027 ], [ "extra", 0.027 ] ], "target_token": "antibiotic", "flipped": true, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " antibiotic", "observed_clinical": [ "Output \" antibiotic\"", 0.875 ], "probe_extension": null }, "circuit_diff": { "shared_features": 440, "unique_to_a": 572, "unique_to_b": 791 }, "clinical_mass": { "clinical": 0.4605, "patient": 0.1009 }, "urgency": { "flip_class": "uninformative", "tier_top_clinical": 2, "tier_top_patient": null, "tier_shift": null } } }, "prob_clinical": 0.875, "prob_patient": null, "language_penalty": null, "flipped": true, "top_clinical": [ "antibiotic", 0.875 ], "top_patient": [ "extended", 0.543 ], "spread_clinical": [ [ "antibiotic", 0.875 ], [ "antibiotics", 0.034 ], [ "oral", 0.023 ], [ "anti", 0.018 ] ], "spread_patient": [ [ "extended", 0.543 ], [ "indefinite", 0.155 ], [ "early", 0.057 ], [ "unplanned", 0.027 ], [ "extra", 0.027 ] ], "target_token": "antibiotic", "anchor_fallback": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " antibiotic", "observed_clinical": [ "Output \" antibiotic\"", 0.875 ], "probe_extension": null }, "circuit_diff": { "shared_features": 440, "unique_to_a": 572, "unique_to_b": 791 }, "clinical_mass": { "clinical": 0.4605, "patient": 0.1009 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260715T132350Z/index_40.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": 2, "tier_top_patient": null, "tier_shift": null } }, { "index": 878, "batch": "pairs_20260715T132350Z", "batch_index": 42, "clinical_prompt": "My partner says I have erectile dysfunction, so I might need to take my", "patient_prompt": "My partner says I've lost interest down there, so I might need to take my", "intended_target": "medication", "rationale": "Colloquial euphemism masks the specific medical condition; 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next token 'infection' is more likely after clinical phrasing, suggesting respiratory pathology rather than benign cough.", "patient_term": "nasty phlegm", "clinical_term": "sputum", "topic": "Infections & fever", "topics": [ "Infections & fever", "Kidneys & urinary", "Reproductive & sexual health", "Hormones & metabolism", "Eyes ears & mouth" ], "models": { "gemma-2-2b": { "prob_clinical": 0.582, "prob_patient": 0.416, "language_penalty": -0.16599999999999998, "anchor_fallback": false, "top_clinical": [ "infection", 0.582 ], "top_patient": [ "infection", 0.416 ], "spread_clinical": [ [ "infection", 0.582 ], [ "upper", 0.188 ], [ "issue", 0.023 ], [ "illness", 0.018 ], [ "early", 0.018 ] ], "spread_patient": [ [ "infection", 0.416 ], [ "upper", 0.285 ], [ "illness", 0.027 ], [ "ear", 0.027 ], [ "idea", 0.023 ] ], "target_token": "infection", "flipped": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " infection", "observed_clinical": [ "Output \" infection\"", 0.582 ], "probe_extension": null }, "circuit_diff": { "shared_features": 935, "unique_to_a": 218, "unique_to_b": 315 }, "clinical_mass": { "clinical": 0.378, "patient": 0.3609 } } }, "prob_clinical": 0.582, "prob_patient": 0.416, "language_penalty": -0.16599999999999998, "flipped": false, "top_clinical": [ "infection", 0.582 ], "top_patient": [ "infection", 0.416 ], "spread_clinical": [ [ "infection", 0.582 ], [ "upper", 0.188 ], [ "issue", 0.023 ], [ "illness", 0.018 ], [ "early", 0.018 ] ], "spread_patient": [ [ "infection", 0.416 ], [ "upper", 0.285 ], [ "illness", 0.027 ], [ "ear", 0.027 ], [ "idea", 0.023 ] ], "target_token": "infection", "anchor_fallback": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " infection", "observed_clinical": [ "Output \" infection\"", 0.582 ], "probe_extension": null }, "circuit_diff": { "shared_features": 935, "unique_to_a": 218, "unique_to_b": 315 }, "clinical_mass": { "clinical": 0.378, "patient": 0.3609 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260715T132350Z/index_43.html" }, { "index": 880, "batch": "pairs_20260715T132350Z", "batch_index": 44, "clinical_prompt": "I've been experiencing polyuria, so I should probably get my", "patient_prompt": "I've been peeing way too often these days, so I should probably get my", "intended_target": "glucose", "rationale": "Lay symptom description versus clinical term for frequent urination; 'glucose' testing is more clinically salient after polyuria (suggesting diabetes) than after colloquial phrasing.", "patient_term": "peeing way too often", "clinical_term": "experiencing polyuria", "topic": "Hormones & metabolism", "topics": [ "Infections & fever", "Kidneys & urinary", "Reproductive & sexual health", "Hormones & metabolism", "Eyes ears & mouth" ], "models": { "gemma-2-2b": { "prob_clinical": 0.065, "prob_patient": null, "language_penalty": null, "anchor_fallback": false, "top_clinical": [ "blood", 0.256 ], "top_patient": [ "bladder", 0.208 ], "spread_clinical": [ [ "blood", 0.256 ], [ "urine", 0.137 ], [ "kidneys", 0.094 ], [ "glucose", 0.065 ], [ "thyroid", 0.031 ] ], "spread_patient": [ [ "bladder", 0.208 ], [ "urine", 0.087 ], [ "prostate", 0.077 ], [ "kidneys", 0.06 ], [ "doctor", 0.06 ] ], "target_token": "glucose", "flipped": true, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " glucose", "observed_clinical": [ "Output \" glucose\"", 0.065 ], "probe_extension": null }, "circuit_diff": { "shared_features": 604, "unique_to_a": 868, "unique_to_b": 906 }, "clinical_mass": { "clinical": 0.328, "patient": 0.2652 }, "urgency": { "flip_class": "uninformative", "tier_top_clinical": 2, "tier_top_patient": null, "tier_shift": null } } }, "prob_clinical": 0.065, "prob_patient": null, "language_penalty": null, "flipped": true, "top_clinical": [ "blood", 0.256 ], "top_patient": [ "bladder", 0.208 ], "spread_clinical": [ [ "blood", 0.256 ], [ "urine", 0.137 ], [ "kidneys", 0.094 ], [ "glucose", 0.065 ], [ "thyroid", 0.031 ] ], "spread_patient": [ [ "bladder", 0.208 ], [ "urine", 0.087 ], [ "prostate", 0.077 ], [ "kidneys", 0.06 ], [ "doctor", 0.06 ] ], "target_token": "glucose", "anchor_fallback": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " glucose", "observed_clinical": [ "Output \" glucose\"", 0.065 ], "probe_extension": null }, "circuit_diff": { "shared_features": 604, "unique_to_a": 868, "unique_to_b": 906 }, "clinical_mass": { "clinical": 0.328, "patient": 0.2652 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260715T132350Z/index_44.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": 2, "tier_top_patient": null, "tier_shift": null } }, { "index": 881, "batch": "pairs_20260715T132350Z", "batch_index": 45, "clinical_prompt": "I have urge incontinence and I keep rushing to the loo, so I need to see a", "patient_prompt": "My bladder's been acting up and I keep rushing to the loo, so I need to see a", "intended_target": "urologist", "rationale": "Vague lay complaint versus specific clinical diagnosis; 'urologist' is the expected specialist referral after clinical naming of urge incontinence rather than colloquial complaint.", "patient_term": "My bladder's been acting up", "clinical_term": "I have urge incontinence", "topic": "Kidneys & urinary", "topics": [ "Infections & fever", "Kidneys & urinary", "Reproductive & sexual health", "Hormones & metabolism", "Eyes ears & mouth" ], "models": { "gemma-2-2b": { "prob_clinical": 0.095, "prob_patient": 0.113, "language_penalty": 0.018000000000000002, "anchor_fallback": false, "top_clinical": [ "doctor", 0.258 ], "top_patient": [ "doctor", 0.574 ], "spread_clinical": [ [ "doctor", 0.258 ], [ "specialist", 0.122 ], [ "uro", 0.095 ], [ "consultant", 0.065 ], [ "GP", 0.065 ] ], "spread_patient": [ [ "doctor", 0.574 ], [ "uro", 0.113 ], [ "GP", 0.047 ], [ "specialist", 0.047 ], [ "doc", 0.047 ] ], "target_token": "uro", "flipped": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " urologist", "observed_clinical": [ "Output \" uro\"", 0.095 ], "probe_extension": null }, "circuit_diff": { "shared_features": 740, "unique_to_a": 605, "unique_to_b": 524 }, "clinical_mass": { "clinical": 0.4017, "patient": 0.3555 }, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.208 } } }, "prob_clinical": 0.095, "prob_patient": 0.113, "language_penalty": 0.018000000000000002, "flipped": false, "top_clinical": [ "doctor", 0.258 ], "top_patient": [ "doctor", 0.574 ], "spread_clinical": [ [ "doctor", 0.258 ], [ "specialist", 0.122 ], [ "uro", 0.095 ], [ "consultant", 0.065 ], [ "GP", 0.065 ] ], "spread_patient": [ [ "doctor", 0.574 ], [ "uro", 0.113 ], [ "GP", 0.047 ], [ "specialist", 0.047 ], [ "doc", 0.047 ] ], "target_token": "uro", "anchor_fallback": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " urologist", "observed_clinical": [ "Output \" uro\"", 0.095 ], "probe_extension": null }, "circuit_diff": { "shared_features": 740, "unique_to_a": 605, "unique_to_b": 524 }, "clinical_mass": { "clinical": 0.4017, "patient": 0.3555 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260715T132350Z/index_45.html", "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.208 } }, { "index": 882, "batch": "pairs_20260715T132350Z", "batch_index": 46, "clinical_prompt": "I've been having symptoms of vulvovaginitis, so I might need to pick up some", "patient_prompt": "I've been having some itching and burning down there, so I might need to pick up some", "intended_target": "cream", "rationale": "Euphemistic symptom description versus clinical diagnosis name; 'cream' (antifungal or antibiotic topical) is a more predictable treatment after the specific clinical term.", "patient_term": "itching and burning down there", "clinical_term": "symptoms of vulvovaginitis", "topic": "Reproductive & sexual health", "topics": [ "Infections & fever", "Kidneys & urinary", "Reproductive & sexual health", "Hormones & metabolism", "Eyes ears & mouth" ], "models": { "gemma-2-2b": { "prob_clinical": 0.034, "prob_patient": 0.07, "language_penalty": 0.036000000000000004, "anchor_fallback": false, "top_clinical": [ "Mon", 0.082 ], "top_patient": [ "more", 0.08 ], "spread_clinical": [ [ "Mon", 0.082 ], [ "antibiotics", 0.044 ], [ "of", 0.044 ], [ "vaginal", 0.034 ], [ "cream", 0.034 ] ], "spread_patient": [ [ "more", 0.08 ], [ "cream", 0.07 ], [ "hydro", 0.07 ], [ "of", 0.055 ], [ "new", 0.038 ] ], "target_token": "cream", "flipped": true, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " cream", "observed_clinical": [ "Output \" cream\"", 0.034 ], "probe_extension": null }, "circuit_diff": { "shared_features": 880, "unique_to_a": 569, "unique_to_b": 578 }, "clinical_mass": { "clinical": 0.4223, "patient": 0.3212 }, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } } }, "prob_clinical": 0.034, "prob_patient": 0.07, "language_penalty": 0.036000000000000004, "flipped": true, "top_clinical": [ "Mon", 0.082 ], "top_patient": [ "more", 0.08 ], "spread_clinical": [ [ "Mon", 0.082 ], [ "antibiotics", 0.044 ], [ "of", 0.044 ], [ "vaginal", 0.034 ], [ "cream", 0.034 ] ], "spread_patient": [ [ "more", 0.08 ], [ "cream", 0.07 ], [ "hydro", 0.07 ], [ "of", 0.055 ], [ "new", 0.038 ] ], "target_token": "cream", "anchor_fallback": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " cream", "observed_clinical": [ "Output \" cream\"", 0.034 ], "probe_extension": null }, "circuit_diff": { "shared_features": 880, "unique_to_a": 569, "unique_to_b": 578 }, "clinical_mass": { "clinical": 0.4223, "patient": 0.3212 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260715T132350Z/index_46.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, { "index": 883, "batch": "pairs_20260715T132350Z", "batch_index": 47, "clinical_prompt": "I think I've got acute gastroenteritis from travelling, so I might need to take an", "patient_prompt": "I think I've picked up some stomach bug while travelling, so I might need to take an", "intended_target": "antibiotic", "rationale": "Lay term for infectious diarrheal illness versus clinical diagnosis; 'antibiotic' becomes a plausible continuation after clinical naming of acute gastroenteritis, reflecting potential bacterial etiology.", "patient_term": "stomach bug", "clinical_term": "acute gastroenteritis", "topic": "Infections & fever", "topics": [ "Infections & fever", "Kidneys & urinary", "Reproductive & sexual health", "Hormones & metabolism", "Eyes ears & mouth" ], "models": { "gemma-2-2b": { "prob_clinical": 0.233, "prob_patient": 0.093, "language_penalty": -0.14, "anchor_fallback": false, "top_clinical": [ "antibiotic", 0.233 ], "top_patient": [ "extra", 0.254 ], "spread_clinical": [ [ "antibiotic", 0.233 ], [ "anti", 0.125 ], [ "extra", 0.086 ], [ "early", 0.052 ], [ "extended", 0.041 ] ], "spread_patient": [ [ "extra", 0.254 ], [ "early", 0.12 ], [ "antibiotic", 0.093 ], [ "anti", 0.072 ], [ "extended", 0.064 ] ], "target_token": "antibiotic", "flipped": true, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " antibiotic", "observed_clinical": [ "Output \" antibiotic\"", 0.233 ], "probe_extension": null }, "circuit_diff": { "shared_features": 824, "unique_to_a": 466, "unique_to_b": 495 }, "clinical_mass": { "clinical": 0.3157, "patient": 0.2618 }, "html": "modes/simulated/pairs_20260715T132350Z/index_47.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": 2, "tier_top_patient": null, "tier_shift": null } } }, "prob_clinical": 0.233, "prob_patient": 0.093, "language_penalty": -0.14, "flipped": true, "top_clinical": [ "antibiotic", 0.233 ], "top_patient": [ "extra", 0.254 ], "spread_clinical": [ [ "antibiotic", 0.233 ], [ "anti", 0.125 ], [ "extra", 0.086 ], [ "early", 0.052 ], [ "extended", 0.041 ] ], "spread_patient": [ [ "extra", 0.254 ], [ "early", 0.12 ], [ "antibiotic", 0.093 ], [ "anti", 0.072 ], [ "extended", 0.064 ] ], "target_token": "antibiotic", "anchor_fallback": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " antibiotic", "observed_clinical": [ "Output \" antibiotic\"", 0.233 ], "probe_extension": null }, "circuit_diff": { "shared_features": 824, "unique_to_a": 466, "unique_to_b": 495 }, "clinical_mass": { "clinical": 0.3157, "patient": 0.2618 }, "html": "modes/simulated/pairs_20260715T132350Z/index_47.html", "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260715T132350Z/index_47.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": 2, "tier_top_patient": null, "tier_shift": null } }, { "index": 884, "batch": "pairs_20260715T132350Z", "batch_index": 48, "clinical_prompt": "I've been feeling really under the weather with an infection, so I might need to take an", "patient_prompt": "I've been feeling really under the weather with a high fever, so I might need to take an", "intended_target": "antibiotic", "rationale": "Swaps a symptom descriptor for the underlying condition, shifting expected treatment from fever reduction to pathogen-targeting therapy. The frame 'take an' strongly predicts a medication name, with antibiotic being the natural clinical continuation.", "patient_term": "high fever", "clinical_term": "infection", "topic": "Infections & fever", "topics": [ "Infections & fever", "Kidneys & urinary", "Reproductive & sexual health", "Hormones & metabolism", "Eyes ears & mouth" ], "models": { "gemma-2-2b": { "prob_clinical": null, "prob_patient": null, "language_penalty": null, "anchor_fallback": false, "top_clinical": [ "extended", 0.523 ], "top_patient": null, "spread_clinical": [ [ "extended", 0.523 ], [ "indefinite", 0.149 ], [ "early", 0.049 ], [ "extra", 0.049 ], [ "absence", 0.029 ] ], "spread_patient": [], "target_token": null, "flipped": false, "screening": { "status": "screened_out", "min_prob": 0.02, "intended_target": " antibiotic", "observed_clinical": null, "probe_extension": null, "reason": "intended target not in the traced clinical spread" }, "circuit_diff": null, "clinical_mass": { "clinical": 0.1476 } } }, "prob_clinical": null, "prob_patient": null, "language_penalty": null, "flipped": false, "top_clinical": [ "extended", 0.523 ], "top_patient": null, "spread_clinical": [ [ "extended", 0.523 ], [ "indefinite", 0.149 ], [ "early", 0.049 ], [ "extra", 0.049 ], [ "absence", 0.029 ] ], "spread_patient": [], "target_token": null, "anchor_fallback": false, "screening": { "status": "screened_out", "min_prob": 0.02, "intended_target": " antibiotic", "observed_clinical": null, "probe_extension": null, "reason": "intended target not in the traced clinical spread" }, "circuit_diff": null, "clinical_mass": { "clinical": 0.1476 } }, { "index": 885, "batch": "pairs_20260715T132350Z", "batch_index": 49, "clinical_prompt": "I have erectile dysfunction, so my partner thinks I should see a", "patient_prompt": "Things haven't been working right down there, so my partner thinks I should see a", "intended_target": "urologist", "rationale": "Moves from euphemistic colloquialism to precise medical terminology, which triggers specialist-seeking behavior. The frame 'see a' funnels toward a professional title; urologist is the clinical equivalent.", "patient_term": "Things haven't been working right down there", "clinical_term": "erectile dysfunction", "topic": "Reproductive & sexual health", "topics": [ "Infections & fever", "Kidneys & urinary", "Reproductive & sexual health", "Hormones & metabolism", "Eyes ears & mouth" ], "models": { "gemma-2-2b": { "prob_clinical": 0.116, "prob_patient": 0.062, "language_penalty": -0.054000000000000006, "anchor_fallback": false, "top_clinical": [ "doctor", 0.316 ], "top_patient": [ "doctor", 0.354 ], "spread_clinical": [ [ "doctor", 0.316 ], [ "therapist", 0.169 ], [ "uro", 0.116 ], [ "sex", 0.103 ], [ "specialist", 0.07 ] ], "spread_patient": [ [ "doctor", 0.354 ], [ "specialist", 0.115 ], [ "uro", 0.062 ], [ "gyne", 0.037 ], [ "therapist", 0.033 ] ], "target_token": "uro", "flipped": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " urologist", "observed_clinical": [ "Output \" uro\"", 0.116 ], "probe_extension": null }, "circuit_diff": { "shared_features": 496, "unique_to_a": 743, "unique_to_b": 833 }, "clinical_mass": { "clinical": 0.3613, "patient": 0.2321 }, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.136 } } }, "prob_clinical": 0.116, "prob_patient": 0.062, "language_penalty": -0.054000000000000006, "flipped": false, "top_clinical": [ "doctor", 0.316 ], "top_patient": [ "doctor", 0.354 ], "spread_clinical": [ [ "doctor", 0.316 ], [ "therapist", 0.169 ], [ "uro", 0.116 ], [ "sex", 0.103 ], [ "specialist", 0.07 ] ], "spread_patient": [ [ "doctor", 0.354 ], [ "specialist", 0.115 ], [ "uro", 0.062 ], [ "gyne", 0.037 ], [ "therapist", 0.033 ] ], "target_token": "uro", "anchor_fallback": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " urologist", "observed_clinical": [ "Output \" uro\"", 0.116 ], "probe_extension": null }, "circuit_diff": { "shared_features": 496, "unique_to_a": 743, "unique_to_b": 833 }, "clinical_mass": { "clinical": 0.3613, "patient": 0.2321 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260715T132350Z/index_49.html", "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.136 } }, { "index": 886, "batch": "pairs_20260715T132350Z", "batch_index": 50, "clinical_prompt": "I have conjunctivitis, so I might need to pick up some", "patient_prompt": "My eye's been all red and crusty in the morning, so I might need to pick up some", "intended_target": "eyedrops", "rationale": "Symptom description versus diagnosis name; clinical term triggers treatment-seeking and specific medication type. 'Pick up some' grammatically predicts a medication or topical remedy.", "patient_term": "all red and crusty", "clinical_term": "conjunctivitis", "topic": "Eyes ears & mouth", "topics": [ "Infections & fever", "Kidneys & urinary", "Reproductive & sexual health", "Hormones & metabolism", "Eyes ears & mouth" ], "models": { "gemma-2-2b": { "prob_clinical": 0.23, "prob_patient": 0.271, "language_penalty": 0.04100000000000001, "anchor_fallback": false, "top_clinical": [ "eye", 0.23 ], "top_patient": [ "eye", 0.271 ], "spread_clinical": [ [ "eye", 0.23 ], [ "drops", 0.123 ], [ "antibiotics", 0.066 ], [ "of", 0.058 ], [ "antibiotic", 0.045 ] ], "spread_patient": [ [ "eye", 0.271 ], [ "drops", 0.078 ], [ "new", 0.061 ], [ "of", 0.061 ], [ "more", 0.037 ] ], "target_token": "eye", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 632, "unique_to_a": 588, "unique_to_b": 726 }, "clinical_mass": { "clinical": 0.344, "patient": 0.2849 } } }, "prob_clinical": 0.23, "prob_patient": 0.271, "language_penalty": 0.04100000000000001, "flipped": false, "top_clinical": [ "eye", 0.23 ], "top_patient": [ "eye", 0.271 ], "spread_clinical": [ [ "eye", 0.23 ], [ "drops", 0.123 ], [ "antibiotics", 0.066 ], [ "of", 0.058 ], [ "antibiotic", 0.045 ] ], "spread_patient": [ [ "eye", 0.271 ], [ "drops", 0.078 ], [ "new", 0.061 ], [ "of", 0.061 ], [ "more", 0.037 ] ], "target_token": "eye", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 632, "unique_to_a": 588, "unique_to_b": 726 }, "clinical_mass": { "clinical": 0.344, "patient": 0.2849 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260715T132350Z/index_50.html" }, { "index": 887, "batch": "pairs_20260715T132350Z", "batch_index": 51, "clinical_prompt": "I've been getting terrible pressure headaches and I have serous otitis media, so this might be my", "patient_prompt": "I've been getting terrible pressure headaches and my ears keep popping, so this might be my", "intended_target": "sinusitis", "rationale": "Colloquial symptom replaced with precise otological diagnosis, shifting from vague self-assessment to recognition of related inflammatory conditions. 'This might be my' precedes condition names naturally in medical reasoning.", "patient_term": "my ears keep popping", "clinical_term": "serous otitis media", "topic": "Eyes ears & mouth", "topics": [ "Infections & fever", "Kidneys & urinary", "Reproductive & sexual health", "Hormones & metabolism", "Eyes ears & mouth" ], "models": { "gemma-2-2b": { "prob_clinical": null, "prob_patient": null, "language_penalty": null, "anchor_fallback": false, "top_clinical": [ "problem", 0.183 ], "top_patient": null, "spread_clinical": [ [ "problem", 0.183 ], [ "ears", 0.086 ], [ "ear", 0.059 ], [ "issue", 0.052 ], [ "solution", 0.046 ] ], "spread_patient": [], "target_token": null, "flipped": false, "screening": { "status": "screened_out", "min_prob": 0.02, "intended_target": " sinusitis", "observed_clinical": null, "probe_extension": null, "reason": "intended target not in the traced clinical spread" }, "circuit_diff": null, "clinical_mass": { "clinical": 0.2659 }, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": 1, "tier_shift": null } } }, "prob_clinical": null, "prob_patient": null, "language_penalty": null, "flipped": false, "top_clinical": [ "problem", 0.183 ], "top_patient": null, "spread_clinical": [ [ "problem", 0.183 ], [ "ears", 0.086 ], [ "ear", 0.059 ], [ "issue", 0.052 ], [ "solution", 0.046 ] ], "spread_patient": [], "target_token": null, "anchor_fallback": false, "screening": { "status": "screened_out", "min_prob": 0.02, "intended_target": " sinusitis", "observed_clinical": null, "probe_extension": null, "reason": "intended target not in the traced clinical spread" }, "circuit_diff": null, "clinical_mass": { "clinical": 0.2659 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260715T132350Z/index_51.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": 1, "tier_shift": null } }, { "index": 888, "batch": "pairs_20260715T132350Z", "batch_index": 52, "clinical_prompt": "I have a viral infection, so I might need to take an", "patient_prompt": "I've been feeling all achy and feverish, so I might need to take an", "intended_target": "antiviral", "rationale": "Patient uses lay symptom description; clinical term triggers medication class expectation. Frame grammar funnels toward single remedy class.", "patient_term": "all achy and feverish", "clinical_term": "viral infection", "topic": "Infections & fever", "topics": [ "Infections & fever", "Kidneys & urinary", "Reproductive & sexual health", "Hormones & metabolism", "Eyes ears & mouth" ], "models": { "gemma-2-2b": { "prob_clinical": 0.115, "prob_patient": null, "language_penalty": null, "anchor_fallback": false, "top_clinical": [ "antibiotic", 0.582 ], "top_patient": [ "extra", 0.217 ], "spread_clinical": [ [ "antibiotic", 0.582 ], [ "antiviral", 0.115 ], [ "anti", 0.102 ], [ "oral", 0.029 ], [ "antibiotics", 0.029 ] ], "spread_patient": [ [ "extra", 0.217 ], [ "early", 0.169 ], [ "afternoon", 0.132 ], [ "extended", 0.08 ], [ "aspirin", 0.038 ] ], "target_token": "antiviral", "flipped": true, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " antiviral", "observed_clinical": [ "Output \" antiviral\"", 0.115 ], "probe_extension": null }, "circuit_diff": { 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"clinical_mass": { "clinical": 0.4262, "patient": 0.2155 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260715T132350Z/index_52.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": 2, "tier_top_patient": null, "tier_shift": null } }, { "index": 889, "batch": "pairs_20260715T132350Z", "batch_index": 53, "clinical_prompt": "My urine is turbid, so I probably have a", "patient_prompt": "My wee's been coming out cloudy, so I probably have a", "intended_target": "urinary", "rationale": "Colloquial 'wee' and lay descriptor 'cloudy' versus clinical 'urine' and medical term 'turbid' shift toward diagnostic condition framing.", "patient_term": "wee's been coming out cloudy", "clinical_term": "urine is turbid", "topic": "Kidneys & urinary", "topics": [ "Infections & fever", "Kidneys & urinary", "Reproductive & sexual health", "Hormones & metabolism", "Eyes ears & mouth" ], "models": { "gemma-2-2b": { "prob_clinical": 0.283, "prob_patient": null, "language_penalty": null, "anchor_fallback": false, "top_clinical": [ "UTI", 0.32 ], "top_patient": [ "UTI", 0.271 ], "spread_clinical": [ [ "UTI", 0.32 ], [ "urinary", 0.283 ], [ "kidney", 0.081 ], [ "bladder", 0.081 ], [ "bacterial", 0.056 ] ], "spread_patient": [ [ "UTI", 0.271 ], [ "bladder", 0.061 ], [ "bit", 0.061 ], [ "yeast", 0.053 ], [ "cold", 0.042 ] ], "target_token": "urinary", "flipped": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " urinary", "observed_clinical": [ "Output \" urinary\"", 0.283 ], "probe_extension": null }, "circuit_diff": { "shared_features": 618, "unique_to_a": 593, "unique_to_b": 860 }, "clinical_mass": { "clinical": 0.4041, "patient": 0.3001 } } }, "prob_clinical": 0.283, "prob_patient": null, "language_penalty": null, "flipped": false, "top_clinical": [ "UTI", 0.32 ], "top_patient": [ "UTI", 0.271 ], "spread_clinical": [ [ "UTI", 0.32 ], [ "urinary", 0.283 ], [ "kidney", 0.081 ], [ "bladder", 0.081 ], [ "bacterial", 0.056 ] ], "spread_patient": [ [ "UTI", 0.271 ], [ "bladder", 0.061 ], [ "bit", 0.061 ], [ "yeast", 0.053 ], [ "cold", 0.042 ] ], "target_token": "urinary", "anchor_fallback": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " urinary", "observed_clinical": [ "Output \" urinary\"", 0.283 ], "probe_extension": null }, "circuit_diff": { "shared_features": 618, "unique_to_a": 593, "unique_to_b": 860 }, "clinical_mass": { "clinical": 0.4041, "patient": 0.3001 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260715T132350Z/index_53.html" }, { "index": 890, "batch": "pairs_20260715T132350Z", "batch_index": 54, "clinical_prompt": "I have erectile dysfunction, so I should probably talk to my", "patient_prompt": "I've been having trouble in the bedroom lately, so I should probably talk to my", "intended_target": "doctor", "rationale": "Euphemistic patient phrasing versus clinical diagnosis shifts conversational partner expectation from general to medical professional.", "patient_term": "trouble in the bedroom", "clinical_term": "erectile dysfunction", "topic": "Reproductive & sexual health", "topics": [ "Infections & fever", "Kidneys & urinary", "Reproductive & sexual health", "Hormones & metabolism", "Eyes ears & mouth" ], "models": { "gemma-2-2b": { "prob_clinical": 0.73, "prob_patient": 0.434, "language_penalty": -0.296, "anchor_fallback": false, "top_clinical": [ "doctor", 0.73 ], "top_patient": [ "doctor", 0.434 ], "spread_clinical": [ [ "doctor", 0.73 ], [ "wife", 0.028 ], [ "doc", 0.028 ], [ "uro", 0.025 ], [ "GP", 0.022 ] ], "spread_patient": [ [ "doctor", 0.434 ], [ "wife", 0.141 ], [ "therapist", 0.11 ], [ "partner", 0.031 ], [ "husband", 0.028 ] ], "target_token": "doctor", "flipped": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " doctor", "observed_clinical": [ "Output \" doctor\"", 0.73 ], "probe_extension": null }, "circuit_diff": { "shared_features": 552, "unique_to_a": 504, "unique_to_b": 713 }, "clinical_mass": { "clinical": 0.3244, "patient": 0.1955 }, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.25 } } }, "prob_clinical": 0.73, "prob_patient": 0.434, "language_penalty": -0.296, "flipped": false, "top_clinical": [ "doctor", 0.73 ], "top_patient": [ "doctor", 0.434 ], "spread_clinical": [ [ "doctor", 0.73 ], [ "wife", 0.028 ], [ "doc", 0.028 ], [ "uro", 0.025 ], [ "GP", 0.022 ] ], "spread_patient": [ [ "doctor", 0.434 ], [ "wife", 0.141 ], [ "therapist", 0.11 ], [ "partner", 0.031 ], [ "husband", 0.028 ] ], "target_token": "doctor", "anchor_fallback": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " doctor", "observed_clinical": [ "Output \" doctor\"", 0.73 ], "probe_extension": null }, "circuit_diff": { "shared_features": 552, "unique_to_a": 504, "unique_to_b": 713 }, "clinical_mass": { "clinical": 0.3244, "patient": 0.1955 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260715T132350Z/index_54.html", "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.25 } }, { "index": 891, "batch": "pairs_20260715T132350Z", "batch_index": 55, "clinical_prompt": "I have metabolic syndrome, so I need to check my", "patient_prompt": "My body's been all out of whack with weight changes, so I need to check my", "intended_target": "glucose", "rationale": "Lay complaint versus named metabolic condition prompts medical measurement rather than lifestyle adjustment.", "patient_term": "all out of whack with weight changes", "clinical_term": "metabolic syndrome", "topic": "Hormones & metabolism", "topics": [ "Infections & fever", "Kidneys & urinary", "Reproductive & sexual health", "Hormones & metabolism", "Eyes ears & mouth" ], "models": { "gemma-2-2b": { "prob_clinical": 0.048, "prob_patient": null, "language_penalty": null, "anchor_fallback": false, "top_clinical": [ "blood", 0.457 ], "top_patient": [ "blood", 0.185 ], "spread_clinical": [ [ "blood", 0.457 ], [ "cholesterol", 0.116 ], [ "sugar", 0.07 ], [ "fasting", 0.054 ], [ "glucose", 0.048 ] ], "spread_patient": [ [ "blood", 0.185 ], [ "weight", 0.127 ], [ "body", 0.041 ], [ "BMI", 0.032 ], [ "diet", 0.028 ] ], "target_token": "glucose", "flipped": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " glucose", "observed_clinical": [ "Output \" glucose\"", 0.048 ], "probe_extension": null }, "circuit_diff": { "shared_features": 438, "unique_to_a": 845, "unique_to_b": 906 }, "clinical_mass": { "clinical": 0.3722, "patient": 0.2103 }, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": 0.003 } } }, "prob_clinical": 0.048, "prob_patient": null, "language_penalty": null, "flipped": false, "top_clinical": [ "blood", 0.457 ], "top_patient": [ "blood", 0.185 ], "spread_clinical": [ [ "blood", 0.457 ], [ "cholesterol", 0.116 ], [ "sugar", 0.07 ], [ "fasting", 0.054 ], [ "glucose", 0.048 ] ], "spread_patient": [ [ "blood", 0.185 ], [ "weight", 0.127 ], [ "body", 0.041 ], [ "BMI", 0.032 ], [ "diet", 0.028 ] ], "target_token": "glucose", "anchor_fallback": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " glucose", "observed_clinical": [ "Output \" glucose\"", 0.048 ], "probe_extension": null }, "circuit_diff": { "shared_features": 438, "unique_to_a": 845, "unique_to_b": 906 }, "clinical_mass": { "clinical": 0.3722, "patient": 0.2103 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260715T132350Z/index_55.html", "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": 0.003 } }, { "index": 892, "batch": "pairs_20260715T132350Z", "batch_index": 56, "clinical_prompt": "I have conjunctivitis, so I should pick up some", "patient_prompt": "My eye's been all gummy and stuck shut in the morning, so I should pick up some", "intended_target": "drops", "rationale": "Descriptive lay symptom versus clinical diagnosis triggers medication form expectation aligned with treatment pathway.", "patient_term": "gummy and stuck shut", "clinical_term": "conjunctivitis", "topic": "Eyes ears & mouth", "topics": [ "Infections & fever", "Kidneys & urinary", "Reproductive & sexual health", "Hormones & metabolism", "Eyes ears & mouth" ], "models": { "gemma-2-2b": { "prob_clinical": 0.16, "prob_patient": 0.095, "language_penalty": -0.065, "anchor_fallback": false, "top_clinical": [ "eye", 0.233 ], "top_patient": [ "eye", 0.293 ], "spread_clinical": [ [ "eye", 0.233 ], [ "drops", 0.16 ], [ "antibiotics", 0.076 ], [ "antibiotic", 0.076 ], [ "of", 0.059 ] ], "spread_patient": [ [ "eye", 0.293 ], [ "drops", 0.095 ], [ "of", 0.058 ], [ "artificial", 0.04 ], [ "new", 0.04 ] ], "target_token": "drops", "flipped": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " drops", "observed_clinical": [ "Output \" drops\"", 0.16 ], "probe_extension": null }, "circuit_diff": { "shared_features": 564, "unique_to_a": 615, "unique_to_b": 775 }, "clinical_mass": { "clinical": 0.3708, "patient": 0.2521 } } }, "prob_clinical": 0.16, "prob_patient": 0.095, "language_penalty": -0.065, "flipped": false, "top_clinical": [ "eye", 0.233 ], "top_patient": [ "eye", 0.293 ], "spread_clinical": [ [ "eye", 0.233 ], [ "drops", 0.16 ], [ "antibiotics", 0.076 ], [ "antibiotic", 0.076 ], [ "of", 0.059 ] ], "spread_patient": [ [ "eye", 0.293 ], [ "drops", 0.095 ], [ "of", 0.058 ], [ "artificial", 0.04 ], [ "new", 0.04 ] ], "target_token": "drops", "anchor_fallback": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " drops", "observed_clinical": [ "Output \" drops\"", 0.16 ], "probe_extension": null }, "circuit_diff": { "shared_features": 564, "unique_to_a": 615, "unique_to_b": 775 }, "clinical_mass": { "clinical": 0.3708, "patient": 0.2521 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260715T132350Z/index_56.html" }, { "index": 893, "batch": "pairs_20260715T132350Z", "batch_index": 57, "clinical_prompt": "I have bacteremia, so this looks like my", "patient_prompt": "I've been getting chills and my temp's been creeping up, so this looks like my", "intended_target": "sepsis", "rationale": "Patient symptom cluster versus precise clinical diagnosis (blood infection) shifts severity framing and condition continuations.", "patient_term": "chills and my temp's been creeping up", "clinical_term": "bacteremia", "topic": "Infections & fever", "topics": [ "Infections & fever", "Kidneys & urinary", "Reproductive & sexual health", "Hormones & metabolism", "Eyes ears & mouth" ], "models": { "gemma-2-2b": { "prob_clinical": null, "prob_patient": null, "language_penalty": null, "anchor_fallback": false, "top_clinical": [ "kind", 0.108 ], "top_patient": null, "spread_clinical": [ [ "kind", 0.108 ], [ "best", 0.108 ], [ "next", 0.045 ], [ "future", 0.045 ], [ "new", 0.045 ] ], "spread_patient": [], "target_token": null, "flipped": false, "screening": { "status": "screened_out", "min_prob": 0.02, "intended_target": " sepsis", "observed_clinical": null, "probe_extension": null, "reason": "intended target not in the traced clinical spread" }, "circuit_diff": null, "clinical_mass": { "clinical": 0.2001 }, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } } }, "prob_clinical": null, "prob_patient": null, "language_penalty": null, "flipped": false, "top_clinical": [ "kind", 0.108 ], "top_patient": null, "spread_clinical": [ [ "kind", 0.108 ], [ "best", 0.108 ], [ "next", 0.045 ], [ "future", 0.045 ], [ "new", 0.045 ] ], "spread_patient": [], "target_token": null, "anchor_fallback": false, "screening": { "status": "screened_out", "min_prob": 0.02, "intended_target": " sepsis", "observed_clinical": null, "probe_extension": null, "reason": "intended target not in the traced clinical spread" }, "circuit_diff": null, "clinical_mass": { "clinical": 0.2001 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260715T132350Z/index_57.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, { "index": 894, "batch": "pairs_20260715T132350Z", "batch_index": 58, "clinical_prompt": "I have dysuria, so I need to see a", "patient_prompt": "My wee's been burning when it comes out, so I need to see a", "intended_target": "urologist", "rationale": "Colloquial symptom description triggers generic doctor; clinical term (painful urination) strongly suggests urologic specialist.", "patient_term": "burning when it comes out", "clinical_term": "dysuria", "topic": "Kidneys & urinary", "topics": [ "Infections & fever", "Kidneys & urinary", "Reproductive & sexual health", "Hormones & metabolism", "Eyes ears & mouth" ], "models": { "gemma-2-2b": { "prob_clinical": 0.418, "prob_patient": null, "language_penalty": null, "anchor_fallback": false, "top_clinical": [ "uro", 0.418 ], "top_patient": [ "doctor", 0.406 ], "spread_clinical": [ [ "uro", 0.418 ], [ "doctor", 0.254 ], [ "specialist", 0.073 ], [ "Uro", 0.064 ], [ "doc", 0.03 ] ], "spread_patient": [ [ "doctor", 0.406 ], [ "doc", 0.132 ], [ "GP", 0.091 ], [ "Dr", 0.091 ], [ "dr", 0.062 ] ], "target_token": "uro", "flipped": true, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " urologist", "observed_clinical": [ "Output \" uro\"", 0.418 ], "probe_extension": null }, "circuit_diff": { "shared_features": 449, "unique_to_a": 825, "unique_to_b": 910 }, "clinical_mass": { "clinical": 0.4573, "patient": 0.3115 }, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": 2, "tier_shift": -0.204 } } }, "prob_clinical": 0.418, "prob_patient": null, "language_penalty": null, "flipped": true, "top_clinical": [ "uro", 0.418 ], "top_patient": [ "doctor", 0.406 ], "spread_clinical": [ [ "uro", 0.418 ], [ "doctor", 0.254 ], [ "specialist", 0.073 ], [ "Uro", 0.064 ], [ "doc", 0.03 ] ], "spread_patient": [ [ "doctor", 0.406 ], [ "doc", 0.132 ], [ "GP", 0.091 ], [ "Dr", 0.091 ], [ "dr", 0.062 ] ], "target_token": "uro", "anchor_fallback": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " urologist", "observed_clinical": [ "Output \" uro\"", 0.418 ], "probe_extension": null }, "circuit_diff": { "shared_features": 449, "unique_to_a": 825, "unique_to_b": 910 }, "clinical_mass": { "clinical": 0.4573, "patient": 0.3115 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260715T132350Z/index_58.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": 2, "tier_shift": -0.204 } }, { "index": 895, "batch": "pairs_20260715T132350Z", "batch_index": 59, "clinical_prompt": "I am amenorrheic, so I should probably take a", "patient_prompt": "I've missed my cycle for weeks now, so I should probably take a", "intended_target": "pregnancy", "rationale": "Colloquial phrasing of missed period is ambiguous; clinical term (absence of menstruation) immediately triggers pregnancy-test expectation.", "patient_term": "missed my cycle", "clinical_term": "amenorrheic", "topic": "Reproductive & sexual health", "topics": [ "Infections & fever", "Kidneys & urinary", "Reproductive & sexual health", "Hormones & metabolism", "Eyes ears & mouth" ], "models": { "gemma-2-2b": { "prob_clinical": 0.119, "prob_patient": 0.484, "language_penalty": 0.365, "anchor_fallback": false, "top_clinical": [ "pregnancy", 0.119 ], "top_patient": [ "pregnancy", 0.484 ], "spread_clinical": [ [ "pregnancy", 0.119 ], [ "pill", 0.092 ], [ "break", 0.082 ], [ "test", 0.072 ], [ "look", 0.056 ] ], "spread_patient": [ [ "pregnancy", 0.484 ], [ "test", 0.428 ], [ "home", 0.035 ] ], "target_token": "pregnancy", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 473, "unique_to_a": 945, "unique_to_b": 680 }, "clinical_mass": { "clinical": 0.3096, "patient": 0.2693 }, "urgency": { "flip_class": null, "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": 1.041 } } }, "prob_clinical": 0.119, "prob_patient": 0.484, "language_penalty": 0.365, "flipped": false, "top_clinical": [ "pregnancy", 0.119 ], "top_patient": [ "pregnancy", 0.484 ], "spread_clinical": [ [ "pregnancy", 0.119 ], [ "pill", 0.092 ], [ "break", 0.082 ], [ "test", 0.072 ], [ "look", 0.056 ] ], "spread_patient": [ [ "pregnancy", 0.484 ], [ "test", 0.428 ], [ "home", 0.035 ] ], "target_token": "pregnancy", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 473, "unique_to_a": 945, "unique_to_b": 680 }, "clinical_mass": { "clinical": 0.3096, "patient": 0.2693 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260715T132350Z/index_59.html", "urgency": { "flip_class": null, "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": 1.041 } }, { "index": 896, "batch": "pairs_20260715T132350Z", "batch_index": 60, "clinical_prompt": "I have central obesity despite stable caloric intake, so I should check my", "patient_prompt": "I've been gaining fat around my middle even though I'm not eating more, so I should check my", "intended_target": "glucose", "rationale": "Lay description of weight distribution is vague; clinical term explicitly signals metabolic dysfunction, steering toward metabolic marker testing.", "patient_term": "gaining fat around my middle", "clinical_term": "central obesity", "topic": "Hormones & metabolism", "topics": [ "Infections & fever", "Kidneys & urinary", "Reproductive & sexual health", "Hormones & metabolism", "Eyes ears & mouth" ], "models": { "gemma-2-2b": { "prob_clinical": 0.143, "prob_patient": 0.102, "language_penalty": -0.040999999999999995, "anchor_fallback": true, "top_clinical": [ "thyroid", 0.143 ], "top_patient": [ "thyroid", 0.102 ], "spread_clinical": [ [ "thyroid", 0.143 ], [ "insulin", 0.098 ], [ "blood", 0.059 ], [ "lept", 0.052 ], [ "testosterone", 0.046 ] ], "spread_patient": [ [ "thyroid", 0.102 ], [ "diet", 0.07 ], [ "metabolism", 0.062 ], [ "insulin", 0.062 ], [ "hormones", 0.055 ] ], "target_token": "thyroid", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 556, "unique_to_a": 804, "unique_to_b": 836 }, "clinical_mass": { "clinical": 0.3364, "patient": 0.2438 } } }, "prob_clinical": 0.143, "prob_patient": 0.102, "language_penalty": -0.040999999999999995, "flipped": false, "top_clinical": [ "thyroid", 0.143 ], "top_patient": [ "thyroid", 0.102 ], "spread_clinical": [ [ "thyroid", 0.143 ], [ "insulin", 0.098 ], [ "blood", 0.059 ], [ "lept", 0.052 ], [ "testosterone", 0.046 ] ], "spread_patient": [ [ "thyroid", 0.102 ], [ "diet", 0.07 ], [ "metabolism", 0.062 ], [ "insulin", 0.062 ], [ "hormones", 0.055 ] ], "target_token": "thyroid", "anchor_fallback": true, "screening": null, "circuit_diff": { "shared_features": 556, "unique_to_a": 804, "unique_to_b": 836 }, "clinical_mass": { "clinical": 0.3364, "patient": 0.2438 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260715T132350Z/index_60.html" }, { "index": 897, "batch": "pairs_20260715T132350Z", "batch_index": 61, "clinical_prompt": "I have dysgeusia, so it might be my", "patient_prompt": "I've got a nasty taste in my mouth that won't go away, so it might be my", "intended_target": "medication", "rationale": "Vague colloquial complaint; clinical term (distorted taste perception) immediately triggers iatrogenic or systemic cause suspicion.", "patient_term": "nasty taste in my mouth", "clinical_term": "dysgeusia", "topic": "Eyes ears & mouth", "topics": [ "Infections & fever", "Kidneys & urinary", "Reproductive & sexual health", "Hormones & metabolism", "Eyes ears & mouth" ], "models": { "gemma-2-2b": { "prob_clinical": null, "prob_patient": null, 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"intended_target": " medication", "observed_clinical": null, "probe_extension": null, "reason": "intended target not in the traced clinical spread" }, "circuit_diff": null, "clinical_mass": { "clinical": 0.2475 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260715T132350Z/index_61.html" }, { "index": 898, "batch": "pairs_20260715T132350Z", "batch_index": 62, "clinical_prompt": "I've been getting aphthous stomatitis lately, so I might need to take my", "patient_prompt": "I've been getting a lot of mouth ulcers lately, so I might need to take my", "intended_target": "medication", "rationale": "Colloquial 'mouth ulcers' versus clinical diagnosis shifts the frame toward medical intervention rather than casual home treatment.", "patient_term": "mouth ulcers", "clinical_term": "aphthous stomatitis", "topic": "Eyes ears & mouth", "topics": [ "Infections & fever", "Kidneys & urinary", "Reproductive & sexual health", "Hormones & metabolism", "Eyes ears & mouth" ], "models": { "gemma-2-2b": { "prob_clinical": 0.063, "prob_patient": null, "language_penalty": null, "anchor_fallback": false, "top_clinical": [ "meds", 0.151 ], "top_patient": [ "vitamins", 0.186 ], "spread_clinical": [ [ "meds", 0.151 ], [ "medication", 0.063 ], [ "vitamins", 0.049 ], [ "antibiotics", 0.034 ], [ "mouth", 0.034 ] ], "spread_patient": [ [ "vitamins", 0.186 ], [ "vitamin", 0.078 ], [ "own", 0.047 ], [ "supplements", 0.042 ], [ "daily", 0.042 ] ], "target_token": "medication", "flipped": true, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " medication", "observed_clinical": [ "Output \" medication\"", 0.063 ], "probe_extension": null }, "circuit_diff": { "shared_features": 846, "unique_to_a": 614, "unique_to_b": 618 }, "clinical_mass": { "clinical": 0.3298, "patient": 0.3019 }, "urgency": { "flip_class": "lateral", "tier_top_clinical": 1, "tier_top_patient": 1, "tier_shift": 0.0 } } }, "prob_clinical": 0.063, "prob_patient": null, 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"models": { "gemma-2-2b": { "prob_clinical": null, "prob_patient": null, "language_penalty": null, "anchor_fallback": false, "top_clinical": [ "solution", 0.151 ], "top_patient": null, "spread_clinical": [ [ "solution", 0.151 ], [ "new", 0.104 ], [ "only", 0.092 ], [ "answer", 0.063 ], [ "best", 0.063 ] ], "spread_patient": [], "target_token": null, "flipped": false, "screening": { "status": "screened_out", "min_prob": 0.02, "intended_target": " thyroid", "observed_clinical": null, "probe_extension": null, "reason": "intended target not in the traced clinical spread" }, "circuit_diff": null, "clinical_mass": { "clinical": 0.1573 } } }, "prob_clinical": null, "prob_patient": null, "language_penalty": null, "flipped": false, "top_clinical": [ "solution", 0.151 ], "top_patient": null, "spread_clinical": [ [ "solution", 0.151 ], [ "new", 0.104 ], [ "only", 0.092 ], [ "answer", 0.063 ], [ "best", 0.063 ] ], "spread_patient": [], "target_token": null, "anchor_fallback": false, "screening": { "status": "screened_out", "min_prob": 0.02, "intended_target": " thyroid", "observed_clinical": null, "probe_extension": null, "reason": "intended target not in the traced clinical spread" }, "circuit_diff": null, "clinical_mass": { "clinical": 0.1573 } }, { "index": 901, "batch": "pairs_20260715T132350Z", "batch_index": 65, "clinical_prompt": "I have urethritis with discharge, so my girlfriend thinks I should take an", "patient_prompt": "There's been some funny discharge down there, so my girlfriend thinks I should take an", "intended_target": "antibiotic", "rationale": "Clinical diagnosis 'urethritis' immediately indexes toward antimicrobial treatment rather than home remedies or reassurance.", "patient_term": "funny discharge down there", "clinical_term": "urethritis with discharge", "topic": "Reproductive & sexual health", "topics": [ "Infections & fever", "Kidneys & urinary", "Reproductive & sexual health", "Hormones & metabolism", "Eyes ears & mouth" ], "models": { "gemma-2-2b": { "prob_clinical": 0.691, "prob_patient": 0.125, "language_penalty": -0.566, "anchor_fallback": false, "top_clinical": [ "antibiotic", 0.691 ], "top_patient": [ "STD", 0.338 ], "spread_clinical": [ [ "antibiotic", 0.691 ], [ "antibiotics", 0.05 ], [ "anti", 0.034 ], [ "STD", 0.034 ], [ "oral", 0.024 ] ], "spread_patient": [ [ "STD", 0.338 ], [ "antibiotic", 0.125 ], [ "HIV", 0.059 ], [ "at", 0.036 ], [ "ultrasound", 0.028 ] ], "target_token": "antibiotic", "flipped": true, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " antibiotic", "observed_clinical": [ "Output \" antibiotic\"", 0.691 ], "probe_extension": null }, "circuit_diff": { "shared_features": 594, "unique_to_a": 666, "unique_to_b": 708 }, "clinical_mass": { "clinical": 0.4172, "patient": 0.2601 }, "html": "modes/simulated/pairs_20260715T132350Z/index_65.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": 2, "tier_top_patient": null, "tier_shift": null } } }, "prob_clinical": 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medication management, whereas colloquial 'dry mouth' might lead to simpler remedies like 'water' or 'gum'.", "patient_term": "mouth's been all dry", "clinical_term": "xerostomia", "topic": "Eyes ears & mouth", "topics": [ "Infections & fever", "Kidneys & urinary", "Reproductive & sexual health", "Hormones & metabolism", "Eyes ears & mouth" ], "models": { "gemma-2-2b": { "prob_clinical": 0.068, "prob_patient": null, "language_penalty": null, "anchor_fallback": false, "top_clinical": [ "meds", 0.087 ], "top_patient": [ "vitamins", 0.132 ], "spread_clinical": [ [ "meds", 0.087 ], [ "medication", 0.068 ], [ "lip", 0.06 ], [ "mouth", 0.047 ], [ "own", 0.036 ] ], "spread_patient": [ [ "vitamins", 0.132 ], [ "meds", 0.116 ], [ "daily", 0.062 ], [ "vitamin", 0.062 ], [ "medicine", 0.043 ] ], "target_token": "medication", "flipped": true, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " medication", "observed_clinical": [ "Output \" medication\"", 0.068 ], "probe_extension": null }, "circuit_diff": { "shared_features": 653, "unique_to_a": 805, "unique_to_b": 657 }, "clinical_mass": { "clinical": 0.3616, "patient": 0.2677 }, "urgency": { "flip_class": "lateral", "tier_top_clinical": 1, "tier_top_patient": 1, "tier_shift": 0.0 } } }, "prob_clinical": 0.068, "prob_patient": null, "language_penalty": null, "flipped": true, "top_clinical": [ "meds", 0.087 ], "top_patient": [ "vitamins", 0.132 ], "spread_clinical": [ [ "meds", 0.087 ], [ "medication", 0.068 ], [ "lip", 0.06 ], [ "mouth", 0.047 ], [ "own", 0.036 ] ], "spread_patient": [ [ "vitamins", 0.132 ], [ "meds", 0.116 ], [ "daily", 0.062 ], [ "vitamin", 0.062 ], [ "medicine", 0.043 ] ], "target_token": "medication", "anchor_fallback": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " medication", "observed_clinical": [ "Output \" medication\"", 0.068 ], "probe_extension": null }, "circuit_diff": { "shared_features": 653, "unique_to_a": 805, "unique_to_b": 657 }, "clinical_mass": { "clinical": 0.3616, "patient": 0.2677 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260715T132350Z/index_67.html", "urgency": { "flip_class": "lateral", "tier_top_clinical": 1, "tier_top_patient": 1, "tier_shift": 0.0 } }, { "index": 904, "batch": "pairs_20260715T132350Z", "batch_index": 68, "clinical_prompt": "I've been experiencing hyperhidrosis at work and I'm always hot, so I might need to check my", "patient_prompt": "I've been sweating through my clothes at work and I'm always hot, so I might need to check my", "intended_target": "thyroid", "rationale": "Hyperhidrosis signals an endocrine workup including thyroid function; the colloquial version is less likely to prompt clinical investigation.", "patient_term": "sweating through my clothes at work and I'm always hot", "clinical_term": "hyperhidrosis", "topic": "Hormones & metabolism", "topics": [ "Infections & fever", "Kidneys & urinary", "Reproductive & sexual health", "Hormones & metabolism", "Eyes ears & mouth" ], "models": { "gemma-2-2b": { "prob_clinical": 0.13, "prob_patient": 0.133, "language_penalty": 0.0030000000000000027, "anchor_fallback": false, "top_clinical": [ "blood", 0.188 ], "top_patient": [ "blood", 0.192 ], "spread_clinical": [ [ "blood", 0.188 ], [ "thyroid", 0.13 ], [ "sweat", 0.061 ], [ "temperature", 0.042 ], [ "body", 0.037 ] ], "spread_patient": [ [ "blood", 0.192 ], [ "thermostat", 0.133 ], [ "thyroid", 0.133 ], [ "body", 0.049 ], [ "temperature", 0.043 ] ], "target_token": "thyroid", "flipped": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " thyroid", "observed_clinical": [ "Output \" thyroid\"", 0.13 ], "probe_extension": null }, "circuit_diff": { "shared_features": 930, "unique_to_a": 598, "unique_to_b": 564 }, "clinical_mass": { "clinical": 0.2535, "patient": 0.1751 }, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": 0.0 } } }, "prob_clinical": 0.13, "prob_patient": 0.133, "language_penalty": 0.0030000000000000027, "flipped": false, "top_clinical": [ "blood", 0.188 ], "top_patient": [ "blood", 0.192 ], "spread_clinical": [ [ "blood", 0.188 ], [ "thyroid", 0.13 ], [ "sweat", 0.061 ], [ "temperature", 0.042 ], [ "body", 0.037 ] ], "spread_patient": [ [ "blood", 0.192 ], [ "thermostat", 0.133 ], [ "thyroid", 0.133 ], [ "body", 0.049 ], [ "temperature", 0.043 ] ], "target_token": "thyroid", "anchor_fallback": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " thyroid", "observed_clinical": [ "Output \" thyroid\"", 0.13 ], "probe_extension": null }, "circuit_diff": { "shared_features": 930, "unique_to_a": 598, "unique_to_b": 564 }, "clinical_mass": { "clinical": 0.2535, "patient": 0.1751 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260715T132350Z/index_68.html", "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": 0.0 } }, { "index": 905, "batch": "pairs_20260715T132350Z", "batch_index": 69, "clinical_prompt": "I have dysuria with urinary urgency, so I need to take an", "patient_prompt": "My wee's been really painful and I've got this burning sensation, so I need to take an", "intended_target": "antibiotic", "rationale": "Dysuria with urgency clinically indicates infection requiring antibiotics; the colloquial phrasing might prompt home remedies or hydration instead.", "patient_term": "wee's been really painful and I've got this burning sensation", "clinical_term": "dysuria with urinary urgency", "topic": "Kidneys & urinary", "topics": [ "Infections & fever", "Kidneys & urinary", "Reproductive & sexual health", "Hormones & metabolism", "Eyes ears & mouth" ], "models": { "gemma-2-2b": { "prob_clinical": 0.222, "prob_patient": 0.215, "language_penalty": -0.007000000000000006, "anchor_fallback": false, "top_clinical": [ "anti", 0.222 ], "top_patient": [ "anti", 0.215 ], "spread_clinical": [ [ "anti", 0.222 ], [ "antibiotic", 0.195 ], [ "over", 0.092 ], [ "en", 0.056 ], [ "extra", 0.044 ] ], "spread_patient": [ [ "anti", 0.215 ], [ "en", 0.167 ], [ "antibiotic", 0.115 ], [ "ant", 0.079 ], [ "ibuprofen", 0.042 ] ], "target_token": "anti", "flipped": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " antibiotic", "observed_clinical": [ "Output \" anti\"", 0.222 ], "probe_extension": null }, "circuit_diff": { "shared_features": 531, "unique_to_a": 791, "unique_to_b": 856 }, "clinical_mass": { "clinical": 0.3911, "patient": 0.3333 }, "urgency": { "flip_class": null, "tier_top_clinical": 1, "tier_top_patient": 1, "tier_shift": -0.102 } } }, "prob_clinical": 0.222, "prob_patient": 0.215, "language_penalty": -0.007000000000000006, "flipped": false, "top_clinical": [ "anti", 0.222 ], "top_patient": [ "anti", 0.215 ], "spread_clinical": [ [ "anti", 0.222 ], [ "antibiotic", 0.195 ], [ "over", 0.092 ], [ "en", 0.056 ], [ "extra", 0.044 ] ], "spread_patient": [ [ "anti", 0.215 ], [ "en", 0.167 ], [ "antibiotic", 0.115 ], [ "ant", 0.079 ], [ "ibuprofen", 0.042 ] ], "target_token": "anti", "anchor_fallback": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " antibiotic", "observed_clinical": [ "Output \" anti\"", 0.222 ], "probe_extension": null }, "circuit_diff": { "shared_features": 531, "unique_to_a": 791, "unique_to_b": 856 }, "clinical_mass": { "clinical": 0.3911, "patient": 0.3333 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260715T132350Z/index_69.html", "urgency": { "flip_class": null, "tier_top_clinical": 1, "tier_top_patient": 1, "tier_shift": -0.102 } }, { "index": 906, "batch": "pairs_20260715T132350Z", "batch_index": 70, "clinical_prompt": "I have hematuria, so I should probably get my", "patient_prompt": "I've been passing water that looks a bit off, so I should probably get my", "intended_target": "checked", "rationale": "Colloquial 'passing water that looks a bit off' (discolored/cloudy urine observation) vs clinical 'hematuria' (blood in urine). Grammar channels toward 'checked' or 'examined' in clinical reading, 'color' in mundane. First-person with future/prescriptive intent.", "patient_term": "passing water that looks a bit off", "clinical_term": "hematuria", "topic": "Kidneys & urinary", "topics": [ "Infections & fever", "Kidneys & urinary", "Reproductive & sexual health", "Hormones & metabolism", "Eyes ears & mouth" ], "models": { "gemma-2-2b": { "prob_clinical": null, "prob_patient": null, "language_penalty": null, "anchor_fallback": false, "top_clinical": [ "kidneys", 0.195 ], "top_patient": null, "spread_clinical": [ [ "kidneys", 0.195 ], [ "blood", 0.152 ], [ "urine", 0.092 ], [ "kidney", 0.092 ], [ "bladder", 0.049 ] ], "spread_patient": [], "target_token": null, "flipped": false, "screening": { "status": "screened_out", "min_prob": 0.02, "intended_target": " checked", "observed_clinical": null, "probe_extension": null, "reason": "intended target not in the traced clinical spread" }, "circuit_diff": null, "clinical_mass": { "clinical": 0.414 } } }, "prob_clinical": null, "prob_patient": null, "language_penalty": null, "flipped": false, "top_clinical": [ "kidneys", 0.195 ], "top_patient": null, "spread_clinical": [ [ "kidneys", 0.195 ], [ "blood", 0.152 ], [ "urine", 0.092 ], [ "kidney", 0.092 ], [ "bladder", 0.049 ] ], "spread_patient": [], "target_token": null, "anchor_fallback": false, "screening": { "status": "screened_out", "min_prob": 0.02, "intended_target": " checked", "observed_clinical": null, "probe_extension": null, "reason": "intended target not in the traced clinical spread" }, "circuit_diff": null, "clinical_mass": { "clinical": 0.414 } }, { "index": 907, "batch": "pairs_20260715T132350Z", "batch_index": 71, "clinical_prompt": "I have erectile dysfunction, so I might need to talk to my", "patient_prompt": "My partner mentioned I've lost my spark down there, so I might need to talk to my", "intended_target": "doctor", "rationale": "Idiomatic 'lost my spark down there' vs precise clinical diagnosis 'erectile dysfunction'. Frame funnels toward 'doctor' in clinical reading; mundane reading might prefer 'partner'. Third-person reference ('my partner mentioned') adds social context variation.", "patient_term": "lost my spark down there", "clinical_term": "erectile dysfunction", "topic": "Reproductive & sexual health", "topics": [ "Infections & fever", "Kidneys & urinary", "Reproductive & sexual health", "Hormones & metabolism", "Eyes ears & mouth" ], "models": { "gemma-2-2b": { "prob_clinical": 0.672, "prob_patient": 0.396, "language_penalty": -0.276, "anchor_fallback": false, "top_clinical": [ "doctor", 0.672 ], "top_patient": [ "doctor", 0.396 ], "spread_clinical": [ [ "doctor", 0.672 ], [ "doc", 0.055 ], [ "uro", 0.043 ], [ "GP", 0.023 ], [ "partner", 0.016 ] ], "spread_patient": [ [ "doctor", 0.396 ], [ "GP", 0.146 ], [ "doc", 0.069 ], [ "partner", 0.037 ], [ "uro", 0.032 ] ], "target_token": "doctor", "flipped": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " doctor", "observed_clinical": [ "Output \" doctor\"", 0.672 ], "probe_extension": null }, "circuit_diff": { "shared_features": 453, "unique_to_a": 616, "unique_to_b": 870 }, "clinical_mass": { "clinical": 0.3301, "patient": 0.2229 }, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": 0.0 } } }, "prob_clinical": 0.672, "prob_patient": 0.396, "language_penalty": -0.276, "flipped": false, "top_clinical": [ "doctor", 0.672 ], "top_patient": [ "doctor", 0.396 ], "spread_clinical": [ [ "doctor", 0.672 ], [ "doc", 0.055 ], [ "uro", 0.043 ], [ "GP", 0.023 ], [ "partner", 0.016 ] ], "spread_patient": [ [ "doctor", 0.396 ], [ "GP", 0.146 ], [ "doc", 0.069 ], [ "partner", 0.037 ], [ "uro", 0.032 ] ], "target_token": "doctor", "anchor_fallback": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " doctor", "observed_clinical": [ "Output \" doctor\"", 0.672 ], "probe_extension": null }, "circuit_diff": { "shared_features": 453, "unique_to_a": 616, "unique_to_b": 870 }, "clinical_mass": { "clinical": 0.3301, "patient": 0.2229 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260715T132350Z/index_71.html", "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": 0.0 } }, { "index": 908, "batch": "pairs_20260715T132350Z", "batch_index": 72, "clinical_prompt": "I have conjunctival injection with epiphora, so I should probably pick up some", "patient_prompt": "My eye's been all watery and the white bit's been bright red, so I should probably pick up some", "intended_target": "drops", "rationale": "Patient phrase describes irritation; clinical terms epiphora and conjunctival injection indicate medicated eye drops as the standard treatment continuation.", "patient_term": "My eye's been all watery and the white bit's been bright red", "clinical_term": "I have conjunctival injection with epiphora", "topic": "Eyes ears & mouth", "topics": [ "Infections & fever", "Kidneys & urinary", "Reproductive & sexual health", "Hormones & metabolism", "Eyes ears & mouth" ], "models": { "gemma-2-2b": { "prob_clinical": 0.061, "prob_patient": 0.095, "language_penalty": 0.034, "anchor_fallback": false, "top_clinical": [ "artificial", 0.213 ], "top_patient": [ "eye", 0.428 ], "spread_clinical": [ [ "artificial", 0.213 ], [ "eye", 0.114 ], [ "of", 0.089 ], [ "drops", 0.061 ], [ "tears", 0.029 ] ], "spread_patient": [ [ "eye", 0.428 ], [ "drops", 0.095 ], [ "new", 0.035 ], [ "of", 0.027 ], [ "anti", 0.024 ] ], "target_token": "drops", "flipped": true, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " drops", "observed_clinical": [ "Output \" drops\"", 0.061 ], "probe_extension": null }, "circuit_diff": { "shared_features": 567, "unique_to_a": 749, "unique_to_b": 742 }, "clinical_mass": { "clinical": 0.3687, "patient": 0.281 }, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } } }, "prob_clinical": 0.061, "prob_patient": 0.095, "language_penalty": 0.034, "flipped": true, "top_clinical": [ "artificial", 0.213 ], "top_patient": [ "eye", 0.428 ], "spread_clinical": [ [ "artificial", 0.213 ], [ "eye", 0.114 ], [ "of", 0.089 ], [ "drops", 0.061 ], [ "tears", 0.029 ] ], "spread_patient": [ [ "eye", 0.428 ], [ "drops", 0.095 ], [ "new", 0.035 ], [ "of", 0.027 ], [ "anti", 0.024 ] ], "target_token": "drops", "anchor_fallback": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " drops", "observed_clinical": [ "Output \" drops\"", 0.061 ], "probe_extension": null }, "circuit_diff": { "shared_features": 567, "unique_to_a": 749, "unique_to_b": 742 }, "clinical_mass": { "clinical": 0.3687, "patient": 0.281 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260715T132350Z/index_72.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, { "index": 909, "batch": "pairs_20260715T132350Z", "batch_index": 73, "clinical_prompt": "I have pharyngitis with oral thrush, so this might be my", "patient_prompt": "My throat's been really sore and I've got white patches in there, so this might be my", "intended_target": "candida", "rationale": "Patient phrase suggests a simple sore throat; clinical phrasing with 'oral thrush' and 'pharyngitis' signals fungal infection, making fungal-agent 'candida' the natural diagnostic continuation.", "patient_term": "really sore and I've got white patches in there", "clinical_term": "pharyngitis with oral thrush", "topic": "Eyes ears & mouth", "topics": [ "Infections & fever", "Kidneys & urinary", "Reproductive & sexual health", "Hormones & metabolism", "Eyes ears & mouth" ], "models": { "gemma-2-2b": { "prob_clinical": null, "prob_patient": null, "language_penalty": null, "anchor_fallback": false, "top_clinical": [ "problem", 0.15 ], "top_patient": null, "spread_clinical": [ [ "problem", 0.15 ], [ "issue", 0.063 ], [ "first", 0.055 ], [ "own", 0.055 ], [ "body", 0.038 ] ], "spread_patient": [], "target_token": null, "flipped": false, "screening": { "status": "screened_out", "min_prob": 0.02, "intended_target": " candida", "observed_clinical": null, "probe_extension": null, "reason": "intended target not in the traced clinical spread" }, "circuit_diff": null, "clinical_mass": { "clinical": 0.2491 } } }, "prob_clinical": null, "prob_patient": null, "language_penalty": null, "flipped": false, "top_clinical": [ "problem", 0.15 ], "top_patient": null, "spread_clinical": [ [ "problem", 0.15 ], [ "issue", 0.063 ], [ "first", 0.055 ], [ "own", 0.055 ], [ "body", 0.038 ] ], "spread_patient": [], "target_token": null, "anchor_fallback": false, "screening": { "status": "screened_out", "min_prob": 0.02, "intended_target": " candida", "observed_clinical": null, "probe_extension": null, "reason": "intended target not in the traced clinical spread" }, "circuit_diff": null, "clinical_mass": { "clinical": 0.2491 } }, { "index": 910, "batch": "pairs_20260715T132350Z", "batch_index": 74, "clinical_prompt": "I have oral candidiasis, so I might have an", "patient_prompt": "I've got this nasty white coating on my tongue, so I might have an", "intended_target": "infection", "rationale": "Oral candidiasis presents as white coating in the mouth and is a fungal infection. The frame naturally leads to 'infection' as the clinical diagnosis.", "patient_term": "white coating on my tongue", "clinical_term": "oral candidiasis", "topic": "Eyes ears & mouth", "topics": [ "Infections & fever", "Kidneys & urinary", "Reproductive & sexual health", "Hormones & metabolism", "Eyes ears & mouth" ], "models": { "gemma-2-2b": { "prob_clinical": null, "prob_patient": null, "language_penalty": null, "anchor_fallback": false, "top_clinical": [ "idea", 0.184 ], "top_patient": null, "spread_clinical": [ [ "idea", 0.184 ], [ "increased", 0.098 ], [ "extra", 0.077 ], [ "advantage", 0.06 ], [ "issue", 0.053 ] ], "spread_patient": [], "target_token": null, "flipped": false, "screening": { "status": "screened_out", "min_prob": 0.02, "intended_target": " infection", "observed_clinical": null, "probe_extension": null, "reason": "intended target not in the traced clinical spread" }, "circuit_diff": null, "clinical_mass": { "clinical": 0.2541 } } }, "prob_clinical": null, "prob_patient": null, "language_penalty": null, "flipped": false, "top_clinical": [ "idea", 0.184 ], "top_patient": null, "spread_clinical": [ [ "idea", 0.184 ], [ "increased", 0.098 ], [ "extra", 0.077 ], [ "advantage", 0.06 ], [ "issue", 0.053 ] ], "spread_patient": [], "target_token": null, "anchor_fallback": false, "screening": { "status": "screened_out", "min_prob": 0.02, "intended_target": " infection", "observed_clinical": null, "probe_extension": null, "reason": "intended target not in the traced clinical spread" }, "circuit_diff": null, "clinical_mass": { "clinical": 0.2541 } }, { "index": 911, "batch": "pairs_20260715T132350Z", "batch_index": 75, "clinical_prompt": "I have conjunctivitis, so I need to pick up some", "patient_prompt": "I've been getting a lot of pus in my eye, so I need to pick up some", "intended_target": "drops", "rationale": "Patient colloquialism 'pus in my eye' versus clinical term 'conjunctivitis' frames a decision about topical treatment. The model should prefer 'drops' or 'ointment' with the clinical phrasing, whereas lay phrasing might prompt more vague responses.", "patient_term": "pus in my eye", "clinical_term": "conjunctivitis", "topic": "Eyes ears & mouth", "topics": [ "Infections & fever", "Kidneys & urinary", "Reproductive & sexual health", "Hormones & metabolism", "Eyes ears & mouth" ], "models": { "gemma-2-2b": { "prob_clinical": 0.174, "prob_patient": 0.164, "language_penalty": -0.009999999999999981, "anchor_fallback": false, "top_clinical": [ "eye", 0.324 ], "top_patient": [ "eye", 0.239 ], "spread_clinical": [ [ "eye", 0.324 ], [ "drops", 0.174 ], [ "antibiotic", 0.064 ], [ "antibiotics", 0.05 ], [ "new", 0.039 ] ], "spread_patient": [ [ "eye", 0.239 ], [ "drops", 0.164 ], [ "antibiotic", 0.145 ], [ "ointment", 0.053 ], [ "new", 0.053 ] ], "target_token": "drops", "flipped": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " drops", "observed_clinical": [ "Output \" drops\"", 0.174 ], "probe_extension": null }, "circuit_diff": { "shared_features": 668, "unique_to_a": 511, "unique_to_b": 710 }, "clinical_mass": { "clinical": 0.3706, "patient": 0.3486 } } }, "prob_clinical": 0.174, "prob_patient": 0.164, "language_penalty": -0.009999999999999981, "flipped": false, "top_clinical": [ "eye", 0.324 ], "top_patient": [ "eye", 0.239 ], "spread_clinical": [ [ "eye", 0.324 ], [ "drops", 0.174 ], [ "antibiotic", 0.064 ], [ "antibiotics", 0.05 ], [ "new", 0.039 ] ], "spread_patient": [ [ "eye", 0.239 ], [ "drops", 0.164 ], [ "antibiotic", 0.145 ], [ "ointment", 0.053 ], [ "new", 0.053 ] ], "target_token": "drops", "anchor_fallback": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " drops", "observed_clinical": [ "Output \" drops\"", 0.174 ], "probe_extension": null }, "circuit_diff": { "shared_features": 668, "unique_to_a": 511, "unique_to_b": 710 }, "clinical_mass": { "clinical": 0.3706, "patient": 0.3486 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260715T132350Z/index_75.html" }, { "index": 912, "batch": "pairs_20260715T132350Z", "batch_index": 76, "clinical_prompt": "I've been running a fever above 39\u00b0C for three days, so I might have a", "patient_prompt": "I've been running a really high temperature for three days, so I might have a", "intended_target": "infection", "rationale": "Vague colloquial descriptor 'really high temperature' versus quantified clinical measurement 'fever above 39\u00b0C' differentiates lay assessment from clinical presentation. The precise threshold should push the model toward infection-related continuations.", "patient_term": "really high temperature", "clinical_term": "fever above 39\u00b0C", "topic": "Infections & fever", "topics": [ "Infections & fever", "Kidneys & urinary", "Reproductive & sexual health", "Hormones & metabolism", "Eyes ears & mouth" ], "models": { "gemma-2-2b": { "prob_clinical": null, "prob_patient": null, "language_penalty": null, "anchor_fallback": false, "top_clinical": [ "cold", 0.252 ], "top_patient": null, "spread_clinical": [ [ "cold", 0.252 ], [ "bit", 0.072 ], [ "virus", 0.056 ], [ "mild", 0.056 ], [ "bad", 0.044 ] ], "spread_patient": [], "target_token": null, "flipped": false, "screening": { "status": "screened_out", "min_prob": 0.02, "intended_target": " infection", "observed_clinical": null, "probe_extension": null, "reason": "intended target not in the traced clinical spread" }, "circuit_diff": null, "clinical_mass": { "clinical": 0.2993 } } }, "prob_clinical": null, "prob_patient": null, "language_penalty": null, "flipped": false, "top_clinical": [ "cold", 0.252 ], "top_patient": null, "spread_clinical": [ [ "cold", 0.252 ], [ "bit", 0.072 ], [ "virus", 0.056 ], [ "mild", 0.056 ], [ "bad", 0.044 ] ], "spread_patient": [], "target_token": null, "anchor_fallback": false, "screening": { "status": "screened_out", "min_prob": 0.02, "intended_target": " infection", "observed_clinical": null, "probe_extension": null, "reason": "intended target not in the traced clinical spread" }, "circuit_diff": null, "clinical_mass": { "clinical": 0.2993 } }, { "index": 913, "batch": "pairs_20260715T132350Z", "batch_index": 77, "clinical_prompt": "I've been gaining weight and experiencing fatigue all the time, so I should probably check my", "patient_prompt": "I've been gaining weight and feeling sluggish all the time, so I should probably check my", "intended_target": "thyroid", "rationale": "Lay colloquialism 'sluggish' versus clinical term 'fatigue' focuses a metabolic/endocrine workup. The precise clinical phrasing should steer strongly toward 'thyroid' as a first-line investigation.", "patient_term": "feeling sluggish", "clinical_term": "experiencing fatigue", "topic": "Hormones & metabolism", "topics": [ "Infections & fever", "Kidneys & urinary", "Reproductive & sexual health", "Hormones & metabolism", "Eyes ears & mouth" ], "models": { "gemma-2-2b": { "prob_clinical": 0.389, "prob_patient": 0.266, "language_penalty": -0.123, "anchor_fallback": false, "top_clinical": [ "thyroid", 0.389 ], "top_patient": [ "thyroid", 0.266 ], "spread_clinical": [ [ "thyroid", 0.389 ], [ "blood", 0.144 ], [ "iron", 0.06 ], [ "hormones", 0.041 ], [ "levels", 0.032 ] ], "spread_patient": [ [ "thyroid", 0.266 ], [ "blood", 0.183 ], [ "diet", 0.086 ], [ "cholesterol", 0.046 ], [ "hormones", 0.041 ] ], "target_token": "thyroid", "flipped": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " thyroid", "observed_clinical": [ "Output \" thyroid\"", 0.389 ], "probe_extension": null }, "circuit_diff": { "shared_features": 1162, "unique_to_a": 280, "unique_to_b": 291 }, "clinical_mass": { "clinical": 0.3162, "patient": 0.2925 } } }, "prob_clinical": 0.389, "prob_patient": 0.266, "language_penalty": -0.123, "flipped": false, "top_clinical": [ "thyroid", 0.389 ], "top_patient": [ "thyroid", 0.266 ], "spread_clinical": [ [ "thyroid", 0.389 ], [ "blood", 0.144 ], [ "iron", 0.06 ], [ "hormones", 0.041 ], [ "levels", 0.032 ] ], "spread_patient": [ [ "thyroid", 0.266 ], [ "blood", 0.183 ], [ "diet", 0.086 ], [ "cholesterol", 0.046 ], [ "hormones", 0.041 ] ], "target_token": "thyroid", "anchor_fallback": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " thyroid", "observed_clinical": [ "Output \" thyroid\"", 0.389 ], "probe_extension": null }, "circuit_diff": { "shared_features": 1162, "unique_to_a": 280, "unique_to_b": 291 }, "clinical_mass": { "clinical": 0.3162, "patient": 0.2925 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260715T132350Z/index_77.html" }, { "index": 914, "batch": "pairs_20260715T132350Z", "batch_index": 79, "clinical_prompt": "I've been feeling flushed and my skin's all hot, so I might have an", "patient_prompt": "I've been feeling flushed and my skin's all hot, so I might have a", "intended_target": "infection", "rationale": "Colloquial 'a' before vowel-initial 'infection' is grammatically awkward, forcing clinical reading; the frame about flushed hot skin naturally leads to infection as a diagnostic continuation in care-seeking context.", "patient_term": "a", "clinical_term": "an", "topic": "Infections & fever", "topics": [ "Infections & fever", "Kidneys & urinary", "Reproductive & sexual health", "Hormones & metabolism", "Eyes ears & mouth" ], "models": { "gemma-2-2b": { "prob_clinical": 0.189, "prob_patient": null, "language_penalty": null, "anchor_fallback": false, "top_clinical": [ "infection", 0.189 ], "top_patient": [ "fever", 0.459 ], "spread_clinical": [ [ "infection", 0.189 ], [ "allergy", 0.101 ], [ "upset", 0.042 ], [ "allergic", 0.042 ], [ "early", 0.042 ] ], "spread_patient": [ [ "fever", 0.459 ], [ "cold", 0.132 ], [ "little", 0.055 ], [ "slight", 0.029 ], [ "bit", 0.029 ] ], "target_token": "infection", "flipped": true, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " infection", "observed_clinical": [ "Output \" infection\"", 0.189 ], "probe_extension": null }, "circuit_diff": { "shared_features": 1161, "unique_to_a": 221, "unique_to_b": 191 }, "clinical_mass": { "clinical": 0.2772, "patient": 0.2578 }, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } } }, "prob_clinical": 0.189, "prob_patient": null, "language_penalty": null, "flipped": true, "top_clinical": [ "infection", 0.189 ], "top_patient": [ "fever", 0.459 ], "spread_clinical": [ [ "infection", 0.189 ], [ "allergy", 0.101 ], [ "upset", 0.042 ], [ "allergic", 0.042 ], [ "early", 0.042 ] ], "spread_patient": [ [ "fever", 0.459 ], [ "cold", 0.132 ], [ "little", 0.055 ], [ "slight", 0.029 ], [ "bit", 0.029 ] ], "target_token": "infection", "anchor_fallback": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " infection", "observed_clinical": [ "Output \" infection\"", 0.189 ], "probe_extension": null }, "circuit_diff": { "shared_features": 1161, "unique_to_a": 221, "unique_to_b": 191 }, "clinical_mass": { "clinical": 0.2772, "patient": 0.2578 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260715T132350Z/index_79.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, { "index": 915, "batch": "pairs_20260715T132350Z", "batch_index": 80, "clinical_prompt": "I've been passing excessive urine and my wee's really dark, so I should probably get my", "patient_prompt": "I've been peeing way too much and my wee's really dark, so I should probably get my", "intended_target": "kidneys", "rationale": "Replacing colloquial 'peeing way too much' with clinical 'passing excessive urine' shifts context toward metabolic/renal concern; the possessive frame funnels toward 'kidneys' as the diagnostic continuation.", "patient_term": "peeing way too much", "clinical_term": "passing excessive urine", "topic": "Kidneys & urinary", "topics": [ "Infections & fever", "Kidneys & urinary", "Reproductive & sexual health", "Hormones & metabolism", "Eyes ears & mouth" ], "models": { "gemma-2-2b": { "prob_clinical": 0.111, "prob_patient": 0.062, "language_penalty": -0.049, "anchor_fallback": false, "top_clinical": [ "blood", 0.266 ], "top_patient": [ "blood", 0.248 ], "spread_clinical": [ [ "blood", 0.266 ], [ "urine", 0.235 ], [ "kidneys", 0.111 ], [ "GP", 0.041 ], [ "kidney", 0.036 ] ], "spread_patient": [ [ "blood", 0.248 ], [ "urine", 0.193 ], [ "thyroid", 0.062 ], [ "kidneys", 0.062 ], [ "self", 0.033 ] ], "target_token": "kidneys", "flipped": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " kidneys", "observed_clinical": [ "Output \" kidneys\"", 0.111 ], "probe_extension": null }, "circuit_diff": { "shared_features": 859, "unique_to_a": 562, "unique_to_b": 669 }, "clinical_mass": { "clinical": 0.317, "patient": 0.2852 }, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": 0.0 } } }, "prob_clinical": 0.111, "prob_patient": 0.062, "language_penalty": -0.049, "flipped": false, "top_clinical": [ "blood", 0.266 ], "top_patient": [ "blood", 0.248 ], "spread_clinical": [ [ "blood", 0.266 ], [ "urine", 0.235 ], [ "kidneys", 0.111 ], [ "GP", 0.041 ], [ "kidney", 0.036 ] ], "spread_patient": [ [ "blood", 0.248 ], [ "urine", 0.193 ], [ "thyroid", 0.062 ], [ "kidneys", 0.062 ], [ "self", 0.033 ] ], "target_token": "kidneys", "anchor_fallback": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " kidneys", "observed_clinical": [ "Output \" kidneys\"", 0.111 ], "probe_extension": null }, "circuit_diff": { "shared_features": 859, "unique_to_a": 562, "unique_to_b": 669 }, "clinical_mass": { "clinical": 0.317, "patient": 0.2852 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260715T132350Z/index_80.html", "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": 0.0 } }, { "index": 916, "batch": "pairs_20260715T132350Z", "batch_index": 81, "clinical_prompt": "My girlfriend says I've been experiencing erectile dysfunction, so I might need to take my", "patient_prompt": "My girlfriend says I've been acting cold down there, so I might need to take my", "intended_target": "medication", "rationale": "Clinical term 'erectile dysfunction' primes medical treatment framing; the possessive+infinitive structure naturally leads to 'medication' rather than dismissive responses.", "patient_term": "acting cold down there", "clinical_term": "experiencing erectile dysfunction", "topic": "Reproductive & sexual health", "topics": [ "Infections & fever", "Kidneys & urinary", "Reproductive & sexual health", "Hormones & metabolism", "Eyes ears & mouth" ], "models": { "gemma-2-2b": { "prob_clinical": 0.047, "prob_patient": null, "language_penalty": null, "anchor_fallback": false, "top_clinical": [ "first", 0.068 ], "top_patient": [ "pants", 0.117 ], "spread_clinical": [ [ "first", 0.068 ], [ "meds", 0.053 ], [ "ED", 0.053 ], [ "penis", 0.047 ], [ "medication", 0.047 ] ], "spread_patient": [ [ "pants", 0.117 ], [ "shirt", 0.049 ], [ "meds", 0.049 ], [ "clothes", 0.049 ], [ "own", 0.043 ] ], "target_token": "medication", "flipped": true, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " medication", "observed_clinical": [ "Output \" medication\"", 0.047 ], "probe_extension": null }, "circuit_diff": { "shared_features": 869, "unique_to_a": 463, "unique_to_b": 584 }, "clinical_mass": { "clinical": 0.2403, "patient": 0.1289 }, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": -1.539 } } }, "prob_clinical": 0.047, "prob_patient": null, "language_penalty": null, "flipped": true, "top_clinical": [ "first", 0.068 ], "top_patient": [ "pants", 0.117 ], "spread_clinical": [ [ "first", 0.068 ], [ "meds", 0.053 ], [ "ED", 0.053 ], [ "penis", 0.047 ], [ "medication", 0.047 ] ], "spread_patient": [ [ "pants", 0.117 ], [ "shirt", 0.049 ], [ "meds", 0.049 ], [ "clothes", 0.049 ], [ "own", 0.043 ] ], "target_token": "medication", "anchor_fallback": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " medication", "observed_clinical": [ "Output \" medication\"", 0.047 ], "probe_extension": null }, "circuit_diff": { "shared_features": 869, "unique_to_a": 463, "unique_to_b": 584 }, "clinical_mass": { "clinical": 0.2403, "patient": 0.1289 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260715T132350Z/index_81.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": -1.539 } }, { "index": 917, "batch": "pairs_20260715T132350Z", "batch_index": 82, "clinical_prompt": "I've got tinnitus that won't stop, so it might be my", "patient_prompt": "I've got this ringing in my ears that won't stop, so it might be my", "intended_target": "hearing", "rationale": "Clinical term 'tinnitus' shifts from symptom description to diagnostic label; the possessive frame with 'might be' naturally funnels toward 'hearing' as the clinical continuation.", "patient_term": "ringing in my ears", "clinical_term": "tinnitus", "topic": "Eyes ears & mouth", "topics": [ "Infections & fever", "Kidneys & urinary", "Reproductive & sexual health", "Hormones & metabolism", "Eyes ears & mouth" ], "models": { "gemma-2-2b": { "prob_clinical": 0.045, "prob_patient": null, "language_penalty": null, "anchor_fallback": false, "top_clinical": [ "ears", 0.227 ], "top_patient": [ "fault", 0.119 ], "spread_clinical": [ [ "ears", 0.227 ], [ "imagination", 0.155 ], [ "hearing", 0.045 ], [ "own", 0.035 ], [ "problem", 0.031 ] ], "spread_patient": [ [ "fault", 0.119 ], [ "turn", 0.082 ], [ "ears", 0.063 ], [ "imagination", 0.063 ], [ "time", 0.039 ] ], "target_token": "hearing", "flipped": true, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " hearing", "observed_clinical": [ "Output \" hearing\"", 0.045 ], "probe_extension": null }, "circuit_diff": { "shared_features": 897, "unique_to_a": 460, "unique_to_b": 602 }, "clinical_mass": { "clinical": 0.1434, "patient": 0.1052 }, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } } }, "prob_clinical": 0.045, "prob_patient": null, "language_penalty": null, "flipped": true, "top_clinical": [ "ears", 0.227 ], "top_patient": [ "fault", 0.119 ], "spread_clinical": [ [ "ears", 0.227 ], [ "imagination", 0.155 ], [ "hearing", 0.045 ], [ "own", 0.035 ], [ "problem", 0.031 ] ], "spread_patient": [ [ "fault", 0.119 ], [ "turn", 0.082 ], [ "ears", 0.063 ], [ "imagination", 0.063 ], [ "time", 0.039 ] ], "target_token": "hearing", "anchor_fallback": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " hearing", "observed_clinical": [ "Output \" hearing\"", 0.045 ], "probe_extension": null }, "circuit_diff": { "shared_features": 897, "unique_to_a": 460, "unique_to_b": 602 }, "clinical_mass": { "clinical": 0.1434, "patient": 0.1052 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260715T132350Z/index_82.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, { "index": 918, "batch": "pairs_20260715T132350Z", "batch_index": 83, "clinical_prompt": "I've been getting stomatitis all over my mouth, so I might need to see a", "patient_prompt": "I've been getting these little sores all over my mouth, so I might need to see a", "intended_target": "dentist", "rationale": "Clinical term 'stomatitis' (mouth inflammation) instead of colloquial 'sores' activates professional-care framing; the structure naturally leads to 'dentist' as the diagnostic continuation in clinical context.", "patient_term": "little sores", "clinical_term": "stomatitis", "topic": "Eyes ears & mouth", "topics": [ "Infections & fever", "Kidneys & urinary", "Reproductive & sexual health", "Hormones & metabolism", "Eyes ears & mouth" ], "models": { "gemma-2-2b": { "prob_clinical": 0.633, "prob_patient": 0.574, "language_penalty": -0.05900000000000005, "anchor_fallback": false, "top_clinical": [ "dentist", 0.633 ], "top_patient": [ "dentist", 0.574 ], "spread_clinical": [ [ "dentist", 0.633 ], [ "doctor", 0.206 ], [ "specialist", 0.036 ], [ "dermatologist", 0.036 ], [ "new", 0.012 ] ], "spread_patient": [ [ "dentist", 0.574 ], [ "doctor", 0.271 ], [ "dermatologist", 0.088 ], [ "doc", 0.009 ], [ "der", 0.008 ] ], "target_token": "dentist", "flipped": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " dentist", "observed_clinical": [ "Output \" dentist\"", 0.633 ], "probe_extension": null }, "circuit_diff": { "shared_features": 806, "unique_to_a": 515, "unique_to_b": 404 }, "clinical_mass": { "clinical": 0.44, "patient": 0.4476 }, "urgency": { "flip_class": null, "tier_top_clinical": 3, "tier_top_patient": 3, "tier_shift": -0.069 } } }, "prob_clinical": 0.633, "prob_patient": 0.574, "language_penalty": -0.05900000000000005, "flipped": false, "top_clinical": [ "dentist", 0.633 ], "top_patient": [ "dentist", 0.574 ], "spread_clinical": [ [ "dentist", 0.633 ], [ "doctor", 0.206 ], [ "specialist", 0.036 ], [ "dermatologist", 0.036 ], [ "new", 0.012 ] ], "spread_patient": [ [ "dentist", 0.574 ], [ "doctor", 0.271 ], [ "dermatologist", 0.088 ], [ "doc", 0.009 ], [ "der", 0.008 ] ], "target_token": "dentist", "anchor_fallback": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " dentist", "observed_clinical": [ "Output \" dentist\"", 0.633 ], "probe_extension": null }, "circuit_diff": { "shared_features": 806, "unique_to_a": 515, "unique_to_b": 404 }, "clinical_mass": { "clinical": 0.44, "patient": 0.4476 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260715T132350Z/index_83.html", "urgency": { "flip_class": null, "tier_top_clinical": 3, "tier_top_patient": 3, "tier_shift": -0.069 } }, { "index": 919, "batch": "pairs_20260715T132350Z", "batch_index": 84, "clinical_prompt": "I have urinary retention, so I should probably see a", "patient_prompt": "I've been having trouble passing water regularly, so I should probably see a", "intended_target": "urologist", "rationale": "Colloquial 'trouble passing water regularly' is lay language for the clinical diagnosis 'urinary retention'. The frame forces selection of a specialist type. A small model should associate the clinical term with urologist more strongly.", "patient_term": "having trouble passing water regularly", "clinical_term": "urinary retention", "topic": "Kidneys & urinary", "topics": [ "Infections & fever", "Kidneys & urinary", "Reproductive & sexual health", "Hormones & metabolism", "Eyes ears & mouth" ], "models": { "gemma-2-2b": { "prob_clinical": 0.645, "prob_patient": 0.049, "language_penalty": -0.596, "anchor_fallback": false, "top_clinical": [ "uro", 0.645 ], "top_patient": [ "doctor", 0.766 ], "spread_clinical": [ [ "uro", 0.645 ], [ "doctor", 0.127 ], [ "Uro", 0.087 ], [ "specialist", 0.041 ], [ "doc", 0.012 ] ], "spread_patient": [ [ "doctor", 0.766 ], [ "uro", 0.049 ], [ "doc", 0.049 ], [ "Dr", 0.026 ], [ "GP", 0.02 ] ], "target_token": "uro", "flipped": true, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " urologist", "observed_clinical": [ "Output \" uro\"", 0.645 ], "probe_extension": null }, "circuit_diff": { "shared_features": 479, "unique_to_a": 678, "unique_to_b": 718 }, "clinical_mass": { "clinical": 0.4552, "patient": 0.3376 }, "html": "modes/simulated/pairs_20260715T132350Z/index_84.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": 2, "tier_shift": null } } }, "prob_clinical": 0.645, "prob_patient": 0.049, "language_penalty": -0.596, "flipped": true, "top_clinical": [ "uro", 0.645 ], "top_patient": [ "doctor", 0.766 ], "spread_clinical": [ [ "uro", 0.645 ], [ "doctor", 0.127 ], [ "Uro", 0.087 ], [ "specialist", 0.041 ], [ "doc", 0.012 ] ], "spread_patient": [ [ "doctor", 0.766 ], [ "uro", 0.049 ], [ "doc", 0.049 ], [ "Dr", 0.026 ], [ "GP", 0.02 ] ], "target_token": "uro", "anchor_fallback": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " urologist", "observed_clinical": [ "Output \" uro\"", 0.645 ], "probe_extension": null }, "circuit_diff": { "shared_features": 479, "unique_to_a": 678, "unique_to_b": 718 }, "clinical_mass": { "clinical": 0.4552, "patient": 0.3376 }, "html": "modes/simulated/pairs_20260715T132350Z/index_84.html", "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260715T132350Z/index_84.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": 2, "tier_shift": null } }, { "index": 920, "batch": "pairs_20260715T132350Z", "batch_index": 85, "clinical_prompt": "I have erectile dysfunction, so I might need to talk to my", "patient_prompt": "My girlfriend thinks I've lost my libido, so I might need to talk to my", "intended_target": "doctor", "rationale": "Colloquial 'lost my libido' is a lay attribution; clinical 'erectile dysfunction' is the precise diagnosis. The frame naturally calls for a professional. The clinical term should strengthen preference for 'doctor' or 'urologist' over 'partner'.", "patient_term": "lost my libido", "clinical_term": "erectile dysfunction", "topic": "Reproductive & sexual health", "topics": [ "Infections & fever", "Kidneys & urinary", "Reproductive & sexual health", "Hormones & metabolism", "Eyes ears & mouth" ], "models": { "gemma-2-2b": { "prob_clinical": 0.672, "prob_patient": 0.602, "language_penalty": -0.07000000000000006, "anchor_fallback": false, "top_clinical": [ "doctor", 0.672 ], "top_patient": [ "doctor", 0.602 ], "spread_clinical": [ [ "doctor", 0.672 ], [ "doc", 0.055 ], [ "uro", 0.043 ], [ "GP", 0.023 ], [ "partner", 0.016 ] ], "spread_patient": [ [ "doctor", 0.602 ], [ "doc", 0.063 ], [ "GP", 0.038 ], [ "therapist", 0.034 ], [ "wife", 0.023 ] ], "target_token": "doctor", "flipped": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " doctor", "observed_clinical": [ "Output \" doctor\"", 0.672 ], "probe_extension": null }, "circuit_diff": { "shared_features": 574, "unique_to_a": 495, "unique_to_b": 649 }, "clinical_mass": { "clinical": 0.3301, "patient": 0.2269 }, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.016 } } }, "prob_clinical": 0.672, "prob_patient": 0.602, "language_penalty": -0.07000000000000006, "flipped": false, "top_clinical": [ "doctor", 0.672 ], "top_patient": [ "doctor", 0.602 ], "spread_clinical": [ [ "doctor", 0.672 ], [ "doc", 0.055 ], [ "uro", 0.043 ], [ "GP", 0.023 ], [ "partner", 0.016 ] ], "spread_patient": [ [ "doctor", 0.602 ], [ "doc", 0.063 ], [ "GP", 0.038 ], [ "therapist", 0.034 ], [ "wife", 0.023 ] ], "target_token": "doctor", "anchor_fallback": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " doctor", "observed_clinical": [ "Output \" doctor\"", 0.672 ], "probe_extension": null }, "circuit_diff": { "shared_features": 574, "unique_to_a": 495, "unique_to_b": 649 }, "clinical_mass": { "clinical": 0.3301, "patient": 0.2269 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260715T132350Z/index_85.html", "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.016 } }, { "index": 921, "batch": "pairs_20260715T132350Z", "batch_index": 87, "clinical_prompt": "I have tinnitus, so this might be my", "patient_prompt": "I've got this constant ringing in my ears that's driving me mad, so this might be my", "intended_target": "hearing", "rationale": "Colloquial 'constant ringing in my ears' versus clinical 'tinnitus'. The frame 'this might be my [noun]' probes for descriptive or diagnostic noun continuations. Clinical term should bias toward 'hearing' or clinical attributes.", "patient_term": "constant ringing in my ears", "clinical_term": "tinnitus", "topic": "Eyes ears & mouth", "topics": [ "Infections & fever", "Kidneys & urinary", "Reproductive & sexual health", "Hormones & metabolism", "Eyes ears & mouth" ], "models": { "gemma-2-2b": { "prob_clinical": null, "prob_patient": null, "language_penalty": null, "anchor_fallback": false, "top_clinical": [ "own", 0.102 ], "top_patient": null, "spread_clinical": [ [ "own", 0.102 ], [ "problem", 0.079 ], [ "imagination", 0.07 ], [ "experience", 0.054 ], [ "only", 0.048 ] ], "spread_patient": [], "target_token": null, "flipped": false, "screening": { "status": "screened_out", "min_prob": 0.02, "intended_target": " hearing", "observed_clinical": null, "probe_extension": null, "reason": "intended target not in the traced clinical spread" }, "circuit_diff": null, "clinical_mass": { "clinical": 0.1361 } } }, "prob_clinical": null, "prob_patient": null, "language_penalty": null, "flipped": false, "top_clinical": [ "own", 0.102 ], "top_patient": null, "spread_clinical": [ [ "own", 0.102 ], [ "problem", 0.079 ], [ "imagination", 0.07 ], [ "experience", 0.054 ], [ "only", 0.048 ] ], "spread_patient": [], "target_token": null, "anchor_fallback": false, "screening": { "status": "screened_out", "min_prob": 0.02, "intended_target": " hearing", "observed_clinical": null, "probe_extension": null, "reason": "intended target not in the traced clinical spread" }, "circuit_diff": null, "clinical_mass": { "clinical": 0.1361 } }, { "index": 922, "batch": "pairs_20260715T132350Z", "batch_index": 88, "clinical_prompt": "I have gingivitis, so I should probably see an", "patient_prompt": "I've been getting really sore gums and my mouth tastes metallic, so I should probably see an", "intended_target": "dentist", "rationale": "Colloquial symptom description 'sore gums and metallic taste' versus precise clinical diagnosis 'gingivitis'. The frame after 'see an' naturally calls for a healthcare professional. Clinical phrasing should bias toward dental specialists.", "patient_term": "getting really sore gums and my mouth tastes metallic", "clinical_term": "gingivitis", "topic": "Eyes ears & mouth", "topics": [ "Infections & fever", "Kidneys & urinary", "Reproductive & sexual health", "Hormones & metabolism", "Eyes ears & mouth" ], "models": { "gemma-2-2b": { "prob_clinical": 0.025, "prob_patient": 0.117, "language_penalty": 0.092, "anchor_fallback": false, "top_clinical": [ "oral", 0.566 ], "top_patient": [ "oral", 0.281 ], "spread_clinical": [ [ "oral", 0.566 ], [ "actual", 0.077 ], [ "end", 0.077 ], [ "orthodon", 0.044 ], [ "dentist", 0.025 ] ], "spread_patient": [ [ "oral", 0.281 ], [ "ENT", 0.171 ], [ "dentist", 0.117 ], [ "orthodon", 0.104 ], [ "end", 0.063 ] ], "target_token": "dentist", "flipped": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " dentist", "observed_clinical": [ "Output \" dentist\"", 0.025 ], "probe_extension": null }, "circuit_diff": { "shared_features": 623, "unique_to_a": 510, "unique_to_b": 659 }, "clinical_mass": { "clinical": 0.3984, "patient": 0.3801 } } }, "prob_clinical": 0.025, "prob_patient": 0.117, "language_penalty": 0.092, "flipped": false, "top_clinical": [ "oral", 0.566 ], "top_patient": [ "oral", 0.281 ], "spread_clinical": [ [ "oral", 0.566 ], [ "actual", 0.077 ], [ "end", 0.077 ], [ "orthodon", 0.044 ], [ "dentist", 0.025 ] ], "spread_patient": [ [ "oral", 0.281 ], [ "ENT", 0.171 ], [ "dentist", 0.117 ], [ "orthodon", 0.104 ], [ "end", 0.063 ] ], "target_token": "dentist", "anchor_fallback": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " dentist", "observed_clinical": [ "Output \" dentist\"", 0.025 ], "probe_extension": null }, "circuit_diff": { "shared_features": 623, "unique_to_a": 510, "unique_to_b": 659 }, "clinical_mass": { "clinical": 0.3984, "patient": 0.3801 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260715T132350Z/index_88.html" }, { "index": 923, "batch": "pairs_20260715T132350Z", "batch_index": 89, "clinical_prompt": "I have erectile dysfunction, so I should probably talk to my", "patient_prompt": "I've been having trouble getting in the mood down there, so I should probably talk to my", "intended_target": "doctor", "rationale": "Patient expression is euphemistic lay language; clinical term is precise medical diagnosis. The frame 'talk to my' strongly predicts 'doctor' as the most natural next token in clinical contexts, shifting from what a patient might colloquially suggest to a care-seeking response.", "patient_term": "trouble getting in the mood down there", "clinical_term": "erectile dysfunction", "topic": "Reproductive & sexual health", "topics": [ "Infections & fever", "Kidneys & urinary", "Reproductive & sexual health", "Hormones & metabolism", "Eyes ears & mouth" ], "models": { "gemma-2-2b": { "prob_clinical": 0.73, "prob_patient": 0.414, "language_penalty": -0.316, "anchor_fallback": false, "top_clinical": [ "doctor", 0.73 ], "top_patient": [ "doctor", 0.414 ], "spread_clinical": [ [ "doctor", 0.73 ], [ "wife", 0.028 ], [ "doc", 0.028 ], [ "uro", 0.025 ], [ "GP", 0.022 ] ], "spread_patient": [ [ "doctor", 0.414 ], [ "therapist", 0.082 ], [ "doc", 0.072 ], [ "wife", 0.044 ], [ "OB", 0.026 ] ], "target_token": "doctor", "flipped": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " doctor", "observed_clinical": [ "Output \" doctor\"", 0.73 ], "probe_extension": null }, "circuit_diff": { "shared_features": 495, "unique_to_a": 563, "unique_to_b": 882 }, "clinical_mass": { "clinical": 0.3242, "patient": 0.1889 }, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": 0.06 } } }, "prob_clinical": 0.73, "prob_patient": 0.414, "language_penalty": -0.316, "flipped": false, "top_clinical": [ "doctor", 0.73 ], "top_patient": [ "doctor", 0.414 ], "spread_clinical": [ [ "doctor", 0.73 ], [ "wife", 0.028 ], [ "doc", 0.028 ], [ "uro", 0.025 ], [ "GP", 0.022 ] ], "spread_patient": [ [ "doctor", 0.414 ], [ "therapist", 0.082 ], [ "doc", 0.072 ], [ "wife", 0.044 ], [ "OB", 0.026 ] ], "target_token": "doctor", "anchor_fallback": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " doctor", "observed_clinical": [ "Output \" doctor\"", 0.73 ], "probe_extension": null }, "circuit_diff": { "shared_features": 495, "unique_to_a": 563, "unique_to_b": 882 }, "clinical_mass": { "clinical": 0.3242, "patient": 0.1889 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260715T132350Z/index_89.html", "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": 0.06 } }, { "index": 924, "batch": "pairs_20260715T132350Z", "batch_index": 90, "clinical_prompt": "I have tinnitus, so it might be my", "patient_prompt": "I've had this constant buzzing in my ear for weeks, so it might be my", "intended_target": "hearing", "rationale": "Patient uses colloquial symptom description; clinical term is the medical diagnosis. The frame 'it might be my' funnels toward 'hearing' (as in 'hearing loss' or hearing-related condition) as the natural next diagnostic token in clinical interpretation, distinguishing from casual worry language.", "patient_term": "constant buzzing in my ear", "clinical_term": "tinnitus", "topic": "Eyes ears & mouth", "topics": [ "Infections & fever", "Kidneys & urinary", "Reproductive & sexual health", "Hormones & metabolism", "Eyes ears & mouth" ], "models": { "gemma-2-2b": { "prob_clinical": 0.078, "prob_patient": 0.069, "language_penalty": -0.008999999999999994, "anchor_fallback": false, "top_clinical": [ "ears", 0.239 ], "top_patient": [ "imagination", 0.129 ], "spread_clinical": [ [ "ears", 0.239 ], [ "imagination", 0.187 ], [ "hearing", 0.078 ], [ "perception", 0.042 ], [ "ear", 0.037 ] ], "spread_patient": [ [ "imagination", 0.129 ], [ "ears", 0.088 ], [ "ear", 0.078 ], [ "hearing", 0.069 ], [ "tinnitus", 0.054 ] ], "target_token": "hearing", "flipped": true, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " hearing", "observed_clinical": [ "Output \" hearing\"", 0.078 ], "probe_extension": null }, "circuit_diff": { "shared_features": 583, "unique_to_a": 586, "unique_to_b": 856 }, "clinical_mass": { "clinical": 0.1778, "patient": 0.1989 }, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } } }, "prob_clinical": 0.078, "prob_patient": 0.069, "language_penalty": -0.008999999999999994, "flipped": true, "top_clinical": [ "ears", 0.239 ], "top_patient": [ "imagination", 0.129 ], "spread_clinical": [ [ "ears", 0.239 ], [ "imagination", 0.187 ], [ "hearing", 0.078 ], [ "perception", 0.042 ], [ "ear", 0.037 ] ], "spread_patient": [ [ "imagination", 0.129 ], [ "ears", 0.088 ], [ "ear", 0.078 ], [ "hearing", 0.069 ], [ "tinnitus", 0.054 ] ], "target_token": "hearing", "anchor_fallback": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " hearing", "observed_clinical": [ "Output \" hearing\"", 0.078 ], "probe_extension": null }, "circuit_diff": { "shared_features": 583, "unique_to_a": 586, "unique_to_b": 856 }, "clinical_mass": { "clinical": 0.1778, "patient": 0.1989 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260715T132350Z/index_90.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, { "index": 925, "batch": "pairs_20260715T132350Z", "batch_index": 91, "clinical_prompt": "I have bacterial vaginosis, so I should probably take my", "patient_prompt": "My partner's been complaining about a funny smell down there, so I should probably take my", "intended_target": "antibiotics", "rationale": "Patient term uses euphemism for genital discharge symptom; clinical term names the infection. Frame directs toward 'antibiotics' as treatment.", "patient_term": "funny smell down there", "clinical_term": "bacterial vaginosis", "topic": "Reproductive & sexual health", "topics": [ "Infections & fever", "Kidneys & urinary", "Reproductive & sexual health", "Hormones & metabolism", "Eyes ears & mouth" ], "models": { "gemma-2-2b": { "prob_clinical": 0.13, "prob_patient": null, "language_penalty": null, "anchor_fallback": false, "top_clinical": [ "antibiotics", 0.13 ], "top_patient": [ "own", 0.221 ], "spread_clinical": [ [ "antibiotics", 0.13 ], [ "probiotics", 0.115 ], [ "probiotic", 0.054 ], [ "meds", 0.048 ], [ "own", 0.048 ] ], "spread_patient": [ [ "own", 0.221 ], [ "pants", 0.081 ], [ "shirt", 0.049 ], [ "turn", 0.049 ], [ "clothes", 0.034 ] ], "target_token": "antibiotics", "flipped": true, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " antibiotics", "observed_clinical": [ "Output \" antibiotics\"", 0.13 ], "probe_extension": null }, "circuit_diff": { "shared_features": 460, "unique_to_a": 862, "unique_to_b": 907 }, "clinical_mass": { "clinical": 0.3773, "patient": 0.1051 }, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } } }, "prob_clinical": 0.13, "prob_patient": null, "language_penalty": null, "flipped": true, "top_clinical": [ "antibiotics", 0.13 ], "top_patient": [ "own", 0.221 ], "spread_clinical": [ [ "antibiotics", 0.13 ], [ "probiotics", 0.115 ], [ "probiotic", 0.054 ], [ "meds", 0.048 ], [ "own", 0.048 ] ], "spread_patient": [ [ "own", 0.221 ], [ "pants", 0.081 ], [ "shirt", 0.049 ], [ "turn", 0.049 ], [ "clothes", 0.034 ] ], "target_token": "antibiotics", "anchor_fallback": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " antibiotics", "observed_clinical": [ "Output \" antibiotics\"", 0.13 ], "probe_extension": null }, "circuit_diff": { "shared_features": 460, "unique_to_a": 862, "unique_to_b": 907 }, "clinical_mass": { "clinical": 0.3773, "patient": 0.1051 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260715T132350Z/index_91.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, { "index": 926, "batch": "pairs_20260715T132350Z", "batch_index": 92, "clinical_prompt": "I have bacterial conjunctivitis, so I need to pick up some", "patient_prompt": "My eye's been all stuck shut with gunk in the morning and it's really red, so I need to pick up some", "intended_target": "drops", "rationale": "Patient phrase describes eye infection symptoms colloquially; clinical term names the condition. Frame funnels toward 'drops' as the standard treatment form.", "patient_term": "all stuck shut with gunk in the morning and it's really red", "clinical_term": "bacterial conjunctivitis", "topic": "Eyes ears & mouth", "topics": [ "Infections & fever", "Kidneys & urinary", "Reproductive & sexual health", "Hormones & metabolism", "Eyes ears & mouth" ], "models": { "gemma-2-2b": { "prob_clinical": 0.197, "prob_patient": 0.136, "language_penalty": -0.061, "anchor_fallback": false, "top_clinical": [ "eye", 0.254 ], "top_patient": [ "eye", 0.369 ], "spread_clinical": [ [ "eye", 0.254 ], [ "drops", 0.197 ], [ "antibiotic", 0.175 ], [ "antibiotics", 0.083 ], [ "ointment", 0.034 ] ], "spread_patient": [ [ "eye", 0.369 ], [ "drops", 0.136 ], [ "antibiotic", 0.044 ], [ "ointment", 0.044 ], [ "artificial", 0.034 ] ], "target_token": "drops", "flipped": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " drops", "observed_clinical": [ "Output \" drops\"", 0.197 ], "probe_extension": null }, "circuit_diff": { "shared_features": 491, "unique_to_a": 684, "unique_to_b": 943 }, "clinical_mass": { "clinical": 0.4179, "patient": 0.2656 } } }, "prob_clinical": 0.197, "prob_patient": 0.136, "language_penalty": -0.061, "flipped": false, "top_clinical": [ "eye", 0.254 ], "top_patient": [ "eye", 0.369 ], "spread_clinical": [ [ "eye", 0.254 ], [ "drops", 0.197 ], [ "antibiotic", 0.175 ], [ "antibiotics", 0.083 ], [ "ointment", 0.034 ] ], "spread_patient": [ [ "eye", 0.369 ], [ "drops", 0.136 ], [ "antibiotic", 0.044 ], [ "ointment", 0.044 ], [ "artificial", 0.034 ] ], "target_token": "drops", "anchor_fallback": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " drops", "observed_clinical": [ "Output \" drops\"", 0.197 ], "probe_extension": null }, "circuit_diff": { "shared_features": 491, "unique_to_a": 684, "unique_to_b": 943 }, "clinical_mass": { "clinical": 0.4179, "patient": 0.2656 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260715T132350Z/index_92.html" }, { "index": 927, "batch": "pairs_20260715T132350Z", "batch_index": 93, "clinical_prompt": "I have amenorrhea for two months now, so I might need to take a", "patient_prompt": "I haven't had my period for two months now, so I might need to take a", "intended_target": "pregnancy", "rationale": "Amenorrhea prompts clinical thinking about pregnancy test first; colloquial phrasing delays that association and suggests lifestyle remedies.", "patient_term": "haven't had my period", "clinical_term": "have amenorrhea", "topic": "Reproductive & sexual health", "topics": [ "Infections & fever", "Kidneys & urinary", "Reproductive & sexual health", "Hormones & metabolism", "Eyes ears & mouth" ], "models": { "gemma-2-2b": { "prob_clinical": 0.309, "prob_patient": 0.742, "language_penalty": 0.433, "anchor_fallback": false, "top_clinical": [ "pregnancy", 0.309 ], "top_patient": [ "pregnancy", 0.742 ], "spread_clinical": [ [ "pregnancy", 0.309 ], [ "test", 0.146 ], [ "break", 0.088 ], [ "blood", 0.078 ], [ "pill", 0.061 ] ], "spread_patient": [ [ "pregnancy", 0.742 ], [ "test", 0.165 ], [ "home", 0.025 ], [ "blood", 0.006 ], [ "trip", 0.006 ] ], "target_token": "pregnancy", "flipped": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " pregnancy", "observed_clinical": [ "Output \" pregnancy\"", 0.309 ], "probe_extension": null }, "circuit_diff": { "shared_features": 592, "unique_to_a": 814, "unique_to_b": 590 }, "clinical_mass": { "clinical": 0.3269, "patient": 0.3061 } } }, "prob_clinical": 0.309, "prob_patient": 0.742, "language_penalty": 0.433, "flipped": false, "top_clinical": [ "pregnancy", 0.309 ], "top_patient": [ "pregnancy", 0.742 ], "spread_clinical": [ [ "pregnancy", 0.309 ], [ "test", 0.146 ], [ "break", 0.088 ], [ "blood", 0.078 ], [ "pill", 0.061 ] ], "spread_patient": [ [ "pregnancy", 0.742 ], [ "test", 0.165 ], [ "home", 0.025 ], [ "blood", 0.006 ], [ "trip", 0.006 ] ], "target_token": "pregnancy", "anchor_fallback": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " pregnancy", "observed_clinical": [ "Output \" pregnancy\"", 0.309 ], "probe_extension": null }, "circuit_diff": { "shared_features": 592, "unique_to_a": 814, "unique_to_b": 590 }, "clinical_mass": { "clinical": 0.3269, "patient": 0.3061 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260715T132350Z/index_93.html" }, { "index": 928, "batch": "pairs_20260715T132350Z", "batch_index": 94, "clinical_prompt": "I have ocular pain with foreign body sensation, so I need to see an", "patient_prompt": "My eye's been really painful and I've got this gritty feeling in there, so I need to see an", "intended_target": "ophthalmologist", "rationale": "Foreign body sensation + pain directs to specialist eye care; colloquial version might be self-treated with drops.", "patient_term": "really painful and I've got this gritty feeling", "clinical_term": "ocular pain with foreign body sensation", "topic": "Eyes ears & mouth", "topics": [ "Infections & fever", "Kidneys & urinary", "Reproductive & sexual health", "Hormones & metabolism", "Eyes ears & mouth" ], "models": { "gemma-2-2b": { "prob_clinical": 0.285, "prob_patient": 0.06, "language_penalty": -0.22499999999999998, "anchor_fallback": false, "top_clinical": [ "ophthal", 0.285 ], "top_patient": [ "op", 0.389 ], "spread_clinical": [ [ "ophthal", 0.285 ], [ "eye", 0.252 ], [ "op", 0.153 ], [ "opto", 0.135 ], [ "Ophthal", 0.03 ] ], "spread_patient": [ [ "op", 0.389 ], [ "eye", 0.303 ], [ "opto", 0.184 ], [ "ophthal", 0.06 ], [ "Ophthal", 0.01 ] ], "target_token": "ophthal", "flipped": true, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " ophthalmologist", "observed_clinical": [ "Output \" ophthal\"", 0.285 ], "probe_extension": null }, "circuit_diff": { "shared_features": 541, "unique_to_a": 619, "unique_to_b": 628 }, "clinical_mass": { "clinical": 0.4497, "patient": 0.3336 }, "html": "modes/simulated/pairs_20260715T132350Z/index_94.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } } }, "prob_clinical": 0.285, "prob_patient": 0.06, "language_penalty": -0.22499999999999998, "flipped": true, "top_clinical": [ "ophthal", 0.285 ], "top_patient": [ "op", 0.389 ], "spread_clinical": [ [ "ophthal", 0.285 ], [ "eye", 0.252 ], [ "op", 0.153 ], [ "opto", 0.135 ], [ "Ophthal", 0.03 ] ], "spread_patient": [ [ "op", 0.389 ], [ "eye", 0.303 ], [ "opto", 0.184 ], [ "ophthal", 0.06 ], [ "Ophthal", 0.01 ] ], "target_token": "ophthal", "anchor_fallback": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " ophthalmologist", "observed_clinical": [ "Output \" ophthal\"", 0.285 ], "probe_extension": null }, "circuit_diff": { "shared_features": 541, "unique_to_a": 619, "unique_to_b": 628 }, "clinical_mass": { "clinical": 0.4497, "patient": 0.3336 }, "html": "modes/simulated/pairs_20260715T132350Z/index_94.html", "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260715T132350Z/index_94.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, { "index": 929, "batch": "pairs_20260715T132350Z", "batch_index": 95, "clinical_prompt": "I have oral thrush with a metallic taste, so I might have an", "patient_prompt": "I've got this nasty white coating all over my tongue and my mouth tastes funny, so I might have an", "intended_target": "infection", "rationale": "Oral thrush + metallic taste indicates candida infection requiring antifungal treatment; lay phrasing could prompt mouth rinse attempts.", "patient_term": "nasty white coating all over my tongue and my mouth tastes funny", "clinical_term": "oral thrush with a metallic taste", "topic": "Eyes ears & mouth", "topics": [ "Infections & fever", "Kidneys & urinary", "Reproductive & sexual health", "Hormones & metabolism", "Eyes ears & mouth" ], "models": { "gemma-2-2b": { "prob_clinical": 0.131, "prob_patient": 0.676, "language_penalty": 0.545, "anchor_fallback": false, "top_clinical": [ "issue", 0.169 ], "top_patient": [ "infection", 0.676 ], "spread_clinical": [ [ "issue", 0.169 ], [ "infection", 0.131 ], [ "idea", 0.09 ], [ "allergy", 0.055 ], [ "oral", 0.048 ] ], "spread_patient": [ [ "infection", 0.676 ], [ "oral", 0.081 ], [ "ulcer", 0.049 ], [ "issue", 0.026 ], [ "allergy", 0.012 ] ], "target_token": "infection", "flipped": true, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " infection", "observed_clinical": [ "Output \" infection\"", 0.131 ], "probe_extension": null }, "circuit_diff": { "shared_features": 565, "unique_to_a": 764, "unique_to_b": 827 }, "clinical_mass": { "clinical": 0.3624, "patient": 0.3924 }, "html": "modes/simulated/pairs_20260715T132350Z/index_95.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } } }, "prob_clinical": 0.131, "prob_patient": 0.676, "language_penalty": 0.545, "flipped": true, "top_clinical": [ "issue", 0.169 ], "top_patient": [ "infection", 0.676 ], "spread_clinical": [ [ "issue", 0.169 ], [ "infection", 0.131 ], [ "idea", 0.09 ], [ "allergy", 0.055 ], [ "oral", 0.048 ] ], "spread_patient": [ [ "infection", 0.676 ], [ "oral", 0.081 ], [ "ulcer", 0.049 ], [ "issue", 0.026 ], [ "allergy", 0.012 ] ], "target_token": "infection", "anchor_fallback": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " infection", "observed_clinical": [ "Output \" infection\"", 0.131 ], "probe_extension": null }, "circuit_diff": { "shared_features": 565, "unique_to_a": 764, "unique_to_b": 827 }, "clinical_mass": { "clinical": 0.3624, "patient": 0.3924 }, "html": "modes/simulated/pairs_20260715T132350Z/index_95.html", "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260715T132350Z/index_95.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, { "index": 930, "batch": "pairs_20260715T132350Z", "batch_index": 97, "clinical_prompt": "I have purulent exudate with periorbital edema, so I need to pick up some", "patient_prompt": "I've got this sticky discharge and my eye's really puffy, so I need to pick up some", "intended_target": "antibiotics", "rationale": "Purulent exudate and periorbital edema are clinical descriptors indicating bacterial eye infection. The clinical phrasing directs toward prescription antibiotics rather than home remedies.", "patient_term": "sticky discharge and my eye's really puffy", "clinical_term": "purulent exudate with periorbital edema", "topic": "Eyes ears & mouth", "topics": [ "Infections & fever", "Kidneys & urinary", "Reproductive & sexual health", "Hormones & metabolism", "Eyes ears & mouth" ], "models": { "gemma-2-2b": { "prob_clinical": 0.183, "prob_patient": null, "language_penalty": null, "anchor_fallback": false, "top_clinical": [ "antibiotics", 0.183 ], "top_patient": [ "eye", 0.33 ], "spread_clinical": [ [ "antibiotics", 0.183 ], [ "eye", 0.076 ], [ "anti", 0.052 ], [ "antibiotic", 0.052 ], [ "medicine", 0.046 ] ], "spread_patient": [ [ "eye", 0.33 ], [ "new", 0.057 ], [ "more", 0.039 ], [ "allergy", 0.039 ], [ "cold", 0.027 ] ], "target_token": "antibiotics", "flipped": true, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " antibiotics", "observed_clinical": [ "Output \" antibiotics\"", 0.183 ], "probe_extension": null }, "circuit_diff": { "shared_features": 534, "unique_to_a": 838, "unique_to_b": 883 }, "clinical_mass": { "clinical": 0.4389, "patient": 0.2995 }, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } } }, "prob_clinical": 0.183, "prob_patient": null, "language_penalty": null, "flipped": true, "top_clinical": [ "antibiotics", 0.183 ], "top_patient": [ "eye", 0.33 ], "spread_clinical": [ [ "antibiotics", 0.183 ], [ "eye", 0.076 ], [ "anti", 0.052 ], [ "antibiotic", 0.052 ], [ "medicine", 0.046 ] ], "spread_patient": [ [ "eye", 0.33 ], [ "new", 0.057 ], [ "more", 0.039 ], [ "allergy", 0.039 ], [ "cold", 0.027 ] ], "target_token": "antibiotics", "anchor_fallback": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " antibiotics", "observed_clinical": [ "Output \" antibiotics\"", 0.183 ], "probe_extension": null }, "circuit_diff": { "shared_features": 534, "unique_to_a": 838, "unique_to_b": 883 }, "clinical_mass": { "clinical": 0.4389, "patient": 0.2995 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260715T132350Z/index_97.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, { "index": 931, "batch": "pairs_20260715T132350Z", "batch_index": 98, "clinical_prompt": "I've been experiencing hot flushes with auricular erythema, so I might need to check my", "patient_prompt": "I've been feeling really flushed and my ears keep getting hot, so I might need to check my", "intended_target": "thyroid", "rationale": "The clinical phrasing (hot flushes + auricular erythema) strongly signals endocrine dysfunction, steering the model toward thyroid-related testing as the natural next step, whereas the colloquial version could vaguely suggest environmental or stress-related warmth.", "patient_term": "feeling really flushed and my ears keep getting hot", "clinical_term": "experiencing hot flushes with auricular erythema", "topic": "Hormones & metabolism", "topics": [ "Infections & fever", "Kidneys & urinary", "Reproductive & sexual health", "Hormones & metabolism", "Eyes ears & mouth" ], "models": { "gemma-2-2b": { "prob_clinical": 0.303, "prob_patient": 0.163, "language_penalty": -0.13999999999999999, "anchor_fallback": false, "top_clinical": [ "thyroid", 0.303 ], "top_patient": [ "blood", 0.391 ], "spread_clinical": [ [ "thyroid", 0.303 ], [ "blood", 0.098 ], [ "hormones", 0.052 ], [ "estrogen", 0.052 ], [ "hormone", 0.046 ] ], "spread_patient": [ [ "blood", 0.391 ], [ "thyroid", 0.163 ], [ "temperature", 0.06 ], [ "ears", 0.053 ], [ "heart", 0.041 ] ], "target_token": "thyroid", "flipped": true, "screening": null, "circuit_diff": { "shared_features": 731, "unique_to_a": 704, "unique_to_b": 737 }, "clinical_mass": { "clinical": 0.3439, "patient": 0.3022 }, "html": "modes/simulated/pairs_20260715T132350Z/index_98.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": 2, "tier_shift": null } } }, "prob_clinical": 0.303, "prob_patient": 0.163, "language_penalty": -0.13999999999999999, "flipped": true, "top_clinical": [ "thyroid", 0.303 ], "top_patient": [ "blood", 0.391 ], "spread_clinical": [ [ "thyroid", 0.303 ], [ "blood", 0.098 ], [ "hormones", 0.052 ], [ "estrogen", 0.052 ], [ "hormone", 0.046 ] ], "spread_patient": [ [ "blood", 0.391 ], [ "thyroid", 0.163 ], [ "temperature", 0.06 ], [ "ears", 0.053 ], [ "heart", 0.041 ] ], "target_token": "thyroid", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 731, "unique_to_a": 704, "unique_to_b": 737 }, "clinical_mass": { "clinical": 0.3439, "patient": 0.3022 }, "html": "modes/simulated/pairs_20260715T132350Z/index_98.html", "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260715T132350Z/index_98.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": 2, "tier_shift": null } }, { "index": 932, "batch": "pairs_20260715T132350Z", "batch_index": 99, "clinical_prompt": "I've been passing turbid urine with dysuria, so I should probably take an", "patient_prompt": "I've been passing cloudy water and it stings like anything, so I should probably take an", "intended_target": "antibiotic", "rationale": "The clinical framing (turbid urine + dysuria) unambiguously signals urinary tract infection, making antibiotic the preferred continuation; the colloquial phrasing is less medically specific and might allow other interpretations.", "patient_term": "passing cloudy water and it stings like anything", "clinical_term": "passing turbid urine with dysuria", "topic": "Kidneys & urinary", "topics": [ "Infections & fever", "Kidneys & urinary", "Reproductive & sexual health", "Hormones & metabolism", "Eyes ears & mouth" ], "models": { "gemma-2-2b": { "prob_clinical": 0.365, "prob_patient": 0.245, "language_penalty": -0.12, "anchor_fallback": false, "top_clinical": [ "antibiotic", 0.365 ], "top_patient": [ "antibiotic", 0.245 ], "spread_clinical": [ [ "antibiotic", 0.365 ], [ "ur", 0.063 ], [ "over", 0.063 ], [ "anti", 0.049 ], [ "exam", 0.043 ] ], "spread_patient": [ [ "antibiotic", 0.245 ], [ "anti", 0.08 ], [ "acid", 0.07 ], [ "aspirin", 0.055 ], [ "eye", 0.048 ] ], "target_token": "antibiotic", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 768, "unique_to_a": 579, "unique_to_b": 627 }, "clinical_mass": { "clinical": 0.3557, "patient": 0.2163 }, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.14 } } }, "prob_clinical": 0.365, "prob_patient": 0.245, "language_penalty": -0.12, "flipped": false, "top_clinical": [ "antibiotic", 0.365 ], "top_patient": [ "antibiotic", 0.245 ], "spread_clinical": [ [ "antibiotic", 0.365 ], [ "ur", 0.063 ], [ "over", 0.063 ], [ "anti", 0.049 ], [ "exam", 0.043 ] ], "spread_patient": [ [ "antibiotic", 0.245 ], [ "anti", 0.08 ], [ "acid", 0.07 ], [ "aspirin", 0.055 ], [ "eye", 0.048 ] ], "target_token": "antibiotic", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 768, "unique_to_a": 579, "unique_to_b": 627 }, "clinical_mass": { "clinical": 0.3557, "patient": 0.2163 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260715T132350Z/index_99.html", "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.14 } }, { "index": 933, "batch": "pairs_20260715T132350Z", "batch_index": 100, "clinical_prompt": "I have vulvovaginal pruritus and it's driving me crazy, so I need to pick up some", "patient_prompt": "I've been getting a nasty itch down below and it's driving me crazy, so I need to pick up some", "intended_target": "cream", "rationale": "The clinical term 'vulvovaginal pruritus' shifts the frame from casual discomfort to a named clinical condition, making the next token diagnostically shift toward medical remedies (cream, antifungal) rather than casual itch solutions. The grammatical frame '...so I need to pick up some' funnels hard toward a countable remedy noun, and the clinical phrasing strongly biases toward clinical-grade treatments.", "patient_term": "nasty itch down below", "clinical_term": "vulvovaginal pruritus", "topic": "Reproductive & sexual health", "topics": [ "Infections & fever", "Kidneys & urinary", "Reproductive & sexual health", "Hormones & metabolism", "Eyes ears & mouth" ], "models": { "gemma-2-2b": { "prob_clinical": 0.107, "prob_patient": 0.085, "language_penalty": -0.021999999999999992, "anchor_fallback": false, "top_clinical": [ "cream", 0.107 ], "top_patient": [ "new", 0.11 ], "spread_clinical": [ [ "cream", 0.107 ], [ "itch", 0.057 ], [ "hydro", 0.051 ], [ "new", 0.04 ], [ "treatment", 0.035 ] ], "spread_patient": [ [ "new", 0.11 ], [ "lotion", 0.097 ], [ "cream", 0.085 ], [ "lube", 0.036 ], [ "anti", 0.036 ] ], "target_token": "cream", "flipped": true, "screening": null, "circuit_diff": { "shared_features": 801, "unique_to_a": 679, "unique_to_b": 766 }, "clinical_mass": { "clinical": 0.3908, "patient": 0.2665 }, "urgency": { "flip_class": "uninformative", "tier_top_clinical": 1, "tier_top_patient": null, "tier_shift": 0.0 } } }, "prob_clinical": 0.107, "prob_patient": 0.085, "language_penalty": -0.021999999999999992, "flipped": true, "top_clinical": [ "cream", 0.107 ], "top_patient": [ "new", 0.11 ], "spread_clinical": [ [ "cream", 0.107 ], [ "itch", 0.057 ], [ "hydro", 0.051 ], [ "new", 0.04 ], [ "treatment", 0.035 ] ], "spread_patient": [ [ "new", 0.11 ], [ "lotion", 0.097 ], [ "cream", 0.085 ], [ "lube", 0.036 ], [ "anti", 0.036 ] ], "target_token": "cream", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 801, "unique_to_a": 679, "unique_to_b": 766 }, "clinical_mass": { "clinical": 0.3908, "patient": 0.2665 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260715T132350Z/index_100.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": 1, "tier_top_patient": null, "tier_shift": 0.0 } }, { "index": 934, "batch": "pairs_20260716T133552Z", "batch_index": 1, "clinical_prompt": "My kid has a fever, so I need to give her some", "patient_prompt": "My kid is burning up, so I need to give her some", "intended_target": "medicine", "rationale": "The colloquial 'burning up' could lead to a mundane continuation like 'water' or 'blanket', while the clinical 'fever' funnels toward the high-frequency medical noun 'medicine', testing whether the model shifts toward care-seeking completions.", "patient_term": "burning up", "clinical_term": "a fever", "topic": "infections and fever", "topics": [ "infections and fever", "reproductive and sexual health", "kidneys and urinary", "hormones and metabolism", "eyes ears and mouth" ], "models": { "gemma-2-2b": { "prob_clinical": 0.307, "prob_patient": 0.132, "language_penalty": -0.175, "anchor_fallback": false, "top_clinical": [ "medicine", 0.307 ], "top_patient": [ "medicine", 0.132 ], "spread_clinical": [ [ "medicine", 0.307 ], [ "T", 0.145 ], [ "medication", 0.06 ], [ "ibuprofen", 0.047 ], [ "para", 0.037 ] ], "spread_patient": [ [ "medicine", 0.132 ], [ "T", 0.116 ], [ "pain", 0.049 ], [ "ibuprofen", 0.049 ], [ "relief", 0.038 ] ], "target_token": "medicine", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 781, "unique_to_a": 509, "unique_to_b": 530 }, "clinical_mass": { "clinical": 0.4025, "patient": 0.2354 }, "urgency": { "flip_class": null, "tier_top_clinical": 1, "tier_top_patient": 1, "tier_shift": 0.0 } } }, "prob_clinical": 0.307, "prob_patient": 0.132, "language_penalty": -0.175, "flipped": false, "top_clinical": [ "medicine", 0.307 ], "top_patient": [ "medicine", 0.132 ], "spread_clinical": [ [ "medicine", 0.307 ], [ "T", 0.145 ], [ "medication", 0.06 ], [ "ibuprofen", 0.047 ], [ "para", 0.037 ] ], "spread_patient": [ [ "medicine", 0.132 ], [ "T", 0.116 ], [ "pain", 0.049 ], [ "ibuprofen", 0.049 ], [ "relief", 0.038 ] ], "target_token": "medicine", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 781, "unique_to_a": 509, "unique_to_b": 530 }, "clinical_mass": { "clinical": 0.4025, "patient": 0.2354 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260716T133552Z/index_01.html", "urgency": { "flip_class": null, "tier_top_clinical": 1, "tier_top_patient": 1, "tier_shift": 0.0 } }, { "index": 935, "batch": "pairs_20260716T133552Z", "batch_index": 2, "clinical_prompt": "I think I have an STI, so I should get a", "patient_prompt": "I think I caught something down there, so I should get a", "intended_target": "test", "rationale": "The vague lay phrase could continue with an everyday noun like 'cream', while the precise clinical term 'STI' strongly funnels toward the common diagnostic noun 'test', letting us measure the shift toward medical framing.", "patient_term": "caught something down there", "clinical_term": "an STI", "topic": "reproductive and sexual health", "topics": [ "infections and fever", "reproductive and sexual health", "kidneys and urinary", "hormones and metabolism", "eyes ears and mouth" ], "models": { "gemma-2-2b": { "prob_clinical": 0.108, "prob_patient": null, "language_penalty": null, "anchor_fallback": false, "top_clinical": [ null, 0.108 ], "top_patient": [ "new", 0.066 ], "spread_clinical": [ [ "STI", 0.108 ], [ "WRX", 0.051 ], [ "new", 0.045 ], [ "tune", 0.031 ] ], "spread_patient": [ [ "new", 0.066 ], [ "test", 0.066 ], [ "check", 0.052 ], [ "blood", 0.052 ], [ "good", 0.052 ] ], "target_token": null, "flipped": true, "screening": null, "circuit_diff": { "shared_features": 538, "unique_to_a": 667, "unique_to_b": 721 }, "clinical_mass": { "clinical": 0.0621, "patient": 0.16 }, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } } }, "prob_clinical": 0.108, "prob_patient": null, "language_penalty": null, "flipped": true, "top_clinical": [ null, 0.108 ], "top_patient": [ "new", 0.066 ], "spread_clinical": [ [ "STI", 0.108 ], [ "WRX", 0.051 ], [ "new", 0.045 ], [ "tune", 0.031 ] ], "spread_patient": [ [ "new", 0.066 ], [ "test", 0.066 ], [ "check", 0.052 ], [ "blood", 0.052 ], [ "good", 0.052 ] ], "target_token": null, "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 538, "unique_to_a": 667, "unique_to_b": 721 }, "clinical_mass": { "clinical": 0.0621, "patient": 0.16 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260716T133552Z/index_02.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, { "index": 936, "batch": "pairs_20260716T133552Z", "batch_index": 3, "clinical_prompt": "I have diabetes, so I need to check my", "patient_prompt": "My sugar's been all over the place lately, so I need to check my", "intended_target": "blood", "rationale": "The colloquial phrase about erratic 'sugar' could continue toward unrelated everyday nouns, while the clinical term 'diabetes' funnels toward the frequent medical noun 'blood' (as in checking blood sugar), revealing a shift toward clinical self-monitoring language.", "patient_term": "my sugar's been all over the place", "clinical_term": "I have diabetes", "topic": "hormones and metabolism", "topics": [ "infections and fever", "reproductive and sexual health", "kidneys and urinary", "hormones and metabolism", "eyes ears and mouth" ], "models": { "gemma-2-2b": { "prob_clinical": 0.719, "prob_patient": 0.242, "language_penalty": -0.477, "anchor_fallback": false, "top_clinical": [ "blood", 0.719 ], "top_patient": [ "blood", 0.242 ], "spread_clinical": [ [ "blood", 0.719 ], [ "sugar", 0.11 ], [ "glucose", 0.086 ], [ "sugars", 0.013 ], [ "levels", 0.009 ] ], "spread_patient": [ [ "blood", 0.242 ], [ "levels", 0.061 ], [ "insulin", 0.061 ], [ "diet", 0.061 ], [ "glucose", 0.048 ] ], "target_token": "blood", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 456, "unique_to_a": 526, "unique_to_b": 788 }, "clinical_mass": { "clinical": 0.3333, "patient": 0.2152 }, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.137 } } }, "prob_clinical": 0.719, "prob_patient": 0.242, "language_penalty": -0.477, "flipped": false, "top_clinical": [ "blood", 0.719 ], "top_patient": [ "blood", 0.242 ], "spread_clinical": [ [ "blood", 0.719 ], [ "sugar", 0.11 ], [ "glucose", 0.086 ], [ "sugars", 0.013 ], [ "levels", 0.009 ] ], "spread_patient": [ [ "blood", 0.242 ], [ "levels", 0.061 ], [ "insulin", 0.061 ], [ "diet", 0.061 ], [ "glucose", 0.048 ] ], "target_token": "blood", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 456, "unique_to_a": 526, "unique_to_b": 788 }, "clinical_mass": { "clinical": 0.3333, "patient": 0.2152 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260716T133552Z/index_03.html", "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.137 } }, { "index": 937, "batch": "pairs_20260716T133552Z", "batch_index": 4, "clinical_prompt": "I have a dental abscess, so I need to see a", "patient_prompt": "My tooth's been killing me, so I need to see a", "intended_target": "dentist", "rationale": "The idiomatic 'killing me' could continue toward informal contexts, whereas the precise clinical term 'dental abscess' strongly funnels toward the high-frequency, care-seeking noun 'dentist'.", "patient_term": "my tooth's been killing me", "clinical_term": "a dental abscess", "topic": "eyes ears and mouth", "topics": [ "infections and fever", "reproductive and sexual health", "kidneys and urinary", "hormones and metabolism", "eyes ears and mouth" ], "models": { "gemma-2-2b": { "prob_clinical": 0.746, "prob_patient": 0.918, "language_penalty": 0.17200000000000004, "anchor_fallback": false, "top_clinical": [ "dentist", 0.746 ], "top_patient": [ "dentist", 0.918 ], "spread_clinical": [ [ "dentist", 0.746 ], [ "specialist", 0.079 ], [ "doctor", 0.079 ], [ "dental", 0.015 ], [ "root", 0.009 ] ], "spread_patient": [ [ "dentist", 0.918 ], [ "doctor", 0.019 ], [ "new", 0.019 ] ], "target_token": "dentist", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 463, "unique_to_a": 580, "unique_to_b": 421 }, "clinical_mass": { "clinical": 0.4654, "patient": 0.3932 }, "urgency": { "flip_class": null, "tier_top_clinical": 3, "tier_top_patient": 3, "tier_shift": 0.067 } } }, "prob_clinical": 0.746, "prob_patient": 0.918, "language_penalty": 0.17200000000000004, "flipped": false, "top_clinical": [ "dentist", 0.746 ], "top_patient": [ "dentist", 0.918 ], "spread_clinical": [ [ "dentist", 0.746 ], [ "specialist", 0.079 ], [ "doctor", 0.079 ], [ "dental", 0.015 ], [ "root", 0.009 ] ], "spread_patient": [ [ "dentist", 0.918 ], [ "doctor", 0.019 ], [ "new", 0.019 ] ], "target_token": "dentist", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 463, "unique_to_a": 580, "unique_to_b": 421 }, "clinical_mass": { "clinical": 0.4654, "patient": 0.3932 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260716T133552Z/index_04.html", "urgency": { "flip_class": null, "tier_top_clinical": 3, "tier_top_patient": 3, "tier_shift": 0.067 } }, { "index": 938, "batch": "pairs_20260716T133552Z", "batch_index": 5, "clinical_prompt": "I have a fever, so I should take my", "patient_prompt": "I feel like I'm burning up, so I should take my", "intended_target": "temperature", "rationale": "The clinical framing 'have a fever' strongly primes 'take my temperature' as a medical action, while the colloquial 'burning up' could plausibly continue toward an everyday reading like weather or exertion, letting the term swap shift the model's top prediction.", "patient_term": "burning up", "clinical_term": "a fever", "topic": "infections and fever", "topics": [ "infections and fever", "reproductive and sexual health", "kidneys and urinary", "hormones and metabolism", "eyes ears and mouth" ], "models": { "gemma-2-2b": { "prob_clinical": 0.328, "prob_patient": 0.179, "language_penalty": -0.14900000000000002, "anchor_fallback": false, "top_clinical": [ "temperature", 0.328 ], "top_patient": [ "temperature", 0.179 ], "spread_clinical": [ [ "temperature", 0.328 ], [ "medicine", 0.256 ], [ "meds", 0.094 ], [ "medication", 0.027 ], [ "own", 0.024 ] ], "spread_patient": [ [ "temperature", 0.179 ], [ "shirt", 0.139 ], [ "clothes", 0.074 ], [ "medicine", 0.065 ], [ "jacket", 0.058 ] ], "target_token": "temperature", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 539, "unique_to_a": 562, "unique_to_b": 671 }, "clinical_mass": { "clinical": 0.2927, "patient": 0.1348 }, "urgency": { "flip_class": null, "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": -0.752 } } }, "prob_clinical": 0.328, "prob_patient": 0.179, "language_penalty": -0.14900000000000002, "flipped": false, "top_clinical": [ "temperature", 0.328 ], "top_patient": [ "temperature", 0.179 ], "spread_clinical": [ [ "temperature", 0.328 ], [ "medicine", 0.256 ], [ "meds", 0.094 ], [ "medication", 0.027 ], [ "own", 0.024 ] ], "spread_patient": [ [ "temperature", 0.179 ], [ "shirt", 0.139 ], [ "clothes", 0.074 ], [ "medicine", 0.065 ], [ "jacket", 0.058 ] ], "target_token": "temperature", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 539, "unique_to_a": 562, "unique_to_b": 671 }, "clinical_mass": { "clinical": 0.2927, "patient": 0.1348 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260716T133552Z/index_05.html", "urgency": { "flip_class": null, "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": -0.752 } }, { "index": 939, "batch": "pairs_20260716T133552Z", "batch_index": 6, "clinical_prompt": "I think I might be pregnant, so I need to take a", "patient_prompt": "I think I might be knocked up, so I need to take a", "intended_target": "test", "rationale": "Both phrasings describe the same condition, but 'pregnant' is the clinical trigger word that should push the model toward 'test' (as in pregnancy test), while 'knocked up' may weaken that association due to its slangy, less medical register.", "patient_term": "knocked up", "clinical_term": "pregnant", "topic": "reproductive and sexual health", "topics": [ "infections and fever", "reproductive and sexual health", "kidneys and urinary", "hormones and metabolism", "eyes ears and mouth" ], "models": { "gemma-2-2b": { "prob_clinical": 0.241, "prob_patient": 0.146, "language_penalty": -0.095, "anchor_fallback": false, "top_clinical": [ "pregnancy", 0.578 ], "top_patient": [ "pregnancy", 0.582 ], "spread_clinical": [ [ "pregnancy", 0.578 ], [ "test", 0.241 ], [ "home", 0.029 ], [ "H", 0.02 ], [ "few", 0.015 ] ], "spread_patient": [ [ "pregnancy", 0.582 ], [ "test", 0.146 ], [ "few", 0.02 ], [ "blood", 0.02 ], [ "home", 0.02 ] ], "target_token": "test", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 675, "unique_to_a": 337, "unique_to_b": 445 }, "clinical_mass": { "clinical": 0.2454, "patient": 0.1961 } } }, "prob_clinical": 0.241, "prob_patient": 0.146, "language_penalty": -0.095, "flipped": false, "top_clinical": [ "pregnancy", 0.578 ], "top_patient": [ "pregnancy", 0.582 ], "spread_clinical": [ [ "pregnancy", 0.578 ], [ "test", 0.241 ], [ "home", 0.029 ], [ "H", 0.02 ], [ "few", 0.015 ] ], "spread_patient": [ [ "pregnancy", 0.582 ], [ "test", 0.146 ], [ "few", 0.02 ], [ "blood", 0.02 ], [ "home", 0.02 ] ], "target_token": "test", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 675, "unique_to_a": 337, "unique_to_b": 445 }, "clinical_mass": { "clinical": 0.2454, "patient": 0.1961 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260716T133552Z/index_06.html" }, { "index": 940, "batch": "pairs_20260716T133552Z", "batch_index": 7, "clinical_prompt": "I've developed tinnitus, so I should get a", "patient_prompt": "My ears have been ringing like crazy, so I should get a", "intended_target": "hearing", "rationale": "The colloquial description could plausibly continue toward a mundane fix like earplugs, while the clinical term 'tinnitus' should bias the model toward a medical noun phrase such as 'hearing test'.", "patient_term": "ears have been ringing like crazy", "clinical_term": "developed tinnitus", "topic": "eyes ears and mouth", "topics": [ "infections and fever", "reproductive and sexual health", "kidneys and urinary", "hormones and metabolism", "eyes ears and mouth" ], "models": { "gemma-2-2b": { "prob_clinical": 0.246, "prob_patient": 0.285, "language_penalty": 0.03899999999999998, "anchor_fallback": false, "top_clinical": [ "hearing", 0.246 ], "top_patient": [ "hearing", 0.285 ], "spread_clinical": [ [ "hearing", 0.246 ], [ "refund", 0.055 ], [ "new", 0.049 ], [ "pair", 0.049 ], [ "good", 0.043 ] ], "spread_patient": [ [ "hearing", 0.285 ], [ "new", 0.105 ], [ "good", 0.072 ], [ "check", 0.056 ], [ "pair", 0.05 ] ], "target_token": "hearing", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 579, "unique_to_a": 664, "unique_to_b": 770 }, "clinical_mass": { "clinical": 0.172, "patient": 0.1904 } } }, "prob_clinical": 0.246, "prob_patient": 0.285, "language_penalty": 0.03899999999999998, "flipped": false, "top_clinical": [ "hearing", 0.246 ], "top_patient": [ "hearing", 0.285 ], "spread_clinical": [ [ "hearing", 0.246 ], [ "refund", 0.055 ], [ "new", 0.049 ], [ "pair", 0.049 ], [ "good", 0.043 ] ], "spread_patient": [ [ "hearing", 0.285 ], [ "new", 0.105 ], [ "good", 0.072 ], [ "check", 0.056 ], [ "pair", 0.05 ] ], "target_token": "hearing", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 579, "unique_to_a": 664, "unique_to_b": 770 }, "clinical_mass": { "clinical": 0.172, "patient": 0.1904 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260716T133552Z/index_07.html" }, { "index": 941, "batch": "pairs_20260716T133552Z", "batch_index": 8, "clinical_prompt": "I have blurred vision, so I need to see an", "patient_prompt": "Everything's been blurry lately, so I need to see an", "intended_target": "eye", "rationale": "Both phrases describe the same visual symptom, but the clinical framing 'blurred vision' should more strongly funnel the vowel-initial article 'an' toward 'eye' (as in eye doctor) than the vaguer everyday phrase 'everything's been blurry'.", "patient_term": "everything's been blurry", "clinical_term": "blurred vision", "topic": "eyes ears and mouth", "topics": [ "infections and fever", "reproductive and sexual health", "kidneys and urinary", "hormones and metabolism", "eyes ears and mouth" ], "models": { "gemma-2-2b": { "prob_clinical": 0.35, "prob_patient": 0.451, "language_penalty": 0.10100000000000003, "anchor_fallback": false, "top_clinical": [ "eye", 0.35 ], "top_patient": [ "eye", 0.451 ], "spread_clinical": [ [ "eye", 0.35 ], [ "opto", 0.24 ], [ "ophthal", 0.146 ], [ "op", 0.088 ], [ "image", 0.025 ] ], "spread_patient": [ [ "eye", 0.451 ], [ "opto", 0.241 ], [ "op", 0.114 ], [ "ophthal", 0.114 ], [ "ENT", 0.014 ] ], "target_token": "eye", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 523, "unique_to_a": 569, "unique_to_b": 662 }, "clinical_mass": { "clinical": 0.2316, "patient": 0.2174 } } }, "prob_clinical": 0.35, "prob_patient": 0.451, "language_penalty": 0.10100000000000003, "flipped": false, "top_clinical": [ "eye", 0.35 ], "top_patient": [ "eye", 0.451 ], "spread_clinical": [ [ "eye", 0.35 ], [ "opto", 0.24 ], [ "ophthal", 0.146 ], [ "op", 0.088 ], [ "image", 0.025 ] ], "spread_patient": [ [ "eye", 0.451 ], [ "opto", 0.241 ], [ "op", 0.114 ], [ "ophthal", 0.114 ], [ "ENT", 0.014 ] ], "target_token": "eye", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 523, "unique_to_a": 569, "unique_to_b": 662 }, "clinical_mass": { "clinical": 0.2316, "patient": 0.2174 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260716T133552Z/index_08.html" }, { "index": 942, "batch": "pairs_20260717T132235Z", "batch_index": 1, "clinical_prompt": "She has dysuria, so her doctor prescribed a", "patient_prompt": "She's been burning down there, so her doctor prescribed a", "intended_target": "antibiotic", "rationale": "Colloquial euphemism 'burning down there' vs. clinical term for painful urination. Frame 'prescribed a' is diagnostically different: clinical term triggers 'antibiotic'; patient phrasing might suggest 'cream' or 'powder'.", "patient_term": "burning down there", "clinical_term": "dysuria", "topic": "kidneys and urinary", "topics": [ "infections and fever", "reproductive and sexual health", "kidneys and urinary", "hormones and metabolism" ], "models": { "gemma-2-2b": { "prob_clinical": 0.098, "prob_patient": null, "language_penalty": null, "anchor_fallback": true, "top_clinical": [ "cyclo", 0.098 ], "top_patient": [ "little", 0.086 ], "spread_clinical": [ [ "cyclo", 0.098 ], [ "course", 0.067 ], [ "drug", 0.067 ], [ "medication", 0.052 ] ], "spread_patient": [ [ "little", 0.086 ], [ "new", 0.086 ], [ "diet", 0.032 ], [ "few", 0.032 ], [ "course", 0.028 ] ], "target_token": "cyclo", "flipped": true, "screening": null, "circuit_diff": { "shared_features": 551, "unique_to_a": 905, "unique_to_b": 826 }, "clinical_mass": { "clinical": 0.4833, "patient": 0.218 }, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, "gemma-3-4b-it": { "prob_clinical": 0.0006, "prob_patient": 0.0, "language_penalty": -0.0006, "anchor_fallback": false, "top_clinical": [ "course", 0.5568 ], "top_patient": [ "new", 0.1143 ], "spread_clinical": [ [ "course", 0.5568 ], [ "low", 0.1096 ], [ "urinary", 0.0665 ], [ "medication", 0.0665 ], [ "trial", 0.0403 ], [ "broad", 0.0216 ], [ "topical", 0.0102 ], [ "prescription", 0.0102 ], [ "fluoro", 0.0079 ] ], "spread_patient": [ [ "new", 0.1143 ], [ "sedative", 0.0693 ], [ "prescription", 0.0395 ], [ "high", 0.0328 ], [ "medication", 0.0289 ], [ "special", 0.0289 ], [ "strong", 0.0289 ], [ "little", 0.0211 ], [ "very", 0.0165 ], [ "fire", 0.0155 ] ], "target_token": "antibiotic", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, "qwen3-4b": { "prob_clinical": 0.0158, "prob_patient": 0.0064, "language_penalty": -0.0094, "anchor_fallback": false, "top_clinical": [ "course", 0.2477 ], "top_patient": [ "new", 0.113 ], "spread_clinical": [ [ "course", 0.2477 ], [ "new", 0.1703 ], [ "drug", 0.0488 ], [ "certain", 0.038 ], [ "urinary", 0.0335 ], [ "medication", 0.0315 ], [ "dose", 0.0169 ], [ "antibiotic", 0.0158 ], [ "low", 0.0149 ] ], "spread_patient": [ [ "new", 0.113 ], [ "course", 0.0777 ], [ "lot", 0.0686 ], [ "cream", 0.0416 ], [ "medication", 0.0324 ], [ "special", 0.0237 ], [ "certain", 0.0237 ], [ "strong", 0.0209 ], [ "low", 0.0185 ], [ "drug", 0.0173 ] ], "target_token": "antibiotic", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": 1, "tier_shift": -0.497 } } }, "prob_clinical": 0.098, "prob_patient": null, "language_penalty": null, "flipped": true, "top_clinical": [ "cyclo", 0.098 ], "top_patient": [ "little", 0.086 ], "spread_clinical": [ [ "cyclo", 0.098 ], [ "course", 0.067 ], [ "drug", 0.067 ], [ "medication", 0.052 ] ], "spread_patient": [ [ "little", 0.086 ], [ "new", 0.086 ], [ "diet", 0.032 ], [ "few", 0.032 ], [ "course", 0.028 ] ], "target_token": "cyclo", "anchor_fallback": true, "screening": null, "circuit_diff": { "shared_features": 551, "unique_to_a": 905, "unique_to_b": 826 }, "clinical_mass": { "clinical": 0.4833, "patient": 0.218 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260717T132235Z/index_01.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, { "index": 943, "batch": "pairs_20260717T132235Z", "batch_index": 2, "clinical_prompt": "I have diabetes, so I need to see an", "patient_prompt": "My sugar levels are all over the map, so I need to see an", "intended_target": "endocrinologist", "rationale": "Lay description of blood glucose dyscontrol vs. clinical diagnosis. The frame 'need to see an' (before a vowel) predicts medical specialist; clinical term steers toward 'endocrinologist', while patient phrasing might suggest 'nutritionist' or 'doctor'.", "patient_term": "sugar levels are all over the map", "clinical_term": "diabetes", "topic": "hormones and metabolism", "topics": [ "infections and fever", "reproductive and sexual health", "kidneys and urinary", "hormones and metabolism" ], "models": { "gemma-2-2b": { "prob_clinical": 0.656, "prob_patient": 0.703, "language_penalty": 0.04699999999999993, "anchor_fallback": false, "top_clinical": [ "endoc", 0.656 ], "top_patient": [ "endoc", 0.703 ], "spread_clinical": [ [ "endoc", 0.656 ], [ "eye", 0.114 ], [ "Endoc", 0.089 ], [ "ophthal", 0.061 ], [ "endo", 0.011 ] ], "spread_patient": [ [ "endoc", 0.703 ], [ "Endoc", 0.139 ], [ "endo", 0.074 ], [ "expert", 0.01 ], [ "end", 0.01 ] ], "target_token": "endoc", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 523, "unique_to_a": 466, "unique_to_b": 621 }, "clinical_mass": { "clinical": 0.3409, "patient": 0.2872 } }, "gemma-3-4b-it": { "prob_clinical": 0.9263, "prob_patient": 0.9766, "language_penalty": 0.0503, "anchor_fallback": false, "top_clinical": [ "endocr", 0.9263 ], "top_patient": [ "endocr", 0.9766 ], "spread_clinical": [ [ "endocr", 0.9263 ], [ "eye", 0.0359 ], [ "ophthalm", 0.0132 ], [ "end", 0.0091 ], [ "Endocr", 0.008 ], [ "optomet", 0.0012 ], [ "Endocrinology", 0.001 ], [ "Eye", 0.0005 ], [ "OB", 0.0005 ], [ "End", 0.0004 ] ], "spread_patient": [ [ "endocr", 0.9766 ], [ "end", 0.0123 ], [ "Endocr", 0.0066 ], [ "expert", 0.0009 ], [ "eye", 0.0005 ], [ "Endocrinology", 0.0005 ], [ "urgent", 0.0004 ], [ "ophthalm", 0.0004 ], [ "endocrine", 0.0003 ], [ "OB", 0.0002 ] ], "target_token": "endocr", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null }, "qwen3-4b": { "prob_clinical": 0.9253, "prob_patient": 0.9863, "language_penalty": 0.061, "anchor_fallback": false, "top_clinical": [ "end", 0.9253 ], "top_patient": [ "end", 0.9863 ], "spread_clinical": [ [ "end", 0.9253 ], [ "eye", 0.0407 ], [ "o", 0.0247 ], [ "End", 0.0033 ], [ "opt", 0.0018 ], [ "expert", 0.001 ], [ "Eye", 0.0004 ], [ "orth", 0.0004 ], [ "O", 0.0003 ], [ "intern", 0.0002 ] ], "spread_patient": [ [ "end", 0.9863 ], [ "expert", 0.0059 ], [ "End", 0.0031 ], [ "eye", 0.0017 ], [ "experienced", 0.0003 ], [ "intern", 0.0003 ], [ "opt", 0.0002 ], [ "A", 0.0002 ], [ "OB", 0.0001 ], [ "doctor", 0.0001 ] ], "target_token": "end", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null } }, "prob_clinical": 0.656, "prob_patient": 0.703, "language_penalty": 0.04699999999999993, "flipped": false, "top_clinical": [ "endoc", 0.656 ], "top_patient": [ "endoc", 0.703 ], "spread_clinical": [ [ "endoc", 0.656 ], [ "eye", 0.114 ], [ "Endoc", 0.089 ], [ "ophthal", 0.061 ], [ "endo", 0.011 ] ], "spread_patient": [ [ "endoc", 0.703 ], [ "Endoc", 0.139 ], [ "endo", 0.074 ], [ "expert", 0.01 ], [ "end", 0.01 ] ], "target_token": "endoc", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 523, "unique_to_a": 466, "unique_to_b": 621 }, "clinical_mass": { "clinical": 0.3409, "patient": 0.2872 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260717T132235Z/index_02.html" }, { "index": 944, "batch": "pairs_20260717T132235Z", "batch_index": 3, "clinical_prompt": "I have kidney stones, so I've been drinking more", "patient_prompt": "I think my pipes are clogged, so I've been drinking more", "intended_target": "water", "rationale": "Colloquial metaphor 'pipes are clogged' vs. clinical diagnosis. Frame 'drinking more' naturally concludes with 'water' in a medical hydration context; patient phrasing might default to 'coffee' or 'tea'.", "patient_term": "pipes are clogged", "clinical_term": "kidney stones", "topic": "kidneys and urinary", "topics": [ "infections and fever", "reproductive and sexual health", "kidneys and urinary", "hormones and metabolism" ], "models": { "gemma-2-2b": { "prob_clinical": 0.84, "prob_patient": 0.443, "language_penalty": -0.39699999999999996, "anchor_fallback": false, "top_clinical": [ "water", 0.84 ], "top_patient": [ "water", 0.443 ], "spread_clinical": [ [ "water", 0.84 ], [ "fluids", 0.037 ], [ "and", 0.033 ], [ "than", 0.022 ], [ "liquids", 0.02 ] ], "spread_patient": [ [ "water", 0.443 ], [ "tea", 0.099 ], [ "coffee", 0.053 ], [ "and", 0.053 ], [ "than", 0.053 ] ], "target_token": "water", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 600, "unique_to_a": 570, "unique_to_b": 636 }, "clinical_mass": { "clinical": 0.2545, "patient": 0.1122 }, "urgency": { "flip_class": null, "tier_top_clinical": 0, "tier_top_patient": 0, "tier_shift": 0.0 } }, "gemma-3-4b-it": { "prob_clinical": 0.9841, "prob_patient": 0.9747, "language_penalty": -0.0094, "anchor_fallback": false, "top_clinical": [ "water", 0.9841 ], "top_patient": [ "water", 0.9747 ], "spread_clinical": [ [ "water", 0.9841 ], [ "fluids", 0.0109 ], [ "than", 0.0012 ], [ "and", 0.0009 ], [ "of", 0.0005 ], [ "fluid", 0.0004 ], [ ".", 0.0003 ], [ ",", 0.0003 ], [ "to", 0.0002 ], [ "H", 0.0002 ] ], "spread_patient": [ [ "water", 0.9747 ], [ "fluids", 0.0066 ], [ "than", 0.0045 ], [ "of", 0.0021 ], [ "and", 0.0019 ], [ "to", 0.0015 ], [ ",", 0.001 ], [ "coffee", 0.0007 ], [ "gallons", 0.0006 ], [ "bottled", 0.0005 ] ], "target_token": "water", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 0, "tier_top_patient": 0, "tier_shift": 0.0 } }, "qwen3-4b": { "prob_clinical": 0.9922, "prob_patient": 0.9571, "language_penalty": -0.0351, "anchor_fallback": false, "top_clinical": [ "water", 0.9922 ], "top_patient": [ "water", 0.9571 ], "spread_clinical": [ [ "water", 0.9922 ], [ "fluids", 0.0052 ], [ "fluid", 0.0005 ], [ ".", 0.0005 ], [ "than", 0.0003 ], [ "juice", 0.0003 ], [ "to", 0.0002 ], [ "and", 0.0002 ], [ ",", 0.0001 ], [ "liquids", 0.0001 ] ], "spread_patient": [ [ "water", 0.9571 ], [ "than", 0.012 ], [ "from", 0.0083 ], [ "tea", 0.0064 ], [ ".", 0.0035 ], [ "coffee", 0.0021 ], [ ",", 0.0011 ], [ "to", 0.0011 ], [ "and", 0.0008 ], [ "often", 0.0006 ] ], "target_token": "water", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 0, "tier_top_patient": 0, "tier_shift": 0.0 } } }, "prob_clinical": 0.84, "prob_patient": 0.443, "language_penalty": -0.39699999999999996, "flipped": false, "top_clinical": [ "water", 0.84 ], "top_patient": [ "water", 0.443 ], "spread_clinical": [ [ "water", 0.84 ], [ "fluids", 0.037 ], [ "and", 0.033 ], [ "than", 0.022 ], [ "liquids", 0.02 ] ], "spread_patient": [ [ "water", 0.443 ], [ "tea", 0.099 ], [ "coffee", 0.053 ], [ "and", 0.053 ], [ "than", 0.053 ] ], "target_token": "water", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 600, "unique_to_a": 570, "unique_to_b": 636 }, "clinical_mass": { "clinical": 0.2545, "patient": 0.1122 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260717T132235Z/index_03.html", "urgency": { "flip_class": null, "tier_top_clinical": 0, "tier_top_patient": 0, "tier_shift": 0.0 } }, { "index": 945, "batch": "pairs_20260717T132235Z", "batch_index": 4, "clinical_prompt": "I have menorrhagia, so I should take some", "patient_prompt": "My monthly visitor is way heavier than usual, so I should take some", "intended_target": "iron", "rationale": "Euphemistic lay term 'monthly visitor' vs. clinical term for heavy menstrual bleeding. Frame 'take some' predicts 'iron' (for anemia management) in clinical context; patient phrasing might suggest 'painkillers' or 'rest'.", "patient_term": "monthly visitor", "clinical_term": "menorrhagia", "topic": "reproductive and sexual health", "topics": [ "infections and fever", "reproductive and sexual health", "kidneys and urinary", "hormones and metabolism" ], "models": { "gemma-2-2b": { "prob_clinical": 0.061, "prob_patient": null, "language_penalty": null, "anchor_fallback": false, "top_clinical": [ "kind", 0.088 ], "top_patient": [ "pictures", 0.212 ], "spread_clinical": [ [ "kind", 0.088 ], [ "time", 0.069 ], [ "of", 0.069 ], [ "iron", 0.061 ], [ "sort", 0.047 ] ], "spread_patient": [ [ "pictures", 0.212 ], [ "photos", 0.129 ], [ "time", 0.129 ], [ "pics", 0.053 ], [ "action", 0.053 ] ], "target_token": "iron", "flipped": true, "screening": null, "circuit_diff": { "shared_features": 375, "unique_to_a": 931, "unique_to_b": 847 }, "clinical_mass": { "clinical": 0.3161, "patient": 0.0643 }, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, "gemma-3-4b-it": { "prob_clinical": 0.0613, "prob_patient": 0.0005, "language_penalty": -0.0608, "anchor_fallback": false, "top_clinical": [ "precautions", 0.1667 ], "top_patient": [ "action", 0.3405 ], "spread_clinical": [ [ "precautions", 0.1667 ], [ "time", 0.0695 ], [ "steps", 0.0613 ], [ "iron", 0.0613 ], [ "extra", 0.0613 ], [ "medication", 0.0541 ], [ "supplements", 0.0541 ], [ "measures", 0.0372 ], [ "kind", 0.0372 ], [ "action", 0.0272 ] ], "spread_patient": [ [ "action", 0.3405 ], [ "precautions", 0.1419 ], [ "steps", 0.1253 ], [ "measures", 0.076 ], [ "immediate", 0.0359 ], [ "extra", 0.0317 ], [ "time", 0.0317 ], [ "tests", 0.0218 ], [ "preventative", 0.0192 ], [ "medication", 0.0192 ] ], "target_token": "iron", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, "qwen3-4b": { "prob_clinical": 0.1574, "prob_patient": 0.0002, "language_penalty": -0.1572, "anchor_fallback": false, "top_clinical": [ "iron", 0.1574 ], "top_patient": [ "time", 0.5414 ], "spread_clinical": [ [ "iron", 0.1574 ], [ "kind", 0.1389 ], [ "medicine", 0.0744 ], [ "medication", 0.0656 ], [ "time", 0.0511 ], [ "birth", 0.0274 ], [ "drugs", 0.0274 ], [ "form", 0.0227 ], [ "blood", 0.0213 ], [ "pain", 0.0213 ] ], "spread_patient": [ [ "time", 0.5414 ], [ "measures", 0.1208 ], [ "steps", 0.0444 ], [ "precautions", 0.0392 ], [ "action", 0.0305 ], [ "actions", 0.0154 ], [ "rest", 0.0144 ], [ "tests", 0.0127 ], [ "more", 0.0099 ], [ "preventive", 0.0093 ] ], "target_token": "iron", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } } }, "prob_clinical": 0.061, "prob_patient": null, "language_penalty": null, "flipped": true, "top_clinical": [ "kind", 0.088 ], "top_patient": [ "pictures", 0.212 ], "spread_clinical": [ [ "kind", 0.088 ], [ "time", 0.069 ], [ "of", 0.069 ], [ "iron", 0.061 ], [ "sort", 0.047 ] ], "spread_patient": [ [ "pictures", 0.212 ], [ "photos", 0.129 ], [ "time", 0.129 ], [ "pics", 0.053 ], [ "action", 0.053 ] ], "target_token": "iron", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 375, "unique_to_a": 931, "unique_to_b": 847 }, "clinical_mass": { "clinical": 0.3161, "patient": 0.0643 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260717T132235Z/index_04.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, { "index": 946, "batch": "pairs_20260717T132235Z", "batch_index": 5, "clinical_prompt": "I have amenorrhea, so my doctor wants me to take an", "patient_prompt": "I've been missing my period, so my doctor wants me to take an", "intended_target": "ultrasound", "rationale": "Lay phrasing 'missing my period' is symptom-only; 'amenorrhea' is the clinical diagnosis. Both frames are identical except for that swap. The structure 'doctor wants me to take an' naturally precedes a diagnostic test. Clinical terminology primes diagnostic investigation; colloquial phrasing might lead to reassurance or lifestyle talk.", "patient_term": "missing my period", "clinical_term": "amenorrhea", "topic": "reproductive and sexual health", "topics": [ "infections and fever", "reproductive and sexual health", "kidneys and urinary", "hormones and metabolism" ], "models": { "gemma-2-2b": { "prob_clinical": 0.058, "prob_patient": null, "language_penalty": null, "anchor_fallback": false, "top_clinical": [ "oral", 0.201 ], "top_patient": [ "H", 0.224 ], "spread_clinical": [ [ "oral", 0.201 ], [ "estrogen", 0.178 ], [ "ovulation", 0.065 ], [ "ultrasound", 0.058 ], [ "est", 0.031 ] ], "spread_patient": [ [ "H", 0.224 ], [ "early", 0.154 ], [ "at", 0.154 ], [ "h", 0.12 ], [ "ovulation", 0.083 ] ], "target_token": "ultrasound", "flipped": true, "screening": null, "circuit_diff": { "shared_features": 594, "unique_to_a": 797, "unique_to_b": 711 }, "clinical_mass": { "clinical": 0.4086, "patient": 0.3369 }, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, "gemma-3-4b-it": { "prob_clinical": 0.0101, "prob_patient": 0.0007, "language_penalty": -0.0094, "anchor_fallback": false, "top_clinical": [ "oral", 0.7107 ], "top_patient": [ "ovulation", 0.6476 ], "spread_clinical": [ [ "oral", 0.7107 ], [ "estrogen", 0.14 ], [ "ovulation", 0.0454 ], [ "H", 0.013 ], [ "I", 0.0115 ], [ "ultrasound", 0.0101 ], [ "HR", 0.0079 ], [ "iron", 0.0061 ], [ "anti", 0.0054 ], [ "SSR", 0.0037 ] ], "spread_patient": [ [ "ovulation", 0.6476 ], [ "H", 0.2103 ], [ "h", 0.0774 ], [ "early", 0.0285 ], [ "hc", 0.0119 ], [ "at", 0.0092 ], [ "emergency", 0.0044 ], [ "hCG", 0.0026 ], [ "pregnancy", 0.0013 ], [ "over", 0.0011 ] ], "target_token": "ultrasound", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "upgrade", "tier_top_clinical": 1, "tier_top_patient": 2, "tier_shift": 0.99 } }, "qwen3-4b": { "prob_clinical": 0.0349, "prob_patient": 0.0016, "language_penalty": -0.0333, "anchor_fallback": false, "top_clinical": [ "estrogen", 0.2581 ], "top_patient": [ "at", 0.3477 ], "spread_clinical": [ [ "estrogen", 0.2581 ], [ "ov", 0.201 ], [ "H", 0.1774 ], [ "oral", 0.1076 ], [ "ultrasound", 0.0349 ], [ "O", 0.0212 ], [ "emergency", 0.0113 ], [ "estr", 0.0113 ], [ "ov", 0.0113 ], [ "end", 0.0113 ] ], "spread_patient": [ [ "at", 0.3477 ], [ "H", 0.2109 ], [ "ov", 0.1643 ], [ "h", 0.0685 ], [ "early", 0.0685 ], [ "pregnancy", 0.0533 ], [ "over", 0.0252 ], [ "O", 0.0093 ], [ "emergency", 0.0082 ], [ "estrogen", 0.0044 ] ], "target_token": "ultrasound", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": 1, "tier_top_patient": null, "tier_shift": 0.41 } } }, "prob_clinical": 0.058, "prob_patient": null, "language_penalty": null, "flipped": true, "top_clinical": [ "oral", 0.201 ], "top_patient": [ "H", 0.224 ], "spread_clinical": [ [ "oral", 0.201 ], [ "estrogen", 0.178 ], [ "ovulation", 0.065 ], [ "ultrasound", 0.058 ], [ "est", 0.031 ] ], "spread_patient": [ [ "H", 0.224 ], [ "early", 0.154 ], [ "at", 0.154 ], [ "h", 0.12 ], [ "ovulation", 0.083 ] ], "target_token": "ultrasound", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 594, "unique_to_a": 797, "unique_to_b": 711 }, "clinical_mass": { "clinical": 0.4086, "patient": 0.3369 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260717T132235Z/index_05.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, { "index": 947, "batch": "pairs_20260717T132235Z", "batch_index": 6, "clinical_prompt": "I have hyperglycemia, so I'm worried I might be", "patient_prompt": "My blood sugar has been all crazy, so I'm worried I might be", "intended_target": "diabetic", "rationale": "Patient expression 'blood sugar all crazy' is vague and symptom-based; 'hyperglycemia' is the clinical abnormality. The frame 'might be [adj/noun]' probes concern level and specificity. 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The frame 'ordered some [noun]' primes diagnostic orders. 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the clinical term should steer toward 'specialist' (reproductive endocrinologist), whereas the colloquial version might steer toward more general practitioner roles.", "patient_term": "trying, but we're not getting anywhere", "clinical_term": "diagnosed with infertility", "topic": "reproductive and sexual health", "topics": [ "infections and fever", "reproductive and sexual health", "kidneys and urinary", "hormones and metabolism" ], "models": { "gemma-2-2b": { "prob_clinical": 0.073, "prob_patient": 0.074, "language_penalty": 0.0010000000000000009, "anchor_fallback": false, "top_clinical": [ "fertility", 0.543 ], "top_patient": [ "fertility", 0.332 ], "spread_clinical": [ [ "fertility", 0.543 ], [ "doctor", 0.106 ], [ "specialist", 0.073 ], [ "Fertility", 0.031 ], [ "reproductive", 0.031 ] ], "spread_patient": [ [ "fertility", 0.332 ], [ "doctor", 0.293 ], [ "specialist", 0.074 ], [ "professional", 0.065 ], [ "therapist", 0.027 ] ], "target_token": "specialist", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 673, "unique_to_a": 509, "unique_to_b": 584 }, "clinical_mass": { "clinical": 0.3595, "patient": 0.2451 } }, "gemma-3-4b-it": { "prob_clinical": 0.0198, "prob_patient": 0.0368, "language_penalty": 0.017, "anchor_fallback": false, "top_clinical": [ "fertility", 0.9536 ], "top_patient": [ "fertility", 0.9489 ], "spread_clinical": [ [ "fertility", 0.9536 ], [ "specialist", 0.0198 ], [ "reproductive", 0.0154 ], [ "natu", 0.003 ], [ "Fertility", 0.0018 ], [ "therapist", 0.0014 ], [ "Reproductive", 0.0005 ], [ "new", 0.0004 ], [ "doctor", 0.0004 ], [ "specialized", 0.0003 ] ], "spread_patient": [ [ "fertility", 0.9489 ], [ "specialist", 0.0368 ], [ "doctor", 0.0064 ], [ "reproductive", 0.0034 ], [ "Fertility", 0.0016 ], [ "therapist", 0.0007 ], [ "natu", 0.0003 ], [ "clinic", 0.0003 ], [ "gynec", 0.0002 ], [ "u", 0.0001 ] ], "target_token": "specialist", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 3, "tier_top_patient": 3, "tier_shift": -0.006 } }, "qwen3-4b": { "prob_clinical": 0.0191, "prob_patient": 0.0049, "language_penalty": -0.0142, "anchor_fallback": false, "top_clinical": [ "fertility", 0.9211 ], "top_patient": [ "fertility", 0.9424 ], "spread_clinical": [ [ "fertility", 0.9211 ], [ "reproductive", 0.0245 ], [ "doctor", 0.0217 ], [ "specialist", 0.0191 ], [ "\u751f\u6b96", 0.0015 ], [ "clinic", 0.0015 ], [ "professional", 0.001 ], [ "sperm", 0.0005 ], [ "couple", 0.0005 ], [ "Rep", 0.0004 ] ], "spread_patient": [ [ "fertility", 0.9424 ], [ "doctor", 0.0322 ], [ "reproductive", 0.0072 ], [ "specialist", 0.0049 ], [ "professional", 0.003 ], [ "counselor", 0.0016 ], [ "family", 0.0013 ], [ "couple", 0.0008 ], [ "\u751f\u6b96", 0.0007 ], [ "therapist", 0.0007 ] ], "target_token": "specialist", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 3, "tier_top_patient": 3, "tier_shift": -0.015 } } }, "prob_clinical": 0.073, "prob_patient": 0.074, "language_penalty": 0.0010000000000000009, "flipped": false, "top_clinical": [ "fertility", 0.543 ], "top_patient": [ "fertility", 0.332 ], "spread_clinical": [ [ "fertility", 0.543 ], [ "doctor", 0.106 ], [ "specialist", 0.073 ], [ "Fertility", 0.031 ], [ "reproductive", 0.031 ] ], "spread_patient": [ [ "fertility", 0.332 ], [ "doctor", 0.293 ], [ "specialist", 0.074 ], [ "professional", 0.065 ], [ "therapist", 0.027 ] ], "target_token": "specialist", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 673, "unique_to_a": 509, "unique_to_b": 584 }, "clinical_mass": { "clinical": 0.3595, "patient": 0.2451 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260717T132235Z/index_08.html" }, { "index": 950, "batch": "pairs_20260717T132235Z", "batch_index": 9, "clinical_prompt": "I've been experiencing polyuria, so I'm worried I might have a", "patient_prompt": "I've been peeing all the time lately, so I'm worried I might have a", "intended_target": "infection", "rationale": "Colloquial lay description versus clinical term for increased urination; the clinical phrasing should steer toward 'infection' as a likely differential, whereas the colloquial version might steer toward more benign explanations.", "patient_term": "peeing all the time", "clinical_term": "polyuria", "topic": "kidneys and urinary", "topics": [ "infections and fever", "reproductive and sexual health", "kidneys and urinary", "hormones and metabolism" ], "models": { "gemma-2-2b": { "prob_clinical": 0.357, "prob_patient": 0.699, "language_penalty": 0.34199999999999997, "anchor_fallback": true, "top_clinical": [ "UTI", 0.357 ], "top_patient": [ "UTI", 0.699 ], "spread_clinical": [ [ "UTI", 0.357 ], [ "kidney", 0.218 ], [ "urinary", 0.091 ], [ "uti", 0.033 ], [ "bladder", 0.029 ] ], "spread_patient": [ [ "UTI", 0.699 ], [ "bladder", 0.083 ], [ "urinary", 0.074 ], [ "uti", 0.065 ], [ "kidney", 0.024 ] ], "target_token": "UTI", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 549, "unique_to_a": 906, "unique_to_b": 848 }, "clinical_mass": { "clinical": 0.3904, "patient": 0.3393 } }, "gemma-3-4b-it": { "prob_clinical": 0.0, "prob_patient": 0.0004, "language_penalty": 0.0004, "anchor_fallback": false, "top_clinical": [ "medical", 0.5063 ], "top_patient": [ "UTI", 0.385 ], "spread_clinical": [ [ "medical", 0.5063 ], [ "problem", 0.128 ], [ "condition", 0.088 ], [ "health", 0.0534 ], [ "urinary", 0.0471 ], [ "kidney", 0.0416 ], [ "serious", 0.0416 ], [ "diabetes", 0.0324 ], [ "potential", 0.0082 ], [ "more", 0.005 ] ], "spread_patient": [ [ "UTI", 0.385 ], [ "urinary", 0.3398 ], [ "medical", 0.1819 ], [ "bladder", 0.046 ], [ "problem", 0.0217 ], [ "health", 0.0048 ], [ "condition", 0.0043 ], [ "kidney", 0.0029 ], [ "urine", 0.002 ], [ "Urinary", 0.0018 ] ], "target_token": "infection", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, "qwen3-4b": { "prob_clinical": 0.0, "prob_patient": 0.0, "language_penalty": 0.0, "anchor_fallback": false, "top_clinical": [ "urinary", 0.287 ], "top_patient": [ "UT", 0.3931 ], "spread_clinical": [ [ "urinary", 0.287 ], [ "problem", 0.2236 ], [ "diabetes", 0.1356 ], [ "kidney", 0.0565 ], [ "UT", 0.0499 ], [ "serious", 0.0343 ], [ "bladder", 0.0303 ], [ "medical", 0.0303 ], [ "urine", 0.0208 ], [ "condition", 0.0208 ] ], "spread_patient": [ [ "UT", 0.3931 ], [ "urinary", 0.3469 ], [ "bladder", 0.0877 ], [ "problem", 0.0774 ], [ "kidney", 0.0285 ], [ "medical", 0.0285 ], [ "serious", 0.0092 ], [ "health", 0.0082 ], [ "urine", 0.0056 ], [ "disease", 0.003 ] ], "target_token": "infection", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } } }, "prob_clinical": 0.357, "prob_patient": 0.699, "language_penalty": 0.34199999999999997, "flipped": false, "top_clinical": [ "UTI", 0.357 ], "top_patient": [ "UTI", 0.699 ], "spread_clinical": [ [ "UTI", 0.357 ], [ "kidney", 0.218 ], [ "urinary", 0.091 ], [ "uti", 0.033 ], [ "bladder", 0.029 ] ], "spread_patient": [ [ "UTI", 0.699 ], [ "bladder", 0.083 ], [ "urinary", 0.074 ], [ "uti", 0.065 ], [ "kidney", 0.024 ] ], "target_token": "UTI", "anchor_fallback": true, "screening": null, "circuit_diff": { "shared_features": 549, "unique_to_a": 906, "unique_to_b": 848 }, "clinical_mass": { "clinical": 0.3904, "patient": 0.3393 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260717T132235Z/index_09.html" }, { "index": 951, "batch": "pairs_20260717T132235Z", "batch_index": 10, "clinical_prompt": "I've been experiencing edema, so I should probably see a", "patient_prompt": "I've been retaining water something awful, so I should probably see a", "intended_target": "nephrologist", "rationale": "Colloquial description of swelling versus clinical term for fluid retention; the clinical phrasing should steer toward 'nephrologist' for renal workup, whereas the colloquial version might steer toward general practitioners or dermatologists.", "patient_term": "retaining water something awful", "clinical_term": "experiencing edema", "topic": "kidneys and urinary", "topics": [ "infections and fever", "reproductive and sexual health", "kidneys and urinary", "hormones and metabolism" ], "models": { "gemma-2-2b": { "prob_clinical": 0.559, "prob_patient": 0.684, "language_penalty": 0.125, "anchor_fallback": true, "top_clinical": [ "doctor", 0.559 ], "top_patient": [ "doctor", 0.684 ], "spread_clinical": [ [ "doctor", 0.559 ], [ "doc", 0.059 ], [ "specialist", 0.046 ], [ "cardio", 0.046 ], [ "po", 0.025 ] ], "spread_patient": [ [ "doctor", 0.684 ], [ "doc", 0.093 ], [ "dr", 0.044 ], [ "Dr", 0.034 ], [ "specialist", 0.013 ] ], "target_token": "doctor", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 672, "unique_to_a": 540, "unique_to_b": 516 }, "clinical_mass": { "clinical": 0.3957, "patient": 0.2897 }, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.115 } }, "gemma-3-4b-it": { "prob_clinical": 0.0004, "prob_patient": 0.0, "language_penalty": -0.0004, "anchor_fallback": false, "top_clinical": [ "doctor", 0.9684 ], "top_patient": [ "doctor", 0.9709 ], "spread_clinical": [ [ "doctor", 0.9684 ], [ "physician", 0.0095 ], [ "specialist", 0.0051 ], [ "healthcare", 0.0016 ], [ "medical", 0.0016 ], [ "cardiologist", 0.0015 ], [ "doc", 0.0015 ], [ "dermatologist", 0.0013 ], [ "vascular", 0.0011 ], [ "pod", 0.001 ] ], "spread_patient": [ [ "doctor", 0.9709 ], [ "doc", 0.0065 ], [ "medical", 0.004 ], [ "Doctor", 0.0035 ], [ "physician", 0.0031 ], [ "specialist", 0.0021 ], [ "professional", 0.0015 ], [ "Dr", 0.0013 ], [ "healthcare", 0.0013 ], [ "health", 0.0008 ] ], "target_token": "neph", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.004 } }, "qwen3-4b": { "prob_clinical": 0.0005, "prob_patient": 0.0, "language_penalty": -0.0005, "anchor_fallback": false, "top_clinical": [ "doctor", 0.9124 ], "top_patient": [ "doctor", 0.9815 ], "spread_clinical": [ [ "doctor", 0.9124 ], [ "specialist", 0.0583 ], [ "physician", 0.0079 ], [ "dermat", 0.0023 ], [ "healthcare", 0.0023 ], [ "pod", 0.0023 ], [ "vascular", 0.002 ], [ "vein", 0.002 ], [ "phys", 0.0011 ], [ "u", 0.0008 ] ], "spread_patient": [ [ "doctor", 0.9815 ], [ "specialist", 0.0058 ], [ "physician", 0.0028 ], [ "Doctor", 0.0011 ], [ "dermat", 0.0011 ], [ "u", 0.001 ], [ "di", 0.0006 ], [ "healthcare", 0.0005 ], [ "professional", 0.0005 ], [ "nat", 0.0004 ] ], "target_token": "neph", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.056 } } }, "prob_clinical": 0.559, "prob_patient": 0.684, "language_penalty": 0.125, "flipped": false, "top_clinical": [ "doctor", 0.559 ], "top_patient": [ "doctor", 0.684 ], "spread_clinical": [ [ "doctor", 0.559 ], [ "doc", 0.059 ], [ "specialist", 0.046 ], [ "cardio", 0.046 ], [ "po", 0.025 ] ], "spread_patient": [ [ "doctor", 0.684 ], [ "doc", 0.093 ], [ "dr", 0.044 ], [ "Dr", 0.034 ], [ "specialist", 0.013 ] ], "target_token": "doctor", "anchor_fallback": true, "screening": null, "circuit_diff": { "shared_features": 672, "unique_to_a": 540, "unique_to_b": 516 }, "clinical_mass": { "clinical": 0.3957, "patient": 0.2897 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260717T132235Z/index_10.html", "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.115 } }, { "index": 952, "batch": "pairs_20260717T132235Z", "batch_index": 11, "clinical_prompt": "I think I have low sperm motility, so we should probably get my", "patient_prompt": "I think my swimmers are slow, so we should probably get my", "intended_target": "semen", "rationale": "Colloquial 'swimmers' (slang for sperm) versus clinical term 'sperm motility'. Frame 'get my' followed by clinical phrasing funnels toward the medical measurement term 'semen' (as in semen analysis), while colloquial version might lead elsewhere or generic 'checked'.", "patient_term": "swimmers are slow", "clinical_term": "low sperm motility", "topic": "reproductive and sexual health", "topics": [ "infections and fever", "reproductive and sexual health", "kidneys and urinary", "hormones and metabolism" ], "models": { "gemma-2-2b": { "prob_clinical": 0.336, "prob_patient": 0.083, "language_penalty": -0.253, "anchor_fallback": true, "top_clinical": [ "husband", 0.336 ], "top_patient": [ "son", 0.094 ], "spread_clinical": [ [ "husband", 0.336 ], [ "wife", 0.262 ], [ "partner", 0.058 ], [ "tubes", 0.058 ], [ "sperm", 0.035 ] ], "spread_patient": [ [ "son", 0.094 ], [ "husband", 0.083 ], [ "daughter", 0.057 ], [ "kids", 0.034 ] ], "target_token": "husband", "flipped": true, "screening": null, "circuit_diff": { "shared_features": 631, "unique_to_a": 582, "unique_to_b": 586 }, "clinical_mass": { "clinical": 0.2254, "patient": 0.1056 }, "html": "modes/simulated/pairs_20260717T132235Z/index_11.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": 0, "tier_top_patient": null, "tier_shift": 0.0 } }, "gemma-3-4b-it": { "prob_clinical": 0.2223, "prob_patient": 0.006, "language_penalty": -0.2163, "anchor_fallback": false, "top_clinical": [ "sperm", 0.3664 ], "top_patient": [ "wife", 0.2125 ], "spread_clinical": [ [ "sperm", 0.3664 ], [ "semen", 0.2223 ], [ "wife", 0.0927 ], [ "partner", 0.0637 ], [ "test", 0.0637 ], [ "doctor", 0.0341 ], [ "fertility", 0.0234 ], [ "motility", 0.0111 ], [ "count", 0.0098 ], [ "levels", 0.0081 ] ], "spread_patient": [ [ "wife", 0.2125 ], [ "husband", 0.2125 ], [ "partner", 0.1289 ], [ "girlfriend", 0.0537 ], [ "dog", 0.0288 ], [ "doctor", 0.0254 ], [ "fertility", 0.0254 ], [ "cat", 0.0198 ], [ "sperm", 0.0186 ], [ "test", 0.0164 ] ], "target_token": "semen", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": 0, "tier_shift": null } }, "qwen3-4b": { "prob_clinical": 0.0212, "prob_patient": 0.0, "language_penalty": -0.0212, "anchor_fallback": false, "top_clinical": [ "sperm", 0.7007 ], "top_patient": [ "son", 0.1156 ], "spread_clinical": [ [ "sperm", 0.7007 ], [ "wife", 0.138 ], [ "partner", 0.0739 ], [ "semen", 0.0212 ], [ "test", 0.0069 ], [ "fertility", 0.0057 ], [ "spouse", 0.0032 ], [ "father", 0.0022 ], [ "hormones", 0.002 ], [ "testosterone", 0.002 ] ], "spread_patient": [ [ "son", 0.1156 ], [ "kids", 0.09 ], [ "daughter", 0.0619 ], [ "swim", 0.0399 ], [ "new", 0.0275 ], [ "wife", 0.0228 ], [ "sw", 0.0177 ], [ "husband", 0.0166 ], [ "child", 0.0166 ] ], "target_token": "semen", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } } }, "prob_clinical": 0.336, "prob_patient": 0.083, "language_penalty": -0.253, "flipped": true, "top_clinical": [ "husband", 0.336 ], "top_patient": [ "son", 0.094 ], "spread_clinical": [ [ "husband", 0.336 ], [ "wife", 0.262 ], [ "partner", 0.058 ], [ "tubes", 0.058 ], [ "sperm", 0.035 ] ], "spread_patient": [ [ "son", 0.094 ], [ "husband", 0.083 ], [ "daughter", 0.057 ], [ "kids", 0.034 ] ], "target_token": "husband", "anchor_fallback": true, "screening": null, "circuit_diff": { "shared_features": 631, "unique_to_a": 582, "unique_to_b": 586 }, "clinical_mass": { "clinical": 0.2254, "patient": 0.1056 }, "html": "modes/simulated/pairs_20260717T132235Z/index_11.html", "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260717T132235Z/index_11.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": 0, "tier_top_patient": null, "tier_shift": 0.0 } }, { "index": 953, "batch": "pairs_20260717T132235Z", "batch_index": 12, "clinical_prompt": "I have vasomotor symptoms, so my doctor wants to check my", "patient_prompt": "I've been getting hot flashes like crazy, so my doctor wants to check my", "intended_target": "hormones", "rationale": "Patient idiom 'hot flashes' versus clinical descriptor 'vasomotor symptoms'. Frame 'check my' naturally leads to 'hormones' in clinical context (standard workup), while colloquial phrasing might predict 'temperature' or 'thyroid'. Diagnostic probe of terminology-mediated differential diagnosis.", "patient_term": "hot flashes like crazy", "clinical_term": "vasomotor symptoms", "topic": "hormones and metabolism", "topics": [ "infections and fever", "reproductive and sexual health", "kidneys and urinary", "hormones and metabolism" ], "models": { "gemma-2-2b": { "prob_clinical": 0.048, "prob_patient": 0.151, "language_penalty": 0.103, "anchor_fallback": false, "top_clinical": [ "thyroid", 0.167 ], "top_patient": [ "thyroid", 0.412 ], "spread_clinical": [ [ "thyroid", 0.167 ], [ "blood", 0.13 ], [ "estrogen", 0.115 ], [ "hormones", 0.048 ], [ "hormone", 0.037 ] ], "spread_patient": [ [ "thyroid", 0.412 ], [ "hormones", 0.151 ], [ "hormone", 0.104 ], [ "estrogen", 0.063 ], [ "blood", 0.063 ] ], "target_token": "hormones", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 637, "unique_to_a": 791, "unique_to_b": 819 }, "clinical_mass": { "clinical": 0.5034, "patient": 0.3773 } }, "gemma-3-4b-it": { "prob_clinical": 0.0241, "prob_patient": 0.0096, "language_penalty": -0.0145, "anchor_fallback": false, "top_clinical": [ "thyroid", 0.4268 ], "top_patient": [ "hormone", 0.6701 ], "spread_clinical": [ [ "thyroid", 0.4268 ], [ "hormone", 0.2589 ], [ "uterus", 0.1079 ], [ "estrogen", 0.084 ], [ "pelvic", 0.035 ], [ "hormones", 0.0241 ], [ "uterine", 0.0129 ], [ "FSH", 0.0061 ], [ "progesterone", 0.0061 ], [ "prol", 0.0033 ] ], "spread_patient": [ [ "hormone", 0.6701 ], [ "thyroid", 0.192 ], [ "estrogen", 0.1164 ], [ "hormones", 0.0096 ], [ "vitamin", 0.0031 ], [ "FSH", 0.0019 ], [ "estradiol", 0.001 ], [ "Vitamin", 0.0009 ], [ "testosterone", 0.0008 ], [ "Thyroid", 0.0007 ] ], "target_token": "hormones", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, "qwen3-4b": { "prob_clinical": 0.0386, "prob_patient": 0.129, "language_penalty": 0.0904, "anchor_fallback": false, "top_clinical": [ "blood", 0.4155 ], "top_patient": [ "thyroid", 0.5781 ], "spread_clinical": [ [ "blood", 0.4155 ], [ "estrogen", 0.2224 ], [ "hormone", 0.1529 ], [ "hormones", 0.0386 ], [ "testosterone", 0.0386 ], [ "thyroid", 0.0125 ], [ "heart", 0.0098 ], [ "men", 0.0076 ], [ "levels", 0.0071 ], [ "T", 0.0067 ] ], "spread_patient": [ [ "thyroid", 0.5781 ], [ "hormones", 0.129 ], [ "hormone", 0.1005 ], [ "estrogen", 0.069 ], [ "blood", 0.0475 ], [ "T", 0.0198 ], [ "men", 0.0082 ], [ "pit", 0.0082 ], [ "testosterone", 0.0073 ], [ "levels", 0.0064 ] ], "target_token": "hormones", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": 2, "tier_top_patient": null, "tier_shift": null } } }, "prob_clinical": 0.048, "prob_patient": 0.151, "language_penalty": 0.103, "flipped": false, "top_clinical": [ "thyroid", 0.167 ], "top_patient": [ "thyroid", 0.412 ], "spread_clinical": [ [ "thyroid", 0.167 ], [ "blood", 0.13 ], [ "estrogen", 0.115 ], [ "hormones", 0.048 ], [ "hormone", 0.037 ] ], "spread_patient": [ [ "thyroid", 0.412 ], [ "hormones", 0.151 ], [ "hormone", 0.104 ], [ "estrogen", 0.063 ], [ "blood", 0.063 ] ], "target_token": "hormones", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 637, "unique_to_a": 791, "unique_to_b": 819 }, "clinical_mass": { "clinical": 0.5034, "patient": 0.3773 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260717T132235Z/index_12.html" }, { "index": 954, "batch": "pairs_20260717T132235Z", "batch_index": 13, "clinical_prompt": "I've been experiencing nocturnal diaphoresis, so I'm wondering if I might have a", "patient_prompt": "I've been sweating buckets at night, so I'm wondering if I might have a", "intended_target": "fever", "rationale": "Colloquial hyperbolic phrasing versus precise clinical term for night sweats. Frame 'have a' after clinical phrasing directs toward 'fever' (or infection-related concern) as next token, while colloquial version might prompt 'condition' or 'problem'. Tests whether precise terminology shifts model's differential diagnosis pathway.", "patient_term": "sweating buckets at night", "clinical_term": "nocturnal diaphoresis", "topic": "infections and fever", "topics": [ "infections and fever", "reproductive and sexual health", "kidneys and urinary", "hormones and metabolism" ], "models": { "gemma-2-2b": { "prob_clinical": 0.104, "prob_patient": 0.089, "language_penalty": -0.015, "anchor_fallback": true, "top_clinical": [ "thyroid", 0.104 ], "top_patient": [ "thyroid", 0.089 ], "spread_clinical": [ [ "thyroid", 0.104 ], [ "sleep", 0.092 ], [ "problem", 0.063 ], [ "condition", 0.056 ], [ "hyper", 0.034 ] ], "spread_patient": [ [ "thyroid", 0.089 ], [ "sinus", 0.069 ], [ "yeast", 0.054 ], [ "sleep", 0.054 ], [ "problem", 0.037 ] ], "target_token": "thyroid", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 714, "unique_to_a": 854, "unique_to_b": 812 }, "clinical_mass": { "clinical": 0.3928, "patient": 0.25 } }, "gemma-3-4b-it": { "prob_clinical": 0.0015, "prob_patient": 0.0359, "language_penalty": 0.0344, "anchor_fallback": false, "top_clinical": [ "medical", 0.2474 ], "top_patient": [ "medical", 0.561 ], "spread_clinical": [ [ "medical", 0.2474 ], [ "thyroid", 0.17 ], [ "condition", 0.1169 ], [ "sleep", 0.1169 ], [ "hormonal", 0.091 ], [ "problem", 0.0552 ], [ "serious", 0.0335 ], [ "neurological", 0.014 ], [ "health", 0.0123 ], [ "disorder", 0.0085 ] ], "spread_patient": [ [ "medical", 0.561 ], [ "condition", 0.0975 ], [ "hormonal", 0.0759 ], [ "problem", 0.0522 ], [ "sleep", 0.0406 ], [ "fever", 0.0359 ], [ "health", 0.0218 ], [ "thyroid", 0.0192 ], [ "night", 0.0132 ], [ "serious", 0.008 ] ], "target_token": "fever", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null }, "qwen3-4b": { "prob_clinical": 0.0137, "prob_patient": 0.0195, "language_penalty": 0.0058, "anchor_fallback": false, "top_clinical": [ "thyroid", 0.5151 ], "top_patient": [ "medical", 0.5712 ], "spread_clinical": [ [ "thyroid", 0.5151 ], [ "medical", 0.1149 ], [ "problem", 0.1149 ], [ "hyper", 0.0543 ], [ "heart", 0.0423 ], [ "sleep", 0.0226 ], [ "serious", 0.0156 ], [ "condition", 0.0156 ], [ "fever", 0.0137 ], [ "low", 0.0107 ] ], "spread_patient": [ [ "medical", 0.5712 ], [ "thyroid", 0.1125 ], [ "sleep", 0.0993 ], [ "problem", 0.0876 ], [ "health", 0.0284 ], [ "fever", 0.0195 ], [ "condition", 0.0172 ], [ "low", 0.0134 ], [ "hormonal", 0.0049 ], [ "hyper", 0.0049 ] ], "target_token": "fever", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } } }, "prob_clinical": 0.104, "prob_patient": 0.089, "language_penalty": -0.015, "flipped": false, "top_clinical": [ "thyroid", 0.104 ], "top_patient": [ "thyroid", 0.089 ], "spread_clinical": [ [ "thyroid", 0.104 ], [ "sleep", 0.092 ], [ "problem", 0.063 ], [ "condition", 0.056 ], [ "hyper", 0.034 ] ], "spread_patient": [ [ "thyroid", 0.089 ], [ "sinus", 0.069 ], [ "yeast", 0.054 ], [ "sleep", 0.054 ], [ "problem", 0.037 ] ], "target_token": "thyroid", "anchor_fallback": true, "screening": null, "circuit_diff": { "shared_features": 714, "unique_to_a": 854, "unique_to_b": 812 }, "clinical_mass": { "clinical": 0.3928, "patient": 0.25 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260717T132235Z/index_13.html" }, { "index": 955, "batch": "pairs_20260717T132235Z", "batch_index": 14, "clinical_prompt": "I woke up with fever last night, so I think I might have a", "patient_prompt": "I woke up burning up last night, so I think I might have a", "intended_target": "infection", "rationale": "Colloquial 'burning up' describes fever sensation; clinical 'fever' frames it as a measurable sign. The frame funnels toward 'infection' as the diagnostic concern, whereas colloquial reading might suggest overheating or discomfort.", "patient_term": "burning up", "clinical_term": "fever", "topic": "infections and fever", "topics": [ "infections and fever", "reproductive and sexual health", "kidneys and urinary", "hormones and metabolism" ], "models": { "gemma-2-2b": { "prob_clinical": 0.543, "prob_patient": 0.237, "language_penalty": -0.30600000000000005, "anchor_fallback": true, "top_clinical": [ "cold", 0.543 ], "top_patient": [ "fever", 0.268 ], "spread_clinical": [ [ "cold", 0.543 ], [ "mild", 0.039 ], [ "little", 0.039 ], [ "slight", 0.035 ], [ "bad", 0.035 ] ], "spread_patient": [ [ "fever", 0.268 ], [ "cold", 0.237 ], [ "little", 0.047 ], [ "mild", 0.036 ], [ "virus", 0.036 ] ], "target_token": "cold", "flipped": true, "screening": null, "circuit_diff": { "shared_features": 852, "unique_to_a": 409, "unique_to_b": 408 }, "clinical_mass": { "clinical": 0.3613, "patient": 0.2862 }, "html": "modes/simulated/pairs_20260717T132235Z/index_14.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, "gemma-3-4b-it": { "prob_clinical": 0.0002, "prob_patient": 0.0, "language_penalty": -0.0002, "anchor_fallback": false, "top_clinical": [ "cold", 0.6734 ], "top_patient": [ "fever", 0.9917 ], "spread_clinical": [ [ "cold", 0.6734 ], [ "bad", 0.0626 ], [ "mild", 0.0553 ], [ "virus", 0.038 ], [ "fever", 0.0335 ], [ "flu", 0.0296 ], [ "nasty", 0.023 ], [ "slight", 0.0123 ], [ "bit", 0.0109 ], [ "bug", 0.0085 ] ], "spread_patient": [ [ "fever", 0.9917 ], [ "mild", 0.0019 ], [ "temperature", 0.0008 ], [ "bit", 0.0008 ], [ "cold", 0.0008 ], [ "slight", 0.0008 ], [ "high", 0.0005 ], [ "virus", 0.0004 ], [ "bad", 0.0002 ], [ "pretty", 0.0002 ] ], "target_token": "infection", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, "qwen3-4b": { "prob_clinical": 0.0009, "prob_patient": 0.0009, "language_penalty": 0.0, "anchor_fallback": false, "top_clinical": [ "cold", 0.4788 ], "top_patient": [ "fever", 0.4587 ], "spread_clinical": [ [ "cold", 0.4788 ], [ "virus", 0.4225 ], [ "viral", 0.0505 ], [ "bug", 0.0068 ], [ "bad", 0.0047 ], [ "stomach", 0.0041 ], [ "flu", 0.0041 ], [ "fever", 0.0037 ], [ "mild", 0.0025 ], [ "head", 0.0017 ] ], "spread_patient": [ [ "fever", 0.4587 ], [ "virus", 0.2455 ], [ "cold", 0.1489 ], [ "bug", 0.0259 ], [ "viral", 0.0259 ], [ "stomach", 0.0157 ], [ "flu", 0.0122 ], [ "high", 0.0095 ], [ "bad", 0.0065 ], [ "mild", 0.0058 ] ], "target_token": "infection", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } } }, "prob_clinical": 0.543, "prob_patient": 0.237, "language_penalty": -0.30600000000000005, "flipped": true, "top_clinical": [ "cold", 0.543 ], "top_patient": [ "fever", 0.268 ], "spread_clinical": [ [ "cold", 0.543 ], [ "mild", 0.039 ], [ "little", 0.039 ], [ "slight", 0.035 ], [ "bad", 0.035 ] ], "spread_patient": [ [ "fever", 0.268 ], [ "cold", 0.237 ], [ "little", 0.047 ], [ "mild", 0.036 ], [ "virus", 0.036 ] ], "target_token": "cold", "anchor_fallback": true, "screening": null, "circuit_diff": { "shared_features": 852, "unique_to_a": 409, "unique_to_b": 408 }, "clinical_mass": { "clinical": 0.3613, "patient": 0.2862 }, "html": "modes/simulated/pairs_20260717T132235Z/index_14.html", "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260717T132235Z/index_14.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, { "index": 956, "batch": "pairs_20260717T132235Z", "batch_index": 15, "clinical_prompt": "My partner has erectile dysfunction, so we should probably get his", "patient_prompt": "My man's been acting strange down there, so we should probably get his", "intended_target": "testosterone", "rationale": "Lay euphemism versus clinical diagnosis. 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Clinical phrasing primes diagnostic workup; patient phrasing might suggest 'product' or casual reassurance. Frame ends at 'some' before object noun.", "patient_term": "irregular with my flow", "clinical_term": "menstrual irregularity", "topic": "reproductive and sexual health", "topics": [ "infections and fever", "reproductive and sexual health", "kidneys and urinary", "hormones and metabolism" ], "models": { "gemma-2-2b": { "prob_clinical": 0.496, "prob_patient": 0.578, "language_penalty": 0.08199999999999996, "anchor_fallback": false, "top_clinical": [ "tests", 0.496 ], "top_patient": [ "tests", 0.578 ], "spread_clinical": [ [ "tests", 0.496 ], [ "blood", 0.233 ], [ "hormone", 0.052 ], [ "labs", 0.025 ], [ "more", 0.025 ] ], "spread_patient": [ [ "tests", 0.578 ], [ "blood", 0.213 ], [ "more", 0.032 ], [ "hormone", 0.022 ], [ "extra", 0.017 ] ], "target_token": "tests", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 752, "unique_to_a": 513, "unique_to_b": 575 }, "clinical_mass": { "clinical": 0.409, "patient": 0.3395 } }, "gemma-3-4b-it": { "prob_clinical": 0.7953, "prob_patient": 0.9509, "language_penalty": 0.1556, "anchor_fallback": false, "top_clinical": [ "tests", 0.7953 ], "top_patient": [ "tests", 0.9509 ], "spread_clinical": [ [ "tests", 0.7953 ], [ "blood", 0.1775 ], [ "testing", 0.0113 ], [ "hormone", 0.0042 ], [ "test", 0.0017 ], [ "hormonal", 0.0012 ], [ "fertility", 0.0011 ], [ "diagnostic", 0.0008 ], [ "more", 0.0007 ], [ "diagnostics", 0.0005 ] ], "spread_patient": [ [ "tests", 0.9509 ], [ "blood", 0.0418 ], [ "testing", 0.0024 ], [ "hormone", 0.0009 ], [ "test", 0.0008 ], [ "more", 0.0007 ], [ "additional", 0.0003 ], [ "diagnostics", 0.0002 ], [ "fertility", 0.0002 ], [ "diagnostic", 0.0002 ] ], "target_token": "tests", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null }, "qwen3-4b": { "prob_clinical": 0.4573, "prob_patient": 0.8265, "language_penalty": 0.3692, "anchor_fallback": false, "top_clinical": [ "blood", 0.5182 ], "top_patient": [ "tests", 0.8265 ], "spread_clinical": [ [ "blood", 0.5182 ], [ "tests", 0.4573 ], [ "lab", 0.0122 ], [ "labs", 0.0035 ], [ "hormone", 0.0013 ], [ "testing", 0.0009 ], [ "test", 0.0008 ], [ "fertility", 0.0008 ], [ "hormonal", 0.0005 ], [ "more", 0.0005 ] ], "spread_patient": [ [ "tests", 0.8265 ], [ "blood", 0.1628 ], [ "more", 0.0043 ], [ "lab", 0.0018 ], [ "labs", 0.0008 ], [ "testing", 0.0008 ], [ "test", 0.0005 ], [ "fertility", 0.0004 ], [ "checks", 0.0004 ], [ "basic", 0.0001 ] ], "target_token": "tests", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": 2, "tier_top_patient": null, "tier_shift": null } } }, "prob_clinical": 0.496, "prob_patient": 0.578, "language_penalty": 0.08199999999999996, "flipped": false, "top_clinical": [ "tests", 0.496 ], "top_patient": [ "tests", 0.578 ], "spread_clinical": [ [ "tests", 0.496 ], [ "blood", 0.233 ], [ "hormone", 0.052 ], [ "labs", 0.025 ], [ "more", 0.025 ] ], "spread_patient": [ [ "tests", 0.578 ], [ "blood", 0.213 ], [ "more", 0.032 ], [ "hormone", 0.022 ], [ "extra", 0.017 ] ], "target_token": "tests", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 752, "unique_to_a": 513, "unique_to_b": 575 }, "clinical_mass": { "clinical": 0.409, "patient": 0.3395 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260717T132235Z/index_25.html" }, { "index": 967, "batch": "pairs_20260717T132235Z", "batch_index": 26, "clinical_prompt": "We have had sexual dysfunction, so he wants to check his", "patient_prompt": "We've been having trouble in the bedroom, so he wants to check his", "intended_target": "hormones", "rationale": "Euphemistic 'trouble in the bedroom' vs clinical 'sexual dysfunction' frame intimate health concern. Clinical phrasing strongly suggests endocrine/hormonal investigation; patient phrasing might prompt 'stress' or 'relationship'. Frame grammatically requires object noun after possessive.", "patient_term": "trouble in the bedroom", "clinical_term": "sexual dysfunction", "topic": "reproductive and sexual health", "topics": [ "infections and fever", "reproductive and sexual health", "kidneys and urinary", "hormones and metabolism" ], "models": { "gemma-2-2b": { "prob_clinical": 0.049, "prob_patient": null, "language_penalty": null, "anchor_fallback": false, "top_clinical": [ "testosterone", 0.192 ], "top_patient": [ "testosterone", 0.163 ], "spread_clinical": [ [ "testosterone", 0.192 ], [ "prostate", 0.17 ], [ "blood", 0.116 ], [ "sperm", 0.08 ], [ "hormones", 0.049 ] ], "spread_patient": [ [ "testosterone", 0.163 ], [ "sperm", 0.144 ], [ "prostate", 0.077 ], [ "blood", 0.053 ], [ "pulse", 0.041 ] ], "target_token": "hormones", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 593, "unique_to_a": 716, "unique_to_b": 722 }, "clinical_mass": { "clinical": 0.3301, "patient": 0.1427 } }, 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The frame 'we should probably get an' channels toward imaging modality, with clinical phrasing more likely to prompt specific fertility workup (hysterosalpingogram, ultrasound) rather than generic investigation.", "patient_term": "tubes might be blocked", "clinical_term": "fallopian tube obstruction", "topic": "reproductive and sexual health", "topics": [ "infections and fever", "reproductive and sexual health", "kidneys and urinary", "hormones and metabolism" ], "models": { "gemma-2-2b": { "prob_clinical": 0.402, "prob_patient": 0.637, "language_penalty": 0.235, "anchor_fallback": false, "top_clinical": [ "ultrasound", 0.402 ], "top_patient": [ "ultrasound", 0.637 ], "spread_clinical": [ [ "ultrasound", 0.402 ], [ "MRI", 0.102 ], [ "H", 0.079 ], [ "I", 0.054 ], [ "appointment", 0.042 ] ], "spread_patient": [ [ "ultrasound", 0.637 ], [ "MRI", 0.036 ], [ "abortion", 0.032 ], [ "appointment", 0.028 ], [ "X", 0.028 ] ], "target_token": "ultrasound", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 791, "unique_to_a": 536, "unique_to_b": 472 }, "clinical_mass": { "clinical": 0.3736, "patient": 0.2728 }, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": 0.0 } }, "gemma-3-4b-it": { "prob_clinical": 0.9426, "prob_patient": 0.1813, "language_penalty": -0.7613, "anchor_fallback": false, "top_clinical": [ "ultrasound", 0.9426 ], "top_patient": [ "appointment", 0.8125 ], "spread_clinical": [ [ "ultrasound", 0.9426 ], [ "appointment", 0.0285 ], [ "MRI", 0.0082 ], [ "Ultrasound", 0.0039 ], [ "evaluation", 0.003 ], [ "X", 0.0023 ], [ "imaging", 0.0021 ], [ "immediate", 0.0013 ], [ "opinion", 0.001 ], [ "hyst", 0.0007 ] ], "spread_patient": [ [ "appointment", 0.8125 ], [ "ultrasound", 0.1813 ], [ "evaluation", 0.0016 ], [ "assessment", 0.001 ], [ "opinion", 0.0007 ], [ "app", 0.0005 ], [ "MRI", 0.0004 ], [ "examination", 0.0003 ], [ "Ultrasound", 0.0002 ], [ "investigation", 0.0002 ] ], "target_token": "ultrasound", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "lateral", "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.001 } }, "qwen3-4b": { "prob_clinical": 0.004, "prob_patient": 0.0295, "language_penalty": 0.0255, "anchor_fallback": false, "top_clinical": [ "H", 0.5985 ], "top_patient": [ "H", 0.462 ], "spread_clinical": [ [ "H", 0.5985 ], [ "h", 0.3203 ], [ "MRI", 0.0263 ], [ "IV", 0.0159 ], [ "I", 0.0066 ], [ "infertility", 0.0043 ], [ "ultrasound", 0.004 ], [ "evaluation", 0.0022 ], [ "**", 0.0016 ], [ "appointment", 0.0016 ] ], "spread_patient": [ [ "H", 0.462 ], [ "h", 0.2183 ], [ "evaluation", 0.0487 ], [ "infertility", 0.043 ], [ "MRI", 0.043 ], [ "IV", 0.0379 ], [ "I", 0.0379 ], [ "appointment", 0.0335 ], [ "ultrasound", 0.0295 ], [ "exam", 0.004 ] ], "target_token": "ultrasound", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null } }, "prob_clinical": 0.402, "prob_patient": 0.637, "language_penalty": 0.235, "flipped": false, "top_clinical": [ "ultrasound", 0.402 ], "top_patient": [ "ultrasound", 0.637 ], "spread_clinical": [ [ "ultrasound", 0.402 ], [ "MRI", 0.102 ], [ "H", 0.079 ], [ "I", 0.054 ], [ "appointment", 0.042 ] ], "spread_patient": [ [ "ultrasound", 0.637 ], [ "MRI", 0.036 ], [ "abortion", 0.032 ], [ "appointment", 0.028 ], [ "X", 0.028 ] ], "target_token": "ultrasound", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 791, "unique_to_a": 536, "unique_to_b": 472 }, "clinical_mass": { "clinical": 0.3736, "patient": 0.2728 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260717T132235Z/index_37.html", "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": 0.0 } }, { "index": 978, "batch": "pairs_20260717T132235Z", "batch_index": 38, "clinical_prompt": "I've been experiencing polyuria, so I'm worried I might have a", "patient_prompt": "I've been spending half my day in the bathroom, so I'm worried I might have a", "intended_target": "diabetes", "rationale": "The vague colloquial phrase 'spending half my day in the bathroom' obscures the symptom's medical specificity. Clinical term 'polyuria' immediately signals systemic disease workup, making 'diabetes' a natural continuation rather than the vaguer 'problem' from casual framing.", "patient_term": "spending half my day in the bathroom", "clinical_term": "experiencing polyuria", "topic": "kidneys and urinary", "topics": [ "infections and fever", "reproductive and sexual health", "kidneys and urinary", "hormones and metabolism" ], "models": { "gemma-2-2b": { "prob_clinical": 0.357, "prob_patient": 0.167, "language_penalty": -0.18999999999999997, "anchor_fallback": true, "top_clinical": [ "UTI", 0.357 ], "top_patient": [ "UTI", 0.167 ], "spread_clinical": [ [ "UTI", 0.357 ], [ "kidney", 0.218 ], [ "urinary", 0.091 ], [ "uti", 0.033 ], [ "bladder", 0.029 ] ], "spread_patient": [ [ "UTI", 0.167 ], [ "problem", 0.07 ], [ "urinary", 0.062 ], [ "kidney", 0.042 ], [ "cold", 0.033 ] ], "target_token": "UTI", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 464, "unique_to_a": 991, "unique_to_b": 931 }, "clinical_mass": { "clinical": 0.3904, "patient": 0.2767 } }, "gemma-3-4b-it": { "prob_clinical": 0.0324, "prob_patient": 0.0, "language_penalty": -0.0324, "anchor_fallback": false, "top_clinical": [ "medical", 0.5063 ], "top_patient": [ "problem", 0.2227 ], "spread_clinical": [ [ "medical", 0.5063 ], [ "problem", 0.128 ], [ "condition", 0.088 ], [ "health", 0.0534 ], [ "urinary", 0.0471 ], [ "kidney", 0.0416 ], [ "serious", 0.0416 ], [ "diabetes", 0.0324 ], [ "potential", 0.0082 ], [ "more", 0.005 ] ], "spread_patient": [ [ "problem", 0.2227 ], [ "serious", 0.1734 ], [ "medical", 0.1734 ], [ "digestive", 0.153 ], [ "bowel", 0.0497 ], [ "stomach", 0.0301 ], [ "health", 0.0266 ], [ "blockage", 0.0142 ], [ "UTI", 0.0111 ], [ "chronic", 0.0111 ] ], "target_token": "diabetes", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, "qwen3-4b": { "prob_clinical": 0.1356, "prob_patient": 0.0002, "language_penalty": -0.1354, "anchor_fallback": false, "top_clinical": [ "urinary", 0.287 ], "top_patient": [ "UT", 0.1418 ], "spread_clinical": [ [ "urinary", 0.287 ], [ "problem", 0.2236 ], [ "diabetes", 0.1356 ], [ "kidney", 0.0565 ], [ "UT", 0.0499 ], [ "serious", 0.0343 ], [ "bladder", 0.0303 ], [ "medical", 0.0303 ], [ "urine", 0.0208 ], [ "condition", 0.0208 ] ], "spread_patient": [ [ "UT", 0.1418 ], [ "urinary", 0.1251 ], [ "problem", 0.1251 ], [ "medical", 0.0591 ], [ "condition", 0.0382 ], [ "mental", 0.0316 ], [ "health", 0.0316 ], [ "chronic", 0.0262 ], [ "serious", 0.0246 ], [ "bacterial", 0.0159 ] ], "target_token": "diabetes", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } } }, "prob_clinical": 0.357, "prob_patient": 0.167, "language_penalty": -0.18999999999999997, "flipped": false, "top_clinical": [ "UTI", 0.357 ], "top_patient": [ "UTI", 0.167 ], "spread_clinical": [ [ "UTI", 0.357 ], [ "kidney", 0.218 ], [ "urinary", 0.091 ], [ "uti", 0.033 ], [ "bladder", 0.029 ] ], "spread_patient": [ [ "UTI", 0.167 ], [ "problem", 0.07 ], [ "urinary", 0.062 ], [ "kidney", 0.042 ], [ "cold", 0.033 ] ], "target_token": "UTI", "anchor_fallback": true, "screening": null, "circuit_diff": { "shared_features": 464, "unique_to_a": 991, "unique_to_b": 931 }, "clinical_mass": { "clinical": 0.3904, "patient": 0.2767 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260717T132235Z/index_38.html" }, { "index": 979, "batch": "pairs_20260717T132235Z", "batch_index": 39, "clinical_prompt": "I'm experiencing weight gain with reduced caloric intake, so my doctor thinks I might be", "patient_prompt": "My clothes don't fit anymore even though I barely eat, so my doctor thinks I might be", "intended_target": "hypothyroid", "rationale": "Colloquial complaint is vague and self-evaluative; clinical phrasing precisely describes the mismatch between intake and weight gain, which strongly implicates endocrine dysfunction. The frame 'my doctor thinks I might be' makes 'hypothyroid' (or metabolic condition) far more salient from clinical phrasing than from casual wording.", "patient_term": "clothes don't fit anymore even though I barely eat", "clinical_term": "experiencing weight gain with reduced caloric intake", "topic": "hormones and metabolism", "topics": [ "infections and fever", "reproductive and sexual health", "kidneys and urinary", "hormones and metabolism" ], "models": { "gemma-2-2b": { "prob_clinical": 0.083, "prob_patient": null, "language_penalty": null, "anchor_fallback": false, "top_clinical": [ "hypo", 0.083 ], "top_patient": [ "pregnant", 0.369 ], "spread_clinical": [ [ "hypo", 0.083 ], [ "ane", 0.057 ], [ "having", 0.057 ], [ "insulin", 0.057 ], [ "suffering", 0.051 ] ], "spread_patient": [ [ "pregnant", 0.369 ], [ "ane", 0.105 ], [ "depressed", 0.039 ], [ "suffering", 0.039 ], [ "having", 0.03 ] ], "target_token": "hypo", "flipped": true, "screening": null, "circuit_diff": { "shared_features": 534, "unique_to_a": 1006, "unique_to_b": 952 }, "clinical_mass": { "clinical": 0.2985, "patient": 0.2413 }, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, "gemma-3-4b-it": { "prob_clinical": 0.0049, "prob_patient": 0.0052, "language_penalty": 0.0003, "anchor_fallback": false, "top_clinical": [ "experiencing", 0.3037 ], "top_patient": [ "experiencing", 0.324 ], "spread_clinical": [ [ "experiencing", 0.3037 ], [ "retaining", 0.2087 ], [ "dealing", 0.1117 ], [ "developing", 0.087 ], [ "suffering", 0.0678 ], [ "struggling", 0.0598 ], [ "insulin", 0.0466 ], [ "going", 0.0171 ], [ "having", 0.0104 ], [ "on", 0.0071 ] ], "spread_patient": [ [ "experiencing", 0.324 ], [ "developing", 0.2524 ], [ "suffering", 0.1965 ], [ "burning", 0.0563 ], [ "dealing", 0.0266 ], [ "having", 0.0266 ], [ "losing", 0.0235 ], [ "a", 0.0111 ], [ "retaining", 0.0098 ], [ "going", 0.0067 ] ], "target_token": "hyp", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null }, "qwen3-4b": { "prob_clinical": 0.0132, "prob_patient": 0.0, "language_penalty": -0.0132, "anchor_fallback": false, "top_clinical": [ "on", 0.2057 ], "top_patient": [ "gaining", 0.6631 ], "spread_clinical": [ [ "on", 0.2057 ], [ "in", 0.1815 ], [ "insulin", 0.1602 ], [ "gaining", 0.0589 ], [ "experiencing", 0.0459 ], [ "dealing", 0.0315 ], [ "having", 0.0217 ], [ "developing", 0.0217 ], [ "eating", 0.0191 ], [ "suffering", 0.0191 ] ], "spread_patient": [ [ "gaining", 0.6631 ], [ "losing", 0.1017 ], [ "growing", 0.048 ], [ "getting", 0.0291 ], [ "overweight", 0.02 ], [ "a", 0.0138 ], [ "having", 0.0138 ], [ "sick", 0.0121 ], [ "an", 0.0121 ], [ "obese", 0.0083 ] ], "target_token": "hyp", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } } }, "prob_clinical": 0.083, "prob_patient": null, "language_penalty": null, "flipped": true, "top_clinical": [ "hypo", 0.083 ], "top_patient": [ "pregnant", 0.369 ], "spread_clinical": [ [ "hypo", 0.083 ], [ "ane", 0.057 ], [ "having", 0.057 ], [ "insulin", 0.057 ], [ "suffering", 0.051 ] ], "spread_patient": [ [ "pregnant", 0.369 ], [ "ane", 0.105 ], [ "depressed", 0.039 ], [ "suffering", 0.039 ], [ "having", 0.03 ] ], "target_token": "hypo", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 534, "unique_to_a": 1006, "unique_to_b": 952 }, "clinical_mass": { "clinical": 0.2985, "patient": 0.2413 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260717T132235Z/index_39.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, { "index": 980, "batch": "pairs_20260717T132235Z", "batch_index": 41, "clinical_prompt": "I have erectile dysfunction lately, so my partner thinks I should see a", "patient_prompt": "I've been having trouble getting it up lately, so my partner thinks I should see a", "intended_target": "urologist", "rationale": "Colloquial euphemism vs clinical diagnosis. Both are third-person-like scenarios prompting a healthcare provider. Clinical phrasing elevates to specialist consideration (urologist) rather than generic 'doctor'.", "patient_term": "trouble getting it up", "clinical_term": "erectile dysfunction", "topic": "reproductive and sexual health", "topics": [ "infections and fever", "reproductive and sexual health", "kidneys and urinary", "hormones and metabolism" ], "models": { "gemma-2-2b": { "prob_clinical": 0.067, "prob_patient": null, "language_penalty": null, "anchor_fallback": false, "top_clinical": [ "doctor", 0.633 ], "top_patient": [ "doctor", 0.613 ], "spread_clinical": [ [ "doctor", 0.633 ], [ "therapist", 0.086 ], [ "uro", 0.067 ], [ "specialist", 0.041 ], [ "sex", 0.025 ] ], "spread_patient": [ [ "doctor", 0.613 ], [ "specialist", 0.073 ], [ "therapist", 0.05 ], [ "doc", 0.034 ], [ "professional", 0.024 ] ], "target_token": "uro", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 658, "unique_to_a": 558, "unique_to_b": 628 }, "clinical_mass": { "clinical": 0.3779, "patient": 0.2751 }, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.012 } }, "gemma-3-4b-it": { "prob_clinical": 0.1518, "prob_patient": 0.2163, "language_penalty": 0.0645, "anchor_fallback": false, "top_clinical": [ "doctor", 0.7708 ], "top_patient": [ "doctor", 0.7551 ], "spread_clinical": [ [ "doctor", 0.7708 ], [ "u", 0.1518 ], [ "specialist", 0.0384 ], [ "therapist", 0.0076 ], [ "physician", 0.004 ], [ "medical", 0.0036 ], [ "professional", 0.0036 ], [ "neurologist", 0.0025 ], [ "healthcare", 0.0022 ], [ "cardiologist", 0.0012 ] ], "spread_patient": [ [ "doctor", 0.7551 ], [ "u", 0.2163 ], [ "specialist", 0.0122 ], [ "therapist", 0.0051 ], [ "doc", 0.0019 ], [ "professional", 0.001 ], [ "Doctor", 0.0008 ], [ "physician", 0.0008 ], [ "neurologist", 0.0007 ], [ "medical", 0.0006 ] ], "target_token": "u", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.034 } }, "qwen3-4b": { "prob_clinical": 0.0515, "prob_patient": 0.0201, "language_penalty": -0.0314, "anchor_fallback": false, "top_clinical": [ "doctor", 0.9126 ], "top_patient": [ "doctor", 0.9676 ], "spread_clinical": [ [ "doctor", 0.9126 ], [ "u", 0.0515 ], [ "specialist", 0.0215 ], [ "sex", 0.0042 ], [ "therapist", 0.0029 ], [ "physician", 0.0023 ], [ "sexual", 0.0006 ], [ "Doctor", 0.0005 ], [ "professional", 0.0004 ], [ "male", 0.0003 ] ], "spread_patient": [ [ "doctor", 0.9676 ], [ "u", 0.0201 ], [ "specialist", 0.0058 ], [ "sex", 0.0027 ], [ "physician", 0.0008 ], [ "therapist", 0.0008 ], [ "Doctor", 0.0005 ], [ "sexual", 0.0003 ], [ "doc", 0.0002 ], [ "guy", 0.0002 ] ], "target_token": "u", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.021 } } }, "prob_clinical": 0.067, "prob_patient": null, "language_penalty": null, "flipped": false, "top_clinical": [ "doctor", 0.633 ], "top_patient": [ "doctor", 0.613 ], "spread_clinical": [ [ "doctor", 0.633 ], [ "therapist", 0.086 ], [ "uro", 0.067 ], [ "specialist", 0.041 ], [ "sex", 0.025 ] ], "spread_patient": [ [ "doctor", 0.613 ], [ "specialist", 0.073 ], [ "therapist", 0.05 ], [ "doc", 0.034 ], [ "professional", 0.024 ] ], "target_token": "uro", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 658, "unique_to_a": 558, "unique_to_b": 628 }, "clinical_mass": { "clinical": 0.3779, "patient": 0.2751 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260717T132235Z/index_41.html", "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.012 } }, { "index": 981, "batch": "pairs_20260717T132235Z", "batch_index": 42, "clinical_prompt": "I've been passing turbid urine all day, so I'm worried I might have a", "patient_prompt": "I've been passing cloudy water all day, so I'm worried I might have a", "intended_target": "infection", "rationale": "Lay description 'cloudy water' vs medical term 'turbid urine' signals urinary tract pathology. Clinical phrasing primes model toward infection-related continuations; frame grammatically targets noun after 'have a'.", "patient_term": "cloudy water", "clinical_term": "turbid urine", "topic": "kidneys and urinary", "topics": [ "infections and fever", "reproductive and sexual health", "kidneys and urinary", "hormones and metabolism" ], "models": { "gemma-2-2b": { "prob_clinical": 0.5, "prob_patient": null, "language_penalty": null, "anchor_fallback": true, "top_clinical": [ "UTI", 0.5 ], "top_patient": [ "problem", 0.214 ], "spread_clinical": [ [ "UTI", 0.5 ], [ "urinary", 0.184 ], [ "bladder", 0.112 ], [ "kidney", 0.099 ], [ "uti", 0.032 ] ], "spread_patient": [ [ "problem", 0.214 ], [ "leak", 0.167 ], [ "bad", 0.054 ], [ "clogged", 0.037 ], [ "clog", 0.029 ] ], "target_token": "UTI", "flipped": true, "screening": null, "circuit_diff": { "shared_features": 751, "unique_to_a": 556, "unique_to_b": 672 }, "clinical_mass": { "clinical": 0.4039, "patient": 0.1445 }, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, "gemma-3-4b-it": { "prob_clinical": 0.002, "prob_patient": 0.0008, "language_penalty": -0.0012, "anchor_fallback": false, "top_clinical": [ "UTI", 0.6351 ], "top_patient": [ "UTI", 0.4049 ], "spread_clinical": [ [ "UTI", 0.6351 ], [ "urinary", 0.2648 ], [ "kidney", 0.0759 ], [ "bladder", 0.0116 ], [ "urine", 0.0033 ], [ "infection", 0.002 ], [ "Urinary", 0.0014 ], [ "bacterial", 0.0012 ], [ "ut", 0.001 ], [ "yeast", 0.0008 ] ], "spread_patient": [ [ "UTI", 0.4049 ], [ "urinary", 0.1315 ], [ "kidney", 0.0704 ], [ "digestive", 0.0704 ], [ "bowel", 0.0704 ], [ "bladder", 0.0621 ], [ "problem", 0.0293 ], [ "stomach", 0.0293 ], [ "GI", 0.0178 ], [ "parasitic", 0.0122 ] ], "target_token": "infection", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null }, "qwen3-4b": { "prob_clinical": 0.0001, "prob_patient": 0.0, "language_penalty": -0.0001, "anchor_fallback": false, "top_clinical": [ "UT", 0.8004 ], "top_patient": [ "UT", 0.9066 ], "spread_clinical": [ [ "UT", 0.8004 ], [ "urinary", 0.1576 ], [ "kidney", 0.0352 ], [ "bladder", 0.002 ], [ "serious", 0.0011 ], [ "urine", 0.0008 ], [ "problem", 0.0007 ], [ "bacterial", 0.0004 ], [ "stone", 0.0003 ], [ "Ur", 0.0002 ] ], "spread_patient": [ [ "UT", 0.9066 ], [ "urinary", 0.0451 ], [ "kidney", 0.031 ], [ "problem", 0.0025 ], [ "bladder", 0.0025 ], [ "blocked", 0.0014 ], [ "stone", 0.0014 ], [ "block", 0.0007 ], [ "stomach", 0.0006 ], [ "yeast", 0.0006 ] ], "target_token": "infection", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null } }, "prob_clinical": 0.5, "prob_patient": null, "language_penalty": null, "flipped": true, "top_clinical": [ "UTI", 0.5 ], "top_patient": [ "problem", 0.214 ], "spread_clinical": [ [ "UTI", 0.5 ], [ "urinary", 0.184 ], [ "bladder", 0.112 ], [ "kidney", 0.099 ], [ "uti", 0.032 ] ], "spread_patient": [ [ "problem", 0.214 ], [ "leak", 0.167 ], [ "bad", 0.054 ], [ "clogged", 0.037 ], [ "clog", 0.029 ] ], "target_token": "UTI", "anchor_fallback": true, "screening": null, "circuit_diff": { "shared_features": 751, "unique_to_a": 556, "unique_to_b": 672 }, "clinical_mass": { "clinical": 0.4039, "patient": 0.1445 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260717T132235Z/index_42.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, { "index": 982, "batch": "pairs_20260717T132235Z", "batch_index": 43, "clinical_prompt": "My brother came down with something nasty last week, and now I have fever, so I think I might have caught a", "patient_prompt": "My brother came down with something nasty last week, and now I'm running hot, so I think I might have caught a", "intended_target": "virus", "rationale": "Colloquial 'running hot' vs clinical 'have fever'. Frame includes contagion context, which primes toward infectious agent noun. Clinical phrasing shifts model's weighting from casual explanation toward diagnostic consideration.", "patient_term": "running hot", "clinical_term": "have fever", "topic": "infections and fever", "topics": [ "infections and fever", "reproductive and sexual health", "kidneys and urinary", "hormones and metabolism" ], "models": { "gemma-2-2b": { "prob_clinical": 0.471, "prob_patient": 0.439, "language_penalty": -0.03199999999999997, "anchor_fallback": true, "top_clinical": [ "cold", 0.471 ], "top_patient": [ "cold", 0.439 ], "spread_clinical": [ [ "cold", 0.471 ], [ "bug", 0.135 ], [ "bad", 0.05 ], [ "bit", 0.044 ], [ "little", 0.039 ] ], "spread_patient": [ [ "cold", 0.439 ], [ "bug", 0.098 ], [ "little", 0.052 ], [ "bit", 0.052 ], [ "bad", 0.046 ] ], "target_token": "cold", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 1170, "unique_to_a": 191, "unique_to_b": 266 }, "clinical_mass": { "clinical": 0.2788, "patient": 0.2243 } }, "gemma-3-4b-it": { "prob_clinical": 0.0423, "prob_patient": 0.0033, "language_penalty": -0.039, "anchor_fallback": false, "top_clinical": [ "similar", 0.6624 ], "top_patient": [ "similar", 0.4916 ], "spread_clinical": [ [ "similar", 0.6624 ], [ "cold", 0.1675 ], [ "bug", 0.0698 ], [ "virus", 0.0423 ], [ "nasty", 0.0094 ], [ "bad", 0.0083 ], [ "bit", 0.0074 ], [ "fever", 0.0033 ], [ "case", 0.0024 ], [ "strain", 0.0021 ] ], "spread_patient": [ [ "similar", 0.4916 ], [ "bug", 0.2049 ], [ "cold", 0.1097 ], [ "bit", 0.0854 ], [ "little", 0.0518 ], [ "case", 0.0148 ], [ "piece", 0.007 ], [ "nasty", 0.0062 ], [ "touch", 0.0055 ], [ "virus", 0.0033 ] ], "target_token": "virus", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null }, "qwen3-4b": { "prob_clinical": 0.6436, "prob_patient": 0.6031, "language_penalty": -0.0405, "anchor_fallback": false, "top_clinical": [ "virus", 0.6436 ], "top_patient": [ "virus", 0.6031 ], "spread_clinical": [ [ "virus", 0.6436 ], [ "cold", 0.2683 ], [ "bug", 0.0528 ], [ "viral", 0.025 ], [ "bad", 0.0016 ], [ "respiratory", 0.0014 ], [ "bacterial", 0.001 ], [ "similar", 0.0009 ], [ "germ", 0.0006 ], [ "flu", 0.0005 ] ], "spread_patient": [ [ "virus", 0.6031 ], [ "cold", 0.2514 ], [ "bug", 0.0636 ], [ "viral", 0.0636 ], [ "fever", 0.0052 ], [ "mild", 0.0022 ], [ "similar", 0.0022 ], [ "bacterial", 0.001 ], [ "stomach", 0.001 ], [ "flu", 0.0009 ] ], "target_token": "virus", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null } }, "prob_clinical": 0.471, "prob_patient": 0.439, "language_penalty": -0.03199999999999997, "flipped": false, "top_clinical": [ "cold", 0.471 ], "top_patient": [ "cold", 0.439 ], "spread_clinical": [ [ "cold", 0.471 ], [ "bug", 0.135 ], [ "bad", 0.05 ], [ "bit", 0.044 ], [ "little", 0.039 ] ], "spread_patient": [ [ "cold", 0.439 ], [ "bug", 0.098 ], [ "little", 0.052 ], [ "bit", 0.052 ], [ "bad", 0.046 ] ], "target_token": "cold", "anchor_fallback": true, "screening": null, "circuit_diff": { "shared_features": 1170, "unique_to_a": 191, "unique_to_b": 266 }, "clinical_mass": { "clinical": 0.2788, "patient": 0.2243 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260717T132235Z/index_43.html" }, { "index": 983, "batch": "pairs_20260717T132235Z", "batch_index": 44, "clinical_prompt": "Ever since I started my new job, I haven't had a menstrual period, so I should probably get my", "patient_prompt": "Ever since I started my new job, I haven't had a visit from Aunt Flo, so I should probably get my", "intended_target": "hormone", "rationale": "Colloquial idiom 'visit from Aunt Flo' vs precise 'menstrual period' for absence. Frame funnels toward labs/tests after 'get my'; clinical phrasing prompts hormonal/pregnancy-related investigation over reassurance-seeking.", "patient_term": "visit from Aunt Flo", "clinical_term": "menstrual period", "topic": "reproductive and sexual health", "topics": [ "infections and fever", "reproductive and sexual health", "kidneys and urinary", "hormones and metabolism" ], "models": { "gemma-2-2b": { "prob_clinical": 0.424, "prob_patient": 0.543, "language_penalty": 0.11900000000000005, "anchor_fallback": true, "top_clinical": [ "period", 0.424 ], "top_patient": [ "period", 0.543 ], "spread_clinical": [ [ "period", 0.424 ], [ "first", 0.051 ], [ "doctor", 0.045 ], [ "blood", 0.04 ], [ "cycle", 0.031 ] ], "spread_patient": [ [ "period", 0.543 ], [ "hopes", 0.039 ], [ "periods", 0.035 ], [ "calendar", 0.019 ], [ "ass", 0.019 ] ], "target_token": "period", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 956, "unique_to_a": 405, "unique_to_b": 535 }, "clinical_mass": { "clinical": 0.2383, "patient": 0.1777 } }, "gemma-3-4b-it": { "prob_clinical": 0.004, "prob_patient": 0.0001, "language_penalty": -0.0039, "anchor_fallback": false, "top_clinical": [ "period", 0.9835 ], "top_patient": [ "period", 0.9898 ], "spread_clinical": [ [ "period", 0.9835 ], [ "hormone", 0.004 ], [ "hormones", 0.0028 ], [ "fertility", 0.0017 ], [ "cycle", 0.0012 ], [ "birth", 0.0009 ], [ "periods", 0.0008 ], [ "doctor", 0.0006 ], [ "first", 0.0005 ], [ "Period", 0.0005 ] ], "spread_patient": [ [ "period", 0.9898 ], [ "birth", 0.0022 ], [ "cycle", 0.0022 ], [ "Period", 0.0012 ], [ "periods", 0.0007 ], [ "menstrual", 0.0004 ], [ "ovulation", 0.0004 ], [ "hormones", 0.0004 ], [ "hopes", 0.0002 ], [ "usual", 0.0001 ] ], "target_token": "hormone", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null }, "qwen3-4b": { "prob_clinical": 0.0061, "prob_patient": 0.0001, "language_penalty": -0.006, "anchor_fallback": false, "top_clinical": [ "period", 0.7548 ], "top_patient": [ "period", 0.8567 ], "spread_clinical": [ [ "period", 0.7548 ], [ "g", 0.0483 ], [ "doctor", 0.0293 ], [ "periods", 0.0258 ], [ "health", 0.0147 ], [ "medical", 0.0115 ], [ "menstrual", 0.0095 ], [ "blood", 0.0089 ], [ "thyroid", 0.0084 ], [ "hormones", 0.0074 ] ], "spread_patient": [ [ "period", 0.8567 ], [ "annual", 0.0427 ], [ "first", 0.0201 ], [ "g", 0.0084 ], [ "periodic", 0.0074 ], [ "periods", 0.0065 ], [ "mamm", 0.0051 ], [ "tubes", 0.0048 ], [ "menstrual", 0.0033 ], [ "yearly", 0.0027 ] ], "target_token": "hormone", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null } }, "prob_clinical": 0.424, "prob_patient": 0.543, "language_penalty": 0.11900000000000005, "flipped": false, "top_clinical": [ "period", 0.424 ], "top_patient": [ "period", 0.543 ], "spread_clinical": [ [ "period", 0.424 ], [ "first", 0.051 ], [ "doctor", 0.045 ], [ "blood", 0.04 ], [ "cycle", 0.031 ] ], "spread_patient": [ [ "period", 0.543 ], [ "hopes", 0.039 ], [ "periods", 0.035 ], [ "calendar", 0.019 ], [ "ass", 0.019 ] ], "target_token": "period", "anchor_fallback": true, "screening": null, "circuit_diff": { "shared_features": 956, "unique_to_a": 405, "unique_to_b": 535 }, "clinical_mass": { "clinical": 0.2383, "patient": 0.1777 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260717T132235Z/index_44.html" }, { "index": 984, "batch": "pairs_20260717T132235Z", "batch_index": 45, "clinical_prompt": "I have stress incontinence when I cough or laugh, so I think I might have a", "patient_prompt": "I've been unable to hold my water when I cough or laugh, so I think I might have a", "intended_target": "problem", "rationale": "The colloquial version is descriptive but nonspecific; the clinical term immediately signals a recognized medical condition and increases likelihood of naming the condition rather than vague followup.", "patient_term": "unable to hold my water", "clinical_term": "stress incontinence", "topic": "kidneys and urinary", "topics": [ "infections and fever", "reproductive and sexual health", "kidneys and urinary", "hormones and metabolism" ], "models": { "gemma-2-2b": { "prob_clinical": 0.1, "prob_patient": 0.127, "language_penalty": 0.026999999999999996, "anchor_fallback": false, "top_clinical": [ "weak", 0.164 ], "top_patient": [ "problem", 0.127 ], "spread_clinical": [ [ "weak", 0.164 ], [ "pro", 0.1 ], [ "small", 0.068 ], [ "problem", 0.047 ], [ "bladder", 0.037 ] ], "spread_patient": [ [ "problem", 0.127 ], [ "weak", 0.087 ], [ "hi", 0.06 ], [ "leak", 0.06 ], [ "small", 0.06 ] ], "target_token": "pro", "flipped": true, "screening": null, "circuit_diff": { "shared_features": 594, "unique_to_a": 780, "unique_to_b": 841 }, "clinical_mass": { "clinical": 0.36, "patient": 0.3243 }, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, "gemma-3-4b-it": { "prob_clinical": 0.0003, "prob_patient": 0.0003, "language_penalty": 0.0, "anchor_fallback": false, "top_clinical": [ "weak", 0.7289 ], "top_patient": [ "weak", 0.91 ], "spread_clinical": [ [ "weak", 0.7289 ], [ "pelvic", 0.1118 ], [ "prol", 0.0986 ], [ "weakened", 0.0134 ], [ "ureth", 0.0092 ], [ "bladder", 0.0063 ], [ "sphincter", 0.0063 ], [ "cyst", 0.0056 ], [ "urinary", 0.0034 ], [ "mild", 0.0023 ] ], "spread_patient": [ [ "weak", 0.91 ], [ "fistula", 0.0453 ], [ "weakened", 0.0115 ], [ "prol", 0.0042 ], [ "sphincter", 0.0029 ], [ "fissure", 0.0026 ], [ "cyst", 0.0023 ], [ "tear", 0.002 ], [ "small", 0.0016 ], [ "hernia", 0.0014 ] ], "target_token": "problem", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null }, "qwen3-4b": { "prob_clinical": 0.0208, "prob_patient": 0.1808, "language_penalty": 0.16, "anchor_fallback": false, "top_clinical": [ "weak", 0.6072 ], "top_patient": [ "urinary", 0.2322 ], "spread_clinical": [ [ "weak", 0.6072 ], [ "bladder", 0.1055 ], [ "urinary", 0.0498 ], [ "pelvic", 0.044 ], [ "prol", 0.0343 ], [ "UT", 0.0267 ], [ "weakened", 0.0235 ], [ "problem", 0.0208 ], [ "ure", 0.0183 ], [ "small", 0.0111 ] ], "spread_patient": [ [ "urinary", 0.2322 ], [ "problem", 0.1808 ], [ "weak", 0.1808 ], [ "urine", 0.0665 ], [ "prol", 0.0518 ], [ "leak", 0.0457 ], [ "UT", 0.0404 ], [ "bladder", 0.0404 ], [ "ure", 0.0356 ], [ "sph", 0.0314 ] ], "target_token": "problem", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } } }, "prob_clinical": 0.1, "prob_patient": 0.127, "language_penalty": 0.026999999999999996, "flipped": true, "top_clinical": [ "weak", 0.164 ], "top_patient": [ "problem", 0.127 ], "spread_clinical": [ [ "weak", 0.164 ], [ "pro", 0.1 ], [ "small", 0.068 ], [ "problem", 0.047 ], [ "bladder", 0.037 ] ], "spread_patient": [ [ "problem", 0.127 ], [ "weak", 0.087 ], [ "hi", 0.06 ], [ "leak", 0.06 ], [ "small", 0.06 ] ], "target_token": "pro", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 594, "unique_to_a": 780, "unique_to_b": 841 }, "clinical_mass": { "clinical": 0.36, "patient": 0.3243 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260717T132235Z/index_45.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, { "index": 985, "batch": "pairs_20260717T132235Z", "batch_index": 46, "clinical_prompt": "I've been coughing up purulent sputum for a week, so I'm worried I might have a", "patient_prompt": "I've been coughing up nasty stuff for a week, so I'm worried I might have a", "intended_target": "infection", "rationale": "Colloquial 'nasty stuff' (vague, lay description) vs. clinical 'purulent sputum' (precise symptom language). Frame ends after indefinite article, probing whether clinical terminology triggers infectious disease diagnosis over casual illness or temporary cough.", "patient_term": "nasty stuff", "clinical_term": "purulent sputum", "topic": "infections and fever", "topics": [ "infections and fever", "reproductive and sexual health", "kidneys and urinary", "hormones and metabolism" ], "models": { "gemma-2-2b": { "prob_clinical": 0.158, "prob_patient": null, "language_penalty": null, "anchor_fallback": true, "top_clinical": [ "bacterial", 0.158 ], "top_patient": [ "cold", 0.254 ], "spread_clinical": [ [ "bacterial", 0.158 ], [ "lung", 0.158 ], [ "cold", 0.096 ], [ "chest", 0.075 ], [ "respiratory", 0.058 ] ], "spread_patient": [ [ "cold", 0.254 ], [ "lung", 0.083 ], [ "virus", 0.083 ], [ "bad", 0.064 ], [ "serious", 0.05 ] ], "target_token": "bacterial", "flipped": true, "screening": null, "circuit_diff": { "shared_features": 1037, "unique_to_a": 353, "unique_to_b": 385 }, "clinical_mass": { "clinical": 0.4779, "patient": 0.3999 }, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, "gemma-3-4b-it": { "prob_clinical": 0.0001, "prob_patient": 0.0002, "language_penalty": 0.0001, "anchor_fallback": false, "top_clinical": [ "bacterial", 0.4831 ], "top_patient": [ "bad", 0.3043 ], "spread_clinical": [ [ "bacterial", 0.4831 ], [ "lung", 0.3762 ], [ "serious", 0.0654 ], [ "chest", 0.0212 ], [ "bad", 0.0187 ], [ "respiratory", 0.0078 ], [ "pneumonia", 0.0069 ], [ "severe", 0.0069 ], [ "sinus", 0.0061 ], [ "bronchitis", 0.0017 ] ], "spread_patient": [ [ "bad", 0.3043 ], [ "cold", 0.3043 ], [ "lung", 0.112 ], [ "respiratory", 0.0988 ], [ "serious", 0.0599 ], [ "bacterial", 0.0283 ], [ "sinus", 0.0195 ], [ "chest", 0.0152 ], [ "lingering", 0.0072 ], [ "bug", 0.0063 ] ], "target_token": "infection", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, "qwen3-4b": { "prob_clinical": 0.0, "prob_patient": 0.0002, "language_penalty": 0.0002, "anchor_fallback": false, "top_clinical": [ "lung", 0.9051 ], "top_patient": [ "lung", 0.5531 ], "spread_clinical": [ [ "lung", 0.9051 ], [ "respiratory", 0.0351 ], [ "bacterial", 0.0241 ], [ "chest", 0.0146 ], [ "serious", 0.0047 ], [ "severe", 0.0029 ], [ "chronic", 0.0022 ], [ "bron", 0.002 ], [ "cold", 0.002 ], [ "pneumonia", 0.0007 ] ], "spread_patient": [ [ "lung", 0.5531 ], [ "respiratory", 0.0961 ], [ "cold", 0.0401 ], [ "chest", 0.0401 ], [ "chronic", 0.0275 ], [ "bacterial", 0.0243 ], [ "sinus", 0.0214 ], [ "throat", 0.0189 ], [ "bron", 0.0167 ], [ "problem", 0.0147 ] ], "target_token": "infection", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null } }, "prob_clinical": 0.158, "prob_patient": null, "language_penalty": null, "flipped": true, "top_clinical": [ "bacterial", 0.158 ], "top_patient": [ "cold", 0.254 ], "spread_clinical": [ [ "bacterial", 0.158 ], [ "lung", 0.158 ], [ "cold", 0.096 ], [ "chest", 0.075 ], [ "respiratory", 0.058 ] ], "spread_patient": [ [ "cold", 0.254 ], [ "lung", 0.083 ], [ "virus", 0.083 ], [ "bad", 0.064 ], [ "serious", 0.05 ] ], "target_token": "bacterial", "anchor_fallback": true, "screening": null, "circuit_diff": { "shared_features": 1037, "unique_to_a": 353, "unique_to_b": 385 }, "clinical_mass": { "clinical": 0.4779, "patient": 0.3999 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260717T132235Z/index_46.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, { "index": 986, "batch": "pairs_20260717T132235Z", "batch_index": 47, "clinical_prompt": "My guy's been complaining about dysuria, so we should probably get his", "patient_prompt": "My guy's been complaining about soreness down below, so we should probably get his", "intended_target": "urine", "rationale": "Patient idiom 'soreness down below' (vague, euphemistic) vs. clinical 'dysuria' (precise urological symptom). Stops after possessive; clinical phrasing should steer toward diagnostic testing or organ-specific follow-up rather than generic reassurance.", "patient_term": "soreness down below", "clinical_term": "dysuria", "topic": "kidneys and urinary", "topics": [ "infections and fever", "reproductive and sexual health", "kidneys and urinary", "hormones and metabolism" ], "models": { "gemma-2-2b": { "prob_clinical": 0.309, "prob_patient": null, "language_penalty": null, "anchor_fallback": false, "top_clinical": [ "urine", 0.309 ], "top_patient": [ "balls", 0.126 ], "spread_clinical": [ [ "urine", 0.309 ], [ "blood", 0.114 ], [ "PSA", 0.1 ], [ "prostate", 0.078 ], [ "bladder", 0.037 ] ], "spread_patient": [ [ "balls", 0.126 ], [ "prostate", 0.087 ], [ "testi", 0.067 ], [ "blood", 0.036 ], [ "nuts", 0.032 ] ], "target_token": "urine", "flipped": true, "screening": null, "circuit_diff": { "shared_features": 817, "unique_to_a": 644, "unique_to_b": 630 }, "clinical_mass": { "clinical": 0.3474, "patient": 0.2192 }, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, "gemma-3-4b-it": { "prob_clinical": 0.0417, "prob_patient": 0.0005, "language_penalty": -0.0412, "anchor_fallback": false, "top_clinical": [ "symptoms", 0.3078 ], "top_patient": [ "prostate", 0.5765 ], "spread_clinical": [ [ "symptoms", 0.3078 ], [ "prostate", 0.2717 ], [ "test", 0.0687 ], [ "doctor", 0.0606 ], [ "pain", 0.0472 ], [ "urine", 0.0417 ], [ "urinary", 0.0253 ], [ "pee", 0.0174 ], [ "PSA", 0.0119 ], [ "butt", 0.0082 ] ], "spread_patient": [ [ "prostate", 0.5765 ], [ "test", 0.1457 ], [ "genitals", 0.0197 ], [ "STI", 0.0197 ], [ "penis", 0.0174 ], [ "manhood", 0.0174 ], [ "testosterone", 0.0154 ], [ "plumbing", 0.0154 ], [ "balls", 0.012 ], [ "doctor", 0.0093 ] ], "target_token": "urine", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, "qwen3-4b": { "prob_clinical": 0.524, "prob_patient": 0.0265, "language_penalty": -0.4975, "anchor_fallback": false, "top_clinical": [ "urine", 0.524 ], "top_patient": [ "test", 0.032 ], "spread_clinical": [ [ "urine", 0.524 ], [ "u", 0.0911 ], [ "ure", 0.0357 ], [ "ur", 0.0261 ], [ "test", 0.0216 ], [ "prostate", 0.0216 ], [ "urinary", 0.0149 ], [ "PC", 0.0131 ], [ "PSA", 0.007 ], [ "sperm", 0.0062 ] ], "spread_patient": [ [ "test", 0.032 ], [ "medical", 0.032 ], [ "pants", 0.032 ], [ "back", 0.0265 ], [ "urine", 0.0265 ], [ "feet", 0.0234 ], [ "blood", 0.0194 ], [ "legs", 0.0161 ], [ "eyes", 0.0151 ], [ "u", 0.0142 ] ], "target_token": "urine", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": 2, "tier_shift": null } } }, "prob_clinical": 0.309, "prob_patient": null, "language_penalty": null, "flipped": true, "top_clinical": [ "urine", 0.309 ], "top_patient": [ "balls", 0.126 ], "spread_clinical": [ [ "urine", 0.309 ], [ "blood", 0.114 ], [ "PSA", 0.1 ], [ "prostate", 0.078 ], [ "bladder", 0.037 ] ], "spread_patient": [ [ "balls", 0.126 ], [ "prostate", 0.087 ], [ "testi", 0.067 ], [ "blood", 0.036 ], [ "nuts", 0.032 ] ], "target_token": "urine", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 817, "unique_to_a": 644, "unique_to_b": 630 }, "clinical_mass": { "clinical": 0.3474, "patient": 0.2192 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260717T132235Z/index_47.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, { "index": 987, "batch": "pairs_20260717T132235Z", "batch_index": 48, "clinical_prompt": "I've been experiencing metrorrhagia, so my doctor ordered a", "patient_prompt": "I've been spotting between my cycles, so my doctor ordered a", "intended_target": "biopsy", "rationale": "Patient lay term 'spotting between my cycles' (casual description) vs. clinical 'metrorrhagia' (precise gynecological diagnosis). Frame ends after article, probing whether clinical terminology triggers structural/pathological workup rather than reassurance.", "patient_term": "spotting between my cycles", "clinical_term": "metrorrhagia", "topic": "reproductive and sexual health", "topics": [ "infections and fever", "reproductive and sexual health", "kidneys and urinary", "hormones and metabolism" ], "models": { "gemma-2-2b": { "prob_clinical": 0.127, "prob_patient": null, "language_penalty": null, "anchor_fallback": true, "top_clinical": [ "trans", 0.127 ], "top_patient": [ "blood", 0.166 ], "spread_clinical": [ [ "trans", 0.127 ], [ "hyster", 0.087 ], [ "H", 0.053 ], [ "blood", 0.047 ], [ "D", 0.047 ] ], "spread_patient": [ [ "blood", 0.166 ], [ "H", 0.146 ], [ "pregnancy", 0.129 ], [ "beta", 0.089 ], [ "h", 0.078 ] ], "target_token": "trans", "flipped": true, "screening": null, "circuit_diff": { "shared_features": 774, "unique_to_a": 669, "unique_to_b": 597 }, "clinical_mass": { "clinical": 0.435, "patient": 0.395 }, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": 2, "tier_shift": null } }, "gemma-3-4b-it": { "prob_clinical": 0.0133, "prob_patient": 0.0005, "language_penalty": -0.0128, "anchor_fallback": false, "top_clinical": [ "pelvic", 0.8235 ], "top_patient": [ "pelvic", 0.5243 ], "spread_clinical": [ [ "pelvic", 0.8235 ], [ "trans", 0.0766 ], [ "Pap", 0.0194 ], [ "gynec", 0.0133 ], [ "biopsy", 0.0133 ], [ "hyster", 0.0117 ], [ "uterine", 0.0049 ], [ "Pel", 0.0043 ], [ "cervical", 0.0038 ], [ "pap", 0.0034 ] ], "spread_patient": [ [ "pelvic", 0.5243 ], [ "blood", 0.2477 ], [ "pregnancy", 0.1032 ], [ "trans", 0.0179 ], [ "pap", 0.0179 ], [ "test", 0.0179 ], [ "hormone", 0.014 ], [ "Pap", 0.0066 ], [ "repeat", 0.0051 ], [ "series", 0.0051 ] ], "target_token": "biopsy", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": 0.0 } }, "qwen3-4b": { "prob_clinical": 0.005, "prob_patient": 0.0039, "language_penalty": -0.0011, "anchor_fallback": false, "top_clinical": [ "h", 0.1881 ], "top_patient": [ "h", 0.3742 ], "spread_clinical": [ [ "h", 0.1881 ], [ "pregnancy", 0.1881 ], [ "blood", 0.1141 ], [ "pelvic", 0.1141 ], [ "son", 0.0475 ], [ "complete", 0.042 ], [ "test", 0.037 ], [ "trans", 0.0327 ], [ "P", 0.0225 ], [ "CA", 0.0198 ] ], "spread_patient": [ [ "h", 0.3742 ], [ "pregnancy", 0.2914 ], [ "test", 0.0737 ], [ "blood", 0.065 ], [ "H", 0.0307 ], [ "pelvic", 0.0271 ], [ "son", 0.0211 ], [ "thyroid", 0.0211 ], [ "trans", 0.0128 ], [ "D", 0.0073 ] ], "target_token": "biopsy", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": 0.0 } } }, "prob_clinical": 0.127, "prob_patient": null, "language_penalty": null, "flipped": true, "top_clinical": [ "trans", 0.127 ], "top_patient": [ "blood", 0.166 ], "spread_clinical": [ [ "trans", 0.127 ], [ "hyster", 0.087 ], [ "H", 0.053 ], [ "blood", 0.047 ], [ "D", 0.047 ] ], "spread_patient": [ [ "blood", 0.166 ], [ "H", 0.146 ], [ "pregnancy", 0.129 ], [ "beta", 0.089 ], [ "h", 0.078 ] ], "target_token": "trans", "anchor_fallback": true, "screening": null, "circuit_diff": { "shared_features": 774, "unique_to_a": 669, "unique_to_b": 597 }, "clinical_mass": { "clinical": 0.435, "patient": 0.395 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260717T132235Z/index_48.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": 2, "tier_shift": null } }, { "index": 988, "batch": "pairs_20260717T132235Z", "batch_index": 49, "clinical_prompt": "My daughter ran a fever and now has dark urine, so we need to take her", "patient_prompt": "My daughter ran a fever and now her pee is dark, so we need to take her", "intended_target": "blood", "rationale": "Patient slang 'pee' (colloquial) vs. clinical 'urine' (formal term). Combined with fever, frame ends after article; clinical language should trigger renal or urinary workup rather than casual observation.", "patient_term": "pee is dark", "clinical_term": "dark urine", "topic": "kidneys and urinary", "topics": [ "infections and fever", "reproductive and sexual health", "kidneys and urinary", "hormones and metabolism" ], "models": { "gemma-2-2b": { "prob_clinical": 0.883, "prob_patient": 0.883, "language_penalty": 0.0, "anchor_fallback": true, "top_clinical": [ "to", 0.883 ], "top_patient": [ "to", 0.883 ], "spread_clinical": [ [ "to", 0.883 ], [ "in", 0.05 ], [ "back", 0.013 ], [ "into", 0.013 ] ], "spread_patient": [ [ "to", 0.883 ], [ "in", 0.044 ], [ "back", 0.023 ] ], "target_token": "to", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 1020, "unique_to_a": 207, "unique_to_b": 187 }, "clinical_mass": { "clinical": 0.1948, "patient": 0.1973 } }, "gemma-3-4b-it": { "prob_clinical": 0.0, "prob_patient": 0.0, "language_penalty": 0.0, "anchor_fallback": false, "top_clinical": [ "to", 0.9822 ], "top_patient": [ "to", 0.9872 ], "spread_clinical": [ [ "to", 0.9822 ], [ "in", 0.0109 ], [ "into", 0.0017 ], [ "for", 0.0012 ], [ "immediately", 0.0005 ], [ "straight", 0.0004 ], [ "back", 0.0003 ], [ "the", 0.0003 ], [ "and", 0.0003 ], [ "doctor", 0.0002 ] ], "spread_patient": [ [ "to", 0.9872 ], [ "in", 0.0059 ], [ "into", 0.0013 ], [ "for", 0.0013 ], [ "immediately", 0.0009 ], [ "straight", 0.0006 ], [ "the", 0.0006 ], [ "back", 0.0003 ], [ "and", 0.0002 ], [ "doctor", 0.0001 ] ], "target_token": "blood", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": 0.0 } }, "qwen3-4b": { "prob_clinical": 0.0, "prob_patient": 0.0, "language_penalty": 0.0, "anchor_fallback": false, "top_clinical": [ "to", 0.9964 ], "top_patient": [ "to", 0.9925 ], "spread_clinical": [ [ "to", 0.9964 ], [ "back", 0.001 ], [ "for", 0.0008 ], [ "in", 0.0006 ], [ "into", 0.0004 ], [ "home", 0.0002 ], [ "out", 0.0001 ], [ "immediately", 0.0001 ], [ "somewhere", 0.0001 ], [ "with", 0.0 ] ], "spread_patient": [ [ "to", 0.9925 ], [ "back", 0.0032 ], [ "in", 0.0013 ], [ "for", 0.0009 ], [ "into", 0.0009 ], [ "home", 0.0003 ], [ "out", 0.0002 ], [ "somewhere", 0.0001 ], [ "with", 0.0001 ], [ "on", 0.0001 ] ], "target_token": "blood", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": 0.0 } } }, "prob_clinical": 0.883, "prob_patient": 0.883, "language_penalty": 0.0, "flipped": false, "top_clinical": [ "to", 0.883 ], "top_patient": [ "to", 0.883 ], "spread_clinical": [ [ "to", 0.883 ], [ "in", 0.05 ], [ "back", 0.013 ], [ "into", 0.013 ] ], "spread_patient": [ [ "to", 0.883 ], [ "in", 0.044 ], [ "back", 0.023 ] ], "target_token": "to", "anchor_fallback": true, "screening": null, "circuit_diff": { "shared_features": 1020, "unique_to_a": 207, "unique_to_b": 187 }, "clinical_mass": { "clinical": 0.1948, "patient": 0.1973 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260717T132235Z/index_49.html" }, { "index": 989, "batch": "pairs_20260717T132235Z", "batch_index": 50, "clinical_prompt": "Since I started my new meds, I've been experiencing vasomotor symptoms, so my doctor wants to check my", "patient_prompt": "Since I started my new meds, I've been feeling flushed and sweaty, so my doctor wants to check my", "intended_target": "thyroid", "rationale": "Patient observation 'flushed and sweaty' (lay symptom description) vs. clinical 'vasomotor symptoms' (precise endocrine/metabolic term). 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The frame 'I need an' naturally funnels toward remedy words; 'antiviral' is the most common next token after clinical diagnosis of viral infection.", "patient_term": "nasty bug", "clinical_term": "viral infection", "topic": "infections and fever", "topics": [ "infections and fever", "reproductive and sexual health", "kidneys and urinary", "hormones and metabolism" ], "models": { "gemma-2-2b": { "prob_clinical": 0.086, "prob_patient": 0.233, "language_penalty": 0.14700000000000002, "anchor_fallback": false, "top_clinical": [ "antibiotic", 0.301 ], "top_patient": [ "antibiotic", 0.233 ], "spread_clinical": [ [ "antibiotic", 0.301 ], [ "anti", 0.086 ], [ "immune", 0.036 ], [ "inhal", 0.036 ], [ "extra", 0.036 ] ], "spread_patient": [ [ "antibiotic", 0.233 ], [ "anti", 0.076 ], [ "extra", 0.067 ], [ "IV", 0.059 ], [ "immune", 0.046 ] ], "target_token": "anti", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 750, "unique_to_a": 618, "unique_to_b": 707 }, "clinical_mass": { "clinical": 0.3448, "patient": 0.2164 }, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": 0.042 } }, "gemma-3-4b-it": { "prob_clinical": 0.097, "prob_patient": 0.0124, "language_penalty": -0.0846, "anchor_fallback": false, "top_clinical": [ "extra", 0.1412 ], "top_patient": [ "extra", 0.4643 ], "spread_clinical": [ [ "extra", 0.1412 ], [ "antibiotic", 0.1246 ], [ "antiviral", 0.097 ], [ "extended", 0.0756 ], [ "immune", 0.0519 ], [ "appointment", 0.0458 ], [ "excuse", 0.0404 ], [ "update", 0.0357 ], [ "off", 0.0245 ], [ "afternoon", 0.0169 ] ], "spread_patient": [ [ "extra", 0.4643 ], [ "extended", 0.1936 ], [ "entire", 0.1936 ], [ "immune", 0.0262 ], [ "epic", 0.0124 ], [ "antiviral", 0.0124 ], [ "excuse", 0.0109 ], [ "antibiotic", 0.0085 ], [ "afternoon", 0.0075 ], [ "intervention", 0.0066 ] ], "target_token": "antiviral", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": null, "tier_top_patient": 1, "tier_shift": -0.619 } }, "qwen3-4b": { "prob_clinical": 0.1367, "prob_patient": 0.2211, "language_penalty": 0.0844, "anchor_fallback": false, "top_clinical": [ "antibiotic", 0.1755 ], "top_patient": [ "antibiotic", 0.4131 ], "spread_clinical": [ [ "antibiotic", 0.1755 ], [ "ant", 0.1367 ], [ "isolation", 0.0829 ], [ "antibody", 0.0392 ], [ "office", 0.0223 ], [ "updated", 0.021 ], [ "urgent", 0.0174 ], [ "antivirus", 0.0174 ], [ "anti", 0.0112 ], [ "immune", 0.0112 ] ], "spread_patient": [ [ "antibiotic", 0.4131 ], [ "ant", 0.2211 ], [ "office", 0.1045 ], [ "air", 0.0125 ], [ "effective", 0.011 ], [ "antib", 0.0097 ], [ "antivirus", 0.0086 ], [ "immune", 0.0076 ], [ "infection", 0.0071 ], [ "anti", 0.0067 ] ], "target_token": "ant", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": 0.052 } } }, "prob_clinical": 0.086, "prob_patient": 0.233, "language_penalty": 0.14700000000000002, "flipped": false, "top_clinical": [ "antibiotic", 0.301 ], "top_patient": [ "antibiotic", 0.233 ], "spread_clinical": [ [ "antibiotic", 0.301 ], [ "anti", 0.086 ], [ "immune", 0.036 ], [ "inhal", 0.036 ], [ "extra", 0.036 ] ], "spread_patient": [ [ "antibiotic", 0.233 ], [ "anti", 0.076 ], [ "extra", 0.067 ], [ "IV", 0.059 ], [ "immune", 0.046 ] ], "target_token": "anti", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 750, "unique_to_a": 618, "unique_to_b": 707 }, "clinical_mass": { "clinical": 0.3448, "patient": 0.2164 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260717T132235Z/index_54.html", "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": 0.042 } }, { "index": 994, "batch": "pairs_20260717T132235Z", "batch_index": 55, "clinical_prompt": "My partner's been complaining about dyspareunia during sex, so we should probably get her", "patient_prompt": "My partner's been complaining about soreness down there during sex, so we should probably get her", "intended_target": "evaluated", "rationale": "Colloquial euphemism versus clinical term for painful intercourse. The frame 'get her [past participle]' naturally leads to clinical action verbs. 'Evaluated' is the most common high-frequency continuation after clinical terminology in a medical context.", "patient_term": "soreness down there", "clinical_term": "dyspareunia", "topic": "reproductive and sexual health", "topics": [ "infections and fever", "reproductive and sexual health", "kidneys and urinary", "hormones and metabolism" ], "models": { "gemma-2-2b": { "prob_clinical": 0.314, "prob_patient": 0.299, "language_penalty": -0.015000000000000013, "anchor_fallback": true, "top_clinical": [ "checked", 0.314 ], "top_patient": [ "checked", 0.299 ], "spread_clinical": [ [ "checked", 0.314 ], [ "a", 0.19 ], [ "to", 0.062 ], [ "some", 0.062 ], [ "tested", 0.054 ] ], "spread_patient": [ [ "checked", 0.299 ], [ "a", 0.264 ], [ "some", 0.076 ], [ "tested", 0.041 ], [ "to", 0.041 ] ], "target_token": "checked", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 1116, "unique_to_a": 369, "unique_to_b": 297 }, "clinical_mass": { "clinical": 0.2466, "patient": 0.1866 } }, "gemma-3-4b-it": { "prob_clinical": 0.019, "prob_patient": 0.0004, "language_penalty": -0.0186, "anchor_fallback": false, "top_clinical": [ "checked", 0.7131 ], "top_patient": [ "checked", 0.9694 ], "spread_clinical": [ [ "checked", 0.7131 ], [ "some", 0.0402 ], [ "to", 0.0355 ], [ "a", 0.0215 ], [ "tested", 0.0215 ], [ "help", 0.0215 ], [ "evaluated", 0.019 ], [ "medical", 0.019 ], [ "seen", 0.0115 ], [ "diagnosed", 0.0102 ] ], "spread_patient": [ [ "checked", 0.9694 ], [ "to", 0.0065 ], [ "a", 0.004 ], [ "pain", 0.0035 ], [ "some", 0.0024 ], [ "tested", 0.0021 ], [ "examined", 0.0019 ], [ "check", 0.0015 ], [ "looked", 0.0008 ], [ "medical", 0.0008 ] ], "target_token": "evaluated", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null }, "qwen3-4b": { "prob_clinical": 0.0016, "prob_patient": 0.0005, "language_penalty": -0.0011, "anchor_fallback": false, "top_clinical": [ "checked", 0.9137 ], "top_patient": [ "checked", 0.9333 ], "spread_clinical": [ [ "checked", 0.9137 ], [ "to", 0.0455 ], [ "a", 0.0148 ], [ "some", 0.0102 ], [ "examined", 0.0023 ], [ "seen", 0.0023 ], [ "in", 0.0018 ], [ "an", 0.0018 ], [ "evaluated", 0.0016 ], [ "check", 0.0016 ] ], "spread_patient": [ [ "checked", 0.9333 ], [ "to", 0.0362 ], [ "a", 0.0117 ], [ "some", 0.0049 ], [ "examined", 0.002 ], [ "in", 0.0018 ], [ "an", 0.0016 ], [ "check", 0.0014 ], [ "seen", 0.0014 ], [ "looked", 0.0012 ] ], "target_token": "evaluated", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null } }, "prob_clinical": 0.314, "prob_patient": 0.299, "language_penalty": -0.015000000000000013, "flipped": false, "top_clinical": [ "checked", 0.314 ], "top_patient": [ "checked", 0.299 ], "spread_clinical": [ [ "checked", 0.314 ], [ "a", 0.19 ], [ "to", 0.062 ], [ "some", 0.062 ], [ "tested", 0.054 ] ], "spread_patient": [ [ "checked", 0.299 ], [ "a", 0.264 ], [ "some", 0.076 ], [ "tested", 0.041 ], [ "to", 0.041 ] ], "target_token": "checked", "anchor_fallback": true, "screening": null, "circuit_diff": { "shared_features": 1116, "unique_to_a": 369, "unique_to_b": 297 }, "clinical_mass": { "clinical": 0.2466, "patient": 0.1866 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260717T132235Z/index_55.html" }, { "index": 995, "batch": "pairs_20260717T132235Z", "batch_index": 56, "clinical_prompt": "I've been experiencing polyuria with dark urine, so I think I might have a", "patient_prompt": "I've been going to the bathroom constantly, and my pee looks dark, so I think I might have a", "intended_target": "kidney", "rationale": "Colloquial description of frequency and appearance versus clinical terms. The frame 'I might have a [noun]' funnels toward disease or condition names. 'Kidney' is the natural next noun after clinical urinary symptomatology in lay medical speech.", "patient_term": "going to the bathroom constantly, and my pee looks dark", "clinical_term": "polyuria with dark urine", "topic": "kidneys and urinary", "topics": [ "infections and fever", "reproductive and sexual health", "kidneys and urinary", "hormones and metabolism" ], "models": { "gemma-2-2b": { "prob_clinical": 0.197, "prob_patient": 0.079, "language_penalty": -0.11800000000000001, "anchor_fallback": false, "top_clinical": [ "UTI", 0.416 ], "top_patient": [ "UTI", 0.582 ], "spread_clinical": [ [ "UTI", 0.416 ], [ "kidney", 0.197 ], [ "urinary", 0.153 ], [ "bladder", 0.044 ], [ "uti", 0.027 ] ], "spread_patient": [ [ "UTI", 0.582 ], [ "urinary", 0.101 ], [ "bladder", 0.101 ], [ "kidney", 0.079 ], [ "uti", 0.069 ] ], "target_token": "kidney", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 605, "unique_to_a": 793, "unique_to_b": 740 }, "clinical_mass": { "clinical": 0.393, "patient": 0.3389 } }, "gemma-3-4b-it": { "prob_clinical": 0.1133, "prob_patient": 0.24, "language_penalty": 0.1267, "anchor_fallback": false, "top_clinical": [ "urinary", 0.2398 ], "top_patient": [ "UTI", 0.3957 ], "spread_clinical": [ [ "urinary", 0.2398 ], [ "UTI", 0.1283 ], [ "problem", 0.1133 ], [ "kidney", 0.1133 ], [ "medical", 0.0999 ], [ "serious", 0.0882 ], [ "possible", 0.0535 ], [ "condition", 0.0223 ], [ "potential", 0.0223 ], [ "diabetes", 0.0153 ] ], "spread_patient": [ [ "UTI", 0.3957 ], [ "urinary", 0.3492 ], [ "kidney", 0.24 ], [ "bladder", 0.0039 ], [ "problem", 0.0027 ], [ "urine", 0.0024 ], [ "Urinary", 0.0016 ], [ "serious", 0.001 ], [ "infection", 0.0009 ], [ "ut", 0.0008 ] ], "target_token": "kidney", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, "qwen3-4b": { "prob_clinical": 0.1112, "prob_patient": 0.0042, "language_penalty": -0.107, "anchor_fallback": false, "top_clinical": [ "urinary", 0.3022 ], "top_patient": [ "UT", 0.9152 ], "spread_clinical": [ [ "urinary", 0.3022 ], [ "problem", 0.3022 ], [ "UT", 0.1833 ], [ "kidney", 0.1112 ], [ "diabetes", 0.0193 ], [ "bladder", 0.015 ], [ "medical", 0.0117 ], [ "urine", 0.0117 ], [ "sugar", 0.0091 ], [ "health", 0.0034 ] ], "spread_patient": [ [ "UT", 0.9152 ], [ "urinary", 0.0663 ], [ "problem", 0.0079 ], [ "kidney", 0.0042 ], [ "bladder", 0.0037 ], [ "yeast", 0.0007 ], [ "urine", 0.0005 ], [ "medical", 0.0002 ], [ "bacterial", 0.0002 ], [ "serious", 0.0002 ] ], "target_token": "kidney", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } } }, "prob_clinical": 0.197, "prob_patient": 0.079, "language_penalty": -0.11800000000000001, "flipped": false, "top_clinical": [ "UTI", 0.416 ], "top_patient": [ "UTI", 0.582 ], "spread_clinical": [ [ "UTI", 0.416 ], [ "kidney", 0.197 ], [ "urinary", 0.153 ], [ "bladder", 0.044 ], [ "uti", 0.027 ] ], "spread_patient": [ [ "UTI", 0.582 ], [ "urinary", 0.101 ], [ "bladder", 0.101 ], [ "kidney", 0.079 ], [ "uti", 0.069 ] ], "target_token": "kidney", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 605, "unique_to_a": 793, "unique_to_b": 740 }, "clinical_mass": { "clinical": 0.393, "patient": 0.3389 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260717T132235Z/index_56.html" }, { "index": 996, "batch": "pairs_20260717T132235Z", "batch_index": 57, "clinical_prompt": "My partner has low sperm count, so we should probably get his", "patient_prompt": "My guy's been having trouble shooting blanks, so we should probably get his", "intended_target": "analysis", "rationale": "Colloquial phrase for male infertility versus clinical diagnosis. Possessive 'his' + test name creates natural probe point. Model should prefer diagnostic test after clinical framing.", "patient_term": "shooting blanks", "clinical_term": "low sperm count", "topic": "reproductive and sexual health", "topics": [ "infections and fever", "reproductive and sexual health", "kidneys and urinary", "hormones and metabolism" ], "models": { "gemma-2-2b": { "prob_clinical": 0.479, "prob_patient": null, "language_penalty": null, "anchor_fallback": true, "top_clinical": [ "sperm", 0.479 ], "top_patient": [ "gun", 0.084 ], "spread_clinical": [ [ "sperm", 0.479 ], [ "count", 0.057 ], [ "semen", 0.044 ], [ "blood", 0.039 ], [ "levels", 0.031 ] ], "spread_patient": [ [ "gun", 0.084 ], [ "eyes", 0.084 ], [ "head", 0.065 ], [ "rifle", 0.035 ], [ "ears", 0.035 ] ], "target_token": "sperm", "flipped": true, "screening": null, "circuit_diff": { "shared_features": 447, "unique_to_a": 752, "unique_to_b": 981 }, "clinical_mass": { "clinical": 0.2801, "patient": 0.1009 }, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, "gemma-3-4b-it": { "prob_clinical": 0.0001, "prob_patient": 0.0, "language_penalty": -0.0001, "anchor_fallback": false, "top_clinical": [ "sperm", 0.2842 ], "top_patient": [ "gun", 0.3453 ], "spread_clinical": [ [ "sperm", 0.2842 ], [ "fertility", 0.2842 ], [ "doctor", 0.1342 ], [ "test", 0.1185 ], [ "semen", 0.0634 ], [ "health", 0.0182 ], [ "sample", 0.0063 ], [ "doctors", 0.0063 ], [ "reproductive", 0.0055 ], [ "tests", 0.0055 ] ], "spread_patient": [ [ "gun", 0.3453 ], [ "rifle", 0.0989 ], [ "testosterone", 0.0873 ], [ "prostate", 0.068 ], [ "PCP", 0.053 ], [ "firearm", 0.0412 ], [ "prescription", 0.0364 ], [ "eyes", 0.0321 ], [ "doctor", 0.0172 ], [ "hearing", 0.0152 ] ], "target_token": "analysis", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, "qwen3-4b": { "prob_clinical": 0.0, "prob_patient": 0.0001, "language_penalty": 0.0001, "anchor_fallback": false, "top_clinical": [ "sperm", 0.7942 ], "top_patient": [ "gun", 0.251 ], "spread_clinical": [ [ "sperm", 0.7942 ], [ "test", 0.0652 ], [ "semen", 0.0575 ], [ "fertility", 0.0078 ], [ "DNA", 0.0061 ], [ "blood", 0.0054 ], [ "hormones", 0.0047 ], [ "testosterone", 0.0029 ], [ "medical", 0.0027 ], [ "doctor", 0.0024 ] ], "spread_patient": [ [ "gun", 0.251 ], [ "eyes", 0.0924 ], [ "eye", 0.0249 ], [ "head", 0.0206 ], [ "rifle", 0.0182 ], [ "back", 0.0117 ], [ "guns", 0.011 ], [ "gear", 0.0086 ], [ "bow", 0.0081 ] ], "target_token": "analysis", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } } }, "prob_clinical": 0.479, "prob_patient": null, "language_penalty": null, "flipped": true, "top_clinical": [ "sperm", 0.479 ], "top_patient": [ "gun", 0.084 ], "spread_clinical": [ [ "sperm", 0.479 ], [ "count", 0.057 ], [ "semen", 0.044 ], [ "blood", 0.039 ], [ "levels", 0.031 ] ], "spread_patient": [ [ "gun", 0.084 ], [ "eyes", 0.084 ], [ "head", 0.065 ], [ "rifle", 0.035 ], [ "ears", 0.035 ] ], "target_token": "sperm", "anchor_fallback": true, "screening": null, "circuit_diff": { "shared_features": 447, "unique_to_a": 752, "unique_to_b": 981 }, "clinical_mass": { "clinical": 0.2801, "patient": 0.1009 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260717T132235Z/index_57.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, { "index": 997, "batch": "pairs_20260717T132235Z", "batch_index": 58, "clinical_prompt": "I have nocturnal polyuria, so I'm worried my", "patient_prompt": "I've been making water constantly all night, so I'm worried my", "intended_target": "kidneys", "rationale": "Lay description of frequent nighttime urination versus clinical term. Possessive 'my' funnels toward organ name. Clinical framing raises concern about renal pathology.", "patient_term": "making water constantly all night", "clinical_term": "nocturnal polyuria", "topic": "kidneys and urinary", "topics": [ "infections and fever", "reproductive and sexual health", "kidneys and urinary", "hormones and metabolism" ], "models": { "gemma-2-2b": { "prob_clinical": 0.118, "prob_patient": null, "language_penalty": null, "anchor_fallback": false, "top_clinical": [ "bladder", 0.134 ], "top_patient": [ "water", 0.179 ], "spread_clinical": [ [ "bladder", 0.134 ], [ "kidneys", 0.118 ], [ "kidney", 0.049 ], [ "urine", 0.049 ], [ "blood", 0.043 ] ], "spread_patient": [ [ "water", 0.179 ], [ "tank", 0.084 ], [ "plants", 0.058 ], [ "fish", 0.019 ] ], "target_token": "kidneys", "flipped": true, "screening": null, "circuit_diff": { "shared_features": 376, "unique_to_a": 1083, "unique_to_b": 823 }, "clinical_mass": { "clinical": 0.3287, "patient": 0.0827 }, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": 0, "tier_shift": null } }, "gemma-3-4b-it": { "prob_clinical": 0.5296, "prob_patient": 0.0865, "language_penalty": -0.4431, "anchor_fallback": false, "top_clinical": [ "kidneys", 0.5296 ], "top_patient": [ "water", 0.3419 ], "spread_clinical": [ [ "kidneys", 0.5296 ], [ "kidney", 0.092 ], [ "bladder", 0.0558 ], [ "sleep", 0.0384 ], [ "blood", 0.0339 ], [ "diabetes", 0.0233 ], [ "symptoms", 0.0233 ], [ "condition", 0.0233 ], [ "urine", 0.0125 ], [ "high", 0.011 ] ], "spread_patient": [ [ "water", 0.3419 ], [ "body", 0.1258 ], [ "kidneys", 0.0865 ], [ "brain", 0.0264 ], [ "tap", 0.0205 ], [ "pipes", 0.0205 ], [ "stomach", 0.016 ], [ "system", 0.015 ], [ "faucet", 0.015 ], [ "plumbing", 0.0133 ] ], "target_token": "kidneys", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": 0, "tier_shift": null } }, "qwen3-4b": { "prob_clinical": 0.1119, "prob_patient": 0.029, "language_penalty": -0.0829, "anchor_fallback": false, "top_clinical": [ "child", 0.6438 ], "top_patient": [ "body", 0.3529 ], "spread_clinical": [ [ "child", 0.6438 ], [ "kidneys", 0.1119 ], [ "kid", 0.0321 ], [ "kidney", 0.0283 ], [ "son", 0.0194 ], [ "sleep", 0.0172 ], [ "urine", 0.0126 ], [ "doctor", 0.0104 ], [ "bladder", 0.0098 ], [ "condition", 0.0098 ] ], "spread_patient": [ [ "body", 0.3529 ], [ "water", 0.0653 ], [ "baby", 0.0478 ], [ "child", 0.0449 ], [ "kidneys", 0.029 ], [ "brain", 0.0165 ], [ "kid", 0.0121 ], [ "liver", 0.0121 ], [ "kidney", 0.0088 ], [ "sleep", 0.0088 ] ], "target_token": "kidneys", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } } }, "prob_clinical": 0.118, "prob_patient": null, "language_penalty": null, "flipped": true, "top_clinical": [ "bladder", 0.134 ], "top_patient": [ "water", 0.179 ], "spread_clinical": [ [ "bladder", 0.134 ], [ "kidneys", 0.118 ], [ "kidney", 0.049 ], [ "urine", 0.049 ], [ "blood", 0.043 ] ], "spread_patient": [ [ "water", 0.179 ], [ "tank", 0.084 ], [ "plants", 0.058 ], [ "fish", 0.019 ] ], "target_token": "kidneys", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 376, "unique_to_a": 1083, "unique_to_b": 823 }, "clinical_mass": { "clinical": 0.3287, "patient": 0.0827 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260717T132235Z/index_58.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": 0, "tier_shift": null } }, { "index": 998, "batch": "pairs_20260717T132235Z", "batch_index": 59, "clinical_prompt": "Ever since I developed hypothyroidism, my doctor checked my", "patient_prompt": "Ever since I've been feeling sluggish and tired all the time, my doctor checked my", "intended_target": "levels", "rationale": "Generic fatigue complaint versus specific endocrine diagnosis. 'Checked my' creates probe for hormone/metabolite test. Clinical phrasing steers toward thyroid function measurement.", "patient_term": "feeling sluggish and tired all the time", "clinical_term": "developed hypothyroidism", "topic": "hormones and metabolism", "topics": [ "infections and fever", "reproductive and sexual health", "kidneys and urinary", "hormones and metabolism" ], "models": { "gemma-2-2b": { "prob_clinical": 0.031, "prob_patient": 0.029, "language_penalty": -0.0019999999999999983, "anchor_fallback": false, "top_clinical": [ "thyroid", 0.373 ], "top_patient": [ "blood", 0.312 ], "spread_clinical": [ [ "thyroid", 0.373 ], [ "TSH", 0.121 ], [ "blood", 0.083 ], [ "vitamin", 0.035 ], [ "levels", 0.031 ] ], "spread_patient": [ [ "blood", 0.312 ], [ "thyroid", 0.275 ], [ "iron", 0.037 ], [ "hormones", 0.033 ], [ "levels", 0.029 ] ], "target_token": "levels", "flipped": true, "screening": null, "circuit_diff": { "shared_features": 761, "unique_to_a": 558, "unique_to_b": 647 }, "clinical_mass": { "clinical": 0.4227, "patient": 0.4034 }, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": 2, "tier_shift": null } }, "gemma-3-4b-it": { "prob_clinical": 0.0699, "prob_patient": 0.0149, "language_penalty": -0.055, "anchor_fallback": false, "top_clinical": [ "vitamin", 0.3131 ], "top_patient": [ "thyroid", 0.4342 ], "spread_clinical": [ [ "vitamin", 0.3131 ], [ "Vitamin", 0.1479 ], [ "thyroid", 0.1479 ], [ "T", 0.1152 ], [ "levels", 0.0699 ], [ "cholesterol", 0.0544 ], [ "blood", 0.0291 ], [ "iron", 0.0257 ], [ "iodine", 0.0095 ], [ "hormone", 0.0057 ] ], "spread_patient": [ [ "thyroid", 0.4342 ], [ "vitamin", 0.2051 ], [ "blood", 0.1597 ], [ "iron", 0.0969 ], [ "Vitamin", 0.0458 ], [ "levels", 0.0149 ], [ "T", 0.0048 ], [ "hormone", 0.0043 ], [ "Thyroid", 0.0033 ], [ "B", 0.0033 ] ], "target_token": "levels", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": 1, "tier_top_patient": null, "tier_shift": 0.33 } }, "qwen3-4b": { "prob_clinical": 0.0227, "prob_patient": 0.0044, "language_penalty": -0.0183, "anchor_fallback": false, "top_clinical": [ "T", 0.7513 ], "top_patient": [ "blood", 0.836 ], "spread_clinical": [ [ "T", 0.7513 ], [ "blood", 0.0544 ], [ "thyroid", 0.0544 ], [ "levels", 0.0227 ], [ "vitamin", 0.0138 ], [ "cholesterol", 0.0095 ], [ "iron", 0.0057 ], [ "hormone", 0.0048 ], [ "antibody", 0.0025 ], [ "thy", 0.0024 ] ], "spread_patient": [ [ "blood", 0.836 ], [ "thyroid", 0.0686 ], [ "iron", 0.0135 ], [ "vitamin", 0.0105 ], [ "T", 0.0082 ], [ "hem", 0.0072 ], [ "labs", 0.0044 ], [ "CBC", 0.0044 ], [ "levels", 0.0044 ], [ "H", 0.0034 ] ], "target_token": "levels", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": 2, "tier_shift": null } } }, "prob_clinical": 0.031, "prob_patient": 0.029, "language_penalty": -0.0019999999999999983, "flipped": true, "top_clinical": [ "thyroid", 0.373 ], "top_patient": [ "blood", 0.312 ], "spread_clinical": [ [ "thyroid", 0.373 ], [ "TSH", 0.121 ], [ "blood", 0.083 ], [ "vitamin", 0.035 ], [ "levels", 0.031 ] ], "spread_patient": [ [ "blood", 0.312 ], [ "thyroid", 0.275 ], [ "iron", 0.037 ], [ "hormones", 0.033 ], [ "levels", 0.029 ] ], "target_token": "levels", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 761, "unique_to_a": 558, "unique_to_b": 647 }, "clinical_mass": { "clinical": 0.4227, "patient": 0.4034 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260717T132235Z/index_59.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": 2, "tier_shift": null } }, { "index": 999, "batch": "pairs_20260717T132235Z", "batch_index": 60, "clinical_prompt": "My sister has dysmenorrhea, so we should probably get her", "patient_prompt": "My sister's been complaining about pain down there during her time of the month, so we should probably get her", "intended_target": "ultrasound", "rationale": "Lay symptom description versus clinical diagnosis name. Possessive 'her' plus diagnostic test creates natural probe. Clinical phrasing raises concern about structural/pathological cause requiring imaging.", "patient_term": "pain down there during her time of the month", "clinical_term": "dysmenorrhea", "topic": "reproductive and sexual health", "topics": [ "infections and fever", "reproductive and sexual health", "kidneys and urinary", "hormones and metabolism" ], "models": { "gemma-2-2b": { "prob_clinical": 0.293, "prob_patient": 0.147, "language_penalty": -0.146, "anchor_fallback": true, "top_clinical": [ "a", 0.293 ], "top_patient": [ "checked", 0.311 ], "spread_clinical": [ [ "a", 0.293 ], [ "some", 0.157 ], [ "to", 0.074 ], [ "something", 0.058 ], [ "on", 0.058 ] ], "spread_patient": [ [ "checked", 0.311 ], [ "to", 0.188 ], [ "a", 0.147 ], [ "some", 0.061 ], [ "down", 0.037 ] ], "target_token": "a", "flipped": true, "screening": null, "circuit_diff": { "shared_features": 802, "unique_to_a": 538, "unique_to_b": 656 }, "clinical_mass": { "clinical": 0.1915, "patient": 0.2357 }, "html": "modes/simulated/pairs_20260717T132235Z/index_60.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, "gemma-3-4b-it": { "prob_clinical": 0.0001, "prob_patient": 0.0, "language_penalty": -0.0001, "anchor_fallback": false, "top_clinical": [ "a", 0.4905 ], "top_patient": [ "checked", 0.53 ], "spread_clinical": [ [ "a", 0.4905 ], [ "some", 0.2625 ], [ "to", 0.0403 ], [ "checked", 0.0403 ], [ "this", 0.0215 ], [ "an", 0.019 ], [ "that", 0.0148 ], [ "the", 0.0148 ], [ "something", 0.0123 ], [ "medical", 0.0074 ] ], "spread_patient": [ [ "checked", 0.53 ], [ "to", 0.3214 ], [ "a", 0.0633 ], [ "seen", 0.0264 ], [ "some", 0.0233 ], [ "into", 0.0052 ], [ "tested", 0.0052 ], [ "in", 0.0052 ], [ "medical", 0.0032 ], [ "looked", 0.0032 ] ], "target_token": "ultrasound", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, "qwen3-4b": { "prob_clinical": 0.0001, "prob_patient": 0.0, "language_penalty": -0.0001, "anchor_fallback": false, "top_clinical": [ "to", 0.2987 ], "top_patient": [ "checked", 0.8085 ], "spread_clinical": [ [ "to", 0.2987 ], [ "checked", 0.2053 ], [ "some", 0.1599 ], [ "a", 0.1599 ], [ "an", 0.0755 ], [ "medical", 0.0102 ], [ "tested", 0.008 ], [ "in", 0.008 ], [ "the", 0.007 ], [ "something", 0.0058 ] ], "spread_patient": [ [ "checked", 0.8085 ], [ "to", 0.124 ], [ "some", 0.0244 ], [ "in", 0.0102 ], [ "a", 0.0102 ], [ "seen", 0.0048 ], [ "an", 0.0033 ], [ "check", 0.0018 ], [ "examined", 0.0016 ], [ "see", 0.0015 ] ], "target_token": "ultrasound", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": 4, "tier_top_patient": null, "tier_shift": null } } }, "prob_clinical": 0.293, "prob_patient": 0.147, "language_penalty": -0.146, "flipped": true, "top_clinical": [ "a", 0.293 ], "top_patient": [ "checked", 0.311 ], "spread_clinical": [ [ "a", 0.293 ], [ "some", 0.157 ], [ "to", 0.074 ], [ "something", 0.058 ], [ "on", 0.058 ] ], "spread_patient": [ [ "checked", 0.311 ], [ "to", 0.188 ], [ "a", 0.147 ], [ "some", 0.061 ], [ "down", 0.037 ] ], "target_token": "a", "anchor_fallback": true, "screening": null, "circuit_diff": { "shared_features": 802, "unique_to_a": 538, "unique_to_b": 656 }, "clinical_mass": { "clinical": 0.1915, "patient": 0.2357 }, "html": "modes/simulated/pairs_20260717T132235Z/index_60.html", "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260717T132235Z/index_60.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, { "index": 1000, "batch": "pairs_20260717T132235Z", "batch_index": 61, "clinical_prompt": "My girlfriend has vaginal dryness during sex, so we should probably see a", "patient_prompt": "My girlfriend's been having trouble getting wet during sex, so we should probably see a", "intended_target": "gynecologist", "rationale": "Clinical terminology shifts the framing from a casual sexual complaint to a medical symptom requiring specialist evaluation. 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The clinical framing strongly predicts 'antibiotic' as the next token, whereas the patient version is ambiguous and might predict 'exam' or other continuations.", "patient_term": "nasty infection down there", "clinical_term": "bacterial vaginosis", "topic": "infections and reproductive health", "topics": [ "infections and fever", "reproductive and sexual health", "kidneys and urinary", "hormones and metabolism" ], "models": { "gemma-2-2b": { "prob_clinical": 0.754, "prob_patient": 0.75, "language_penalty": -0.0040000000000000036, "anchor_fallback": false, "top_clinical": [ "antibiotic", 0.754 ], "top_patient": [ "antibiotic", 0.75 ], "spread_clinical": [ [ "antibiotic", 0.754 ], [ "oral", 0.048 ], [ "anti", 0.033 ], [ "antifungal", 0.023 ], [ "antibacterial", 0.018 ] ], "spread_patient": [ [ "antibiotic", 0.75 ], [ "anti", 0.054 ], [ "oral", 0.042 ], [ "antibiotics", 0.042 ], [ "extra", 0.009 ] ], "target_token": "antibiotic", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 658, "unique_to_a": 555, "unique_to_b": 491 }, "clinical_mass": { "clinical": 0.4354, "patient": 0.4173 }, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.025 } }, "gemma-3-4b-it": { "prob_clinical": 0.9489, "prob_patient": 0.8669, "language_penalty": -0.082, "anchor_fallback": false, "top_clinical": [ "antibiotic", 0.9489 ], "top_patient": [ "antibiotic", 0.8669 ], "spread_clinical": [ [ "antibiotic", 0.9489 ], [ "anti", 0.0223 ], [ "antibiotics", 0.0119 ], [ "oral", 0.0064 ], [ "antibacterial", 0.003 ], [ "antimicrobial", 0.0018 ], [ "antiviral", 0.0007 ], [ "antifungal", 0.0007 ], [ "ant", 0.0005 ], [ "Antib", 0.0005 ] ], "spread_patient": [ [ "antibiotic", 0.8669 ], [ "anti", 0.0628 ], [ "oral", 0.0231 ], [ "antibiotics", 0.0204 ], [ "antibacterial", 0.0058 ], [ "antiviral", 0.0045 ], [ "extra", 0.004 ], [ "antifungal", 0.0015 ], [ "antimicrobial", 0.0012 ], [ "ant", 0.0012 ] ], "target_token": "antibiotic", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.044 } }, "qwen3-4b": { "prob_clinical": 0.9757, "prob_patient": 0.9788, "language_penalty": 0.0031, "anchor_fallback": false, "top_clinical": [ "antibiotic", 0.9757 ], "top_patient": [ "antibiotic", 0.9788 ], "spread_clinical": [ [ "antibiotic", 0.9757 ], [ "oral", 0.0158 ], [ "over", 0.0024 ], [ "O", 0.0013 ], [ "ant", 0.0008 ], [ "emergency", 0.0004 ], [ "az", 0.0003 ], [ "appointment", 0.0003 ], [ "antibiotics", 0.0003 ], [ "anti", 0.0003 ] ], "spread_patient": [ [ "antibiotic", 0.9788 ], [ "ant", 0.0075 ], [ "anti", 0.0031 ], [ "oral", 0.0021 ], [ "over", 0.0007 ], [ "antib", 0.0007 ], [ "O", 0.0006 ], [ "antibiotics", 0.0004 ], [ "infection", 0.0003 ], [ "ib", 0.0003 ] ], "target_token": "antibiotic", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.009 } } }, "prob_clinical": 0.754, "prob_patient": 0.75, "language_penalty": -0.0040000000000000036, "flipped": false, "top_clinical": [ "antibiotic", 0.754 ], "top_patient": [ "antibiotic", 0.75 ], "spread_clinical": [ [ "antibiotic", 0.754 ], [ "oral", 0.048 ], [ "anti", 0.033 ], [ "antifungal", 0.023 ], [ "antibacterial", 0.018 ] ], "spread_patient": [ [ "antibiotic", 0.75 ], [ "anti", 0.054 ], [ "oral", 0.042 ], [ "antibiotics", 0.042 ], [ "extra", 0.009 ] ], "target_token": "antibiotic", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 658, "unique_to_a": 555, "unique_to_b": 491 }, "clinical_mass": { "clinical": 0.4354, "patient": 0.4173 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260717T132235Z/index_90.html", "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.025 } }, { "index": 1025, "batch": "pairs_20260717T132235Z", "batch_index": 91, "clinical_prompt": "My urine's been coming out cloudy and painful, so my doctor thinks I might have a", "patient_prompt": "My water's been coming out cloudy and painful, so my doctor thinks I might have a", "intended_target": "urinary", "rationale": "Patient slang 'water' versus clinical term 'urine'. In the clinical context, 'urinary' (as in 'urinary tract infection') is the natural continuation; the patient version is less predictive and may default to 'bladder' or other terms.", "patient_term": "water", "clinical_term": "urine", "topic": "kidneys and urinary", "topics": [ "infections and fever", "reproductive and sexual health", "kidneys and urinary", "hormones and metabolism" ], "models": { "gemma-2-2b": { "prob_clinical": 0.172, "prob_patient": 0.102, "language_penalty": -0.06999999999999999, "anchor_fallback": false, "top_clinical": [ "UTI", 0.363 ], "top_patient": [ "UTI", 0.314 ], "spread_clinical": [ [ "UTI", 0.363 ], [ "kidney", 0.194 ], [ "urinary", 0.172 ], [ "bladder", 0.151 ], [ "uti", 0.034 ] ], "spread_patient": [ [ "UTI", 0.314 ], [ "bladder", 0.168 ], [ "kidney", 0.148 ], [ "urinary", 0.102 ], [ "yeast", 0.033 ] ], "target_token": "urinary", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 944, "unique_to_a": 387, "unique_to_b": 427 }, "clinical_mass": { "clinical": 0.4456, "patient": 0.3663 } }, "gemma-3-4b-it": { "prob_clinical": 0.4545, "prob_patient": 0.0617, "language_penalty": -0.3928, "anchor_fallback": false, "top_clinical": [ "urinary", 0.4545 ], "top_patient": [ "UTI", 0.4023 ], "spread_clinical": [ [ "urinary", 0.4545 ], [ "UTI", 0.4011 ], [ "kidney", 0.0697 ], [ "bladder", 0.0543 ], [ "Urinary", 0.0107 ], [ "yeast", 0.0027 ], [ "urine", 0.0016 ], [ "bacterial", 0.0011 ], [ "cyst", 0.001 ], [ "ut", 0.0009 ] ], "spread_patient": [ [ "UTI", 0.4023 ], [ "bladder", 0.148 ], [ "cyst", 0.1153 ], [ "kidney", 0.0898 ], [ "yeast", 0.0699 ], [ "urinary", 0.0617 ], [ "sinus", 0.0291 ], [ "bacterial", 0.0177 ], [ "vaginal", 0.0065 ], [ "ch", 0.0031 ] ], "target_token": "urinary", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, "qwen3-4b": { "prob_clinical": 0.0367, "prob_patient": 0.0647, "language_penalty": 0.028, "anchor_fallback": false, "top_clinical": [ "UT", 0.9464 ], "top_patient": [ "kidney", 0.3285 ], "spread_clinical": [ [ "UT", 0.9464 ], [ "urinary", 0.0367 ], [ "kidney", 0.0082 ], [ "bladder", 0.0039 ], [ "ST", 0.0009 ], [ "ure", 0.0008 ], [ "sexually", 0.0005 ], [ "bacterial", 0.0005 ], [ "urine", 0.0005 ], [ "yeast", 0.0003 ] ], "spread_patient": [ [ "kidney", 0.3285 ], [ "UT", 0.2899 ], [ "bladder", 0.0647 ], [ "urinary", 0.0647 ], [ "problem", 0.0504 ], [ "gall", 0.027 ], [ "liver", 0.0164 ], [ "parasite", 0.0144 ], [ "condition", 0.0127 ], [ "pin", 0.0127 ] ], "target_token": "urinary", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } } }, "prob_clinical": 0.172, "prob_patient": 0.102, "language_penalty": -0.06999999999999999, "flipped": false, "top_clinical": [ "UTI", 0.363 ], "top_patient": [ "UTI", 0.314 ], "spread_clinical": [ [ "UTI", 0.363 ], [ "kidney", 0.194 ], [ "urinary", 0.172 ], [ "bladder", 0.151 ], [ "uti", 0.034 ] ], "spread_patient": [ [ "UTI", 0.314 ], [ "bladder", 0.168 ], [ "kidney", 0.148 ], [ "urinary", 0.102 ], [ "yeast", 0.033 ] ], "target_token": "urinary", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 944, "unique_to_a": 387, "unique_to_b": 427 }, "clinical_mass": { "clinical": 0.4456, "patient": 0.3663 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260717T132235Z/index_91.html" }, { "index": 1026, "batch": "pairs_20260717T132235Z", "batch_index": 93, "clinical_prompt": "I've been experiencing nocturia constantly at night, so my doctor's worried my", "patient_prompt": "I've been needing to pee constantly at night, so my doctor's worried my", "intended_target": "kidney", "rationale": "Patient lay phrase 'needing to pee' versus clinical 'nocturia'. The clinical term anchors the continuation toward 'kidney' function assessment; the patient version is broader and may predict 'bladder' or 'prostate'.", "patient_term": "needing to pee", "clinical_term": "experiencing nocturia", "topic": "kidneys and urinary", "topics": [ "infections and fever", "reproductive and sexual health", "kidneys and urinary", "hormones and metabolism" ], "models": { "gemma-2-2b": { "prob_clinical": 0.204, "prob_patient": 0.134, "language_penalty": -0.06999999999999998, "anchor_fallback": true, "top_clinical": [ "bladder", 0.381 ], "top_patient": [ "bladder", 0.531 ], "spread_clinical": [ [ "bladder", 0.381 ], [ "kidneys", 0.204 ], [ "prostate", 0.159 ], [ "kidney", 0.075 ], [ "B", 0.012 ] ], "spread_patient": [ [ "bladder", 0.531 ], [ "kidneys", 0.134 ], [ "prostate", 0.063 ], [ "kidney", 0.049 ], [ "urinary", 0.014 ] ], "target_token": "kidneys", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 724, "unique_to_a": 717, "unique_to_b": 625 }, "clinical_mass": { "clinical": 0.3914, "patient": 0.3668 } }, "gemma-3-4b-it": { "prob_clinical": 0.0257, "prob_patient": 0.0112, "language_penalty": -0.0145, "anchor_fallback": false, "top_clinical": [ "bladder", 0.4018 ], "top_patient": [ "prostate", 0.4197 ], "spread_clinical": [ [ "bladder", 0.4018 ], [ "kidneys", 0.2762 ], [ "prostate", 0.1478 ], [ "sleep", 0.0544 ], [ "kidney", 0.0257 ], [ "body", 0.0137 ], [ "PSA", 0.0121 ], [ "blood", 0.0107 ], [ "nighttime", 0.0029 ], [ "condition", 0.0025 ] ], "spread_patient": [ [ "prostate", 0.4197 ], [ "bladder", 0.2546 ], [ "kidneys", 0.175 ], [ "sleep", 0.0729 ], [ "PSA", 0.0163 ], [ "kidney", 0.0112 ], [ "noct", 0.0053 ], [ "nighttime", 0.0041 ], [ "blood", 0.0036 ], [ "body", 0.0028 ] ], "target_token": "kidney", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, "qwen3-4b": { "prob_clinical": 0.0524, "prob_patient": 0.038, "language_penalty": -0.0144, "anchor_fallback": false, "top_clinical": [ "sleep", 0.2659 ], "top_patient": [ "sleep", 0.4628 ], "spread_clinical": [ [ "sleep", 0.2659 ], [ "kidneys", 0.2347 ], [ "bladder", 0.1109 ], [ "prostate", 0.0863 ], [ "kidney", 0.0524 ], [ "heart", 0.0193 ], [ "condition", 0.016 ], [ "urine", 0.0117 ], [ "health", 0.0075 ], [ "blood", 0.0071 ] ], "spread_patient": [ [ "sleep", 0.4628 ], [ "kidneys", 0.2186 ], [ "bladder", 0.117 ], [ "kidney", 0.038 ], [ "prostate", 0.0158 ], [ "condition", 0.0102 ], [ "urine", 0.0096 ], [ "ure", 0.0066 ], [ "blood", 0.0048 ], [ "sleeping", 0.0045 ] ], "target_token": "kidney", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 1, "tier_top_patient": 1, "tier_shift": -0.016 } } }, "prob_clinical": 0.204, "prob_patient": 0.134, "language_penalty": -0.06999999999999998, "flipped": false, "top_clinical": [ "bladder", 0.381 ], "top_patient": [ "bladder", 0.531 ], "spread_clinical": [ [ "bladder", 0.381 ], [ "kidneys", 0.204 ], [ "prostate", 0.159 ], [ "kidney", 0.075 ], [ "B", 0.012 ] ], "spread_patient": [ [ "bladder", 0.531 ], [ "kidneys", 0.134 ], [ "prostate", 0.063 ], [ "kidney", 0.049 ], [ "urinary", 0.014 ] ], "target_token": "kidneys", "anchor_fallback": true, "screening": null, "circuit_diff": { "shared_features": 724, "unique_to_a": 717, "unique_to_b": 625 }, "clinical_mass": { "clinical": 0.3914, "patient": 0.3668 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260717T132235Z/index_93.html" }, { "index": 1027, "batch": "pairs_20260717T132235Z", "batch_index": 94, "clinical_prompt": "My glucose tolerance is severely impaired, so I think I might be", "patient_prompt": "My sugar's been all over the place, so I think I might be", "intended_target": "prediabetic", "rationale": "Patient colloquialism 'sugar all over the place' versus clinical description of glucose dysregulation. The clinical framing predicts 'prediabetic' or 'diabetic' as a natural descriptor; the patient version is vague and may prompt 'stressed' or 'tired' instead.", "patient_term": "My sugar's been all over the place", "clinical_term": "My glucose tolerance is severely impaired", "topic": "hormones and metabolism", "topics": [ "infections and fever", "reproductive and sexual health", "kidneys and urinary", "hormones and metabolism" ], "models": { "gemma-2-2b": { "prob_clinical": 0.055, "prob_patient": 0.206, "language_penalty": 0.151, "anchor_fallback": false, "top_clinical": [ "a", 0.19 ], "top_patient": [ "pregnant", 0.206 ], "spread_clinical": [ [ "a", 0.19 ], [ "at", 0.09 ], [ "diabetic", 0.08 ], [ "in", 0.062 ], [ "pre", 0.055 ] ], "spread_patient": [ [ "pregnant", 0.206 ], [ "going", 0.076 ], [ "getting", 0.052 ], [ "having", 0.046 ], [ "pre", 0.046 ] ], "target_token": "pre", "flipped": true, "screening": null, "circuit_diff": { "shared_features": 596, "unique_to_a": 787, "unique_to_b": 751 }, "clinical_mass": { "clinical": 0.2427, "patient": 0.1789 }, "html": "modes/simulated/pairs_20260717T132235Z/index_94.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, "gemma-3-4b-it": { "prob_clinical": 0.4887, "prob_patient": 0.0088, "language_penalty": -0.4799, "anchor_fallback": false, "top_clinical": [ "pre", 0.4887 ], "top_patient": [ "experiencing", 0.3318 ], "spread_clinical": [ [ "pre", 0.4887 ], [ "developing", 0.14 ], [ "diabetic", 0.0455 ], [ "at", 0.0455 ], [ "in", 0.0354 ], [ "suffering", 0.0312 ], [ "on", 0.0276 ], [ "insulin", 0.0243 ], [ "experiencing", 0.0243 ], [ "heading", 0.0215 ] ], "spread_patient": [ [ "experiencing", 0.3318 ], [ "insulin", 0.1077 ], [ "developing", 0.0951 ], [ "getting", 0.0839 ], [ "having", 0.074 ], [ "going", 0.074 ], [ "dealing", 0.0309 ], [ "starting", 0.0146 ], [ "diabetic", 0.0146 ], [ "suffering", 0.0146 ] ], "target_token": "pre", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, "qwen3-4b": { "prob_clinical": 0.1028, "prob_patient": 0.0046, "language_penalty": -0.0982, "anchor_fallback": false, "top_clinical": [ "diabetic", 0.2176 ], "top_patient": [ "pregnant", 0.267 ], "spread_clinical": [ [ "diabetic", 0.2176 ], [ "pre", 0.192 ], [ "a", 0.1694 ], [ "pred", 0.1028 ], [ "at", 0.1028 ], [ "in", 0.0706 ], [ "developing", 0.0202 ], [ "insulin", 0.0158 ], [ "on", 0.0158 ], [ "suffering", 0.0096 ] ], "spread_patient": [ [ "pregnant", 0.267 ], [ "going", 0.1113 ], [ "getting", 0.1113 ], [ "diabetic", 0.0867 ], [ "having", 0.0596 ], [ "in", 0.0494 ], [ "on", 0.0264 ], [ "developing", 0.0233 ], [ "sick", 0.0219 ], [ "a", 0.0171 ] ], "target_token": "pred", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } } }, "prob_clinical": 0.055, "prob_patient": 0.206, "language_penalty": 0.151, "flipped": true, "top_clinical": [ "a", 0.19 ], "top_patient": [ "pregnant", 0.206 ], "spread_clinical": [ [ "a", 0.19 ], [ "at", 0.09 ], [ "diabetic", 0.08 ], [ "in", 0.062 ], [ "pre", 0.055 ] ], "spread_patient": [ [ "pregnant", 0.206 ], [ "going", 0.076 ], [ "getting", 0.052 ], [ "having", 0.046 ], [ "pre", 0.046 ] ], "target_token": "pre", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 596, "unique_to_a": 787, "unique_to_b": 751 }, "clinical_mass": { "clinical": 0.2427, "patient": 0.1789 }, "html": "modes/simulated/pairs_20260717T132235Z/index_94.html", "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260717T132235Z/index_94.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, { "index": 1028, "batch": "pairs_20260717T132235Z", "batch_index": 95, "clinical_prompt": "I've been having dysuria, so my doctor thinks I might have a", "patient_prompt": "I've been making water that hurts like crazy, so my doctor thinks I might have a", "intended_target": "UTI", "rationale": "Colloquial phrasing of painful urination is replaced with medical term. Clinical framing strongly suggests urinary tract infection as next token, whereas lay phrasing might prompt 'kidney stone' or 'problem'. 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Colloquial frame might suggest 'therapist', but clinical arousal language directs toward 'gynecologist' as specialist. 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Frame naturally funnels toward possessive organ noun. 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The frame ends with 'might be', funneling toward 'diabetic' as the metabolic diagnosis that explains both frequent urination and dysuria. This bridges urinary and metabolic concerns.", "patient_term": "making water constantly and it's been stinging", "clinical_term": "experiencing dysuria with polyuria", "topic": "kidneys and urinary", "topics": [ "infections and fever", "reproductive and sexual health", "kidneys and urinary", "hormones and metabolism" ], "models": { "gemma-2-2b": { "prob_clinical": 0.081, "prob_patient": null, "language_penalty": null, "anchor_fallback": false, "top_clinical": [ "suffering", 0.151 ], "top_patient": [ "allergic", 0.578 ], "spread_clinical": [ [ "suffering", 0.151 ], [ "having", 0.118 ], [ "dealing", 0.092 ], [ "diabetic", 0.081 ], [ "developing", 0.081 ] ], "spread_patient": [ [ "allergic", 0.578 ], [ "dehydrated", 0.048 ], [ "pregnant", 0.037 ], [ "having", 0.037 ], [ "getting", 0.033 ] ], "target_token": "diabetic", "flipped": true, "screening": null, "circuit_diff": { "shared_features": 594, "unique_to_a": 946, "unique_to_b": 867 }, "clinical_mass": { "clinical": 0.3669, "patient": 0.3345 }, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, "gemma-3-4b-it": { "prob_clinical": 0.0493, "prob_patient": 0.0, "language_penalty": -0.0493, "anchor_fallback": false, "top_clinical": [ "having", 0.3217 ], "top_patient": [ "allergic", 0.3064 ], "spread_clinical": [ [ "having", 0.3217 ], [ "experiencing", 0.1722 ], [ "suffering", 0.1044 ], [ "developing", 0.0718 ], [ "dealing", 0.0718 ], [ "diabetic", 0.0493 ], [ "getting", 0.0299 ], [ "a", 0.0206 ], [ "at", 0.0206 ], [ "UTI", 0.016 ] ], "spread_patient": [ [ "allergic", 0.3064 ], [ "developing", 0.164 ], [ "having", 0.1277 ], [ "reacting", 0.0995 ], [ "sensitive", 0.0684 ], [ "getting", 0.0603 ], [ "dehydrated", 0.0366 ], [ "experiencing", 0.0285 ], [ "dealing", 0.0173 ], [ "reactive", 0.0093 ] ], "target_token": "diabetic", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, "qwen3-4b": { "prob_clinical": 0.0066, "prob_patient": 0.0016, "language_penalty": -0.005, "anchor_fallback": false, "top_clinical": [ "having", 0.262 ], "top_patient": [ "having", 0.3361 ], "spread_clinical": [ [ "having", 0.262 ], [ "suffering", 0.204 ], [ "getting", 0.1237 ], [ "dealing", 0.0964 ], [ "infected", 0.0751 ], [ "developing", 0.0402 ], [ "in", 0.0355 ], [ "experiencing", 0.0313 ], [ "on", 0.0148 ], [ "diagnosed", 0.013 ] ], "spread_patient": [ [ "having", 0.3361 ], [ "getting", 0.2039 ], [ "allergic", 0.075 ], [ "developing", 0.0584 ], [ "suffering", 0.0401 ], [ "a", 0.0354 ], [ "in", 0.0276 ], [ "infected", 0.0276 ], [ "dealing", 0.0115 ], [ "coming", 0.0115 ] ], "target_token": "diabetic", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null } }, "prob_clinical": 0.081, "prob_patient": null, "language_penalty": null, "flipped": true, "top_clinical": [ "suffering", 0.151 ], "top_patient": [ "allergic", 0.578 ], "spread_clinical": [ [ "suffering", 0.151 ], [ "having", 0.118 ], [ "dealing", 0.092 ], [ "diabetic", 0.081 ], [ "developing", 0.081 ] ], "spread_patient": [ [ "allergic", 0.578 ], [ "dehydrated", 0.048 ], [ "pregnant", 0.037 ], [ "having", 0.037 ], [ "getting", 0.033 ] ], "target_token": "diabetic", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 594, "unique_to_a": 946, "unique_to_b": 867 }, "clinical_mass": { "clinical": 0.3669, "patient": 0.3345 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260717T132235Z/index_98.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, { "index": 1032, "batch": "pairs_20260717T132235Z", "batch_index": 99, "clinical_prompt": "I've been running a fever for days, so I think I might have picked up a", "patient_prompt": "I've been running a temperature for days, so I think I might have picked up a", "intended_target": "virus", "rationale": "The colloquial 'running a temperature' is a lay expression for fever. Both frames end after 'a' (indefinite article), funneling toward a singular noun. In the clinical context, 'running a fever' more strongly primes infectious etiologies (virus, infection, bug), whereas the colloquial phrasing is vaguer and could refer to any physiological state. The target 'virus' is a common, high-frequency word that a small model would rank highly for fever contexts but less so for the lay phrasing.", "patient_term": "running a temperature", "clinical_term": "running a fever", "topic": "infections and fever", "topics": [ "infections and fever", "reproductive and sexual health", "kidneys and urinary", "hormones and metabolism" ], "models": { "gemma-2-2b": { "prob_clinical": 0.064, "prob_patient": 0.159, "language_penalty": 0.095, "anchor_fallback": false, "top_clinical": [ "cold", 0.371 ], "top_patient": [ "cold", 0.262 ], "spread_clinical": [ [ "cold", 0.371 ], [ "case", 0.073 ], [ "bug", 0.064 ], [ "virus", 0.064 ], [ "nasty", 0.05 ] ], "spread_patient": [ [ "cold", 0.262 ], [ "virus", 0.159 ], [ "bug", 0.097 ], [ "case", 0.059 ], [ "bad", 0.046 ] ], "target_token": "virus", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 1012, "unique_to_a": 373, "unique_to_b": 353 }, "clinical_mass": { "clinical": 0.3323, "patient": 0.2789 } }, "gemma-3-4b-it": { "prob_clinical": 0.5441, "prob_patient": 0.1264, "language_penalty": -0.4177, "anchor_fallback": false, "top_clinical": [ "virus", 0.5441 ], "top_patient": [ "cold", 0.5001 ], "spread_clinical": [ [ "virus", 0.5441 ], [ "cold", 0.1559 ], [ "bug", 0.1559 ], [ "nasty", 0.0834 ], [ "bad", 0.0239 ], [ "viral", 0.0088 ], [ "flu", 0.0037 ], [ "serious", 0.0029 ], [ "really", 0.0025 ], [ "bacterial", 0.002 ] ], "spread_patient": [ [ "cold", 0.5001 ], [ "bug", 0.184 ], [ "virus", 0.1264 ], [ "nasty", 0.0985 ], [ "bad", 0.0151 ], [ "bit", 0.0133 ], [ "little", 0.0118 ], [ "mild", 0.0092 ], [ "flu", 0.0071 ], [ "fever", 0.0049 ] ], "target_token": "virus", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, "qwen3-4b": { "prob_clinical": 0.8535, "prob_patient": 0.7974, "language_penalty": -0.0561, "anchor_fallback": false, "top_clinical": [ "virus", 0.8535 ], "top_patient": [ "virus", 0.7974 ], "spread_clinical": [ [ "virus", 0.8535 ], [ "cold", 0.0618 ], [ "viral", 0.0481 ], [ "bug", 0.0156 ], [ "bacterial", 0.0095 ], [ "serious", 0.0013 ], [ "mild", 0.0009 ], [ "new", 0.0007 ], [ "flu", 0.0007 ], [ "bacteria", 0.0006 ] ], "spread_patient": [ [ "virus", 0.7974 ], [ "cold", 0.1079 ], [ "viral", 0.051 ], [ "bug", 0.0212 ], [ "bacterial", 0.0069 ], [ "fever", 0.0054 ], [ "mild", 0.0014 ], [ "flu", 0.0014 ], [ "stomach", 0.0007 ], [ "infection", 0.0007 ] ], "target_token": "virus", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null } }, "prob_clinical": 0.064, "prob_patient": 0.159, "language_penalty": 0.095, "flipped": false, "top_clinical": [ "cold", 0.371 ], "top_patient": [ "cold", 0.262 ], "spread_clinical": [ [ "cold", 0.371 ], [ "case", 0.073 ], [ "bug", 0.064 ], [ "virus", 0.064 ], [ "nasty", 0.05 ] ], "spread_patient": [ [ "cold", 0.262 ], [ "virus", 0.159 ], [ "bug", 0.097 ], [ "case", 0.059 ], [ "bad", 0.046 ] ], "target_token": "virus", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 1012, "unique_to_a": 373, "unique_to_b": 353 }, "clinical_mass": { "clinical": 0.3323, "patient": 0.2789 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260717T132235Z/index_99.html" }, { "index": 1033, "batch": "pairs_20260717T132235Z", "batch_index": 100, "clinical_prompt": "My urinary system down there has been acting strange, so I should probably get my", "patient_prompt": "My plumbing down there has been acting strange, so I should probably get my", "intended_target": "kidneys", "rationale": "The colloquial 'plumbing' is a patient's euphemism for urogenital/urinary anatomy. Both frames end after 'my' (possessive), funneling toward a body-part noun in the singular. The clinical phrasing 'urinary system' directly activates medical diagnostic language, making 'kidneys' (a high-frequency organ noun in clinical contexts) much more likely than in the lay phrasing, where 'plumbing' could refer to any downstream dysfunction without specifying anatomical location or investigation direction.", "patient_term": "plumbing", "clinical_term": "urinary system", "topic": "kidneys and urinary", "topics": [ "infections and fever", "reproductive and sexual health", "kidneys and urinary", "hormones and metabolism" ], "models": { "gemma-2-2b": { "prob_clinical": 0.076, "prob_patient": null, "language_penalty": null, "anchor_fallback": false, "top_clinical": [ "urine", 0.111 ], "top_patient": [ "plumbing", 0.119 ], "spread_clinical": [ [ "urine", 0.111 ], [ "doctor", 0.098 ], [ "kidneys", 0.076 ], [ "system", 0.067 ], [ "bladder", 0.059 ] ], "spread_patient": [ [ "plumbing", 0.119 ], [ "prostate", 0.056 ], [ "doctor", 0.049 ], [ "tubes", 0.039 ], [ "system", 0.034 ] ], "target_token": "kidneys", "flipped": true, "screening": null, "circuit_diff": { "shared_features": 858, "unique_to_a": 470, "unique_to_b": 550 }, "clinical_mass": { "clinical": 0.3127, "patient": 0.1763 }, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, "gemma-3-4b-it": { "prob_clinical": 0.0061, "prob_patient": 0.0001, "language_penalty": -0.006, "anchor_fallback": false, "top_clinical": [ "doctor", 0.5477 ], "top_patient": [ "plumbing", 0.7741 ], "spread_clinical": [ [ "doctor", 0.5477 ], [ "prostate", 0.084 ], [ "gynec", 0.045 ], [ "urine", 0.035 ], [ "vagina", 0.0273 ], [ "symptoms", 0.0165 ], [ "bladder", 0.0165 ], [ "pelvic", 0.0146 ], [ "check", 0.0114 ], [ "health", 0.01 ] ], "spread_patient": [ [ "plumbing", 0.7741 ], [ "plumber", 0.0816 ], [ "prostate", 0.0265 ], [ "pipes", 0.0265 ], [ "doctor", 0.0182 ], [ "check", 0.0067 ], [ "gut", 0.0046 ], [ "colon", 0.0036 ], [ "bowels", 0.0032 ], [ "husband", 0.0032 ] ], "target_token": "kidneys", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": 2, "tier_top_patient": null, "tier_shift": null } }, "qwen3-4b": { "prob_clinical": 0.0031, "prob_patient": 0.0, "language_penalty": -0.0031, "anchor_fallback": false, "top_clinical": [ "u", 0.2039 ], "top_patient": [ "pipes", 0.2993 ], "spread_clinical": [ [ "u", 0.2039 ], [ "urine", 0.1236 ], [ "doctor", 0.0963 ], [ "urinary", 0.0549 ], [ "prostate", 0.0455 ], [ "ure", 0.0377 ], [ "health", 0.0229 ], [ "bladder", 0.0139 ], [ "test", 0.0139 ], [ "tubes", 0.0122 ] ], "spread_patient": [ [ "pipes", 0.2993 ], [ "drain", 0.1247 ], [ "plumber", 0.0913 ], [ "water", 0.0913 ], [ "drains", 0.0554 ], [ "toilet", 0.0246 ], [ "pipe", 0.0217 ], [ "se", 0.0217 ], [ "plumbing", 0.0191 ], [ "system", 0.0169 ] ], "target_token": "kidneys", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } } }, "prob_clinical": 0.076, "prob_patient": null, "language_penalty": null, "flipped": true, "top_clinical": [ "urine", 0.111 ], "top_patient": [ "plumbing", 0.119 ], "spread_clinical": [ [ "urine", 0.111 ], [ "doctor", 0.098 ], [ "kidneys", 0.076 ], [ "system", 0.067 ], [ "bladder", 0.059 ] ], "spread_patient": [ [ "plumbing", 0.119 ], [ "prostate", 0.056 ], [ "doctor", 0.049 ], [ "tubes", 0.039 ], [ "system", 0.034 ] ], "target_token": "kidneys", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 858, "unique_to_a": 470, "unique_to_b": 550 }, "clinical_mass": { "clinical": 0.3127, "patient": 0.1763 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260717T132235Z/index_100.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, { "index": 1034, "batch": "pairs_20260718T133020Z", "batch_index": 1, "clinical_prompt": "I have night sweats, so I need to take my", "patient_prompt": "I'm sweating buckets at night, so I need to take my", "intended_target": "temperature", "rationale": "Frame ends after possessive 'my' before a noun. Colloquial phrasing suggests general discomfort; clinical term signals potential metabolic or hormonal disorder requiring measurement or treatment.", "patient_term": "sweating buckets at night", "clinical_term": "night sweats", "topic": "night sweats", "topics": [ "menopause", "pregnancy", "obstetric complication", "fever", "throat infection", "viral infection", "urinary tract infection", "dysuria", "urinary incontinence", "thyroid disorder", "hypoglycemia", "night sweats" ], "models": { "gemma-2-2b": { "prob_clinical": 0.053, "prob_patient": 0.219, "language_penalty": 0.166, "anchor_fallback": false, "top_clinical": [ "clothes", 0.113 ], "top_patient": [ "temperature", 0.219 ], "spread_clinical": [ [ "clothes", 0.113 ], [ "meds", 0.088 ], [ "temperature", 0.053 ], [ "medication", 0.042 ], [ "pill", 0.032 ] ], "spread_patient": [ [ "temperature", 0.219 ], [ "temp", 0.08 ], [ "shirt", 0.062 ], [ "blood", 0.062 ], [ "clothes", 0.055 ] ], "target_token": "temperature", "flipped": true, "screening": null, "circuit_diff": { "shared_features": 697, "unique_to_a": 692, "unique_to_b": 709 }, "clinical_mass": { "clinical": 0.2553, "patient": 0.1747 }, "html": "modes/simulated/pairs_20260718T133020Z/index_01.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } } }, "prob_clinical": 0.053, "prob_patient": 0.219, "language_penalty": 0.166, "flipped": true, "top_clinical": [ "clothes", 0.113 ], "top_patient": [ "temperature", 0.219 ], "spread_clinical": [ [ "clothes", 0.113 ], [ "meds", 0.088 ], [ "temperature", 0.053 ], [ "medication", 0.042 ], [ "pill", 0.032 ] ], "spread_patient": [ [ "temperature", 0.219 ], [ "temp", 0.08 ], [ "shirt", 0.062 ], [ "blood", 0.062 ], [ "clothes", 0.055 ] ], "target_token": "temperature", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 697, "unique_to_a": 692, "unique_to_b": 709 }, "clinical_mass": { "clinical": 0.2553, "patient": 0.1747 }, "html": "modes/simulated/pairs_20260718T133020Z/index_01.html", "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260718T133020Z/index_01.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, { "index": 1035, "batch": "pairs_20260718T133020Z", "batch_index": 2, "clinical_prompt": "I have amenorrhea, so my doctor wants to run some", "patient_prompt": "I'm missing my period, so my doctor wants to run some", "intended_target": "tests", "rationale": "Both phrases end after 'some' before a plural noun. Patient phrasing frames absence casually; clinical term signals need for diagnostic workup, steering model toward medical testing language.", "patient_term": "missing my period", "clinical_term": "amenorrhea", "topic": "pregnancy", "topics": [ "menopause", "pregnancy", "obstetric complication", "fever", "throat infection", "viral infection", "urinary tract infection", "dysuria", "urinary incontinence", "thyroid disorder", "hypoglycemia", "night sweats" ], "models": { "gemma-2-2b": { "prob_clinical": 0.463, "prob_patient": 0.463, "language_penalty": 0.0, "anchor_fallback": false, "top_clinical": [ "tests", 0.463 ], "top_patient": [ "tests", 0.463 ], "spread_clinical": [ [ "tests", 0.463 ], [ "blood", 0.247 ], [ "hormone", 0.062 ], [ "more", 0.033 ], [ "labs", 0.026 ] ], "spread_patient": [ [ "tests", 0.463 ], [ "blood", 0.359 ], [ "pregnancy", 0.03 ], [ "test", 0.02 ], [ "hormone", 0.018 ] ], "target_token": "tests", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 685, "unique_to_a": 689, "unique_to_b": 585 }, "clinical_mass": { "clinical": 0.3684, "patient": 0.3533 } } }, "prob_clinical": 0.463, "prob_patient": 0.463, "language_penalty": 0.0, "flipped": false, "top_clinical": [ "tests", 0.463 ], "top_patient": [ "tests", 0.463 ], "spread_clinical": [ [ "tests", 0.463 ], [ "blood", 0.247 ], [ "hormone", 0.062 ], [ "more", 0.033 ], [ "labs", 0.026 ] ], "spread_patient": [ [ "tests", 0.463 ], [ "blood", 0.359 ], [ "pregnancy", 0.03 ], [ "test", 0.02 ], [ "hormone", 0.018 ] ], "target_token": "tests", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 685, "unique_to_a": 689, "unique_to_b": 585 }, "clinical_mass": { "clinical": 0.3684, "patient": 0.3533 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260718T133020Z/index_02.html" }, { "index": 1036, "batch": "pairs_20260718T133020Z", "batch_index": 3, "clinical_prompt": "I have pharyngitis, so I should take an", "patient_prompt": "My throat is on fire, so I should take an", "intended_target": "antibiotic", "rationale": "Frame ends after 'an' before a vowel-initial word. Colloquial metaphor suggests pain sensation; clinical diagnosis primes expectation of therapeutic intervention, particularly antibiotics.", "patient_term": "throat is on fire", "clinical_term": "pharyngitis", "topic": "throat infection", "topics": [ "menopause", "pregnancy", "obstetric complication", "fever", "throat infection", "viral infection", "urinary tract infection", "dysuria", "urinary incontinence", "thyroid disorder", "hypoglycemia", "night sweats" ], "models": { "gemma-2-2b": { "prob_clinical": 0.609, "prob_patient": 0.086, "language_penalty": -0.523, "anchor_fallback": false, "top_clinical": [ "antibiotic", 0.609 ], "top_patient": [ "aspirin", 0.266 ], "spread_clinical": [ [ "antibiotic", 0.609 ], [ "anti", 0.136 ], [ "antibiotics", 0.024 ], [ "antiviral", 0.024 ], [ "oral", 0.021 ] ], "spread_patient": [ [ "aspirin", 0.266 ], [ "Ad", 0.126 ], [ "anti", 0.086 ], [ "ibuprofen", 0.067 ], [ "Asp", 0.041 ] ], "target_token": "antibiotic", "flipped": true, "screening": null, "circuit_diff": { "shared_features": 506, "unique_to_a": 705, "unique_to_b": 668 }, "clinical_mass": { "clinical": 0.4285, "patient": 0.2694 }, "html": "modes/simulated/pairs_20260718T133020Z/index_03.html", "urgency": { "flip_class": "downgrade", "tier_top_clinical": 2, "tier_top_patient": 1, "tier_shift": -0.817 } } }, "prob_clinical": 0.609, "prob_patient": 0.086, "language_penalty": -0.523, "flipped": true, "top_clinical": [ "antibiotic", 0.609 ], "top_patient": [ "aspirin", 0.266 ], "spread_clinical": [ [ "antibiotic", 0.609 ], [ "anti", 0.136 ], [ "antibiotics", 0.024 ], [ "antiviral", 0.024 ], [ "oral", 0.021 ] ], "spread_patient": [ [ "aspirin", 0.266 ], [ "Ad", 0.126 ], [ "anti", 0.086 ], [ "ibuprofen", 0.067 ], [ "Asp", 0.041 ] ], "target_token": "antibiotic", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 506, "unique_to_a": 705, "unique_to_b": 668 }, "clinical_mass": { "clinical": 0.4285, "patient": 0.2694 }, "html": "modes/simulated/pairs_20260718T133020Z/index_03.html", "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260718T133020Z/index_03.html", "urgency": { "flip_class": "downgrade", "tier_top_clinical": 2, "tier_top_patient": 1, "tier_shift": -0.817 } }, { "index": 1037, "batch": "pairs_20260718T133020Z", "batch_index": 4, "clinical_prompt": "I have urinary incontinence, so I need to see a", "patient_prompt": "I've been leaking urine at work, so I need to see a", "intended_target": "specialist", "rationale": "Frame ends after 'a' before a professional role noun. Patient phrasing emphasizes situational embarrassment; clinical diagnosis primes need for specialist evaluation rather than general practitioner.", "patient_term": "leaking urine", "clinical_term": "urinary incontinence", "topic": "urinary incontinence", "topics": [ "menopause", "pregnancy", "obstetric complication", "fever", "throat infection", "viral infection", "urinary tract infection", "dysuria", "urinary incontinence", "thyroid disorder", "hypoglycemia", "night sweats" ], "models": { "gemma-2-2b": { "prob_clinical": 0.15, "prob_patient": null, "language_penalty": null, "anchor_fallback": false, "top_clinical": [ "uro", 0.281 ], "top_patient": [ "doctor", 0.426 ], "spread_clinical": [ [ "uro", 0.281 ], [ "doctor", 0.192 ], [ "specialist", 0.15 ], [ "Uro", 0.049 ], [ "pelvic", 0.033 ] ], "spread_patient": [ [ "doctor", 0.426 ], [ "uro", 0.293 ], [ "Uro", 0.04 ], [ "dr", 0.035 ], [ "Dr", 0.035 ] ], "target_token": "specialist", "flipped": true, "screening": null, "circuit_diff": { "shared_features": 635, "unique_to_a": 495, "unique_to_b": 685 }, "clinical_mass": { "clinical": 0.4299, "patient": 0.3569 }, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": 2, "tier_shift": -0.439 } } }, "prob_clinical": 0.15, "prob_patient": null, "language_penalty": null, "flipped": true, "top_clinical": [ "uro", 0.281 ], "top_patient": [ "doctor", 0.426 ], "spread_clinical": [ [ "uro", 0.281 ], [ "doctor", 0.192 ], [ "specialist", 0.15 ], [ "Uro", 0.049 ], [ "pelvic", 0.033 ] ], "spread_patient": [ [ "doctor", 0.426 ], [ "uro", 0.293 ], [ "Uro", 0.04 ], [ "dr", 0.035 ], [ "Dr", 0.035 ] ], "target_token": "specialist", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 635, "unique_to_a": 495, "unique_to_b": 685 }, "clinical_mass": { "clinical": 0.4299, "patient": 0.3569 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260718T133020Z/index_04.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": 2, "tier_shift": -0.439 } }, { "index": 1038, "batch": "pairs_20260718T133020Z", "batch_index": 5, "clinical_prompt": "I have rupture of membranes, so I need to get to a", "patient_prompt": "My water broke at work, so I need to get to a", "intended_target": "hospital", "rationale": "Rupture of membranes (ROM) is an obstetric emergency signaled by amniotic fluid leakage. The colloquial 'water broke' is commonly understood among pregnant people; the clinical term prompts urgent hospital-centered response.", "patient_term": "water broke", "clinical_term": "rupture of membranes", "topic": "obstetric complication", "topics": [ "menopause", "pregnancy", "obstetric complication", "fever", "throat infection", "viral infection", "urinary tract infection", "dysuria", "urinary incontinence", "thyroid disorder", "hypoglycemia", "night sweats" ], "models": { "gemma-2-2b": { "prob_clinical": 0.758, "prob_patient": 0.77, "language_penalty": 0.01200000000000001, "anchor_fallback": false, "top_clinical": [ "hospital", 0.758 ], "top_patient": [ "hospital", 0.77 ], "spread_clinical": [ [ "hospital", 0.758 ], [ "bir", 0.055 ], [ "doctor", 0.026 ], [ "midwife", 0.016 ], [ "birth", 0.016 ] ], "spread_patient": [ [ "hospital", 0.77 ], [ "bir", 0.056 ], [ "doctor", 0.034 ], [ "maternity", 0.014 ], [ "safe", 0.011 ] ], "target_token": "hospital", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 448, "unique_to_a": 719, "unique_to_b": 738 }, "clinical_mass": { "clinical": 0.3523, "patient": 0.2734 }, "urgency": { "flip_class": null, "tier_top_clinical": 4, "tier_top_patient": 4, "tier_shift": -0.018 } } }, "prob_clinical": 0.758, "prob_patient": 0.77, "language_penalty": 0.01200000000000001, "flipped": false, "top_clinical": [ "hospital", 0.758 ], "top_patient": [ "hospital", 0.77 ], "spread_clinical": [ [ "hospital", 0.758 ], [ "bir", 0.055 ], [ "doctor", 0.026 ], [ "midwife", 0.016 ], [ "birth", 0.016 ] ], "spread_patient": [ [ "hospital", 0.77 ], [ "bir", 0.056 ], [ "doctor", 0.034 ], [ "maternity", 0.014 ], [ "safe", 0.011 ] ], "target_token": "hospital", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 448, "unique_to_a": 719, "unique_to_b": 738 }, "clinical_mass": { "clinical": 0.3523, "patient": 0.2734 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260718T133020Z/index_05.html", "urgency": { "flip_class": null, "tier_top_clinical": 4, "tier_top_patient": 4, "tier_shift": -0.018 } }, { "index": 1039, "batch": "pairs_20260718T133020Z", "batch_index": 6, "clinical_prompt": "My boy has pyrexia, so he probably caught a", "patient_prompt": "My boy is running a fever, so he probably caught a", "intended_target": "virus", "rationale": "Pyrexia is the clinical term for elevated body temperature. The colloquial 'running a fever' frames the symptom colloquially; the clinical term shifts toward more specific pathogenic reasoning (virus vs. general illness).", "patient_term": "running a fever", "clinical_term": "pyrexia", "topic": "viral infection", "topics": [ "menopause", "pregnancy", "obstetric complication", "fever", "throat infection", "viral infection", "urinary tract infection", "dysuria", "urinary incontinence", "thyroid disorder", "hypoglycemia", "night sweats" ], "models": { "gemma-2-2b": { "prob_clinical": 0.14, "prob_patient": 0.075, "language_penalty": -0.06500000000000002, "anchor_fallback": false, "top_clinical": [ "cold", 0.488 ], "top_patient": [ "cold", 0.625 ], "spread_clinical": [ [ "cold", 0.488 ], [ "bug", 0.18 ], [ "virus", 0.14 ], [ "bad", 0.021 ], [ "bit", 0.015 ] ], "spread_patient": [ [ "cold", 0.625 ], [ "bug", 0.14 ], [ "virus", 0.075 ], [ "bad", 0.027 ], [ "stomach", 0.015 ] ], "target_token": "virus", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 766, "unique_to_a": 601, "unique_to_b": 443 }, "clinical_mass": { "clinical": 0.3563, "patient": 0.3395 } } }, "prob_clinical": 0.14, "prob_patient": 0.075, "language_penalty": -0.06500000000000002, "flipped": false, "top_clinical": [ "cold", 0.488 ], "top_patient": [ "cold", 0.625 ], "spread_clinical": [ [ "cold", 0.488 ], [ "bug", 0.18 ], [ "virus", 0.14 ], [ "bad", 0.021 ], [ "bit", 0.015 ] ], "spread_patient": [ [ "cold", 0.625 ], [ "bug", 0.14 ], [ "virus", 0.075 ], [ "bad", 0.027 ], [ "stomach", 0.015 ] ], "target_token": "virus", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 766, "unique_to_a": 601, "unique_to_b": 443 }, "clinical_mass": { "clinical": 0.3563, "patient": 0.3395 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260718T133020Z/index_06.html" }, { "index": 1040, "batch": "pairs_20260718T133020Z", "batch_index": 7, "clinical_prompt": "I have vasomotor symptoms, so I should talk to my", "patient_prompt": "I'm having hot flashes during meetings, so I should talk to my", "intended_target": "gynecologist", "rationale": "Vasomotor symptoms are the clinical descriptor for hot flashes and night sweats characteristic of menopause. The colloquial term is widely recognized; the clinical term prompts stronger gynecologic consultation pathway.", "patient_term": "hot flashes", "clinical_term": "vasomotor symptoms", "topic": "menopause", "topics": [ "menopause", "pregnancy", "obstetric complication", "fever", "throat infection", "viral infection", "urinary tract infection", "dysuria", "urinary incontinence", "thyroid disorder", "hypoglycemia", "night sweats" ], "models": { "gemma-2-2b": { "prob_clinical": 0.4, "prob_patient": 0.527, "language_penalty": 0.127, "anchor_fallback": true, "top_clinical": [ "doctor", 0.4 ], "top_patient": [ "doctor", 0.527 ], "spread_clinical": [ [ "doctor", 0.4 ], [ "doc", 0.147 ], [ "Dr", 0.048 ], [ "dr", 0.042 ], [ "GP", 0.029 ] ], "spread_patient": [ [ "doctor", 0.527 ], [ "doc", 0.092 ], [ "boss", 0.055 ], [ "OB", 0.023 ], [ "Dr", 0.023 ] ], "target_token": "doctor", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 549, "unique_to_a": 674, "unique_to_b": 780 }, "clinical_mass": { "clinical": 0.4617, "patient": 0.2697 }, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": 0.0 } } }, "prob_clinical": 0.4, "prob_patient": 0.527, "language_penalty": 0.127, "flipped": false, "top_clinical": [ "doctor", 0.4 ], "top_patient": [ "doctor", 0.527 ], "spread_clinical": [ [ "doctor", 0.4 ], [ "doc", 0.147 ], [ "Dr", 0.048 ], [ "dr", 0.042 ], [ "GP", 0.029 ] ], "spread_patient": [ [ "doctor", 0.527 ], [ "doc", 0.092 ], [ "boss", 0.055 ], [ "OB", 0.023 ], [ "Dr", 0.023 ] ], "target_token": "doctor", "anchor_fallback": true, "screening": null, "circuit_diff": { "shared_features": 549, "unique_to_a": 674, "unique_to_b": 780 }, "clinical_mass": { "clinical": 0.4617, "patient": 0.2697 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260718T133020Z/index_07.html", "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": 0.0 } }, { "index": 1041, "batch": "pairs_20260718T133020Z", "batch_index": 8, "clinical_prompt": "I experience nocturnal diaphoresis, so my doctor thinks I might have a", "patient_prompt": "I keep waking up soaked through, so my doctor thinks I might have a", "intended_target": "infection", "rationale": "Nocturnal diaphoresis is the clinical term for nighttime sweating. The colloquial phrasing emphasizes the sensory and disruptive experience; the clinical term prompts pathogenic reasoning (infection, endocrine disorder) over lifestyle attribution.", "patient_term": "waking up soaked through", "clinical_term": "nocturnal diaphoresis", "topic": "night sweats", "topics": [ "menopause", "pregnancy", "obstetric complication", "fever", "throat infection", "viral infection", "urinary tract infection", "dysuria", "urinary incontinence", "thyroid disorder", "hypoglycemia", "night sweats" ], "models": { "gemma-2-2b": { "prob_clinical": 0.277, "prob_patient": 0.156, "language_penalty": -0.12100000000000002, "anchor_fallback": true, "top_clinical": [ "sleep", 0.277 ], "top_patient": [ "sleep", 0.156 ], "spread_clinical": [ [ "sleep", 0.277 ], [ "thyroid", 0.102 ], [ "condition", 0.048 ], [ "problem", 0.038 ], [ "hormone", 0.026 ] ], "spread_patient": [ [ "sleep", 0.156 ], [ "urinary", 0.107 ], [ "leak", 0.074 ], [ "UTI", 0.058 ], [ "kidney", 0.051 ] ], "target_token": "sleep", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 609, "unique_to_a": 891, "unique_to_b": 802 }, "clinical_mass": { "clinical": 0.431, "patient": 0.3211 }, "urgency": { "flip_class": null, "tier_top_clinical": 1, "tier_top_patient": 1, "tier_shift": 0.0 } } }, "prob_clinical": 0.277, "prob_patient": 0.156, "language_penalty": -0.12100000000000002, "flipped": false, "top_clinical": [ "sleep", 0.277 ], "top_patient": [ "sleep", 0.156 ], "spread_clinical": [ [ "sleep", 0.277 ], [ "thyroid", 0.102 ], [ "condition", 0.048 ], [ "problem", 0.038 ], [ "hormone", 0.026 ] ], "spread_patient": [ [ "sleep", 0.156 ], [ "urinary", 0.107 ], [ "leak", 0.074 ], [ "UTI", 0.058 ], [ "kidney", 0.051 ] ], "target_token": "sleep", "anchor_fallback": true, "screening": null, "circuit_diff": { "shared_features": 609, "unique_to_a": 891, "unique_to_b": 802 }, "clinical_mass": { "clinical": 0.431, "patient": 0.3211 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260718T133020Z/index_08.html", "urgency": { "flip_class": null, "tier_top_clinical": 1, "tier_top_patient": 1, "tier_shift": 0.0 } }, { "index": 1042, "batch": "pairs_20260718T133020Z", "batch_index": 9, "clinical_prompt": "I have nocturnal hyperhidrosis, so I should ask my", "patient_prompt": "I've been having the sweats all night, so I should ask my", "intended_target": "doctor", "rationale": "Night sweats are a key symptom of menopause, hypoglycemia, and infection. Colloquial phrasing suggests vague discomfort; clinical term signals a symptom cluster requiring diagnostic workup.", "patient_term": "sweats all night", "clinical_term": "nocturnal hyperhidrosis", "topic": "night sweats", "topics": [ "menopause", "pregnancy", "obstetric complication", "fever", "throat infection", "viral infection", "urinary tract infection", "dysuria", "urinary incontinence", "thyroid disorder", "hypoglycemia", "night sweats" ], "models": { "gemma-2-2b": { "prob_clinical": 0.5, "prob_patient": 0.231, "language_penalty": -0.269, "anchor_fallback": false, "top_clinical": [ "doctor", 0.5 ], "top_patient": [ "doctor", 0.231 ], "spread_clinical": [ [ "doctor", 0.5 ], [ "doc", 0.112 ], [ "dermatologist", 0.068 ], [ "GP", 0.036 ], [ "dr", 0.019 ] ], "spread_patient": [ [ "doctor", 0.231 ], [ "question", 0.096 ], [ "husband", 0.085 ], [ "doc", 0.075 ], [ "wife", 0.052 ] ], "target_token": "doctor", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 578, "unique_to_a": 668, "unique_to_b": 772 }, "clinical_mass": { "clinical": 0.3317, "patient": 0.1435 }, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.711 } } }, "prob_clinical": 0.5, "prob_patient": 0.231, "language_penalty": -0.269, "flipped": false, "top_clinical": [ "doctor", 0.5 ], "top_patient": [ "doctor", 0.231 ], "spread_clinical": [ [ "doctor", 0.5 ], [ "doc", 0.112 ], [ "dermatologist", 0.068 ], [ "GP", 0.036 ], [ "dr", 0.019 ] ], "spread_patient": [ [ "doctor", 0.231 ], [ "question", 0.096 ], [ "husband", 0.085 ], [ "doc", 0.075 ], [ "wife", 0.052 ] ], "target_token": "doctor", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 578, "unique_to_a": 668, "unique_to_b": 772 }, "clinical_mass": { "clinical": 0.3317, "patient": 0.1435 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260718T133020Z/index_09.html", "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.711 } }, { "index": 1043, "batch": "pairs_20260718T133020Z", "batch_index": 10, "clinical_prompt": "I think I'm pregnant, so I need to take my", "patient_prompt": "I think I'm expecting, so I need to take my", "intended_target": "vitamins", "rationale": "The colloquial 'expecting' is used casually; 'pregnant' signals medical status and triggers care-seeking frame. Natural continuation differs: mundane reading might suggest something general, clinical reading funnels toward obstetric care items.", "patient_term": "expecting", "clinical_term": "pregnant", "topic": "pregnancy", "topics": [ "menopause", "pregnancy", "obstetric complication", "fever", "throat infection", "viral infection", "urinary tract infection", "dysuria", "urinary incontinence", "thyroid disorder", "hypoglycemia", "night sweats" ], "models": { "gemma-2-2b": { "prob_clinical": 0.113, "prob_patient": 0.126, "language_penalty": 0.012999999999999998, "anchor_fallback": true, "top_clinical": [ "blood", 0.113 ], "top_patient": [ "blood", 0.126 ], "spread_clinical": [ [ "blood", 0.113 ], [ "first", 0.1 ], [ "pregnancy", 0.061 ], [ "temperature", 0.047 ], [ "own", 0.047 ] ], "spread_patient": [ [ "blood", 0.126 ], [ "vitamins", 0.087 ], [ "prenatal", 0.046 ], [ "own", 0.036 ], [ "time", 0.036 ] ], "target_token": "blood", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 796, "unique_to_a": 399, "unique_to_b": 374 }, "clinical_mass": { "clinical": 0.2305, "patient": 0.1673 }, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.408 } } }, "prob_clinical": 0.113, "prob_patient": 0.126, "language_penalty": 0.012999999999999998, "flipped": false, "top_clinical": [ "blood", 0.113 ], "top_patient": [ "blood", 0.126 ], "spread_clinical": [ [ "blood", 0.113 ], [ "first", 0.1 ], [ "pregnancy", 0.061 ], [ "temperature", 0.047 ], [ "own", 0.047 ] ], "spread_patient": [ [ "blood", 0.126 ], [ "vitamins", 0.087 ], [ "prenatal", 0.046 ], [ "own", 0.036 ], [ "time", 0.036 ] ], "target_token": "blood", "anchor_fallback": true, "screening": null, "circuit_diff": { "shared_features": 796, "unique_to_a": 399, "unique_to_b": 374 }, "clinical_mass": { "clinical": 0.2305, "patient": 0.1673 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260718T133020Z/index_10.html", "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.408 } }, { "index": 1044, "batch": "pairs_20260718T133020Z", "batch_index": 11, "clinical_prompt": "I have pharyngitis, so I should take an", "patient_prompt": "My throat feels like sandpaper, so I should take an", "intended_target": "antibiotic", "rationale": "Pharyngitis is a common viral or bacterial infection. Colloquial symptom description is sensory; clinical term invokes diagnostic category that narrows treatment expectations.", "patient_term": "throat feels like sandpaper", "clinical_term": "pharyngitis", "topic": "throat infection", "topics": [ "menopause", "pregnancy", "obstetric complication", "fever", "throat infection", "viral infection", "urinary tract infection", "dysuria", "urinary incontinence", "thyroid disorder", "hypoglycemia", "night sweats" ], "models": { "gemma-2-2b": { "prob_clinical": 0.609, "prob_patient": 0.098, "language_penalty": -0.511, "anchor_fallback": false, "top_clinical": [ "antibiotic", 0.609 ], "top_patient": [ "aspirin", 0.126 ], "spread_clinical": [ [ "antibiotic", 0.609 ], [ "anti", 0.136 ], [ "antibiotics", 0.024 ], [ "antiviral", 0.024 ], [ "oral", 0.021 ] ], "spread_patient": [ [ "aspirin", 0.126 ], [ "extra", 0.098 ], [ "anti", 0.098 ], [ "allergy", 0.086 ], [ "Ad", 0.076 ] ], "target_token": "antibiotic", "flipped": true, "screening": null, "circuit_diff": { "shared_features": 541, "unique_to_a": 670, "unique_to_b": 689 }, "clinical_mass": { "clinical": 0.4285, "patient": 0.2564 }, "html": "modes/simulated/pairs_20260718T133020Z/index_11.html", "urgency": { "flip_class": "downgrade", "tier_top_clinical": 2, "tier_top_patient": 1, "tier_shift": -0.817 } } }, "prob_clinical": 0.609, "prob_patient": 0.098, "language_penalty": -0.511, "flipped": true, "top_clinical": [ "antibiotic", 0.609 ], "top_patient": [ "aspirin", 0.126 ], "spread_clinical": [ [ "antibiotic", 0.609 ], [ "anti", 0.136 ], [ "antibiotics", 0.024 ], [ "antiviral", 0.024 ], [ "oral", 0.021 ] ], "spread_patient": [ [ "aspirin", 0.126 ], [ "extra", 0.098 ], [ "anti", 0.098 ], [ "allergy", 0.086 ], [ "Ad", 0.076 ] ], "target_token": "antibiotic", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 541, "unique_to_a": 670, "unique_to_b": 689 }, "clinical_mass": { "clinical": 0.4285, "patient": 0.2564 }, "html": "modes/simulated/pairs_20260718T133020Z/index_11.html", "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260718T133020Z/index_11.html", "urgency": { "flip_class": "downgrade", "tier_top_clinical": 2, "tier_top_patient": 1, "tier_shift": -0.817 } }, { "index": 1045, "batch": "pairs_20260718T133020Z", "batch_index": 12, "clinical_prompt": "I have stress incontinence, so I need to take my", "patient_prompt": "I keep leaking when I cough, so I need to take my", "intended_target": "medication", "rationale": "Stress incontinence is involuntary urine loss during physical exertion; common in menopause and pregnancy. Colloquial phrasing describes a symptom; clinical term signals a named condition requiring intervention.", "patient_term": "leaking when I cough", "clinical_term": "stress incontinence", "topic": "urinary incontinence", "topics": [ "menopause", "pregnancy", "obstetric complication", "fever", "throat infection", "viral infection", "urinary tract infection", "dysuria", "urinary incontinence", "thyroid disorder", "hypoglycemia", "night sweats" ], "models": { "gemma-2-2b": { "prob_clinical": 0.191, "prob_patient": null, "language_penalty": null, "anchor_fallback": true, "top_clinical": [ "pads", 0.191 ], "top_patient": [ "meds", 0.092 ], "spread_clinical": [ [ "pads", 0.191 ], [ "bladder", 0.09 ], [ "pad", 0.07 ], [ "Depends", 0.038 ], [ "time", 0.038 ] ], "spread_patient": [ [ "meds", 0.092 ], [ "inhal", 0.063 ], [ "medicine", 0.05 ], [ "medication", 0.05 ], [ "time", 0.05 ] ], "target_token": "pads", "flipped": true, "screening": null, "circuit_diff": { "shared_features": 565, "unique_to_a": 700, "unique_to_b": 783 }, "clinical_mass": { "clinical": 0.3081, "patient": 0.2662 }, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": 1, "tier_shift": null } } }, "prob_clinical": 0.191, "prob_patient": null, "language_penalty": null, "flipped": true, "top_clinical": [ "pads", 0.191 ], "top_patient": [ "meds", 0.092 ], "spread_clinical": [ [ "pads", 0.191 ], [ "bladder", 0.09 ], [ "pad", 0.07 ], [ "Depends", 0.038 ], [ "time", 0.038 ] ], "spread_patient": [ [ "meds", 0.092 ], [ "inhal", 0.063 ], [ "medicine", 0.05 ], [ "medication", 0.05 ], [ "time", 0.05 ] ], "target_token": "pads", "anchor_fallback": true, "screening": null, "circuit_diff": { "shared_features": 565, "unique_to_a": 700, "unique_to_b": 783 }, "clinical_mass": { "clinical": 0.3081, "patient": 0.2662 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260718T133020Z/index_12.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": 1, "tier_shift": null } }, { "index": 1046, "batch": "pairs_20260718T133020Z", "batch_index": 13, "clinical_prompt": "I have amenorrhea, so my doctor ordered some", "patient_prompt": "I missed my cycle last month, so my doctor ordered some", "intended_target": "tests", "rationale": "Amenorrhea (absence of menstruation) is a hallmark of menopause but also indicates pregnancy or thyroid disorder. Colloquial phrasing is indirect; clinical term frames the absence as a diagnostic symptom requiring workup.", "patient_term": "missed my cycle", "clinical_term": "amenorrhea", "topic": "menopause", "topics": [ "menopause", "pregnancy", "obstetric complication", "fever", "throat infection", "viral infection", "urinary tract infection", "dysuria", "urinary incontinence", "thyroid disorder", "hypoglycemia", "night sweats" ], "models": { "gemma-2-2b": { "prob_clinical": 0.18, "prob_patient": 0.129, "language_penalty": -0.05099999999999999, "anchor_fallback": false, "top_clinical": [ "blood", 0.381 ], "top_patient": [ "blood", 0.512 ], "spread_clinical": [ [ "blood", 0.381 ], [ "tests", 0.18 ], [ "hormone", 0.04 ], [ "estrogen", 0.028 ], [ "pregnancy", 0.021 ] ], "spread_patient": [ [ "blood", 0.512 ], [ "tests", 0.129 ], [ "pregnancy", 0.114 ], [ "H", 0.033 ], [ "hormone", 0.02 ] ], "target_token": "tests", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 657, "unique_to_a": 723, "unique_to_b": 572 }, "clinical_mass": { "clinical": 0.4375, "patient": 0.3747 }, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": 0.0 } } }, "prob_clinical": 0.18, "prob_patient": 0.129, "language_penalty": -0.05099999999999999, "flipped": false, "top_clinical": [ "blood", 0.381 ], "top_patient": [ "blood", 0.512 ], "spread_clinical": [ [ "blood", 0.381 ], [ "tests", 0.18 ], [ "hormone", 0.04 ], [ "estrogen", 0.028 ], [ "pregnancy", 0.021 ] ], "spread_patient": [ [ "blood", 0.512 ], [ "tests", 0.129 ], [ "pregnancy", 0.114 ], [ "H", 0.033 ], [ "hormone", 0.02 ] ], "target_token": "tests", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 657, "unique_to_a": 723, "unique_to_b": 572 }, "clinical_mass": { "clinical": 0.4375, "patient": 0.3747 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260718T133020Z/index_13.html", "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": 0.0 } }, { "index": 1047, "batch": "pairs_20260718T133020Z", "batch_index": 15, "clinical_prompt": "I'm experiencing night sweats, so I wonder if I might have a", "patient_prompt": "I'm soaking through my sheets every night, so I wonder if I might have a", "intended_target": "fever", "rationale": "Specific symptom description versus clinical label. Clinical phrasing primes differential diagnosis reasoning (fever, thyroid, infection), whereas colloquial version suggests non-medical explanations.", "patient_term": "soaking through my sheets every night", "clinical_term": "night sweats", "topic": "night sweats", "topics": [ "menopause", "pregnancy", "obstetric complication", "fever", "throat infection", "viral infection", "urinary tract infection", "dysuria", "urinary incontinence", "thyroid disorder", "hypoglycemia", "night sweats" ], "models": { "gemma-2-2b": { "prob_clinical": 0.071, "prob_patient": null, "language_penalty": null, "anchor_fallback": false, "top_clinical": [ "thyroid", 0.118 ], "top_patient": [ "UTI", 0.128 ], "spread_clinical": [ [ "thyroid", 0.118 ], [ "fever", 0.071 ], [ "low", 0.056 ], [ "UTI", 0.038 ], [ "yeast", 0.038 ] ], "spread_patient": [ [ "UTI", 0.128 ], [ "leak", 0.1 ], [ "yeast", 0.078 ], [ "urinary", 0.069 ], [ "leaky", 0.053 ] ], "target_token": "fever", "flipped": true, "screening": null, "circuit_diff": { "shared_features": 633, "unique_to_a": 864, "unique_to_b": 808 }, "clinical_mass": { "clinical": 0.3486, "patient": 0.2423 }, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } } }, "prob_clinical": 0.071, "prob_patient": null, "language_penalty": null, "flipped": true, "top_clinical": [ "thyroid", 0.118 ], "top_patient": [ "UTI", 0.128 ], "spread_clinical": [ [ "thyroid", 0.118 ], [ "fever", 0.071 ], [ "low", 0.056 ], [ "UTI", 0.038 ], [ "yeast", 0.038 ] ], "spread_patient": [ [ "UTI", 0.128 ], [ "leak", 0.1 ], [ "yeast", 0.078 ], [ "urinary", 0.069 ], [ "leaky", 0.053 ] ], "target_token": "fever", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 633, "unique_to_a": 864, "unique_to_b": 808 }, "clinical_mass": { "clinical": 0.3486, "patient": 0.2423 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260718T133020Z/index_15.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, { "index": 1048, "batch": "pairs_20260718T133020Z", "batch_index": 16, "clinical_prompt": "I have a viral infection, so I'm pretty sure it's a", "patient_prompt": "I caught something nasty going around, so I'm pretty sure it's a", "intended_target": "virus", "rationale": "Colloquial attribution of contagion versus precise etiology. Clinical phrasing shifts probability toward technical terminology ('virus') rather than conversational 'bug' or 'cold'.", "patient_term": "caught something nasty going around", "clinical_term": "viral infection", "topic": "viral infection", "topics": [ "menopause", "pregnancy", "obstetric complication", "fever", "throat infection", "viral infection", "urinary tract infection", "dysuria", "urinary incontinence", "thyroid disorder", "hypoglycemia", "night sweats" ], "models": { "gemma-2-2b": { "prob_clinical": 0.115, "prob_patient": 0.179, "language_penalty": 0.06399999999999999, "anchor_fallback": false, "top_clinical": [ "cold", 0.312 ], "top_patient": [ "cold", 0.26 ], "spread_clinical": [ [ "cold", 0.312 ], [ "virus", 0.115 ], [ "sinus", 0.079 ], [ "viral", 0.029 ], [ "bug", 0.029 ] ], "spread_patient": [ [ "cold", 0.26 ], [ "virus", 0.179 ], [ "flu", 0.045 ], [ "stomach", 0.045 ], [ "good", 0.04 ] ], "target_token": "virus", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 627, "unique_to_a": 617, "unique_to_b": 677 }, "clinical_mass": { "clinical": 0.4124, "patient": 0.3035 } } }, "prob_clinical": 0.115, "prob_patient": 0.179, "language_penalty": 0.06399999999999999, "flipped": false, "top_clinical": [ "cold", 0.312 ], "top_patient": [ "cold", 0.26 ], "spread_clinical": [ [ "cold", 0.312 ], [ "virus", 0.115 ], [ "sinus", 0.079 ], [ "viral", 0.029 ], [ "bug", 0.029 ] ], "spread_patient": [ [ "cold", 0.26 ], [ "virus", 0.179 ], [ "flu", 0.045 ], [ "stomach", 0.045 ], [ "good", 0.04 ] ], "target_token": "virus", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 627, "unique_to_a": 617, "unique_to_b": 677 }, "clinical_mass": { "clinical": 0.4124, "patient": 0.3035 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260718T133020Z/index_16.html" }, { "index": 1049, "batch": "pairs_20260718T133020Z", "batch_index": 17, "clinical_prompt": "I have urinary incontinence during exercise, so I need to talk to my", "patient_prompt": "I'm having trouble holding it in at the gym, so I need to talk to my", "intended_target": "doctor", "rationale": "Euphemistic patient phrasing versus clinical diagnosis. Clinical term signals medical legitimacy, increasing likelihood of 'doctor' over dismissive or non-professional responses.", "patient_term": "trouble holding it in at the gym", "clinical_term": "urinary incontinence during exercise", "topic": "urinary incontinence", "topics": [ "menopause", "pregnancy", "obstetric complication", "fever", "throat infection", "viral infection", "urinary tract infection", "dysuria", "urinary incontinence", "thyroid disorder", "hypoglycemia", "night sweats" ], "models": { "gemma-2-2b": { "prob_clinical": 0.508, "prob_patient": 0.291, "language_penalty": -0.21700000000000003, "anchor_fallback": false, "top_clinical": [ "doctor", 0.508 ], "top_patient": [ "doctor", 0.291 ], "spread_clinical": [ [ "doctor", 0.508 ], [ "uro", 0.078 ], [ "doc", 0.061 ], [ "GP", 0.042 ], [ "physio", 0.017 ] ], "spread_patient": [ [ "doctor", 0.291 ], [ "therapist", 0.065 ], [ "wife", 0.051 ], [ "doc", 0.051 ], [ "coach", 0.045 ] ], "target_token": "doctor", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 498, "unique_to_a": 657, "unique_to_b": 891 }, "clinical_mass": { "clinical": 0.3878, "patient": 0.1603 }, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.081 } } }, "prob_clinical": 0.508, "prob_patient": 0.291, "language_penalty": -0.21700000000000003, "flipped": false, "top_clinical": [ "doctor", 0.508 ], "top_patient": [ "doctor", 0.291 ], "spread_clinical": [ [ "doctor", 0.508 ], [ "uro", 0.078 ], [ "doc", 0.061 ], [ "GP", 0.042 ], [ "physio", 0.017 ] ], "spread_patient": [ [ "doctor", 0.291 ], [ "therapist", 0.065 ], [ "wife", 0.051 ], [ "doc", 0.051 ], [ "coach", 0.045 ] ], "target_token": "doctor", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 498, "unique_to_a": 657, "unique_to_b": 891 }, "clinical_mass": { "clinical": 0.3878, "patient": 0.1603 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260718T133020Z/index_17.html", "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.081 } }, { "index": 1050, "batch": "pairs_20260718T133020Z", "batch_index": 18, "clinical_prompt": "I'm experiencing hypoglycemia, so my doctor thinks I might have low", "patient_prompt": "I've been feeling dizzy and shaky lately, so my doctor thinks I might have low", "intended_target": "blood", "rationale": "Symptom constellation versus specific metabolic diagnosis. Clinical phrasing funnels continuation toward precise physiological measure ('blood sugar', 'glucose') rather than generic symptom discussion.", "patient_term": "feeling dizzy and shaky", "clinical_term": "hypoglycemia", "topic": "hypoglycemia", "topics": [ "menopause", "pregnancy", "obstetric complication", "fever", "throat infection", "viral infection", "urinary tract infection", "dysuria", "urinary incontinence", "thyroid disorder", "hypoglycemia", "night sweats" ], "models": { "gemma-2-2b": { "prob_clinical": 0.303, "prob_patient": 0.656, "language_penalty": 0.35300000000000004, "anchor_fallback": false, "top_clinical": [ "blood", 0.303 ], "top_patient": [ "blood", 0.656 ], "spread_clinical": [ [ "blood", 0.303 ], [ "thyroid", 0.235 ], [ "insulin", 0.059 ], [ "-", 0.046 ], [ "cortisol", 0.041 ] ], "spread_patient": [ [ "blood", 0.656 ], [ "iron", 0.213 ], [ "B", 0.025 ], [ "thyroid", 0.012 ], [ "potassium", 0.012 ] ], "target_token": "blood", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 700, "unique_to_a": 707, "unique_to_b": 605 }, "clinical_mass": { "clinical": 0.3775, "patient": 0.3685 }, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": 0.0 } } }, "prob_clinical": 0.303, "prob_patient": 0.656, "language_penalty": 0.35300000000000004, "flipped": false, "top_clinical": [ "blood", 0.303 ], "top_patient": [ "blood", 0.656 ], "spread_clinical": [ [ "blood", 0.303 ], [ "thyroid", 0.235 ], [ "insulin", 0.059 ], [ "-", 0.046 ], [ "cortisol", 0.041 ] ], "spread_patient": [ [ "blood", 0.656 ], [ "iron", 0.213 ], [ "B", 0.025 ], [ "thyroid", 0.012 ], [ "potassium", 0.012 ] ], "target_token": "blood", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 700, "unique_to_a": 707, "unique_to_b": 605 }, "clinical_mass": { "clinical": 0.3775, "patient": 0.3685 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260718T133020Z/index_18.html", "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": 0.0 } }, { "index": 1051, "batch": "pairs_20260718T133020Z", "batch_index": 19, "clinical_prompt": "I have a urinary tract infection, so I probably need to take an", "patient_prompt": "I've been passing cloudy water, so I probably need to take an", "intended_target": "antibiotic", "rationale": "Colloquial description of dysuria/cloudy urine versus clinical diagnosis. Grammar funnels toward 'antibiotic' as the standard treatment after 'an' with vowel-initial word.", "patient_term": "passing cloudy water", "clinical_term": "urinary tract infection", "topic": "urinary tract infection", "topics": [ "menopause", "pregnancy", "obstetric complication", "fever", "throat infection", "viral infection", "urinary tract infection", "dysuria", "urinary incontinence", "thyroid disorder", "hypoglycemia", "night sweats" ], "models": { "gemma-2-2b": { "prob_clinical": 0.895, "prob_patient": 0.037, "language_penalty": -0.858, "anchor_fallback": false, "top_clinical": [ "antibiotic", 0.895 ], "top_patient": [ "algae", 0.089 ], "spread_clinical": [ [ "antibiotic", 0.895 ], [ "antibiotics", 0.024 ], [ "anti", 0.024 ], [ "over", 0.007 ] ], "spread_patient": [ [ "algae", 0.089 ], [ "acid", 0.089 ], [ "ammonia", 0.061 ], [ "extra", 0.054 ], [ "antibiotic", 0.037 ] ], "target_token": "antibiotic", "flipped": true, "screening": null, "circuit_diff": { "shared_features": 452, "unique_to_a": 663, "unique_to_b": 858 }, "clinical_mass": { "clinical": 0.4874, "patient": 0.1015 }, "html": "modes/simulated/pairs_20260718T133020Z/index_19.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": 2, "tier_top_patient": null, "tier_shift": null } } }, "prob_clinical": 0.895, "prob_patient": 0.037, "language_penalty": -0.858, "flipped": true, "top_clinical": [ "antibiotic", 0.895 ], "top_patient": [ "algae", 0.089 ], "spread_clinical": [ [ "antibiotic", 0.895 ], [ "antibiotics", 0.024 ], [ "anti", 0.024 ], [ "over", 0.007 ] ], "spread_patient": [ [ "algae", 0.089 ], [ "acid", 0.089 ], [ "ammonia", 0.061 ], [ "extra", 0.054 ], [ "antibiotic", 0.037 ] ], "target_token": "antibiotic", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 452, "unique_to_a": 663, "unique_to_b": 858 }, "clinical_mass": { "clinical": 0.4874, "patient": 0.1015 }, "html": "modes/simulated/pairs_20260718T133020Z/index_19.html", "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260718T133020Z/index_19.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": 2, "tier_top_patient": null, "tier_shift": null } }, { "index": 1052, "batch": "pairs_20260718T133020Z", "batch_index": 20, "clinical_prompt": "I have dysuria, so I should see my", "patient_prompt": "I keep burning when I pee, so I should see my", "intended_target": "doctor", "rationale": "Lay description of painful urination versus precise clinical term. Context drives toward 'doctor' as next token for clinical phrasing.", "patient_term": "burning when I pee", "clinical_term": "dysuria", "topic": "dysuria", "topics": [ "menopause", "pregnancy", "obstetric complication", "fever", "throat infection", "viral infection", "urinary tract infection", "dysuria", "urinary incontinence", "thyroid disorder", "hypoglycemia", "night sweats" ], "models": { "gemma-2-2b": { "prob_clinical": 0.344, "prob_patient": 0.492, "language_penalty": 0.14800000000000002, "anchor_fallback": false, "top_clinical": [ "doctor", 0.344 ], "top_patient": [ "doctor", 0.492 ], "spread_clinical": [ [ "doctor", 0.344 ], [ "uro", 0.209 ], [ "GP", 0.068 ], [ "doc", 0.06 ], [ "Uro", 0.036 ] ], "spread_patient": [ [ "doctor", 0.492 ], [ "uro", 0.076 ], [ "doc", 0.076 ], [ "GP", 0.067 ], [ "Dr", 0.036 ] ], "target_token": "doctor", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 610, "unique_to_a": 689, "unique_to_b": 570 }, "clinical_mass": { "clinical": 0.425, "patient": 0.3439 }, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": 0.0 } } }, "prob_clinical": 0.344, "prob_patient": 0.492, "language_penalty": 0.14800000000000002, "flipped": false, "top_clinical": [ "doctor", 0.344 ], "top_patient": [ "doctor", 0.492 ], "spread_clinical": [ [ "doctor", 0.344 ], [ "uro", 0.209 ], [ "GP", 0.068 ], [ "doc", 0.06 ], [ "Uro", 0.036 ] ], "spread_patient": [ [ "doctor", 0.492 ], [ "uro", 0.076 ], [ "doc", 0.076 ], [ "GP", 0.067 ], [ "Dr", 0.036 ] ], "target_token": "doctor", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 610, "unique_to_a": 689, "unique_to_b": 570 }, "clinical_mass": { "clinical": 0.425, "patient": 0.3439 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260718T133020Z/index_20.html", "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": 0.0 } }, { "index": 1053, "batch": "pairs_20260718T133020Z", "batch_index": 21, "clinical_prompt": "I'm experiencing profuse diaphoresis, so I wonder if my", "patient_prompt": "I'm sweating like crazy all day and night, so I wonder if my", "intended_target": "thyroid", "rationale": "Colloquial description of excessive sweating versus medical term. Frame naturally probes for a body system/organ after possessive 'my'.", "patient_term": "sweating like crazy all day and night", "clinical_term": "profuse diaphoresis", "topic": "thyroid disorder", "topics": [ "menopause", "pregnancy", "obstetric complication", "fever", "throat infection", "viral infection", "urinary tract infection", "dysuria", "urinary incontinence", "thyroid disorder", "hypoglycemia", "night sweats" ], "models": { "gemma-2-2b": { "prob_clinical": 0.078, "prob_patient": 0.093, "language_penalty": 0.015, "anchor_fallback": false, "top_clinical": [ "body", 0.188 ], "top_patient": [ "body", 0.287 ], "spread_clinical": [ [ "body", 0.188 ], [ "thyroid", 0.078 ], [ "blood", 0.069 ], [ "heart", 0.047 ], [ "sweat", 0.025 ] ], "spread_patient": [ [ "body", 0.287 ], [ "thyroid", 0.093 ], [ "blood", 0.064 ], [ "heart", 0.034 ], [ "sweat", 0.03 ] ], "target_token": "thyroid", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 691, "unique_to_a": 795, "unique_to_b": 694 }, "clinical_mass": { "clinical": 0.2858, "patient": 0.2014 } } }, "prob_clinical": 0.078, "prob_patient": 0.093, "language_penalty": 0.015, "flipped": false, "top_clinical": [ "body", 0.188 ], "top_patient": [ "body", 0.287 ], "spread_clinical": [ [ "body", 0.188 ], [ "thyroid", 0.078 ], [ "blood", 0.069 ], [ "heart", 0.047 ], [ "sweat", 0.025 ] ], "spread_patient": [ [ "body", 0.287 ], [ "thyroid", 0.093 ], [ "blood", 0.064 ], [ "heart", 0.034 ], [ "sweat", 0.03 ] ], "target_token": "thyroid", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 691, "unique_to_a": 795, "unique_to_b": 694 }, "clinical_mass": { "clinical": 0.2858, "patient": 0.2014 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260718T133020Z/index_21.html" }, { "index": 1054, "batch": "pairs_20260718T133020Z", "batch_index": 22, "clinical_prompt": "My daughter has acute hypoglycemia at soccer, so she needs some", "patient_prompt": "My daughter's sugar just tanked at soccer, so she needs some", "intended_target": "juice", "rationale": "Colloquial reference to low blood sugar versus clinical diagnosis. Grammar naturally probes for a quick remedy word after 'some'.", "patient_term": "sugar just tanked", "clinical_term": "acute hypoglycemia", "topic": "hypoglycemia", "topics": [ "menopause", "pregnancy", "obstetric complication", "fever", "throat infection", "viral infection", "urinary tract infection", "dysuria", "urinary incontinence", "thyroid disorder", "hypoglycemia", "night sweats" ], "models": { "gemma-2-2b": { "prob_clinical": 0.102, "prob_patient": null, "language_penalty": null, "anchor_fallback": true, "top_clinical": [ "snacks", 0.102 ], "top_patient": [ "sugar", 0.124 ], "spread_clinical": [ [ "snacks", 0.102 ], [ "sugar", 0.07 ], [ "quick", 0.07 ], [ "food", 0.062 ], [ "extra", 0.048 ] ], "spread_patient": [ [ "sugar", 0.124 ], [ "help", 0.066 ], [ "carbs", 0.059 ], [ "quick", 0.046 ], [ "food", 0.046 ] ], "target_token": "snacks", "flipped": true, "screening": null, "circuit_diff": { "shared_features": 677, "unique_to_a": 752, "unique_to_b": 594 }, "clinical_mass": { "clinical": 0.2496, "patient": 0.1147 }, "urgency": { "flip_class": "lateral", "tier_top_clinical": 0, "tier_top_patient": 0, "tier_shift": 0.0 } } }, "prob_clinical": 0.102, "prob_patient": null, "language_penalty": null, "flipped": true, "top_clinical": [ "snacks", 0.102 ], "top_patient": [ "sugar", 0.124 ], "spread_clinical": [ [ "snacks", 0.102 ], [ "sugar", 0.07 ], [ "quick", 0.07 ], [ "food", 0.062 ], [ "extra", 0.048 ] ], "spread_patient": [ [ "sugar", 0.124 ], [ "help", 0.066 ], [ "carbs", 0.059 ], [ "quick", 0.046 ], [ "food", 0.046 ] ], "target_token": "snacks", "anchor_fallback": true, "screening": null, "circuit_diff": { "shared_features": 677, "unique_to_a": 752, "unique_to_b": 594 }, "clinical_mass": { "clinical": 0.2496, "patient": 0.1147 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260718T133020Z/index_22.html", "urgency": { "flip_class": "lateral", "tier_top_clinical": 0, "tier_top_patient": 0, "tier_shift": 0.0 } }, { "index": 1055, "batch": "pairs_20260718T133020Z", "batch_index": 23, "clinical_prompt": "I have placental abruption at 32 weeks, so my midwife ordered some", "patient_prompt": "I think I'm in trouble at 32 weeks, so my midwife ordered some", "intended_target": "imaging", "rationale": "Vague lay expression of pregnancy distress versus specific obstetric diagnosis. Frame steers toward diagnostic or monitoring term after 'some'.", "patient_term": "in trouble", "clinical_term": "placental abruption", "topic": "obstetric complication", "topics": [ "menopause", "pregnancy", "obstetric complication", "fever", "throat infection", "viral infection", "urinary tract infection", "dysuria", "urinary incontinence", "thyroid disorder", "hypoglycemia", "night sweats" ], "models": { "gemma-2-2b": { "prob_clinical": 0.086, "prob_patient": 0.295, "language_penalty": 0.209, "anchor_fallback": true, "top_clinical": [ "blood", 0.086 ], "top_patient": [ "blood", 0.295 ], "spread_clinical": [ [ "blood", 0.086 ], [ "steroids", 0.067 ], [ "bed", 0.046 ], [ "progesterone", 0.046 ], [ "cer", 0.046 ] ], "spread_patient": [ [ "blood", 0.295 ], [ "tests", 0.14 ], [ "extra", 0.04 ], [ "steroids", 0.031 ], [ "scans", 0.027 ] ], "target_token": "blood", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 693, "unique_to_a": 735, "unique_to_b": 668 }, "clinical_mass": { "clinical": 0.4206, "patient": 0.3539 }, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": 0.697 } } }, "prob_clinical": 0.086, "prob_patient": 0.295, "language_penalty": 0.209, "flipped": false, "top_clinical": [ "blood", 0.086 ], "top_patient": [ "blood", 0.295 ], "spread_clinical": [ [ "blood", 0.086 ], [ "steroids", 0.067 ], [ "bed", 0.046 ], [ "progesterone", 0.046 ], [ "cer", 0.046 ] ], "spread_patient": [ [ "blood", 0.295 ], [ "tests", 0.14 ], [ "extra", 0.04 ], [ "steroids", 0.031 ], [ "scans", 0.027 ] ], "target_token": "blood", "anchor_fallback": true, "screening": null, "circuit_diff": { "shared_features": 693, "unique_to_a": 735, "unique_to_b": 668 }, "clinical_mass": { "clinical": 0.4206, "patient": 0.3539 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260718T133020Z/index_23.html", "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": 0.697 } }, { "index": 1056, "batch": "pairs_20260718T133020Z", "batch_index": 25, "clinical_prompt": "My daughter's been up all night with nocturnal hyperhidrosis, so we're worried she might have a", "patient_prompt": "My daughter's been up all night drenched in sweat, so we're worried she might have a", "intended_target": "fever", "rationale": "Colloquial 'drenched in sweat' contrasts with clinical term for night sweats. Frame naturally probes for condition noun (fever, infection, virus). Clinical phrasing should increase weight toward clinical diagnoses.", "patient_term": "drenched in sweat", "clinical_term": "nocturnal hyperhidrosis", "topic": "night sweats", "topics": [ "menopause", "pregnancy", "obstetric complication", "fever", "throat infection", "viral infection", "urinary tract infection", "dysuria", "urinary incontinence", "thyroid disorder", "hypoglycemia", "night sweats" ], "models": { "gemma-2-2b": { "prob_clinical": 0.09, "prob_patient": 0.719, "language_penalty": 0.629, "anchor_fallback": false, "top_clinical": [ "fever", 0.09 ], "top_patient": [ "fever", 0.719 ], "spread_clinical": [ [ "fever", 0.09 ], [ "virus", 0.054 ], [ "sleep", 0.054 ], [ "heat", 0.048 ], [ "serious", 0.037 ] ], "spread_patient": [ [ "fever", 0.719 ], [ "virus", 0.046 ], [ "high", 0.025 ], [ "cold", 0.017 ], [ "temperature", 0.017 ] ], "target_token": "fever", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 876, "unique_to_a": 692, "unique_to_b": 516 }, "clinical_mass": { "clinical": 0.3794, "patient": 0.3189 } } }, "prob_clinical": 0.09, "prob_patient": 0.719, "language_penalty": 0.629, "flipped": false, "top_clinical": [ "fever", 0.09 ], "top_patient": [ "fever", 0.719 ], "spread_clinical": [ [ "fever", 0.09 ], [ "virus", 0.054 ], [ "sleep", 0.054 ], [ "heat", 0.048 ], [ "serious", 0.037 ] ], "spread_patient": [ [ "fever", 0.719 ], [ "virus", 0.046 ], [ "high", 0.025 ], [ "cold", 0.017 ], [ "temperature", 0.017 ] ], "target_token": "fever", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 876, "unique_to_a": 692, "unique_to_b": 516 }, "clinical_mass": { "clinical": 0.3794, "patient": 0.3189 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260718T133020Z/index_25.html" }, { "index": 1057, "batch": "pairs_20260718T133020Z", "batch_index": 26, "clinical_prompt": "I have dysuria, so I need to see a", "patient_prompt": "I've got this constant burning down there, so I need to see a", "intended_target": "gynecologist", "rationale": "Colloquial patient descriptor vs. clinical term for painful urination. Frame ends after article 'a', naturally funneling toward a specialist noun. Clinical term should increase preference for 'gynecologist' or related specialist.", "patient_term": "burning down there", "clinical_term": "dysuria", "topic": "dysuria", "topics": [ "menopause", "pregnancy", "obstetric complication", "fever", "throat infection", "viral infection", "urinary tract infection", "dysuria", "urinary incontinence", "thyroid disorder", "hypoglycemia", "night sweats" ], "models": { "gemma-2-2b": { "prob_clinical": 0.418, "prob_patient": 0.062, "language_penalty": -0.356, "anchor_fallback": true, "top_clinical": [ "uro", 0.418 ], "top_patient": [ "doctor", 0.586 ], "spread_clinical": [ [ "uro", 0.418 ], [ "doctor", 0.254 ], [ "specialist", 0.073 ], [ "Uro", 0.064 ], [ "doc", 0.03 ] ], "spread_patient": [ [ "doctor", 0.586 ], [ "doc", 0.07 ], [ "uro", 0.062 ], [ "specialist", 0.048 ], [ "gyne", 0.037 ] ], "target_token": "uro", "flipped": true, "screening": null, "circuit_diff": { "shared_features": 454, "unique_to_a": 820, "unique_to_b": 796 }, "clinical_mass": { "clinical": 0.4573, "patient": 0.2936 }, "html": "modes/simulated/pairs_20260718T133020Z/index_26.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": 2, "tier_shift": -0.136 } } }, "prob_clinical": 0.418, "prob_patient": 0.062, "language_penalty": -0.356, "flipped": true, "top_clinical": [ "uro", 0.418 ], "top_patient": [ "doctor", 0.586 ], "spread_clinical": [ [ "uro", 0.418 ], [ "doctor", 0.254 ], [ "specialist", 0.073 ], [ "Uro", 0.064 ], [ "doc", 0.03 ] ], "spread_patient": [ [ "doctor", 0.586 ], [ "doc", 0.07 ], [ "uro", 0.062 ], [ "specialist", 0.048 ], [ "gyne", 0.037 ] ], "target_token": "uro", "anchor_fallback": true, "screening": null, "circuit_diff": { "shared_features": 454, "unique_to_a": 820, "unique_to_b": 796 }, "clinical_mass": { "clinical": 0.4573, "patient": 0.2936 }, "html": "modes/simulated/pairs_20260718T133020Z/index_26.html", "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260718T133020Z/index_26.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": 2, "tier_shift": -0.136 } }, { "index": 1058, "batch": "pairs_20260718T133020Z", "batch_index": 28, "clinical_prompt": "I have dysuria, so I need to see a", "patient_prompt": "I'm having trouble down there, so I need to see a", "intended_target": "urologist", "rationale": "The vague colloquial phrasing is ambiguous and could refer to many issues; the clinical term dysuria (painful urination) points specifically to urogenital pathology requiring specialist evaluation, making urologist a likely continuation.", "patient_term": "trouble down there", "clinical_term": "dysuria", "topic": "dysuria", "topics": [ "menopause", "pregnancy", "obstetric complication", "fever", "throat infection", "viral infection", "urinary tract infection", "dysuria", "urinary incontinence", "thyroid disorder", "hypoglycemia", "night sweats" ], "models": { "gemma-2-2b": { "prob_clinical": 0.418, "prob_patient": 0.147, "language_penalty": -0.271, "anchor_fallback": false, "top_clinical": [ "uro", 0.418 ], "top_patient": [ "doctor", 0.354 ], "spread_clinical": [ [ "uro", 0.418 ], [ "doctor", 0.254 ], [ "specialist", 0.073 ], [ "Uro", 0.064 ], [ "doc", 0.03 ] ], "spread_patient": [ [ "doctor", 0.354 ], [ "specialist", 0.189 ], [ "uro", 0.147 ], [ "gyne", 0.033 ], [ "doc", 0.026 ] ], "target_token": "uro", "flipped": true, "screening": null, "circuit_diff": { "shared_features": 459, "unique_to_a": 815, "unique_to_b": 787 }, "clinical_mass": { "clinical": 0.4572, "patient": 0.2614 }, "html": "modes/simulated/pairs_20260718T133020Z/index_28.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": 2, "tier_shift": 0.128 } } }, "prob_clinical": 0.418, "prob_patient": 0.147, "language_penalty": -0.271, "flipped": true, "top_clinical": [ "uro", 0.418 ], "top_patient": [ "doctor", 0.354 ], "spread_clinical": [ [ "uro", 0.418 ], [ "doctor", 0.254 ], [ "specialist", 0.073 ], [ "Uro", 0.064 ], [ "doc", 0.03 ] ], "spread_patient": [ [ "doctor", 0.354 ], [ "specialist", 0.189 ], [ "uro", 0.147 ], [ "gyne", 0.033 ], [ "doc", 0.026 ] ], "target_token": "uro", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 459, "unique_to_a": 815, "unique_to_b": 787 }, "clinical_mass": { "clinical": 0.4572, "patient": 0.2614 }, "html": "modes/simulated/pairs_20260718T133020Z/index_28.html", "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260718T133020Z/index_28.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": 2, "tier_shift": 0.128 } }, { "index": 1059, "batch": "pairs_20260718T133020Z", "batch_index": 29, "clinical_prompt": "My husband says I have night sweats, so we think I might have a", "patient_prompt": "My husband says I'm burning up at night, so we think I might have a", "intended_target": "fever", "rationale": "The colloquial 'burning up' suggests general heat discomfort; the clinical term 'night sweats' is a specific symptom cluster that often triggers differential diagnosis toward infection, malignancy, or endocrine disorder\u2014fever is a common initial hypothesis.", "patient_term": "burning up at night", "clinical_term": "night sweats", "topic": "night sweats", "topics": [ "menopause", "pregnancy", "obstetric complication", "fever", "throat infection", "viral infection", "urinary tract infection", "dysuria", "urinary incontinence", "thyroid disorder", "hypoglycemia", "night sweats" ], "models": { "gemma-2-2b": { "prob_clinical": 0.143, "prob_patient": null, "language_penalty": null, "anchor_fallback": true, "top_clinical": [ "thyroid", 0.143 ], "top_patient": [ "fever", 0.398 ], "spread_clinical": [ [ "thyroid", 0.143 ], [ "hormone", 0.076 ], [ "low", 0.067 ], [ "hormonal", 0.046 ], [ "sleep", 0.036 ] ], "spread_patient": [ [ "fever", 0.398 ], [ "sinus", 0.069 ], [ "low", 0.054 ], [ "UTI", 0.054 ], [ "virus", 0.048 ] ], "target_token": "thyroid", "flipped": true, "screening": null, "circuit_diff": { "shared_features": 712, "unique_to_a": 737, "unique_to_b": 623 }, "clinical_mass": { "clinical": 0.3339, "patient": 0.2734 }, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } } }, "prob_clinical": 0.143, "prob_patient": null, "language_penalty": null, "flipped": true, "top_clinical": [ "thyroid", 0.143 ], "top_patient": [ "fever", 0.398 ], "spread_clinical": [ [ "thyroid", 0.143 ], [ "hormone", 0.076 ], [ "low", 0.067 ], [ "hormonal", 0.046 ], [ "sleep", 0.036 ] ], "spread_patient": [ [ "fever", 0.398 ], [ "sinus", 0.069 ], [ "low", 0.054 ], [ "UTI", 0.054 ], [ "virus", 0.048 ] ], "target_token": "thyroid", "anchor_fallback": true, "screening": null, "circuit_diff": { "shared_features": 712, "unique_to_a": 737, "unique_to_b": 623 }, "clinical_mass": { "clinical": 0.3339, "patient": 0.2734 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260718T133020Z/index_29.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, { "index": 1060, "batch": "pairs_20260718T133020Z", "batch_index": 30, "clinical_prompt": "I have hypoglycemia and my hands are shaking, so I should probably have some", "patient_prompt": "I feel faint and my hands are shaking, so I should probably have some", "intended_target": "sugar", "rationale": "The symptom description is nonspecific; the clinical diagnosis hypoglycemia directly triggers the appropriate immediate treatment (sugar/glucose), making that word a strong next-token prediction.", "patient_term": "feel faint and my hands are shaking", "clinical_term": "have hypoglycemia", "topic": "hypoglycemia", "topics": [ "menopause", "pregnancy", "obstetric complication", "fever", "throat infection", "viral infection", "urinary tract infection", "dysuria", "urinary incontinence", "thyroid disorder", "hypoglycemia", "night sweats" ], "models": { "gemma-2-2b": { "prob_clinical": 0.101, "prob_patient": null, "language_penalty": null, "anchor_fallback": false, "top_clinical": [ "sugar", 0.101 ], "top_patient": [ "water", 0.299 ], "spread_clinical": [ [ "sugar", 0.101 ], [ "food", 0.101 ], [ "more", 0.069 ], [ "snacks", 0.061 ], [ "protein", 0.037 ] ], "spread_patient": [ [ "water", 0.299 ], [ "tea", 0.097 ], [ "coffee", 0.076 ], [ "more", 0.067 ], [ "food", 0.052 ] ], "target_token": "sugar", "flipped": true, "screening": null, "circuit_diff": { "shared_features": 775, "unique_to_a": 622, "unique_to_b": 582 }, "clinical_mass": { "clinical": 0.2223, "patient": 0.1349 }, "urgency": { "flip_class": "lateral", "tier_top_clinical": 0, "tier_top_patient": 0, "tier_shift": 0.0 } } }, "prob_clinical": 0.101, "prob_patient": null, "language_penalty": null, "flipped": true, "top_clinical": [ "sugar", 0.101 ], "top_patient": [ "water", 0.299 ], "spread_clinical": [ [ "sugar", 0.101 ], [ "food", 0.101 ], [ "more", 0.069 ], [ "snacks", 0.061 ], [ "protein", 0.037 ] ], "spread_patient": [ [ "water", 0.299 ], [ "tea", 0.097 ], [ "coffee", 0.076 ], [ "more", 0.067 ], [ "food", 0.052 ] ], "target_token": "sugar", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 775, "unique_to_a": 622, "unique_to_b": 582 }, "clinical_mass": { "clinical": 0.2223, "patient": 0.1349 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260718T133020Z/index_30.html", "urgency": { "flip_class": "lateral", "tier_top_clinical": 0, "tier_top_patient": 0, "tier_shift": 0.0 } }, { "index": 1061, "batch": "pairs_20260718T133020Z", "batch_index": 31, "clinical_prompt": "I have acute pharyngitis, so I probably caught a", "patient_prompt": "My throat is killing me, so I probably caught a", "intended_target": "virus", "rationale": "The patient phrasing is generic pain language; the clinical term acute pharyngitis narrows etiology and prognosis, guiding the model toward viral vs. bacterial distinction. 'Virus' is high-frequency for pharyngitis in clinical reasoning.", "patient_term": "throat is killing me", "clinical_term": "have acute pharyngitis", "topic": "throat infection", "topics": [ "menopause", "pregnancy", "obstetric complication", "fever", "throat infection", "viral infection", "urinary tract infection", "dysuria", "urinary incontinence", "thyroid disorder", "hypoglycemia", "night sweats" ], "models": { "gemma-2-2b": { "prob_clinical": 0.08, "prob_patient": 0.055, "language_penalty": -0.025, "anchor_fallback": false, "top_clinical": [ "cold", 0.594 ], "top_patient": [ "cold", 0.672 ], "spread_clinical": [ [ "cold", 0.594 ], [ "virus", 0.08 ], [ "bug", 0.038 ], [ "bad", 0.038 ], [ "viral", 0.018 ] ], "spread_patient": [ [ "cold", 0.672 ], [ "virus", 0.055 ], [ "bad", 0.055 ], [ "bug", 0.043 ], [ "nasty", 0.03 ] ], "target_token": "virus", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 650, "unique_to_a": 621, "unique_to_b": 554 }, "clinical_mass": { "clinical": 0.421, "patient": 0.3167 } } }, "prob_clinical": 0.08, "prob_patient": 0.055, "language_penalty": -0.025, "flipped": false, "top_clinical": [ "cold", 0.594 ], "top_patient": [ "cold", 0.672 ], "spread_clinical": [ [ "cold", 0.594 ], [ "virus", 0.08 ], [ "bug", 0.038 ], [ "bad", 0.038 ], [ "viral", 0.018 ] ], "spread_patient": [ [ "cold", 0.672 ], [ "virus", 0.055 ], [ "bad", 0.055 ], [ "bug", 0.043 ], [ "nasty", 0.03 ] ], "target_token": "virus", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 650, "unique_to_a": 621, "unique_to_b": 554 }, "clinical_mass": { "clinical": 0.421, "patient": 0.3167 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260718T133020Z/index_31.html" }, { "index": 1062, "batch": "pairs_20260718T133020Z", "batch_index": 33, "clinical_prompt": "I have pharyngitis with a scratchy throat, so I should probably take an", "patient_prompt": "I'm feeling a bit under the weather with a scratchy throat, so I should probably take an", "intended_target": "antibiotic", "rationale": "The colloquial 'under the weather' is vague and suggests mild general illness, which would prompt symptomatic over-the-counter remedies. 'Pharyngitis' signals bacterial throat infection requiring pharmaceutical intervention. The frame '...so I should probably take an' grammatically funnels toward a medication noun after the indefinite article, making 'antibiotic' the natural clinical continuation versus 'aspirin' or 'lozenge' for the colloquial version.", "patient_term": "under the weather", "clinical_term": "pharyngitis", "topic": "throat infection", "topics": [ "menopause", "pregnancy", "obstetric complication", "fever", "throat infection", "viral infection", "urinary tract infection", "dysuria", "urinary incontinence", "thyroid disorder", "hypoglycemia", "night sweats" ], "models": { "gemma-2-2b": { "prob_clinical": 0.336, "prob_patient": 0.06, "language_penalty": -0.276, "anchor_fallback": false, "top_clinical": [ "antibiotic", 0.336 ], "top_patient": [ "extra", 0.164 ], "spread_clinical": [ [ "antibiotic", 0.336 ], [ "anti", 0.18 ], [ "over", 0.075 ], [ "aspirin", 0.035 ], [ "allergy", 0.035 ] ], "spread_patient": [ [ "extra", 0.164 ], [ "aspirin", 0.113 ], [ "early", 0.068 ], [ "antibiotic", 0.06 ], [ "afternoon", 0.06 ] ], "target_token": "antibiotic", "flipped": true, "screening": null, "circuit_diff": { "shared_features": 700, "unique_to_a": 613, "unique_to_b": 612 }, "clinical_mass": { "clinical": 0.3953, "patient": 0.232 }, "html": "modes/simulated/pairs_20260718T133020Z/index_33.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": 2, "tier_top_patient": null, "tier_shift": -0.161 } } }, "prob_clinical": 0.336, "prob_patient": 0.06, "language_penalty": -0.276, "flipped": true, "top_clinical": [ "antibiotic", 0.336 ], "top_patient": [ "extra", 0.164 ], "spread_clinical": [ [ "antibiotic", 0.336 ], [ "anti", 0.18 ], [ "over", 0.075 ], [ "aspirin", 0.035 ], [ "allergy", 0.035 ] ], "spread_patient": [ [ "extra", 0.164 ], [ "aspirin", 0.113 ], [ "early", 0.068 ], [ "antibiotic", 0.06 ], [ "afternoon", 0.06 ] ], "target_token": "antibiotic", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 700, "unique_to_a": 613, "unique_to_b": 612 }, "clinical_mass": { "clinical": 0.3953, "patient": 0.232 }, "html": "modes/simulated/pairs_20260718T133020Z/index_33.html", "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260718T133020Z/index_33.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": 2, "tier_top_patient": null, "tier_shift": -0.161 } }, { "index": 1063, "batch": "pairs_20260718T133020Z", "batch_index": 34, "clinical_prompt": "I've been having placental bleeding and spotting in my second trimester, so my doctor wants to order an", "patient_prompt": "I've been having bad stomach cramps and spotting in my second trimester, so my doctor wants to order an", "intended_target": "ultrasound", "rationale": "Colloquial cramping suggests benign pregnancy discomfort; 'placental bleeding' signals an obstetric emergency requiring urgent imaging. The frame '...so my doctor wants to order an' creates a natural probe for diagnostic procedures. Clinical phrasing prompts 'ultrasound' as the immediate next action, while colloquial language might lead to 'antacid' or 'painkiller'.", "patient_term": "bad stomach cramps", "clinical_term": "placental bleeding", "topic": "obstetric complication", "topics": [ "menopause", "pregnancy", "obstetric complication", "fever", "throat infection", "viral infection", "urinary tract infection", "dysuria", "urinary incontinence", "thyroid disorder", "hypoglycemia", "night sweats" ], "models": { "gemma-2-2b": { "prob_clinical": 0.73, "prob_patient": 0.695, "language_penalty": -0.03500000000000003, "anchor_fallback": false, "top_clinical": [ "ultrasound", 0.73 ], "top_patient": [ "ultrasound", 0.695 ], "spread_clinical": [ [ "ultrasound", 0.73 ], [ "early", 0.036 ], [ "NST", 0.022 ], [ "US", 0.019 ], [ "H", 0.019 ] ], "spread_patient": [ [ "ultrasound", 0.695 ], [ "H", 0.106 ], [ "abdominal", 0.044 ], [ "u", 0.013 ], [ "early", 0.011 ] ], "target_token": "ultrasound", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 828, "unique_to_a": 329, "unique_to_b": 460 }, "clinical_mass": { "clinical": 0.4341, "patient": 0.4461 }, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": 0.0 } } }, "prob_clinical": 0.73, "prob_patient": 0.695, "language_penalty": -0.03500000000000003, "flipped": false, "top_clinical": [ "ultrasound", 0.73 ], "top_patient": [ "ultrasound", 0.695 ], "spread_clinical": [ [ "ultrasound", 0.73 ], [ "early", 0.036 ], [ "NST", 0.022 ], [ "US", 0.019 ], [ "H", 0.019 ] ], "spread_patient": [ [ "ultrasound", 0.695 ], [ "H", 0.106 ], [ "abdominal", 0.044 ], [ "u", 0.013 ], [ "early", 0.011 ] ], "target_token": "ultrasound", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 828, "unique_to_a": 329, "unique_to_b": 460 }, "clinical_mass": { "clinical": 0.4341, "patient": 0.4461 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260718T133020Z/index_34.html", "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": 0.0 } }, { "index": 1064, "batch": "pairs_20260718T133020Z", "batch_index": 35, "clinical_prompt": "I've got an upper respiratory viral infection that's going around the office, so I should probably be taking some", "patient_prompt": "I've got this awful bug that's going around the office, so I should probably be taking some", "intended_target": "fluids", "rationale": "Colloquial 'bug' is lay language for any circulating illness; 'upper respiratory viral infection' specifies the infection type and severity. The frame '...so I should probably be taking some' funnels toward either symptomatic care or specific medications. Clinical phrasing more strongly suggests 'fluids' (standard viral infection care), while colloquial might default to 'vitamins' or 'medicine'.", "patient_term": "awful bug", "clinical_term": "upper respiratory viral infection", "topic": "viral infection", "topics": [ "menopause", "pregnancy", "obstetric complication", "fever", "throat infection", "viral infection", "urinary tract infection", "dysuria", "urinary incontinence", "thyroid disorder", "hypoglycemia", "night sweats" ], "models": { "gemma-2-2b": { "prob_clinical": 0.146, "prob_patient": 0.477, "language_penalty": 0.33099999999999996, "anchor_fallback": true, "top_clinical": [ "time", 0.146 ], "top_patient": [ "time", 0.477 ], "spread_clinical": [ [ "time", 0.146 ], [ "kind", 0.088 ], [ "sort", 0.068 ], [ "T", 0.068 ], [ "antibiotics", 0.047 ] ], "spread_patient": [ [ "time", 0.477 ], [ "sick", 0.039 ], [ "medicine", 0.034 ], [ "T", 0.031 ], [ "of", 0.031 ] ], "target_token": "time", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 863, "unique_to_a": 553, "unique_to_b": 507 }, "clinical_mass": { "clinical": 0.3656, "patient": 0.2179 } } }, "prob_clinical": 0.146, "prob_patient": 0.477, "language_penalty": 0.33099999999999996, "flipped": false, "top_clinical": [ "time", 0.146 ], "top_patient": [ "time", 0.477 ], "spread_clinical": [ [ "time", 0.146 ], [ "kind", 0.088 ], [ "sort", 0.068 ], [ "T", 0.068 ], [ "antibiotics", 0.047 ] ], "spread_patient": [ [ "time", 0.477 ], [ "sick", 0.039 ], [ "medicine", 0.034 ], [ "T", 0.031 ], [ "of", 0.031 ] ], "target_token": "time", "anchor_fallback": true, "screening": null, "circuit_diff": { "shared_features": 863, "unique_to_a": 553, "unique_to_b": 507 }, "clinical_mass": { "clinical": 0.3656, "patient": 0.2179 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260718T133020Z/index_35.html" }, { "index": 1065, "batch": "pairs_20260718T133020Z", "batch_index": 37, "clinical_prompt": "I have a urinary tract infection, so I need to see a", "patient_prompt": "I'm having trouble with my woman's plumbing, so I need to see a", "intended_target": "doctor", "rationale": "Colloquial euphemism for urinary system versus clinical diagnosis. The frame 'need to see a' funnels toward a healthcare provider in the clinical case but might default to other responses with the vague lay phrasing.", "patient_term": "woman's plumbing", "clinical_term": "urinary tract infection", "topic": "urinary tract infection", "topics": [ "menopause", "pregnancy", "obstetric complication", "fever", "throat infection", "viral infection", "urinary tract infection", "dysuria", "urinary incontinence", "thyroid disorder", "hypoglycemia", "night sweats" ], "models": { "gemma-2-2b": { "prob_clinical": 0.566, "prob_patient": 0.471, "language_penalty": -0.09499999999999997, "anchor_fallback": false, "top_clinical": [ "doctor", 0.566 ], "top_patient": [ "doctor", 0.471 ], "spread_clinical": [ [ "doctor", 0.566 ], [ "uro", 0.162 ], [ "specialist", 0.067 ], [ "gyne", 0.019 ], [ "Dr", 0.019 ] ], "spread_patient": [ [ "doctor", 0.471 ], [ "specialist", 0.119 ], [ "uro", 0.105 ], [ "gyne", 0.064 ], [ "plumber", 0.023 ] ], "target_token": "doctor", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 537, "unique_to_a": 635, "unique_to_b": 768 }, "clinical_mass": { "clinical": 0.5075, "patient": 0.2777 }, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": 0.099 } } }, "prob_clinical": 0.566, "prob_patient": 0.471, "language_penalty": -0.09499999999999997, "flipped": false, "top_clinical": [ "doctor", 0.566 ], "top_patient": [ "doctor", 0.471 ], "spread_clinical": [ [ "doctor", 0.566 ], [ "uro", 0.162 ], [ "specialist", 0.067 ], [ "gyne", 0.019 ], [ "Dr", 0.019 ] ], "spread_patient": [ [ "doctor", 0.471 ], [ "specialist", 0.119 ], [ "uro", 0.105 ], [ "gyne", 0.064 ], [ "plumber", 0.023 ] ], "target_token": "doctor", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 537, "unique_to_a": 635, "unique_to_b": 768 }, "clinical_mass": { "clinical": 0.5075, "patient": 0.2777 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260718T133020Z/index_37.html", "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": 0.099 } }, { "index": 1066, "batch": "pairs_20260718T133020Z", "batch_index": 38, "clinical_prompt": "I have pharyngitis, so I should probably take an", "patient_prompt": "My throat's raw and it hurts to swallow, so I should probably take an", "intended_target": "antibiotic", "rationale": "Patient describes symptom constellation versus clinical diagnosis term. The frame 'take an' before a vowel-initial word strongly biases toward medication, especially with the clinical term which signals bacterial/treatable infection.", "patient_term": "throat's raw and it hurts to swallow", "clinical_term": "pharyngitis", "topic": "throat infection", "topics": [ "menopause", "pregnancy", "obstetric complication", "fever", "throat infection", "viral infection", "urinary tract infection", "dysuria", "urinary incontinence", "thyroid disorder", "hypoglycemia", "night sweats" ], "models": { "gemma-2-2b": { "prob_clinical": 0.551, "prob_patient": 0.049, "language_penalty": -0.502, "anchor_fallback": false, "top_clinical": [ "antibiotic", 0.551 ], "top_patient": [ "Ad", 0.25 ], "spread_clinical": [ [ "antibiotic", 0.551 ], [ "anti", 0.108 ], [ "over", 0.027 ], [ "aspirin", 0.024 ], [ "antibiotics", 0.021 ] ], "spread_patient": [ [ "Ad", 0.25 ], [ "aspirin", 0.172 ], [ "ibuprofen", 0.063 ], [ "Asp", 0.056 ], [ "anti", 0.049 ] ], "target_token": "antibiotic", "flipped": true, "screening": null, "circuit_diff": { "shared_features": 558, "unique_to_a": 689, "unique_to_b": 707 }, "clinical_mass": { "clinical": 0.3925, "patient": 0.3015 }, "html": "modes/simulated/pairs_20260718T133020Z/index_38.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": 2, "tier_top_patient": null, "tier_shift": -0.776 } } }, "prob_clinical": 0.551, "prob_patient": 0.049, "language_penalty": -0.502, "flipped": true, "top_clinical": [ "antibiotic", 0.551 ], "top_patient": [ "Ad", 0.25 ], "spread_clinical": [ [ "antibiotic", 0.551 ], [ "anti", 0.108 ], [ "over", 0.027 ], [ "aspirin", 0.024 ], [ "antibiotics", 0.021 ] ], "spread_patient": [ [ "Ad", 0.25 ], [ "aspirin", 0.172 ], [ "ibuprofen", 0.063 ], [ "Asp", 0.056 ], [ "anti", 0.049 ] ], "target_token": "antibiotic", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 558, "unique_to_a": 689, "unique_to_b": 707 }, "clinical_mass": { "clinical": 0.3925, "patient": 0.3015 }, "html": "modes/simulated/pairs_20260718T133020Z/index_38.html", "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260718T133020Z/index_38.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": 2, "tier_top_patient": null, "tier_shift": -0.776 } }, { "index": 1067, "batch": "pairs_20260718T133020Z", "batch_index": 39, "clinical_prompt": "I have fever with night sweats, so my doctor thinks I might have a", "patient_prompt": "I keep getting the chills and sweating buckets, so my doctor thinks I might have a", "intended_target": "virus", "rationale": "Colloquial symptom description versus clinical symptom pairing. The frame 'my doctor thinks I might have a' followed by clinical terminology strongly biases the model toward naming a specific illness category rather than generic discomfort.", "patient_term": "getting the chills and sweating buckets", "clinical_term": "fever with night sweats", "topic": "viral infection", "topics": [ "menopause", "pregnancy", "obstetric complication", "fever", "throat infection", "viral infection", "urinary tract infection", "dysuria", "urinary incontinence", "thyroid disorder", "hypoglycemia", "night sweats" ], "models": { "gemma-2-2b": { "prob_clinical": 0.191, "prob_patient": 0.115, "language_penalty": -0.076, "anchor_fallback": false, "top_clinical": [ "virus", 0.191 ], "top_patient": [ "virus", 0.115 ], "spread_clinical": [ [ "virus", 0.191 ], [ "sinus", 0.132 ], [ "bacterial", 0.09 ], [ "viral", 0.07 ], [ "UTI", 0.062 ] ], "spread_patient": [ [ "virus", 0.115 ], [ "thyroid", 0.115 ], [ "fever", 0.115 ], [ "sinus", 0.07 ], [ "cold", 0.062 ] ], "target_token": "virus", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 778, "unique_to_a": 639, "unique_to_b": 678 }, "clinical_mass": { "clinical": 0.5038, "patient": 0.3946 } } }, "prob_clinical": 0.191, "prob_patient": 0.115, "language_penalty": -0.076, "flipped": false, "top_clinical": [ "virus", 0.191 ], "top_patient": [ "virus", 0.115 ], "spread_clinical": [ [ "virus", 0.191 ], [ "sinus", 0.132 ], [ "bacterial", 0.09 ], [ "viral", 0.07 ], [ "UTI", 0.062 ] ], "spread_patient": [ [ "virus", 0.115 ], [ "thyroid", 0.115 ], [ "fever", 0.115 ], [ "sinus", 0.07 ], [ "cold", 0.062 ] ], "target_token": "virus", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 778, "unique_to_a": 639, "unique_to_b": 678 }, "clinical_mass": { "clinical": 0.5038, "patient": 0.3946 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260718T133020Z/index_39.html" }, { "index": 1068, "batch": "pairs_20260718T133020Z", "batch_index": 40, "clinical_prompt": "I'm having vasomotor symptoms, so I should talk to my", "patient_prompt": "I'm having the hot flushes really bad this month, so I should talk to my", "intended_target": "gynecologist", "rationale": "Lay descriptor of menopausal symptom versus precise clinical term. The clinical term signals a recognized medical condition requiring specialist input, while the colloquial phrasing might suggest general practitioner or self-management.", "patient_term": "hot flushes", "clinical_term": "vasomotor symptoms", "topic": "menopause", "topics": [ "menopause", "pregnancy", "obstetric complication", "fever", "throat infection", "viral infection", "urinary tract infection", "dysuria", "urinary incontinence", "thyroid disorder", "hypoglycemia", "night sweats" ], "models": { "gemma-2-2b": { "prob_clinical": 0.377, "prob_patient": 0.266, "language_penalty": -0.11099999999999999, "anchor_fallback": true, "top_clinical": [ "doctor", 0.377 ], "top_patient": [ "GP", 0.266 ], "spread_clinical": [ [ "doctor", 0.377 ], [ "doc", 0.157 ], [ "dr", 0.051 ], [ "Dr", 0.045 ], [ "OB", 0.04 ] ], "spread_patient": [ [ "GP", 0.266 ], [ "doctor", 0.266 ], [ "doc", 0.126 ], [ "Dr", 0.076 ], [ "gp", 0.067 ] ], "target_token": "doctor", "flipped": true, "screening": null, "circuit_diff": { "shared_features": 666, "unique_to_a": 615, "unique_to_b": 700 }, "clinical_mass": { "clinical": 0.4497, "patient": 0.3025 }, "html": "modes/simulated/pairs_20260718T133020Z/index_40.html", "urgency": { "flip_class": "lateral", "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": 0.0 } } }, "prob_clinical": 0.377, "prob_patient": 0.266, "language_penalty": -0.11099999999999999, "flipped": true, "top_clinical": [ "doctor", 0.377 ], "top_patient": [ "GP", 0.266 ], "spread_clinical": [ [ "doctor", 0.377 ], [ "doc", 0.157 ], [ "dr", 0.051 ], [ "Dr", 0.045 ], [ "OB", 0.04 ] ], "spread_patient": [ [ "GP", 0.266 ], [ "doctor", 0.266 ], [ "doc", 0.126 ], [ "Dr", 0.076 ], [ "gp", 0.067 ] ], "target_token": "doctor", "anchor_fallback": true, "screening": null, "circuit_diff": { "shared_features": 666, "unique_to_a": 615, "unique_to_b": 700 }, "clinical_mass": { "clinical": 0.4497, "patient": 0.3025 }, "html": "modes/simulated/pairs_20260718T133020Z/index_40.html", "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260718T133020Z/index_40.html", "urgency": { "flip_class": "lateral", "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": 0.0 } }, { "index": 1069, "batch": "pairs_20260718T133020Z", "batch_index": 41, "clinical_prompt": "I have placental abruption risk at six months, so my midwife ordered some", "patient_prompt": "I'm worried I'm carrying wrong at six months, so my midwife ordered some", "intended_target": "imaging", "rationale": "Colloquial pregnancy anxiety versus specific obstetric complication diagnosis. The clinical term signals urgent need for diagnostic testing, while the lay phrase might suggest reassurance or routine monitoring.", "patient_term": "carrying wrong", "clinical_term": "placental abruption risk", "topic": "obstetric complication", "topics": [ "menopause", "pregnancy", "obstetric complication", "fever", "throat infection", "viral infection", "urinary tract infection", "dysuria", "urinary incontinence", "thyroid disorder", "hypoglycemia", "night sweats" ], "models": { "gemma-2-2b": { "prob_clinical": 0.175, "prob_patient": null, "language_penalty": null, "anchor_fallback": true, "top_clinical": [ "blood", 0.175 ], "top_patient": [ "scans", 0.221 ], "spread_clinical": [ [ "blood", 0.175 ], [ "tests", 0.121 ], [ "extra", 0.039 ], [ "scans", 0.034 ], [ "progesterone", 0.024 ] ], "spread_patient": [ [ "scans", 0.221 ], [ "tests", 0.071 ], [ "measurements", 0.056 ], [ "do", 0.056 ], [ "dating", 0.034 ] ], "target_token": "blood", "flipped": true, "screening": null, "circuit_diff": { "shared_features": 559, "unique_to_a": 858, "unique_to_b": 816 }, "clinical_mass": { "clinical": 0.4337, "patient": 0.2904 }, "urgency": { "flip_class": "uninformative", "tier_top_clinical": 2, "tier_top_patient": null, "tier_shift": null } } }, "prob_clinical": 0.175, "prob_patient": null, "language_penalty": null, "flipped": true, "top_clinical": [ "blood", 0.175 ], "top_patient": [ "scans", 0.221 ], "spread_clinical": [ [ "blood", 0.175 ], [ "tests", 0.121 ], [ "extra", 0.039 ], [ "scans", 0.034 ], [ "progesterone", 0.024 ] ], "spread_patient": [ [ "scans", 0.221 ], [ "tests", 0.071 ], [ "measurements", 0.056 ], [ "do", 0.056 ], [ "dating", 0.034 ] ], "target_token": "blood", "anchor_fallback": true, "screening": null, "circuit_diff": { "shared_features": 559, "unique_to_a": 858, "unique_to_b": 816 }, "clinical_mass": { "clinical": 0.4337, "patient": 0.2904 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260718T133020Z/index_41.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": 2, "tier_top_patient": null, "tier_shift": null } }, { "index": 1070, "batch": "pairs_20260718T133020Z", "batch_index": 42, "clinical_prompt": "I have dysuria, so I should take an", "patient_prompt": "I've been having trouble with my plumbing down there, so I should take an", "intended_target": "antibiotic", "rationale": "Dysuria (painful urination) typically requires antibiotic treatment. The colloquial phrasing suggests a general urinary issue, while the clinical term signals a specific symptomatic condition requiring medication. The frame 'take an' funnels toward a remedy.", "patient_term": "trouble with my plumbing down there", "clinical_term": "dysuria", "topic": "dysuria", "topics": [ "menopause", "pregnancy", "obstetric complication", "fever", "throat infection", "viral infection", "urinary tract infection", "dysuria", "urinary incontinence", "thyroid disorder", "hypoglycemia", "night sweats" ], "models": { "gemma-2-2b": { "prob_clinical": 0.539, "prob_patient": null, "language_penalty": null, "anchor_fallback": false, "top_clinical": [ "antibiotic", 0.539 ], "top_patient": [ "opportunity", 0.088 ], "spread_clinical": [ [ "antibiotic", 0.539 ], [ "anti", 0.094 ], [ "over", 0.064 ], [ "extra", 0.024 ], [ "en", 0.014 ] ], "spread_patient": [ [ "opportunity", 0.088 ], [ "interest", 0.078 ], [ "inventory", 0.061 ], [ "extra", 0.053 ], [ "hour", 0.037 ] ], "target_token": "antibiotic", "flipped": true, "screening": null, "circuit_diff": { "shared_features": 450, "unique_to_a": 839, "unique_to_b": 889 }, "clinical_mass": { "clinical": 0.3964, "patient": 0.1176 }, "urgency": { "flip_class": "uninformative", "tier_top_clinical": 2, "tier_top_patient": null, "tier_shift": null } } }, "prob_clinical": 0.539, "prob_patient": null, "language_penalty": null, "flipped": true, "top_clinical": [ "antibiotic", 0.539 ], "top_patient": [ "opportunity", 0.088 ], "spread_clinical": [ [ "antibiotic", 0.539 ], [ "anti", 0.094 ], [ "over", 0.064 ], [ "extra", 0.024 ], [ "en", 0.014 ] ], "spread_patient": [ [ "opportunity", 0.088 ], [ "interest", 0.078 ], [ "inventory", 0.061 ], [ "extra", 0.053 ], [ "hour", 0.037 ] ], "target_token": "antibiotic", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 450, "unique_to_a": 839, "unique_to_b": 889 }, "clinical_mass": { "clinical": 0.3964, "patient": 0.1176 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260718T133020Z/index_42.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": 2, "tier_top_patient": null, "tier_shift": null } }, { "index": 1071, "batch": "pairs_20260718T133020Z", "batch_index": 44, "clinical_prompt": "I have pharyngitis with lymphadenopathy, so I probably caught a", "patient_prompt": "My glands are all swollen and my throat is killing me, so I probably caught a", "intended_target": "virus", "rationale": "Pharyngitis with lymphadenopathy describes a specific throat infection presentation. The clinical phrasing narrows the differential toward viral or bacterial infection; the colloquial version is more generic symptom description. Frame funnels toward infectious agent.", "patient_term": "glands are all swollen and my throat is killing me", "clinical_term": "pharyngitis with lymphadenopathy", "topic": "throat infection", "topics": [ "menopause", "pregnancy", "obstetric complication", "fever", "throat infection", "viral infection", "urinary tract infection", "dysuria", "urinary incontinence", "thyroid disorder", "hypoglycemia", "night sweats" ], "models": { "gemma-2-2b": { "prob_clinical": 0.101, "prob_patient": 0.048, "language_penalty": -0.053000000000000005, "anchor_fallback": false, "top_clinical": [ "cold", 0.582 ], "top_patient": [ "cold", 0.656 ], "spread_clinical": [ [ "cold", 0.582 ], [ "virus", 0.101 ], [ "viral", 0.029 ], [ "bug", 0.023 ], [ "flu", 0.02 ] ], "spread_patient": [ [ "cold", 0.656 ], [ "bug", 0.069 ], [ "bad", 0.048 ], [ "virus", 0.048 ], [ "nasty", 0.037 ] ], "target_token": "virus", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 651, "unique_to_a": 594, "unique_to_b": 609 }, "clinical_mass": { "clinical": 0.4578, "patient": 0.3743 } } }, "prob_clinical": 0.101, "prob_patient": 0.048, "language_penalty": -0.053000000000000005, "flipped": false, "top_clinical": [ "cold", 0.582 ], "top_patient": [ "cold", 0.656 ], "spread_clinical": [ [ "cold", 0.582 ], [ "virus", 0.101 ], [ "viral", 0.029 ], [ "bug", 0.023 ], [ "flu", 0.02 ] ], "spread_patient": [ [ "cold", 0.656 ], [ "bug", 0.069 ], [ "bad", 0.048 ], [ "virus", 0.048 ], [ "nasty", 0.037 ] ], "target_token": "virus", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 651, "unique_to_a": 594, "unique_to_b": 609 }, "clinical_mass": { "clinical": 0.4578, "patient": 0.3743 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260718T133020Z/index_44.html" }, { "index": 1072, "batch": "pairs_20260718T133020Z", "batch_index": 45, "clinical_prompt": "I'm experiencing nocturnal hyperhidrosis every single night this month, so I'm wondering if I'm having some", "patient_prompt": "I'm waking up drenched every single night this month, so I'm wondering if I'm having some", "intended_target": "hormonal", "rationale": "Nocturnal hyperhidrosis is the clinical term for night sweats. The clinical phrasing in context of monthly cycling suggests hormonal etiology (menopause, thyroid). Colloquial phrasing is less specific about mechanism.", "patient_term": "waking up drenched", "clinical_term": "experiencing nocturnal hyperhidrosis", "topic": "night sweats", "topics": [ "menopause", "pregnancy", "obstetric complication", "fever", "throat infection", "viral infection", "urinary tract infection", "dysuria", "urinary incontinence", "thyroid disorder", "hypoglycemia", "night sweats" ], "models": { "gemma-2-2b": { "prob_clinical": 0.428, "prob_patient": 0.396, "language_penalty": -0.03199999999999997, "anchor_fallback": true, "top_clinical": [ "sort", 0.428 ], "top_patient": [ "sort", 0.396 ], "spread_clinical": [ [ "sort", 0.428 ], [ "kind", 0.332 ], [ "type", 0.065 ], [ "form", 0.031 ], [ "weird", 0.015 ] ], "spread_patient": [ [ "sort", 0.396 ], [ "kind", 0.352 ], [ "type", 0.061 ], [ "form", 0.033 ], [ "weird", 0.029 ] ], "target_token": "sort", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 832, "unique_to_a": 475, "unique_to_b": 469 }, "clinical_mass": { "clinical": 0.2191, "patient": 0.1657 } } }, "prob_clinical": 0.428, "prob_patient": 0.396, "language_penalty": -0.03199999999999997, "flipped": false, "top_clinical": [ "sort", 0.428 ], "top_patient": [ "sort", 0.396 ], "spread_clinical": [ [ "sort", 0.428 ], [ "kind", 0.332 ], [ "type", 0.065 ], [ "form", 0.031 ], [ "weird", 0.015 ] ], "spread_patient": [ [ "sort", 0.396 ], [ "kind", 0.352 ], [ "type", 0.061 ], [ "form", 0.033 ], [ "weird", 0.029 ] ], "target_token": "sort", "anchor_fallback": true, "screening": null, "circuit_diff": { "shared_features": 832, "unique_to_a": 475, "unique_to_b": 469 }, "clinical_mass": { "clinical": 0.2191, "patient": 0.1657 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260718T133020Z/index_45.html" }, { "index": 1073, "batch": "pairs_20260718T133020Z", "batch_index": 46, "clinical_prompt": "I have stress urinary incontinence when I laugh at parties, so I should probably talk to my", "patient_prompt": "I keep leaking a little when I laugh at parties, so I should probably talk to my", "intended_target": "gynecologist", "rationale": "Stress urinary incontinence is a specific diagnosis requiring specialist evaluation. The clinical term signals need for gynecologic assessment; colloquial phrasing suggests minor symptom. Frame 'talk to my' expects a medical provider specialty.", "patient_term": "leaking a little", "clinical_term": "stress urinary incontinence", "topic": "urinary incontinence", "topics": [ "menopause", "pregnancy", "obstetric complication", "fever", "throat infection", "viral infection", "urinary tract infection", "dysuria", "urinary incontinence", "thyroid disorder", "hypoglycemia", "night sweats" ], "models": { "gemma-2-2b": { "prob_clinical": 0.026, "prob_patient": null, "language_penalty": null, "anchor_fallback": false, "top_clinical": [ "doctor", 0.523 ], "top_patient": [ "doctor", 0.477 ], "spread_clinical": [ [ "doctor", 0.523 ], [ "uro", 0.103 ], [ "doc", 0.062 ], [ "GP", 0.043 ], [ "gyne", 0.026 ] ], "spread_patient": [ [ "doctor", 0.477 ], [ "dentist", 0.106 ], [ "uro", 0.05 ], [ "doc", 0.031 ], [ "therapist", 0.024 ] ], "target_token": "gyne", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 699, "unique_to_a": 555, "unique_to_b": 602 }, "clinical_mass": { "clinical": 0.3507, "patient": 0.2133 }, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": 0.204 } } }, "prob_clinical": 0.026, "prob_patient": null, "language_penalty": null, "flipped": false, "top_clinical": [ "doctor", 0.523 ], "top_patient": [ "doctor", 0.477 ], "spread_clinical": [ [ "doctor", 0.523 ], [ "uro", 0.103 ], [ "doc", 0.062 ], [ "GP", 0.043 ], [ "gyne", 0.026 ] ], "spread_patient": [ [ "doctor", 0.477 ], [ "dentist", 0.106 ], [ "uro", 0.05 ], [ "doc", 0.031 ], [ "therapist", 0.024 ] ], "target_token": "gyne", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 699, "unique_to_a": 555, "unique_to_b": 602 }, "clinical_mass": { "clinical": 0.3507, "patient": 0.2133 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260718T133020Z/index_46.html", "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": 0.204 } }, { "index": 1074, "batch": "pairs_20260718T133020Z", "batch_index": 47, "clinical_prompt": "I have thyroid dysfunction for weeks now, so my doctor thinks my", "patient_prompt": "I've been running hot and cold for weeks now, so my doctor thinks my", "intended_target": "thyroid", "rationale": "Thyroid dysfunction explicitly names the organ at issue. The clinical phrasing makes 'thyroid' the natural next word for laboratory findings ('think my thyroid is...'); colloquial phrasing is symptom-focused, less specific about anatomical target.", "patient_term": "running hot and cold", "clinical_term": "thyroid dysfunction", "topic": "thyroid disorder", "topics": [ "menopause", "pregnancy", "obstetric complication", "fever", "throat infection", "viral infection", "urinary tract infection", "dysuria", "urinary incontinence", "thyroid disorder", "hypoglycemia", "night sweats" ], "models": { "gemma-2-2b": { "prob_clinical": 0.279, "prob_patient": 0.193, "language_penalty": -0.08600000000000002, "anchor_fallback": false, "top_clinical": [ "thyroid", 0.279 ], "top_patient": [ "thyroid", 0.193 ], "spread_clinical": [ [ "thyroid", 0.279 ], [ "body", 0.103 ], [ "TSH", 0.062 ], [ "blood", 0.038 ], [ "symptoms", 0.033 ] ], "spread_patient": [ [ "thyroid", 0.193 ], [ "body", 0.091 ], [ "problem", 0.071 ], [ "symptoms", 0.043 ], [ "hormones", 0.038 ] ], "target_token": "thyroid", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 637, "unique_to_a": 678, "unique_to_b": 761 }, "clinical_mass": { "clinical": 0.3988, "patient": 0.2833 } } }, "prob_clinical": 0.279, "prob_patient": 0.193, "language_penalty": -0.08600000000000002, "flipped": false, "top_clinical": [ "thyroid", 0.279 ], "top_patient": [ "thyroid", 0.193 ], "spread_clinical": [ [ "thyroid", 0.279 ], [ "body", 0.103 ], [ "TSH", 0.062 ], [ "blood", 0.038 ], [ "symptoms", 0.033 ] ], "spread_patient": [ [ "thyroid", 0.193 ], [ "body", 0.091 ], [ "problem", 0.071 ], [ "symptoms", 0.043 ], [ "hormones", 0.038 ] ], "target_token": "thyroid", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 637, "unique_to_a": 678, "unique_to_b": 761 }, "clinical_mass": { "clinical": 0.3988, "patient": 0.2833 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260718T133020Z/index_47.html" }, { "index": 1075, "batch": "pairs_20260718T133020Z", "batch_index": 49, "clinical_prompt": "My pharyngitis won't quit and I keep feeling warm, so my doctor thinks I might have a", "patient_prompt": "My sore throat won't quit and I keep feeling warm, so my doctor thinks I might have a", "intended_target": "bacterial", "rationale": "Colloquial 'sore throat' versus medical 'pharyngitis'. Frame positions the diagnosis probe after 'might have a', where clinical term should nudge model toward more specific infection-type continuations rather than generic remedies.", "patient_term": "sore throat", "clinical_term": "pharyngitis", "topic": "throat infection", "topics": [ "menopause", "pregnancy", "obstetric complication", "fever", "throat infection", "viral infection", "urinary tract infection", "dysuria", "urinary incontinence", "thyroid disorder", "hypoglycemia", "night sweats" ], "models": { "gemma-2-2b": { "prob_clinical": 0.041, "prob_patient": null, "language_penalty": null, "anchor_fallback": false, "top_clinical": [ "sinus", 0.303 ], "top_patient": [ "sinus", 0.225 ], "spread_clinical": [ [ "sinus", 0.303 ], [ "fever", 0.098 ], [ "virus", 0.077 ], [ "stre", 0.067 ], [ "bacterial", 0.041 ] ], "spread_patient": [ [ "sinus", 0.225 ], [ "virus", 0.154 ], [ "cold", 0.106 ], [ "fever", 0.093 ], [ "stre", 0.05 ] ], "target_token": "bacterial", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 1055, "unique_to_a": 463, "unique_to_b": 414 }, "clinical_mass": { "clinical": 0.4314, "patient": 0.4226 } } }, "prob_clinical": 0.041, "prob_patient": null, "language_penalty": null, "flipped": false, "top_clinical": [ "sinus", 0.303 ], "top_patient": [ "sinus", 0.225 ], "spread_clinical": [ [ "sinus", 0.303 ], [ "fever", 0.098 ], [ "virus", 0.077 ], [ "stre", 0.067 ], [ "bacterial", 0.041 ] ], "spread_patient": [ [ "sinus", 0.225 ], [ "virus", 0.154 ], [ "cold", 0.106 ], [ "fever", 0.093 ], [ "stre", 0.05 ] ], "target_token": "bacterial", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 1055, "unique_to_a": 463, "unique_to_b": 414 }, "clinical_mass": { "clinical": 0.4314, "patient": 0.4226 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260718T133020Z/index_49.html" }, { "index": 1076, "batch": "pairs_20260718T133020Z", "batch_index": 50, "clinical_prompt": "I'm experiencing nocturnal hyperhidrosis most nights, so my doctor ordered some", "patient_prompt": "I'm sweating buckets at three in the morning most nights, so my doctor ordered some", "intended_target": "tests", "rationale": "Colloquial intensity marker ('buckets') and time-specific phrasing versus clinical descriptor of pathological nighttime sweating. Context ('ordered some') funnels toward diagnostic workup rather than symptom management alone.", "patient_term": "sweating buckets at three in the morning", "clinical_term": "nocturnal hyperhidrosis", "topic": "night sweats", "topics": [ "menopause", "pregnancy", "obstetric complication", "fever", "throat infection", "viral infection", "urinary tract infection", "dysuria", "urinary incontinence", "thyroid disorder", "hypoglycemia", "night sweats" ], "models": { "gemma-2-2b": { "prob_clinical": 0.119, "prob_patient": 0.088, "language_penalty": -0.031, "anchor_fallback": false, "top_clinical": [ "prescription", 0.119 ], "top_patient": [ "blood", 0.165 ], "spread_clinical": [ [ "prescription", 0.119 ], [ "tests", 0.119 ], [ "anti", 0.056 ], [ "Botox", 0.026 ] ], "spread_patient": [ [ "blood", 0.165 ], [ "tests", 0.088 ], [ "anti", 0.047 ], [ "medication", 0.042 ], [ "prescription", 0.032 ] ], "target_token": "tests", "flipped": true, "screening": null, "circuit_diff": { "shared_features": 772, "unique_to_a": 746, "unique_to_b": 823 }, "clinical_mass": { "clinical": 0.4345, "patient": 0.3592 }, "urgency": { "flip_class": "lateral", "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": 0.009 } } }, "prob_clinical": 0.119, "prob_patient": 0.088, "language_penalty": -0.031, "flipped": true, "top_clinical": [ "prescription", 0.119 ], "top_patient": [ "blood", 0.165 ], "spread_clinical": [ [ "prescription", 0.119 ], [ "tests", 0.119 ], [ "anti", 0.056 ], [ "Botox", 0.026 ] ], "spread_patient": [ [ "blood", 0.165 ], [ "tests", 0.088 ], [ "anti", 0.047 ], [ "medication", 0.042 ], [ "prescription", 0.032 ] ], "target_token": "tests", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 772, "unique_to_a": 746, "unique_to_b": 823 }, "clinical_mass": { "clinical": 0.4345, "patient": 0.3592 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260718T133020Z/index_50.html", "urgency": { "flip_class": "lateral", "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": 0.009 } }, { "index": 1077, "batch": "pairs_20260718T133020Z", "batch_index": 51, "clinical_prompt": "I have pharyngitis and hurts when I swallow, so I probably need to take an", "patient_prompt": "My throat's raw and hurts when I swallow, so I probably need to take an", "intended_target": "antibiotic", "rationale": "The patient phrase uses colloquial description of throat symptoms ('raw and hurts when I swallow'), while the clinical term 'pharyngitis' names the condition precisely. The frame 'probably need to take an' before a vowel-initial word strongly directs toward 'antibiotic' when the clinical diagnosis is stated, versus a lay person might expect 'aspirin' or 'lozenge'.", "patient_term": "My throat's raw and hurts when I swallow", "clinical_term": "I have pharyngitis and hurts when I swallow", "topic": "throat infection", "topics": [ "menopause", "pregnancy", "obstetric complication", "fever", "throat infection", "viral infection", "urinary tract infection", "dysuria", "urinary incontinence", "thyroid disorder", "hypoglycemia", "night sweats" ], "models": { "gemma-2-2b": { "prob_clinical": 0.605, "prob_patient": 0.157, "language_penalty": -0.44799999999999995, "anchor_fallback": false, "top_clinical": [ "antibiotic", 0.605 ], "top_patient": [ "anti", 0.157 ], "spread_clinical": [ [ "antibiotic", 0.605 ], [ "anti", 0.223 ], [ "ant", 0.024 ], [ "antibiotics", 0.018 ], [ "oral", 0.013 ] ], "spread_patient": [ [ "anti", 0.157 ], [ "antibiotic", 0.139 ], [ "Ad", 0.096 ], [ "aspirin", 0.084 ], [ "ant", 0.058 ] ], "target_token": "antibiotic", "flipped": true, "screening": null, "circuit_diff": { "shared_features": 625, "unique_to_a": 651, "unique_to_b": 654 }, "clinical_mass": { "clinical": 0.4694, "patient": 0.3343 }, "html": "modes/simulated/pairs_20260718T133020Z/index_51.html", "urgency": { "flip_class": "downgrade", "tier_top_clinical": 2, "tier_top_patient": 1, "tier_shift": -0.393 } } }, "prob_clinical": 0.605, "prob_patient": 0.157, "language_penalty": -0.44799999999999995, "flipped": true, "top_clinical": [ "antibiotic", 0.605 ], "top_patient": [ "anti", 0.157 ], "spread_clinical": [ [ "antibiotic", 0.605 ], [ "anti", 0.223 ], [ "ant", 0.024 ], [ "antibiotics", 0.018 ], [ "oral", 0.013 ] ], "spread_patient": [ [ "anti", 0.157 ], [ "antibiotic", 0.139 ], [ "Ad", 0.096 ], [ "aspirin", 0.084 ], [ "ant", 0.058 ] ], "target_token": "antibiotic", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 625, "unique_to_a": 651, "unique_to_b": 654 }, "clinical_mass": { "clinical": 0.4694, "patient": 0.3343 }, "html": "modes/simulated/pairs_20260718T133020Z/index_51.html", "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260718T133020Z/index_51.html", "urgency": { "flip_class": "downgrade", "tier_top_clinical": 2, "tier_top_patient": 1, "tier_shift": -0.393 } }, { "index": 1078, "batch": "pairs_20260718T133020Z", "batch_index": 52, "clinical_prompt": "I have a viral infection and my whole body aches, so I should probably take my", "patient_prompt": "I've got the bug that's going around and my whole body aches, so I should probably take my", "intended_target": "temperature", "rationale": "The patient phrase uses colloquial 'the bug that's going around' to describe a contagious illness, while 'viral infection' is the clinical term. The frame 'take my' naturally leads to 'temperature' (checking one's temperature) in a medical context, versus the patient phrasing might elicit 'medicine' or 'time'.", "patient_term": "got the bug that's going around", "clinical_term": "have a viral infection", "topic": "viral infection", "topics": [ "menopause", "pregnancy", "obstetric complication", "fever", "throat infection", "viral infection", "urinary tract infection", "dysuria", "urinary incontinence", "thyroid disorder", "hypoglycemia", "night sweats" ], "models": { "gemma-2-2b": { "prob_clinical": 0.107, "prob_patient": 0.258, "language_penalty": 0.15100000000000002, "anchor_fallback": true, "top_clinical": [ "medicine", 0.107 ], "top_patient": [ "meds", 0.33 ], "spread_clinical": [ [ "medicine", 0.107 ], [ "meds", 0.107 ], [ "T", 0.051 ], [ "antibiotics", 0.051 ], [ "own", 0.045 ] ], "spread_patient": [ [ "meds", 0.33 ], [ "medicine", 0.258 ], [ "medication", 0.04 ], [ "antibiotics", 0.027 ], [ "own", 0.024 ] ], "target_token": "medicine", "flipped": true, "screening": null, "circuit_diff": { "shared_features": 782, "unique_to_a": 562, "unique_to_b": 540 }, "clinical_mass": { "clinical": 0.3943, "patient": 0.267 }, "html": "modes/simulated/pairs_20260718T133020Z/index_52.html", "urgency": { "flip_class": "lateral", "tier_top_clinical": 1, "tier_top_patient": 1, "tier_shift": 0.0 } } }, "prob_clinical": 0.107, "prob_patient": 0.258, "language_penalty": 0.15100000000000002, "flipped": true, "top_clinical": [ "medicine", 0.107 ], "top_patient": [ "meds", 0.33 ], "spread_clinical": [ [ "medicine", 0.107 ], [ "meds", 0.107 ], [ "T", 0.051 ], [ "antibiotics", 0.051 ], [ "own", 0.045 ] ], "spread_patient": [ [ "meds", 0.33 ], [ "medicine", 0.258 ], [ "medication", 0.04 ], [ "antibiotics", 0.027 ], [ "own", 0.024 ] ], "target_token": "medicine", "anchor_fallback": true, "screening": null, "circuit_diff": { "shared_features": 782, "unique_to_a": 562, "unique_to_b": 540 }, "clinical_mass": { "clinical": 0.3943, "patient": 0.267 }, "html": "modes/simulated/pairs_20260718T133020Z/index_52.html", "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260718T133020Z/index_52.html", "urgency": { "flip_class": "lateral", "tier_top_clinical": 1, "tier_top_patient": 1, "tier_shift": 0.0 } }, { "index": 1079, "batch": "pairs_20260718T133020Z", "batch_index": 53, "clinical_prompt": "I have stress incontinence at work when I sneeze or cough, so I should talk to my", "patient_prompt": "I keep having accidents at work when I sneeze or cough, so I should talk to my", "intended_target": "gynecologist", "rationale": "The patient phrase 'having accidents' is a lay euphemism for involuntary urine leakage, while 'stress incontinence' is the clinical diagnosis. The frame 'talk to my' with the clinical term directs toward medical specialists; 'gynecologist' is the expected clinical continuation, whereas 'accidents' might prompt 'boss' or 'friend'.", "patient_term": "keep having accidents", "clinical_term": "have stress incontinence", "topic": "urinary incontinence", "topics": [ "menopause", "pregnancy", "obstetric complication", "fever", "throat infection", "viral infection", "urinary tract infection", "dysuria", "urinary incontinence", "thyroid disorder", "hypoglycemia", "night sweats" ], "models": { "gemma-2-2b": { "prob_clinical": 0.404, "prob_patient": 0.504, "language_penalty": 0.09999999999999998, "anchor_fallback": true, "top_clinical": [ "doctor", 0.404 ], "top_patient": [ "doctor", 0.504 ], "spread_clinical": [ [ "doctor", 0.404 ], [ "GP", 0.148 ], [ "doc", 0.08 ], [ "uro", 0.055 ], [ "dr", 0.029 ] ], "spread_patient": [ [ "doctor", 0.504 ], [ "boss", 0.128 ], [ "employer", 0.06 ], [ "GP", 0.06 ], [ "manager", 0.032 ] ], "target_token": "doctor", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 675, "unique_to_a": 616, "unique_to_b": 586 }, "clinical_mass": { "clinical": 0.3399, "patient": 0.2183 }, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": 0.0 } } }, "prob_clinical": 0.404, "prob_patient": 0.504, "language_penalty": 0.09999999999999998, "flipped": false, "top_clinical": [ "doctor", 0.404 ], "top_patient": [ "doctor", 0.504 ], "spread_clinical": [ [ "doctor", 0.404 ], [ "GP", 0.148 ], [ "doc", 0.08 ], [ "uro", 0.055 ], [ "dr", 0.029 ] ], "spread_patient": [ [ "doctor", 0.504 ], [ "boss", 0.128 ], [ "employer", 0.06 ], [ "GP", 0.06 ], [ "manager", 0.032 ] ], "target_token": "doctor", "anchor_fallback": true, "screening": null, "circuit_diff": { "shared_features": 675, "unique_to_a": 616, "unique_to_b": 586 }, "clinical_mass": { "clinical": 0.3399, "patient": 0.2183 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260718T133020Z/index_53.html", "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": 0.0 } }, { "index": 1080, "batch": "pairs_20260718T133020Z", "batch_index": 54, "clinical_prompt": "I'm worried about fetal abnormality at five months, so my doctor ordered an", "patient_prompt": "I'm worried something's wrong with my baby at five months, so my doctor ordered an", "intended_target": "ultrasound", "rationale": "The patient phrase uses vague lay language 'something's wrong with my baby', while 'fetal abnormality' is the precise clinical term for potential prenatal complications. The frame 'my doctor ordered an' funnels naturally toward 'ultrasound' when the clinical diagnosis is stated, versus the colloquial phrasing might elicit 'appointment' or 'test'.", "patient_term": "something's wrong with my baby", "clinical_term": "fetal abnormality", "topic": "obstetric complication", "topics": [ "menopause", "pregnancy", "obstetric complication", "fever", "throat infection", "viral infection", "urinary tract infection", "dysuria", "urinary incontinence", "thyroid disorder", "hypoglycemia", "night sweats" ], "models": { "gemma-2-2b": { "prob_clinical": 0.582, "prob_patient": 0.406, "language_penalty": -0.17599999999999993, "anchor_fallback": false, "top_clinical": [ "ultrasound", 0.582 ], "top_patient": [ "ultrasound", 0.406 ], "spread_clinical": [ [ "ultrasound", 0.582 ], [ "amnio", 0.189 ], [ "N", 0.023 ], [ "early", 0.016 ], [ "abdominal", 0.014 ] ], "spread_patient": [ [ "ultrasound", 0.406 ], [ "echocardio", 0.117 ], [ "MRI", 0.117 ], [ "EEG", 0.08 ], [ "echo", 0.071 ] ], "target_token": "ultrasound", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 731, "unique_to_a": 461, "unique_to_b": 634 }, "clinical_mass": { "clinical": 0.4121, "patient": 0.3544 }, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": 0.0 } } }, "prob_clinical": 0.582, "prob_patient": 0.406, "language_penalty": -0.17599999999999993, "flipped": false, "top_clinical": [ "ultrasound", 0.582 ], "top_patient": [ "ultrasound", 0.406 ], "spread_clinical": [ [ "ultrasound", 0.582 ], [ "amnio", 0.189 ], [ "N", 0.023 ], [ "early", 0.016 ], [ "abdominal", 0.014 ] ], "spread_patient": [ [ "ultrasound", 0.406 ], [ "echocardio", 0.117 ], [ "MRI", 0.117 ], [ "EEG", 0.08 ], [ "echo", 0.071 ] ], "target_token": "ultrasound", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 731, "unique_to_a": 461, "unique_to_b": 634 }, "clinical_mass": { "clinical": 0.4121, "patient": 0.3544 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260718T133020Z/index_54.html", "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": 0.0 } }, { "index": 1081, "batch": "pairs_20260718T133020Z", "batch_index": 56, "clinical_prompt": "I have nocturnal hyperhidrosis, so my doctor thinks I might be going through some", "patient_prompt": "I keep getting those night sweats really badly, so my doctor thinks I might be going through some", "intended_target": "hormonal", "rationale": "Patient colloquialism 'night sweats' versus clinical term 'nocturnal hyperhidrosis.' The frame ending with 'going through some' funnels toward adjectives describing transition or change; clinical phrasing steers toward 'hormonal' (changes), while colloquial might default to 'rough' or 'tough.'", "patient_term": "those night sweats", "clinical_term": "nocturnal hyperhidrosis", "topic": "menopause", "topics": [ "menopause", "pregnancy", "obstetric complication", "fever", "throat infection", "viral infection", "urinary tract infection", "dysuria", "urinary incontinence", "thyroid disorder", "hypoglycemia", "night sweats" ], "models": { "gemma-2-2b": { "prob_clinical": 0.054, "prob_patient": 0.055, "language_penalty": 0.0010000000000000009, "anchor_fallback": false, "top_clinical": [ "sort", 0.355 ], "top_patient": [ "kind", 0.218 ], "spread_clinical": [ [ "sort", 0.355 ], [ "kind", 0.277 ], [ "hormonal", 0.054 ], [ "type", 0.042 ], [ "form", 0.042 ] ], "spread_patient": [ [ "kind", 0.218 ], [ "sort", 0.192 ], [ "menopause", 0.169 ], [ "hormonal", 0.055 ], [ "per", 0.049 ] ], "target_token": "hormonal", "flipped": true, "screening": null, "circuit_diff": { "shared_features": 780, "unique_to_a": 599, "unique_to_b": 744 }, "clinical_mass": { "clinical": 0.2804, "patient": 0.283 }, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } } }, "prob_clinical": 0.054, "prob_patient": 0.055, "language_penalty": 0.0010000000000000009, "flipped": true, "top_clinical": [ "sort", 0.355 ], "top_patient": [ "kind", 0.218 ], "spread_clinical": [ [ "sort", 0.355 ], [ "kind", 0.277 ], [ "hormonal", 0.054 ], [ "type", 0.042 ], [ "form", 0.042 ] ], "spread_patient": [ [ "kind", 0.218 ], [ "sort", 0.192 ], [ "menopause", 0.169 ], [ "hormonal", 0.055 ], [ "per", 0.049 ] ], "target_token": "hormonal", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 780, "unique_to_a": 599, "unique_to_b": 744 }, "clinical_mass": { "clinical": 0.2804, "patient": 0.283 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260718T133020Z/index_56.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, { "index": 1082, "batch": "pairs_20260718T133020Z", "batch_index": 57, "clinical_prompt": "I'm worried I have placental insufficiency at seven months, so my midwife ordered some", "patient_prompt": "I'm worried I'm carrying the baby funny at seven months, so my midwife ordered some", "intended_target": "bloodwork", "rationale": "Patient expression 'carrying funny' is a lay concern about pregnancy positioning; clinical diagnosis is placental insufficiency. The frame ending with 'ordered some' naturally funnels toward tests or interventions; the clinical term steers toward diagnostic workup like 'bloodwork.'", "patient_term": "carrying the baby funny", "clinical_term": "placental insufficiency", "topic": "obstetric complication", "topics": [ "menopause", "pregnancy", "obstetric complication", "fever", "throat infection", "viral infection", "urinary tract infection", "dysuria", "urinary incontinence", "thyroid disorder", "hypoglycemia", "night sweats" ], "models": { "gemma-2-2b": { "prob_clinical": 0.422, "prob_patient": null, "language_penalty": null, "anchor_fallback": false, "top_clinical": [ "blood", 0.422 ], "top_patient": [ "exercises", 0.059 ], "spread_clinical": [ [ "blood", 0.422 ], [ "tests", 0.176 ], [ "scans", 0.027 ], [ "growth", 0.024 ], [ "extra", 0.021 ] ], "spread_patient": [ [ "exercises", 0.059 ], [ "scans", 0.052 ], [ "pictures", 0.052 ], [ "pelvic", 0.046 ], [ "abdominal", 0.04 ] ], "target_token": "blood", "flipped": true, "screening": null, "circuit_diff": { "shared_features": 704, "unique_to_a": 598, "unique_to_b": 713 }, "clinical_mass": { "clinical": 0.4124, "patient": 0.2929 }, "urgency": { "flip_class": "uninformative", "tier_top_clinical": 2, "tier_top_patient": null, "tier_shift": null } } }, "prob_clinical": 0.422, "prob_patient": null, "language_penalty": null, "flipped": true, "top_clinical": [ "blood", 0.422 ], "top_patient": [ "exercises", 0.059 ], "spread_clinical": [ [ "blood", 0.422 ], [ "tests", 0.176 ], [ "scans", 0.027 ], [ "growth", 0.024 ], [ "extra", 0.021 ] ], "spread_patient": [ [ "exercises", 0.059 ], [ "scans", 0.052 ], [ "pictures", 0.052 ], [ "pelvic", 0.046 ], [ "abdominal", 0.04 ] ], "target_token": "blood", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 704, "unique_to_a": 598, "unique_to_b": 713 }, "clinical_mass": { "clinical": 0.4124, "patient": 0.2929 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260718T133020Z/index_57.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": 2, "tier_top_patient": null, "tier_shift": null } }, { "index": 1083, "batch": "pairs_20260718T133020Z", "batch_index": 58, "clinical_prompt": "I have stress urinary incontinence with exertion, so I should probably see a", "patient_prompt": "I keep having these little accidents when I exercise hard, so I should probably see a", "intended_target": "urologist", "rationale": "Patient euphemism 'little accidents' versus clinical description 'stress urinary incontinence.' The frame 'should probably see a' naturally leads to specialist titles; the clinical phrasing steers more reliably toward 'urologist' rather than the vague 'doctor' that colloquial phrasing might elicit.", "patient_term": "little accidents when I exercise hard", "clinical_term": "stress urinary incontinence with exertion", "topic": "urinary incontinence", "topics": [ "menopause", "pregnancy", "obstetric complication", "fever", "throat infection", "viral infection", "urinary tract infection", "dysuria", "urinary incontinence", "thyroid disorder", "hypoglycemia", "night sweats" ], "models": { "gemma-2-2b": { "prob_clinical": 0.539, "prob_patient": null, "language_penalty": null, "anchor_fallback": false, "top_clinical": [ "uro", 0.539 ], "top_patient": [ "doctor", 0.73 ], "spread_clinical": [ [ "uro", 0.539 ], [ "doctor", 0.094 ], [ "pelvic", 0.083 ], [ "specialist", 0.064 ], [ "Uro", 0.05 ] ], "spread_patient": [ [ "doctor", 0.73 ], [ "doc", 0.06 ], [ "physio", 0.022 ], [ "specialist", 0.015 ], [ "po", 0.012 ] ], "target_token": "uro", "flipped": true, "screening": null, "circuit_diff": { "shared_features": 483, "unique_to_a": 726, "unique_to_b": 722 }, "clinical_mass": { "clinical": 0.4441, "patient": 0.3164 }, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": 2, "tier_shift": null } } }, "prob_clinical": 0.539, "prob_patient": null, "language_penalty": null, "flipped": true, "top_clinical": [ "uro", 0.539 ], "top_patient": [ "doctor", 0.73 ], "spread_clinical": [ [ "uro", 0.539 ], [ "doctor", 0.094 ], [ "pelvic", 0.083 ], [ "specialist", 0.064 ], [ "Uro", 0.05 ] ], "spread_patient": [ [ "doctor", 0.73 ], [ "doc", 0.06 ], [ "physio", 0.022 ], [ "specialist", 0.015 ], [ "po", 0.012 ] ], "target_token": "uro", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 483, "unique_to_a": 726, "unique_to_b": 722 }, "clinical_mass": { "clinical": 0.4441, "patient": 0.3164 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260718T133020Z/index_58.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": 2, "tier_shift": null } }, { "index": 1084, "batch": "pairs_20260718T133020Z", "batch_index": 60, "clinical_prompt": "I have stress urinary incontinence, so I probably need to see a", "patient_prompt": "I keep having little leaks when I'm out running errands, so I probably need to see a", "intended_target": "specialist", "rationale": "Patient describes symptom contextually; clinical term names the specific type. Frame probes which type of provider ('specialist' vs. everyday continuations) the model prefers for the clinical phrasing.", "patient_term": "little leaks when I'm out running errands", "clinical_term": "stress urinary incontinence", "topic": "urinary incontinence", "topics": [ "menopause", "pregnancy", "obstetric complication", "fever", "throat infection", "viral infection", "urinary tract infection", "dysuria", "urinary incontinence", "thyroid disorder", "hypoglycemia", "night sweats" ], "models": { "gemma-2-2b": { "prob_clinical": 0.086, "prob_patient": null, "language_penalty": null, "anchor_fallback": false, "top_clinical": [ "uro", 0.438 ], "top_patient": [ "mechanic", 0.367 ], "spread_clinical": [ [ "uro", 0.438 ], [ "doctor", 0.111 ], [ "specialist", 0.086 ], [ "pelvic", 0.076 ], [ "Uro", 0.052 ] ], "spread_patient": [ [ "mechanic", 0.367 ], [ "doctor", 0.174 ], [ "dentist", 0.05 ], [ "uro", 0.044 ], [ "plumber", 0.039 ] ], "target_token": "specialist", "flipped": true, "screening": null, "circuit_diff": { "shared_features": 564, "unique_to_a": 652, "unique_to_b": 823 }, "clinical_mass": { "clinical": 0.4388, "patient": 0.1779 }, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } } }, "prob_clinical": 0.086, "prob_patient": null, "language_penalty": null, "flipped": true, "top_clinical": [ "uro", 0.438 ], "top_patient": [ "mechanic", 0.367 ], "spread_clinical": [ [ "uro", 0.438 ], [ "doctor", 0.111 ], [ "specialist", 0.086 ], [ "pelvic", 0.076 ], [ "Uro", 0.052 ] ], "spread_patient": [ [ "mechanic", 0.367 ], [ "doctor", 0.174 ], [ "dentist", 0.05 ], [ "uro", 0.044 ], [ "plumber", 0.039 ] ], "target_token": "specialist", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 564, "unique_to_a": 652, "unique_to_b": 823 }, "clinical_mass": { "clinical": 0.4388, "patient": 0.1779 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260718T133020Z/index_60.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, { "index": 1085, "batch": "pairs_20260718T133020Z", "batch_index": 61, "clinical_prompt": "My daughter's been experiencing hypoglycemic episodes before lunch, so I'm wondering if she might have low", "patient_prompt": "My daughter's been feeling groggy and shaky before lunch, so I'm wondering if she might have low", "intended_target": "blood", "rationale": "Patient describes symptoms vaguely; clinical term specifies the metabolic condition. Frame naturally leads to 'blood' (glucose) after 'low' in the clinical context.", "patient_term": "groggy and shaky before lunch", "clinical_term": "hypoglycemic episodes before lunch", "topic": "hypoglycemia", "topics": [ "menopause", "pregnancy", "obstetric complication", "fever", "throat infection", "viral infection", "urinary tract infection", "dysuria", "urinary incontinence", "thyroid disorder", "hypoglycemia", "night sweats" ], "models": { "gemma-2-2b": { "prob_clinical": 0.629, "prob_patient": 0.75, "language_penalty": 0.121, "anchor_fallback": false, "top_clinical": [ "blood", 0.629 ], "top_patient": [ "blood", 0.75 ], "spread_clinical": [ [ "blood", 0.629 ], [ "iron", 0.075 ], [ "thyroid", 0.046 ], [ "carb", 0.04 ], [ "-", 0.031 ] ], "spread_patient": [ [ "blood", 0.75 ], [ "iron", 0.168 ], [ "sugar", 0.018 ], [ "B", 0.009 ], [ "-", 0.004 ] ], "target_token": "blood", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 830, "unique_to_a": 614, "unique_to_b": 549 }, "clinical_mass": { "clinical": 0.3173, "patient": 0.2689 }, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.047 } } }, "prob_clinical": 0.629, "prob_patient": 0.75, "language_penalty": 0.121, "flipped": false, "top_clinical": [ "blood", 0.629 ], "top_patient": [ "blood", 0.75 ], "spread_clinical": [ [ "blood", 0.629 ], [ "iron", 0.075 ], [ "thyroid", 0.046 ], [ "carb", 0.04 ], [ "-", 0.031 ] ], "spread_patient": [ [ "blood", 0.75 ], [ "iron", 0.168 ], [ "sugar", 0.018 ], [ "B", 0.009 ], [ "-", 0.004 ] ], "target_token": "blood", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 830, "unique_to_a": 614, "unique_to_b": 549 }, "clinical_mass": { "clinical": 0.3173, "patient": 0.2689 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260718T133020Z/index_61.html", "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.047 } }, { "index": 1086, "batch": "pairs_20260718T133020Z", "batch_index": 62, "clinical_prompt": "I'm having vasomotor symptoms all day at work, so I think I need to take my", "patient_prompt": "I'm having hot flushes all day at work, so I think I need to take my", "intended_target": "hormone", "rationale": "Vasomotor symptoms is the precise clinical term for hot flushes; the frame 'take my' funnels toward hormone-replacement therapy or medications, contrasting with lay expectation of general remedies.", "patient_term": "hot flushes", "clinical_term": "vasomotor symptoms", "topic": "menopause", "topics": [ "menopause", "pregnancy", "obstetric complication", "fever", "throat infection", "viral infection", "urinary tract infection", "dysuria", "urinary incontinence", "thyroid disorder", "hypoglycemia", "night sweats" ], "models": { "gemma-2-2b": { "prob_clinical": 0.171, "prob_patient": 0.069, "language_penalty": -0.10200000000000001, "anchor_fallback": true, "top_clinical": [ "meds", 0.171 ], "top_patient": [ "HRT", 0.271 ], "spread_clinical": [ [ "meds", 0.171 ], [ "medication", 0.104 ], [ "medicine", 0.063 ], [ "pill", 0.023 ] ], "spread_patient": [ [ "HRT", 0.271 ], [ "meds", 0.069 ], [ "medication", 0.042 ], [ "hormone", 0.029 ], [ "hormones", 0.025 ] ], "target_token": "meds", "flipped": true, "screening": null, "circuit_diff": { "shared_features": 759, "unique_to_a": 677, "unique_to_b": 705 }, "clinical_mass": { "clinical": 0.4351, "patient": 0.2856 }, "urgency": { "flip_class": "uninformative", "tier_top_clinical": 1, "tier_top_patient": null, "tier_shift": null } } }, "prob_clinical": 0.171, "prob_patient": 0.069, "language_penalty": -0.10200000000000001, "flipped": true, "top_clinical": [ "meds", 0.171 ], "top_patient": [ "HRT", 0.271 ], "spread_clinical": [ [ "meds", 0.171 ], [ "medication", 0.104 ], [ "medicine", 0.063 ], [ "pill", 0.023 ] ], "spread_patient": [ [ "HRT", 0.271 ], [ "meds", 0.069 ], [ "medication", 0.042 ], [ "hormone", 0.029 ], [ "hormones", 0.025 ] ], "target_token": "meds", "anchor_fallback": true, "screening": null, "circuit_diff": { "shared_features": 759, "unique_to_a": 677, "unique_to_b": 705 }, "clinical_mass": { "clinical": 0.4351, "patient": 0.2856 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260718T133020Z/index_62.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": 1, "tier_top_patient": null, "tier_shift": null } }, { "index": 1087, "batch": "pairs_20260718T133020Z", "batch_index": 63, "clinical_prompt": "I've been experiencing placental hemorrhage at four months, so my doctor wants to rule out a", "patient_prompt": "I've been spotting heavily at four months, so my doctor wants to rule out a", "intended_target": "miscarriage", "rationale": "Placental hemorrhage is the clinical diagnosis; 'spotting' is lay language. The frame 'rule out a' after hemorrhage shifts the model toward serious outcome language, whereas spotting might prompt benign reassurance.", "patient_term": "spotting heavily", "clinical_term": "placental hemorrhage", "topic": "obstetric complication", "topics": [ "menopause", "pregnancy", "obstetric complication", "fever", "throat infection", "viral infection", "urinary tract infection", "dysuria", "urinary incontinence", "thyroid disorder", "hypoglycemia", "night sweats" ], "models": { "gemma-2-2b": { "prob_clinical": 0.035, "prob_patient": 0.455, "language_penalty": 0.42000000000000004, "anchor_fallback": false, "top_clinical": [ "placenta", 0.083 ], "top_patient": [ "miscarriage", 0.455 ], "spread_clinical": [ [ "placenta", 0.083 ], [ "placental", 0.073 ], [ "blood", 0.044 ], [ "uterine", 0.039 ], [ "miscarriage", 0.035 ] ], "spread_patient": [ [ "miscarriage", 0.455 ], [ "possible", 0.062 ], [ "sub", 0.048 ], [ "pregnancy", 0.048 ], [ "threatened", 0.033 ] ], "target_token": "miscarriage", "flipped": true, "screening": null, "circuit_diff": { "shared_features": 784, "unique_to_a": 550, "unique_to_b": 576 }, "clinical_mass": { "clinical": 0.4117, "patient": 0.3606 }, "html": "modes/simulated/pairs_20260718T133020Z/index_63.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } } }, "prob_clinical": 0.035, "prob_patient": 0.455, "language_penalty": 0.42000000000000004, "flipped": true, "top_clinical": [ "placenta", 0.083 ], "top_patient": [ "miscarriage", 0.455 ], "spread_clinical": [ [ "placenta", 0.083 ], [ "placental", 0.073 ], [ "blood", 0.044 ], [ "uterine", 0.039 ], [ "miscarriage", 0.035 ] ], "spread_patient": [ [ "miscarriage", 0.455 ], [ "possible", 0.062 ], [ "sub", 0.048 ], [ "pregnancy", 0.048 ], [ "threatened", 0.033 ] ], "target_token": "miscarriage", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 784, "unique_to_a": 550, "unique_to_b": 576 }, "clinical_mass": { "clinical": 0.4117, "patient": 0.3606 }, "html": "modes/simulated/pairs_20260718T133020Z/index_63.html", "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260718T133020Z/index_63.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, { "index": 1088, "batch": "pairs_20260718T133020Z", "batch_index": 64, "clinical_prompt": "I woke up with dysuria in my private area, so I should probably take an", "patient_prompt": "I woke up burning in my private area, so I should probably take an", "intended_target": "antibiotic", "rationale": "Dysuria is the clinical term for painful urination; after this term, the model should favor medical interventions like antibiotics over general remedies.", "patient_term": "burning", "clinical_term": "dysuria", "topic": "dysuria", "topics": [ "menopause", "pregnancy", "obstetric complication", "fever", "throat infection", "viral infection", "urinary tract infection", "dysuria", "urinary incontinence", "thyroid disorder", "hypoglycemia", "night sweats" ], "models": { "gemma-2-2b": { "prob_clinical": 0.326, "prob_patient": 0.059, "language_penalty": -0.267, "anchor_fallback": false, "top_clinical": [ "antibiotic", 0.326 ], "top_patient": [ "aspirin", 0.161 ], "spread_clinical": [ [ "antibiotic", 0.326 ], [ "over", 0.083 ], [ "exam", 0.073 ], [ "ur", 0.05 ], [ "anti", 0.034 ] ], "spread_patient": [ [ "aspirin", 0.161 ], [ "adv", 0.098 ], [ "ibuprofen", 0.076 ], [ "anti", 0.059 ], [ "over", 0.059 ] ], "target_token": "antibiotic", "flipped": true, "screening": null, "circuit_diff": { "shared_features": 742, "unique_to_a": 660, "unique_to_b": 539 }, "clinical_mass": { "clinical": 0.3468, "patient": 0.2028 }, "html": "modes/simulated/pairs_20260718T133020Z/index_64.html", "urgency": { "flip_class": "downgrade", "tier_top_clinical": 2, "tier_top_patient": 1, "tier_shift": -0.773 } } }, "prob_clinical": 0.326, "prob_patient": 0.059, "language_penalty": -0.267, "flipped": true, "top_clinical": [ "antibiotic", 0.326 ], "top_patient": [ "aspirin", 0.161 ], "spread_clinical": [ [ "antibiotic", 0.326 ], [ "over", 0.083 ], [ "exam", 0.073 ], [ "ur", 0.05 ], [ "anti", 0.034 ] ], "spread_patient": [ [ "aspirin", 0.161 ], [ "adv", 0.098 ], [ "ibuprofen", 0.076 ], [ "anti", 0.059 ], [ "over", 0.059 ] ], "target_token": "antibiotic", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 742, "unique_to_a": 660, "unique_to_b": 539 }, "clinical_mass": { "clinical": 0.3468, "patient": 0.2028 }, "html": "modes/simulated/pairs_20260718T133020Z/index_64.html", "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260718T133020Z/index_64.html", "urgency": { "flip_class": "downgrade", "tier_top_clinical": 2, "tier_top_patient": 1, "tier_shift": -0.773 } }, { "index": 1089, "batch": "pairs_20260718T133020Z", "batch_index": 65, "clinical_prompt": "My daughter came home from school with a fever, so I think she's caught a", "patient_prompt": "My daughter came home from school with a high temperature, so I think she's caught a", "intended_target": "virus", "rationale": "Fever is the clinical term; 'high temperature' is colloquial. After 'fever' the model should more strongly predict infectious etiology language like virus or infection.", "patient_term": "high temperature", "clinical_term": "fever", "topic": "fever", "topics": [ "menopause", "pregnancy", "obstetric complication", "fever", "throat infection", "viral infection", "urinary tract infection", "dysuria", "urinary incontinence", "thyroid disorder", "hypoglycemia", "night sweats" ], "models": { "gemma-2-2b": { "prob_clinical": 0.044, "prob_patient": 0.078, "language_penalty": 0.034, "anchor_fallback": false, "top_clinical": [ "cold", 0.691 ], "top_patient": [ "cold", 0.574 ], "spread_clinical": [ [ "cold", 0.691 ], [ "bug", 0.12 ], [ "virus", 0.044 ], [ "bad", 0.021 ], [ "nasty", 0.016 ] ], "spread_patient": [ [ "cold", 0.574 ], [ "bug", 0.164 ], [ "virus", 0.078 ], [ "bit", 0.037 ], [ "bad", 0.022 ] ], "target_token": "virus", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 993, "unique_to_a": 234, "unique_to_b": 271 }, "clinical_mass": { "clinical": 0.3517, "patient": 0.3422 } } }, "prob_clinical": 0.044, "prob_patient": 0.078, "language_penalty": 0.034, "flipped": false, "top_clinical": [ "cold", 0.691 ], "top_patient": [ "cold", 0.574 ], "spread_clinical": [ [ "cold", 0.691 ], [ "bug", 0.12 ], [ "virus", 0.044 ], [ "bad", 0.021 ], [ "nasty", 0.016 ] ], "spread_patient": [ [ "cold", 0.574 ], [ "bug", 0.164 ], [ "virus", 0.078 ], [ "bit", 0.037 ], [ "bad", 0.022 ] ], "target_token": "virus", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 993, "unique_to_a": 234, "unique_to_b": 271 }, "clinical_mass": { "clinical": 0.3517, "patient": 0.3422 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260718T133020Z/index_65.html" }, { "index": 1090, "batch": "pairs_20260718T133020Z", "batch_index": 67, "clinical_prompt": "I have a thyroid disorder, so I need to take my", "patient_prompt": "I've been having trouble with my female plumbing acting up, so I need to take my", "intended_target": "medication", "rationale": "Both frames end after a possessive, funneling toward a medication or treatment noun. The colloquial 'plumbing' refers to reproductive/endocrine systems vaguely; the clinical term pinpoints thyroid, shifting the expected continuation from reproductive care to endocrine management.", "patient_term": "female plumbing acting up", "clinical_term": "thyroid disorder", "topic": "thyroid disorder", "topics": [ "menopause", "pregnancy", "obstetric complication", "fever", "throat infection", "viral infection", "urinary tract infection", "dysuria", "urinary incontinence", "thyroid disorder", "hypoglycemia", "night sweats" ], "models": { "gemma-2-2b": { "prob_clinical": 0.145, "prob_patient": null, "language_penalty": null, "anchor_fallback": false, "top_clinical": [ "thyroid", 0.305 ], "top_patient": [ "car", 0.295 ], "spread_clinical": [ [ "thyroid", 0.305 ], [ "meds", 0.145 ], [ "medication", 0.145 ], [ "medicine", 0.036 ], [ "daily", 0.032 ] ], "spread_patient": [ [ "car", 0.295 ], [ "tank", 0.075 ], [ "truck", 0.031 ], [ "female", 0.027 ] ], "target_token": "medication", "flipped": true, "screening": null, "circuit_diff": { "shared_features": 416, "unique_to_a": 755, "unique_to_b": 972 }, "clinical_mass": { "clinical": 0.4041, "patient": 0.1058 }, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } } }, "prob_clinical": 0.145, "prob_patient": null, "language_penalty": null, "flipped": true, "top_clinical": [ "thyroid", 0.305 ], "top_patient": [ "car", 0.295 ], "spread_clinical": [ [ "thyroid", 0.305 ], [ "meds", 0.145 ], [ "medication", 0.145 ], [ "medicine", 0.036 ], [ "daily", 0.032 ] ], "spread_patient": [ [ "car", 0.295 ], [ "tank", 0.075 ], [ "truck", 0.031 ], [ "female", 0.027 ] ], "target_token": "medication", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 416, "unique_to_a": 755, "unique_to_b": 972 }, "clinical_mass": { "clinical": 0.4041, "patient": 0.1058 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260718T133020Z/index_67.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, { "index": 1091, "batch": "pairs_20260718T133020Z", "batch_index": 68, "clinical_prompt": "My boy came home from school with a fever, so I think he caught a", "patient_prompt": "My boy came home from school burning up, so I think he caught a", "intended_target": "virus", "rationale": "Colloquial 'burning up' is vague and everyday; clinical 'fever' activates medical reasoning, steering toward medical diagnoses like virus or infection rather than casual explanations.", "patient_term": "burning up", "clinical_term": "fever", "topic": "viral infection", "topics": [ "menopause", "pregnancy", "obstetric complication", "fever", "throat infection", "viral infection", "urinary tract infection", "dysuria", "urinary incontinence", "thyroid disorder", "hypoglycemia", "night sweats" ], "models": { "gemma-2-2b": { "prob_clinical": 0.06, "prob_patient": 0.078, "language_penalty": 0.018000000000000002, "anchor_fallback": false, "top_clinical": [ "cold", 0.641 ], "top_patient": [ "cold", 0.574 ], "spread_clinical": [ [ "cold", 0.641 ], [ "bug", 0.126 ], [ "virus", 0.06 ], [ "stomach", 0.025 ], [ "bad", 0.025 ] ], "spread_patient": [ [ "cold", 0.574 ], [ "bug", 0.128 ], [ "virus", 0.078 ], [ "bad", 0.032 ], [ "fever", 0.029 ] ], "target_token": "virus", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 932, "unique_to_a": 309, "unique_to_b": 329 }, "clinical_mass": { "clinical": 0.3463, "patient": 0.2763 } } }, "prob_clinical": 0.06, "prob_patient": 0.078, "language_penalty": 0.018000000000000002, "flipped": false, "top_clinical": [ "cold", 0.641 ], "top_patient": [ "cold", 0.574 ], "spread_clinical": [ [ "cold", 0.641 ], [ "bug", 0.126 ], [ "virus", 0.06 ], [ "stomach", 0.025 ], [ "bad", 0.025 ] ], "spread_patient": [ [ "cold", 0.574 ], [ "bug", 0.128 ], [ "virus", 0.078 ], [ "bad", 0.032 ], [ "fever", 0.029 ] ], "target_token": "virus", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 932, "unique_to_a": 309, "unique_to_b": 329 }, "clinical_mass": { "clinical": 0.3463, "patient": 0.2763 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260718T133020Z/index_68.html" }, { "index": 1092, "batch": "pairs_20260718T133020Z", "batch_index": 69, "clinical_prompt": "I wake up absolutely drenched in nocturnal diaphoresis at three in the morning, so I'm wondering if I need to take my", "patient_prompt": "I wake up absolutely soaking at three in the morning, so I'm wondering if I need to take my", "intended_target": "thyroid", "rationale": "Patient phrasing is vague and could suggest menopause; clinical term specifies night sweats as a medical symptom, directing the model toward thyroid or endocrine medication rather than hormonal replacement.", "patient_term": "soaking", "clinical_term": "drenched in nocturnal diaphoresis", "topic": "thyroid disorder", "topics": [ "menopause", "pregnancy", "obstetric complication", "fever", "throat infection", "viral infection", "urinary tract infection", "dysuria", "urinary incontinence", "thyroid disorder", "hypoglycemia", "night sweats" ], "models": { "gemma-2-2b": { "prob_clinical": 0.179, "prob_patient": 0.078, "language_penalty": -0.10099999999999999, "anchor_fallback": true, "top_clinical": [ "blood", 0.179 ], "top_patient": [ "meds", 0.114 ], "spread_clinical": [ [ "blood", 0.179 ], [ "meds", 0.096 ], [ "medication", 0.066 ], [ "morning", 0.058 ], [ "medicine", 0.035 ] ], "spread_patient": [ [ "meds", 0.114 ], [ "blood", 0.078 ], [ "medication", 0.069 ], [ "medicine", 0.047 ], [ "pill", 0.047 ] ], "target_token": "blood", "flipped": true, "screening": null, "circuit_diff": { "shared_features": 909, "unique_to_a": 610, "unique_to_b": 522 }, "clinical_mass": { "clinical": 0.2898, "patient": 0.1827 }, "urgency": { "flip_class": "downgrade", "tier_top_clinical": 2, "tier_top_patient": 1, "tier_shift": -0.256 } } }, "prob_clinical": 0.179, "prob_patient": 0.078, "language_penalty": -0.10099999999999999, "flipped": true, "top_clinical": [ "blood", 0.179 ], "top_patient": [ "meds", 0.114 ], "spread_clinical": [ [ "blood", 0.179 ], [ "meds", 0.096 ], [ "medication", 0.066 ], [ "morning", 0.058 ], [ "medicine", 0.035 ] ], "spread_patient": [ [ "meds", 0.114 ], [ "blood", 0.078 ], [ "medication", 0.069 ], [ "medicine", 0.047 ], [ "pill", 0.047 ] ], "target_token": "blood", "anchor_fallback": true, "screening": null, "circuit_diff": { "shared_features": 909, "unique_to_a": 610, "unique_to_b": 522 }, "clinical_mass": { "clinical": 0.2898, "patient": 0.1827 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260718T133020Z/index_69.html", "urgency": { "flip_class": "downgrade", "tier_top_clinical": 2, "tier_top_patient": 1, "tier_shift": -0.256 } }, { "index": 1093, "batch": "pairs_20260718T133020Z", "batch_index": 70, "clinical_prompt": "I've been having dysuria, so I probably need to take an", "patient_prompt": "I've been having this burning down below when I pee, so I probably need to take an", "intended_target": "antibiotic", "rationale": "Patient phrasing is vague and colloquial; clinical term specifies painful urination as a symptom, funneling toward medical treatment (antibiotic) rather than OTC remedies or unspecified relief.", "patient_term": "burning down below when I pee", "clinical_term": "dysuria", "topic": "dysuria", "topics": [ "menopause", "pregnancy", "obstetric complication", "fever", "throat infection", "viral infection", "urinary tract infection", "dysuria", "urinary incontinence", "thyroid disorder", "hypoglycemia", "night sweats" ], "models": { "gemma-2-2b": { "prob_clinical": 0.738, "prob_patient": 0.367, "language_penalty": -0.371, "anchor_fallback": false, "top_clinical": [ "antibiotic", 0.738 ], "top_patient": [ "antibiotic", 0.367 ], "spread_clinical": [ [ "antibiotic", 0.738 ], [ "over", 0.047 ], [ "anti", 0.029 ], [ "antibiotics", 0.025 ], [ "ab", 0.02 ] ], "spread_patient": [ [ "antibiotic", 0.367 ], [ "over", 0.135 ], [ "anti", 0.082 ], [ "acid", 0.044 ], [ "ant", 0.034 ] ], "target_token": "antibiotic", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 719, "unique_to_a": 609, "unique_to_b": 627 }, "clinical_mass": { "clinical": 0.4039, "patient": 0.3017 }, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.313 } } }, "prob_clinical": 0.738, "prob_patient": 0.367, "language_penalty": -0.371, "flipped": false, "top_clinical": [ "antibiotic", 0.738 ], "top_patient": [ "antibiotic", 0.367 ], "spread_clinical": [ [ "antibiotic", 0.738 ], [ "over", 0.047 ], [ "anti", 0.029 ], [ "antibiotics", 0.025 ], [ "ab", 0.02 ] ], "spread_patient": [ [ "antibiotic", 0.367 ], [ "over", 0.135 ], [ "anti", 0.082 ], [ "acid", 0.044 ], [ "ant", 0.034 ] ], "target_token": "antibiotic", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 719, "unique_to_a": 609, "unique_to_b": 627 }, "clinical_mass": { "clinical": 0.4039, "patient": 0.3017 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260718T133020Z/index_70.html", "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.313 } }, { "index": 1094, "batch": "pairs_20260718T133020Z", "batch_index": 71, "clinical_prompt": "I've been feeling flushed and irritable all week, so I think I'm experiencing menopause and need some", "patient_prompt": "I've been feeling flushed and irritable all week, so I think I'm going through some", "intended_target": "hormone", "rationale": "The frame 'need some' after discussing flushing and irritability naturally funnels toward 'hormone' replacement therapy in clinical context, whereas the colloquial phrasing leaves the continuation more ambiguous (could be reassurance, advice, etc.). Both phrases end mid-thought before the treatment modality.", "patient_term": "going through some", "clinical_term": "experiencing menopause and need some", "topic": "menopause", "topics": [ "menopause", "pregnancy", "obstetric complication", "fever", "throat infection", "viral infection", "urinary tract infection", "dysuria", "urinary incontinence", "thyroid disorder", "hypoglycemia", "night sweats" ], "models": { "gemma-2-2b": { "prob_clinical": 0.287, "prob_patient": null, "language_penalty": null, "anchor_fallback": true, "top_clinical": [ "help", 0.287 ], "top_patient": [ "sort", 0.281 ], "spread_clinical": [ [ "help", 0.287 ], [ "advice", 0.224 ], [ "support", 0.057 ], [ "tips", 0.039 ], [ "relief", 0.039 ] ], "spread_patient": [ [ "sort", 0.281 ], [ "kind", 0.281 ], [ "PMS", 0.043 ], [ "hormonal", 0.038 ], [ "form", 0.034 ] ], "target_token": "help", "flipped": true, "screening": null, "circuit_diff": { "shared_features": 804, "unique_to_a": 603, "unique_to_b": 538 }, "clinical_mass": { "clinical": 0.2154, "patient": 0.2623 }, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } } }, "prob_clinical": 0.287, "prob_patient": null, "language_penalty": null, "flipped": true, "top_clinical": [ "help", 0.287 ], "top_patient": [ "sort", 0.281 ], "spread_clinical": [ [ "help", 0.287 ], [ "advice", 0.224 ], [ "support", 0.057 ], [ "tips", 0.039 ], [ "relief", 0.039 ] ], "spread_patient": [ [ "sort", 0.281 ], [ "kind", 0.281 ], [ "PMS", 0.043 ], [ "hormonal", 0.038 ], [ "form", 0.034 ] ], "target_token": "help", "anchor_fallback": true, "screening": null, "circuit_diff": { "shared_features": 804, "unique_to_a": 603, "unique_to_b": 538 }, "clinical_mass": { "clinical": 0.2154, "patient": 0.2623 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260718T133020Z/index_71.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, { "index": 1095, "batch": "pairs_20260718T133020Z", "batch_index": 72, "clinical_prompt": "My breasts are tender and I'm experiencing nausea, so I should probably pick up a", "patient_prompt": "My breasts are tender and I'm feeling queasy in the mornings, so I should probably pick up a", "intended_target": "test", "rationale": "The colloquial 'queasy in the mornings' suggests general malaise; the clinical 'nausea' combined with breast tenderness strongly narrows to pregnancy confirmation via a test. The frame 'pick up a' naturally leads to 'test' in the pregnancy scenario.", "patient_term": "queasy in the mornings", "clinical_term": "nausea", "topic": "pregnancy", "topics": [ "menopause", "pregnancy", "obstetric complication", "fever", "throat infection", "viral infection", "urinary tract infection", "dysuria", "urinary incontinence", "thyroid disorder", "hypoglycemia", "night sweats" ], "models": { "gemma-2-2b": { "prob_clinical": 0.271, "prob_patient": 0.346, "language_penalty": 0.07499999999999996, "anchor_fallback": true, "top_clinical": [ "pregnancy", 0.271 ], "top_patient": [ "pregnancy", 0.346 ], "spread_clinical": [ [ "pregnancy", 0.271 ], [ "few", 0.078 ], [ "bottle", 0.054 ], [ "prescription", 0.054 ], [ "box", 0.037 ] ], "spread_patient": [ [ "pregnancy", 0.346 ], [ "few", 0.06 ], [ "prenatal", 0.053 ], [ "box", 0.047 ], [ "bottle", 0.041 ] ], "target_token": "pregnancy", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 1206, "unique_to_a": 181, "unique_to_b": 260 }, "clinical_mass": { "clinical": 0.2859, "patient": 0.2784 } } }, "prob_clinical": 0.271, "prob_patient": 0.346, "language_penalty": 0.07499999999999996, "flipped": false, "top_clinical": [ "pregnancy", 0.271 ], "top_patient": [ "pregnancy", 0.346 ], "spread_clinical": [ [ "pregnancy", 0.271 ], [ "few", 0.078 ], [ "bottle", 0.054 ], [ "prescription", 0.054 ], [ "box", 0.037 ] ], "spread_patient": [ [ "pregnancy", 0.346 ], [ "few", 0.06 ], [ "prenatal", 0.053 ], [ "box", 0.047 ], [ "bottle", 0.041 ] ], "target_token": "pregnancy", "anchor_fallback": true, "screening": null, "circuit_diff": { "shared_features": 1206, "unique_to_a": 181, "unique_to_b": 260 }, "clinical_mass": { "clinical": 0.2859, "patient": 0.2784 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260718T133020Z/index_72.html" }, { "index": 1096, "batch": "pairs_20260718T133020Z", "batch_index": 73, "clinical_prompt": "I've been spotting bright red blood since yesterday and I'm experiencing abdominal pain, so my midwife wants me to get an", "patient_prompt": "I've been spotting bright red blood since yesterday and my belly is cramping bad, so my midwife wants me to get an", "intended_target": "ultrasound", "rationale": "Both describe concerning second/third-trimester symptoms, but the clinical phrasing 'abdominal pain' in the context of bleeding raises stronger concern for placental abruption or preterm labour, making 'ultrasound' the diagnostic gold standard. The colloquial 'cramping bad' is more ambiguous.", "patient_term": "my belly is cramping bad", "clinical_term": "I'm experiencing abdominal pain", "topic": "obstetric complication", "topics": [ "menopause", "pregnancy", "obstetric complication", "fever", "throat infection", "viral infection", "urinary tract infection", "dysuria", "urinary incontinence", "thyroid disorder", "hypoglycemia", "night sweats" ], "models": { "gemma-2-2b": { "prob_clinical": 0.449, "prob_patient": 0.762, "language_penalty": 0.313, "anchor_fallback": false, "top_clinical": [ "ultrasound", 0.449 ], "top_patient": [ "ultrasound", 0.762 ], "spread_clinical": [ [ "ultrasound", 0.449 ], [ "internal", 0.165 ], [ "early", 0.146 ], [ "emergency", 0.088 ], [ "appointment", 0.037 ] ], "spread_patient": [ [ "ultrasound", 0.762 ], [ "internal", 0.043 ], [ "early", 0.043 ], [ "emergency", 0.02 ], [ "ultra", 0.02 ] ], "target_token": "ultrasound", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 1113, "unique_to_a": 280, "unique_to_b": 157 }, "clinical_mass": { "clinical": 0.3855, "patient": 0.3769 }, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.255 } } }, "prob_clinical": 0.449, "prob_patient": 0.762, "language_penalty": 0.313, "flipped": false, "top_clinical": [ "ultrasound", 0.449 ], "top_patient": [ "ultrasound", 0.762 ], "spread_clinical": [ [ "ultrasound", 0.449 ], [ "internal", 0.165 ], [ "early", 0.146 ], [ "emergency", 0.088 ], [ "appointment", 0.037 ] ], "spread_patient": [ [ "ultrasound", 0.762 ], [ "internal", 0.043 ], [ "early", 0.043 ], [ "emergency", 0.02 ], [ "ultra", 0.02 ] ], "target_token": "ultrasound", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 1113, "unique_to_a": 280, "unique_to_b": 157 }, "clinical_mass": { "clinical": 0.3855, "patient": 0.3769 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260718T133020Z/index_73.html", "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.255 } }, { "index": 1097, "batch": "pairs_20260718T133020Z", "batch_index": 74, "clinical_prompt": "I've been achy and I'm experiencing a viral syndrome, so I think I need to take my", "patient_prompt": "I've been achy and I caught this bug from my colleague, so I think I need to take my", "intended_target": "temperature", "rationale": "The clinical framing 'viral syndrome' combined with 'take my' most naturally leads to 'temperature' (to monitor). The colloquial 'caught this bug' is less specific and might lead to different continuations like 'medicine' or 'time'.", "patient_term": "caught this bug from my colleague", "clinical_term": "experiencing a viral syndrome", "topic": "viral infection", "topics": [ "menopause", "pregnancy", "obstetric complication", "fever", "throat infection", "viral infection", "urinary tract infection", "dysuria", "urinary incontinence", "thyroid disorder", "hypoglycemia", "night sweats" ], "models": { "gemma-2-2b": { "prob_clinical": 0.098, "prob_patient": 0.11, "language_penalty": 0.011999999999999997, "anchor_fallback": true, "top_clinical": [ "meds", 0.098 ], "top_patient": [ "meds", 0.11 ], "spread_clinical": [ [ "meds", 0.098 ], [ "vitamins", 0.077 ], [ "T", 0.06 ], [ "medicine", 0.06 ], [ "antibiotics", 0.032 ] ], "spread_patient": [ [ "meds", 0.11 ], [ "own", 0.086 ], [ "medicine", 0.076 ], [ "vitamins", 0.059 ], [ "day", 0.059 ] ], "target_token": "meds", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 1050, "unique_to_a": 412, "unique_to_b": 425 }, "clinical_mass": { "clinical": 0.3382, "patient": 0.2377 }, "urgency": { "flip_class": null, "tier_top_clinical": 1, "tier_top_patient": 1, "tier_shift": 0.0 } } }, "prob_clinical": 0.098, "prob_patient": 0.11, "language_penalty": 0.011999999999999997, "flipped": false, "top_clinical": [ "meds", 0.098 ], "top_patient": [ "meds", 0.11 ], "spread_clinical": [ [ "meds", 0.098 ], [ "vitamins", 0.077 ], [ "T", 0.06 ], [ "medicine", 0.06 ], [ "antibiotics", 0.032 ] ], "spread_patient": [ [ "meds", 0.11 ], [ "own", 0.086 ], [ "medicine", 0.076 ], [ "vitamins", 0.059 ], [ "day", 0.059 ] ], "target_token": "meds", "anchor_fallback": true, "screening": null, "circuit_diff": { "shared_features": 1050, "unique_to_a": 412, "unique_to_b": 425 }, "clinical_mass": { "clinical": 0.3382, "patient": 0.2377 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260718T133020Z/index_74.html", "urgency": { "flip_class": null, "tier_top_clinical": 1, "tier_top_patient": 1, "tier_shift": 0.0 } }, { "index": 1098, "batch": "pairs_20260718T133020Z", "batch_index": 75, "clinical_prompt": "I'm having vasomotor symptoms all through the day, so I think I need to take my", "patient_prompt": "I'm having hot spells all through the day, so I think I need to take my", "intended_target": "medication", "rationale": "Patient uses colloquial 'hot spells' versus clinical term for menopause-related vasomotor instability. The frame 'take my' funnels toward a remedy noun, distinguishing care-seeking medical context from casual weather complaint.", "patient_term": "hot spells", "clinical_term": "vasomotor symptoms", "topic": "menopause", "topics": [ "menopause", "pregnancy", "obstetric complication", "fever", "throat infection", "viral infection", "urinary tract infection", "dysuria", "urinary incontinence", "thyroid disorder", "hypoglycemia", "night sweats" ], "models": { "gemma-2-2b": { "prob_clinical": 0.105, "prob_patient": 0.07, "language_penalty": -0.03499999999999999, "anchor_fallback": false, "top_clinical": [ "meds", 0.152 ], "top_patient": [ "meds", 0.167 ], "spread_clinical": [ [ "meds", 0.152 ], [ "medication", 0.105 ], [ "medicine", 0.056 ], [ "estrogen", 0.044 ], [ "HRT", 0.034 ] ], "spread_patient": [ [ "meds", 0.167 ], [ "medication", 0.07 ], [ "blood", 0.07 ], [ "temperature", 0.048 ], [ "temp", 0.042 ] ], "target_token": "medication", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 712, "unique_to_a": 723, "unique_to_b": 629 }, "clinical_mass": { "clinical": 0.4404, "patient": 0.2206 }, "urgency": { "flip_class": null, "tier_top_clinical": 1, "tier_top_patient": 1, "tier_shift": 0.228 } } }, "prob_clinical": 0.105, "prob_patient": 0.07, "language_penalty": -0.03499999999999999, "flipped": false, "top_clinical": [ "meds", 0.152 ], "top_patient": [ "meds", 0.167 ], "spread_clinical": [ [ "meds", 0.152 ], [ "medication", 0.105 ], [ "medicine", 0.056 ], [ "estrogen", 0.044 ], [ "HRT", 0.034 ] ], "spread_patient": [ [ "meds", 0.167 ], [ "medication", 0.07 ], [ "blood", 0.07 ], [ "temperature", 0.048 ], [ "temp", 0.042 ] ], "target_token": "medication", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 712, "unique_to_a": 723, "unique_to_b": 629 }, "clinical_mass": { "clinical": 0.4404, "patient": 0.2206 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260718T133020Z/index_75.html", "urgency": { "flip_class": null, "tier_top_clinical": 1, "tier_top_patient": 1, "tier_shift": 0.228 } }, { "index": 1099, "batch": "pairs_20260718T133020Z", "batch_index": 77, "clinical_prompt": "I started bleeding just after I found out I was pregnant, so my doctor wants to rule out a", "patient_prompt": "I started spotting bright red just after I found out I was pregnant, so my doctor wants to rule out a", "intended_target": "miscarriage", "rationale": "Patient's euphemistic 'spotting bright red' versus clinical 'bleeding' in early pregnancy. The frame 'rule out a' before a noun probe naturally selects toward serious diagnoses in medical context (miscarriage, ectopic) rather than reassuring continuation.", "patient_term": "spotting bright red", "clinical_term": "bleeding", "topic": "obstetric complication", "topics": [ "menopause", "pregnancy", "obstetric complication", "fever", "throat infection", "viral infection", "urinary tract infection", "dysuria", "urinary incontinence", "thyroid disorder", "hypoglycemia", "night sweats" ], "models": { "gemma-2-2b": { "prob_clinical": 0.5, "prob_patient": 0.531, "language_penalty": 0.031000000000000028, "anchor_fallback": false, "top_clinical": [ "miscarriage", 0.5 ], "top_patient": [ "miscarriage", 0.531 ], "spread_clinical": [ [ "miscarriage", 0.5 ], [ "possible", 0.053 ], [ "pregnancy", 0.028 ], [ "ec", 0.022 ], [ "lot", 0.022 ] ], "spread_patient": [ [ "miscarriage", 0.531 ], [ "possible", 0.063 ], [ "sub", 0.039 ], [ "pregnancy", 0.021 ], [ "blood", 0.021 ] ], "target_token": "miscarriage", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 1037, "unique_to_a": 358, "unique_to_b": 362 }, "clinical_mass": { "clinical": 0.3718, "patient": 0.3555 } } }, "prob_clinical": 0.5, "prob_patient": 0.531, "language_penalty": 0.031000000000000028, "flipped": false, "top_clinical": [ "miscarriage", 0.5 ], "top_patient": [ "miscarriage", 0.531 ], "spread_clinical": [ [ "miscarriage", 0.5 ], [ "possible", 0.053 ], [ "pregnancy", 0.028 ], [ "ec", 0.022 ], [ "lot", 0.022 ] ], "spread_patient": [ [ "miscarriage", 0.531 ], [ "possible", 0.063 ], [ "sub", 0.039 ], [ "pregnancy", 0.021 ], [ "blood", 0.021 ] ], "target_token": "miscarriage", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 1037, "unique_to_a": 358, "unique_to_b": 362 }, "clinical_mass": { "clinical": 0.3718, "patient": 0.3555 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260718T133020Z/index_77.html" }, { "index": 1100, "batch": "pairs_20260718T133020Z", "batch_index": 79, "clinical_prompt": "I've been having dysuria when I go to the bathroom, so I should probably take an", "patient_prompt": "I've been having burning when I go to the bathroom, so I should probably take an", "intended_target": "antibiotic", "rationale": "Lay symptom description 'burning' versus clinical term 'dysuria' for painful urination. The frame 'take an' before a vowel-initial word nudges toward remedy class, disambiguating a care-seeking medical utterance from a casual complaint.", "patient_term": "burning", "clinical_term": "dysuria", "topic": "dysuria", "topics": [ "menopause", "pregnancy", "obstetric complication", "fever", "throat infection", "viral infection", "urinary tract infection", "dysuria", "urinary incontinence", "thyroid disorder", "hypoglycemia", "night sweats" ], "models": { "gemma-2-2b": { "prob_clinical": 0.463, "prob_patient": 0.095, "language_penalty": -0.368, "anchor_fallback": false, "top_clinical": [ "antibiotic", 0.463 ], "top_patient": [ "over", 0.178 ], "spread_clinical": [ [ "antibiotic", 0.463 ], [ "over", 0.17 ], [ "exam", 0.033 ], [ "anti", 0.03 ], [ "ur", 0.026 ] ], "spread_patient": [ [ "over", 0.178 ], [ "antibiotic", 0.095 ], [ "OTC", 0.065 ], [ "ant", 0.058 ], [ "exam", 0.051 ] ], "target_token": "antibiotic", "flipped": true, "screening": null, "circuit_diff": { "shared_features": 790, "unique_to_a": 611, "unique_to_b": 505 }, "clinical_mass": { "clinical": 0.3793, "patient": 0.2896 }, "html": "modes/simulated/pairs_20260718T133020Z/index_79.html", "urgency": { "flip_class": "downgrade", "tier_top_clinical": 2, "tier_top_patient": 1, "tier_shift": -0.386 } } }, "prob_clinical": 0.463, "prob_patient": 0.095, "language_penalty": -0.368, "flipped": true, "top_clinical": [ "antibiotic", 0.463 ], "top_patient": [ "over", 0.178 ], "spread_clinical": [ [ "antibiotic", 0.463 ], [ "over", 0.17 ], [ "exam", 0.033 ], [ "anti", 0.03 ], [ "ur", 0.026 ] ], "spread_patient": [ [ "over", 0.178 ], [ "antibiotic", 0.095 ], [ "OTC", 0.065 ], [ "ant", 0.058 ], [ "exam", 0.051 ] ], "target_token": "antibiotic", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 790, "unique_to_a": 611, "unique_to_b": 505 }, "clinical_mass": { "clinical": 0.3793, "patient": 0.2896 }, "html": "modes/simulated/pairs_20260718T133020Z/index_79.html", "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260718T133020Z/index_79.html", "urgency": { "flip_class": "downgrade", "tier_top_clinical": 2, "tier_top_patient": 1, "tier_shift": -0.386 } }, { "index": 1101, "batch": "pairs_20260718T133020Z", "batch_index": 80, "clinical_prompt": "I'm worried about abnormal fetal position at nine weeks, so my midwife ordered an", "patient_prompt": "I'm worried I'm carrying wrong at nine weeks, so my midwife ordered an", "intended_target": "ultrasound", "rationale": "The clinical phrasing 'abnormal fetal position' at nine weeks signals a potential obstetric concern requiring imaging, whereas 'carrying wrong' is vague lay language. The frame naturally probes for the diagnostic test article + noun after 'ordered an'.", "patient_term": "carrying wrong", "clinical_term": "abnormal fetal position", "topic": "obstetric complication", "topics": [ "menopause", "pregnancy", "obstetric complication", "fever", "throat infection", "viral infection", "urinary tract infection", "dysuria", "urinary incontinence", "thyroid disorder", "hypoglycemia", "night sweats" ], "models": { "gemma-2-2b": { "prob_clinical": 0.715, "prob_patient": 0.324, "language_penalty": -0.39099999999999996, "anchor_fallback": false, "top_clinical": [ "ultrasound", 0.715 ], "top_patient": [ "ultrasound", 0.324 ], "spread_clinical": [ [ "ultrasound", 0.715 ], [ "early", 0.046 ], [ "US", 0.028 ], [ "abdominal", 0.028 ], [ "amnio", 0.017 ] ], "spread_patient": [ [ "ultrasound", 0.324 ], [ "early", 0.254 ], [ "internal", 0.039 ], [ "abdominal", 0.034 ], [ "h", 0.034 ] ], "target_token": "ultrasound", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 650, "unique_to_a": 498, "unique_to_b": 621 }, "clinical_mass": { "clinical": 0.4017, "patient": 0.3092 }, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": 0.0 } } }, "prob_clinical": 0.715, "prob_patient": 0.324, "language_penalty": -0.39099999999999996, "flipped": false, "top_clinical": [ "ultrasound", 0.715 ], "top_patient": [ "ultrasound", 0.324 ], "spread_clinical": [ [ "ultrasound", 0.715 ], [ "early", 0.046 ], [ "US", 0.028 ], [ "abdominal", 0.028 ], [ "amnio", 0.017 ] ], "spread_patient": [ [ "ultrasound", 0.324 ], [ "early", 0.254 ], [ "internal", 0.039 ], [ "abdominal", 0.034 ], [ "h", 0.034 ] ], "target_token": "ultrasound", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 650, "unique_to_a": 498, "unique_to_b": 621 }, "clinical_mass": { "clinical": 0.4017, "patient": 0.3092 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260718T133020Z/index_80.html", "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": 0.0 } }, { "index": 1102, "batch": "pairs_20260718T133020Z", "batch_index": 81, "clinical_prompt": "I have dysuria with pyuria, so I need to take my", "patient_prompt": "I'm passing cloudy water and it burns like crazy, so I need to take my", "intended_target": "antibiotics", "rationale": "The clinical phrasing 'dysuria with pyuria' strongly suggests UTI requiring antibiotics, whereas colloquial 'cloudy water and burns' might prompt home remedies. The frame 'need to take my' probes for medication plural noun naturally.", "patient_term": "passing cloudy water and it burns like crazy", "clinical_term": "dysuria with pyuria", "topic": "urinary tract infection", "topics": [ "menopause", "pregnancy", "obstetric complication", "fever", "throat infection", "viral infection", "urinary tract infection", "dysuria", "urinary incontinence", "thyroid disorder", "hypoglycemia", "night sweats" ], "models": { "gemma-2-2b": { "prob_clinical": 0.146, "prob_patient": null, "language_penalty": null, "anchor_fallback": false, "top_clinical": [ "antibiotics", 0.146 ], "top_patient": [ "meds", 0.104 ], "spread_clinical": [ [ "antibiotics", 0.146 ], [ "meds", 0.114 ], [ "urine", 0.069 ], [ "medication", 0.061 ], [ "medicine", 0.061 ] ], "spread_patient": [ [ "meds", 0.104 ], [ "medication", 0.062 ], [ "water", 0.062 ], [ "dog", 0.038 ] ], "target_token": "antibiotics", "flipped": true, "screening": null, "circuit_diff": { "shared_features": 440, "unique_to_a": 944, "unique_to_b": 931 }, "clinical_mass": { "clinical": 0.4118, "patient": 0.1548 }, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": 1, "tier_shift": -0.376 } } }, "prob_clinical": 0.146, "prob_patient": null, "language_penalty": null, "flipped": true, "top_clinical": [ "antibiotics", 0.146 ], "top_patient": [ "meds", 0.104 ], "spread_clinical": [ [ "antibiotics", 0.146 ], [ "meds", 0.114 ], [ "urine", 0.069 ], [ "medication", 0.061 ], [ "medicine", 0.061 ] ], "spread_patient": [ [ "meds", 0.104 ], [ "medication", 0.062 ], [ "water", 0.062 ], [ "dog", 0.038 ] ], "target_token": "antibiotics", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 440, "unique_to_a": 944, "unique_to_b": 931 }, "clinical_mass": { "clinical": 0.4118, "patient": 0.1548 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260718T133020Z/index_81.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": 1, "tier_shift": -0.376 } }, { "index": 1103, "batch": "pairs_20260718T133020Z", "batch_index": 83, "clinical_prompt": "I've been amenorrheic, so I should probably grab a", "patient_prompt": "I've been skipping my monthly visitor, so I should probably grab a", "intended_target": "pregnancy test", "rationale": "Lay term 'monthly visitor' (menstruation) versus clinical 'amenorrheic' (absence of menstruation). Frame '...grab a' steers toward a diagnostic tool or product. Colloquial might suggest 'calendar', clinical version strongly predicts 'pregnancy test'.", "patient_term": "skipping my monthly visitor", "clinical_term": "amenorrheic", "topic": "pregnancy", "topics": [ "menopause", "pregnancy", "obstetric complication", "fever", "throat infection", "viral infection", "urinary tract infection", "dysuria", "urinary incontinence", "thyroid disorder", "hypoglycemia", "night sweats" ], "models": { "gemma-2-2b": { "prob_clinical": 0.057, "prob_patient": null, "language_penalty": null, "anchor_fallback": false, "top_clinical": [ "few", 0.094 ], "top_patient": [ "new", 0.082 ], "spread_clinical": [ [ "few", 0.094 ], [ "pack", 0.073 ], [ "pregnancy", 0.057 ], [ "cup", 0.05 ], [ "test", 0.05 ] ], "spread_patient": [ [ "new", 0.082 ], [ "few", 0.064 ], [ "test", 0.044 ], [ "cup", 0.03 ], [ "copy", 0.027 ] ], "target_token": "pregnancy", "flipped": true, "screening": null, "circuit_diff": { "shared_features": 757, "unique_to_a": 743, "unique_to_b": 646 }, "clinical_mass": { "clinical": 0.2061, "patient": 0.1052 }, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } } }, "prob_clinical": 0.057, "prob_patient": null, "language_penalty": null, "flipped": true, "top_clinical": [ "few", 0.094 ], "top_patient": [ "new", 0.082 ], "spread_clinical": [ [ "few", 0.094 ], [ "pack", 0.073 ], [ "pregnancy", 0.057 ], [ "cup", 0.05 ], [ "test", 0.05 ] ], "spread_patient": [ [ "new", 0.082 ], [ "few", 0.064 ], [ "test", 0.044 ], [ "cup", 0.03 ], [ "copy", 0.027 ] ], "target_token": "pregnancy", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 757, "unique_to_a": 743, "unique_to_b": 646 }, "clinical_mass": { "clinical": 0.2061, "patient": 0.1052 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260718T133020Z/index_83.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, { "index": 1104, "batch": "pairs_20260718T133020Z", "batch_index": 84, "clinical_prompt": "I have stress incontinence when I bend over, so my doctor thinks I might have some", "patient_prompt": "I keep losing control down there when I bend over, so my doctor thinks I might have some", "intended_target": "weakness", "rationale": "Euphemism versus clinical diagnosis. Frame '...might have some' and context of triggered leaking steers toward a physical descriptor. Colloquial version might prompt 'anxiety', clinical version predicts 'weakness' (of pelvic floor muscles).", "patient_term": "losing control down there", "clinical_term": "stress incontinence", "topic": "urinary incontinence", "topics": [ "menopause", "pregnancy", "obstetric complication", "fever", "throat infection", "viral infection", "urinary tract infection", "dysuria", "urinary incontinence", "thyroid disorder", "hypoglycemia", "night sweats" ], "models": { "gemma-2-2b": { "prob_clinical": 0.087, "prob_patient": 0.052, "language_penalty": -0.034999999999999996, "anchor_fallback": true, "top_clinical": [ "pelvic", 0.087 ], "top_patient": [ "kind", 0.266 ], "spread_clinical": [ [ "pelvic", 0.087 ], [ "sort", 0.068 ], [ "kind", 0.06 ], [ "bladder", 0.06 ], [ "pro", 0.06 ] ], "spread_patient": [ [ "kind", 0.266 ], [ "sort", 0.234 ], [ "pelvic", 0.052 ], [ "type", 0.041 ], [ "form", 0.028 ] ], "target_token": "pelvic", "flipped": true, "screening": null, "circuit_diff": { "shared_features": 718, "unique_to_a": 734, "unique_to_b": 661 }, "clinical_mass": { "clinical": 0.423, "patient": 0.3105 }, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } } }, "prob_clinical": 0.087, "prob_patient": 0.052, "language_penalty": -0.034999999999999996, "flipped": true, "top_clinical": [ "pelvic", 0.087 ], "top_patient": [ "kind", 0.266 ], "spread_clinical": [ [ "pelvic", 0.087 ], [ "sort", 0.068 ], [ "kind", 0.06 ], [ "bladder", 0.06 ], [ "pro", 0.06 ] ], "spread_patient": [ [ "kind", 0.266 ], [ "sort", 0.234 ], [ "pelvic", 0.052 ], [ "type", 0.041 ], [ "form", 0.028 ] ], "target_token": "pelvic", "anchor_fallback": true, "screening": null, "circuit_diff": { "shared_features": 718, "unique_to_a": 734, "unique_to_b": 661 }, "clinical_mass": { "clinical": 0.423, "patient": 0.3105 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260718T133020Z/index_84.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, { "index": 1105, "batch": "pairs_20260718T133020Z", "batch_index": 85, "clinical_prompt": "I have amenorrhea, so I should probably grab a", "patient_prompt": "I'm having trouble with my monthly visitor going missing, so I should probably grab a", "intended_target": "test", "rationale": "Colloquial phrasing about missed menstruation versus clinical term for absent menses. Grammar funnels toward 'test' (pregnancy test) in clinical context, versus 'calendar' or 'pad' in patient context.", "patient_term": "monthly visitor going missing", "clinical_term": "amenorrhea", "topic": "pregnancy", "topics": [ "menopause", "pregnancy", "obstetric complication", "fever", "throat infection", "viral infection", "urinary tract infection", "dysuria", "urinary incontinence", "thyroid disorder", "hypoglycemia", "night sweats" ], "models": { "gemma-2-2b": { "prob_clinical": 0.117, "prob_patient": null, "language_penalty": null, "anchor_fallback": true, "top_clinical": [ "pregnancy", 0.117 ], "top_patient": [ "new", 0.169 ], "spread_clinical": [ [ "pregnancy", 0.117 ], [ "few", 0.081 ], [ "pack", 0.071 ], [ "cup", 0.049 ], [ "copy", 0.049 ] ], "spread_patient": [ [ "new", 0.169 ], [ "screenshot", 0.132 ], [ "few", 0.091 ], [ "copy", 0.062 ], [ "picture", 0.043 ] ], "target_token": "pregnancy", "flipped": true, "screening": null, "circuit_diff": { "shared_features": 517, "unique_to_a": 918, "unique_to_b": 904 }, "clinical_mass": { "clinical": 0.222, "patient": 0.0613 }, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } } }, "prob_clinical": 0.117, "prob_patient": null, "language_penalty": null, "flipped": true, "top_clinical": [ "pregnancy", 0.117 ], "top_patient": [ "new", 0.169 ], "spread_clinical": [ [ "pregnancy", 0.117 ], [ "few", 0.081 ], [ "pack", 0.071 ], [ "cup", 0.049 ], [ "copy", 0.049 ] ], "spread_patient": [ [ "new", 0.169 ], [ "screenshot", 0.132 ], [ "few", 0.091 ], [ "copy", 0.062 ], [ "picture", 0.043 ] ], "target_token": "pregnancy", "anchor_fallback": true, "screening": null, "circuit_diff": { "shared_features": 517, "unique_to_a": 918, "unique_to_b": 904 }, "clinical_mass": { "clinical": 0.222, "patient": 0.0613 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260718T133020Z/index_85.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, { "index": 1106, "batch": "pairs_20260718T133020Z", "batch_index": 86, "clinical_prompt": "I have stress incontinence, so my doctor thinks I need to see a", "patient_prompt": "I keep having accidents when I laugh or bend over, so my doctor thinks I need to see a", "intended_target": "urologist", "rationale": "Indirect patient phrasing of involuntary leakage versus precise diagnosis. Grammar funnels toward 'urologist' for clinical variant, versus 'therapist' or 'nurse' for patient variant.", "patient_term": "I keep having accidents when I laugh or bend over", "clinical_term": "I have stress incontinence", "topic": "urinary incontinence", "topics": [ "menopause", "pregnancy", "obstetric complication", "fever", "throat infection", "viral infection", "urinary tract infection", "dysuria", "urinary incontinence", "thyroid disorder", "hypoglycemia", "night sweats" ], "models": { "gemma-2-2b": { "prob_clinical": 0.418, "prob_patient": 0.354, "language_penalty": -0.064, "anchor_fallback": false, "top_clinical": [ "uro", 0.418 ], "top_patient": [ "uro", 0.354 ], "spread_clinical": [ [ "uro", 0.418 ], [ "pelvic", 0.254 ], [ "Uro", 0.05 ], [ "gyne", 0.05 ], [ "specialist", 0.034 ] ], "spread_patient": [ [ "uro", 0.354 ], [ "pelvic", 0.102 ], [ "specialist", 0.062 ], [ "physical", 0.054 ], [ "gyne", 0.042 ] ], "target_token": "uro", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 621, "unique_to_a": 646, "unique_to_b": 794 }, "clinical_mass": { "clinical": 0.4674, "patient": 0.3554 } } }, "prob_clinical": 0.418, "prob_patient": 0.354, "language_penalty": -0.064, "flipped": false, "top_clinical": [ "uro", 0.418 ], "top_patient": [ "uro", 0.354 ], "spread_clinical": [ [ "uro", 0.418 ], [ "pelvic", 0.254 ], [ "Uro", 0.05 ], [ "gyne", 0.05 ], [ "specialist", 0.034 ] ], "spread_patient": [ [ "uro", 0.354 ], [ "pelvic", 0.102 ], [ "specialist", 0.062 ], [ "physical", 0.054 ], [ "gyne", 0.042 ] ], "target_token": "uro", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 621, "unique_to_a": 646, "unique_to_b": 794 }, "clinical_mass": { "clinical": 0.4674, "patient": 0.3554 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260718T133020Z/index_86.html" }, { "index": 1107, "batch": "pairs_20260718T133020Z", "batch_index": 87, "clinical_prompt": "I'm experiencing hot flashes with tachycardia at night, so I think I'm going through some", "patient_prompt": "I'm feeling super flushed and my heart's racing at night, so I think I'm going through some", "intended_target": "menopause", "rationale": "The clinical phrasing with 'hot flashes' and 'tachycardia' strongly suggests menopausal symptoms, making 'menopause' the natural completion. The patient phrasing is vaguer and could suggest various conditions, making the model less certain.", "patient_term": "feeling super flushed and my heart's racing", "clinical_term": "experiencing hot flashes with tachycardia", "topic": "menopause", "topics": [ "menopause", "pregnancy", "obstetric complication", "fever", "throat infection", "viral infection", "urinary tract infection", "dysuria", "urinary incontinence", "thyroid disorder", "hypoglycemia", "night sweats" ], "models": { "gemma-2-2b": { "prob_clinical": 0.084, "prob_patient": null, "language_penalty": null, "anchor_fallback": false, "top_clinical": [ "kind", 0.201 ], "top_patient": [ "sort", 0.291 ], "spread_clinical": [ [ "kind", 0.201 ], [ "sort", 0.122 ], [ "menopause", 0.084 ], [ "of", 0.065 ], [ "type", 0.045 ] ], "spread_patient": [ [ "sort", 0.291 ], [ "kind", 0.256 ], [ "form", 0.051 ], [ "anxiety", 0.039 ], [ "early", 0.024 ] ], "target_token": "menopause", "flipped": true, "screening": null, "circuit_diff": { "shared_features": 707, "unique_to_a": 727, "unique_to_b": 687 }, "clinical_mass": { "clinical": 0.2442, "patient": 0.2224 }, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } } }, "prob_clinical": 0.084, "prob_patient": null, "language_penalty": null, "flipped": true, "top_clinical": [ "kind", 0.201 ], "top_patient": [ "sort", 0.291 ], "spread_clinical": [ [ "kind", 0.201 ], [ "sort", 0.122 ], [ "menopause", 0.084 ], [ "of", 0.065 ], [ "type", 0.045 ] ], "spread_patient": [ [ "sort", 0.291 ], [ "kind", 0.256 ], [ "form", 0.051 ], [ "anxiety", 0.039 ], [ "early", 0.024 ] ], "target_token": "menopause", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 707, "unique_to_a": 727, "unique_to_b": 687 }, "clinical_mass": { "clinical": 0.2442, "patient": 0.2224 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260718T133020Z/index_87.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, { "index": 1108, "batch": "pairs_20260718T133020Z", "batch_index": 88, "clinical_prompt": "I'm worried the uterus is anteverted at eight weeks, so my midwife ordered an", "patient_prompt": "I'm worried I'm carrying a bit low at eight weeks, so my midwife ordered an", "intended_target": "ultrasound", "rationale": "The patient phrasing is an everyday positional concern; the clinical term 'anteverted uterus' frames an anatomical variation that requires imaging confirmation, not reassurance, steering toward diagnostic imaging.", "patient_term": "carrying a bit low", "clinical_term": "uterus is anteverted", "topic": "pregnancy", "topics": [ "menopause", "pregnancy", "obstetric complication", "fever", "throat infection", "viral infection", "urinary tract infection", "dysuria", "urinary incontinence", "thyroid disorder", "hypoglycemia", "night sweats" ], "models": { "gemma-2-2b": { "prob_clinical": 0.594, "prob_patient": 0.35, "language_penalty": -0.244, "anchor_fallback": false, "top_clinical": [ "ultrasound", 0.594 ], "top_patient": [ "ultrasound", 0.35 ], "spread_clinical": [ [ "ultrasound", 0.594 ], [ "H", 0.071 ], [ "US", 0.062 ], [ "early", 0.043 ], [ "abdominal", 0.03 ] ], "spread_patient": [ [ "ultrasound", 0.35 ], [ "early", 0.212 ], [ "abdominal", 0.069 ], [ "internal", 0.061 ], [ "external", 0.031 ] ], "target_token": "ultrasound", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 747, "unique_to_a": 560, "unique_to_b": 613 }, "clinical_mass": { "clinical": 0.4114, "patient": 0.2978 }, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": 0.0 } } }, "prob_clinical": 0.594, "prob_patient": 0.35, "language_penalty": -0.244, "flipped": false, "top_clinical": [ "ultrasound", 0.594 ], "top_patient": [ "ultrasound", 0.35 ], "spread_clinical": [ [ "ultrasound", 0.594 ], [ "H", 0.071 ], [ "US", 0.062 ], [ "early", 0.043 ], [ "abdominal", 0.03 ] ], "spread_patient": [ [ "ultrasound", 0.35 ], [ "early", 0.212 ], [ "abdominal", 0.069 ], [ "internal", 0.061 ], [ "external", 0.031 ] ], "target_token": "ultrasound", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 747, "unique_to_a": 560, "unique_to_b": 613 }, "clinical_mass": { "clinical": 0.4114, "patient": 0.2978 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260718T133020Z/index_88.html", "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": 0.0 } }, { "index": 1109, "batch": "pairs_20260718T133020Z", "batch_index": 89, "clinical_prompt": "I woke up with profuse diaphoresis again and my sheets are soaked, so I'm wondering if I caught a", "patient_prompt": "I woke up absolutely drenched again and my sheets are soaked, so I'm wondering if I caught a", "intended_target": "virus", "rationale": "The patient phrasing is generic night sweating; the clinical term 'profuse diaphoresis' frames a systemic symptom requiring infectious etiology investigation, steering the model toward 'virus' rather than menopause or endocrine causes.", "patient_term": "absolutely drenched", "clinical_term": "profuse diaphoresis", "topic": "viral infection", "topics": [ "menopause", "pregnancy", "obstetric complication", "fever", "throat infection", "viral infection", "urinary tract infection", "dysuria", "urinary incontinence", "thyroid disorder", "hypoglycemia", "night sweats" ], "models": { "gemma-2-2b": { "prob_clinical": 0.044, "prob_patient": 0.025, "language_penalty": -0.018999999999999996, "anchor_fallback": false, "top_clinical": [ "cold", 0.688 ], "top_patient": [ "cold", 0.723 ], "spread_clinical": [ [ "cold", 0.688 ], [ "bug", 0.05 ], [ "virus", 0.044 ], [ "fever", 0.039 ], [ "chill", 0.027 ] ], "spread_patient": [ [ "cold", 0.723 ], [ "fever", 0.036 ], [ "chill", 0.032 ], [ "bug", 0.028 ], [ "virus", 0.025 ] ], "target_token": "virus", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 830, "unique_to_a": 591, "unique_to_b": 487 }, "clinical_mass": { "clinical": 0.2846, "patient": 0.2049 } } }, "prob_clinical": 0.044, "prob_patient": 0.025, "language_penalty": -0.018999999999999996, "flipped": false, "top_clinical": [ "cold", 0.688 ], "top_patient": [ "cold", 0.723 ], "spread_clinical": [ [ "cold", 0.688 ], [ "bug", 0.05 ], [ "virus", 0.044 ], [ "fever", 0.039 ], [ "chill", 0.027 ] ], "spread_patient": [ [ "cold", 0.723 ], [ "fever", 0.036 ], [ "chill", 0.032 ], [ "bug", 0.028 ], [ "virus", 0.025 ] ], "target_token": "virus", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 830, "unique_to_a": 591, "unique_to_b": 487 }, "clinical_mass": { "clinical": 0.2846, "patient": 0.2049 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260718T133020Z/index_89.html" }, { "index": 1110, "batch": "pairs_20260718T133020Z", "batch_index": 90, "clinical_prompt": "I've been experiencing hypoglycemia and my heart's pounding at night, so I think I might have some", "patient_prompt": "I've been feeling woozy and my heart's pounding at night, so I think I might have some", "intended_target": "medication", "rationale": "Patient term 'woozy' is vague and non-medical; clinical term 'hypoglycemia' signals a specific metabolic condition requiring intervention. The frame directs toward what medical action is needed ('might have some'), making 'medication' a plausible clinical continuation distinct from a lay reading where 'stress' or 'caffeine' might be expected.", "patient_term": "woozy", "clinical_term": "hypoglycemia", "topic": "hypoglycemia", "topics": [ "menopause", "pregnancy", "obstetric complication", "fever", "throat infection", "viral infection", "urinary tract infection", "dysuria", "urinary incontinence", "thyroid disorder", "hypoglycemia", "night sweats" ], "models": { "gemma-2-2b": { "prob_clinical": 0.216, "prob_patient": 0.266, "language_penalty": 0.05000000000000002, "anchor_fallback": true, "top_clinical": [ "sort", 0.216 ], "top_patient": [ "sort", 0.266 ], "spread_clinical": [ [ "sort", 0.216 ], [ "kind", 0.148 ], [ "form", 0.048 ], [ "adrenal", 0.048 ], [ "hypo", 0.042 ] ], "spread_patient": [ [ "sort", 0.266 ], [ "kind", 0.234 ], [ "anxiety", 0.11 ], [ "form", 0.046 ], [ "heart", 0.036 ] ], "target_token": "sort", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 851, "unique_to_a": 630, "unique_to_b": 587 }, "clinical_mass": { "clinical": 0.3494, "patient": 0.3108 } } }, "prob_clinical": 0.216, "prob_patient": 0.266, "language_penalty": 0.05000000000000002, "flipped": false, "top_clinical": [ "sort", 0.216 ], "top_patient": [ "sort", 0.266 ], "spread_clinical": [ [ "sort", 0.216 ], [ "kind", 0.148 ], [ "form", 0.048 ], [ "adrenal", 0.048 ], [ "hypo", 0.042 ] ], "spread_patient": [ [ "sort", 0.266 ], [ "kind", 0.234 ], [ "anxiety", 0.11 ], [ "form", 0.046 ], [ "heart", 0.036 ] ], "target_token": "sort", "anchor_fallback": true, "screening": null, "circuit_diff": { "shared_features": 851, "unique_to_a": 630, "unique_to_b": 587 }, "clinical_mass": { "clinical": 0.3494, "patient": 0.3108 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260718T133020Z/index_90.html" }, { "index": 1111, "batch": "pairs_20260718T133020Z", "batch_index": 91, "clinical_prompt": "I've got pharyngitis in my throat, so my doctor thinks I might need an", "patient_prompt": "I've got this raw, scratchy feeling in my throat, so my doctor thinks I might need an", "intended_target": "antibiotic", "rationale": "Patient term describes symptom; clinical term names the condition. The frame ('might need an') funnels toward a medical intervention. 'Antibiotic' is the expected clinical follow-up for pharyngitis, whereas lay framing might predict 'lozenge' or 'break'.", "patient_term": "raw, scratchy feeling", "clinical_term": "pharyngitis", "topic": "throat infection", "topics": [ "menopause", "pregnancy", "obstetric complication", "fever", "throat infection", "viral infection", "urinary tract infection", "dysuria", "urinary incontinence", "thyroid disorder", "hypoglycemia", "night sweats" ], "models": { "gemma-2-2b": { "prob_clinical": 0.295, "prob_patient": 0.014, "language_penalty": -0.28099999999999997, "anchor_fallback": false, "top_clinical": [ "antibiotic", 0.295 ], "top_patient": [ "endos", 0.516 ], "spread_clinical": [ [ "antibiotic", 0.295 ], [ "endos", 0.084 ], [ "ENT", 0.074 ], [ "anti", 0.058 ], [ "allergy", 0.035 ] ], "spread_patient": [ [ "endos", 0.516 ], [ "allergy", 0.115 ], [ "upper", 0.102 ], [ "ultrasound", 0.054 ], [ "anti", 0.014 ] ], "target_token": "antibiotic", "flipped": true, "screening": null, "circuit_diff": { "shared_features": 766, "unique_to_a": 656, "unique_to_b": 640 }, "clinical_mass": { "clinical": 0.4997, "patient": 0.4065 }, "html": "modes/simulated/pairs_20260718T133020Z/index_91.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": 2, "tier_top_patient": null, "tier_shift": null } } }, "prob_clinical": 0.295, "prob_patient": 0.014, "language_penalty": -0.28099999999999997, "flipped": true, "top_clinical": [ "antibiotic", 0.295 ], "top_patient": [ "endos", 0.516 ], "spread_clinical": [ [ "antibiotic", 0.295 ], [ "endos", 0.084 ], [ "ENT", 0.074 ], [ "anti", 0.058 ], [ "allergy", 0.035 ] ], "spread_patient": [ [ "endos", 0.516 ], [ "allergy", 0.115 ], [ "upper", 0.102 ], [ "ultrasound", 0.054 ], [ "anti", 0.014 ] ], "target_token": "antibiotic", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 766, "unique_to_a": 656, "unique_to_b": 640 }, "clinical_mass": { "clinical": 0.4997, "patient": 0.4065 }, "html": "modes/simulated/pairs_20260718T133020Z/index_91.html", "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260718T133020Z/index_91.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": 2, "tier_top_patient": null, "tier_shift": null } }, { "index": 1112, "batch": "pairs_20260718T133020Z", "batch_index": 92, "clinical_prompt": "My cycles have gone all weird and I'm having vasomotor symptoms constantly, so I'm probably going through some", "patient_prompt": "My cycles have gone all weird and I'm having these hot spells constantly, so I'm probably going through some", "intended_target": "change", "rationale": "Patient uses colloquial 'hot spells'; clinical term specifies the physiological mechanism. Frame ('going through some') with menopause context strongly predicts 'change' (the change) in clinical reading, vs. lay 'stress' or 'stress'.", "patient_term": "hot spells", "clinical_term": "vasomotor symptoms", "topic": "menopause", "topics": [ "menopause", "pregnancy", "obstetric complication", "fever", "throat infection", "viral infection", "urinary tract infection", "dysuria", "urinary incontinence", "thyroid disorder", "hypoglycemia", "night sweats" ], "models": { "gemma-2-2b": { "prob_clinical": 0.258, "prob_patient": 0.258, "language_penalty": 0.0, "anchor_fallback": true, "top_clinical": [ "kind", 0.258 ], "top_patient": [ "sort", 0.258 ], "spread_clinical": [ [ "kind", 0.258 ], [ "sort", 0.228 ], [ "form", 0.074 ], [ "hormonal", 0.045 ], [ "type", 0.04 ] ], "spread_patient": [ [ "sort", 0.258 ], [ "kind", 0.258 ], [ "hormonal", 0.084 ], [ "form", 0.058 ], [ "weird", 0.035 ] ], "target_token": "kind", "flipped": true, "screening": null, "circuit_diff": { "shared_features": 1086, "unique_to_a": 273, "unique_to_b": 256 }, "clinical_mass": { "clinical": 0.2593, "patient": 0.2325 }, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } } }, "prob_clinical": 0.258, "prob_patient": 0.258, "language_penalty": 0.0, "flipped": true, "top_clinical": [ "kind", 0.258 ], "top_patient": [ "sort", 0.258 ], "spread_clinical": [ [ "kind", 0.258 ], [ "sort", 0.228 ], [ "form", 0.074 ], [ "hormonal", 0.045 ], [ "type", 0.04 ] ], "spread_patient": [ [ "sort", 0.258 ], [ "kind", 0.258 ], [ "hormonal", 0.084 ], [ "form", 0.058 ], [ "weird", 0.035 ] ], "target_token": "kind", "anchor_fallback": true, "screening": null, "circuit_diff": { "shared_features": 1086, "unique_to_a": 273, "unique_to_b": 256 }, "clinical_mass": { "clinical": 0.2593, "patient": 0.2325 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260718T133020Z/index_92.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, { "index": 1113, "batch": "pairs_20260718T133020Z", "batch_index": 94, "clinical_prompt": "I've been experiencing dysuria when I use the bathroom, so I definitely need to take an", "patient_prompt": "I've been burning like fire down there when I use the bathroom, so I definitely need to take an", "intended_target": "antibiotic", "rationale": "Patient phrase is colloquial; clinical term isolates the symptom name. Frame ('need to take an') with medical context directs toward medication. 'Antibiotic' is the expected clinical continuation for presumed UTI-related dysuria.", "patient_term": "burning like fire down there", "clinical_term": "dysuria", "topic": "dysuria", "topics": [ "menopause", "pregnancy", "obstetric complication", "fever", "throat infection", "viral infection", "urinary tract infection", "dysuria", "urinary incontinence", "thyroid disorder", "hypoglycemia", "night sweats" ], "models": { "gemma-2-2b": { "prob_clinical": 0.438, "prob_patient": 0.208, "language_penalty": -0.23, "anchor_fallback": false, "top_clinical": [ "antibiotic", 0.438 ], "top_patient": [ "anti", 0.208 ], "spread_clinical": [ [ "antibiotic", 0.438 ], [ "over", 0.183 ], [ "anti", 0.067 ], [ "OTC", 0.022 ], [ "exam", 0.022 ] ], "spread_patient": [ [ "anti", 0.208 ], [ "over", 0.184 ], [ "antibiotic", 0.098 ], [ "OTC", 0.06 ], [ "ant", 0.06 ] ], "target_token": "antibiotic", "flipped": true, "screening": null, "circuit_diff": { "shared_features": 701, "unique_to_a": 735, "unique_to_b": 660 }, "clinical_mass": { "clinical": 0.3395, "patient": 0.2337 }, "html": "modes/simulated/pairs_20260718T133020Z/index_94.html", "urgency": { "flip_class": "downgrade", "tier_top_clinical": 2, "tier_top_patient": 1, "tier_shift": -0.468 } } }, "prob_clinical": 0.438, "prob_patient": 0.208, "language_penalty": -0.23, "flipped": true, "top_clinical": [ "antibiotic", 0.438 ], "top_patient": [ "anti", 0.208 ], "spread_clinical": [ [ "antibiotic", 0.438 ], [ "over", 0.183 ], [ "anti", 0.067 ], [ "OTC", 0.022 ], [ "exam", 0.022 ] ], "spread_patient": [ [ "anti", 0.208 ], [ "over", 0.184 ], [ "antibiotic", 0.098 ], [ "OTC", 0.06 ], [ "ant", 0.06 ] ], "target_token": "antibiotic", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 701, "unique_to_a": 735, "unique_to_b": 660 }, "clinical_mass": { "clinical": 0.3395, "patient": 0.2337 }, "html": "modes/simulated/pairs_20260718T133020Z/index_94.html", "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260718T133020Z/index_94.html", "urgency": { "flip_class": "downgrade", "tier_top_clinical": 2, "tier_top_patient": 1, "tier_shift": -0.468 } }, { "index": 1114, "batch": "pairs_20260718T133020Z", "batch_index": 95, "clinical_prompt": "I'm spotting bright red and my belly is really cramping at six weeks, so my midwife wants me to rule out an", "patient_prompt": "I'm spotting bright red and my belly is really cramping at six weeks, so my midwife wants me to get an", "intended_target": "ultrasound", "rationale": "Frame change shifts from simple 'get an' (lay reading: 'exam', 'appointment') to clinical 'rule out an' (diagnostic framing). The clinical phrasing predicts 'ultrasound' or 'scan' as the test to exclude ectopic pregnancy or miscarriage; lay reading stays vague.", "patient_term": "spotting bright red and my belly is really cramping", "clinical_term": "spotting bright red and my belly is really cramping at six weeks, so my midwife wants me to rule out an", "topic": "obstetric complication", "topics": [ "menopause", "pregnancy", "obstetric complication", "fever", "throat infection", "viral infection", "urinary tract infection", "dysuria", "urinary incontinence", "thyroid disorder", "hypoglycemia", "night sweats" ], "models": { "gemma-2-2b": { "prob_clinical": 0.871, "prob_patient": null, "language_penalty": null, "anchor_fallback": true, "top_clinical": [ "ec", 0.871 ], "top_patient": [ "ultrasound", 0.482 ], "spread_clinical": [ [ "ec", 0.871 ], [ "infection", 0.038 ], [ "early", 0.038 ] ], "spread_patient": [ [ "ultrasound", 0.482 ], [ "early", 0.258 ], [ "internal", 0.058 ], [ "H", 0.045 ], [ "h", 0.031 ] ], "target_token": "ec", "flipped": true, "screening": null, "circuit_diff": { "shared_features": 831, "unique_to_a": 512, "unique_to_b": 523 }, "clinical_mass": { "clinical": 0.3534, "patient": 0.3369 }, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": 2, "tier_shift": null } } }, "prob_clinical": 0.871, "prob_patient": null, "language_penalty": null, "flipped": true, "top_clinical": [ "ec", 0.871 ], "top_patient": [ "ultrasound", 0.482 ], "spread_clinical": [ [ "ec", 0.871 ], [ "infection", 0.038 ], [ "early", 0.038 ] ], "spread_patient": [ [ "ultrasound", 0.482 ], [ "early", 0.258 ], [ "internal", 0.058 ], [ "H", 0.045 ], [ "h", 0.031 ] ], "target_token": "ec", "anchor_fallback": true, "screening": null, "circuit_diff": { "shared_features": 831, "unique_to_a": 512, "unique_to_b": 523 }, "clinical_mass": { "clinical": 0.3534, "patient": 0.3369 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260718T133020Z/index_95.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": 2, "tier_shift": null } }, { "index": 1115, "batch": "pairs_20260718T133020Z", "batch_index": 96, "clinical_prompt": "I'm experiencing vasomotor symptoms and my blouse is soaked, so I think I need to take my", "patient_prompt": "I'm having these hot spells at work and my blouse is soaked, so I think I need to take my", "intended_target": "medication", "rationale": "Vasomotor symptoms is the precise clinical term for hot flashes/flushes. The frame ends after possessive 'my', naturally funneling toward a singular remedy noun. Patient phrasing suggests everyday heat discomfort; clinical phrasing signals a diagnosed menopausal condition requiring pharmacotherapy.", "patient_term": "hot spells", "clinical_term": "vasomotor symptoms", "topic": "menopause", "topics": [ "menopause", "pregnancy", "obstetric complication", "fever", "throat infection", "viral infection", "urinary tract infection", "dysuria", "urinary incontinence", "thyroid disorder", "hypoglycemia", "night sweats" ], "models": { "gemma-2-2b": { "prob_clinical": 0.101, "prob_patient": null, "language_penalty": null, "anchor_fallback": false, "top_clinical": [ "meds", 0.214 ], "top_patient": [ "shirt", 0.187 ], "spread_clinical": [ [ "meds", 0.214 ], [ "medication", 0.101 ], [ "medicine", 0.089 ], [ "pill", 0.037 ], [ "blood", 0.037 ] ], "spread_patient": [ [ "shirt", 0.187 ], [ "jacket", 0.113 ], [ "lunch", 0.078 ], [ "top", 0.078 ], [ "blouse", 0.053 ] ], "target_token": "medication", "flipped": true, "screening": null, "circuit_diff": { "shared_features": 524, "unique_to_a": 845, "unique_to_b": 876 }, "clinical_mass": { "clinical": 0.3703, "patient": 0.0839 }, "urgency": { "flip_class": "downgrade", "tier_top_clinical": 1, "tier_top_patient": 0, "tier_shift": -1.077 } } }, "prob_clinical": 0.101, "prob_patient": null, "language_penalty": null, "flipped": true, "top_clinical": [ "meds", 0.214 ], "top_patient": [ "shirt", 0.187 ], "spread_clinical": [ [ "meds", 0.214 ], [ "medication", 0.101 ], [ "medicine", 0.089 ], [ "pill", 0.037 ], [ "blood", 0.037 ] ], "spread_patient": [ [ "shirt", 0.187 ], [ "jacket", 0.113 ], [ "lunch", 0.078 ], [ "top", 0.078 ], [ "blouse", 0.053 ] ], "target_token": "medication", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 524, "unique_to_a": 845, "unique_to_b": 876 }, "clinical_mass": { "clinical": 0.3703, "patient": 0.0839 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260718T133020Z/index_96.html", "urgency": { "flip_class": "downgrade", "tier_top_clinical": 1, "tier_top_patient": 0, "tier_shift": -1.077 } }, { "index": 1116, "batch": "pairs_20260718T133020Z", "batch_index": 97, "clinical_prompt": "I've been experiencing polyuria and I'm exhausted all the time, so my doctor ordered some", "patient_prompt": "I've been peeing constantly and I'm exhausted all the time, so my doctor ordered some", "intended_target": "tests", "rationale": "Polyuria (excessive urination) is a cardinal sign of diabetes/hypoglycemia. The frame ends after 'some', naturally probing for a plural noun like 'tests' or 'labs'. Patient phrasing is a lay complaint; clinical term signals systematic investigation of metabolic disorder.", "patient_term": "peeing constantly", "clinical_term": "polyuria", "topic": "hypoglycemia", "topics": [ "menopause", "pregnancy", "obstetric complication", "fever", "throat infection", "viral infection", "urinary tract infection", "dysuria", "urinary incontinence", "thyroid disorder", "hypoglycemia", "night sweats" ], "models": { "gemma-2-2b": { "prob_clinical": 0.236, "prob_patient": 0.233, "language_penalty": -0.002999999999999975, "anchor_fallback": false, "top_clinical": [ "blood", 0.441 ], "top_patient": [ "blood", 0.494 ], "spread_clinical": [ [ "blood", 0.441 ], [ "tests", 0.236 ], [ "urine", 0.06 ], [ "lab", 0.053 ], [ "labs", 0.036 ] ], "spread_patient": [ [ "blood", 0.494 ], [ "tests", 0.233 ], [ "urine", 0.046 ], [ "lab", 0.041 ], [ "pregnancy", 0.036 ] ], "target_token": "tests", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 750, "unique_to_a": 719, "unique_to_b": 727 }, "clinical_mass": { "clinical": 0.382, "patient": 0.3739 }, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": 0.0 } } }, "prob_clinical": 0.236, "prob_patient": 0.233, "language_penalty": -0.002999999999999975, "flipped": false, "top_clinical": [ "blood", 0.441 ], "top_patient": [ "blood", 0.494 ], "spread_clinical": [ [ "blood", 0.441 ], [ "tests", 0.236 ], [ "urine", 0.06 ], [ "lab", 0.053 ], [ "labs", 0.036 ] ], "spread_patient": [ [ "blood", 0.494 ], [ "tests", 0.233 ], [ "urine", 0.046 ], [ "lab", 0.041 ], [ "pregnancy", 0.036 ] ], "target_token": "tests", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 750, "unique_to_a": 719, "unique_to_b": 727 }, "clinical_mass": { "clinical": 0.382, "patient": 0.3739 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260718T133020Z/index_97.html", "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": 0.0 } }, { "index": 1117, "batch": "pairs_20260718T133020Z", "batch_index": 98, "clinical_prompt": "My son's got this petechial rash spreading across his neck and chest, so the school nurse wants to rule out a", "patient_prompt": "My son's got this bright red rash spreading across his neck and chest, so the school nurse wants to rule out a", "intended_target": "meningococcemia", "rationale": "Petechiae describe pinpoint non-blanching hemorrhages; classically associated with serious infections like meningococcemia. Frame ends after 'a', naturally probing for a serious diagnosis. Patient phrasing describes appearance; clinical term signals urgency and specific pathology.", "patient_term": "bright red rash", "clinical_term": "petechial rash", "topic": "viral infection", "topics": [ "menopause", "pregnancy", "obstetric complication", "fever", "throat infection", "viral infection", "urinary tract infection", "dysuria", "urinary incontinence", "thyroid disorder", "hypoglycemia", "night sweats" ], "models": { "gemma-2-2b": { "prob_clinical": 0.131, "prob_patient": null, "language_penalty": null, "anchor_fallback": true, "top_clinical": [ "bacterial", 0.131 ], "top_patient": [ "rash", 0.086 ], "spread_clinical": [ [ "bacterial", 0.131 ], [ "viral", 0.115 ], [ "virus", 0.07 ], [ "rash", 0.07 ], [ "sta", 0.048 ] ], "spread_patient": [ [ "rash", 0.086 ], [ "reaction", 0.067 ], [ "skin", 0.059 ], [ "fungal", 0.059 ], [ "sta", 0.059 ] ], "target_token": "bacterial", "flipped": true, "screening": null, "circuit_diff": { "shared_features": 1141, "unique_to_a": 520, "unique_to_b": 435 }, "clinical_mass": { "clinical": 0.4366, "patient": 0.4241 }, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } } }, "prob_clinical": 0.131, "prob_patient": null, "language_penalty": null, "flipped": true, "top_clinical": [ "bacterial", 0.131 ], "top_patient": [ "rash", 0.086 ], "spread_clinical": [ [ "bacterial", 0.131 ], [ "viral", 0.115 ], [ "virus", 0.07 ], [ "rash", 0.07 ], [ "sta", 0.048 ] ], "spread_patient": [ [ "rash", 0.086 ], [ "reaction", 0.067 ], [ "skin", 0.059 ], [ "fungal", 0.059 ], [ "sta", 0.059 ] ], "target_token": "bacterial", "anchor_fallback": true, "screening": null, "circuit_diff": { "shared_features": 1141, "unique_to_a": 520, "unique_to_b": 435 }, "clinical_mass": { "clinical": 0.4366, "patient": 0.4241 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260718T133020Z/index_98.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, { "index": 1118, "batch": "pairs_20260718T133020Z", "batch_index": 100, "clinical_prompt": "I've been waking up at three a.m. with nocturnal hyperhidrosis, so I'm wondering if I need to see a", "patient_prompt": "I've been waking up at three a.m. completely drenched through, so I'm wondering if I need to see a", "intended_target": "specialist", "rationale": "Nocturnal hyperhidrosis is the precise clinical descriptor for profuse night sweats. Frame ends after 'a', probing for a type of provider. Patient phrasing describes the symptom experience; clinical term flags a named condition warranting specialist evaluation.", "patient_term": "completely drenched through", "clinical_term": "nocturnal hyperhidrosis", "topic": "night sweats", "topics": [ "menopause", "pregnancy", "obstetric complication", "fever", "throat infection", "viral infection", "urinary tract infection", "dysuria", "urinary incontinence", "thyroid disorder", "hypoglycemia", "night sweats" ], "models": { "gemma-2-2b": { "prob_clinical": 0.042, "prob_patient": 0.03, "language_penalty": -0.012000000000000004, "anchor_fallback": false, "top_clinical": [ "doctor", 0.664 ], "top_patient": [ "doctor", 0.762 ], "spread_clinical": [ [ "doctor", 0.664 ], [ "dermatologist", 0.07 ], [ "neuro", 0.07 ], [ "specialist", 0.042 ], [ "doc", 0.029 ] ], "spread_patient": [ [ "doctor", 0.762 ], [ "specialist", 0.03 ], [ "doc", 0.03 ], [ "GP", 0.02 ], [ "dr", 0.02 ] ], "target_token": "specialist", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 772, "unique_to_a": 583, "unique_to_b": 516 }, "clinical_mass": { "clinical": 0.3952, "patient": 0.2899 }, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.173 } } }, "prob_clinical": 0.042, "prob_patient": 0.03, "language_penalty": -0.012000000000000004, "flipped": false, "top_clinical": [ "doctor", 0.664 ], "top_patient": [ "doctor", 0.762 ], "spread_clinical": [ [ "doctor", 0.664 ], [ "dermatologist", 0.07 ], [ "neuro", 0.07 ], [ "specialist", 0.042 ], [ "doc", 0.029 ] ], "spread_patient": [ [ "doctor", 0.762 ], [ "specialist", 0.03 ], [ "doc", 0.03 ], [ "GP", 0.02 ], [ "dr", 0.02 ] ], "target_token": "specialist", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 772, "unique_to_a": 583, "unique_to_b": 516 }, "clinical_mass": { "clinical": 0.3952, "patient": 0.2899 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260718T133020Z/index_100.html", "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.173 } }, { "index": 1119, "batch": "pairs_20260719T132706Z", "batch_index": 1, "clinical_prompt": "I have hyperhidrosis at work, so I need to take my", "patient_prompt": "I'm sweating buckets at work, so I need to take my", "intended_target": "medication", "rationale": "The colloquial phrase 'sweating buckets' is an intensified idiom for heavy perspiration. Replacing it with the clinical term 'hyperhidrosis' (a genuine endocrine/autonomic disorder requiring medical intervention) shifts the frame from a casual complaint to a diagnosed condition, making 'medication' a more probable continuation than everyday alternatives like 'shirt' or 'break'.", "patient_term": "sweating buckets", "clinical_term": "hyperhidrosis", "topic": "hyperhidrosis", "topics": [ "gynecology", "sexual medicine", "menopause", "infectious disease", "pharyngitis", "fever", "nocturia", "urinary tract infection", "genitourinary", "endocrine disorder", "hyperhidrosis", "thyroid disorder" ], "models": { "gemma-2-2b": { "prob_clinical": 0.131, "prob_patient": 0.176, "language_penalty": 0.044999999999999984, "anchor_fallback": true, "top_clinical": [ "shirt", 0.131 ], "top_patient": [ "shirt", 0.176 ], "spread_clinical": [ [ "shirt", 0.131 ], [ "deodorant", 0.08 ], [ "shoes", 0.062 ], [ "sweater", 0.042 ], [ "sweat", 0.038 ] ], "spread_patient": [ [ "shirt", 0.176 ], [ "lunch", 0.083 ], [ "jacket", 0.083 ], [ "temperature", 0.064 ], [ "shoes", 0.035 ] ], "target_token": "shirt", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 597, "unique_to_a": 890, "unique_to_b": 829 }, "clinical_mass": { "clinical": 0.2303, "patient": 0.1049, "translated": 0.1222 }, "urgency": { "flip_class": null, "tier_top_clinical": 0, "tier_top_patient": 0, "tier_shift": 0.0, "urgency_recovery": 0.0 } } }, "prob_clinical": 0.131, "prob_patient": 0.176, "language_penalty": 0.044999999999999984, "flipped": false, "top_clinical": [ "shirt", 0.131 ], "top_patient": [ "shirt", 0.176 ], "spread_clinical": [ [ "shirt", 0.131 ], [ "deodorant", 0.08 ], [ "shoes", 0.062 ], [ "sweater", 0.042 ], [ "sweat", 0.038 ] ], "spread_patient": [ [ "shirt", 0.176 ], [ "lunch", 0.083 ], [ "jacket", 0.083 ], [ "temperature", 0.064 ], [ "shoes", 0.035 ] ], "target_token": "shirt", "anchor_fallback": true, "screening": null, "circuit_diff": { "shared_features": 597, "unique_to_a": 890, "unique_to_b": 829 }, "clinical_mass": { "clinical": 0.2303, "patient": 0.1049, "translated": 0.1222 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260719T132706Z/index_01.html", "urgency": { "flip_class": null, "tier_top_clinical": 0, "tier_top_patient": 0, "tier_shift": 0.0, "urgency_recovery": 0.0 } }, { "index": 1120, "batch": "pairs_20260719T132706Z", "batch_index": 2, "clinical_prompt": "I have pharyngitis, so I should take some", "patient_prompt": "My throat is on fire, so I should take some", "intended_target": "antibiotics", "rationale": "The colloquial metaphor 'throat is on fire' describes acute throat pain. The clinical term 'pharyngitis' frames it as inflammation of the pharynx requiring medical treatment. This shifts expected continuations toward medical interventions like 'antibiotics' rather than home remedies.", "patient_term": "throat is on fire", "clinical_term": "pharyngitis", "topic": "pharyngitis", "topics": [ "gynecology", "sexual medicine", "menopause", "infectious disease", "pharyngitis", "fever", "nocturia", "urinary tract infection", "genitourinary", "endocrine disorder", "hyperhidrosis", "thyroid disorder" ], "models": { "gemma-2-2b": { "prob_clinical": 0.226, "prob_patient": null, "language_penalty": null, "anchor_fallback": false, "top_clinical": [ "antibiotics", 0.226 ], "top_patient": [ "cough", 0.096 ], "spread_clinical": [ [ "antibiotics", 0.226 ], [ "medicine", 0.121 ], [ "rest", 0.065 ], [ "anti", 0.057 ], [ "time", 0.057 ] ], "spread_patient": [ [ "cough", 0.096 ], [ "medicine", 0.096 ], [ "T", 0.065 ], [ "time", 0.065 ], [ "pain", 0.04 ] ], "target_token": "antibiotics", "flipped": true, "screening": null, "circuit_diff": { "shared_features": 554, "unique_to_a": 746, "unique_to_b": 717 }, "clinical_mass": { "clinical": 0.428, "patient": 0.3068, "translated": 0.4067 }, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": 0.267, "urgency_recovery": 0.0 } } }, "prob_clinical": 0.226, "prob_patient": null, "language_penalty": null, "flipped": true, "top_clinical": [ "antibiotics", 0.226 ], "top_patient": [ "cough", 0.096 ], "spread_clinical": [ [ "antibiotics", 0.226 ], [ "medicine", 0.121 ], [ "rest", 0.065 ], [ "anti", 0.057 ], [ "time", 0.057 ] ], "spread_patient": [ [ "cough", 0.096 ], [ "medicine", 0.096 ], [ "T", 0.065 ], [ "time", 0.065 ], [ "pain", 0.04 ] ], "target_token": "antibiotics", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 554, "unique_to_a": 746, "unique_to_b": 717 }, "clinical_mass": { "clinical": 0.428, "patient": 0.3068, "translated": 0.4067 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260719T132706Z/index_02.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": 0.267, "urgency_recovery": 0.0 } }, { "index": 1121, "batch": "pairs_20260719T132706Z", "batch_index": 3, "clinical_prompt": "I have nocturia, so I need to see a", "patient_prompt": "I'm up ten times a night peeing, so I need to see a", "intended_target": "urologist", "rationale": "The patient phrasing 'up ten times a night peeing' is colloquial description of excessive nighttime urination. 'Nocturia' is the clinical diagnosis. This shift elevates the perceived seriousness, making professional specialist consultation ('urologist') more probable than self-care responses.", "patient_term": "up ten times a night peeing", "clinical_term": "nocturia", "topic": "nocturia", "topics": [ "gynecology", "sexual medicine", "menopause", "infectious disease", "pharyngitis", "fever", "nocturia", "urinary tract infection", "genitourinary", "endocrine disorder", "hyperhidrosis", "thyroid disorder" ], "models": { "gemma-2-2b": { "prob_clinical": 0.326, "prob_patient": 0.22, "language_penalty": -0.10600000000000001, "anchor_fallback": false, "top_clinical": [ "uro", 0.326 ], "top_patient": [ "doctor", 0.412 ], "spread_clinical": [ [ "uro", 0.326 ], [ "doctor", 0.254 ], [ "specialist", 0.12 ], [ "doc", 0.044 ], [ "Uro", 0.039 ] ], "spread_patient": [ [ "doctor", 0.412 ], [ "uro", 0.22 ], [ "doc", 0.104 ], [ "specialist", 0.056 ], [ "Dr", 0.043 ] ], "target_token": "uro", "flipped": true, "screening": null, "circuit_diff": { "shared_features": 525, "unique_to_a": 811, "unique_to_b": 837 }, "clinical_mass": { "clinical": 0.3683, "patient": 0.2581, "translated": 0.3367 }, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": 2, "tier_shift": -0.196, "urgency_recovery": 0.203 } } }, "prob_clinical": 0.326, "prob_patient": 0.22, "language_penalty": -0.10600000000000001, "flipped": true, "top_clinical": [ "uro", 0.326 ], "top_patient": [ "doctor", 0.412 ], "spread_clinical": [ [ "uro", 0.326 ], [ "doctor", 0.254 ], [ "specialist", 0.12 ], [ "doc", 0.044 ], [ "Uro", 0.039 ] ], "spread_patient": [ [ "doctor", 0.412 ], [ "uro", 0.22 ], [ "doc", 0.104 ], [ "specialist", 0.056 ], [ "Dr", 0.043 ] ], "target_token": "uro", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 525, "unique_to_a": 811, "unique_to_b": 837 }, "clinical_mass": { "clinical": 0.3683, "patient": 0.2581, "translated": 0.3367 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260719T132706Z/index_03.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": 2, "tier_shift": -0.196, "urgency_recovery": 0.203 } }, { "index": 1122, "batch": "pairs_20260719T132706Z", "batch_index": 4, "clinical_prompt": "I have pyrexia, so my body is running a", "patient_prompt": "I've got a fever, so my body is running a", "intended_target": "temperature", "rationale": "While 'fever' is already semi-clinical, 'pyrexia' is the formal medical term for elevated body temperature. The clinical framing makes the continuation 'temperature' (a measurable clinical parameter) more likely than colloquial alternatives like 'course' or 'risk'.", "patient_term": "a fever", "clinical_term": "pyrexia", "topic": "fever", "topics": [ "gynecology", "sexual medicine", "menopause", "infectious disease", "pharyngitis", "fever", "nocturia", "urinary tract infection", "genitourinary", "endocrine disorder", "hyperhidrosis", "thyroid disorder" ], "models": { "gemma-2-2b": { "prob_clinical": 0.064, "prob_patient": 0.467, "language_penalty": 0.403, "anchor_fallback": false, "top_clinical": [ "fever", 0.535 ], "top_patient": [ "temperature", 0.467 ], "spread_clinical": [ [ "fever", 0.535 ], [ "little", 0.082 ], [ "high", 0.073 ], [ "temperature", 0.064 ], [ "higher", 0.064 ] ], "spread_patient": [ [ "temperature", 0.467 ], [ "little", 0.092 ], [ "high", 0.071 ], [ "low", 0.063 ], [ "fever", 0.034 ] ], "target_token": "temperature", "flipped": true, "screening": null, "circuit_diff": { "shared_features": 532, "unique_to_a": 907, "unique_to_b": 713 }, "clinical_mass": { "clinical": 0.2535, "patient": 0.2029, "translated": 0.2345 }, "html": "modes/simulated/pairs_20260719T132706Z/index_04.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } } }, "prob_clinical": 0.064, "prob_patient": 0.467, "language_penalty": 0.403, "flipped": true, "top_clinical": [ "fever", 0.535 ], "top_patient": [ "temperature", 0.467 ], "spread_clinical": [ [ "fever", 0.535 ], [ "little", 0.082 ], [ "high", 0.073 ], [ "temperature", 0.064 ], [ "higher", 0.064 ] ], "spread_patient": [ [ "temperature", 0.467 ], [ "little", 0.092 ], [ "high", 0.071 ], [ "low", 0.063 ], [ "fever", 0.034 ] ], "target_token": "temperature", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 532, "unique_to_a": 907, "unique_to_b": 713 }, "clinical_mass": { "clinical": 0.2535, "patient": 0.2029, "translated": 0.2345 }, "html": "modes/simulated/pairs_20260719T132706Z/index_04.html", "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260719T132706Z/index_04.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, { "index": 1123, "batch": "pairs_20260719T132706Z", "batch_index": 5, "clinical_prompt": "I can't stand the vasomotor symptoms, so I'm considering my", "patient_prompt": "I can't stand the heat flashes, so I'm considering my", "intended_target": "options", "rationale": "The colloquial phrase 'heat flashes' is a lay description of a hallmark menopause symptom. The clinical term 'vasomotor symptoms' refers to the same phenomenon in medical language. The clinical framing shifts continuations toward medical options like 'treatment' or 'medication' rather than coping strategies.", "patient_term": "heat flashes", "clinical_term": "vasomotor symptoms", "topic": "menopause", "topics": [ "gynecology", "sexual medicine", "menopause", "infectious disease", "pharyngitis", "fever", "nocturia", "urinary tract infection", "genitourinary", "endocrine disorder", "hyperhidrosis", "thyroid disorder" ], "models": { "gemma-2-2b": { "prob_clinical": 0.711, "prob_patient": 0.707, "language_penalty": -0.0040000000000000036, "anchor_fallback": false, "top_clinical": [ "options", 0.711 ], "top_patient": [ "options", 0.707 ], "spread_clinical": [ [ "options", 0.711 ], [ "next", 0.035 ], [ "treatment", 0.028 ], [ "choices", 0.017 ], [ "first", 0.017 ] ], "spread_patient": [ [ "options", 0.707 ], [ "first", 0.045 ], [ "next", 0.031 ], [ "choices", 0.015 ] ], "target_token": "options", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 821, "unique_to_a": 452, "unique_to_b": 440 }, "clinical_mass": { "clinical": 0.2198, "patient": 0.1066, "translated": 0.1775 } } }, "prob_clinical": 0.711, "prob_patient": 0.707, "language_penalty": -0.0040000000000000036, "flipped": false, "top_clinical": [ "options", 0.711 ], "top_patient": [ "options", 0.707 ], "spread_clinical": [ [ "options", 0.711 ], [ "next", 0.035 ], [ "treatment", 0.028 ], [ "choices", 0.017 ], [ "first", 0.017 ] ], "spread_patient": [ [ "options", 0.707 ], [ "first", 0.045 ], [ "next", 0.031 ], [ "choices", 0.015 ] ], "target_token": "options", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 821, "unique_to_a": 452, "unique_to_b": 440 }, "clinical_mass": { "clinical": 0.2198, "patient": 0.1066, "translated": 0.1775 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260719T132706Z/index_05.html" }, { "index": 1124, "batch": "pairs_20260719T132706Z", "batch_index": 7, "clinical_prompt": "I have irregular menstruation, so I need to see a", "patient_prompt": "My period is all over the place, so I need to see a", "intended_target": "gynecologist", "rationale": "Colloquial descriptor of menstrual irregularity versus clinical diagnosis. The frame naturally funnels toward a specialist name. A model should strongly prefer 'gynecologist' after the clinical phrasing.", "patient_term": "period is all over the place", "clinical_term": "irregular menstruation", "topic": "gynecology", "topics": [ "gynecology", "sexual medicine", "menopause", "infectious disease", "pharyngitis", "fever", "nocturia", "urinary tract infection", "genitourinary", "endocrine disorder", "hyperhidrosis", "thyroid disorder" ], "models": { "gemma-2-2b": { "prob_clinical": 0.24, "prob_patient": 0.098, "language_penalty": -0.142, "anchor_fallback": false, "top_clinical": [ "doctor", 0.449 ], "top_patient": [ "doctor", 0.438 ], "spread_clinical": [ [ "doctor", 0.449 ], [ "gyne", 0.24 ], [ "g", 0.061 ], [ "specialist", 0.054 ], [ "gy", 0.037 ] ], "spread_patient": [ [ "doctor", 0.438 ], [ "gyne", 0.098 ], [ "gy", 0.076 ], [ "specialist", 0.067 ], [ "new", 0.041 ] ], "target_token": "gyne", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 592, "unique_to_a": 575, "unique_to_b": 608 }, "clinical_mass": { "clinical": 0.418, "patient": 0.3424, "translated": 0.3971 }, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": 0.025, "urgency_recovery": 0.015 } } }, "prob_clinical": 0.24, "prob_patient": 0.098, "language_penalty": -0.142, "flipped": false, "top_clinical": [ "doctor", 0.449 ], "top_patient": [ "doctor", 0.438 ], "spread_clinical": [ [ "doctor", 0.449 ], [ "gyne", 0.24 ], [ "g", 0.061 ], [ "specialist", 0.054 ], [ "gy", 0.037 ] ], "spread_patient": [ [ "doctor", 0.438 ], [ "gyne", 0.098 ], [ "gy", 0.076 ], [ "specialist", 0.067 ], [ "new", 0.041 ] ], "target_token": "gyne", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 592, "unique_to_a": 575, "unique_to_b": 608 }, "clinical_mass": { "clinical": 0.418, "patient": 0.3424, "translated": 0.3971 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260719T132706Z/index_07.html", "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": 0.025, "urgency_recovery": 0.015 } }, { "index": 1125, "batch": "pairs_20260719T132706Z", "batch_index": 8, "clinical_prompt": "I have erectile dysfunction, so I should talk to my", "patient_prompt": "I can't get it up anymore, so I should talk to my", "intended_target": "doctor", "rationale": "Slang for erectile dysfunction versus clinical terminology. The possessive frame 'talk to my' strongly predicts a healthcare provider. Clinical phrasing should increase likelihood of seeking medical consultation.", "patient_term": "can't get it up", "clinical_term": "erectile dysfunction", "topic": "sexual medicine", "topics": [ "gynecology", "sexual medicine", "menopause", "infectious disease", "pharyngitis", "fever", "nocturia", "urinary tract infection", "genitourinary", "endocrine disorder", "hyperhidrosis", "thyroid disorder" ], "models": { "gemma-2-2b": { "prob_clinical": 0.711, "prob_patient": 0.531, "language_penalty": -0.17999999999999994, "anchor_fallback": false, "top_clinical": [ "doctor", 0.711 ], "top_patient": [ "doctor", 0.531 ], "spread_clinical": [ [ "doctor", 0.711 ], [ "partner", 0.031 ], [ "wife", 0.031 ], [ "GP", 0.028 ], [ "doc", 0.021 ] ], "spread_patient": [ [ "doctor", 0.531 ], [ "GP", 0.034 ], [ "wife", 0.034 ], [ "doc", 0.026 ], [ "therapist", 0.023 ] ], "target_token": "doctor", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 478, "unique_to_a": 580, "unique_to_b": 645 }, "clinical_mass": { "clinical": 0.3304, "patient": 0.1644, "translated": 0.3304 }, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": 0.009, "urgency_recovery": -0.009 } } }, "prob_clinical": 0.711, "prob_patient": 0.531, "language_penalty": -0.17999999999999994, "flipped": false, "top_clinical": [ "doctor", 0.711 ], "top_patient": [ "doctor", 0.531 ], "spread_clinical": [ [ "doctor", 0.711 ], [ "partner", 0.031 ], [ "wife", 0.031 ], [ "GP", 0.028 ], [ "doc", 0.021 ] ], "spread_patient": [ [ "doctor", 0.531 ], [ "GP", 0.034 ], [ "wife", 0.034 ], [ "doc", 0.026 ], [ "therapist", 0.023 ] ], "target_token": "doctor", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 478, "unique_to_a": 580, "unique_to_b": 645 }, "clinical_mass": { "clinical": 0.3304, "patient": 0.1644, "translated": 0.3304 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260719T132706Z/index_08.html", "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": 0.009, "urgency_recovery": -0.009 } }, { "index": 1126, "batch": "pairs_20260719T132706Z", "batch_index": 9, "clinical_prompt": "I have vasomotor symptoms, so I'm probably going through my", "patient_prompt": "I'm having night sweats constantly, so I'm probably going through my", "intended_target": "menopause", "rationale": "Patient's lay symptom description versus clinical term for menopausal phenomenon. Frame ends after possessive, naturally funneling toward 'menopause' as the most likely continuation in clinical context.", "patient_term": "night sweats", "clinical_term": "vasomotor symptoms", "topic": "menopause", "topics": [ "gynecology", "sexual medicine", "menopause", "infectious disease", "pharyngitis", "fever", "nocturia", "urinary tract infection", "genitourinary", "endocrine disorder", "hyperhidrosis", "thyroid disorder" ], "models": { "gemma-2-2b": { "prob_clinical": 0.209, "prob_patient": 0.092, "language_penalty": -0.11699999999999999, "anchor_fallback": false, "top_clinical": [ "menopause", 0.209 ], "top_patient": [ "menopause", 0.092 ], "spread_clinical": [ [ "menopause", 0.209 ], [ "period", 0.06 ], [ "worst", 0.047 ], [ "peri", 0.047 ], [ "first", 0.047 ] ], "spread_patient": [ [ "menopause", 0.092 ], [ "first", 0.092 ], [ "period", 0.081 ], [ "last", 0.049 ] ], "target_token": "menopause", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 731, "unique_to_a": 676, "unique_to_b": 768 }, "clinical_mass": { "clinical": 0.2898, "patient": 0.2376, "translated": 0.1878 } } }, "prob_clinical": 0.209, "prob_patient": 0.092, "language_penalty": -0.11699999999999999, "flipped": false, "top_clinical": [ "menopause", 0.209 ], "top_patient": [ "menopause", 0.092 ], "spread_clinical": [ [ "menopause", 0.209 ], [ "period", 0.06 ], [ "worst", 0.047 ], [ "peri", 0.047 ], [ "first", 0.047 ] ], "spread_patient": [ [ "menopause", 0.092 ], [ "first", 0.092 ], [ "period", 0.081 ], [ "last", 0.049 ] ], "target_token": "menopause", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 731, "unique_to_a": 676, "unique_to_b": 768 }, "clinical_mass": { "clinical": 0.2898, "patient": 0.2376, "translated": 0.1878 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260719T132706Z/index_09.html" }, { "index": 1127, "batch": "pairs_20260719T132706Z", "batch_index": 11, "clinical_prompt": "I keep getting recurrent urinary tract infections, so I should see a", "patient_prompt": "I keep getting these painful infections down below, so I should see a", "intended_target": "urologist", "rationale": "Euphemistic colloquial description versus clinical diagnosis. Frame naturally predicts a specialist title. Clinical phrasing should increase preference for 'urologist' over more generic providers.", "patient_term": "these painful infections down below", "clinical_term": "recurrent urinary tract infections", "topic": "urinary tract infection", "topics": [ "gynecology", "sexual medicine", "menopause", "infectious disease", "pharyngitis", "fever", "nocturia", "urinary tract infection", "genitourinary", "endocrine disorder", "hyperhidrosis", "thyroid disorder" ], "models": { "gemma-2-2b": { "prob_clinical": 0.379, "prob_patient": null, "language_penalty": null, "anchor_fallback": false, "top_clinical": [ "uro", 0.379 ], "top_patient": [ "doctor", 0.707 ], "spread_clinical": [ [ "uro", 0.379 ], [ "doctor", 0.379 ], [ "specialist", 0.084 ], [ "Uro", 0.031 ], [ "gyne", 0.019 ] ], "spread_patient": [ [ "doctor", 0.707 ], [ "gyne", 0.058 ], [ "doc", 0.035 ], [ "specialist", 0.027 ], [ "gy", 0.027 ] ], "target_token": "uro", "flipped": true, "screening": null, "circuit_diff": { "shared_features": 710, "unique_to_a": 468, "unique_to_b": 464 }, "clinical_mass": { "clinical": 0.4826, "patient": 0.4235, "translated": 0.4655 }, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": 2, "tier_shift": -0.146, "urgency_recovery": 0.047 } } }, "prob_clinical": 0.379, "prob_patient": null, "language_penalty": null, "flipped": true, "top_clinical": [ "uro", 0.379 ], "top_patient": [ "doctor", 0.707 ], "spread_clinical": [ [ "uro", 0.379 ], [ "doctor", 0.379 ], [ "specialist", 0.084 ], [ "Uro", 0.031 ], [ "gyne", 0.019 ] ], "spread_patient": [ [ "doctor", 0.707 ], [ "gyne", 0.058 ], [ "doc", 0.035 ], [ "specialist", 0.027 ], [ "gy", 0.027 ] ], "target_token": "uro", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 710, "unique_to_a": 468, "unique_to_b": 464 }, "clinical_mass": { "clinical": 0.4826, "patient": 0.4235, "translated": 0.4655 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260719T132706Z/index_11.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": 2, "tier_shift": -0.146, "urgency_recovery": 0.047 } }, { "index": 1128, "batch": "pairs_20260719T132706Z", "batch_index": 12, "clinical_prompt": "I have hyperhidrosis, so I should talk to my", "patient_prompt": "I'm drenched in sweat all day long, so I should talk to my", "intended_target": "dermatologist", "rationale": "Lay description emphasizes discomfort; clinical term signals systemic condition requiring specialist consultation. Frame naturally leads to specialist name after possessive.", "patient_term": "drenched in sweat all day long", "clinical_term": "hyperhidrosis", "topic": "hyperhidrosis", "topics": [ "gynecology", "sexual medicine", "menopause", "infectious disease", "pharyngitis", "fever", "nocturia", "urinary tract infection", "genitourinary", "endocrine disorder", "hyperhidrosis", "thyroid disorder" ], "models": { "gemma-2-2b": { "prob_clinical": 0.082, "prob_patient": 0.015, "language_penalty": -0.067, "anchor_fallback": false, "top_clinical": [ "doctor", 0.605 ], "top_patient": [ "doctor", 0.656 ], "spread_clinical": [ [ "doctor", 0.605 ], [ "doc", 0.093 ], [ "dermatologist", 0.082 ], [ "dr", 0.021 ], [ "GP", 0.021 ] ], "spread_patient": [ [ "doctor", 0.656 ], [ "boss", 0.037 ], [ "doc", 0.029 ], [ "GP", 0.025 ], [ "dermatologist", 0.015 ] ], "target_token": "dermatologist", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 530, "unique_to_a": 702, "unique_to_b": 704 }, "clinical_mass": { "clinical": 0.3632, "patient": 0.1938, "translated": 0.3543 }, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.079, "urgency_recovery": -0.021 } } }, "prob_clinical": 0.082, "prob_patient": 0.015, "language_penalty": -0.067, "flipped": false, "top_clinical": [ "doctor", 0.605 ], "top_patient": [ "doctor", 0.656 ], "spread_clinical": [ [ "doctor", 0.605 ], [ "doc", 0.093 ], [ "dermatologist", 0.082 ], [ "dr", 0.021 ], [ "GP", 0.021 ] ], "spread_patient": [ [ "doctor", 0.656 ], [ "boss", 0.037 ], [ "doc", 0.029 ], [ "GP", 0.025 ], [ "dermatologist", 0.015 ] ], "target_token": "dermatologist", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 530, "unique_to_a": 702, "unique_to_b": 704 }, "clinical_mass": { "clinical": 0.3632, "patient": 0.1938, "translated": 0.3543 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260719T132706Z/index_12.html", "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.079, "urgency_recovery": -0.021 } }, { "index": 1129, "batch": "pairs_20260719T132706Z", "batch_index": 13, "clinical_prompt": "I have a urinary tract infection, so I should see a", "patient_prompt": "I'm getting really itchy down there, so I should see a", "intended_target": "doctor", "rationale": "Patient symptom description is ambiguous; clinical diagnosis specifies infection requiring medical intervention. Frame drives toward 'doctor' as appropriate care-seeker response.", "patient_term": "really itchy down there", "clinical_term": "urinary tract infection", "topic": "urinary tract infection", "topics": [ "gynecology", "sexual medicine", "menopause", "infectious disease", "pharyngitis", "fever", "nocturia", "urinary tract infection", "genitourinary", "endocrine disorder", "hyperhidrosis", "thyroid disorder" ], "models": { "gemma-2-2b": { "prob_clinical": 0.617, "prob_patient": 0.613, "language_penalty": -0.0040000000000000036, "anchor_fallback": false, "top_clinical": [ "doctor", 0.617 ], "top_patient": [ "doctor", 0.613 ], "spread_clinical": [ [ "doctor", 0.617 ], [ "uro", 0.122 ], [ "specialist", 0.058 ], [ "doc", 0.027 ], [ "Dr", 0.016 ] ], "spread_patient": [ [ "doctor", 0.613 ], [ "dermatologist", 0.137 ], [ "doc", 0.065 ], [ "Dr", 0.031 ], [ "dr", 0.019 ] ], "target_token": "doctor", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 565, "unique_to_a": 565, "unique_to_b": 706 }, "clinical_mass": { "clinical": 0.4781, "patient": 0.3529, "translated": 0.4313 }, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": 0.078, "urgency_recovery": 0.639 } } }, "prob_clinical": 0.617, "prob_patient": 0.613, "language_penalty": -0.0040000000000000036, "flipped": false, "top_clinical": [ "doctor", 0.617 ], "top_patient": [ "doctor", 0.613 ], "spread_clinical": [ [ "doctor", 0.617 ], [ "uro", 0.122 ], [ "specialist", 0.058 ], [ "doc", 0.027 ], [ "Dr", 0.016 ] ], "spread_patient": [ [ "doctor", 0.613 ], [ "dermatologist", 0.137 ], [ "doc", 0.065 ], [ "Dr", 0.031 ], [ "dr", 0.019 ] ], "target_token": "doctor", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 565, "unique_to_a": 565, "unique_to_b": 706 }, "clinical_mass": { "clinical": 0.4781, "patient": 0.3529, "translated": 0.4313 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260719T132706Z/index_13.html", "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": 0.078, "urgency_recovery": 0.639 } }, { "index": 1130, "batch": "pairs_20260719T132706Z", "batch_index": 14, "clinical_prompt": "I have irregular menses, so I need to schedule an", "patient_prompt": "My woman parts are acting weird this month, so I need to schedule an", "intended_target": "appointment", "rationale": "Vague colloquial phrasing versus precise clinical description of menstrual irregularity. Frame grammatically funnels toward 'appointment' after 'an', distinguishing casual concern from medical scheduling.", "patient_term": "woman parts are acting weird", "clinical_term": "irregular menses", "topic": "gynecology", "topics": [ "gynecology", "sexual medicine", "menopause", "infectious disease", "pharyngitis", "fever", "nocturia", "urinary tract infection", "genitourinary", "endocrine disorder", "hyperhidrosis", "thyroid disorder" ], "models": { "gemma-2-2b": { "prob_clinical": 0.652, "prob_patient": 0.816, "language_penalty": 0.16399999999999992, "anchor_fallback": false, "top_clinical": [ "appointment", 0.652 ], "top_patient": [ "appointment", 0.816 ], "spread_clinical": [ [ "appointment", 0.652 ], [ "ultrasound", 0.129 ], [ "app", 0.042 ], [ "abortion", 0.022 ], [ "exam", 0.014 ] ], "spread_patient": [ [ "appointment", 0.816 ], [ "OB", 0.046 ], [ "exam", 0.031 ], [ "annual", 0.022 ], [ "app", 0.022 ] ], "target_token": "appointment", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 508, "unique_to_a": 857, "unique_to_b": 704 }, "clinical_mass": { "clinical": 0.3166, "patient": 0.2991, "translated": 0.3879 }, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": 0.05, "urgency_recovery": 0.101 } } }, "prob_clinical": 0.652, "prob_patient": 0.816, "language_penalty": 0.16399999999999992, "flipped": false, "top_clinical": [ "appointment", 0.652 ], "top_patient": [ "appointment", 0.816 ], "spread_clinical": [ [ "appointment", 0.652 ], [ "ultrasound", 0.129 ], [ "app", 0.042 ], [ "abortion", 0.022 ], [ "exam", 0.014 ] ], "spread_patient": [ [ "appointment", 0.816 ], [ "OB", 0.046 ], [ "exam", 0.031 ], [ "annual", 0.022 ], [ "app", 0.022 ] ], "target_token": "appointment", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 508, "unique_to_a": 857, "unique_to_b": 704 }, "clinical_mass": { "clinical": 0.3166, "patient": 0.2991, "translated": 0.3879 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260719T132706Z/index_14.html", "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": 0.05, "urgency_recovery": 0.101 } }, { "index": 1131, "batch": "pairs_20260719T132706Z", "batch_index": 15, "clinical_prompt": "I have nocturnal diaphoresis, so I probably need to see a", "patient_prompt": "I woke up soaking wet again last night, so I probably need to see a", "intended_target": "physician", "rationale": "Patient describes symptom colloquially; clinical term signals pathological night sweating warranting medical evaluation. Frame naturally completes with healthcare provider noun.", "patient_term": "soaking wet", "clinical_term": "nocturnal diaphoresis", "topic": "nocturia", "topics": [ "gynecology", "sexual medicine", "menopause", "infectious disease", "pharyngitis", "fever", "nocturia", "urinary tract infection", "genitourinary", "endocrine disorder", "hyperhidrosis", "thyroid disorder" ], "models": { "gemma-2-2b": { "prob_clinical": 0.385, "prob_patient": 0.793, "language_penalty": 0.40800000000000003, "anchor_fallback": true, "top_clinical": [ "doctor", 0.385 ], "top_patient": [ "doctor", 0.793 ], "spread_clinical": [ [ "doctor", 0.385 ], [ "dermatologist", 0.11 ], [ "sleep", 0.098 ], [ "neuro", 0.067 ], [ "doc", 0.067 ] ], "spread_patient": [ [ "doctor", 0.793 ], [ "specialist", 0.021 ], [ "doc", 0.019 ], [ "dermatologist", 0.013 ], [ "new", 0.013 ] ], "target_token": "doctor", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 536, "unique_to_a": 843, "unique_to_b": 686 }, "clinical_mass": { "clinical": 0.3841, "patient": 0.248, "translated": 0.3775 }, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.068, "urgency_recovery": 0.128 } } }, "prob_clinical": 0.385, "prob_patient": 0.793, "language_penalty": 0.40800000000000003, "flipped": false, "top_clinical": [ "doctor", 0.385 ], "top_patient": [ "doctor", 0.793 ], "spread_clinical": [ [ "doctor", 0.385 ], [ "dermatologist", 0.11 ], [ "sleep", 0.098 ], [ "neuro", 0.067 ], [ "doc", 0.067 ] ], "spread_patient": [ [ "doctor", 0.793 ], [ "specialist", 0.021 ], [ "doc", 0.019 ], [ "dermatologist", 0.013 ], [ "new", 0.013 ] ], "target_token": "doctor", "anchor_fallback": true, "screening": null, "circuit_diff": { "shared_features": 536, "unique_to_a": 843, "unique_to_b": 686 }, "clinical_mass": { "clinical": 0.3841, "patient": 0.248, "translated": 0.3775 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260719T132706Z/index_15.html", "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.068, "urgency_recovery": 0.128 } }, { "index": 1132, "batch": "pairs_20260719T132706Z", "batch_index": 16, "clinical_prompt": "I've been experiencing vasomotor symptoms at work, so I should probably take my", "patient_prompt": "I've been getting these hot flushes at work, so I should probably take my", "intended_target": "temperature", "rationale": "Vasomotor symptoms (clinical) vs. hot flushes (lay) in a workplace setting shifts the frame toward clinical monitoring rather than coping. The grammar 'take my' funnels toward 'temperature' (clinical measurement) or 'medication'.", "patient_term": "hot flushes", "clinical_term": "vasomotor symptoms", "topic": "menopause", "topics": [ "gynecology", "sexual medicine", "menopause", "infectious disease", "pharyngitis", "fever", "nocturia", "urinary tract infection", "genitourinary", "endocrine disorder", "hyperhidrosis", "thyroid disorder" ], "models": { "gemma-2-2b": { "prob_clinical": 0.154, "prob_patient": 0.087, "language_penalty": -0.067, "anchor_fallback": true, "top_clinical": [ "meds", 0.154 ], "top_patient": [ "HRT", 0.184 ], "spread_clinical": [ [ "meds", 0.154 ], [ "medication", 0.106 ], [ "medicine", 0.057 ], [ "HRT", 0.039 ], [ "blood", 0.034 ] ], "spread_patient": [ [ "HRT", 0.184 ], [ "meds", 0.087 ], [ "medication", 0.046 ], [ "blood", 0.041 ], [ "lunch", 0.025 ] ], "target_token": "meds", "flipped": true, "screening": null, "circuit_diff": { "shared_features": 722, "unique_to_a": 719, "unique_to_b": 784 }, "clinical_mass": { "clinical": 0.396, "patient": 0.2444 }, "urgency": { "flip_class": "uninformative", "tier_top_clinical": 1, "tier_top_patient": null, "tier_shift": -0.016, "urgency_recovery": 0.277 } } }, "prob_clinical": 0.154, "prob_patient": 0.087, "language_penalty": -0.067, "flipped": true, "top_clinical": [ "meds", 0.154 ], "top_patient": [ "HRT", 0.184 ], "spread_clinical": [ [ "meds", 0.154 ], [ "medication", 0.106 ], [ "medicine", 0.057 ], [ "HRT", 0.039 ], [ "blood", 0.034 ] ], "spread_patient": [ [ "HRT", 0.184 ], [ "meds", 0.087 ], [ "medication", 0.046 ], [ "blood", 0.041 ], [ "lunch", 0.025 ] ], "target_token": "meds", "anchor_fallback": true, "screening": null, "circuit_diff": { "shared_features": 722, "unique_to_a": 719, "unique_to_b": 784 }, "clinical_mass": { "clinical": 0.396, "patient": 0.2444 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260719T132706Z/index_16.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": 1, "tier_top_patient": null, "tier_shift": -0.016, "urgency_recovery": 0.277 } }, { "index": 1133, "batch": "pairs_20260719T132706Z", "batch_index": 17, "clinical_prompt": "I have vulvovaginitis, so I need to apply a", "patient_prompt": "My intimate area feels raw and irritated, so I need to apply a", "intended_target": "cream", "rationale": "The shift from lay symptom description to clinical diagnosis changes the expected topical intervention. 'Apply a' naturally funnels toward 'cream', a common gynecological treatment.", "patient_term": "intimate area feels raw and irritated", "clinical_term": "vulvovaginitis", "topic": "gynecology", "topics": [ "gynecology", "sexual medicine", "menopause", "infectious disease", "pharyngitis", "fever", "nocturia", "urinary tract infection", "genitourinary", "endocrine disorder", "hyperhidrosis", "thyroid disorder" ], "models": { "gemma-2-2b": { "prob_clinical": 0.16, "prob_patient": 0.132, "language_penalty": -0.027999999999999997, "anchor_fallback": false, "top_clinical": [ "cream", 0.16 ], "top_patient": [ "cream", 0.132 ], "spread_clinical": [ [ "cream", 0.16 ], [ "vaginal", 0.142 ], [ "lot", 0.046 ], [ "sup", 0.036 ], [ "topical", 0.028 ] ], "spread_patient": [ [ "cream", 0.132 ], [ "soothing", 0.08 ], [ "moisturizer", 0.07 ], [ "little", 0.038 ], [ "good", 0.029 ] ], "target_token": "cream", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 531, "unique_to_a": 778, "unique_to_b": 852 }, "clinical_mass": { "clinical": 0.39, "patient": 0.2992 }, "urgency": { "flip_class": null, "tier_top_clinical": 1, "tier_top_patient": 1, "tier_shift": 0.0, "urgency_recovery": 0.0 } } }, "prob_clinical": 0.16, "prob_patient": 0.132, "language_penalty": -0.027999999999999997, "flipped": false, "top_clinical": [ "cream", 0.16 ], "top_patient": [ "cream", 0.132 ], "spread_clinical": [ [ "cream", 0.16 ], [ "vaginal", 0.142 ], [ "lot", 0.046 ], [ "sup", 0.036 ], [ "topical", 0.028 ] ], "spread_patient": [ [ "cream", 0.132 ], [ "soothing", 0.08 ], [ "moisturizer", 0.07 ], [ "little", 0.038 ], [ "good", 0.029 ] ], "target_token": "cream", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 531, "unique_to_a": 778, "unique_to_b": 852 }, "clinical_mass": { "clinical": 0.39, "patient": 0.2992 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260719T132706Z/index_17.html", "urgency": { "flip_class": null, "tier_top_clinical": 1, "tier_top_patient": 1, "tier_shift": 0.0, "urgency_recovery": 0.0 } }, { "index": 1134, "batch": "pairs_20260719T132706Z", "batch_index": 18, "clinical_prompt": "I have nocturia, so I should ask my", "patient_prompt": "I'm running to the bathroom constantly at night, so I should ask my", "intended_target": "doctor", "rationale": "The clinical term nocturia reframes the symptom as a medical condition requiring specialist evaluation rather than a life inconvenience. 'Ask my' funnels toward a medical professional.", "patient_term": "running to the bathroom constantly at night", "clinical_term": "nocturia", "topic": "nocturia", "topics": [ "gynecology", "sexual medicine", "menopause", "infectious disease", "pharyngitis", "fever", "nocturia", "urinary tract infection", "genitourinary", "endocrine disorder", "hyperhidrosis", "thyroid disorder" ], "models": { "gemma-2-2b": { "prob_clinical": 0.445, "prob_patient": 0.455, "language_penalty": 0.010000000000000009, "anchor_fallback": false, "top_clinical": [ "doctor", 0.445 ], "top_patient": [ "doctor", 0.455 ], "spread_clinical": [ [ "doctor", 0.445 ], [ "uro", 0.145 ], [ "doc", 0.113 ], [ "GP", 0.053 ], [ "Dr", 0.032 ] ], "spread_patient": [ [ "doctor", 0.455 ], [ "doc", 0.079 ], [ "husband", 0.07 ], [ "OB", 0.042 ], [ "GP", 0.033 ] ], "target_token": "doctor", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 497, "unique_to_a": 793, "unique_to_b": 762 }, "clinical_mass": { "clinical": 0.3425, "patient": 0.1885, "translated": 0.3267 }, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.22 } } }, "prob_clinical": 0.445, "prob_patient": 0.455, "language_penalty": 0.010000000000000009, "flipped": false, "top_clinical": [ "doctor", 0.445 ], "top_patient": [ "doctor", 0.455 ], "spread_clinical": [ [ "doctor", 0.445 ], [ "uro", 0.145 ], [ "doc", 0.113 ], [ "GP", 0.053 ], [ "Dr", 0.032 ] ], "spread_patient": [ [ "doctor", 0.455 ], [ "doc", 0.079 ], [ "husband", 0.07 ], [ "OB", 0.042 ], [ "GP", 0.033 ] ], "target_token": "doctor", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 497, "unique_to_a": 793, "unique_to_b": 762 }, "clinical_mass": { "clinical": 0.3425, "patient": 0.1885, "translated": 0.3267 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260719T132706Z/index_18.html", "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.22 } }, { "index": 1135, "batch": "pairs_20260719T132706Z", "batch_index": 19, "clinical_prompt": "I have acute pharyngitis, so I'm taking an", "patient_prompt": "My throat feels like it's got razors in it, so I'm taking an", "intended_target": "antibiotic", "rationale": "The clinical diagnosis pharyngitis shifts expectations from pain management alone to specific antimicrobial therapy. 'Taking an' before a vowel-initial medication naturally funnels to 'antibiotic'.", "patient_term": "feels like it's got razors in it", "clinical_term": "acute pharyngitis", "topic": "pharyngitis", "topics": [ "gynecology", "sexual medicine", "menopause", "infectious disease", "pharyngitis", "fever", "nocturia", "urinary tract infection", "genitourinary", "endocrine disorder", "hyperhidrosis", "thyroid disorder" ], "models": { "gemma-2-2b": { "prob_clinical": 0.641, "prob_patient": 0.094, "language_penalty": -0.547, "anchor_fallback": false, "top_clinical": [ "antibiotic", 0.641 ], "top_patient": [ "extra", 0.137 ], "spread_clinical": [ [ "antibiotic", 0.641 ], [ "anti", 0.098 ], [ "oral", 0.06 ], [ "over", 0.032 ], [ "antibiotics", 0.017 ] ], "spread_patient": [ [ "extra", 0.137 ], [ "Ad", 0.107 ], [ "anti", 0.094 ], [ "hour", 0.073 ], [ "aspirin", 0.05 ] ], "target_token": "antibiotic", "flipped": true, "screening": null, "circuit_diff": { "shared_features": 520, "unique_to_a": 682, "unique_to_b": 760 }, "clinical_mass": { "clinical": 0.4821, "patient": 0.2762, "translated": 0.3594 }, "html": "modes/simulated/pairs_20260719T132706Z/index_19.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": 2, "tier_top_patient": null, "tier_shift": -0.831 } } }, "prob_clinical": 0.641, "prob_patient": 0.094, "language_penalty": -0.547, "flipped": true, "top_clinical": [ "antibiotic", 0.641 ], "top_patient": [ "extra", 0.137 ], "spread_clinical": [ [ "antibiotic", 0.641 ], [ "anti", 0.098 ], [ "oral", 0.06 ], [ "over", 0.032 ], [ "antibiotics", 0.017 ] ], "spread_patient": [ [ "extra", 0.137 ], [ "Ad", 0.107 ], [ "anti", 0.094 ], [ "hour", 0.073 ], [ "aspirin", 0.05 ] ], "target_token": "antibiotic", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 520, "unique_to_a": 682, "unique_to_b": 760 }, "clinical_mass": { "clinical": 0.4821, "patient": 0.2762, "translated": 0.3594 }, "html": "modes/simulated/pairs_20260719T132706Z/index_19.html", "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260719T132706Z/index_19.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": 2, "tier_top_patient": null, "tier_shift": -0.831 } }, { "index": 1136, "batch": "pairs_20260719T132706Z", "batch_index": 20, "clinical_prompt": "I've been experiencing nocturnal hyperhidrosis, so I probably need to check my", "patient_prompt": "I've been getting these awful night sweats, so I probably need to check my", "intended_target": "thyroid", "rationale": "Night sweats can indicate thyroid disorder or menopause, but nocturnal hyperhidrosis as a clinical term specifically prompts consideration of systemic endocrine causes. The frame 'need to check my' naturally leads to an organ/system; thyroid is a high-frequency next token for this clinical phrasing.", "patient_term": "awful night sweats", "clinical_term": "nocturnal hyperhidrosis", "topic": "hyperhidrosis", "topics": [ "gynecology", "sexual medicine", "menopause", "infectious disease", "pharyngitis", "fever", "nocturia", "urinary tract infection", "genitourinary", "endocrine disorder", "hyperhidrosis", "thyroid disorder" ], "models": { "gemma-2-2b": { "prob_clinical": 0.129, "prob_patient": 0.264, "language_penalty": 0.135, "anchor_fallback": false, "top_clinical": [ "thyroid", 0.129 ], "top_patient": [ "thyroid", 0.264 ], "spread_clinical": [ [ "thyroid", 0.129 ], [ "blood", 0.079 ], [ "sweat", 0.069 ], [ "diet", 0.029 ], [ "heart", 0.025 ] ], "spread_patient": [ [ "thyroid", 0.264 ], [ "blood", 0.232 ], [ "iron", 0.067 ], [ "hormones", 0.059 ], [ "testosterone", 0.052 ] ], "target_token": "thyroid", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 748, "unique_to_a": 771, "unique_to_b": 802 }, "clinical_mass": { "clinical": 0.3155, "patient": 0.3126, "translated": 0.3596 }, "urgency": { "flip_class": null, "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": 0.537 } } }, "prob_clinical": 0.129, "prob_patient": 0.264, "language_penalty": 0.135, "flipped": false, "top_clinical": [ "thyroid", 0.129 ], "top_patient": [ "thyroid", 0.264 ], "spread_clinical": [ [ "thyroid", 0.129 ], [ "blood", 0.079 ], [ "sweat", 0.069 ], [ "diet", 0.029 ], [ "heart", 0.025 ] ], "spread_patient": [ [ "thyroid", 0.264 ], [ "blood", 0.232 ], [ "iron", 0.067 ], [ "hormones", 0.059 ], [ "testosterone", 0.052 ] ], "target_token": "thyroid", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 748, "unique_to_a": 771, "unique_to_b": 802 }, "clinical_mass": { "clinical": 0.3155, "patient": 0.3126, "translated": 0.3596 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260719T132706Z/index_20.html", "urgency": { "flip_class": null, "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": 0.537 } }, { "index": 1137, "batch": "pairs_20260719T132706Z", "batch_index": 21, "clinical_prompt": "I have stress urinary incontinence, so I should probably talk to my", "patient_prompt": "I keep leaking a bit when I cough, so I should probably talk to my", "intended_target": "doctor", "rationale": "The colloquial frame suggests a minor, embarrassing issue; the clinical term flags a recognized condition requiring medical evaluation. The frame 'talk to my' + clinically-framed condition strongly predicts 'doctor' as the next token.", "patient_term": "leaking a bit when I cough", "clinical_term": "stress urinary incontinence", "topic": "urinary tract infection", "topics": [ "gynecology", "sexual medicine", "menopause", "infectious disease", "pharyngitis", "fever", "nocturia", "urinary tract infection", "genitourinary", "endocrine disorder", "hyperhidrosis", "thyroid disorder" ], "models": { "gemma-2-2b": { "prob_clinical": 0.508, "prob_patient": 0.516, "language_penalty": 0.008000000000000007, "anchor_fallback": false, "top_clinical": [ "doctor", 0.508 ], "top_patient": [ "doctor", 0.516 ], "spread_clinical": [ [ "doctor", 0.508 ], [ "uro", 0.1 ], [ "doc", 0.061 ], [ "GP", 0.053 ], [ "Dr", 0.029 ] ], "spread_patient": [ [ "doctor", 0.516 ], [ "doc", 0.102 ], [ "GP", 0.09 ], [ "OB", 0.023 ], [ "dr", 0.023 ] ], "target_token": "doctor", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 645, "unique_to_a": 546, "unique_to_b": 552 }, "clinical_mass": { "clinical": 0.3832, "patient": 0.3081, "translated": 0.3931 }, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": 0.0 } } }, "prob_clinical": 0.508, "prob_patient": 0.516, "language_penalty": 0.008000000000000007, "flipped": false, "top_clinical": [ "doctor", 0.508 ], "top_patient": [ "doctor", 0.516 ], "spread_clinical": [ [ "doctor", 0.508 ], [ "uro", 0.1 ], [ "doc", 0.061 ], [ "GP", 0.053 ], [ "Dr", 0.029 ] ], "spread_patient": [ [ "doctor", 0.516 ], [ "doc", 0.102 ], [ "GP", 0.09 ], [ "OB", 0.023 ], [ "dr", 0.023 ] ], "target_token": "doctor", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 645, "unique_to_a": 546, "unique_to_b": 552 }, "clinical_mass": { "clinical": 0.3832, "patient": 0.3081, "translated": 0.3931 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260719T132706Z/index_21.html", "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": 0.0 } }, { "index": 1138, "batch": "pairs_20260719T132706Z", "batch_index": 23, "clinical_prompt": "I'm experiencing nocturia, so I probably need to take an", "patient_prompt": "I keep waking up to pee multiple times, so I probably need to take an", "intended_target": "antibiotic", "rationale": "Colloquial phrasing describes symptom; clinical term invokes diagnostic thinking. The frame 'need to take an' + clinical diagnosis of nocturia directs toward treatment; antibiotic is a high-frequency next token when nocturia is suspected to be infection-related (UTI).", "patient_term": "waking up to pee multiple times", "clinical_term": "nocturia", "topic": "nocturia", "topics": [ "gynecology", "sexual medicine", "menopause", "infectious disease", "pharyngitis", "fever", "nocturia", "urinary tract infection", "genitourinary", "endocrine disorder", "hyperhidrosis", "thyroid disorder" ], "models": { "gemma-2-2b": { "prob_clinical": 0.21, "prob_patient": 0.105, "language_penalty": -0.105, "anchor_fallback": false, "top_clinical": [ "over", 0.21 ], "top_patient": [ "over", 0.135 ], "spread_clinical": [ [ "over", 0.21 ], [ "anti", 0.21 ], [ "extra", 0.06 ], [ "alpha", 0.041 ], [ "en", 0.036 ] ], "spread_patient": [ [ "over", 0.135 ], [ "extra", 0.119 ], [ "anti", 0.105 ], [ "early", 0.064 ], [ "alarm", 0.056 ] ], "target_token": "anti", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 716, "unique_to_a": 689, "unique_to_b": 584 }, "clinical_mass": { "clinical": 0.3131, "patient": 0.2257, "translated": 0.2524 }, "urgency": { "flip_class": null, "tier_top_clinical": 1, "tier_top_patient": 1, "tier_shift": -0.189 } } }, "prob_clinical": 0.21, "prob_patient": 0.105, "language_penalty": -0.105, "flipped": false, "top_clinical": [ "over", 0.21 ], "top_patient": [ "over", 0.135 ], "spread_clinical": [ [ "over", 0.21 ], [ "anti", 0.21 ], [ "extra", 0.06 ], [ "alpha", 0.041 ], [ "en", 0.036 ] ], "spread_patient": [ [ "over", 0.135 ], [ "extra", 0.119 ], [ "anti", 0.105 ], [ "early", 0.064 ], [ "alarm", 0.056 ] ], "target_token": "anti", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 716, "unique_to_a": 689, "unique_to_b": 584 }, "clinical_mass": { "clinical": 0.3131, "patient": 0.2257, "translated": 0.2524 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260719T132706Z/index_23.html", "urgency": { "flip_class": null, "tier_top_clinical": 1, "tier_top_patient": 1, "tier_shift": -0.189 } }, { "index": 1139, "batch": "pairs_20260719T132706Z", "batch_index": 24, "clinical_prompt": "I have erectile dysfunction, so I should probably take my", "patient_prompt": "I'm having trouble down there, so I should probably take my", "intended_target": "medication", "rationale": "The clinical term 'erectile dysfunction' establishes a medical context where pharmaceutical intervention is expected; the colloquial phrase is vague and could apply to many situations. The frame ending with 'take my' strongly funnels toward a singular medical remedy.", "patient_term": "trouble down there", "clinical_term": "erectile dysfunction", "topic": "sexual medicine", "topics": [ "gynecology", "sexual medicine", "menopause", "infectious disease", "pharyngitis", "fever", "nocturia", "urinary tract infection", "genitourinary", "endocrine disorder", "hyperhidrosis", "thyroid disorder" ], "models": { "gemma-2-2b": { "prob_clinical": 0.08, "prob_patient": null, "language_penalty": null, "anchor_fallback": false, "top_clinical": [ "meds", 0.116 ], "top_patient": [ "own", 0.301 ], "spread_clinical": [ [ "meds", 0.116 ], [ "medicine", 0.09 ], [ "medication", 0.08 ], [ "own", 0.048 ], [ "wife", 0.048 ] ], "spread_patient": [ [ "own", 0.301 ], [ "meds", 0.067 ], [ "pants", 0.046 ], [ "medicine", 0.036 ], [ "wife", 0.036 ] ], "target_token": "medication", "flipped": true, "screening": null, "circuit_diff": { "shared_features": 580, "unique_to_a": 604, "unique_to_b": 736 }, "clinical_mass": { "clinical": 0.2796, "patient": 0.1075, "translated": 0.1949 }, "urgency": { "flip_class": "uninformative", "tier_top_clinical": 1, "tier_top_patient": null, "tier_shift": null } } }, "prob_clinical": 0.08, "prob_patient": null, "language_penalty": null, "flipped": true, "top_clinical": [ "meds", 0.116 ], "top_patient": [ "own", 0.301 ], "spread_clinical": [ [ "meds", 0.116 ], [ "medicine", 0.09 ], [ "medication", 0.08 ], [ "own", 0.048 ], [ "wife", 0.048 ] ], "spread_patient": [ [ "own", 0.301 ], [ "meds", 0.067 ], [ "pants", 0.046 ], [ "medicine", 0.036 ], [ "wife", 0.036 ] ], "target_token": "medication", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 580, "unique_to_a": 604, "unique_to_b": 736 }, "clinical_mass": { "clinical": 0.2796, "patient": 0.1075, "translated": 0.1949 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260719T132706Z/index_24.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": 1, "tier_top_patient": null, "tier_shift": null } }, { "index": 1140, "batch": "pairs_20260719T132706Z", "batch_index": 25, "clinical_prompt": "I have bacterial vaginosis, so I need to see a", "patient_prompt": "I've been getting these weird discharge problems, so I need to see a", "intended_target": "gynecologist", "rationale": "The specific diagnosis 'bacterial vaginosis' signals a gynecological condition requiring specialist evaluation; the vague colloquial phrase doesn't establish medical urgency. The frame 'so I need to see a' naturally predicts a specialist.", "patient_term": "discharge problems", "clinical_term": "bacterial vaginosis", "topic": "gynecology", "topics": [ "gynecology", "sexual medicine", "menopause", "infectious disease", "pharyngitis", "fever", "nocturia", "urinary tract infection", "genitourinary", "endocrine disorder", "hyperhidrosis", "thyroid disorder" ], "models": { "gemma-2-2b": { "prob_clinical": 0.148, "prob_patient": 0.134, "language_penalty": -0.013999999999999985, "anchor_fallback": false, "top_clinical": [ "doctor", 0.404 ], "top_patient": [ "doctor", 0.41 ], "spread_clinical": [ [ "doctor", 0.404 ], [ "gyne", 0.148 ], [ "gy", 0.102 ], [ "specialist", 0.09 ], [ "gyn", 0.029 ] ], "spread_patient": [ [ "doctor", 0.41 ], [ "gyne", 0.134 ], [ "gy", 0.081 ], [ "specialist", 0.056 ], [ "uro", 0.049 ] ], "target_token": "gyne", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 572, "unique_to_a": 679, "unique_to_b": 702 }, "clinical_mass": { "clinical": 0.4626, "patient": 0.3743, "translated": 0.4476 }, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.062, "urgency_recovery": -0.045 } } }, "prob_clinical": 0.148, "prob_patient": 0.134, "language_penalty": -0.013999999999999985, "flipped": false, "top_clinical": [ "doctor", 0.404 ], "top_patient": [ "doctor", 0.41 ], "spread_clinical": [ [ "doctor", 0.404 ], [ "gyne", 0.148 ], [ "gy", 0.102 ], [ "specialist", 0.09 ], [ "gyn", 0.029 ] ], "spread_patient": [ [ "doctor", 0.41 ], [ "gyne", 0.134 ], [ "gy", 0.081 ], [ "specialist", 0.056 ], [ "uro", 0.049 ] ], "target_token": "gyne", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 572, "unique_to_a": 679, "unique_to_b": 702 }, "clinical_mass": { "clinical": 0.4626, "patient": 0.3743, "translated": 0.4476 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260719T132706Z/index_25.html", "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.062, "urgency_recovery": -0.045 } }, { "index": 1141, "batch": "pairs_20260719T132706Z", "batch_index": 26, "clinical_prompt": "I have nocturia, so I probably have", "patient_prompt": "I'm always running to the bathroom to urinate at night, so I probably have", "intended_target": "a", "rationale": "Replacing the symptom description with the clinical diagnosis shifts context from symptom narration to disease state discussion. The frame 'so I probably have' funnels toward an indefinite article preceding a clinical descriptor or condition name.", "patient_term": "running to the bathroom to urinate at night", "clinical_term": "nocturia", "topic": "nocturia", "topics": [ "gynecology", "sexual medicine", "menopause", "infectious disease", "pharyngitis", "fever", "nocturia", "urinary tract infection", "genitourinary", "endocrine disorder", "hyperhidrosis", "thyroid disorder" ], "models": { "gemma-2-2b": { "prob_clinical": 0.235, "prob_patient": 0.247, "language_penalty": 0.01200000000000001, "anchor_fallback": false, "top_clinical": [ "a", 0.235 ], "top_patient": [ "to", 0.279 ], "spread_clinical": [ [ "a", 0.235 ], [ "to", 0.208 ], [ "an", 0.067 ], [ "the", 0.052 ], [ "more", 0.041 ] ], "spread_patient": [ [ "to", 0.279 ], [ "a", 0.247 ], [ "an", 0.062 ], [ "some", 0.038 ], [ "the", 0.03 ] ], "target_token": "a", "flipped": true, "screening": null, "circuit_diff": { "shared_features": 664, "unique_to_a": 641, "unique_to_b": 679 }, "clinical_mass": { "clinical": 0.3095, "patient": 0.2427, "translated": 0.3349 }, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } } }, "prob_clinical": 0.235, "prob_patient": 0.247, "language_penalty": 0.01200000000000001, "flipped": true, "top_clinical": [ "a", 0.235 ], "top_patient": [ "to", 0.279 ], "spread_clinical": [ [ "a", 0.235 ], [ "to", 0.208 ], [ "an", 0.067 ], [ "the", 0.052 ], [ "more", 0.041 ] ], "spread_patient": [ [ "to", 0.279 ], [ "a", 0.247 ], [ "an", 0.062 ], [ "some", 0.038 ], [ "the", 0.03 ] ], "target_token": "a", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 664, "unique_to_a": 641, "unique_to_b": 679 }, "clinical_mass": { "clinical": 0.3095, "patient": 0.2427, "translated": 0.3349 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260719T132706Z/index_26.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, { "index": 1142, "batch": "pairs_20260719T132706Z", "batch_index": 27, "clinical_prompt": "I have acute pharyngitis, so I'm probably getting a", "patient_prompt": "My throat feels really raw and scratchy, so I'm probably getting a", "intended_target": "fever", "rationale": "The clinical term 'acute pharyngitis' emphasizes infectious disease trajectory; the colloquial description could be dismissed as minor irritation. The frame 'so I'm probably getting a' predicts a common symptom complication in pharyngitis cases.", "patient_term": "throat feels really raw and scratchy", "clinical_term": "acute pharyngitis", "topic": "pharyngitis", "topics": [ "gynecology", "sexual medicine", "menopause", "infectious disease", "pharyngitis", "fever", "nocturia", "urinary tract infection", "genitourinary", "endocrine disorder", "hyperhidrosis", "thyroid disorder" ], "models": { "gemma-2-2b": { "prob_clinical": 0.173, "prob_patient": 0.111, "language_penalty": -0.061999999999999986, "anchor_fallback": true, "top_clinical": [ "sore", 0.173 ], "top_patient": [ "cold", 0.641 ], "spread_clinical": [ [ "sore", 0.173 ], [ "little", 0.152 ], [ "bit", 0.092 ], [ "lot", 0.082 ], [ "cold", 0.082 ] ], "spread_patient": [ [ "cold", 0.641 ], [ "sore", 0.111 ], [ "little", 0.025 ], [ "bit", 0.025 ], [ "head", 0.019 ] ], "target_token": "sore", "flipped": true, "screening": null, "circuit_diff": { "shared_features": 583, "unique_to_a": 781, "unique_to_b": 718 }, "clinical_mass": { "clinical": 0.3547, "patient": 0.3345, "translated": 0.4209 }, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } } }, "prob_clinical": 0.173, "prob_patient": 0.111, "language_penalty": -0.061999999999999986, "flipped": true, "top_clinical": [ "sore", 0.173 ], "top_patient": [ "cold", 0.641 ], "spread_clinical": [ [ "sore", 0.173 ], [ "little", 0.152 ], [ "bit", 0.092 ], [ "lot", 0.082 ], [ "cold", 0.082 ] ], "spread_patient": [ [ "cold", 0.641 ], [ "sore", 0.111 ], [ "little", 0.025 ], [ "bit", 0.025 ], [ "head", 0.019 ] ], "target_token": "sore", "anchor_fallback": true, "screening": null, "circuit_diff": { "shared_features": 583, "unique_to_a": 781, "unique_to_b": 718 }, "clinical_mass": { "clinical": 0.3547, "patient": 0.3345, "translated": 0.4209 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260719T132706Z/index_27.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, { "index": 1143, "batch": "pairs_20260719T132706Z", "batch_index": 28, "clinical_prompt": "I have hyperhidrosis, so I should probably get my", "patient_prompt": "I've been sweating way more than usual lately, so I should probably get my", "intended_target": "thyroid", "rationale": "The clinical diagnosis 'hyperhidrosis' triggers investigation into endocrine causes; the lay description is mere observation. The frame 'so I should probably get my' naturally anticipates a body system or gland for evaluation.", "patient_term": "sweating way more than usual", "clinical_term": "hyperhidrosis", "topic": "hyperhidrosis", "topics": [ "gynecology", "sexual medicine", "menopause", "infectious disease", "pharyngitis", "fever", "nocturia", "urinary tract infection", "genitourinary", "endocrine disorder", "hyperhidrosis", "thyroid disorder" ], "models": { "gemma-2-2b": { "prob_clinical": 0.215, "prob_patient": null, "language_penalty": null, "anchor_fallback": true, "top_clinical": [ "hands", 0.215 ], "top_patient": [ "blood", 0.258 ], "spread_clinical": [ [ "hands", 0.215 ], [ "own", 0.168 ], [ "sweat", 0.102 ], [ "feet", 0.042 ], [ "money", 0.026 ] ], "spread_patient": [ [ "blood", 0.258 ], [ "body", 0.065 ], [ "heart", 0.057 ], [ "sweat", 0.04 ], [ "doctor", 0.035 ] ], "target_token": "hands", "flipped": true, "screening": null, "circuit_diff": { "shared_features": 605, "unique_to_a": 795, "unique_to_b": 866 }, "clinical_mass": { "clinical": 0.2107, "patient": 0.1689, "translated": 0.2524 }, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": 2, "tier_shift": null } } }, "prob_clinical": 0.215, "prob_patient": null, "language_penalty": null, "flipped": true, "top_clinical": [ "hands", 0.215 ], "top_patient": [ "blood", 0.258 ], "spread_clinical": [ [ "hands", 0.215 ], [ "own", 0.168 ], [ "sweat", 0.102 ], [ "feet", 0.042 ], [ "money", 0.026 ] ], "spread_patient": [ [ "blood", 0.258 ], [ "body", 0.065 ], [ "heart", 0.057 ], [ "sweat", 0.04 ], [ "doctor", 0.035 ] ], "target_token": "hands", "anchor_fallback": true, "screening": null, "circuit_diff": { "shared_features": 605, "unique_to_a": 795, "unique_to_b": 866 }, "clinical_mass": { "clinical": 0.2107, "patient": 0.1689, "translated": 0.2524 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260719T132706Z/index_28.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": 2, "tier_shift": null } }, { "index": 1144, "batch": "pairs_20260719T132706Z", "batch_index": 29, "clinical_prompt": "I have persistent pyrexia, so I need to take an", "patient_prompt": "I've been running a temperature all week, so I need to take an", "intended_target": "antibiotic", "rationale": "The clinical term 'persistent pyrexia' suggests infectious etiology and need for antimicrobial therapy; colloquial 'running a temperature' sounds self-limiting. The frame 'so I need to take an' before a vowel-initial word strongly funnels toward medication names.", "patient_term": "running a temperature", "clinical_term": "persistent pyrexia", "topic": "fever", "topics": [ "gynecology", "sexual medicine", "menopause", "infectious disease", "pharyngitis", "fever", "nocturia", "urinary tract infection", "genitourinary", "endocrine disorder", "hyperhidrosis", "thyroid disorder" ], "models": { "gemma-2-2b": { "prob_clinical": 0.428, "prob_patient": 0.244, "language_penalty": -0.184, "anchor_fallback": false, "top_clinical": [ "anti", 0.428 ], "top_patient": [ "antibiotic", 0.244 ], "spread_clinical": [ [ "anti", 0.428 ], [ "antibiotic", 0.202 ], [ "oral", 0.058 ], [ "aspirin", 0.045 ], [ "NSA", 0.031 ] ], "spread_patient": [ [ "antibiotic", 0.244 ], [ "anti", 0.102 ], [ "extra", 0.102 ], [ "aspirin", 0.08 ], [ "early", 0.038 ] ], "target_token": "anti", "flipped": true, "screening": null, "circuit_diff": { "shared_features": 421, "unique_to_a": 1062, "unique_to_b": 861 }, "clinical_mass": { "clinical": 0.3818, "patient": 0.2193, "translated": 0.2741 }, "html": "modes/simulated/pairs_20260719T132706Z/index_29.html", "urgency": { "flip_class": "upgrade", "tier_top_clinical": 1, "tier_top_patient": 2, "tier_shift": 0.287, "urgency_recovery": -0.285 } } }, "prob_clinical": 0.428, "prob_patient": 0.244, "language_penalty": -0.184, "flipped": true, "top_clinical": [ "anti", 0.428 ], "top_patient": [ "antibiotic", 0.244 ], "spread_clinical": [ [ "anti", 0.428 ], [ "antibiotic", 0.202 ], [ "oral", 0.058 ], [ "aspirin", 0.045 ], [ "NSA", 0.031 ] ], "spread_patient": [ [ "antibiotic", 0.244 ], [ "anti", 0.102 ], [ "extra", 0.102 ], [ "aspirin", 0.08 ], [ "early", 0.038 ] ], "target_token": "anti", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 421, "unique_to_a": 1062, "unique_to_b": 861 }, "clinical_mass": { "clinical": 0.3818, "patient": 0.2193, "translated": 0.2741 }, "html": "modes/simulated/pairs_20260719T132706Z/index_29.html", "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260719T132706Z/index_29.html", "urgency": { "flip_class": "upgrade", "tier_top_clinical": 1, "tier_top_patient": 2, "tier_shift": 0.287, "urgency_recovery": -0.285 } }, { "index": 1145, "batch": "pairs_20260719T132706Z", "batch_index": 30, "clinical_prompt": "I've been getting these awful itches in my vulva, so my doctor wants to check my", "patient_prompt": "I've been getting these awful itches down below, so my doctor wants to check my", "intended_target": "pH", "rationale": "Precise anatomical terminology (vulva) versus euphemistic lay phrasing creates context for diagnostic testing language; pH testing is standard for vulvitis.", "patient_term": "down below", "clinical_term": "vulva", "topic": "gynecology", "topics": [ "gynecology", "sexual medicine", "menopause", "infectious disease", "pharyngitis", "fever", "nocturia", "urinary tract infection", "genitourinary", "endocrine disorder", "hyperhidrosis", "thyroid disorder" ], "models": { "gemma-2-2b": { "prob_clinical": 0.092, "prob_patient": null, "language_penalty": null, "anchor_fallback": true, "top_clinical": [ "vul", 0.092 ], "top_patient": [ "thyroid", 0.137 ], "spread_clinical": [ [ "vul", 0.092 ], [ "blood", 0.072 ], [ "cervix", 0.063 ], [ "vagina", 0.056 ], [ "pap", 0.049 ] ], "spread_patient": [ [ "thyroid", 0.137 ], [ "blood", 0.106 ], [ "lymph", 0.05 ], [ "cervix", 0.044 ], [ "prostate", 0.044 ] ], "target_token": "vul", "flipped": true, "screening": null, "circuit_diff": { "shared_features": 1186, "unique_to_a": 366, "unique_to_b": 397 }, "clinical_mass": { "clinical": 0.4287, "patient": 0.3944, "translated": 0.4888 }, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } } }, "prob_clinical": 0.092, "prob_patient": null, "language_penalty": null, "flipped": true, "top_clinical": [ "vul", 0.092 ], "top_patient": [ "thyroid", 0.137 ], "spread_clinical": [ [ "vul", 0.092 ], [ "blood", 0.072 ], [ "cervix", 0.063 ], [ "vagina", 0.056 ], [ "pap", 0.049 ] ], "spread_patient": [ [ "thyroid", 0.137 ], [ "blood", 0.106 ], [ "lymph", 0.05 ], [ "cervix", 0.044 ], [ "prostate", 0.044 ] ], "target_token": "vul", "anchor_fallback": true, "screening": null, "circuit_diff": { "shared_features": 1186, "unique_to_a": 366, "unique_to_b": 397 }, "clinical_mass": { "clinical": 0.4287, "patient": 0.3944, "translated": 0.4888 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260719T132706Z/index_30.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, { "index": 1146, "batch": "pairs_20260719T132706Z", "batch_index": 31, "clinical_prompt": "I'm experiencing nocturnal hyperhidrosis, so I probably need my", "patient_prompt": "I'm sweating through my sheets every single night, so I probably need my", "intended_target": "thyroid", "rationale": "Clinical term (nocturnal hyperhidrosis) frames the symptom as potentially pathological, inviting endocrine workup; colloquial version reads as complaint.", "patient_term": "sweating through my sheets every single night", "clinical_term": "nocturnal hyperhidrosis", "topic": "hyperhidrosis", "topics": [ "gynecology", "sexual medicine", "menopause", "infectious disease", "pharyngitis", "fever", "nocturia", "urinary tract infection", "genitourinary", "endocrine disorder", "hyperhidrosis", "thyroid disorder" ], "models": { "gemma-2-2b": { "prob_clinical": 0.328, "prob_patient": 0.275, "language_penalty": -0.05299999999999999, "anchor_fallback": true, "top_clinical": [ "own", 0.328 ], "top_patient": [ "own", 0.275 ], "spread_clinical": [ [ "own", 0.328 ], [ "sweat", 0.044 ], [ "hands", 0.039 ], [ "shirt", 0.027 ], [ "under", 0.024 ] ], "spread_patient": [ [ "own", 0.275 ], [ "mattress", 0.079 ], [ "air", 0.062 ], [ "bed", 0.048 ], [ "sleep", 0.042 ] ], "target_token": "own", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 718, "unique_to_a": 696, "unique_to_b": 660 }, "clinical_mass": { "clinical": 0.1828, "patient": 0.0883, "translated": 0.2168 } } }, "prob_clinical": 0.328, "prob_patient": 0.275, "language_penalty": -0.05299999999999999, "flipped": false, "top_clinical": [ "own", 0.328 ], "top_patient": [ "own", 0.275 ], "spread_clinical": [ [ "own", 0.328 ], [ "sweat", 0.044 ], [ "hands", 0.039 ], [ "shirt", 0.027 ], [ "under", 0.024 ] ], "spread_patient": [ [ "own", 0.275 ], [ "mattress", 0.079 ], [ "air", 0.062 ], [ "bed", 0.048 ], [ "sleep", 0.042 ] ], "target_token": "own", "anchor_fallback": true, "screening": null, "circuit_diff": { "shared_features": 718, "unique_to_a": 696, "unique_to_b": 660 }, "clinical_mass": { "clinical": 0.1828, "patient": 0.0883, "translated": 0.2168 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260719T132706Z/index_31.html" }, { "index": 1147, "batch": "pairs_20260719T132706Z", "batch_index": 32, "clinical_prompt": "I have erectile dysfunction, so I should probably talk to my", "patient_prompt": "I can't perform in the bedroom anymore, so I should probably talk to my", "intended_target": "cardiologist", "rationale": "Clinical diagnosis (erectile dysfunction) invokes specialist referral pathway; colloquial phrasing reads as relationship or confidence issue.", "patient_term": "I can't perform in the bedroom", "clinical_term": "I have erectile dysfunction", "topic": "sexual medicine", "topics": [ "gynecology", "sexual medicine", "menopause", "infectious disease", "pharyngitis", "fever", "nocturia", "urinary tract infection", "genitourinary", "endocrine disorder", "hyperhidrosis", "thyroid disorder" ], "models": { "gemma-2-2b": { "prob_clinical": 0.73, "prob_patient": 0.539, "language_penalty": -0.19099999999999995, "anchor_fallback": true, "top_clinical": [ "doctor", 0.73 ], "top_patient": [ "doctor", 0.539 ], "spread_clinical": [ [ "doctor", 0.73 ], [ "wife", 0.028 ], [ "doc", 0.028 ], [ "uro", 0.025 ], [ "GP", 0.022 ] ], "spread_patient": [ [ "doctor", 0.539 ], [ "wife", 0.073 ], [ "therapist", 0.057 ], [ "uro", 0.03 ], [ "doc", 0.03 ] ], "target_token": "doctor", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 526, "unique_to_a": 531, "unique_to_b": 686 }, "clinical_mass": { "clinical": 0.3243, "patient": 0.1975, "translated": 0.2884 }, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.058, "urgency_recovery": -0.035 } } }, "prob_clinical": 0.73, "prob_patient": 0.539, "language_penalty": -0.19099999999999995, "flipped": false, "top_clinical": [ "doctor", 0.73 ], "top_patient": [ "doctor", 0.539 ], "spread_clinical": [ [ "doctor", 0.73 ], [ "wife", 0.028 ], [ "doc", 0.028 ], [ "uro", 0.025 ], [ "GP", 0.022 ] ], "spread_patient": [ [ "doctor", 0.539 ], [ "wife", 0.073 ], [ "therapist", 0.057 ], [ "uro", 0.03 ], [ "doc", 0.03 ] ], "target_token": "doctor", "anchor_fallback": true, "screening": null, "circuit_diff": { "shared_features": 526, "unique_to_a": 531, "unique_to_b": 686 }, "clinical_mass": { "clinical": 0.3243, "patient": 0.1975, "translated": 0.2884 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260719T132706Z/index_32.html", "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.058, "urgency_recovery": -0.035 } }, { "index": 1148, "batch": "pairs_20260719T132706Z", "batch_index": 33, "clinical_prompt": "I have nocturia with frequency greater than two episodes per night, so I should ask my doctor about my", "patient_prompt": "I'm running to the toilet constantly to pee at night, so I should ask my doctor about my", "intended_target": "prostate", "rationale": "Precise clinical definition (nocturia with threshold) frames symptom as measurable condition requiring organ-system workup versus casual nocturnal bathroom trips.", "patient_term": "I'm running to the toilet constantly to pee at night", "clinical_term": "I have nocturia with frequency greater than two episodes per night", "topic": "nocturia", "topics": [ "gynecology", "sexual medicine", "menopause", "infectious disease", "pharyngitis", "fever", "nocturia", "urinary tract infection", "genitourinary", "endocrine disorder", "hyperhidrosis", "thyroid disorder" ], "models": { "gemma-2-2b": { "prob_clinical": 0.121, "prob_patient": null, "language_penalty": null, "anchor_fallback": true, "top_clinical": [ "noct", 0.121 ], "top_patient": [ "bladder", 0.218 ], "spread_clinical": [ [ "noct", 0.121 ], [ "symptoms", 0.073 ], [ "bladder", 0.065 ], [ "options", 0.057 ], [ "condition", 0.057 ] ], "spread_patient": [ [ "bladder", 0.218 ], [ "blood", 0.071 ], [ "diet", 0.055 ], [ "urine", 0.049 ], [ "medication", 0.043 ] ], "target_token": "noct", "flipped": true, "screening": null, "circuit_diff": { "shared_features": 603, "unique_to_a": 947, "unique_to_b": 902 }, "clinical_mass": { "clinical": 0.3681, "patient": 0.3382, "translated": 0.358 }, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } } }, "prob_clinical": 0.121, "prob_patient": null, "language_penalty": null, "flipped": true, "top_clinical": [ "noct", 0.121 ], "top_patient": [ "bladder", 0.218 ], "spread_clinical": [ [ "noct", 0.121 ], [ "symptoms", 0.073 ], [ "bladder", 0.065 ], [ "options", 0.057 ], [ "condition", 0.057 ] ], "spread_patient": [ [ "bladder", 0.218 ], [ "blood", 0.071 ], [ "diet", 0.055 ], [ "urine", 0.049 ], [ "medication", 0.043 ] ], "target_token": "noct", "anchor_fallback": true, "screening": null, "circuit_diff": { "shared_features": 603, "unique_to_a": 947, "unique_to_b": 902 }, "clinical_mass": { "clinical": 0.3681, "patient": 0.3382, "translated": 0.358 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260719T132706Z/index_33.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, { "index": 1149, "batch": "pairs_20260719T132706Z", "batch_index": 34, "clinical_prompt": "I have erectile dysfunction, so I should probably talk to my", "patient_prompt": "I'm having trouble down there with my partner, so I should probably talk to my", "intended_target": "doctor", "rationale": "Patient phrase emphasizes relational context; clinical term focuses on specific physiological dysfunction. Both end mid-sentence before a natural next token (person to consult). Frames funnel toward care-seeking language.", "patient_term": "trouble down there with my partner", "clinical_term": "erectile dysfunction", "topic": "sexual medicine", "topics": [ "gynecology", "sexual medicine", "menopause", "infectious disease", "pharyngitis", "fever", "nocturia", "urinary tract infection", "genitourinary", "endocrine disorder", "hyperhidrosis", "thyroid disorder" ], "models": { "gemma-2-2b": { "prob_clinical": 0.73, "prob_patient": 0.484, "language_penalty": -0.246, "anchor_fallback": false, "top_clinical": [ "doctor", 0.73 ], "top_patient": [ "doctor", 0.484 ], "spread_clinical": [ [ "doctor", 0.73 ], [ "wife", 0.028 ], [ "doc", 0.028 ], [ "uro", 0.025 ], [ "GP", 0.022 ] ], "spread_patient": [ [ "doctor", 0.484 ], [ "GP", 0.108 ], [ "partner", 0.051 ], [ "doc", 0.045 ], [ "therapist", 0.027 ] ], "target_token": "doctor", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 522, "unique_to_a": 534, "unique_to_b": 744 }, "clinical_mass": { "clinical": 0.3244, "patient": 0.2305, "translated": 0.3035 }, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": 0.11, "urgency_recovery": -0.041 } } }, "prob_clinical": 0.73, "prob_patient": 0.484, "language_penalty": -0.246, "flipped": false, "top_clinical": [ "doctor", 0.73 ], "top_patient": [ "doctor", 0.484 ], "spread_clinical": [ [ "doctor", 0.73 ], [ "wife", 0.028 ], [ "doc", 0.028 ], [ "uro", 0.025 ], [ "GP", 0.022 ] ], "spread_patient": [ [ "doctor", 0.484 ], [ "GP", 0.108 ], [ "partner", 0.051 ], [ "doc", 0.045 ], [ "therapist", 0.027 ] ], "target_token": "doctor", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 522, "unique_to_a": 534, "unique_to_b": 744 }, "clinical_mass": { "clinical": 0.3244, "patient": 0.2305, "translated": 0.3035 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260719T132706Z/index_34.html", "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": 0.11, "urgency_recovery": -0.041 } }, { "index": 1150, "batch": "pairs_20260719T132706Z", "batch_index": 36, "clinical_prompt": "I have cervicitis with purulent discharge, so I need to see a", "patient_prompt": "I'm getting these weird yellow discharge problems down there, so I need to see a", "intended_target": "gynecologist", "rationale": "Patient phrase uses vague colloquial language; clinical term specifies inflammation and discharge type. Both end before profession, where clinical reading should trigger specialist-seeking behavior over general practitioner.", "patient_term": "weird yellow discharge problems down there", "clinical_term": "cervicitis with purulent discharge", "topic": "gynecology", "topics": [ "gynecology", "sexual medicine", "menopause", "infectious disease", "pharyngitis", "fever", "nocturia", "urinary tract infection", "genitourinary", "endocrine disorder", "hyperhidrosis", "thyroid disorder" ], "models": { "gemma-2-2b": { "prob_clinical": 0.287, "prob_patient": 0.12, "language_penalty": -0.16699999999999998, "anchor_fallback": false, "top_clinical": [ "doctor", 0.418 ], "top_patient": [ "doctor", 0.475 ], "spread_clinical": [ [ "doctor", 0.418 ], [ "gyne", 0.287 ], [ "specialist", 0.083 ], [ "g", 0.044 ], [ "gy", 0.03 ] ], "spread_patient": [ [ "doctor", 0.475 ], [ "gyne", 0.12 ], [ "gy", 0.083 ], [ "doc", 0.05 ], [ "uro", 0.039 ] ], "target_token": "gyne", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 529, "unique_to_a": 781, "unique_to_b": 809 }, "clinical_mass": { "clinical": 0.4887, "patient": 0.3496, "translated": 0.4316 }, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.166, "urgency_recovery": 0.068 } } }, "prob_clinical": 0.287, "prob_patient": 0.12, "language_penalty": -0.16699999999999998, "flipped": false, "top_clinical": [ "doctor", 0.418 ], "top_patient": [ "doctor", 0.475 ], "spread_clinical": [ [ "doctor", 0.418 ], [ "gyne", 0.287 ], [ "specialist", 0.083 ], [ "g", 0.044 ], [ "gy", 0.03 ] ], "spread_patient": [ [ "doctor", 0.475 ], [ "gyne", 0.12 ], [ "gy", 0.083 ], [ "doc", 0.05 ], [ "uro", 0.039 ] ], "target_token": "gyne", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 529, "unique_to_a": 781, "unique_to_b": 809 }, "clinical_mass": { "clinical": 0.4887, "patient": 0.3496, "translated": 0.4316 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260719T132706Z/index_36.html", "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.166, "urgency_recovery": 0.068 } }, { "index": 1151, "batch": "pairs_20260719T132706Z", "batch_index": 37, "clinical_prompt": "I have hyperhidrosis, so I should probably get my", "patient_prompt": "I'm sweating like crazy even in the cold, so I should probably get my", "intended_target": "thyroid", "rationale": "Patient phrase is colloquial and emphasizes perceptual intensity; clinical term is precise diagnosis. Frame ends before what to evaluate/check, where clinical reading should prompt endocrine or metabolic workup language.", "patient_term": "sweating like crazy even in the cold", "clinical_term": "hyperhidrosis", "topic": "hyperhidrosis", "topics": [ "gynecology", "sexual medicine", "menopause", "infectious disease", "pharyngitis", "fever", "nocturia", "urinary tract infection", "genitourinary", "endocrine disorder", "hyperhidrosis", "thyroid disorder" ], "models": { "gemma-2-2b": { "prob_clinical": 0.215, "prob_patient": null, "language_penalty": null, "anchor_fallback": true, "top_clinical": [ "hands", 0.215 ], "top_patient": [ "blood", 0.082 ], "spread_clinical": [ [ "hands", 0.215 ], [ "own", 0.168 ], [ "sweat", 0.102 ], [ "feet", 0.042 ], [ "money", 0.026 ] ], "spread_patient": [ [ "blood", 0.082 ], [ "ass", 0.05 ], [ "own", 0.044 ], [ "body", 0.034 ], [ "sweat", 0.03 ] ], "target_token": "hands", "flipped": true, "screening": null, "circuit_diff": { "shared_features": 639, "unique_to_a": 761, "unique_to_b": 811 }, "clinical_mass": { "clinical": 0.2107, "patient": 0.1116, "translated": 0.2863 }, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": 2, "tier_shift": null, "urgency_recovery": 0.0 } } }, "prob_clinical": 0.215, "prob_patient": null, "language_penalty": null, "flipped": true, "top_clinical": [ "hands", 0.215 ], "top_patient": [ "blood", 0.082 ], "spread_clinical": [ [ "hands", 0.215 ], [ "own", 0.168 ], [ "sweat", 0.102 ], [ "feet", 0.042 ], [ "money", 0.026 ] ], "spread_patient": [ [ "blood", 0.082 ], [ "ass", 0.05 ], [ "own", 0.044 ], [ "body", 0.034 ], [ "sweat", 0.03 ] ], "target_token": "hands", "anchor_fallback": true, "screening": null, "circuit_diff": { "shared_features": 639, "unique_to_a": 761, "unique_to_b": 811 }, "clinical_mass": { "clinical": 0.2107, "patient": 0.1116, "translated": 0.2863 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260719T132706Z/index_37.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": 2, "tier_shift": null, "urgency_recovery": 0.0 } }, { "index": 1152, "batch": "pairs_20260719T132706Z", "batch_index": 39, "clinical_prompt": "I have dyspareunia, so I should probably take my", "patient_prompt": "I've been burning down there during sex, so I should probably take my", "intended_target": "doctor", "rationale": "Patient colloquialism 'burning down there during sex' replaces clinical term 'dyspareunia' (painful intercourse). The frame '...so I should probably take my' funnels toward 'doctor' as a natural continuation in the clinical context, whereas the patient phrasing might suggest 'medication' or 'time off'.", "patient_term": "burning down there during sex", "clinical_term": "dyspareunia", "topic": "sexual medicine", "topics": [ "gynecology", "sexual medicine", "menopause", "infectious disease", "pharyngitis", "fever", "nocturia", "urinary tract infection", "genitourinary", "endocrine disorder", "hyperhidrosis", "thyroid disorder" ], "models": { "gemma-2-2b": { "prob_clinical": 0.252, "prob_patient": 0.146, "language_penalty": -0.10600000000000001, "anchor_fallback": true, "top_clinical": [ "own", 0.252 ], "top_patient": [ "own", 0.146 ], "spread_clinical": [ [ "own", 0.252 ], [ "meds", 0.092 ], [ "time", 0.05 ], [ "husband", 0.044 ], [ "partner", 0.034 ] ], "spread_patient": [ [ "own", 0.146 ], [ "chances", 0.069 ], [ "clothes", 0.048 ], [ "meds", 0.048 ], [ "time", 0.048 ] ], "target_token": "own", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 597, "unique_to_a": 792, "unique_to_b": 761 }, "clinical_mass": { "clinical": 0.2578, "patient": 0.0912, "translated": 0.3065 } } }, "prob_clinical": 0.252, "prob_patient": 0.146, "language_penalty": -0.10600000000000001, "flipped": false, "top_clinical": [ "own", 0.252 ], "top_patient": [ "own", 0.146 ], "spread_clinical": [ [ "own", 0.252 ], [ "meds", 0.092 ], [ "time", 0.05 ], [ "husband", 0.044 ], [ "partner", 0.034 ] ], "spread_patient": [ [ "own", 0.146 ], [ "chances", 0.069 ], [ "clothes", 0.048 ], [ "meds", 0.048 ], [ "time", 0.048 ] ], "target_token": "own", "anchor_fallback": true, "screening": null, "circuit_diff": { "shared_features": 597, "unique_to_a": 792, "unique_to_b": 761 }, "clinical_mass": { "clinical": 0.2578, "patient": 0.0912, "translated": 0.3065 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260719T132706Z/index_39.html" }, { "index": 1153, "batch": "pairs_20260719T132706Z", "batch_index": 40, "clinical_prompt": "I have amenorrhea, so I'm probably going through my", "patient_prompt": "My period hasn't shown up in months, so I'm probably going through my", "intended_target": "menopause", "rationale": "Patient phrase 'period hasn't shown up in months' is replaced with clinical term 'amenorrhea' (absence of menstruation). The frame naturally funnels toward 'menopause' as a completion in the clinical context.", "patient_term": "period hasn't shown up in months", "clinical_term": "amenorrhea", "topic": "gynecology", "topics": [ "gynecology", "sexual medicine", "menopause", "infectious disease", "pharyngitis", "fever", "nocturia", "urinary tract infection", "genitourinary", "endocrine disorder", "hyperhidrosis", "thyroid disorder" ], "models": { "gemma-2-2b": { "prob_clinical": 0.072, "prob_patient": 0.129, "language_penalty": 0.05700000000000001, "anchor_fallback": false, "top_clinical": [ "period", 0.135 ], "top_patient": [ "first", 0.188 ], "spread_clinical": [ [ "period", 0.135 ], [ "first", 0.105 ], [ "menopause", 0.072 ], [ "per", 0.05 ] ], "spread_patient": [ [ "first", 0.188 ], [ "menopause", 0.129 ], [ "second", 0.078 ], [ "last", 0.047 ] ], "target_token": "menopause", "flipped": true, "screening": null, "circuit_diff": { "shared_features": 644, "unique_to_a": 776, "unique_to_b": 708 }, "clinical_mass": { "clinical": 0.264, "patient": 0.2138, "translated": 0.2442 }, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } } }, "prob_clinical": 0.072, "prob_patient": 0.129, "language_penalty": 0.05700000000000001, "flipped": true, "top_clinical": [ "period", 0.135 ], "top_patient": [ "first", 0.188 ], "spread_clinical": [ [ "period", 0.135 ], [ "first", 0.105 ], [ "menopause", 0.072 ], [ "per", 0.05 ] ], "spread_patient": [ [ "first", 0.188 ], [ "menopause", 0.129 ], [ "second", 0.078 ], [ "last", 0.047 ] ], "target_token": "menopause", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 644, "unique_to_a": 776, "unique_to_b": 708 }, "clinical_mass": { "clinical": 0.264, "patient": 0.2138, "translated": 0.2442 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260719T132706Z/index_40.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, { "index": 1154, "batch": "pairs_20260719T132706Z", "batch_index": 42, "clinical_prompt": "I keep getting recurrent UTIs, so I should probably ask my doctor about my", "patient_prompt": "I keep getting these recurring bladder infections, so I should probably ask my doctor about my", "intended_target": "prophylaxis", "rationale": "Patient term 'recurring bladder infections' replaced with clinical acronym 'recurrent UTIs'. Frame naturally funnels toward 'prophylaxis' or 'prevention' in medical context, versus 'hydration' in lay context.", "patient_term": "recurring bladder infections", "clinical_term": "recurrent UTIs", "topic": "urinary tract infection", "topics": [ "gynecology", "sexual medicine", "menopause", "infectious disease", "pharyngitis", "fever", "nocturia", "urinary tract infection", "genitourinary", "endocrine disorder", "hyperhidrosis", "thyroid disorder" ], "models": { "gemma-2-2b": { "prob_clinical": 0.336, "prob_patient": 0.375, "language_penalty": 0.03899999999999998, "anchor_fallback": true, "top_clinical": [ "diet", 0.336 ], "top_patient": [ "diet", 0.375 ], "spread_clinical": [ [ "diet", 0.336 ], [ "bladder", 0.052 ], [ "medication", 0.04 ], [ "meds", 0.035 ], [ "lifestyle", 0.031 ] ], "spread_patient": [ [ "diet", 0.375 ], [ "bladder", 0.057 ], [ "lifestyle", 0.04 ], [ "urinary", 0.031 ], [ "medication", 0.031 ] ], "target_token": "diet", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 968, "unique_to_a": 477, "unique_to_b": 477 }, "clinical_mass": { "clinical": 0.415, "patient": 0.4451 }, "urgency": { "flip_class": null, "tier_top_clinical": 0, "tier_top_patient": 0, "tier_shift": -0.106, "urgency_recovery": 0.009 } } }, "prob_clinical": 0.336, "prob_patient": 0.375, "language_penalty": 0.03899999999999998, "flipped": false, "top_clinical": [ "diet", 0.336 ], "top_patient": [ "diet", 0.375 ], "spread_clinical": [ [ "diet", 0.336 ], [ "bladder", 0.052 ], [ "medication", 0.04 ], [ "meds", 0.035 ], [ "lifestyle", 0.031 ] ], "spread_patient": [ [ "diet", 0.375 ], [ "bladder", 0.057 ], [ "lifestyle", 0.04 ], [ "urinary", 0.031 ], [ "medication", 0.031 ] ], "target_token": "diet", "anchor_fallback": true, "screening": null, "circuit_diff": { "shared_features": 968, "unique_to_a": 477, "unique_to_b": 477 }, "clinical_mass": { "clinical": 0.415, "patient": 0.4451 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260719T132706Z/index_42.html", "urgency": { "flip_class": null, "tier_top_clinical": 0, "tier_top_patient": 0, "tier_shift": -0.106, "urgency_recovery": 0.009 } }, { "index": 1155, "batch": "pairs_20260719T132706Z", "batch_index": 44, "clinical_prompt": "I have hyperthyroidism, so I probably need my", "patient_prompt": "I've got this overactive thyroid thing going on, so I probably need my", "intended_target": "TSH", "rationale": "Patient colloquialism 'overactive thyroid thing' is replaced with clinical term 'hyperthyroidism'. The frame '...so I probably need my' naturally funnels toward 'TSH' (thyroid-stimulating hormone levels monitored), a specific diagnostic marker in clinical context.", "patient_term": "overactive thyroid thing", "clinical_term": "hyperthyroidism", "topic": "thyroid disorder", "topics": [ "gynecology", "sexual medicine", "menopause", "infectious disease", "pharyngitis", "fever", "nocturia", "urinary tract infection", "genitourinary", "endocrine disorder", "hyperhidrosis", "thyroid disorder" ], "models": { "gemma-2-2b": { "prob_clinical": 0.359, "prob_patient": 0.139, "language_penalty": -0.21999999999999997, "anchor_fallback": true, "top_clinical": [ "thyroid", 0.359 ], "top_patient": [ "thyroid", 0.139 ], "spread_clinical": [ [ "thyroid", 0.359 ], [ "meds", 0.091 ], [ "dose", 0.071 ], [ "blood", 0.043 ], [ "medication", 0.038 ] ], "spread_patient": [ [ "thyroid", 0.139 ], [ "meds", 0.123 ], [ "daily", 0.058 ], [ "dose", 0.045 ], [ "T", 0.045 ] ], "target_token": "thyroid", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 711, "unique_to_a": 450, "unique_to_b": 669 }, "clinical_mass": { "clinical": 0.2943, "patient": 0.22 }, "urgency": { "flip_class": null, "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": -0.177, "urgency_recovery": 0.177 } } }, "prob_clinical": 0.359, "prob_patient": 0.139, "language_penalty": -0.21999999999999997, "flipped": false, "top_clinical": [ "thyroid", 0.359 ], "top_patient": [ "thyroid", 0.139 ], "spread_clinical": [ [ "thyroid", 0.359 ], [ "meds", 0.091 ], [ "dose", 0.071 ], [ "blood", 0.043 ], [ "medication", 0.038 ] ], "spread_patient": [ [ "thyroid", 0.139 ], [ "meds", 0.123 ], [ "daily", 0.058 ], [ "dose", 0.045 ], [ "T", 0.045 ] ], "target_token": "thyroid", "anchor_fallback": true, "screening": null, "circuit_diff": { "shared_features": 711, "unique_to_a": 450, "unique_to_b": 669 }, "clinical_mass": { "clinical": 0.2943, "patient": 0.22 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260719T132706Z/index_44.html", "urgency": { "flip_class": null, "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": -0.177, "urgency_recovery": 0.177 } }, { "index": 1156, "batch": "pairs_20260719T132706Z", "batch_index": 45, "clinical_prompt": "I have irregular menstruation this month, so I need to see my", "patient_prompt": "I'm having my monthly troubles early this month, so I need to see my", "intended_target": "gynecologist", "rationale": "Colloquial 'monthly troubles' versus clinical 'irregular menstruation' both frame a condition requiring specialist care. The clinical term strongly predicts 'gynecologist' as the natural next token, while the colloquial phrasing might admit more general practitioner responses.", "patient_term": "monthly troubles", "clinical_term": "irregular menstruation", "topic": "gynecology", "topics": [ "gynecology", "sexual medicine", "menopause", "infectious disease", "pharyngitis", "fever", "nocturia", "urinary tract infection", "genitourinary", "endocrine disorder", "hyperhidrosis", "thyroid disorder" ], "models": { "gemma-2-2b": { "prob_clinical": 0.174, "prob_patient": null, "language_penalty": null, "anchor_fallback": false, "top_clinical": [ "doctor", 0.416 ], "top_patient": [ "doctor", 0.283 ], "spread_clinical": [ [ "doctor", 0.416 ], [ "gyne", 0.174 ], [ "period", 0.064 ], [ "g", 0.05 ], [ "family", 0.03 ] ], "spread_patient": [ [ "doctor", 0.283 ], [ "OB", 0.092 ], [ "doc", 0.072 ], [ "GP", 0.056 ], [ "ob", 0.034 ] ], "target_token": "gyne", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 602, "unique_to_a": 627, "unique_to_b": 677 }, "clinical_mass": { "clinical": 0.334, "patient": 0.247 }, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": 0.135, "urgency_recovery": 0.0 } } }, "prob_clinical": 0.174, "prob_patient": null, "language_penalty": null, "flipped": false, "top_clinical": [ "doctor", 0.416 ], "top_patient": [ "doctor", 0.283 ], "spread_clinical": [ [ "doctor", 0.416 ], [ "gyne", 0.174 ], [ "period", 0.064 ], [ "g", 0.05 ], [ "family", 0.03 ] ], "spread_patient": [ [ "doctor", 0.283 ], [ "OB", 0.092 ], [ "doc", 0.072 ], [ "GP", 0.056 ], [ "ob", 0.034 ] ], "target_token": "gyne", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 602, "unique_to_a": 627, "unique_to_b": 677 }, "clinical_mass": { "clinical": 0.334, "patient": 0.247 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260719T132706Z/index_45.html", "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": 0.135, "urgency_recovery": 0.0 } }, { "index": 1157, "batch": "pairs_20260719T132706Z", "batch_index": 46, "clinical_prompt": "I have dyspareunia after intercourse, so I probably need an", "patient_prompt": "I'm burning down there after intercourse, so I probably need an", "intended_target": "evaluation", "rationale": "Patient phrase uses lay description of pain symptom; clinical term is precise diagnosis. The clinical phrasing naturally leads to 'evaluation' or formal assessment, whereas colloquial phrasing might suggest home remedies or lubricants.", "patient_term": "burning down there", "clinical_term": "dyspareunia", "topic": "sexual medicine", "topics": [ "gynecology", "sexual medicine", "menopause", "infectious disease", "pharyngitis", "fever", "nocturia", "urinary tract infection", "genitourinary", "endocrine disorder", "hyperhidrosis", "thyroid disorder" ], "models": { "gemma-2-2b": { "prob_clinical": 0.141, "prob_patient": 0.052, "language_penalty": -0.089, "anchor_fallback": true, "top_clinical": [ "I", 0.141 ], "top_patient": [ "anti", 0.067 ], "spread_clinical": [ [ "I", 0.141 ], [ "internal", 0.052 ], [ "estrogen", 0.046 ], [ "anti", 0.046 ], [ "exam", 0.04 ] ], "spread_patient": [ [ "anti", 0.067 ], [ "extra", 0.06 ], [ "I", 0.052 ], [ "ointment", 0.041 ], [ "antibiotic", 0.036 ] ], "target_token": "I", "flipped": true, "screening": null, "circuit_diff": { "shared_features": 621, "unique_to_a": 745, "unique_to_b": 711 }, "clinical_mass": { "clinical": 0.3536, "patient": 0.2002 }, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": 1, "tier_shift": null, "urgency_recovery": 0.627 } } }, "prob_clinical": 0.141, "prob_patient": 0.052, "language_penalty": -0.089, "flipped": true, "top_clinical": [ "I", 0.141 ], "top_patient": [ "anti", 0.067 ], "spread_clinical": [ [ "I", 0.141 ], [ "internal", 0.052 ], [ "estrogen", 0.046 ], [ "anti", 0.046 ], [ "exam", 0.04 ] ], "spread_patient": [ [ "anti", 0.067 ], [ "extra", 0.06 ], [ "I", 0.052 ], [ "ointment", 0.041 ], [ "antibiotic", 0.036 ] ], "target_token": "I", "anchor_fallback": true, "screening": null, "circuit_diff": { "shared_features": 621, "unique_to_a": 745, "unique_to_b": 711 }, "clinical_mass": { "clinical": 0.3536, "patient": 0.2002 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260719T132706Z/index_46.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": 1, "tier_shift": null, "urgency_recovery": 0.627 } }, { "index": 1158, "batch": "pairs_20260719T132706Z", "batch_index": 47, "clinical_prompt": "I'm experiencing vasomotor symptoms at night, so I should probably take my", "patient_prompt": "I'm getting these sudden hot spells at night, so I should probably take my", "intended_target": "medication", "rationale": "Colloquial 'hot spells' versus clinical 'vasomotor symptoms' describe the same phenomenon. The clinical term strongly directs toward formal medical intervention ('medication'), whereas the colloquial version might lead to lifestyle suggestions ('temperature' down, etc.).", "patient_term": "hot spells", "clinical_term": "vasomotor symptoms", "topic": "menopause", "topics": [ "gynecology", "sexual medicine", "menopause", "infectious disease", "pharyngitis", "fever", "nocturia", "urinary tract infection", "genitourinary", "endocrine disorder", "hyperhidrosis", "thyroid disorder" ], "models": { "gemma-2-2b": { "prob_clinical": 0.106, "prob_patient": 0.057, "language_penalty": -0.048999999999999995, "anchor_fallback": false, "top_clinical": [ "meds", 0.176 ], "top_patient": [ "meds", 0.136 ], "spread_clinical": [ [ "meds", 0.176 ], [ "medication", 0.106 ], [ "medicine", 0.044 ], [ "blood", 0.035 ], [ "morning", 0.021 ] ], "spread_patient": [ [ "meds", 0.136 ], [ "blood", 0.064 ], [ "medication", 0.057 ], [ "temperature", 0.05 ], [ "shirt", 0.034 ] ], "target_token": "medication", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 598, "unique_to_a": 802, "unique_to_b": 760 }, "clinical_mass": { "clinical": 0.4297, "patient": 0.1641 }, "urgency": { "flip_class": null, "tier_top_clinical": 1, "tier_top_patient": 1, "tier_shift": 0.006, "urgency_recovery": 0.289 } } }, "prob_clinical": 0.106, "prob_patient": 0.057, "language_penalty": -0.048999999999999995, "flipped": false, "top_clinical": [ "meds", 0.176 ], "top_patient": [ "meds", 0.136 ], "spread_clinical": [ [ "meds", 0.176 ], [ "medication", 0.106 ], [ "medicine", 0.044 ], [ "blood", 0.035 ], [ "morning", 0.021 ] ], "spread_patient": [ [ "meds", 0.136 ], [ "blood", 0.064 ], [ "medication", 0.057 ], [ "temperature", 0.05 ], [ "shirt", 0.034 ] ], "target_token": "medication", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 598, "unique_to_a": 802, "unique_to_b": 760 }, "clinical_mass": { "clinical": 0.4297, "patient": 0.1641 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260719T132706Z/index_47.html", "urgency": { "flip_class": null, "tier_top_clinical": 1, "tier_top_patient": 1, "tier_shift": 0.006, "urgency_recovery": 0.289 } }, { "index": 1159, "batch": "pairs_20260719T132706Z", "batch_index": 48, "clinical_prompt": "I woke up with acute pharyngitis, so I'm probably fighting off a", "patient_prompt": "I woke up with a red, scratchy throat, so I'm probably fighting off a", "intended_target": "virus", "rationale": "Patient description uses symptom language; clinical term names the condition. The clinical phrasing naturally leads to etiological tokens like 'virus' or 'bacterial infection,' while the symptom-based phrasing might lead to 'cold' or 'bug.'", "patient_term": "red, scratchy throat", "clinical_term": "acute pharyngitis", "topic": "pharyngitis", "topics": [ "gynecology", "sexual medicine", "menopause", "infectious disease", "pharyngitis", "fever", "nocturia", "urinary tract infection", "genitourinary", "endocrine disorder", "hyperhidrosis", "thyroid disorder" ], "models": { "gemma-2-2b": { "prob_clinical": 0.072, "prob_patient": 0.019, "language_penalty": -0.05299999999999999, "anchor_fallback": false, "top_clinical": [ "cold", 0.605 ], "top_patient": [ "cold", 0.82 ], "spread_clinical": [ [ "cold", 0.605 ], [ "virus", 0.072 ], [ "nasty", 0.044 ], [ "viral", 0.021 ], [ "sore", 0.016 ] ], "spread_patient": [ [ "cold", 0.82 ], [ "nasty", 0.036 ], [ "virus", 0.019 ], [ "head", 0.013 ], [ "little", 0.01 ] ], "target_token": "virus", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 793, "unique_to_a": 540, "unique_to_b": 457 }, "clinical_mass": { "clinical": 0.4178, "patient": 0.3638 } } }, "prob_clinical": 0.072, "prob_patient": 0.019, "language_penalty": -0.05299999999999999, "flipped": false, "top_clinical": [ "cold", 0.605 ], "top_patient": [ "cold", 0.82 ], "spread_clinical": [ [ "cold", 0.605 ], [ "virus", 0.072 ], [ "nasty", 0.044 ], [ "viral", 0.021 ], [ "sore", 0.016 ] ], "spread_patient": [ [ "cold", 0.82 ], [ "nasty", 0.036 ], [ "virus", 0.019 ], [ "head", 0.013 ], [ "little", 0.01 ] ], "target_token": "virus", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 793, "unique_to_a": 540, "unique_to_b": 457 }, "clinical_mass": { "clinical": 0.4178, "patient": 0.3638 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260719T132706Z/index_48.html" }, { "index": 1160, "batch": "pairs_20260719T132706Z", "batch_index": 50, "clinical_prompt": "I'm experiencing nocturia with frequency, so my doctor thinks I might have", "patient_prompt": "I'm constantly running to the loo at odd hours, so my doctor thinks I might have", "intended_target": "hyperglycemia", "rationale": "Patient uses colloquial behavioral description; clinical term specifies the medical phenomenon. The clinical phrasing naturally predicts endocrine/metabolic etiologies ('hyperglycemia,' 'diabetes'), while the colloquial phrasing might lead to 'uti' or 'prostate' (more everyday differential diagnoses).", "patient_term": "running to the loo at odd hours", "clinical_term": "nocturia with frequency", "topic": "endocrine disorder", "topics": [ "gynecology", "sexual medicine", "menopause", "infectious disease", "pharyngitis", "fever", "nocturia", "urinary tract infection", "genitourinary", "endocrine disorder", "hyperhidrosis", "thyroid disorder" ], "models": { "gemma-2-2b": { "prob_clinical": 0.275, "prob_patient": 0.084, "language_penalty": -0.191, "anchor_fallback": true, "top_clinical": [ "an", 0.275 ], "top_patient": [ "IBS", 0.229 ], "spread_clinical": [ [ "an", 0.275 ], [ "a", 0.243 ], [ "B", 0.079 ], [ "interstitial", 0.079 ], [ "over", 0.033 ] ], "spread_patient": [ [ "IBS", 0.229 ], [ "a", 0.202 ], [ "an", 0.084 ], [ "irritable", 0.051 ], [ "interstitial", 0.045 ] ], "target_token": "an", "flipped": true, "screening": null, "circuit_diff": { "shared_features": 714, "unique_to_a": 748, "unique_to_b": 842 }, "clinical_mass": { "clinical": 0.4098, "patient": 0.3767 }, "html": "modes/simulated/pairs_20260719T132706Z/index_50.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } } }, "prob_clinical": 0.275, "prob_patient": 0.084, "language_penalty": -0.191, "flipped": true, "top_clinical": [ "an", 0.275 ], "top_patient": [ "IBS", 0.229 ], "spread_clinical": [ [ "an", 0.275 ], [ "a", 0.243 ], [ "B", 0.079 ], [ "interstitial", 0.079 ], [ "over", 0.033 ] ], "spread_patient": [ [ "IBS", 0.229 ], [ "a", 0.202 ], [ "an", 0.084 ], [ "irritable", 0.051 ], [ "interstitial", 0.045 ] ], "target_token": "an", "anchor_fallback": true, "screening": null, "circuit_diff": { "shared_features": 714, "unique_to_a": 748, "unique_to_b": 842 }, "clinical_mass": { "clinical": 0.4098, "patient": 0.3767 }, "html": "modes/simulated/pairs_20260719T132706Z/index_50.html", "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260719T132706Z/index_50.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, { "index": 1161, "batch": "pairs_20260719T132706Z", "batch_index": 51, "clinical_prompt": "I have hyperhidrosis in the genital region, so I should probably see a", "patient_prompt": "I'm sweating buckets down there, so I should probably see a", "intended_target": "dermatologist", "rationale": "Colloquial expression of excessive localized sweating versus clinical diagnosis; frames a specialty recommendation naturally after 'see a', with dermatologist as the diagnostic continuation.", "patient_term": "sweating buckets down there", "clinical_term": "hyperhidrosis in the genital region", "topic": "hyperhidrosis", "topics": [ "gynecology", "sexual medicine", "menopause", "infectious disease", "pharyngitis", "fever", "nocturia", "urinary tract infection", "genitourinary", "endocrine disorder", "hyperhidrosis", "thyroid disorder" ], "models": { "gemma-2-2b": { "prob_clinical": 0.242, "prob_patient": 0.023, "language_penalty": -0.219, "anchor_fallback": false, "top_clinical": [ "doctor", 0.398 ], "top_patient": [ "doctor", 0.668 ], "spread_clinical": [ [ "doctor", 0.398 ], [ "dermatologist", 0.242 ], [ "uro", 0.069 ], [ "specialist", 0.061 ], [ "doc", 0.033 ] ], "spread_patient": [ [ "doctor", 0.668 ], [ "doc", 0.103 ], [ "uro", 0.043 ], [ "dermatologist", 0.023 ], [ "specialist", 0.023 ] ], "target_token": "dermatologist", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 560, "unique_to_a": 759, "unique_to_b": 725 }, "clinical_mass": { "clinical": 0.4148, "patient": 0.2717, "translated": 0.3938 }, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.357, "urgency_recovery": 0.047 } } }, "prob_clinical": 0.242, "prob_patient": 0.023, "language_penalty": -0.219, "flipped": false, "top_clinical": [ "doctor", 0.398 ], "top_patient": [ "doctor", 0.668 ], "spread_clinical": [ [ "doctor", 0.398 ], [ "dermatologist", 0.242 ], [ "uro", 0.069 ], [ "specialist", 0.061 ], [ "doc", 0.033 ] ], "spread_patient": [ [ "doctor", 0.668 ], [ "doc", 0.103 ], [ "uro", 0.043 ], [ "dermatologist", 0.023 ], [ "specialist", 0.023 ] ], "target_token": "dermatologist", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 560, "unique_to_a": 759, "unique_to_b": 725 }, "clinical_mass": { "clinical": 0.4148, "patient": 0.2717, "translated": 0.3938 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260719T132706Z/index_51.html", "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.357, "urgency_recovery": 0.047 } }, { "index": 1162, "batch": "pairs_20260719T132706Z", "batch_index": 52, "clinical_prompt": "I have vulvovaginitis, so I need to take my", "patient_prompt": "I've got this itchy, burny feeling down there, so I need to take my", "intended_target": "medication", "rationale": "Lay description of genital inflammation versus precise clinical diagnosis; the frame naturally leads to 'medication' as a clinical next token, distinct from lay self-help remedies.", "patient_term": "itchy, burny feeling down there", "clinical_term": "vulvovaginitis", "topic": "gynecology", "topics": [ "gynecology", "sexual medicine", "menopause", "infectious disease", "pharyngitis", "fever", "nocturia", "urinary tract infection", "genitourinary", "endocrine disorder", "hyperhidrosis", "thyroid disorder" ], "models": { "gemma-2-2b": { "prob_clinical": 0.048, "prob_patient": null, "language_penalty": null, "anchor_fallback": false, "top_clinical": [ "meds", 0.07 ], "top_patient": [ "meds", 0.074 ], "spread_clinical": [ [ "meds", 0.07 ], [ "medicine", 0.054 ], [ "own", 0.054 ], [ "vaginal", 0.048 ], [ "medication", 0.048 ] ], "spread_patient": [ [ "meds", 0.074 ], [ "bath", 0.065 ], [ "daily", 0.045 ], [ "shower", 0.045 ], [ "clothes", 0.045 ] ], "target_token": "medication", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 622, "unique_to_a": 698, "unique_to_b": 831 }, "clinical_mass": { "clinical": 0.3755, "patient": 0.2604, "translated": 0.3542 }, "urgency": { "flip_class": null, "tier_top_clinical": 1, "tier_top_patient": 1, "tier_shift": -0.598, "urgency_recovery": 0.231 } } }, "prob_clinical": 0.048, "prob_patient": null, "language_penalty": null, "flipped": false, "top_clinical": [ "meds", 0.07 ], "top_patient": [ "meds", 0.074 ], "spread_clinical": [ [ "meds", 0.07 ], [ "medicine", 0.054 ], [ "own", 0.054 ], [ "vaginal", 0.048 ], [ "medication", 0.048 ] ], "spread_patient": [ [ "meds", 0.074 ], [ "bath", 0.065 ], [ "daily", 0.045 ], [ "shower", 0.045 ], [ "clothes", 0.045 ] ], "target_token": "medication", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 622, "unique_to_a": 698, "unique_to_b": 831 }, "clinical_mass": { "clinical": 0.3755, "patient": 0.2604, "translated": 0.3542 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260719T132706Z/index_52.html", "urgency": { "flip_class": null, "tier_top_clinical": 1, "tier_top_patient": 1, "tier_shift": -0.598, "urgency_recovery": 0.231 } }, { "index": 1163, "batch": "pairs_20260719T132706Z", "batch_index": 53, "clinical_prompt": "I have nocturia, so I probably need an", "patient_prompt": "I'm up five times a night to pee, so I probably need an", "intended_target": "evaluation", "rationale": "Colloquial symptom description versus clinical term for nighttime urinary frequency; frames a diagnostic pathway, where 'evaluation' becomes the natural clinical continuation.", "patient_term": "up five times a night to pee", "clinical_term": "nocturia", "topic": "nocturia", "topics": [ "gynecology", "sexual medicine", "menopause", "infectious disease", "pharyngitis", "fever", "nocturia", "urinary tract infection", "genitourinary", "endocrine disorder", "hyperhidrosis", "thyroid disorder" ], "models": { "gemma-2-2b": { "prob_clinical": 0.314, "prob_patient": 0.277, "language_penalty": -0.03699999999999998, "anchor_fallback": true, "top_clinical": [ "alarm", 0.314 ], "top_patient": [ "alarm", 0.277 ], "spread_clinical": [ [ "alarm", 0.314 ], [ "en", 0.102 ], [ "extra", 0.09 ], [ "over", 0.038 ], [ "anti", 0.026 ] ], "spread_patient": [ [ "alarm", 0.277 ], [ "en", 0.169 ], [ "adult", 0.09 ], [ "extra", 0.062 ], [ "over", 0.029 ] ], "target_token": "alarm", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 625, "unique_to_a": 752, "unique_to_b": 723 }, "clinical_mass": { "clinical": 0.2616, "patient": 0.1787, "translated": 0.267 }, "urgency": { "flip_class": null, "tier_top_clinical": 0, "tier_top_patient": 0, "tier_shift": -0.075, "urgency_recovery": 0.187 } } }, "prob_clinical": 0.314, "prob_patient": 0.277, "language_penalty": -0.03699999999999998, "flipped": false, "top_clinical": [ "alarm", 0.314 ], "top_patient": [ "alarm", 0.277 ], "spread_clinical": [ [ "alarm", 0.314 ], [ "en", 0.102 ], [ "extra", 0.09 ], [ "over", 0.038 ], [ "anti", 0.026 ] ], "spread_patient": [ [ "alarm", 0.277 ], [ "en", 0.169 ], [ "adult", 0.09 ], [ "extra", 0.062 ], [ "over", 0.029 ] ], "target_token": "alarm", "anchor_fallback": true, "screening": null, "circuit_diff": { "shared_features": 625, "unique_to_a": 752, "unique_to_b": 723 }, "clinical_mass": { "clinical": 0.2616, "patient": 0.1787, "translated": 0.267 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260719T132706Z/index_53.html", "urgency": { "flip_class": null, "tier_top_clinical": 0, "tier_top_patient": 0, "tier_shift": -0.075, "urgency_recovery": 0.187 } }, { "index": 1164, "batch": "pairs_20260719T132706Z", "batch_index": 54, "clinical_prompt": "I have acute pharyngitis, so I'm probably fighting an", "patient_prompt": "My throat feels like it's on fire, so I'm probably fighting an", "intended_target": "infection", "rationale": "Hyperbolic lay description of throat pain versus clinical diagnosis; the frame naturally funnels toward 'infection' as the diagnostic continuation in clinical context.", "patient_term": "My throat feels like it's on fire", "clinical_term": "I have acute pharyngitis", "topic": "pharyngitis", "topics": [ "gynecology", "sexual medicine", "menopause", "infectious disease", "pharyngitis", "fever", "nocturia", "urinary tract infection", "genitourinary", "endocrine disorder", "hyperhidrosis", "thyroid disorder" ], "models": { "gemma-2-2b": { "prob_clinical": 0.691, "prob_patient": 0.656, "language_penalty": -0.03499999999999992, "anchor_fallback": false, "top_clinical": [ "infection", 0.691 ], "top_patient": [ "infection", 0.656 ], "spread_clinical": [ [ "infection", 0.691 ], [ "upper", 0.175 ], [ "ear", 0.014 ], [ "antibiotic", 0.007 ], [ "immune", 0.007 ] ], "spread_patient": [ [ "infection", 0.656 ], [ "upper", 0.129 ], [ "illness", 0.029 ], [ "awful", 0.025 ], [ "oncoming", 0.017 ] ], "target_token": "infection", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 592, "unique_to_a": 646, "unique_to_b": 665 }, "clinical_mass": { "clinical": 0.4291, "patient": 0.3101, "translated": 0.3614 } } }, "prob_clinical": 0.691, "prob_patient": 0.656, "language_penalty": -0.03499999999999992, "flipped": false, "top_clinical": [ "infection", 0.691 ], "top_patient": [ "infection", 0.656 ], "spread_clinical": [ [ "infection", 0.691 ], [ "upper", 0.175 ], [ "ear", 0.014 ], [ "antibiotic", 0.007 ], [ "immune", 0.007 ] ], "spread_patient": [ [ "infection", 0.656 ], [ "upper", 0.129 ], [ "illness", 0.029 ], [ "awful", 0.025 ], [ "oncoming", 0.017 ] ], "target_token": "infection", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 592, "unique_to_a": 646, "unique_to_b": 665 }, "clinical_mass": { "clinical": 0.4291, "patient": 0.3101, "translated": 0.3614 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260719T132706Z/index_54.html" }, { "index": 1165, "batch": "pairs_20260719T132706Z", "batch_index": 55, "clinical_prompt": "I have stress urinary incontinence, so I should talk to my", "patient_prompt": "I'm having trouble staying dry down there during the day, so I should talk to my", "intended_target": "urologist", "rationale": "Euphemistic description of leakage versus precise clinical diagnosis; frames specialist recommendation naturally, with 'urologist' as the clinical target token.", "patient_term": "having trouble staying dry down there during the day", "clinical_term": "stress urinary incontinence", "topic": "urinary tract infection", "topics": [ "gynecology", "sexual medicine", "menopause", "infectious disease", "pharyngitis", "fever", "nocturia", "urinary tract infection", "genitourinary", "endocrine disorder", "hyperhidrosis", "thyroid disorder" ], "models": { "gemma-2-2b": { "prob_clinical": 0.107, "prob_patient": 0.11, "language_penalty": 0.0030000000000000027, "anchor_fallback": false, "top_clinical": [ "doctor", 0.479 ], "top_patient": [ "doctor", 0.34 ], "spread_clinical": [ [ "doctor", 0.479 ], [ "uro", 0.107 ], [ "doc", 0.065 ], [ "GP", 0.044 ], [ "Dr", 0.027 ] ], "spread_patient": [ [ "doctor", 0.34 ], [ "doc", 0.183 ], [ "uro", 0.11 ], [ "dr", 0.041 ], [ "Dr", 0.032 ] ], "target_token": "uro", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 499, "unique_to_a": 672, "unique_to_b": 827 }, "clinical_mass": { "clinical": 0.3842, "patient": 0.2508, "translated": 0.3418 }, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": 0.0, "urgency_recovery": 0.0 } } }, "prob_clinical": 0.107, "prob_patient": 0.11, "language_penalty": 0.0030000000000000027, "flipped": false, "top_clinical": [ "doctor", 0.479 ], "top_patient": [ "doctor", 0.34 ], "spread_clinical": [ [ "doctor", 0.479 ], [ "uro", 0.107 ], [ "doc", 0.065 ], [ "GP", 0.044 ], [ "Dr", 0.027 ] ], "spread_patient": [ [ "doctor", 0.34 ], [ "doc", 0.183 ], [ "uro", 0.11 ], [ "dr", 0.041 ], [ "Dr", 0.032 ] ], "target_token": "uro", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 499, "unique_to_a": 672, "unique_to_b": 827 }, "clinical_mass": { "clinical": 0.3842, "patient": 0.2508, "translated": 0.3418 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260719T132706Z/index_55.html", "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": 0.0, "urgency_recovery": 0.0 } }, { "index": 1166, "batch": "pairs_20260719T132706Z", "batch_index": 56, "clinical_prompt": "I have thyroid dysfunction, so I need to get my", "patient_prompt": "My thyroid's been acting up, so I need to get my", "intended_target": "levels", "rationale": "Colloquial description of thyroid malfunction versus clinical term; the frame naturally leads to 'levels' (TSH levels, thyroid hormone levels) as the diagnostic measurement continuation.", "patient_term": "thyroid's been acting up", "clinical_term": "thyroid dysfunction", "topic": "thyroid disorder", "topics": [ "gynecology", "sexual medicine", "menopause", "infectious disease", "pharyngitis", "fever", "nocturia", "urinary tract infection", "genitourinary", "endocrine disorder", "hyperhidrosis", "thyroid disorder" ], "models": { "gemma-2-2b": { "prob_clinical": 0.097, "prob_patient": 0.149, "language_penalty": 0.05199999999999999, "anchor_fallback": false, "top_clinical": [ "thyroid", 0.264 ], "top_patient": [ "blood", 0.191 ], "spread_clinical": [ [ "thyroid", 0.264 ], [ "TSH", 0.125 ], [ "blood", 0.125 ], [ "levels", 0.097 ], [ "hormones", 0.059 ] ], "spread_patient": [ [ "blood", 0.191 ], [ "levels", 0.149 ], [ "TSH", 0.09 ], [ "thyroid", 0.09 ], [ "meds", 0.048 ] ], "target_token": "levels", "flipped": true, "screening": null, "circuit_diff": { "shared_features": 784, "unique_to_a": 408, "unique_to_b": 470 }, "clinical_mass": { "clinical": 0.3553, "patient": 0.3194, "translated": 0.3163 }, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": 2, "tier_shift": null } } }, "prob_clinical": 0.097, "prob_patient": 0.149, "language_penalty": 0.05199999999999999, "flipped": true, "top_clinical": [ "thyroid", 0.264 ], "top_patient": [ "blood", 0.191 ], "spread_clinical": [ [ "thyroid", 0.264 ], [ "TSH", 0.125 ], [ "blood", 0.125 ], [ "levels", 0.097 ], [ "hormones", 0.059 ] ], "spread_patient": [ [ "blood", 0.191 ], [ "levels", 0.149 ], [ "TSH", 0.09 ], [ "thyroid", 0.09 ], [ "meds", 0.048 ] ], "target_token": "levels", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 784, "unique_to_a": 408, "unique_to_b": 470 }, "clinical_mass": { "clinical": 0.3553, "patient": 0.3194, "translated": 0.3163 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260719T132706Z/index_56.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": 2, "tier_shift": null } }, { "index": 1167, "batch": "pairs_20260719T132706Z", "batch_index": 57, "clinical_prompt": "I'm experiencing nocturnal hyperhidrosis, so I probably need to get my", "patient_prompt": "I'm sweating through my clothes at night, so I probably need to get my", "intended_target": "thyroid", "rationale": "Patient phrasing suggests benign sleep issue; clinical term hyperhidrosis suggests endocrine dysfunction requiring thyroid workup. Frame forces next token to be a medical test or system.", "patient_term": "sweating through my clothes at night", "clinical_term": "nocturnal hyperhidrosis", "topic": "hyperhidrosis", "topics": [ "gynecology", "sexual medicine", "menopause", "infectious disease", "pharyngitis", "fever", "nocturia", "urinary tract infection", "genitourinary", "endocrine disorder", "hyperhidrosis", "thyroid disorder" ], "models": { "gemma-2-2b": { "prob_clinical": 0.147, "prob_patient": null, "language_penalty": null, "anchor_fallback": true, "top_clinical": [ "hands", 0.147 ], "top_patient": [ "blood", 0.119 ], "spread_clinical": [ [ "hands", 0.147 ], [ "sweat", 0.13 ], [ "feet", 0.048 ], [ "doctor", 0.033 ], [ "own", 0.029 ] ], "spread_patient": [ [ "blood", 0.119 ], [ "temperature", 0.082 ], [ "body", 0.063 ], [ "sleep", 0.05 ], [ "heart", 0.03 ] ], "target_token": "hands", "flipped": true, "screening": null, "circuit_diff": { "shared_features": 696, "unique_to_a": 789, "unique_to_b": 734 }, "clinical_mass": { "clinical": 0.2563, "patient": 0.1588, "translated": 0.3068 }, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": 2, "tier_shift": null } } }, "prob_clinical": 0.147, "prob_patient": null, "language_penalty": null, "flipped": true, "top_clinical": [ "hands", 0.147 ], "top_patient": [ "blood", 0.119 ], "spread_clinical": [ [ "hands", 0.147 ], [ "sweat", 0.13 ], [ "feet", 0.048 ], [ "doctor", 0.033 ], [ "own", 0.029 ] ], "spread_patient": [ [ "blood", 0.119 ], [ "temperature", 0.082 ], [ "body", 0.063 ], [ "sleep", 0.05 ], [ "heart", 0.03 ] ], "target_token": "hands", "anchor_fallback": true, "screening": null, "circuit_diff": { "shared_features": 696, "unique_to_a": 789, "unique_to_b": 734 }, "clinical_mass": { "clinical": 0.2563, "patient": 0.1588, "translated": 0.3068 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260719T132706Z/index_57.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": 2, "tier_shift": null } }, { "index": 1168, "batch": "pairs_20260719T132706Z", "batch_index": 59, "clinical_prompt": "I've been experiencing a loss of libido, so I need to talk to my", "patient_prompt": "My husband says I'm not interested anymore, so I need to talk to my", "intended_target": "gynecologist", "rationale": "Patient phrasing frames issue as relational; clinical term frames as medical symptom requiring specialist evaluation. Possessive + article strongly funnels toward medical professional.", "patient_term": "not interested anymore", "clinical_term": "loss of libido", "topic": "sexual medicine", "topics": [ "gynecology", "sexual medicine", "menopause", "infectious disease", "pharyngitis", "fever", "nocturia", "urinary tract infection", "genitourinary", "endocrine disorder", "hyperhidrosis", "thyroid disorder" ], "models": { "gemma-2-2b": { "prob_clinical": 0.475, "prob_patient": 0.058, "language_penalty": -0.417, "anchor_fallback": true, "top_clinical": [ "doctor", 0.475 ], "top_patient": [ "therapist", 0.158 ], "spread_clinical": [ [ "doctor", 0.475 ], [ "husband", 0.064 ], [ "doc", 0.064 ], [ "GP", 0.044 ], [ "partner", 0.039 ] ], "spread_patient": [ [ "therapist", 0.158 ], [ "friends", 0.096 ], [ "husband", 0.075 ], [ "doctor", 0.058 ], [ "friend", 0.058 ] ], "target_token": "doctor", "flipped": true, "screening": null, "circuit_diff": { "shared_features": 455, "unique_to_a": 793, "unique_to_b": 844 }, "clinical_mass": { "clinical": 0.283, "patient": 0.0849 }, "html": "modes/simulated/pairs_20260719T132706Z/index_59.html", "urgency": { "flip_class": "upgrade", "tier_top_clinical": 2, "tier_top_patient": 3, "tier_shift": -0.112, "urgency_recovery": 0.309 } } }, "prob_clinical": 0.475, "prob_patient": 0.058, "language_penalty": -0.417, "flipped": true, "top_clinical": [ "doctor", 0.475 ], "top_patient": [ "therapist", 0.158 ], "spread_clinical": [ [ "doctor", 0.475 ], [ "husband", 0.064 ], [ "doc", 0.064 ], [ "GP", 0.044 ], [ "partner", 0.039 ] ], "spread_patient": [ [ "therapist", 0.158 ], [ "friends", 0.096 ], [ "husband", 0.075 ], [ "doctor", 0.058 ], [ "friend", 0.058 ] ], "target_token": "doctor", "anchor_fallback": true, "screening": null, "circuit_diff": { "shared_features": 455, "unique_to_a": 793, "unique_to_b": 844 }, "clinical_mass": { "clinical": 0.283, "patient": 0.0849 }, "html": "modes/simulated/pairs_20260719T132706Z/index_59.html", "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260719T132706Z/index_59.html", "urgency": { "flip_class": "upgrade", "tier_top_clinical": 2, "tier_top_patient": 3, "tier_shift": -0.112, "urgency_recovery": 0.309 } }, { "index": 1169, "batch": "pairs_20260719T132706Z", "batch_index": 60, "clinical_prompt": "I woke up with profuse nocturnal perspiration, so I'm probably going through my", "patient_prompt": "I woke up with my nightgown soaked, so I'm probably going through my", "intended_target": "menopause", "rationale": "Colloquial image contrasts with clinical symptom descriptor. Frame 'going through my' is strongly diagnostic for life-stage transitions in menopause context.", "patient_term": "my nightgown soaked", "clinical_term": "profuse nocturnal perspiration", "topic": "menopause", "topics": [ "gynecology", "sexual medicine", "menopause", "infectious disease", "pharyngitis", "fever", "nocturia", "urinary tract infection", "genitourinary", "endocrine disorder", "hyperhidrosis", "thyroid disorder" ], "models": { "gemma-2-2b": { "prob_clinical": 0.066, "prob_patient": null, "language_penalty": null, "anchor_fallback": false, "top_clinical": [ "first", 0.109 ], "top_patient": [ "period", 0.231 ], "spread_clinical": [ [ "first", 0.109 ], [ "menopause", 0.066 ], [ "own", 0.059 ], [ "\"", 0.052 ] ], "spread_patient": [ [ "period", 0.231 ], [ "second", 0.097 ], [ "first", 0.066 ], [ "third", 0.059 ] ], "target_token": "menopause", "flipped": true, "screening": null, "circuit_diff": { "shared_features": 943, "unique_to_a": 407, "unique_to_b": 443 }, "clinical_mass": { "clinical": 0.1435, "patient": 0.1154 }, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } } }, "prob_clinical": 0.066, "prob_patient": null, "language_penalty": null, "flipped": true, "top_clinical": [ "first", 0.109 ], "top_patient": [ "period", 0.231 ], "spread_clinical": [ [ "first", 0.109 ], [ "menopause", 0.066 ], [ "own", 0.059 ], [ "\"", 0.052 ] ], "spread_patient": [ [ "period", 0.231 ], [ "second", 0.097 ], [ "first", 0.066 ], [ "third", 0.059 ] ], "target_token": "menopause", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 943, "unique_to_a": 407, "unique_to_b": 443 }, "clinical_mass": { "clinical": 0.1435, "patient": 0.1154 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260719T132706Z/index_60.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, { "index": 1170, "batch": "pairs_20260719T132706Z", "batch_index": 61, "clinical_prompt": "I've been experiencing sustained pyrexia for days, so I should probably see a", "patient_prompt": "I've been running a high fever for days, so I should probably see a", "intended_target": "doctor", "rationale": "Colloquial 'running a fever' suggests minor illness; clinical term pyrexia suggests systemic investigation. Frame 'see a' predicts medical professional regardless, but clinical phrasing elevates urgency.", "patient_term": "running a high fever", "clinical_term": "sustained pyrexia", "topic": "fever", "topics": [ "gynecology", "sexual medicine", "menopause", "infectious disease", "pharyngitis", "fever", "nocturia", "urinary tract infection", "genitourinary", "endocrine disorder", "hyperhidrosis", "thyroid disorder" ], "models": { "gemma-2-2b": { "prob_clinical": 0.777, "prob_patient": 0.926, "language_penalty": 0.14900000000000002, "anchor_fallback": false, "top_clinical": [ "doctor", 0.777 ], "top_patient": [ "doctor", 0.926 ], "spread_clinical": [ [ "doctor", 0.777 ], [ "GP", 0.072 ], [ "doc", 0.056 ], [ "Dr", 0.021 ], [ "physician", 0.013 ] ], "spread_patient": [ [ "doctor", 0.926 ], [ "doc", 0.032 ] ], "target_token": "doctor", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 658, "unique_to_a": 674, "unique_to_b": 459 }, "clinical_mass": { "clinical": 0.3895, "patient": 0.3966, "translated": 0.2465 }, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": 0.0 } } }, "prob_clinical": 0.777, "prob_patient": 0.926, "language_penalty": 0.14900000000000002, "flipped": false, "top_clinical": [ "doctor", 0.777 ], "top_patient": [ "doctor", 0.926 ], "spread_clinical": [ [ "doctor", 0.777 ], [ "GP", 0.072 ], [ "doc", 0.056 ], [ "Dr", 0.021 ], [ "physician", 0.013 ] ], "spread_patient": [ [ "doctor", 0.926 ], [ "doc", 0.032 ] ], "target_token": "doctor", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 658, "unique_to_a": 674, "unique_to_b": 459 }, "clinical_mass": { "clinical": 0.3895, "patient": 0.3966, "translated": 0.2465 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260719T132706Z/index_61.html", "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": 0.0 } }, { "index": 1171, "batch": "pairs_20260719T132706Z", "batch_index": 62, "clinical_prompt": "I have acute pharyngitis, so I'm probably dealing with a", "patient_prompt": "My throat is killing me, so I'm probably dealing with a", "intended_target": "bacterial", "rationale": "Patient phrasing is hyperbolic; clinical diagnosis triggers etiology-based continuations. Frame 'dealing with a' grammatically funnels toward pathogen type or infection category.", "patient_term": "throat is killing me", "clinical_term": "acute pharyngitis", "topic": "pharyngitis", "topics": [ "gynecology", "sexual medicine", "menopause", "infectious disease", "pharyngitis", "fever", "nocturia", "urinary tract infection", "genitourinary", "endocrine disorder", "hyperhidrosis", "thyroid disorder" ], "models": { "gemma-2-2b": { "prob_clinical": 0.116, "prob_patient": null, "language_penalty": null, "anchor_fallback": false, "top_clinical": [ "virus", 0.169 ], "top_patient": [ "cold", 0.299 ], "spread_clinical": [ [ "virus", 0.169 ], [ "viral", 0.132 ], [ "bacterial", 0.116 ], [ "sore", 0.062 ], [ "lot", 0.062 ] ], "spread_patient": [ [ "cold", 0.299 ], [ "sinus", 0.076 ], [ "sore", 0.067 ], [ "virus", 0.046 ], [ "bad", 0.041 ] ], "target_token": "bacterial", "flipped": true, "screening": null, "circuit_diff": { "shared_features": 610, "unique_to_a": 761, "unique_to_b": 659 }, "clinical_mass": { "clinical": 0.4533, "patient": 0.3683, "translated": 0.4611 }, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } } }, "prob_clinical": 0.116, "prob_patient": null, "language_penalty": null, "flipped": true, "top_clinical": [ "virus", 0.169 ], "top_patient": [ "cold", 0.299 ], "spread_clinical": [ [ "virus", 0.169 ], [ "viral", 0.132 ], [ "bacterial", 0.116 ], [ "sore", 0.062 ], [ "lot", 0.062 ] ], "spread_patient": [ [ "cold", 0.299 ], [ "sinus", 0.076 ], [ "sore", 0.067 ], [ "virus", 0.046 ], [ "bad", 0.041 ] ], "target_token": "bacterial", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 610, "unique_to_a": 761, "unique_to_b": 659 }, "clinical_mass": { "clinical": 0.4533, "patient": 0.3683, "translated": 0.4611 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260719T132706Z/index_62.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, { "index": 1172, "batch": "pairs_20260719T132706Z", "batch_index": 63, "clinical_prompt": "I have nocturia, so my doctor is worried about my", "patient_prompt": "I'm up four times a night running to pee, so my doctor is worried about my", "intended_target": "glucose", "rationale": "Colloquial description frames as inconvenience; clinical term signals potential endocrine disorder (diabetes). Doctor's concern naturally probes toward metabolic screening.", "patient_term": "up four times a night running to pee", "clinical_term": "nocturia", "topic": "nocturia", "topics": [ "gynecology", "sexual medicine", "menopause", "infectious disease", "pharyngitis", "fever", "nocturia", "urinary tract infection", "genitourinary", "endocrine disorder", "hyperhidrosis", "thyroid disorder" ], "models": { "gemma-2-2b": { "prob_clinical": 0.23, "prob_patient": 0.198, "language_penalty": -0.032, "anchor_fallback": true, "top_clinical": [ "bladder", 0.23 ], "top_patient": [ "kidneys", 0.198 ], "spread_clinical": [ [ "bladder", 0.23 ], [ "kidneys", 0.18 ], [ "kidney", 0.14 ], [ "prostate", 0.051 ], [ "blood", 0.031 ] ], "spread_patient": [ [ "kidneys", 0.198 ], [ "bladder", 0.198 ], [ "blood", 0.064 ], [ "kidney", 0.064 ], [ "heart", 0.064 ] ], "target_token": "bladder", "flipped": true, "screening": null, "circuit_diff": { "shared_features": 601, "unique_to_a": 813, "unique_to_b": 876 }, "clinical_mass": { "clinical": 0.3943, "patient": 0.327, "translated": 0.3658 }, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } } }, "prob_clinical": 0.23, "prob_patient": 0.198, "language_penalty": -0.032, "flipped": true, "top_clinical": [ "bladder", 0.23 ], "top_patient": [ "kidneys", 0.198 ], "spread_clinical": [ [ "bladder", 0.23 ], [ "kidneys", 0.18 ], [ "kidney", 0.14 ], [ "prostate", 0.051 ], [ "blood", 0.031 ] ], "spread_patient": [ [ "kidneys", 0.198 ], [ "bladder", 0.198 ], [ "blood", 0.064 ], [ "kidney", 0.064 ], [ "heart", 0.064 ] ], "target_token": "bladder", "anchor_fallback": true, "screening": null, "circuit_diff": { "shared_features": 601, "unique_to_a": 813, "unique_to_b": 876 }, "clinical_mass": { "clinical": 0.3943, "patient": 0.327, "translated": 0.3658 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260719T132706Z/index_63.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, { "index": 1173, "batch": "pairs_20260719T132706Z", "batch_index": 64, "clinical_prompt": "I have vulvovaginitis, so I probably need an", "patient_prompt": "I'm getting this nasty discharge down there, so I probably need an", "intended_target": "antibiotic", "rationale": "Patient phrase is vague lay description; clinical diagnosis of vulvovaginitis directs toward specific therapeutic class. The article 'an' before vowel funnels toward treatment word.", "patient_term": "nasty discharge down there", "clinical_term": "vulvovaginitis", "topic": "gynecology", "topics": [ "gynecology", "sexual medicine", "menopause", "infectious disease", "pharyngitis", "fever", "nocturia", "urinary tract infection", "genitourinary", "endocrine disorder", "hyperhidrosis", "thyroid disorder" ], "models": { "gemma-2-2b": { "prob_clinical": 0.18, "prob_patient": 0.112, "language_penalty": -0.06799999999999999, "anchor_fallback": false, "top_clinical": [ "antibiotic", 0.18 ], "top_patient": [ "I", 0.128 ], "spread_clinical": [ [ "antibiotic", 0.18 ], [ "antifungal", 0.18 ], [ "anti", 0.085 ], [ "estrogen", 0.075 ], [ "over", 0.045 ] ], "spread_patient": [ [ "I", 0.128 ], [ "antibiotic", 0.112 ], [ "exam", 0.099 ], [ "internal", 0.06 ], [ "OB", 0.041 ] ], "target_token": "antibiotic", "flipped": true, "screening": null, "circuit_diff": { "shared_features": 629, "unique_to_a": 662, "unique_to_b": 757 }, "clinical_mass": { "clinical": 0.3754, "patient": 0.304, "translated": 0.3516 }, "urgency": { "flip_class": "uninformative", "tier_top_clinical": 2, "tier_top_patient": null, "tier_shift": 0.419 } } }, "prob_clinical": 0.18, "prob_patient": 0.112, "language_penalty": -0.06799999999999999, "flipped": true, "top_clinical": [ "antibiotic", 0.18 ], "top_patient": [ "I", 0.128 ], "spread_clinical": [ [ "antibiotic", 0.18 ], [ "antifungal", 0.18 ], [ "anti", 0.085 ], [ "estrogen", 0.075 ], [ "over", 0.045 ] ], "spread_patient": [ [ "I", 0.128 ], [ "antibiotic", 0.112 ], [ "exam", 0.099 ], [ "internal", 0.06 ], [ "OB", 0.041 ] ], "target_token": "antibiotic", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 629, "unique_to_a": 662, "unique_to_b": 757 }, "clinical_mass": { "clinical": 0.3754, "patient": 0.304, "translated": 0.3516 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260719T132706Z/index_64.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": 2, "tier_top_patient": null, "tier_shift": 0.419 } }, { "index": 1174, "batch": "pairs_20260719T132706Z", "batch_index": 65, "clinical_prompt": "I have decreased libido, so I need to talk to my", "patient_prompt": "My partner says I've lost interest in intimacy, so I need to talk to my", "intended_target": "doctor", "rationale": "Relationship-framed concern versus medical symptom. Clinical phrasing directs toward clinical professional categories rather than general support.", "patient_term": "lost interest in intimacy", "clinical_term": "decreased libido", "topic": "sexual medicine", "topics": [ "gynecology", "sexual medicine", "menopause", "infectious disease", "pharyngitis", "fever", "nocturia", "urinary tract infection", "genitourinary", "endocrine disorder", "hyperhidrosis", "thyroid disorder" ], "models": { "gemma-2-2b": { "prob_clinical": 0.512, "prob_patient": 0.293, "language_penalty": -0.21900000000000003, "anchor_fallback": false, "top_clinical": [ "doctor", 0.512 ], "top_patient": [ "doctor", 0.293 ], "spread_clinical": [ [ "doctor", 0.512 ], [ "partner", 0.069 ], [ "husband", 0.054 ], [ "doc", 0.054 ], [ "wife", 0.054 ] ], "spread_patient": [ [ "doctor", 0.293 ], [ "therapist", 0.156 ], [ "GP", 0.122 ], [ "partner", 0.074 ], [ "husband", 0.021 ] ], "target_token": "doctor", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 548, "unique_to_a": 579, "unique_to_b": 799 }, "clinical_mass": { "clinical": 0.289, "patient": 0.1882, "translated": 0.2672 }, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": 0.513 } } }, "prob_clinical": 0.512, "prob_patient": 0.293, "language_penalty": -0.21900000000000003, "flipped": false, "top_clinical": [ "doctor", 0.512 ], "top_patient": [ "doctor", 0.293 ], "spread_clinical": [ [ "doctor", 0.512 ], [ "partner", 0.069 ], [ "husband", 0.054 ], [ "doc", 0.054 ], [ "wife", 0.054 ] ], "spread_patient": [ [ "doctor", 0.293 ], [ "therapist", 0.156 ], [ "GP", 0.122 ], [ "partner", 0.074 ], [ "husband", 0.021 ] ], "target_token": "doctor", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 548, "unique_to_a": 579, "unique_to_b": 799 }, "clinical_mass": { "clinical": 0.289, "patient": 0.1882, "translated": 0.2672 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260719T132706Z/index_65.html", "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": 0.513 } }, { "index": 1175, "batch": "pairs_20260719T132706Z", "batch_index": 66, "clinical_prompt": "I woke up with acute pharyngitis, so I'm probably dealing with a", "patient_prompt": "I woke up with this angry red throat, so I'm probably dealing with a", "intended_target": "bacterial", "rationale": "Patient description emphasizes appearance; clinical term signals specific condition requiring pathogen classification. Frame naturally probes toward etiology word.", "patient_term": "angry red throat", "clinical_term": "acute pharyngitis", "topic": "pharyngitis", "topics": [ "gynecology", "sexual medicine", "menopause", "infectious disease", "pharyngitis", "fever", "nocturia", "urinary tract infection", "genitourinary", "endocrine disorder", "hyperhidrosis", "thyroid disorder" ], "models": { "gemma-2-2b": { "prob_clinical": 0.054, "prob_patient": null, "language_penalty": null, "anchor_fallback": false, "top_clinical": [ "cold", 0.19 ], "top_patient": [ "cold", 0.318 ], "spread_clinical": [ [ "cold", 0.19 ], [ "viral", 0.102 ], [ "virus", 0.09 ], [ "sore", 0.062 ], [ "bacterial", 0.054 ] ], "spread_patient": [ [ "cold", 0.318 ], [ "sinus", 0.103 ], [ "virus", 0.071 ], [ "sore", 0.062 ], [ "stre", 0.038 ] ], "target_token": "bacterial", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 804, "unique_to_a": 583, "unique_to_b": 572 }, "clinical_mass": { "clinical": 0.4378, "patient": 0.3706, "translated": 0.4712 } } }, "prob_clinical": 0.054, "prob_patient": null, "language_penalty": null, "flipped": false, "top_clinical": [ "cold", 0.19 ], "top_patient": [ "cold", 0.318 ], "spread_clinical": [ [ "cold", 0.19 ], [ "viral", 0.102 ], [ "virus", 0.09 ], [ "sore", 0.062 ], [ "bacterial", 0.054 ] ], "spread_patient": [ [ "cold", 0.318 ], [ "sinus", 0.103 ], [ "virus", 0.071 ], [ "sore", 0.062 ], [ "stre", 0.038 ] ], "target_token": "bacterial", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 804, "unique_to_a": 583, "unique_to_b": 572 }, "clinical_mass": { "clinical": 0.4378, "patient": 0.3706, "translated": 0.4712 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260719T132706Z/index_66.html" }, { "index": 1176, "batch": "pairs_20260719T132706Z", "batch_index": 67, "clinical_prompt": "I've been getting pelvic inflammatory disease symptoms, so my gynecologist wants to rule out an", "patient_prompt": "I've been getting these weird cramps down low, so my gynecologist wants to rule out an", "intended_target": "infection", "rationale": "Patient uses vague, colloquial descriptor ('weird cramps down low'); clinical phrasing names the condition. Frame naturally funnels toward 'infection' as the diagnostic next token in the clinical context.", "patient_term": "weird cramps down low", "clinical_term": "pelvic inflammatory disease", "topic": "gynecology", "topics": [ "gynecology", "sexual medicine", "menopause", "infectious disease", "pharyngitis", "fever", "nocturia", "urinary tract infection", "genitourinary", "endocrine disorder", "hyperhidrosis", "thyroid disorder" ], "models": { "gemma-2-2b": { "prob_clinical": 0.222, "prob_patient": 0.119, "language_penalty": -0.10300000000000001, "anchor_fallback": false, "top_clinical": [ "ec", 0.283 ], "top_patient": [ "ec", 0.605 ], "spread_clinical": [ [ "ec", 0.283 ], [ "infection", 0.222 ], [ "STD", 0.195 ], [ "STI", 0.063 ], [ "ovarian", 0.063 ] ], "spread_patient": [ [ "ec", 0.605 ], [ "ovarian", 0.174 ], [ "infection", 0.119 ], [ "STD", 0.016 ], [ "endometriosis", 0.01 ] ], "target_token": "infection", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 823, "unique_to_a": 564, "unique_to_b": 582 }, "clinical_mass": { "clinical": 0.4935, "patient": 0.437, "translated": 0.4639 } } }, "prob_clinical": 0.222, "prob_patient": 0.119, "language_penalty": -0.10300000000000001, "flipped": false, "top_clinical": [ "ec", 0.283 ], "top_patient": [ "ec", 0.605 ], "spread_clinical": [ [ "ec", 0.283 ], [ "infection", 0.222 ], [ "STD", 0.195 ], [ "STI", 0.063 ], [ "ovarian", 0.063 ] ], "spread_patient": [ [ "ec", 0.605 ], [ "ovarian", 0.174 ], [ "infection", 0.119 ], [ "STD", 0.016 ], [ "endometriosis", 0.01 ] ], "target_token": "infection", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 823, "unique_to_a": 564, "unique_to_b": 582 }, "clinical_mass": { "clinical": 0.4935, "patient": 0.437, "translated": 0.4639 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260719T132706Z/index_67.html" }, { "index": 1177, "batch": "pairs_20260719T132706Z", "batch_index": 68, "clinical_prompt": "I have vulvovaginal tenderness right now, so I probably need to take an", "patient_prompt": "My lady bits feel really tender right now, so I probably need to take an", "intended_target": "antibiotic", "rationale": "Patient uses euphemism; clinical phrasing uses anatomical term. Frame set to probe for antibiotic as a common UTI/infection treatment in the clinical reading.", "patient_term": "lady bits feel really tender", "clinical_term": "vulvovaginal tenderness", "topic": "urinary tract infection", "topics": [ "gynecology", "sexual medicine", "menopause", "infectious disease", "pharyngitis", "fever", "nocturia", "urinary tract infection", "genitourinary", "endocrine disorder", "hyperhidrosis", "thyroid disorder" ], "models": { "gemma-2-2b": { "prob_clinical": 0.132, "prob_patient": 0.11, "language_penalty": -0.022000000000000006, "anchor_fallback": false, "top_clinical": [ "antibiotic", 0.132 ], "top_patient": [ "extra", 0.232 ], "spread_clinical": [ [ "antibiotic", 0.132 ], [ "anti", 0.132 ], [ "extra", 0.091 ], [ "ibuprofen", 0.091 ], [ "over", 0.071 ] ], "spread_patient": [ [ "extra", 0.232 ], [ "anti", 0.11 ], [ "ibuprofen", 0.085 ], [ "adv", 0.046 ], [ "over", 0.046 ] ], "target_token": "antibiotic", "flipped": true, "screening": null, "circuit_diff": { "shared_features": 685, "unique_to_a": 619, "unique_to_b": 687 }, "clinical_mass": { "clinical": 0.3726, "patient": 0.2259, "translated": 0.29 }, "urgency": { "flip_class": "uninformative", "tier_top_clinical": 2, "tier_top_patient": null, "tier_shift": -0.394 } } }, "prob_clinical": 0.132, "prob_patient": 0.11, "language_penalty": -0.022000000000000006, "flipped": true, "top_clinical": [ "antibiotic", 0.132 ], "top_patient": [ "extra", 0.232 ], "spread_clinical": [ [ "antibiotic", 0.132 ], [ "anti", 0.132 ], [ "extra", 0.091 ], [ "ibuprofen", 0.091 ], [ "over", 0.071 ] ], "spread_patient": [ [ "extra", 0.232 ], [ "anti", 0.11 ], [ "ibuprofen", 0.085 ], [ "adv", 0.046 ], [ "over", 0.046 ] ], "target_token": "antibiotic", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 685, "unique_to_a": 619, "unique_to_b": 687 }, "clinical_mass": { "clinical": 0.3726, "patient": 0.2259, "translated": 0.29 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260719T132706Z/index_68.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": 2, "tier_top_patient": null, "tier_shift": -0.394 } }, { "index": 1178, "batch": "pairs_20260719T132706Z", "batch_index": 69, "clinical_prompt": "I have low libido, so we've been talking to a", "patient_prompt": "I'm not in the mood for my husband anymore, so we've been talking to a", "intended_target": "therapist", "rationale": "Patient describes loss of sexual desire colloquially; clinical phrasing names the condition. Frame probes for professional (therapist/counselor) as the natural continuation in sexual medicine context.", "patient_term": "not in the mood for my husband", "clinical_term": "low libido", "topic": "sexual medicine", "topics": [ "gynecology", "sexual medicine", "menopause", "infectious disease", "pharyngitis", "fever", "nocturia", "urinary tract infection", "genitourinary", "endocrine disorder", "hyperhidrosis", "thyroid disorder" ], "models": { "gemma-2-2b": { "prob_clinical": 0.076, "prob_patient": 0.101, "language_penalty": 0.02500000000000001, "anchor_fallback": false, "top_clinical": [ "sex", 0.142 ], "top_patient": [ "counselor", 0.146 ], "spread_clinical": [ [ "sex", 0.142 ], [ "doctor", 0.125 ], [ "therapist", 0.076 ], [ "couple", 0.059 ], [ "few", 0.059 ] ], "spread_patient": [ [ "counselor", 0.146 ], [ "divorce", 0.146 ], [ "marriage", 0.114 ], [ "therapist", 0.101 ], [ "couple", 0.042 ] ], "target_token": "therapist", "flipped": true, "screening": null, "circuit_diff": { "shared_features": 449, "unique_to_a": 759, "unique_to_b": 938 }, "clinical_mass": { "clinical": 0.3017, "patient": 0.1106, "translated": 0.1274 }, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": 3, "tier_shift": 0.622 } } }, "prob_clinical": 0.076, "prob_patient": 0.101, "language_penalty": 0.02500000000000001, "flipped": true, "top_clinical": [ "sex", 0.142 ], "top_patient": [ "counselor", 0.146 ], "spread_clinical": [ [ "sex", 0.142 ], [ "doctor", 0.125 ], [ "therapist", 0.076 ], [ "couple", 0.059 ], [ "few", 0.059 ] ], "spread_patient": [ [ "counselor", 0.146 ], [ "divorce", 0.146 ], [ "marriage", 0.114 ], [ "therapist", 0.101 ], [ "couple", 0.042 ] ], "target_token": "therapist", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 449, "unique_to_a": 759, "unique_to_b": 938 }, "clinical_mass": { "clinical": 0.3017, "patient": 0.1106, "translated": 0.1274 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260719T132706Z/index_69.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": 3, "tier_shift": 0.622 } }, { "index": 1179, "batch": "pairs_20260719T132706Z", "batch_index": 70, "clinical_prompt": "I keep having to get up to urinate during my shift at work, so I'm worried I might have", "patient_prompt": "I keep having to get up to pee during my shift at work, so I'm worried I might have", "intended_target": "diabetes", "rationale": "Patient uses colloquial 'pee'; clinical phrasing uses precise 'urinate'. Frame is daytime-focused (not night) but probes for systemic cause (diabetes) rather than nocturnal reading in clinical context.", "patient_term": "get up to pee", "clinical_term": "get up to urinate", "topic": "nocturia", "topics": [ "gynecology", "sexual medicine", "menopause", "infectious disease", "pharyngitis", "fever", "nocturia", "urinary tract infection", "genitourinary", "endocrine disorder", "hyperhidrosis", "thyroid disorder" ], "models": { "gemma-2-2b": { "prob_clinical": 0.369, "prob_patient": 0.314, "language_penalty": -0.05499999999999999, "anchor_fallback": true, "top_clinical": [ "a", 0.369 ], "top_patient": [ "a", 0.314 ], "spread_clinical": [ [ "a", 0.369 ], [ "to", 0.174 ], [ "an", 0.12 ], [ "bladder", 0.056 ], [ "kidney", 0.039 ] ], "spread_patient": [ [ "a", 0.314 ], [ "to", 0.277 ], [ "an", 0.09 ], [ "bladder", 0.048 ], [ "some", 0.026 ] ], "target_token": "a", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 1206, "unique_to_a": 266, "unique_to_b": 203 }, "clinical_mass": { "clinical": 0.2867, "patient": 0.2746, "translated": 0.2866 } } }, "prob_clinical": 0.369, "prob_patient": 0.314, "language_penalty": -0.05499999999999999, "flipped": false, "top_clinical": [ "a", 0.369 ], "top_patient": [ "a", 0.314 ], "spread_clinical": [ [ "a", 0.369 ], [ "to", 0.174 ], [ "an", 0.12 ], [ "bladder", 0.056 ], [ "kidney", 0.039 ] ], "spread_patient": [ [ "a", 0.314 ], [ "to", 0.277 ], [ "an", 0.09 ], [ "bladder", 0.048 ], [ "some", 0.026 ] ], "target_token": "a", "anchor_fallback": true, "screening": null, "circuit_diff": { "shared_features": 1206, "unique_to_a": 266, "unique_to_b": 203 }, "clinical_mass": { "clinical": 0.2867, "patient": 0.2746, "translated": 0.2866 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260719T132706Z/index_70.html" }, { "index": 1180, "batch": "pairs_20260719T132706Z", "batch_index": 72, "clinical_prompt": "I have acute pharyngitis, so I'm probably fighting an", "patient_prompt": "My throat is absolutely killing me, so I'm probably fighting an", "intended_target": "infection", "rationale": "Lay hyperbole 'killing me' versus clinical diagnosis 'acute pharyngitis'. Frame funnels toward 'infection' as natural continuation in medical context.", "patient_term": "My throat is absolutely killing me", "clinical_term": "I have acute pharyngitis", "topic": "pharyngitis", "topics": [ "gynecology", "sexual medicine", "menopause", "infectious disease", "pharyngitis", "fever", "nocturia", "urinary tract infection", "genitourinary", "endocrine disorder", "hyperhidrosis", "thyroid disorder" ], "models": { "gemma-2-2b": { "prob_clinical": 0.691, "prob_patient": 0.539, "language_penalty": -0.1519999999999999, "anchor_fallback": false, "top_clinical": [ "infection", 0.691 ], "top_patient": [ "infection", 0.539 ], "spread_clinical": [ [ "infection", 0.691 ], [ "upper", 0.175 ], [ "ear", 0.014 ], [ "antibiotic", 0.007 ], [ "immune", 0.007 ] ], "spread_patient": [ [ "infection", 0.539 ], [ "upper", 0.073 ], [ "awful", 0.05 ], [ "illness", 0.03 ], [ "oncoming", 0.018 ] ], "target_token": "infection", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 597, "unique_to_a": 641, "unique_to_b": 626 }, "clinical_mass": { "clinical": 0.429, "patient": 0.2651, "translated": 0.364 } } }, "prob_clinical": 0.691, "prob_patient": 0.539, "language_penalty": -0.1519999999999999, "flipped": false, "top_clinical": [ "infection", 0.691 ], "top_patient": [ "infection", 0.539 ], "spread_clinical": [ [ "infection", 0.691 ], [ "upper", 0.175 ], [ "ear", 0.014 ], [ "antibiotic", 0.007 ], [ "immune", 0.007 ] ], "spread_patient": [ [ "infection", 0.539 ], [ "upper", 0.073 ], [ "awful", 0.05 ], [ "illness", 0.03 ], [ "oncoming", 0.018 ] ], "target_token": "infection", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 597, "unique_to_a": 641, "unique_to_b": 626 }, "clinical_mass": { "clinical": 0.429, "patient": 0.2651, "translated": 0.364 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260719T132706Z/index_72.html" }, { "index": 1181, "batch": "pairs_20260719T132706Z", "batch_index": 73, "clinical_prompt": "I have a fever, so I should probably take an", "patient_prompt": "I've been burning up all morning, so I should probably take an", "intended_target": "antipyretic", "rationale": "Colloquial 'burning up' (idiomatic for feeling hot) replaced by clinical 'fever'. Frame 'take an' positions for medical remedy rather than casual cooling.", "patient_term": "burning up", "clinical_term": "fever", "topic": "fever", "topics": [ "gynecology", "sexual medicine", "menopause", "infectious disease", "pharyngitis", "fever", "nocturia", "urinary tract infection", "genitourinary", "endocrine disorder", "hyperhidrosis", "thyroid disorder" ], "models": { "gemma-2-2b": { "prob_clinical": 0.076, "prob_patient": null, "language_penalty": null, "anchor_fallback": false, "top_clinical": [ "aspirin", 0.438 ], "top_patient": [ "aspirin", 0.268 ], "spread_clinical": [ [ "aspirin", 0.438 ], [ "Ad", 0.076 ], [ "anti", 0.076 ], [ "ibuprofen", 0.059 ], [ "antibiotic", 0.052 ] ], "spread_patient": [ [ "aspirin", 0.268 ], [ "hour", 0.112 ], [ "afternoon", 0.099 ], [ "ibuprofen", 0.053 ], [ "ice", 0.053 ] ], "target_token": "anti", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 551, "unique_to_a": 541, "unique_to_b": 695 }, "clinical_mass": { "clinical": 0.3003, "patient": 0.1224, "translated": 0.2559 }, "urgency": { "flip_class": null, "tier_top_clinical": 1, "tier_top_patient": 1, "tier_shift": -0.257 } } }, "prob_clinical": 0.076, "prob_patient": null, "language_penalty": null, "flipped": false, "top_clinical": [ "aspirin", 0.438 ], "top_patient": [ "aspirin", 0.268 ], "spread_clinical": [ [ "aspirin", 0.438 ], [ "Ad", 0.076 ], [ "anti", 0.076 ], [ "ibuprofen", 0.059 ], [ "antibiotic", 0.052 ] ], "spread_patient": [ [ "aspirin", 0.268 ], [ "hour", 0.112 ], [ "afternoon", 0.099 ], [ "ibuprofen", 0.053 ], [ "ice", 0.053 ] ], "target_token": "anti", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 551, "unique_to_a": 541, "unique_to_b": 695 }, "clinical_mass": { "clinical": 0.3003, "patient": 0.1224, "translated": 0.2559 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260719T132706Z/index_73.html", "urgency": { "flip_class": null, "tier_top_clinical": 1, "tier_top_patient": 1, "tier_shift": -0.257 } }, { "index": 1182, "batch": "pairs_20260719T132706Z", "batch_index": 74, "clinical_prompt": "I have a gynecological concern, so I need to talk to my", "patient_prompt": "I'm having some female troubles down there, so I need to talk to my", "intended_target": "gynecologist", "rationale": "Vague lay phrase 'female troubles' contrasts with precise 'gynecological concern'. Frame naturally funnels toward specialist name.", "patient_term": "female troubles down there", "clinical_term": "gynecological concern", "topic": "gynecology", "topics": [ "gynecology", "sexual medicine", "menopause", "infectious disease", "pharyngitis", "fever", "nocturia", "urinary tract infection", "genitourinary", "endocrine disorder", "hyperhidrosis", "thyroid disorder" ], "models": { "gemma-2-2b": { "prob_clinical": 0.131, "prob_patient": 0.038, "language_penalty": -0.093, "anchor_fallback": false, "top_clinical": [ "doctor", 0.586 ], "top_patient": [ "doctor", 0.408 ], "spread_clinical": [ [ "doctor", 0.586 ], [ "gyne", 0.131 ], [ "GP", 0.023 ], [ "family", 0.018 ], [ "OB", 0.016 ] ], "spread_patient": [ [ "doctor", 0.408 ], [ "doc", 0.081 ], [ "wife", 0.043 ], [ "gyne", 0.038 ], [ "OB", 0.034 ] ], "target_token": "gyne", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 524, "unique_to_a": 594, "unique_to_b": 767 }, "clinical_mass": { "clinical": 0.3675, "patient": 0.2294, "translated": 0.3729 }, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.104 } } }, "prob_clinical": 0.131, "prob_patient": 0.038, "language_penalty": -0.093, "flipped": false, "top_clinical": [ "doctor", 0.586 ], "top_patient": [ "doctor", 0.408 ], "spread_clinical": [ [ "doctor", 0.586 ], [ "gyne", 0.131 ], [ "GP", 0.023 ], [ "family", 0.018 ], [ "OB", 0.016 ] ], "spread_patient": [ [ "doctor", 0.408 ], [ "doc", 0.081 ], [ "wife", 0.043 ], [ "gyne", 0.038 ], [ "OB", 0.034 ] ], "target_token": "gyne", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 524, "unique_to_a": 594, "unique_to_b": 767 }, "clinical_mass": { "clinical": 0.3675, "patient": 0.2294, "translated": 0.3729 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260719T132706Z/index_74.html", "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.104 } }, { "index": 1183, "batch": "pairs_20260719T132706Z", "batch_index": 75, "clinical_prompt": "I have hyperhidrosis, so I should probably get my", "patient_prompt": "I'm sweating buckets even when it's freezing out, so I should probably get my", "intended_target": "levels", "rationale": "Colloquial exaggeration 'sweating buckets' versus clinical term 'hyperhidrosis'. Frame 'get my' positions for medical evaluation or lab work continuation.", "patient_term": "sweating buckets even when it's freezing out", "clinical_term": "hyperhidrosis", "topic": "hyperhidrosis", "topics": [ "gynecology", "sexual medicine", "menopause", "infectious disease", "pharyngitis", "fever", "nocturia", "urinary tract infection", "genitourinary", "endocrine disorder", "hyperhidrosis", "thyroid disorder" ], "models": { "gemma-2-2b": { "prob_clinical": 0.215, "prob_patient": null, "language_penalty": null, "anchor_fallback": true, "top_clinical": [ "hands", 0.215 ], "top_patient": [ "blood", 0.078 ], "spread_clinical": [ [ "hands", 0.215 ], [ "own", 0.168 ], [ "sweat", 0.102 ], [ "feet", 0.042 ], [ "money", 0.026 ] ], "spread_patient": [ [ "blood", 0.078 ], [ "ass", 0.061 ], [ "butt", 0.042 ], [ "body", 0.037 ], [ "act", 0.037 ] ], "target_token": "hands", "flipped": true, "screening": null, "circuit_diff": { "shared_features": 629, "unique_to_a": 771, "unique_to_b": 879 }, "clinical_mass": { "clinical": 0.2107, "patient": 0.1236, "translated": 0.2359 }, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": 2, "tier_shift": null } } }, "prob_clinical": 0.215, "prob_patient": null, "language_penalty": null, "flipped": true, "top_clinical": [ "hands", 0.215 ], "top_patient": [ "blood", 0.078 ], "spread_clinical": [ [ "hands", 0.215 ], [ "own", 0.168 ], [ "sweat", 0.102 ], [ "feet", 0.042 ], [ "money", 0.026 ] ], "spread_patient": [ [ "blood", 0.078 ], [ "ass", 0.061 ], [ "butt", 0.042 ], [ "body", 0.037 ], [ "act", 0.037 ] ], "target_token": "hands", "anchor_fallback": true, "screening": null, "circuit_diff": { "shared_features": 629, "unique_to_a": 771, "unique_to_b": 879 }, "clinical_mass": { "clinical": 0.2107, "patient": 0.1236, "translated": 0.2359 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260719T132706Z/index_75.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": 2, "tier_shift": null } }, { "index": 1184, "batch": "pairs_20260719T132706Z", "batch_index": 76, "clinical_prompt": "I have a thyroid disorder, so I need to take my", "patient_prompt": "My gland's been acting strange, so I need to take my", "intended_target": "medication", "rationale": "Lay 'gland's been acting strange' versus clinical diagnosis 'thyroid disorder'. Frame 'take my' strongly signals pharmaceutical intervention in medical context.", "patient_term": "gland's been acting strange", "clinical_term": "thyroid disorder", "topic": "thyroid disorder", "topics": [ "gynecology", "sexual medicine", "menopause", "infectious disease", "pharyngitis", "fever", "nocturia", "urinary tract infection", "genitourinary", "endocrine disorder", "hyperhidrosis", "thyroid disorder" ], "models": { "gemma-2-2b": { "prob_clinical": 0.145, "prob_patient": 0.055, "language_penalty": -0.09, "anchor_fallback": false, "top_clinical": [ "thyroid", 0.305 ], "top_patient": [ "meds", 0.168 ], "spread_clinical": [ [ "thyroid", 0.305 ], [ "meds", 0.145 ], [ "medication", 0.145 ], [ "medicine", 0.036 ], [ "daily", 0.032 ] ], "spread_patient": [ [ "meds", 0.168 ], [ "thyroid", 0.102 ], [ "medicine", 0.055 ], [ "medication", 0.055 ], [ "dog", 0.055 ] ], "target_token": "medication", "flipped": true, "screening": null, "circuit_diff": { "shared_features": 562, "unique_to_a": 609, "unique_to_b": 729 }, "clinical_mass": { "clinical": 0.4041, "patient": 0.241, "translated": 0.3594 }, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": 1, "tier_shift": -0.165 } } }, "prob_clinical": 0.145, "prob_patient": 0.055, "language_penalty": -0.09, "flipped": true, "top_clinical": [ "thyroid", 0.305 ], "top_patient": [ "meds", 0.168 ], "spread_clinical": [ [ "thyroid", 0.305 ], [ "meds", 0.145 ], [ "medication", 0.145 ], [ "medicine", 0.036 ], [ "daily", 0.032 ] ], "spread_patient": [ [ "meds", 0.168 ], [ "thyroid", 0.102 ], [ "medicine", 0.055 ], [ "medication", 0.055 ], [ "dog", 0.055 ] ], "target_token": "medication", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 562, "unique_to_a": 609, "unique_to_b": 729 }, "clinical_mass": { "clinical": 0.4041, "patient": 0.241, "translated": 0.3594 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260719T132706Z/index_76.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": 1, "tier_shift": -0.165 } }, { "index": 1185, "batch": "pairs_20260719T132706Z", "batch_index": 77, "clinical_prompt": "I experience nocturia several times per night, so my doctor thinks I might have", "patient_prompt": "I keep having to rush to the bathroom to urinate at night, so my doctor thinks I might have", "intended_target": "diabetes", "rationale": "Patient phrasing frames as an inconvenient symptom; clinical term signals a named condition with differential diagnoses. Natural continuations diverge between complaint-focused and diagnostic-focused responses.", "patient_term": "keep having to rush to the bathroom to urinate at night", "clinical_term": "nocturia several times per night", "topic": "nocturia", "topics": [ "gynecology", "sexual medicine", "menopause", "infectious disease", "pharyngitis", "fever", "nocturia", "urinary tract infection", "genitourinary", "endocrine disorder", "hyperhidrosis", "thyroid disorder" ], "models": { "gemma-2-2b": { "prob_clinical": 0.312, "prob_patient": 0.273, "language_penalty": -0.03899999999999998, "anchor_fallback": true, "top_clinical": [ "an", 0.312 ], "top_patient": [ "a", 0.352 ], "spread_clinical": [ [ "an", 0.312 ], [ "a", 0.243 ], [ "B", 0.054 ], [ "interstitial", 0.042 ], [ "enlarged", 0.042 ] ], "spread_patient": [ [ "a", 0.352 ], [ "an", 0.273 ], [ "interstitial", 0.069 ], [ "kidney", 0.033 ], [ "bladder", 0.029 ] ], "target_token": "an", "flipped": true, "screening": null, "circuit_diff": { "shared_features": 815, "unique_to_a": 661, "unique_to_b": 631 }, "clinical_mass": { "clinical": 0.4041, "patient": 0.3673, "translated": 0.3675 }, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } } }, "prob_clinical": 0.312, "prob_patient": 0.273, "language_penalty": -0.03899999999999998, "flipped": true, "top_clinical": [ "an", 0.312 ], "top_patient": [ "a", 0.352 ], "spread_clinical": [ [ "an", 0.312 ], [ "a", 0.243 ], [ "B", 0.054 ], [ "interstitial", 0.042 ], [ "enlarged", 0.042 ] ], "spread_patient": [ [ "a", 0.352 ], [ "an", 0.273 ], [ "interstitial", 0.069 ], [ "kidney", 0.033 ], [ "bladder", 0.029 ] ], "target_token": "an", "anchor_fallback": true, "screening": null, "circuit_diff": { "shared_features": 815, "unique_to_a": 661, "unique_to_b": 631 }, "clinical_mass": { "clinical": 0.4041, "patient": 0.3673, "translated": 0.3675 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260719T132706Z/index_77.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, { "index": 1186, "batch": "pairs_20260719T132706Z", "batch_index": 79, "clinical_prompt": "I woke up with acute pharyngitis this morning, so I'm probably fighting an", "patient_prompt": "I woke up with this nasty red, swollen throat this morning, so I'm probably fighting an", "intended_target": "infection", "rationale": "Patient phrasing describes symptoms descriptively; clinical term is diagnostic. Shifts expected continuations from general complaint language to specific pathogen/infection markers.", "patient_term": "nasty red, swollen throat", "clinical_term": "acute pharyngitis", "topic": "pharyngitis", "topics": [ "gynecology", "sexual medicine", "menopause", "infectious disease", "pharyngitis", "fever", "nocturia", "urinary tract infection", "genitourinary", "endocrine disorder", "hyperhidrosis", "thyroid disorder" ], "models": { "gemma-2-2b": { "prob_clinical": 0.566, "prob_patient": 0.699, "language_penalty": 0.133, "anchor_fallback": false, "top_clinical": [ "infection", 0.566 ], "top_patient": [ "infection", 0.699 ], "spread_clinical": [ [ "infection", 0.566 ], [ "upper", 0.235 ], [ "ear", 0.036 ], [ "early", 0.013 ], [ "illness", 0.012 ] ], "spread_patient": [ [ "infection", 0.699 ], [ "upper", 0.138 ], [ "early", 0.024 ], [ "illness", 0.021 ], [ "ear", 0.016 ] ], "target_token": "infection", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 856, "unique_to_a": 431, "unique_to_b": 402 }, "clinical_mass": { "clinical": 0.3692, "patient": 0.3625 } } }, "prob_clinical": 0.566, "prob_patient": 0.699, "language_penalty": 0.133, "flipped": false, "top_clinical": [ "infection", 0.566 ], "top_patient": [ "infection", 0.699 ], "spread_clinical": [ [ "infection", 0.566 ], [ "upper", 0.235 ], [ "ear", 0.036 ], [ "early", 0.013 ], [ "illness", 0.012 ] ], "spread_patient": [ [ "infection", 0.699 ], [ "upper", 0.138 ], [ "early", 0.024 ], [ "illness", 0.021 ], [ "ear", 0.016 ] ], "target_token": "infection", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 856, "unique_to_a": 431, "unique_to_b": 402 }, "clinical_mass": { "clinical": 0.3692, "patient": 0.3625 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260719T132706Z/index_79.html" }, { "index": 1187, "batch": "pairs_20260719T132706Z", "batch_index": 80, "clinical_prompt": "I've been experiencing dysuria related to sexual activity, so I should probably see a", "patient_prompt": "I've been getting these burning sensations down there after intercourse, so I should probably see a", "intended_target": "urologist", "rationale": "Patient phrasing avoids naming the symptom directly; clinical term uses medical nomenclature. Diverges in specialist type and clinical urgency signaling.", "patient_term": "burning sensations down there after intercourse", "clinical_term": "dysuria related to sexual activity", "topic": "urinary tract infection", "topics": [ "gynecology", "sexual medicine", "menopause", "infectious disease", "pharyngitis", "fever", "nocturia", "urinary tract infection", "genitourinary", "endocrine disorder", "hyperhidrosis", "thyroid disorder" ], "models": { "gemma-2-2b": { "prob_clinical": 0.48, "prob_patient": null, "language_penalty": null, "anchor_fallback": false, "top_clinical": [ "uro", 0.48 ], "top_patient": [ "doctor", 0.68 ], "spread_clinical": [ [ "uro", 0.48 ], [ "doctor", 0.291 ], [ "Uro", 0.051 ], [ "doc", 0.035 ], [ "gyne", 0.027 ] ], "spread_patient": [ [ "doctor", 0.68 ], [ "gyne", 0.072 ], [ "doc", 0.056 ], [ "gy", 0.049 ], [ "Dr", 0.026 ] ], "target_token": "uro", "flipped": true, "screening": null, "circuit_diff": { "shared_features": 634, "unique_to_a": 738, "unique_to_b": 640 }, "clinical_mass": { "clinical": 0.4341, "patient": 0.363, "translated": 0.4414 }, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": 2, "tier_shift": 0.0, "urgency_recovery": 0.0 } } }, "prob_clinical": 0.48, "prob_patient": null, "language_penalty": null, "flipped": true, "top_clinical": [ "uro", 0.48 ], "top_patient": [ "doctor", 0.68 ], "spread_clinical": [ [ "uro", 0.48 ], [ "doctor", 0.291 ], [ "Uro", 0.051 ], [ "doc", 0.035 ], [ "gyne", 0.027 ] ], "spread_patient": [ [ "doctor", 0.68 ], [ "gyne", 0.072 ], [ "doc", 0.056 ], [ "gy", 0.049 ], [ "Dr", 0.026 ] ], "target_token": "uro", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 634, "unique_to_a": 738, "unique_to_b": 640 }, "clinical_mass": { "clinical": 0.4341, "patient": 0.363, "translated": 0.4414 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260719T132706Z/index_80.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": 2, "tier_shift": 0.0, "urgency_recovery": 0.0 } }, { "index": 1188, "batch": "pairs_20260719T132706Z", "batch_index": 81, "clinical_prompt": "I have hyperhidrosis all day, so I should probably see a", "patient_prompt": "I'm sweating like a stuck pig all day, so I should probably see a", "intended_target": "dermatologist", "rationale": "Patient idiom 'sweating like a stuck pig' vs clinical term 'hyperhidrosis' should shift the model toward recognizing a medical condition requiring specialist evaluation (dermatologist) rather than a casual complaint.", "patient_term": "sweating like a stuck pig", "clinical_term": "hyperhidrosis", "topic": "hyperhidrosis", "topics": [ "gynecology", "sexual medicine", "menopause", "infectious disease", "pharyngitis", "fever", "nocturia", "urinary tract infection", "genitourinary", "endocrine disorder", "hyperhidrosis", "thyroid disorder" ], "models": { "gemma-2-2b": { "prob_clinical": 0.158, "prob_patient": 0.027, "language_penalty": -0.131, "anchor_fallback": false, "top_clinical": [ "doctor", 0.625 ], "top_patient": [ "doctor", 0.789 ], "spread_clinical": [ [ "doctor", 0.625 ], [ "dermatologist", 0.158 ], [ "doc", 0.051 ], [ "specialist", 0.035 ], [ "neuro", 0.021 ] ], "spread_patient": [ [ "doctor", 0.789 ], [ "doc", 0.083 ], [ "dermatologist", 0.027 ], [ "dr", 0.014 ], [ "Dr", 0.011 ] ], "target_token": "dermatologist", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 615, "unique_to_a": 671, "unique_to_b": 584 }, "clinical_mass": { "clinical": 0.3909, "patient": 0.2628, "translated": 0.2791 }, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.211, "urgency_recovery": -0.029 } } }, "prob_clinical": 0.158, "prob_patient": 0.027, "language_penalty": -0.131, "flipped": false, "top_clinical": [ "doctor", 0.625 ], "top_patient": [ "doctor", 0.789 ], "spread_clinical": [ [ "doctor", 0.625 ], [ "dermatologist", 0.158 ], [ "doc", 0.051 ], [ "specialist", 0.035 ], [ "neuro", 0.021 ] ], "spread_patient": [ [ "doctor", 0.789 ], [ "doc", 0.083 ], [ "dermatologist", 0.027 ], [ "dr", 0.014 ], [ "Dr", 0.011 ] ], "target_token": "dermatologist", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 615, "unique_to_a": 671, "unique_to_b": 584 }, "clinical_mass": { "clinical": 0.3909, "patient": 0.2628, "translated": 0.2791 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260719T132706Z/index_81.html", "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.211, "urgency_recovery": -0.029 } }, { "index": 1189, "batch": "pairs_20260719T132706Z", "batch_index": 82, "clinical_prompt": "I have nocturia, so I'm worried I might have", "patient_prompt": "I keep running to pee at all hours, so I'm worried I might have", "intended_target": "diabetes", "rationale": "Patient description of symptom versus clinical diagnosis name should shift the model toward considering underlying endocrine pathology (diabetes) as a cause.", "patient_term": "I keep running to pee at all hours", "clinical_term": "I have nocturia", "topic": "nocturia", "topics": [ "gynecology", "sexual medicine", "menopause", "infectious disease", "pharyngitis", "fever", "nocturia", "urinary tract infection", "genitourinary", "endocrine disorder", "hyperhidrosis", "thyroid disorder" ], "models": { "gemma-2-2b": { "prob_clinical": 0.189, "prob_patient": 0.322, "language_penalty": 0.133, "anchor_fallback": true, "top_clinical": [ "a", 0.189 ], "top_patient": [ "a", 0.322 ], "spread_clinical": [ [ "a", 0.189 ], [ "an", 0.13 ], [ "to", 0.101 ], [ "bladder", 0.062 ], [ "kidney", 0.054 ] ], "spread_patient": [ [ "a", 0.322 ], [ "to", 0.222 ], [ "an", 0.082 ], [ "UTI", 0.063 ], [ "bladder", 0.05 ] ], "target_token": "a", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 698, "unique_to_a": 743, "unique_to_b": 719 }, "clinical_mass": { "clinical": 0.3597, "patient": 0.2626, "translated": 0.2998 } } }, "prob_clinical": 0.189, "prob_patient": 0.322, "language_penalty": 0.133, "flipped": false, "top_clinical": [ "a", 0.189 ], "top_patient": [ "a", 0.322 ], "spread_clinical": [ [ "a", 0.189 ], [ "an", 0.13 ], [ "to", 0.101 ], [ "bladder", 0.062 ], [ "kidney", 0.054 ] ], "spread_patient": [ [ "a", 0.322 ], [ "to", 0.222 ], [ "an", 0.082 ], [ "UTI", 0.063 ], [ "bladder", 0.05 ] ], "target_token": "a", "anchor_fallback": true, "screening": null, "circuit_diff": { "shared_features": 698, "unique_to_a": 743, "unique_to_b": 719 }, "clinical_mass": { "clinical": 0.3597, "patient": 0.2626, "translated": 0.2998 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260719T132706Z/index_82.html" }, { "index": 1190, "batch": "pairs_20260719T132706Z", "batch_index": 83, "clinical_prompt": "I have fever, so I think I might be catching a", "patient_prompt": "I've been running hot and cold all week, so I think I might be catching a", "intended_target": "virus", "rationale": "Colloquial expression for thermal symptoms versus clinical term should shift continuation toward specific infectious agent identification rather than vague illness.", "patient_term": "running hot and cold", "clinical_term": "fever", "topic": "fever", "topics": [ "gynecology", "sexual medicine", "menopause", "infectious disease", "pharyngitis", "fever", "nocturia", "urinary tract infection", "genitourinary", "endocrine disorder", "hyperhidrosis", "thyroid disorder" ], "models": { "gemma-2-2b": { "prob_clinical": 0.009, "prob_patient": 0.015, "language_penalty": 0.006, "anchor_fallback": false, "top_clinical": [ "cold", 0.891 ], "top_patient": [ "cold", 0.824 ], "spread_clinical": [ [ "cold", 0.891 ], [ "bug", 0.014 ], [ "flu", 0.014 ], [ "bad", 0.013 ], [ "virus", 0.009 ] ], "spread_patient": [ [ "cold", 0.824 ], [ "bug", 0.041 ], [ "virus", 0.015 ], [ "head", 0.013 ], [ "little", 0.013 ] ], "target_token": "virus", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 546, "unique_to_a": 534, "unique_to_b": 630 }, "clinical_mass": { "clinical": 0.341, "patient": 0.246, "translated": 0.3238 } } }, "prob_clinical": 0.009, "prob_patient": 0.015, "language_penalty": 0.006, "flipped": false, "top_clinical": [ "cold", 0.891 ], "top_patient": [ "cold", 0.824 ], "spread_clinical": [ [ "cold", 0.891 ], [ "bug", 0.014 ], [ "flu", 0.014 ], [ "bad", 0.013 ], [ "virus", 0.009 ] ], "spread_patient": [ [ "cold", 0.824 ], [ "bug", 0.041 ], [ "virus", 0.015 ], [ "head", 0.013 ], [ "little", 0.013 ] ], "target_token": "virus", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 546, "unique_to_a": 534, "unique_to_b": 630 }, "clinical_mass": { "clinical": 0.341, "patient": 0.246, "translated": 0.3238 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260719T132706Z/index_83.html" }, { "index": 1191, "batch": "pairs_20260719T132706Z", "batch_index": 84, "clinical_prompt": "I have hypothyroidism, so I need to take my", "patient_prompt": "My thyroid's been making me feel sluggish, so I need to take my", "intended_target": "medication", "rationale": "Lay description of symptom versus clinical diagnosis should shift the model toward recognizing the need for pharmacological management (medication) rather than lifestyle adjustment.", "patient_term": "My thyroid's been making me feel sluggish", "clinical_term": "I have hypothyroidism", "topic": "thyroid disorder", "topics": [ "gynecology", "sexual medicine", "menopause", "infectious disease", "pharyngitis", "fever", "nocturia", "urinary tract infection", "genitourinary", "endocrine disorder", "hyperhidrosis", "thyroid disorder" ], "models": { "gemma-2-2b": { "prob_clinical": 0.127, "prob_patient": 0.079, "language_penalty": -0.048, "anchor_fallback": false, "top_clinical": [ "thyroid", 0.305 ], "top_patient": [ "meds", 0.189 ], "spread_clinical": [ [ "thyroid", 0.305 ], [ "meds", 0.145 ], [ "medication", 0.127 ], [ "Synth", 0.041 ], [ "le", 0.041 ] ], "spread_patient": [ [ "meds", 0.189 ], [ "thyroid", 0.189 ], [ "medication", 0.079 ], [ "medicine", 0.07 ], [ "vitamins", 0.042 ] ], "target_token": "medication", "flipped": true, "screening": null, "circuit_diff": { "shared_features": 640, "unique_to_a": 555, "unique_to_b": 638 }, "clinical_mass": { "clinical": 0.407, "patient": 0.3451, "translated": 0.3344 }, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": 1, "tier_shift": 0.0, "urgency_recovery": 0.0 } } }, "prob_clinical": 0.127, "prob_patient": 0.079, "language_penalty": -0.048, "flipped": true, "top_clinical": [ "thyroid", 0.305 ], "top_patient": [ "meds", 0.189 ], "spread_clinical": [ [ "thyroid", 0.305 ], [ "meds", 0.145 ], [ "medication", 0.127 ], [ "Synth", 0.041 ], [ "le", 0.041 ] ], "spread_patient": [ [ "meds", 0.189 ], [ "thyroid", 0.189 ], [ "medication", 0.079 ], [ "medicine", 0.07 ], [ "vitamins", 0.042 ] ], "target_token": "medication", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 640, "unique_to_a": 555, "unique_to_b": 638 }, "clinical_mass": { "clinical": 0.407, "patient": 0.3451, "translated": 0.3344 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260719T132706Z/index_84.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": 1, "tier_shift": 0.0, "urgency_recovery": 0.0 } }, { "index": 1192, "batch": "pairs_20260719T132706Z", "batch_index": 85, "clinical_prompt": "I have hypothyroidism, so I need to get my", "patient_prompt": "My thyroid's been making me gain weight and feel tired, so I need to get my", "intended_target": "levels", "rationale": "Patient describes symptoms; clinical diagnosis signals need for laboratory testing. Frame guides toward 'levels' as the natural follow-up after possessive for thyroid evaluation.", "patient_term": "thyroid's been making me gain weight and feel tired", "clinical_term": "hypothyroidism", "topic": "thyroid disorder", "topics": [ "gynecology", "sexual medicine", "menopause", "infectious disease", "pharyngitis", "fever", "nocturia", "urinary tract infection", "genitourinary", "endocrine disorder", "hyperhidrosis", "thyroid disorder" ], "models": { "gemma-2-2b": { "prob_clinical": 0.072, "prob_patient": 0.139, "language_penalty": 0.06700000000000002, "anchor_fallback": false, "top_clinical": [ "thyroid", 0.365 ], "top_patient": [ "thyroid", 0.26 ], "spread_clinical": [ [ "thyroid", 0.365 ], [ "TSH", 0.152 ], [ "blood", 0.105 ], [ "levels", 0.072 ], [ "T", 0.056 ] ], "spread_patient": [ [ "thyroid", 0.26 ], [ "levels", 0.139 ], [ "hormones", 0.084 ], [ "TSH", 0.065 ], [ "blood", 0.058 ] ], "target_token": "levels", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 607, "unique_to_a": 598, "unique_to_b": 688 }, "clinical_mass": { "clinical": 0.3724, "patient": 0.2937, "translated": 0.3146 } } }, "prob_clinical": 0.072, "prob_patient": 0.139, "language_penalty": 0.06700000000000002, "flipped": false, "top_clinical": [ "thyroid", 0.365 ], "top_patient": [ "thyroid", 0.26 ], "spread_clinical": [ [ "thyroid", 0.365 ], [ "TSH", 0.152 ], [ "blood", 0.105 ], [ "levels", 0.072 ], [ "T", 0.056 ] ], "spread_patient": [ [ "thyroid", 0.26 ], [ "levels", 0.139 ], [ "hormones", 0.084 ], [ "TSH", 0.065 ], [ "blood", 0.058 ] ], "target_token": "levels", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 607, "unique_to_a": 598, "unique_to_b": 688 }, "clinical_mass": { "clinical": 0.3724, "patient": 0.2937, "translated": 0.3146 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260719T132706Z/index_85.html" }, { "index": 1193, "batch": "pairs_20260719T132706Z", "batch_index": 86, "clinical_prompt": "I've been having pelvic inflammatory disease, so my doctor wants to rule out an", "patient_prompt": "I've been having these weird pains in my lower belly, so my doctor wants to rule out an", "intended_target": "ectopic", "rationale": "Patient uses vague lay descriptor; clinical term signals serious gynecological condition requiring exclusion of complications. Frame naturally leads to 'ectopic pregnancy' as differential concern.", "patient_term": "weird pains in my lower belly", "clinical_term": "pelvic inflammatory disease", "topic": "gynecology", "topics": [ "gynecology", "sexual medicine", "menopause", "infectious disease", "pharyngitis", "fever", "nocturia", "urinary tract infection", "genitourinary", "endocrine disorder", "hyperhidrosis", "thyroid disorder" ], "models": { "gemma-2-2b": { "prob_clinical": 0.42, "prob_patient": 0.457, "language_penalty": 0.03700000000000003, "anchor_fallback": false, "top_clinical": [ "ec", 0.42 ], "top_patient": [ "ec", 0.457 ], "spread_clinical": [ [ "ec", 0.42 ], [ "infection", 0.154 ], [ "STD", 0.136 ], [ "ovarian", 0.064 ], [ "STI", 0.05 ] ], "spread_patient": [ [ "ec", 0.457 ], [ "ovarian", 0.216 ], [ "infection", 0.168 ], [ "STD", 0.02 ], [ "abscess", 0.012 ] ], "target_token": "ec", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 832, "unique_to_a": 581, "unique_to_b": 602 }, "clinical_mass": { "clinical": 0.4658, "patient": 0.4554, "translated": 0.4626 } } }, "prob_clinical": 0.42, "prob_patient": 0.457, "language_penalty": 0.03700000000000003, "flipped": false, "top_clinical": [ "ec", 0.42 ], "top_patient": [ "ec", 0.457 ], "spread_clinical": [ [ "ec", 0.42 ], [ "infection", 0.154 ], [ "STD", 0.136 ], [ "ovarian", 0.064 ], [ "STI", 0.05 ] ], "spread_patient": [ [ "ec", 0.457 ], [ "ovarian", 0.216 ], [ "infection", 0.168 ], [ "STD", 0.02 ], [ "abscess", 0.012 ] ], "target_token": "ec", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 832, "unique_to_a": 581, "unique_to_b": 602 }, "clinical_mass": { "clinical": 0.4658, "patient": 0.4554, "translated": 0.4626 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260719T132706Z/index_86.html" }, { "index": 1194, "batch": "pairs_20260719T132706Z", "batch_index": 87, "clinical_prompt": "I have nocturia, so I might have", "patient_prompt": "I keep having to get up multiple times at night to use the bathroom, so I might have", "intended_target": "diabetes", "rationale": "Patient describes the symptom behaviorally; clinical term names the condition. Frame positions a differential diagnosis, with diabetes as a plausible and frequent next-token continuation for clinical assessment.", "patient_term": "keep having to get up multiple times at night to use the bathroom", "clinical_term": "nocturia", "topic": "nocturia", "topics": [ "gynecology", "sexual medicine", "menopause", "infectious disease", "pharyngitis", "fever", "nocturia", "urinary tract infection", "genitourinary", "endocrine disorder", "hyperhidrosis", "thyroid disorder" ], "models": { "gemma-2-2b": { "prob_clinical": 0.316, "prob_patient": 0.381, "language_penalty": 0.065, "anchor_fallback": true, "top_clinical": [ "to", 0.316 ], "top_patient": [ "to", 0.381 ], "spread_clinical": [ [ "to", 0.316 ], [ "a", 0.192 ], [ "some", 0.055 ], [ "more", 0.055 ], [ "an", 0.055 ] ], "spread_patient": [ [ "to", 0.381 ], [ "a", 0.18 ], [ "been", 0.052 ], [ "some", 0.045 ], [ "an", 0.045 ] ], "target_token": "to", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 581, "unique_to_a": 646, "unique_to_b": 666 }, "clinical_mass": { "clinical": 0.1419, "patient": 0.1381, "translated": 0.2556 } } }, "prob_clinical": 0.316, "prob_patient": 0.381, "language_penalty": 0.065, "flipped": false, "top_clinical": [ "to", 0.316 ], "top_patient": [ "to", 0.381 ], "spread_clinical": [ [ "to", 0.316 ], [ "a", 0.192 ], [ "some", 0.055 ], [ "more", 0.055 ], [ "an", 0.055 ] ], "spread_patient": [ [ "to", 0.381 ], [ "a", 0.18 ], [ "been", 0.052 ], [ "some", 0.045 ], [ "an", 0.045 ] ], "target_token": "to", "anchor_fallback": true, "screening": null, "circuit_diff": { "shared_features": 581, "unique_to_a": 646, "unique_to_b": 666 }, "clinical_mass": { "clinical": 0.1419, "patient": 0.1381, "translated": 0.2556 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260719T132706Z/index_87.html" }, { "index": 1195, "batch": "pairs_20260719T132706Z", "batch_index": 88, "clinical_prompt": "I have hyperhidrosis at night, so I probably need to check my", "patient_prompt": "I'm sweating up a storm all through the night, so I probably need to check my", "intended_target": "thyroid", "rationale": "Nocturnal sweating in a patient reporting excessive sweating disorder naturally prompts thyroid testing (as hyperhidrosis can indicate thyroid dysfunction). The colloquial 'sweating up a storm' is vague and everyday; 'hyperhidrosis' signals a medical complaint, shifting the model's continuation preference toward diagnostic workup.", "patient_term": "sweating up a storm all through the night", "clinical_term": "hyperhidrosis at night", "topic": "hyperhidrosis", "topics": [ "gynecology", "sexual medicine", "menopause", "infectious disease", "pharyngitis", "fever", "nocturia", "urinary tract infection", "genitourinary", "endocrine disorder", "hyperhidrosis", "thyroid disorder" ], "models": { "gemma-2-2b": { "prob_clinical": 0.116, "prob_patient": null, "language_penalty": null, "anchor_fallback": true, "top_clinical": [ "feet", 0.116 ], "top_patient": [ "blood", 0.17 ], "spread_clinical": [ [ "feet", 0.116 ], [ "pillow", 0.062 ], [ "sweat", 0.055 ], [ "armp", 0.048 ], [ "blood", 0.029 ] ], "spread_patient": [ [ "blood", 0.17 ], [ "temperature", 0.055 ], [ "water", 0.049 ], [ "thermostat", 0.033 ], [ "body", 0.033 ] ], "target_token": "feet", "flipped": true, "screening": null, "circuit_diff": { "shared_features": 630, "unique_to_a": 848, "unique_to_b": 886 }, "clinical_mass": { "clinical": 0.2354, "patient": 0.1318, "translated": 0.3317 }, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": 2, "tier_shift": null, "urgency_recovery": 0.447 } } }, "prob_clinical": 0.116, "prob_patient": null, "language_penalty": null, "flipped": true, "top_clinical": [ "feet", 0.116 ], "top_patient": [ "blood", 0.17 ], "spread_clinical": [ [ "feet", 0.116 ], [ "pillow", 0.062 ], [ "sweat", 0.055 ], [ "armp", 0.048 ], [ "blood", 0.029 ] ], "spread_patient": [ [ "blood", 0.17 ], [ "temperature", 0.055 ], [ "water", 0.049 ], [ "thermostat", 0.033 ], [ "body", 0.033 ] ], "target_token": "feet", "anchor_fallback": true, "screening": null, "circuit_diff": { "shared_features": 630, "unique_to_a": 848, "unique_to_b": 886 }, "clinical_mass": { "clinical": 0.2354, "patient": 0.1318, "translated": 0.3317 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260719T132706Z/index_88.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": 2, "tier_shift": null, "urgency_recovery": 0.447 } }, { "index": 1196, "batch": "pairs_20260719T132706Z", "batch_index": 89, "clinical_prompt": "I'm getting vulvodynia during intimacy, so I should probably ask my", "patient_prompt": "I'm getting this weird burning sensation down there during intimacy, so I should probably ask my", "intended_target": "gynecologist", "rationale": "The clinical term 'vulvodynia' directly names a gynecological condition requiring specialist evaluation, whereas 'burning sensation down there' is imprecise and lay. The frame ending with 'ask my' funnels toward a medical professional, with 'gynecologist' being the natural continuation only after the clinical diagnosis is named.", "patient_term": "burning sensation down there", "clinical_term": "vulvodynia", "topic": "gynecology", "topics": [ "gynecology", "sexual medicine", "menopause", "infectious disease", "pharyngitis", "fever", "nocturia", "urinary tract infection", "genitourinary", "endocrine disorder", "hyperhidrosis", "thyroid disorder" ], "models": { "gemma-2-2b": { "prob_clinical": 0.079, "prob_patient": 0.047, "language_penalty": -0.032, "anchor_fallback": false, "top_clinical": [ "doctor", 0.352 ], "top_patient": [ "doctor", 0.348 ], "spread_clinical": [ [ "doctor", 0.352 ], [ "gyne", 0.079 ], [ "doc", 0.079 ], [ "OB", 0.061 ], [ "gy", 0.048 ] ], "spread_patient": [ [ "doctor", 0.348 ], [ "doc", 0.088 ], [ "partner", 0.06 ], [ "gyne", 0.047 ], [ "husband", 0.047 ] ], "target_token": "gyne", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 785, "unique_to_a": 615, "unique_to_b": 551 }, "clinical_mass": { "clinical": 0.3454, "patient": 0.2279, "translated": 0.3054 }, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.195, "urgency_recovery": 0.195 } } }, "prob_clinical": 0.079, "prob_patient": 0.047, "language_penalty": -0.032, "flipped": false, "top_clinical": [ "doctor", 0.352 ], "top_patient": [ "doctor", 0.348 ], "spread_clinical": [ [ "doctor", 0.352 ], [ "gyne", 0.079 ], [ "doc", 0.079 ], [ "OB", 0.061 ], [ "gy", 0.048 ] ], "spread_patient": [ [ "doctor", 0.348 ], [ "doc", 0.088 ], [ "partner", 0.06 ], [ "gyne", 0.047 ], [ "husband", 0.047 ] ], "target_token": "gyne", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 785, "unique_to_a": 615, "unique_to_b": 551 }, "clinical_mass": { "clinical": 0.3454, "patient": 0.2279, "translated": 0.3054 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260719T132706Z/index_89.html", "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.195, "urgency_recovery": 0.195 } }, { "index": 1197, "batch": "pairs_20260719T132706Z", "batch_index": 90, "clinical_prompt": "I'm experiencing irregular menstrual cycles, so I might be heading into my", "patient_prompt": "My monthly cycle's been all wonky lately, so I might be heading into my", "intended_target": "menopause", "rationale": "The clinical phrasing 'irregular menstrual cycles' is the hallmark presentation of menopause transition, so the model should predict 'menopause' as the natural next token. The colloquial 'all wonky' is vague and everyday, not diagnostic, so it would not strongly suggest menopause as the continuation.", "patient_term": "monthly cycle's been all wonky", "clinical_term": "irregular menstrual cycles", "topic": "menopause", "topics": [ "gynecology", "sexual medicine", "menopause", "infectious disease", "pharyngitis", "fever", "nocturia", "urinary tract infection", "genitourinary", "endocrine disorder", "hyperhidrosis", "thyroid disorder" ], "models": { "gemma-2-2b": { "prob_clinical": 0.108, "prob_patient": null, "language_penalty": null, "anchor_fallback": false, "top_clinical": [ null, 0.108 ], "top_patient": [ "period", 0.33 ], "spread_clinical": [ [ "second", 0.074 ], [ "period", 0.074 ], [ "first", 0.074 ], [ "late", 0.058 ] ], "spread_patient": [ [ "period", 0.33 ], [ "next", 0.057 ], [ "late", 0.051 ], [ "first", 0.039 ] ], "target_token": null, "flipped": true, "screening": null, "circuit_diff": { "shared_features": 675, "unique_to_a": 694, "unique_to_b": 659 }, "clinical_mass": { "clinical": 0.2486, "patient": 0.2148, "translated": 0.2472 }, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } } }, "prob_clinical": 0.108, "prob_patient": null, "language_penalty": null, "flipped": true, "top_clinical": [ null, 0.108 ], "top_patient": [ "period", 0.33 ], "spread_clinical": [ [ "second", 0.074 ], [ "period", 0.074 ], [ "first", 0.074 ], [ "late", 0.058 ] ], "spread_patient": [ [ "period", 0.33 ], [ "next", 0.057 ], [ "late", 0.051 ], [ "first", 0.039 ] ], "target_token": null, "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 675, "unique_to_a": 694, "unique_to_b": 659 }, "clinical_mass": { "clinical": 0.2486, "patient": 0.2148, "translated": 0.2472 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260719T132706Z/index_90.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, { "index": 1198, "batch": "pairs_20260719T132706Z", "batch_index": 91, "clinical_prompt": "I was exposed to group A streptococcus at the office, so I'm probably dealing with a", "patient_prompt": "I caught some nasty bug going around at the office, so I'm probably dealing with a", "intended_target": "pharyngitis", "rationale": "The clinical pathogen name 'group A streptococcus' strongly predicts the infectious outcome 'pharyngitis'. The colloquial 'nasty bug' is too vague to yield a specific disease prediction; it could be any infection. The frame ending with 'dealing with a' naturally funnels toward a disease noun.", "patient_term": "nasty bug going around", "clinical_term": "group A streptococcus", "topic": "pharyngitis", "topics": [ "gynecology", "sexual medicine", "menopause", "infectious disease", "pharyngitis", "fever", "nocturia", "urinary tract infection", "genitourinary", "endocrine disorder", "hyperhidrosis", "thyroid disorder" ], "models": { "gemma-2-2b": { "prob_clinical": 0.086, "prob_patient": null, "language_penalty": null, "anchor_fallback": true, "top_clinical": [ "stre", 0.086 ], "top_patient": [ "cold", 0.103 ], "spread_clinical": [ [ "stre", 0.086 ], [ "case", 0.067 ], [ "mild", 0.059 ], [ "sore", 0.052 ], [ "bacterial", 0.046 ] ], "spread_patient": [ [ "cold", 0.103 ], [ "bit", 0.091 ], [ "case", 0.062 ], [ "little", 0.055 ], [ "lot", 0.049 ] ], "target_token": "stre", "flipped": true, "screening": null, "circuit_diff": { "shared_features": 635, "unique_to_a": 782, "unique_to_b": 776 }, "clinical_mass": { "clinical": 0.4159, "patient": 0.2525, "translated": 0.438 }, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } } }, "prob_clinical": 0.086, "prob_patient": null, "language_penalty": null, "flipped": true, "top_clinical": [ "stre", 0.086 ], "top_patient": [ "cold", 0.103 ], "spread_clinical": [ [ "stre", 0.086 ], [ "case", 0.067 ], [ "mild", 0.059 ], [ "sore", 0.052 ], [ "bacterial", 0.046 ] ], "spread_patient": [ [ "cold", 0.103 ], [ "bit", 0.091 ], [ "case", 0.062 ], [ "little", 0.055 ], [ "lot", 0.049 ] ], "target_token": "stre", "anchor_fallback": true, "screening": null, "circuit_diff": { "shared_features": 635, "unique_to_a": 782, "unique_to_b": 776 }, "clinical_mass": { "clinical": 0.4159, "patient": 0.2525, "translated": 0.438 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260719T132706Z/index_91.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, { "index": 1199, "batch": "pairs_20260719T132706Z", "batch_index": 92, "clinical_prompt": "I've been running a fever all day, so I should probably take an", "patient_prompt": "I've been running hot all day, so I should probably take an", "intended_target": "antipyretic", "rationale": "The clinical term 'fever' is a diagnosis that prompts fever-reduction medication ('antipyretic', or colloquially 'aspirin' or 'ibuprofen'). The vague colloquial 'running hot' could mean ambient heat or discomfort, so it would not trigger a medical intervention continuation. The frame 'take an' after a medical complaint strongly narrows to a remedy.", "patient_term": "running hot", "clinical_term": "running a fever", "topic": "fever", "topics": [ "gynecology", "sexual medicine", "menopause", "infectious disease", "pharyngitis", "fever", "nocturia", "urinary tract infection", "genitourinary", "endocrine disorder", "hyperhidrosis", "thyroid disorder" ], "models": { "gemma-2-2b": { "prob_clinical": 0.396, "prob_patient": 0.161, "language_penalty": -0.23500000000000001, "anchor_fallback": true, "top_clinical": [ "aspirin", 0.396 ], "top_patient": [ "hour", 0.183 ], "spread_clinical": [ [ "aspirin", 0.396 ], [ "Ad", 0.1 ], [ "ibuprofen", 0.088 ], [ "adv", 0.047 ], [ "antibiotic", 0.037 ] ], "spread_patient": [ [ "hour", 0.183 ], [ "aspirin", 0.161 ], [ "ice", 0.098 ], [ "afternoon", 0.067 ], [ "early", 0.052 ] ], "target_token": "aspirin", "flipped": true, "screening": null, "circuit_diff": { "shared_features": 851, "unique_to_a": 432, "unique_to_b": 391 }, "clinical_mass": { "clinical": 0.2404, "patient": 0.0936, "translated": 0.2444 }, "html": "modes/simulated/pairs_20260719T132706Z/index_92.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": 1, "tier_top_patient": null, "tier_shift": -0.455, "urgency_recovery": 0.378 } } }, "prob_clinical": 0.396, "prob_patient": 0.161, "language_penalty": -0.23500000000000001, "flipped": true, "top_clinical": [ "aspirin", 0.396 ], "top_patient": [ "hour", 0.183 ], "spread_clinical": [ [ "aspirin", 0.396 ], [ "Ad", 0.1 ], [ "ibuprofen", 0.088 ], [ "adv", 0.047 ], [ "antibiotic", 0.037 ] ], "spread_patient": [ [ "hour", 0.183 ], [ "aspirin", 0.161 ], [ "ice", 0.098 ], [ "afternoon", 0.067 ], [ "early", 0.052 ] ], "target_token": "aspirin", "anchor_fallback": true, "screening": null, "circuit_diff": { "shared_features": 851, "unique_to_a": 432, "unique_to_b": 391 }, "clinical_mass": { "clinical": 0.2404, "patient": 0.0936, "translated": 0.2444 }, "html": "modes/simulated/pairs_20260719T132706Z/index_92.html", "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260719T132706Z/index_92.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": 1, "tier_top_patient": null, "tier_shift": -0.455, "urgency_recovery": 0.378 } }, { "index": 1200, "batch": "pairs_20260719T132706Z", "batch_index": 93, "clinical_prompt": "I'm experiencing nocturia with frequency, so my doctor thinks I might have a", "patient_prompt": "I'm up constantly peeing at all hours, so my doctor thinks I might have a", "intended_target": "UTI", "rationale": "The clinical dual presentation 'nocturia with frequency' (nighttime urination plus daytime urgency) is a classic sign of UTI (urinary tract infection), prompting the model to predict the abbreviation or condition name. The colloquial 'constantly peeing' is nonspecific and could suggest normal hydration or lifestyle. The frame 'might have a' funnels to a condition or diagnosis.", "patient_term": "constantly peeing at all hours", "clinical_term": "nocturia with frequency", "topic": "urinary tract infection", "topics": [ "gynecology", "sexual medicine", "menopause", "infectious disease", "pharyngitis", "fever", "nocturia", "urinary tract infection", "genitourinary", "endocrine disorder", "hyperhidrosis", "thyroid disorder" ], "models": { "gemma-2-2b": { "prob_clinical": 0.138, "prob_patient": 0.43, "language_penalty": 0.292, "anchor_fallback": false, "top_clinical": [ "bladder", 0.156 ], "top_patient": [ "UTI", 0.43 ], "spread_clinical": [ [ "bladder", 0.156 ], [ "UTI", 0.138 ], [ "urinary", 0.107 ], [ "benign", 0.083 ], [ "pro", 0.083 ] ], "spread_patient": [ [ "UTI", 0.43 ], [ "bladder", 0.18 ], [ "urinary", 0.14 ], [ "kidney", 0.066 ], [ "uti", 0.052 ] ], "target_token": "UTI", "flipped": true, "screening": null, "circuit_diff": { "shared_features": 642, "unique_to_a": 820, "unique_to_b": 813 }, "clinical_mass": { "clinical": 0.4204, "patient": 0.3592, "translated": 0.437 }, "html": "modes/simulated/pairs_20260719T132706Z/index_93.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } } }, "prob_clinical": 0.138, "prob_patient": 0.43, "language_penalty": 0.292, "flipped": true, "top_clinical": [ "bladder", 0.156 ], "top_patient": [ "UTI", 0.43 ], "spread_clinical": [ [ "bladder", 0.156 ], [ "UTI", 0.138 ], [ "urinary", 0.107 ], [ "benign", 0.083 ], [ "pro", 0.083 ] ], "spread_patient": [ [ "UTI", 0.43 ], [ "bladder", 0.18 ], [ "urinary", 0.14 ], [ "kidney", 0.066 ], [ "uti", 0.052 ] ], "target_token": "UTI", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 642, "unique_to_a": 820, "unique_to_b": 813 }, "clinical_mass": { "clinical": 0.4204, "patient": 0.3592, "translated": 0.437 }, "html": "modes/simulated/pairs_20260719T132706Z/index_93.html", "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260719T132706Z/index_93.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, { "index": 1201, "batch": "pairs_20260719T132706Z", "batch_index": 94, "clinical_prompt": "I've been experiencing nocturnal hyperhidrosis, so I probably need to check my", "patient_prompt": "I've been sweating like I'm in a sauna at night, so I probably need to check my", "intended_target": "thyroid", "rationale": "The frame ends after a possessive, naturally funneling toward a medical organ or system. The clinical term (nocturnal hyperhidrosis) is a recognized endocrine/metabolic symptom that strongly suggests thyroid dysfunction, while the colloquial version is ambiguous. Both maintain identical syntax: '...need to check my [TARGET]'.", "patient_term": "sweating like I'm in a sauna at night", "clinical_term": "nocturnal hyperhidrosis", "topic": "hyperhidrosis", "topics": [ "gynecology", "sexual medicine", "menopause", "infectious disease", "pharyngitis", "fever", "nocturia", "urinary tract infection", "genitourinary", "endocrine disorder", "hyperhidrosis", "thyroid disorder" ], "models": { "gemma-2-2b": { "prob_clinical": 0.129, "prob_patient": 0.106, "language_penalty": -0.023000000000000007, "anchor_fallback": false, "top_clinical": [ "thyroid", 0.129 ], "top_patient": [ "blood", 0.198 ], "spread_clinical": [ [ "thyroid", 0.129 ], [ "blood", 0.079 ], [ "sweat", 0.069 ], [ "diet", 0.029 ], [ "heart", 0.025 ] ], "spread_patient": [ [ "blood", 0.198 ], [ "thyroid", 0.106 ], [ "thermostat", 0.044 ], [ "hormones", 0.03 ], [ "body", 0.024 ] ], "target_token": "thyroid", "flipped": true, "screening": null, "circuit_diff": { "shared_features": 755, "unique_to_a": 764, "unique_to_b": 752 }, "clinical_mass": { "clinical": 0.3155, "patient": 0.1892, "translated": 0.3184 }, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": 2, "tier_shift": 0.537, "urgency_recovery": 0.0 } } }, "prob_clinical": 0.129, "prob_patient": 0.106, "language_penalty": -0.023000000000000007, "flipped": true, "top_clinical": [ "thyroid", 0.129 ], "top_patient": [ "blood", 0.198 ], "spread_clinical": [ [ "thyroid", 0.129 ], [ "blood", 0.079 ], [ "sweat", 0.069 ], [ "diet", 0.029 ], [ "heart", 0.025 ] ], "spread_patient": [ [ "blood", 0.198 ], [ "thyroid", 0.106 ], [ "thermostat", 0.044 ], [ "hormones", 0.03 ], [ "body", 0.024 ] ], "target_token": "thyroid", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 755, "unique_to_a": 764, "unique_to_b": 752 }, "clinical_mass": { "clinical": 0.3155, "patient": 0.1892, "translated": 0.3184 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260719T132706Z/index_94.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": 2, "tier_shift": 0.537, "urgency_recovery": 0.0 } }, { "index": 1202, "batch": "pairs_20260719T132706Z", "batch_index": 95, "clinical_prompt": "My wife has developed cervicitis, so we're going to see a", "patient_prompt": "My lady's got some unusual discharge happening, so we're going to see a", "intended_target": "gynecologist", "rationale": "Both prompts end after an article in an obligatory agent-role context (visiting a professional). The clinical term cervicitis is a specific inflammatory condition requiring gynecological care, while the colloquial framing is vague. Frame structure: '...going to see a [TARGET]'.", "patient_term": "lady's got some unusual discharge happening", "clinical_term": "wife has developed cervicitis", "topic": "gynecology", "topics": [ "gynecology", "sexual medicine", "menopause", "infectious disease", "pharyngitis", "fever", "nocturia", "urinary tract infection", "genitourinary", "endocrine disorder", "hyperhidrosis", "thyroid disorder" ], "models": { "gemma-2-2b": { "prob_clinical": 0.141, "prob_patient": 0.055, "language_penalty": -0.086, "anchor_fallback": false, "top_clinical": [ "doctor", 0.383 ], "top_patient": [ "doctor", 0.408 ], "spread_clinical": [ [ "doctor", 0.383 ], [ "gyne", 0.141 ], [ "specialist", 0.141 ], [ "gy", 0.066 ], [ "uro", 0.059 ] ], "spread_patient": [ [ "doctor", 0.408 ], [ "specialist", 0.091 ], [ "doc", 0.091 ], [ "vet", 0.062 ], [ "gyne", 0.055 ] ], "target_token": "gyne", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 550, "unique_to_a": 810, "unique_to_b": 753 }, "clinical_mass": { "clinical": 0.4689, "patient": 0.3362, "translated": 0.4506 }, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.32, "urgency_recovery": 0.458 } } }, "prob_clinical": 0.141, "prob_patient": 0.055, "language_penalty": -0.086, "flipped": false, "top_clinical": [ "doctor", 0.383 ], "top_patient": [ "doctor", 0.408 ], "spread_clinical": [ [ "doctor", 0.383 ], [ "gyne", 0.141 ], [ "specialist", 0.141 ], [ "gy", 0.066 ], [ "uro", 0.059 ] ], "spread_patient": [ [ "doctor", 0.408 ], [ "specialist", 0.091 ], [ "doc", 0.091 ], [ "vet", 0.062 ], [ "gyne", 0.055 ] ], "target_token": "gyne", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 550, "unique_to_a": 810, "unique_to_b": 753 }, "clinical_mass": { "clinical": 0.4689, "patient": 0.3362, "translated": 0.4506 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260719T132706Z/index_95.html", "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.32, "urgency_recovery": 0.458 } }, { "index": 1203, "batch": "pairs_20260719T132706Z", "batch_index": 96, "clinical_prompt": "I've been experiencing dysuria with urethral pruritus, so I should probably take an", "patient_prompt": "I've been getting this weird itchy feeling in my urinary area, so I should probably take an", "intended_target": "antibiotic", "rationale": "The clinical phrasing (dysuria with urethral pruritus) combines burning and itching symptoms characteristic of UTI/urethritis, strongly predicting an antibiotic. The colloquial version is nonspecific. Both end after the article 'an', creating a strong grammatical pull toward a single-wordpiece noun starting with a vowel.", "patient_term": "weird itchy feeling in my urinary area", "clinical_term": "dysuria with urethral pruritus", "topic": "urinary tract infection", "topics": [ "gynecology", "sexual medicine", "menopause", "infectious disease", "pharyngitis", "fever", "nocturia", "urinary tract infection", "genitourinary", "endocrine disorder", "hyperhidrosis", "thyroid disorder" ], "models": { "gemma-2-2b": { "prob_clinical": 0.277, "prob_patient": 0.067, "language_penalty": -0.21000000000000002, "anchor_fallback": false, "top_clinical": [ "antibiotic", 0.277 ], "top_patient": [ "over", 0.126 ], "spread_clinical": [ [ "antibiotic", 0.277 ], [ "over", 0.08 ], [ "anti", 0.07 ], [ "STD", 0.055 ], [ "exam", 0.055 ] ], "spread_patient": [ [ "over", 0.126 ], [ "exam", 0.087 ], [ "antibiotic", 0.067 ], [ "STD", 0.067 ], [ "extra", 0.053 ] ], "target_token": "antibiotic", "flipped": true, "screening": null, "circuit_diff": { "shared_features": 766, "unique_to_a": 615, "unique_to_b": 583 }, "clinical_mass": { "clinical": 0.3818, "patient": 0.2673, "translated": 0.321 }, "html": "modes/simulated/pairs_20260719T132706Z/index_96.html", "urgency": { "flip_class": "downgrade", "tier_top_clinical": 2, "tier_top_patient": 1, "tier_shift": -0.139, "urgency_recovery": -0.219 } } }, "prob_clinical": 0.277, "prob_patient": 0.067, "language_penalty": -0.21000000000000002, "flipped": true, "top_clinical": [ "antibiotic", 0.277 ], "top_patient": [ "over", 0.126 ], "spread_clinical": [ [ "antibiotic", 0.277 ], [ "over", 0.08 ], [ "anti", 0.07 ], [ "STD", 0.055 ], [ "exam", 0.055 ] ], "spread_patient": [ [ "over", 0.126 ], [ "exam", 0.087 ], [ "antibiotic", 0.067 ], [ "STD", 0.067 ], [ "extra", 0.053 ] ], "target_token": "antibiotic", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 766, "unique_to_a": 615, "unique_to_b": 583 }, "clinical_mass": { "clinical": 0.3818, "patient": 0.2673, "translated": 0.321 }, "html": "modes/simulated/pairs_20260719T132706Z/index_96.html", "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260719T132706Z/index_96.html", "urgency": { "flip_class": "downgrade", "tier_top_clinical": 2, "tier_top_patient": 1, "tier_shift": -0.139, "urgency_recovery": -0.219 } }, { "index": 1204, "batch": "pairs_20260719T132706Z", "batch_index": 97, "clinical_prompt": "I've been experiencing nocturia with increased nocturnal frequency, so my doctor suspects I might have an", "patient_prompt": "I've been getting up to urinate way too often at night lately, so my doctor suspects I might have an", "intended_target": "issue", "rationale": "The clinical phrasing formally names the symptom (nocturia), signaling a recognized medical condition requiring investigation. The colloquial version sounds like a temporary inconvenience. Both end after 'an' + vowel-initial word, funneling toward diagnostic language.", "patient_term": "getting up to urinate way too often at night lately", "clinical_term": "nocturia with increased nocturnal frequency", "topic": "nocturia", "topics": [ "gynecology", "sexual medicine", "menopause", "infectious disease", "pharyngitis", "fever", "nocturia", "urinary tract infection", "genitourinary", "endocrine disorder", "hyperhidrosis", "thyroid disorder" ], "models": { "gemma-2-2b": { "prob_clinical": 0.57, "prob_patient": 0.371, "language_penalty": -0.19899999999999995, "anchor_fallback": true, "top_clinical": [ "enlarged", 0.57 ], "top_patient": [ "enlarged", 0.371 ], "spread_clinical": [ [ "enlarged", 0.57 ], [ "over", 0.237 ], [ "underlying", 0.06 ], [ "under", 0.025 ], [ "interstitial", 0.022 ] ], "spread_patient": [ [ "enlarged", 0.371 ], [ "infection", 0.254 ], [ "over", 0.175 ], [ "interstitial", 0.039 ], [ "under", 0.027 ] ], "target_token": "enlarged", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 722, "unique_to_a": 700, "unique_to_b": 798 }, "clinical_mass": { "clinical": 0.4213, "patient": 0.3646, "translated": 0.4118 } } }, "prob_clinical": 0.57, "prob_patient": 0.371, "language_penalty": -0.19899999999999995, "flipped": false, "top_clinical": [ "enlarged", 0.57 ], "top_patient": [ "enlarged", 0.371 ], "spread_clinical": [ [ "enlarged", 0.57 ], [ "over", 0.237 ], [ "underlying", 0.06 ], [ "under", 0.025 ], [ "interstitial", 0.022 ] ], "spread_patient": [ [ "enlarged", 0.371 ], [ "infection", 0.254 ], [ "over", 0.175 ], [ "interstitial", 0.039 ], [ "under", 0.027 ] ], "target_token": "enlarged", "anchor_fallback": true, "screening": null, "circuit_diff": { "shared_features": 722, "unique_to_a": 700, "unique_to_b": 798 }, "clinical_mass": { "clinical": 0.4213, "patient": 0.3646, "translated": 0.4118 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260719T132706Z/index_97.html" }, { "index": 1205, "batch": "pairs_20260719T132706Z", "batch_index": 98, "clinical_prompt": "I'm experiencing diminished libido and sexual dysfunction, and that's been worrying me, so I should probably talk to a", "patient_prompt": "I haven't been interested in anything intimate with my partner, and that's been worrying me, so I should probably talk to a", "intended_target": "doctor", "rationale": "The clinical phrasing (diminished libido and sexual dysfunction) signals a medical concern requiring professional evaluation; the patient version frames it as emotional distance. 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-0.0 } }, "qwen3-4b": { "prob_clinical": 0.0215, "prob_patient": 0.0063, "language_penalty": -0.0152, "anchor_fallback": false, "top_clinical": [ "doctor", 0.9144 ], "top_patient": [ "doctor", 0.9345 ], "spread_clinical": [ [ "doctor", 0.9144 ], [ "gastro", 0.0215 ], [ "healthcare", 0.0148 ], [ "physician", 0.0115 ], [ "specialist", 0.007 ], [ "medical", 0.0037 ], [ "GP", 0.0037 ], [ "professional", 0.0033 ], [ "health", 0.0033 ], [ "diet", 0.0017 ] ], "spread_patient": [ [ "doctor", 0.9345 ], [ "healthcare", 0.022 ], [ "specialist", 0.0118 ], [ "professional", 0.0081 ], [ "gastro", 0.0063 ], [ "physician", 0.0043 ], [ "medical", 0.0034 ], [ "health", 0.0026 ], [ "diet", 0.0016 ], [ "nutrition", 0.001 ] ], "target_token": "gastro", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.011 } }, "qwen3-1.7b": { "prob_clinical": 0.0439, "prob_patient": 0.0202, "language_penalty": -0.0237, "anchor_fallback": false, "top_clinical": [ "doctor", 0.7785 ], "top_patient": [ "doctor", 0.46 ], "spread_clinical": [ [ "doctor", 0.7785 ], [ "gastro", 0.0439 ], [ "nutrition", 0.0388 ], [ "diet", 0.0342 ], [ "physician", 0.0302 ], [ "healthcare", 0.0143 ], [ "GP", 0.0076 ], [ "health", 0.0067 ], [ "nurse", 0.0059 ], [ "specialist", 0.0046 ] ], "spread_patient": [ [ "doctor", 0.46 ], [ "diet", 0.1692 ], [ "nutrition", 0.1692 ], [ "nurse", 0.0294 ], [ "healthcare", 0.0229 ], [ "professional", 0.0229 ], [ "gastro", 0.0202 ], [ "registered", 0.0157 ], [ "health", 0.0139 ], [ "physician", 0.0123 ] ], "target_token": "gastro", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.424 } } }, "prob_clinical": 0.068, "prob_patient": null, "language_penalty": null, "flipped": false, "top_clinical": [ "doctor", 0.346 ], "top_patient": [ "doctor", 0.486 ], "spread_clinical": [ [ "doctor", 0.346 ], [ "GI", 0.087 ], [ "nutrition", 0.068 ], [ "gastroenter", 0.068 ], [ "doc", 0.068 ] ], "spread_patient": [ [ "doctor", 0.486 ], [ "nutrition", 0.123 ], [ "die", 0.109 ], [ "specialist", 0.035 ], [ "doc", 0.024 ] ], "target_token": "gastroenter", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 679, "unique_to_a": 618, "unique_to_b": 618 }, "clinical_mass": { "clinical": 0.3922, "patient": 0.2831 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260731T211704Z/index_61.html", "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.208 } }, { "index": 1257, "batch": "pairs_20260731T211704Z", "batch_index": 62, "clinical_prompt": "I have tachycardia, so I need to take my", "patient_prompt": "I keep feeling like my heart's pounding out of my chest, so I need to take my", "intended_target": "medication", "rationale": "The colloquial 'pounding out of chest' is a lay description of tachycardia (elevated heart rate). The clinical frame should steer toward 'medication' as the natural next word after 'take my', whereas the patient phrasing might invite less medical continuations like 'breath' or 'time'.", "patient_term": "heart's pounding out of my chest", "clinical_term": "tachycardia", "topic": "cardiovascular", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": 0.04, "prob_patient": 0.057, "language_penalty": 0.017, "anchor_fallback": false, "top_clinical": [ "heart", 0.299 ], "top_patient": [ "heart", 0.198 ], "spread_clinical": [ [ "heart", 0.299 ], [ "blood", 0.232 ], [ "meds", 0.076 ], [ "pulse", 0.059 ], [ "medication", 0.04 ] ], "spread_patient": [ [ "heart", 0.198 ], [ "blood", 0.154 ], [ "meds", 0.12 ], [ "pulse", 0.083 ], [ "medication", 0.057 ] ], "target_token": "medication", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 520, "unique_to_a": 590, "unique_to_b": 714 }, "clinical_mass": { "clinical": 0.4172, "patient": 0.2687 }, "urgency": { "flip_class": null, "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": -0.201 } }, "gemma-3-4b-it": { "prob_clinical": 0.0203, "prob_patient": 0.2175, "language_penalty": 0.1972, "anchor_fallback": false, "top_clinical": [ "heart", 0.8642 ], "top_patient": [ "blood", 0.2793 ], "spread_clinical": [ [ "heart", 0.8642 ], [ "pulse", 0.0709 ], [ "medication", 0.0203 ], [ "blood", 0.014 ], [ "medications", 0.0066 ], [ "medicine", 0.0051 ], [ "rate", 0.004 ], [ "resting", 0.0031 ], [ "heartbeat", 0.0021 ], [ "HR", 0.0021 ] ], "spread_patient": [ [ "blood", 0.2793 ], [ "medication", 0.2175 ], [ "heart", 0.1694 ], [ "pulse", 0.1319 ], [ "medicine", 0.1027 ], [ "anxiety", 0.0108 ], [ "medications", 0.0096 ], [ "meds", 0.0074 ], [ "temperature", 0.0051 ], [ "own", 0.0037 ] ], "target_token": "medication", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": 2, "tier_shift": null } }, "qwen3-4b": { "prob_clinical": 0.027, "prob_patient": 0.1297, "language_penalty": 0.1027, "anchor_fallback": false, "top_clinical": [ "heart", 0.3731 ], "top_patient": [ "medicine", 0.1469 ], "spread_clinical": [ [ "heart", 0.3731 ], [ "pulse", 0.3731 ], [ "blood", 0.0572 ], [ "beta", 0.0505 ], [ "prescribed", 0.027 ], [ "medication", 0.027 ], [ "medications", 0.0186 ], [ "usual", 0.0077 ], [ "medicine", 0.0068 ], [ "E", 0.0039 ] ], "spread_patient": [ [ "medicine", 0.1469 ], [ "medication", 0.1297 ], [ "heart", 0.0891 ], [ "pulse", 0.0891 ], [ "time", 0.0652 ], [ "pills", 0.0349 ], [ "medications", 0.024 ], [ "meds", 0.0212 ], [ "life", 0.0212 ], [ "pill", 0.0212 ] ], "target_token": "medication", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": 1, "tier_shift": null } }, "qwen3-1.7b": { "prob_clinical": 0.1784, "prob_patient": 0.0266, "language_penalty": -0.1518, "anchor_fallback": false, "top_clinical": [ "heart", 0.1784 ], "top_patient": [ "pulse", 0.4168 ], "spread_clinical": [ [ "heart", 0.1784 ], [ "medication", 0.1784 ], [ "medications", 0.1226 ], [ "pulse", 0.0955 ], [ "blood", 0.0843 ], [ "medicine", 0.0351 ], [ "beta", 0.031 ], [ "potassium", 0.0274 ], [ "E", 0.0114 ], [ "medicines", 0.0089 ] ], "spread_patient": [ [ "pulse", 0.4168 ], [ "heart", 0.1737 ], [ "blood", 0.1054 ], [ "medicine", 0.0498 ], [ "time", 0.0439 ], [ "medication", 0.0266 ], [ "chest", 0.0143 ], [ "heartbeat", 0.0111 ], [ "anxiety", 0.0098 ], [ "breath", 0.0098 ] ], "target_token": "medication", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } } }, "prob_clinical": 0.04, "prob_patient": 0.057, "language_penalty": 0.017, "flipped": false, "top_clinical": [ "heart", 0.299 ], "top_patient": [ "heart", 0.198 ], "spread_clinical": [ [ "heart", 0.299 ], [ "blood", 0.232 ], [ "meds", 0.076 ], [ "pulse", 0.059 ], [ "medication", 0.04 ] ], "spread_patient": [ [ "heart", 0.198 ], [ "blood", 0.154 ], [ "meds", 0.12 ], [ "pulse", 0.083 ], [ "medication", 0.057 ] ], "target_token": "medication", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 520, "unique_to_a": 590, "unique_to_b": 714 }, "clinical_mass": { "clinical": 0.4172, "patient": 0.2687 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260731T211704Z/index_62.html", "urgency": { "flip_class": null, "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": -0.201 } }, { "index": 1258, "batch": "pairs_20260731T211704Z", "batch_index": 63, "clinical_prompt": "I have restless leg syndrome, so my doctor said I need to take my", "patient_prompt": "My legs feel like they're on fire at night, so my doctor said I need to take my", "intended_target": "medication", "rationale": "RLS is colloquially described as burning or restless sensations in the legs. The clinical name should shift the expected continuation toward 'medication' (a treatment for a named syndrome) rather than the vaguer responses the symptom description might invite.", "patient_term": "legs feel like they're on fire at night", "clinical_term": "restless leg syndrome", "topic": "neurological", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": 0.061, "prob_patient": null, "language_penalty": null, "anchor_fallback": false, "top_clinical": [ "iron", 0.166 ], "top_patient": [ "blood", 0.135 ], "spread_clinical": [ [ "iron", 0.166 ], [ "magnesium", 0.101 ], [ "meds", 0.089 ], [ "medication", 0.061 ], [ "blood", 0.048 ] ], "spread_patient": [ [ "blood", 0.135 ], [ "socks", 0.072 ], [ "pain", 0.05 ], [ "meds", 0.05 ], [ "compression", 0.034 ] ], "target_token": "medication", "flipped": true, "screening": null, "circuit_diff": { "shared_features": 615, "unique_to_a": 823, "unique_to_b": 820 }, "clinical_mass": { "clinical": 0.3753, "patient": 0.331 }, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": 2, "tier_shift": 0.332 } }, "gemma-3-4b-it": { "prob_clinical": 0.4064, "prob_patient": 0.236, "language_penalty": -0.1704, "anchor_fallback": false, "top_clinical": [ "medication", 0.4064 ], "top_patient": [ "blood", 0.303 ], "spread_clinical": [ [ "medication", 0.4064 ], [ "medications", 0.1694 ], [ "vitamins", 0.0706 ], [ "leg", 0.0485 ], [ "medicine", 0.0485 ], [ "iron", 0.0334 ], [ "vitamin", 0.0334 ], [ "supplements", 0.0294 ], [ "pills", 0.0179 ], [ "legs", 0.0139 ] ], "spread_patient": [ [ "blood", 0.303 ], [ "medication", 0.236 ], [ "medicine", 0.0527 ], [ "medications", 0.0465 ], [ "iron", 0.0465 ], [ "vitamin", 0.0465 ], [ "magnesium", 0.0319 ], [ "vitamins", 0.0194 ], [ "meds", 0.0151 ], [ "thyroid", 0.0133 ] ], "target_token": "medication", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "lateral", "tier_top_clinical": 1, "tier_top_patient": 1, "tier_shift": 0.0 } }, "qwen3-4b": { "prob_clinical": 0.2288, "prob_patient": 0.0511, "language_penalty": -0.1777, "anchor_fallback": false, "top_clinical": [ "medication", 0.2288 ], "top_patient": [ "blood", 0.2437 ], "spread_clinical": [ [ "medication", 0.2288 ], [ "medicine", 0.1081 ], [ "iron", 0.0954 ], [ "prescribed", 0.0842 ], [ "blood", 0.0656 ], [ "medications", 0.048 ], [ "meds", 0.02 ], [ "sleep", 0.0188 ], [ "Z", 0.0166 ], [ "usual", 0.0146 ] ], "spread_patient": [ [ "blood", 0.2437 ], [ "medication", 0.0511 ], [ "prescribed", 0.0424 ], [ "ant", 0.0351 ], [ "temperature", 0.031 ], [ "medicine", 0.031 ], [ "sleep", 0.0188 ], [ "pain", 0.0177 ], [ "sleeping", 0.0177 ], [ "pills", 0.0146 ] ], "target_token": "medication", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "lateral", "tier_top_clinical": 1, "tier_top_patient": 1, "tier_shift": -0.111 } }, "qwen3-1.7b": { "prob_clinical": 0.3306, "prob_patient": 0.0277, "language_penalty": -0.3029, "anchor_fallback": false, "top_clinical": [ "medication", 0.3306 ], "top_patient": [ "blood", 0.2323 ], "spread_clinical": [ [ "medication", 0.3306 ], [ "medications", 0.0836 ], [ "vitamin", 0.0574 ], [ "ant", 0.0447 ], [ "iron", 0.0395 ], [ "blood", 0.0395 ], [ "prescribed", 0.0308 ], [ "medicine", 0.0308 ], [ "supplements", 0.0187 ], [ "sleep", 0.0145 ] ], "spread_patient": [ [ "blood", 0.2323 ], [ "vitamin", 0.0855 ], [ "cholesterol", 0.0518 ], [ "temperature", 0.0457 ], [ "calcium", 0.0356 ], [ "legs", 0.0356 ], [ "medication", 0.0277 ], [ "potassium", 0.0245 ], [ "pulse", 0.0245 ], [ "leg", 0.0216 ] ], "target_token": "medication", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "upgrade", "tier_top_clinical": 1, "tier_top_patient": 2, "tier_shift": 0.561 } } }, "prob_clinical": 0.061, "prob_patient": null, "language_penalty": null, "flipped": true, "top_clinical": [ "iron", 0.166 ], "top_patient": [ "blood", 0.135 ], "spread_clinical": [ [ "iron", 0.166 ], [ "magnesium", 0.101 ], [ "meds", 0.089 ], [ "medication", 0.061 ], [ "blood", 0.048 ] ], "spread_patient": [ [ "blood", 0.135 ], [ "socks", 0.072 ], [ "pain", 0.05 ], [ "meds", 0.05 ], [ "compression", 0.034 ] ], "target_token": "medication", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 615, "unique_to_a": 823, "unique_to_b": 820 }, "clinical_mass": { "clinical": 0.3753, "patient": 0.331 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260731T211704Z/index_63.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": 2, "tier_shift": 0.332 } }, { "index": 1259, "batch": "pairs_20260731T211704Z", "batch_index": 64, "clinical_prompt": "I have attention deficit disorder, so I think I need to get my", "patient_prompt": "I keep spacing out in meetings, so I think I need to get my", "intended_target": "assessed", "rationale": "ADHD is colloquially expressed as 'spacing out' or losing focus. The clinical phrasing should pull toward 'assessed' or 'evaluated' as a diagnostic step, while the lay phrasing might suggest 'sleep' or 'coffee'.", "patient_term": "spacing out in meetings", "clinical_term": "attention deficit disorder", "topic": "cognitive", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": 0.133, "prob_patient": null, "language_penalty": null, "anchor_fallback": true, "top_clinical": [ "hands", 0.133 ], "top_patient": [ "brain", 0.098 ], "spread_clinical": [ [ "hands", 0.133 ], [ "head", 0.081 ], [ "own", 0.049 ], [ "priorities", 0.049 ], [ "attention", 0.038 ] ], "spread_patient": [ [ "brain", 0.098 ], [ "head", 0.098 ], [ "mind", 0.067 ], [ "sleep", 0.041 ], [ "attention", 0.041 ] ], "target_token": "hands", "flipped": true, "screening": null, "circuit_diff": { "shared_features": 594, "unique_to_a": 737, "unique_to_b": 815 }, "clinical_mass": { "clinical": 0.1736, "patient": 0.1174 }, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, "gemma-3-4b-it": { "prob_clinical": 0.0, "prob_patient": 0.0, "language_penalty": 0.0, "anchor_fallback": false, "top_clinical": [ "ADHD", 0.4108 ], "top_patient": [ "sleep", 0.2078 ], "spread_clinical": [ [ "ADHD", 0.4108 ], [ "attention", 0.1039 ], [ "thoughts", 0.0556 ], [ "medication", 0.0298 ], [ "blood", 0.0232 ], [ "hearing", 0.0205 ], [ "head", 0.0205 ], [ "life", 0.018 ], [ "eyes", 0.0132 ], [ "own", 0.0109 ] ], "spread_patient": [ [ "sleep", 0.2078 ], [ "focus", 0.2078 ], [ "attention", 0.1834 ], [ "brain", 0.0764 ], [ "mind", 0.0464 ], [ "head", 0.0409 ], [ "act", 0.0361 ], [ "ADHD", 0.0319 ], [ "concentration", 0.0281 ], [ "energy", 0.0219 ] ], "target_token": "assessed", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "downgrade", "tier_top_clinical": 1, "tier_top_patient": 0, "tier_shift": null } }, "qwen3-4b": { "prob_clinical": 0.0, "prob_patient": 0.0, "language_penalty": 0.0, "anchor_fallback": false, "top_clinical": [ "attention", 0.2365 ], "top_patient": [ "attention", 0.1905 ], "spread_clinical": [ [ "attention", 0.2365 ], [ "child", 0.1842 ], [ "brain", 0.0986 ], [ "eyes", 0.0817 ], [ "head", 0.0207 ], [ "ears", 0.0133 ], [ "hands", 0.0133 ], [ "kid", 0.0118 ], [ "medication", 0.0098 ], [ "life", 0.0098 ] ], "spread_patient": [ [ "attention", 0.1905 ], [ "act", 0.09 ], [ "focus", 0.0794 ], [ "brain", 0.0658 ], [ "head", 0.0546 ], [ "sleep", 0.0482 ], [ "priorities", 0.0425 ], [ "mind", 0.0228 ], [ "time", 0.0228 ], [ "eyes", 0.0214 ] ], "target_token": "assessed", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null }, "qwen3-1.7b": { "prob_clinical": 0.0, "prob_patient": 0.0, "language_penalty": 0.0, "anchor_fallback": false, "top_clinical": [ "attention", 0.1136 ], "top_patient": [ "attention", 0.5878 ], "spread_clinical": [ [ "attention", 0.1136 ], [ "child", 0.0781 ], [ "kids", 0.0473 ], [ "medication", 0.0418 ], [ "sleep", 0.0418 ], [ "life", 0.0369 ], [ "kid", 0.0287 ], [ "act", 0.0287 ], [ "ADHD", 0.0224 ], [ "eyes", 0.0224 ] ], "spread_patient": [ [ "attention", 0.5878 ], [ "focus", 0.2777 ], [ "mind", 0.0376 ], [ "brain", 0.0138 ], [ "head", 0.0084 ], [ "thoughts", 0.0074 ], [ "energy", 0.0074 ], [ "concentration", 0.0058 ], [ "life", 0.004 ], [ "mental", 0.0031 ] ], "target_token": "assessed", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null } }, "prob_clinical": 0.133, "prob_patient": null, "language_penalty": null, "flipped": true, "top_clinical": [ "hands", 0.133 ], "top_patient": [ "brain", 0.098 ], "spread_clinical": [ [ "hands", 0.133 ], [ "head", 0.081 ], [ "own", 0.049 ], [ "priorities", 0.049 ], [ "attention", 0.038 ] ], "spread_patient": [ [ "brain", 0.098 ], [ "head", 0.098 ], [ "mind", 0.067 ], [ "sleep", 0.041 ], [ "attention", 0.041 ] ], "target_token": "hands", "anchor_fallback": true, "screening": null, "circuit_diff": { "shared_features": 594, "unique_to_a": 737, "unique_to_b": 815 }, "clinical_mass": { "clinical": 0.1736, "patient": 0.1174 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260731T211704Z/index_64.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, { "index": 1260, "batch": "pairs_20260731T211704Z", "batch_index": 65, "clinical_prompt": "I have paresthesia, so I need to take an", "patient_prompt": "I've been getting these weird pins and needles all over my body, so I need to take an", "intended_target": "anticonvulsant", "rationale": "Paresthesia is the clinical term for abnormal tingling or 'pins and needles' sensation. The clinical framing should bias toward 'anticonvulsant' or specific medication class, whereas the symptom-based lay phrasing might invite 'rest' or 'break'.", "patient_term": "weird pins and needles all over my body", "clinical_term": "paresthesia", "topic": "neurological", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": 0.418, "prob_patient": 0.129, "language_penalty": -0.289, "anchor_fallback": false, "top_clinical": [ "anti", 0.418 ], "top_patient": [ "MRI", 0.129 ], "spread_clinical": [ [ "anti", 0.418 ], [ "antidepress", 0.044 ], [ "aspirin", 0.044 ], [ "occasional", 0.034 ], [ "extra", 0.03 ] ], "spread_patient": [ [ "MRI", 0.129 ], [ "anti", 0.129 ], [ "aspirin", 0.078 ], [ "allergy", 0.047 ], [ "EEG", 0.025 ] ], "target_token": "anti", "flipped": true, "screening": null, "circuit_diff": { "shared_features": 536, "unique_to_a": 777, "unique_to_b": 942 }, "clinical_mass": { "clinical": 0.3318, "patient": 0.2677 }, "html": 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specialized medical language, making specialist referral the expected continuation. 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The frame 'should take my' before a medication-class noun creates diagnostic pressure: 'antacid' is the high-frequency next token for reflux management, distinct from generic pain relief.", "patient_term": "burning sensation in my chest", "clinical_term": "gastroesophageal reflux", "topic": "reflux disease", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": 0.12, "prob_patient": null, "language_penalty": null, "anchor_fallback": false, "top_clinical": [ "medication", 0.154 ], "top_patient": [ "heart", 0.079 ], "spread_clinical": [ [ "medication", 0.154 ], [ "ant", 0.12 ], [ "medicine", 0.057 ], [ "meds", 0.044 ], [ "proton", 0.044 ] ], "spread_patient": [ [ "heart", 0.079 ], [ "medicine", 0.069 ], [ "medication", 0.069 ], [ "meds", 0.069 ], [ "blood", 0.069 ] ], "target_token": "ant", "flipped": true, "screening": null, "circuit_diff": { "shared_features": 796, "unique_to_a": 522, "unique_to_b": 556 }, "clinical_mass": { "clinical": 0.3484, "patient": 0.2858 }, "urgency": { 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The frame 'it might be a' after clinical phrasing directs toward medical classification words, whereas colloquial phrasing allows more casual attributions.", "patient_term": "face gets all flushed", "clinical_term": "facial flushing", "topic": "flushing", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": null, "prob_patient": null, "language_penalty": null, "anchor_fallback": false, "top_clinical": [ "food", 0.101 ], "top_patient": null, "spread_clinical": [ [ "food", 0.101 ], [ "little", 0.079 ], [ "good", 0.079 ], [ "bit", 0.079 ], [ "sign", 0.079 ] ], "spread_patient": [], "target_token": null, "flipped": false, "screening": { "status": "screened_out", "min_prob": 0.02, "intended_target": " symptom", "observed_clinical": null, "probe_extension": null, "reason": "intended target not in the traced clinical spread" }, "circuit_diff": null, "clinical_mass": { "clinical": 0.2773 }, "urgency": { "flip_class": "uninformative", "tier_top_clinical": 0, "tier_top_patient": null, "tier_shift": null } }, "gemma-3-4b-it": { "prob_clinical": 0.0194, "prob_patient": 0.1074, "language_penalty": 0.088, "anchor_fallback": false, "top_clinical": [ "food", 0.3888 ], "top_patient": [ "sign", 0.4246 ], "spread_clinical": [ [ "food", 0.3888 ], [ "trigger", 0.143 ], [ "histamine", 0.0676 ], [ "connection", 0.0596 ], [ "sensitivity", 0.041 ], [ "reaction", 0.0362 ], [ "symptom", 0.0194 ], [ "possible", 0.0171 ], [ "link", 0.0117 ], [ "migraine", 0.0104 ] ], "spread_patient": [ [ "sign", 0.4246 ], [ "reaction", 0.1217 ], [ "symptom", 0.1074 ], [ "side", 0.0349 ], [ "food", 0.0308 ], [ "bit", 0.0175 ], [ "case", 0.0136 ], [ "result", 0.01 ], [ "mild", 0.01 ], [ "skin", 0.0088 ] ], "target_token": "symptom", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": 0, "tier_top_patient": null, "tier_shift": null } }, "qwen3-4b": { "prob_clinical": 0.0022, "prob_patient": 0.0314, "language_penalty": 0.0292, "anchor_fallback": false, "top_clinical": [ "food", 0.4484 ], "top_patient": [ "sign", 0.4919 ], "spread_clinical": [ [ "food", 0.4484 ], [ "reaction", 0.3082 ], [ "hist", 0.0536 ], [ "problem", 0.0473 ], [ "type", 0.0119 ], [ "mast", 0.0105 ], [ "sign", 0.0056 ], [ "red", 0.0053 ], [ "case", 0.0044 ], [ "side", 0.0036 ] ], "spread_patient": [ [ "sign", 0.4919 ], [ "problem", 0.1244 ], [ "good", 0.0855 ], [ "reaction", 0.0458 ], [ "symptom", 0.0314 ], [ "side", 0.0216 ], [ "bad", 0.0123 ], [ "red", 0.0116 ], [ "natural", 0.0096 ], [ "type", 0.0096 ] ], "target_token": "symptom", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": 1, "tier_top_patient": null, "tier_shift": null } }, "qwen3-1.7b": { "prob_clinical": 0.0028, "prob_patient": 0.0107, "language_penalty": 0.0079, "anchor_fallback": false, "top_clinical": [ "reaction", 0.219 ], "top_patient": [ "problem", 0.1298 ], "spread_clinical": [ [ "reaction", 0.219 ], [ "problem", 0.1034 ], [ "food", 0.0806 ], [ "condition", 0.0381 ], [ "side", 0.0336 ], [ "possible", 0.0262 ], [ "hormone", 0.0231 ], [ "hormonal", 0.0159 ], [ "trigger", 0.014 ], [ "case", 0.014 ] ], "spread_patient": [ [ "problem", 0.1298 ], [ "reaction", 0.1011 ], [ "sign", 0.0787 ], [ "side", 0.0695 ], [ "blush", 0.0541 ], [ "red", 0.0421 ], [ "skin", 0.029 ], [ "possible", 0.029 ], [ "bad", 0.0256 ], [ "good", 0.0256 ] ], "target_token": "symptom", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } } }, "prob_clinical": null, "prob_patient": null, "language_penalty": null, "flipped": false, "top_clinical": [ "food", 0.101 ], "top_patient": null, "spread_clinical": [ [ "food", 0.101 ], [ "little", 0.079 ], [ "good", 0.079 ], [ "bit", 0.079 ], [ "sign", 0.079 ] ], "spread_patient": [], "target_token": null, "anchor_fallback": false, "screening": { "status": "screened_out", "min_prob": 0.02, "intended_target": " symptom", "observed_clinical": null, "probe_extension": null, "reason": "intended target not in the traced clinical spread" }, "circuit_diff": null, "clinical_mass": { "clinical": 0.2773 }, "urgency": { "flip_class": "uninformative", "tier_top_clinical": 0, "tier_top_patient": null, "tier_shift": null } }, { "index": 1307, "batch": "pairs_20260803T132340Z", "batch_index": 21, "clinical_prompt": "I have a dermatological condition, so I'm going to book an appointment with my", "patient_prompt": "My skin is acting up again, so I'm going to book an appointment with my", "intended_target": "dermatologist", "rationale": "Informal behavioral metaphor for skin abnormality versus formal diagnosis category. The frame 'appointment with my' strongly predicts a medical professional title; clinical phrasing increases specificity toward specialist naming.", "patient_term": "skin is acting up", "clinical_term": "dermatological condition", "topic": "skin conditions", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": 0.237, "prob_patient": 0.547, "language_penalty": 0.31000000000000005, "anchor_fallback": false, "top_clinical": [ "dermatologist", 0.237 ], "top_patient": [ "dermatologist", 0.547 ], "spread_clinical": [ [ "dermatologist", 0.237 ], [ "GP", 0.209 ], [ "doctor", 0.209 ], [ "regular", 0.047 ], [ "family", 0.036 ] ], "spread_patient": [ [ "dermatologist", 0.547 ], [ "der", 0.156 ], [ "doctor", 0.084 ], [ "est", 0.024 ], [ "dermat", 0.016 ] ], "target_token": "dermatologist", "flipped": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " dermatologist", "observed_clinical": [ "Output \" dermatologist\"", 0.237 ], "probe_extension": null }, "circuit_diff": { "shared_features": 572, "unique_to_a": 700, "unique_to_b": 525 }, "clinical_mass": { "clinical": 0.4124, "patient": 0.3359 }, "urgency": { "flip_class": null, "tier_top_clinical": 3, "tier_top_patient": 3, "tier_shift": 0.654 } }, "gemma-3-4b-it": { "prob_clinical": 0.814, "prob_patient": 0.9814, "language_penalty": 0.1674, "anchor_fallback": false, "top_clinical": [ "dermatologist", 0.814 ], "top_patient": [ "dermatologist", 0.9814 ], "spread_clinical": [ [ "dermatologist", 0.814 ], [ "doctor", 0.1415 ], [ "GP", 0.0191 ], [ "primary", 0.0055 ], [ "dermat", 0.0029 ], [ "skin", 0.002 ], [ "specialist", 0.0016 ], [ "physician", 0.0014 ], [ "derm", 0.0012 ], [ "general", 0.0011 ] ], "spread_patient": [ [ "dermatologist", 0.9814 ], [ "est", 0.0075 ], [ "derm", 0.0058 ], [ "doctor", 0.0019 ], [ "dermat", 0.0011 ], [ "Dermat", 0.0011 ], [ "aesthetic", 0.0004 ], [ "skin", 0.0003 ], [ "skincare", 0.0001 ], [ "dermatology", 0.0 ] ], "target_token": "dermatologist", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 3, "tier_top_patient": 3, "tier_shift": 0.168 } }, "qwen3-4b": { "prob_clinical": 0.5163, "prob_patient": 0.9342, "language_penalty": 0.4179, "anchor_fallback": false, "top_clinical": [ "dermat", 0.5163 ], "top_patient": [ "dermat", 0.9342 ], "spread_clinical": [ [ "dermat", 0.5163 ], [ "doctor", 0.4021 ], [ "specialist", 0.0138 ], [ "skin", 0.0129 ], [ "general", 0.0089 ], [ "GP", 0.0074 ], [ "physician", 0.0054 ], [ "primary", 0.0037 ], [ "family", 0.0035 ], [ "local", 0.0031 ] ], "spread_patient": [ [ "dermat", 0.9342 ], [ "doctor", 0.032 ], [ "skin", 0.0104 ], [ "der", 0.0036 ], [ "skincare", 0.0019 ], [ "est", 0.0018 ], [ "aesthetic", 0.0014 ], [ "physician", 0.0009 ], [ "new", 0.0008 ], [ "__", 0.0007 ] ], "target_token": "dermat", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 3, "tier_top_patient": 3, "tier_shift": 0.412 } }, "qwen3-1.7b": { "prob_clinical": 0.6117, "prob_patient": 0.9819, "language_penalty": 0.3702, "anchor_fallback": false, "top_clinical": [ "dermat", 0.6117 ], "top_patient": [ "dermat", 0.9819 ], "spread_clinical": [ [ "dermat", 0.6117 ], [ "GP", 0.1063 ], [ "doctor", 0.1063 ], [ "family", 0.0828 ], [ "general", 0.0163 ], [ "primary", 0.0127 ], [ "local", 0.0112 ], [ "skin", 0.0077 ], [ "physician", 0.006 ], [ "Derm", 0.0028 ] ], "spread_patient": [ [ "dermat", 0.9819 ], [ "doctor", 0.0052 ], [ "skin", 0.0021 ], [ "family", 0.0017 ], [ "plastic", 0.0015 ], [ "Derm", 0.001 ], [ "skincare", 0.0008 ], [ "cos", 0.0007 ], [ "GP", 0.0006 ], [ "physician", 0.0005 ] ], "target_token": "dermat", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 3, "tier_top_patient": 3, "tier_shift": 0.32 } } }, "prob_clinical": 0.237, "prob_patient": 0.547, "language_penalty": 0.31000000000000005, "flipped": false, "top_clinical": [ "dermatologist", 0.237 ], "top_patient": [ "dermatologist", 0.547 ], "spread_clinical": [ [ "dermatologist", 0.237 ], [ "GP", 0.209 ], [ "doctor", 0.209 ], [ "regular", 0.047 ], [ "family", 0.036 ] ], "spread_patient": [ [ "dermatologist", 0.547 ], [ "der", 0.156 ], [ "doctor", 0.084 ], [ "est", 0.024 ], [ "dermat", 0.016 ] ], "target_token": "dermatologist", "anchor_fallback": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " dermatologist", "observed_clinical": [ "Output \" dermatologist\"", 0.237 ], "probe_extension": null }, "circuit_diff": { "shared_features": 572, "unique_to_a": 700, "unique_to_b": 525 }, "clinical_mass": { "clinical": 0.4124, "patient": 0.3359 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260803T132340Z/index_21.html", "urgency": { "flip_class": null, "tier_top_clinical": 3, "tier_top_patient": 3, "tier_shift": 0.654 } }, { "index": 1308, "batch": "pairs_20260803T132340Z", "batch_index": 22, "clinical_prompt": "I've been having vasomotor symptoms, so I should talk to my", "patient_prompt": "I've been having hot flashes, so I should talk to my", "intended_target": "doctor", "rationale": "Colloquial 'hot flashes' is the lay description of vasomotor symptoms. The clinical term prompts a physician consultation, whereas the colloquial version might lead to self-help or informal advice.", "patient_term": "hot flashes", "clinical_term": "vasomotor symptoms", "topic": "menopause", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": 0.389, "prob_patient": 0.523, "language_penalty": 0.134, "anchor_fallback": false, "top_clinical": [ "doctor", 0.389 ], "top_patient": [ "doctor", 0.523 ], "spread_clinical": [ [ "doctor", 0.389 ], [ "doc", 0.162 ], [ "OB", 0.052 ], [ "Dr", 0.046 ], [ "dr", 0.046 ] ], "spread_patient": [ [ "doctor", 0.523 ], [ "doc", 0.15 ], [ "Dr", 0.043 ], [ "OB", 0.043 ], [ "dr", 0.034 ] ], "target_token": "doctor", "flipped": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " doctor", "observed_clinical": [ "Output \" doctor\"", 0.389 ], "probe_extension": null }, "circuit_diff": { "shared_features": 736, "unique_to_a": 529, "unique_to_b": 477 }, "clinical_mass": { "clinical": 0.4459, "patient": 0.3119 }, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": 0.0 } }, "gemma-3-4b-it": { "prob_clinical": 0.901, "prob_patient": 0.9593, "language_penalty": 0.0583, "anchor_fallback": false, "top_clinical": [ "doctor", 0.901 ], "top_patient": [ "doctor", 0.9593 ], "spread_clinical": [ [ "doctor", 0.901 ], [ "gynec", 0.0272 ], [ "healthcare", 0.0165 ], [ "primary", 0.0129 ], [ "physician", 0.0061 ], [ "GP", 0.0061 ], [ "OB", 0.0037 ], [ "PCP", 0.0032 ], [ "health", 0.0022 ], [ "provider", 0.0022 ] ], "spread_patient": [ [ "doctor", 0.9593 ], [ "primary", 0.0083 ], [ "healthcare", 0.0073 ], [ "physician", 0.0057 ], [ "gynec", 0.0039 ], [ "GP", 0.0024 ], [ "Doctor", 0.0024 ], [ "health", 0.0013 ], [ "PCP", 0.0009 ], [ "doc", 0.0009 ] ], "target_token": "doctor", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": 0.0 } }, "qwen3-4b": { "prob_clinical": 0.9486, "prob_patient": 0.9587, "language_penalty": 0.0101, "anchor_fallback": false, "top_clinical": [ "doctor", 0.9486 ], "top_patient": [ "doctor", 0.9587 ], "spread_clinical": [ [ "doctor", 0.9486 ], [ "g", 0.0153 ], [ "physician", 0.0105 ], [ "GP", 0.0072 ], [ "healthcare", 0.0044 ], [ "provider", 0.0027 ], [ "OB", 0.0018 ], [ "primary", 0.0018 ], [ "health", 0.0016 ], [ "PC", 0.0007 ] ], "spread_patient": [ [ "doctor", 0.9587 ], [ "g", 0.0199 ], [ "physician", 0.0057 ], [ "GP", 0.0057 ], [ "healthcare", 0.0019 ], [ "OB", 0.0016 ], [ "health", 0.0011 ], [ "primary", 0.0005 ], [ "provider", 0.0005 ], [ "family", 0.0005 ] ], "target_token": "doctor", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.001 } }, "qwen3-1.7b": { "prob_clinical": 0.875, "prob_patient": 0.9377, "language_penalty": 0.0627, "anchor_fallback": false, "top_clinical": [ "doctor", 0.875 ], "top_patient": [ "doctor", 0.9377 ], "spread_clinical": [ [ "doctor", 0.875 ], [ "physician", 0.0299 ], [ "OB", 0.0206 ], [ "healthcare", 0.016 ], [ "g", 0.0141 ], [ "GP", 0.0125 ], [ "provider", 0.0059 ], [ "primary", 0.0046 ], [ "PC", 0.0025 ], [ "family", 0.0022 ] ], "spread_patient": [ [ "doctor", 0.9377 ], [ "physician", 0.0152 ], [ "healthcare", 0.0134 ], [ "OB", 0.0104 ], [ "GP", 0.0034 ], [ "g", 0.0034 ], [ "provider", 0.003 ], [ "health", 0.0023 ], [ "family", 0.0012 ], [ "primary", 0.0012 ] ], "target_token": "doctor", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": 0.002 } } }, "prob_clinical": 0.389, "prob_patient": 0.523, "language_penalty": 0.134, "flipped": false, "top_clinical": [ "doctor", 0.389 ], "top_patient": [ "doctor", 0.523 ], "spread_clinical": [ [ "doctor", 0.389 ], [ "doc", 0.162 ], [ "OB", 0.052 ], [ "Dr", 0.046 ], [ "dr", 0.046 ] ], "spread_patient": [ [ "doctor", 0.523 ], [ "doc", 0.15 ], [ "Dr", 0.043 ], [ "OB", 0.043 ], [ "dr", 0.034 ] ], "target_token": "doctor", "anchor_fallback": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " doctor", "observed_clinical": [ "Output \" doctor\"", 0.389 ], "probe_extension": null }, "circuit_diff": { "shared_features": 736, "unique_to_a": 529, "unique_to_b": 477 }, "clinical_mass": { "clinical": 0.4459, "patient": 0.3119 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260803T132340Z/index_22.html", "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": 0.0 } }, { "index": 1309, "batch": "pairs_20260803T132340Z", "batch_index": 23, "clinical_prompt": "I keep getting neuropathic pain in my leg, so my doctor wants to run a", "patient_prompt": "I keep getting this stabbing pain in my leg, so my doctor wants to run a", 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"top_clinical": [ "blood", 0.7998 ], "top_patient": [ "doctor", 0.5352 ], "spread_clinical": [ [ "blood", 0.7998 ], [ "doctor", 0.0955 ], [ "BP", 0.031 ], [ "body", 0.0089 ], [ "syst", 0.0078 ], [ "heart", 0.0025 ], [ "pulse", 0.002 ], [ "di", 0.0017 ], [ "physician", 0.0015 ], [ "pressure", 0.0015 ] ], "spread_patient": [ [ "doctor", 0.5352 ], [ "balance", 0.1194 ], [ "mom", 0.0639 ], [ "brain", 0.0266 ], [ "blood", 0.0266 ], [ "friend", 0.0183 ], [ "body", 0.0162 ], [ "wife", 0.0162 ], [ "ears", 0.0111 ], [ "family", 0.0111 ] ], "target_token": "blood", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "lateral", "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.326 } } }, "prob_clinical": 0.084, "prob_patient": null, "language_penalty": null, "flipped": false, "top_clinical": [ "doctor", 0.26 ], "top_patient": [ "doctor", 0.371 ], "spread_clinical": [ [ "doctor", 0.26 ], [ "blood", 0.084 ], [ "heart", 0.075 ], [ 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"intended_target": "nerves", "rationale": "Colloquial 'on fire' description versus clinical 'neuropathic pain' diagnosis. 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clinical term is the medical diagnosis. Both end after 'an', funneling toward a specialist or procedure. Clinical framing prompts professional specialist referral rather than self-care.", "patient_term": "ringing sounds", "clinical_term": "tinnitus", "topic": "otologic", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": 0.031, "prob_patient": 0.038, "language_penalty": 0.006999999999999999, "anchor_fallback": false, "top_clinical": [ "appointment", 0.801 ], "top_patient": [ "appointment", 0.859 ], "spread_clinical": [ [ "appointment", 0.801 ], [ "MRI", 0.031 ], [ "audio", 0.031 ], [ "app", 0.024 ], [ "exam", 0.015 ] ], "spread_patient": [ [ "appointment", 0.859 ], [ "audio", 0.038 ], [ "ear", 0.016 ], [ "exam", 0.016 ], [ "app", 0.014 ] ], "target_token": "audio", "flipped": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " audiologist", "observed_clinical": [ "Output \" audio\"", 0.031 ], "probe_extension": null }, "circuit_diff": { "shared_features": 764, "unique_to_a": 399, "unique_to_b": 466 }, "clinical_mass": { "clinical": 0.3005, "patient": 0.2796 }, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": 0.024 } }, "gemma-3-4b-it": { "prob_clinical": 0.0039, "prob_patient": 0.0007, "language_penalty": -0.0032, "anchor_fallback": false, "top_clinical": [ "appointment", 0.9442 ], "top_patient": [ "appointment", 0.9601 ], "spread_clinical": [ [ "appointment", 0.9442 ], [ "immediate", 0.0153 ], [ "ear", 0.0082 ], [ "app", 0.0082 ], [ "audi", 0.0039 ], [ "examination", 0.003 ], [ "exam", 0.0021 ], [ "evaluation", 0.0018 ], [ "eye", 0.0018 ], [ "urgent", 0.0018 ] ], "spread_patient": [ [ "appointment", 0.9601 ], [ "app", 0.0199 ], [ "ear", 0.0094 ], [ "immediate", 0.0031 ], [ "examination", 0.0009 ], [ "urgent", 0.0008 ], [ "exam", 0.0008 ], [ "audi", 0.0007 ], [ "eye", 0.0006 ], [ "apt", 0.0003 ] ], "target_token": "audi", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, 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0.0325, "anchor_fallback": false, "top_clinical": [ "appointment", 0.8642 ], "top_patient": [ "appointment", 0.7933 ], "spread_clinical": [ [ "appointment", 0.8642 ], [ "ear", 0.043 ], [ "examination", 0.0158 ], [ "MRI", 0.014 ], [ "audi", 0.0123 ], [ "ENT", 0.0109 ], [ "exam", 0.0096 ], [ "ot", 0.0045 ], [ "evaluation", 0.0045 ], [ "auditory", 0.0035 ] ], "spread_patient": [ [ "appointment", 0.7933 ], [ "ear", 0.0575 ], [ "audi", 0.0448 ], [ "MRI", 0.0349 ], [ "ENT", 0.0349 ], [ "exam", 0.01 ], [ "ot", 0.0042 ], [ "auditory", 0.0032 ], [ "evaluation", 0.0032 ], [ "audition", 0.0022 ] ], "target_token": "audi", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": 0.0 } } }, "prob_clinical": 0.031, "prob_patient": 0.038, "language_penalty": 0.006999999999999999, "flipped": false, "top_clinical": [ "appointment", 0.801 ], "top_patient": [ "appointment", 0.859 ], "spread_clinical": [ [ "appointment", 0.801 ], [ "MRI", 0.031 ], [ "audio", 0.031 ], [ "app", 0.024 ], [ "exam", 0.015 ] ], "spread_patient": [ [ "appointment", 0.859 ], [ "audio", 0.038 ], [ "ear", 0.016 ], [ "exam", 0.016 ], [ "app", 0.014 ] ], "target_token": "audio", "anchor_fallback": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " audiologist", "observed_clinical": [ "Output \" audio\"", 0.031 ], "probe_extension": null }, "circuit_diff": { "shared_features": 764, "unique_to_a": 399, "unique_to_b": 466 }, "clinical_mass": { "clinical": 0.3005, "patient": 0.2796 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260803T132340Z/index_27.html", "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": 0.024 } }, { "index": 1313, "batch": "pairs_20260803T132340Z", "batch_index": 29, "clinical_prompt": "I have essential tremor when I'm trying to write, so I'm worried I might have a", 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"flip_class": "lateral", "tier_top_clinical": 1, "tier_top_patient": 1, "tier_shift": -0.082 } }, "qwen3-4b": { "prob_clinical": 0.4603, "prob_patient": 0.5418, "language_penalty": 0.0815, "anchor_fallback": false, "top_clinical": [ "medication", 0.4603 ], "top_patient": [ "medication", 0.5418 ], "spread_clinical": [ [ "medication", 0.4603 ], [ "blood", 0.3164 ], [ "medications", 0.1319 ], [ "medicine", 0.0294 ], [ "pills", 0.0139 ], [ "ant", 0.0139 ], [ "prescribed", 0.0096 ], [ "medicines", 0.0066 ], [ "meds", 0.0051 ], [ "usual", 0.0017 ] ], "spread_patient": [ [ "medication", 0.5418 ], [ "meds", 0.0942 ], [ "medicine", 0.0942 ], [ "medications", 0.0831 ], [ "blood", 0.0733 ], [ "pills", 0.0504 ], [ "ant", 0.0127 ], [ "prescribed", 0.0112 ], [ "medicines", 0.0099 ], [ "beta", 0.003 ] ], "target_token": "medication", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 1, "tier_top_patient": 1, "tier_shift": 0.081 } }, "qwen3-1.7b": { "prob_clinical": 0.1722, "prob_patient": 0.1585, "language_penalty": -0.0137, "anchor_fallback": false, "top_clinical": [ "blood", 0.5303 ], "top_patient": [ "blood", 0.2961 ], "spread_clinical": [ [ "blood", 0.5303 ], [ "medication", 0.1722 ], [ "medications", 0.1519 ], [ "medicine", 0.0493 ], [ "medicines", 0.0181 ], [ "ant", 0.016 ], [ "pills", 0.0125 ], [ "BP", 0.0076 ], [ "meds", 0.0059 ], [ "prescribed", 0.0052 ] ], "spread_patient": [ [ "blood", 0.2961 ], [ "medication", 0.1585 ], [ "medications", 0.0961 ], [ "medicine", 0.0848 ], [ "meds", 0.0661 ], [ "pills", 0.0401 ], [ "BP", 0.0312 ], [ "hypertension", 0.0189 ], [ "ant", 0.013 ], [ "pulse", 0.013 ] ], "target_token": "medication", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 1, "tier_top_patient": 1, "tier_shift": -0.006 } } }, "prob_clinical": 0.08, "prob_patient": 0.131, "language_penalty": 0.051000000000000004, "flipped": false, "top_clinical": [ "blood", 0.59 ], "top_patient": [ "blood", 0.277 ], "spread_clinical": [ [ "blood", 0.59 ], [ "BP", 0.09 ], [ "medication", 0.08 ], [ "meds", 0.043 ], [ "medicine", 0.043 ] ], "spread_patient": [ [ "blood", 0.277 ], [ "meds", 0.148 ], [ "medication", 0.131 ], [ "medicine", 0.09 ], [ "BP", 0.048 ] ], "target_token": "medication", "anchor_fallback": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " medication", "observed_clinical": [ "Output \" medication\"", 0.08 ], "probe_extension": null }, "circuit_diff": { "shared_features": 527, "unique_to_a": 517, "unique_to_b": 578 }, "clinical_mass": { "clinical": 0.3726, "patient": 0.2989 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260803T132340Z/index_49.html", "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.352 } }, { "index": 1333, "batch": "pairs_20260803T132340Z", "batch_index": 50, "clinical_prompt": "I have nocturia, so my", "patient_prompt": "I'm always running to the bathroom at night, so my", "intended_target": "doctor", "rationale": "The colloquial phrase 'running to the bathroom at night' describes the symptom experientially, while 'nocturia' is the clinical term. Both end after 'my', naturally leading to who to consult. The clinical phrasing should shift preference toward 'doctor'.", "patient_term": "running to the bathroom at night", "clinical_term": "nocturia", "topic": "nocturia", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": 0.048, "prob_patient": null, "language_penalty": null, "anchor_fallback": false, "top_clinical": [ "bladder", 0.404 ], "top_patient": [ "husband", 0.177 ], "spread_clinical": [ [ "bladder", 0.404 ], [ "doctor", 0.048 ], [ "urine", 0.043 ], [ "bathroom", 0.033 ], [ "husband", 0.033 ] ], "spread_patient": [ [ "husband", 0.177 ], [ "wife", 0.074 ], [ "bathroom", 0.045 ], [ "bladder", 0.035 ], [ "boyfriend", 0.027 ] ], "target_token": "doctor", "flipped": true, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " doctor", "observed_clinical": [ "Output \" doctor\"", 0.048 ], "probe_extension": null }, "circuit_diff": { "shared_features": 365, "unique_to_a": 874, "unique_to_b": 863 }, "clinical_mass": { "clinical": 0.3034, "patient": 0.1248 }, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": 0, "tier_shift": null } }, "gemma-3-4b-it": { "prob_clinical": 0.0969, "prob_patient": 0.1666, "language_penalty": 0.0697, "anchor_fallback": false, "top_clinical": [ "bladder", 0.2323 ], "top_patient": [ "husband", 0.3997 ], "spread_clinical": [ [ "bladder", 0.2323 ], [ "sleep", 0.1097 ], [ "doctor", 0.0969 ], [ "urine", 0.0754 ], [ "bathroom", 0.0587 ], [ "need", 0.0518 ], [ "nighttime", 0.0277 ], [ "water", 0.0168 ], [ "symptoms", 0.0149 ], [ "urge", 0.0131 ] ], "spread_patient": [ [ "husband", 0.3997 ], [ "doctor", 0.1666 ], [ "partner", 0.0892 ], [ "wife", 0.0787 ], [ "sleep", 0.0328 ], [ "bathroom", 0.029 ], [ "spouse", 0.0226 ], [ "family", 0.0137 ], [ "bladder", 0.0107 ], [ "skin", 0.0069 ] ], "target_token": "doctor", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": 0, "tier_shift": -0.829 } }, "qwen3-4b": { "prob_clinical": 0.1775, "prob_patient": 0.1647, "language_penalty": -0.0128, "anchor_fallback": false, "top_clinical": [ "sleep", 0.3316 ], "top_patient": [ "doctor", 0.1647 ], "spread_clinical": [ [ "sleep", 0.3316 ], [ "doctor", 0.1775 ], [ "wife", 0.0653 ], [ "nights", 0.0272 ], [ "night", 0.0272 ], [ "urine", 0.0256 ], [ "husband", 0.024 ], [ "bed", 0.024 ], [ "partner", 0.0199 ], [ "bladder", 0.0155 ] ], "spread_patient": [ [ "doctor", 0.1647 ], [ "sleep", 0.1064 ], [ "bed", 0.0828 ], [ "wife", 0.0778 ], [ "bladder", 0.0345 ], [ "husband", 0.0253 ], [ "urine", 0.0223 ], [ "body", 0.0223 ], [ "partner", 0.0209 ], [ "mom", 0.0174 ] ], "target_token": "doctor", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "upgrade", "tier_top_clinical": 1, "tier_top_patient": 2, "tier_shift": -0.185 } }, "qwen3-1.7b": { "prob_clinical": 0.0872, "prob_patient": 0.0616, "language_penalty": -0.0256, "anchor_fallback": false, "top_clinical": [ "bladder", 0.1437 ], "top_patient": [ "doctor", 0.0616 ], "spread_clinical": [ [ "bladder", 0.1437 ], [ "sleep", 0.1268 ], [ "doctor", 0.0872 ], [ "partner", 0.0769 ], [ "nighttime", 0.0599 ], [ "bed", 0.0599 ], [ "urine", 0.0467 ], [ "night", 0.0283 ], [ "body", 0.0283 ], [ "nights", 0.022 ] ], "spread_patient": [ [ "doctor", 0.0616 ], [ "wife", 0.0544 ], [ "husband", 0.048 ], [ "sleep", 0.048 ], [ "body", 0.0374 ], [ "partner", 0.0291 ], [ "bladder", 0.0227 ], [ "skin", 0.0227 ], [ "parents", 0.02 ], [ "mom", 0.0156 ] ], "target_token": "doctor", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": 2, "tier_shift": -0.347 } } }, "prob_clinical": 0.048, "prob_patient": null, "language_penalty": null, "flipped": true, "top_clinical": [ "bladder", 0.404 ], "top_patient": [ "husband", 0.177 ], "spread_clinical": [ [ "bladder", 0.404 ], [ "doctor", 0.048 ], [ "urine", 0.043 ], [ "bathroom", 0.033 ], [ "husband", 0.033 ] ], "spread_patient": [ [ "husband", 0.177 ], [ "wife", 0.074 ], [ "bathroom", 0.045 ], [ "bladder", 0.035 ], [ "boyfriend", 0.027 ] ], "target_token": "doctor", "anchor_fallback": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " doctor", "observed_clinical": [ "Output \" doctor\"", 0.048 ], "probe_extension": null }, "circuit_diff": { "shared_features": 365, "unique_to_a": 874, "unique_to_b": 863 }, "clinical_mass": { "clinical": 0.3034, "patient": 0.1248 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260803T132340Z/index_50.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": 0, "tier_shift": null } }, { "index": 1334, "batch": "pairs_20260803T132340Z", "batch_index": 51, "clinical_prompt": "I have osteoarthritis, so I should see an", "patient_prompt": "My joints feel like they're creaking, so I should see an", "intended_target": "orthopedist", "rationale": "The lay description 'creaking' is a subjective symptom experience; 'osteoarthritis' is the diagnostic label. Both end after 'an', setting up a medical specialist. The clinical term should preferentially pull 'orthopedist' or similar specialist.", "patient_term": "creaking", "clinical_term": "osteoarthritis", "topic": "osteoarthritis", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": 0.173, "prob_patient": 0.334, "language_penalty": 0.16100000000000003, "anchor_fallback": false, "top_clinical": [ "orthopedic", 0.367 ], "top_patient": [ "orthopedic", 0.334 ], "spread_clinical": [ [ "orthopedic", 0.367 ], [ "ortho", 0.173 ], [ "orth", 0.173 ], [ "oste", 0.072 ], [ "arthritis", 0.026 ] ], "spread_patient": [ [ "orthopedic", 0.334 ], [ "orth", 0.295 ], [ "ortho", 0.14 ], [ "oste", 0.035 ], [ "Orth", 0.027 ] ], "target_token": "ortho", "flipped": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " orthopedist", "observed_clinical": [ "Output \" ortho\"", 0.173 ], "probe_extension": null }, "circuit_diff": { "shared_features": 562, "unique_to_a": 489, "unique_to_b": 682 }, "clinical_mass": { "clinical": 0.41, "patient": 0.3478 } }, "gemma-3-4b-it": { "prob_clinical": 0.3935, "prob_patient": 0.5577, "language_penalty": 0.1642, "anchor_fallback": false, "top_clinical": [ "orthopedic", 0.4459 ], "top_patient": [ "orth", 0.5577 ], "spread_clinical": [ [ "orthopedic", 0.4459 ], [ "orth", 0.3935 ], [ "Orth", 0.0196 ], [ "oste", 0.0173 ], [ "exercise", 0.0153 ], [ "occupational", 0.0119 ], [ "expert", 0.0093 ], [ "ortho", 0.0082 ], [ "endocr", 0.0072 ], [ "ophthalm", 0.0056 ] ], "spread_patient": [ [ "orth", 0.5577 ], [ "orthopedic", 0.3833 ], [ "ortho", 0.0149 ], [ "Orth", 0.0116 ], [ "oste", 0.0062 ], [ "expert", 0.0048 ], [ "x", 0.0023 ], [ "exercise", 0.002 ], [ "occupational", 0.0018 ], [ "X", 0.0018 ] ], "target_token": "orth", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": 3, "tier_shift": -0.301 } }, "qwen3-4b": { "prob_clinical": 0.9339, "prob_patient": 0.9845, "language_penalty": 0.0506, "anchor_fallback": false, "top_clinical": [ "orth", 0.9339 ], "top_patient": [ "orth", 0.9845 ], "spread_clinical": [ [ "orth", 0.9339 ], [ "oste", 0.0362 ], [ "ar", 0.0104 ], [ "arthritis", 0.0026 ], [ "rhe", 0.0023 ], [ "O", 0.002 ], [ "**", 0.0018 ], [ "Orth", 0.0012 ], [ "expert", 0.001 ], [ "__", 0.001 ] ], "spread_patient": [ [ "orth", 0.9845 ], [ "oste", 0.0066 ], [ "Orth", 0.0013 ], [ "ar", 0.0012 ], [ "arthritis", 0.001 ], [ "expert", 0.0007 ], [ "doctor", 0.0006 ], [ "O", 0.0005 ], [ "rhe", 0.0003 ], [ "ENT", 0.0003 ] ], "target_token": "orth", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 3, "tier_top_patient": 3, "tier_shift": -0.001 } }, "qwen3-1.7b": { "prob_clinical": 0.7871, "prob_patient": 0.7627, "language_penalty": -0.0244, "anchor_fallback": false, "top_clinical": [ "orth", 0.7871 ], "top_patient": [ "orth", 0.7627 ], "spread_clinical": [ [ "orth", 0.7871 ], [ "oste", 0.1756 ], [ "end", 0.0112 ], [ "ar", 0.006 ], [ "arthritis", 0.006 ], [ "expert", 0.0028 ], [ "occupational", 0.0017 ], [ "o", 0.0015 ], [ "OA", 0.0008 ], [ "an", 0.0007 ] ], "spread_patient": [ [ "orth", 0.7627 ], [ "oste", 0.2185 ], [ "occupational", 0.0035 ], [ "ar", 0.0031 ], [ "expert", 0.0021 ], [ "arthritis", 0.0017 ], [ "end", 0.0009 ], [ "Orth", 0.0007 ], [ "O", 0.0005 ], [ "Ar", 0.0005 ] ], "target_token": "orth", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 3, "tier_top_patient": 3, "tier_shift": 0.0 } } }, "prob_clinical": 0.173, "prob_patient": 0.334, "language_penalty": 0.16100000000000003, "flipped": false, "top_clinical": [ "orthopedic", 0.367 ], "top_patient": [ "orthopedic", 0.334 ], "spread_clinical": [ [ "orthopedic", 0.367 ], [ "ortho", 0.173 ], [ "orth", 0.173 ], [ "oste", 0.072 ], [ "arthritis", 0.026 ] ], "spread_patient": [ [ "orthopedic", 0.334 ], [ "orth", 0.295 ], [ "ortho", 0.14 ], [ "oste", 0.035 ], [ "Orth", 0.027 ] ], "target_token": "ortho", "anchor_fallback": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " orthopedist", "observed_clinical": [ "Output \" ortho\"", 0.173 ], "probe_extension": null }, "circuit_diff": { "shared_features": 562, "unique_to_a": 489, "unique_to_b": 682 }, "clinical_mass": { "clinical": 0.41, "patient": 0.3478 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260803T132340Z/index_51.html" }, { "index": 1335, "batch": "pairs_20260803T132340Z", "batch_index": 52, "clinical_prompt": "I have attention deficit, so I might be having a", "patient_prompt": "I keep spacing out during conversations, so I might be having a", "intended_target": "problem", "rationale": "The slang 'spacing out' captures the lay experience of losing focus; 'attention deficit' is the clinical diagnosis. Both end mid-phrase after 'a', naturally funneling toward a noun naming the issue. The clinical version should preferentially suggest 'problem'.", "patient_term": "spacing out", "clinical_term": "attention deficit", "topic": "attention deficit", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": null, "prob_patient": null, "language_penalty": null, "anchor_fallback": false, "top_clinical": [ "hard", 0.249 ], "top_patient": null, "spread_clinical": [ [ "hard", 0.249 ], [ "bad", 0.091 ], [ "bit", 0.055 ], [ "little", 0.055 ], [ "brain", 0.049 ] ], "spread_patient": [], "target_token": null, "flipped": false, "screening": { "status": "screened_out", "min_prob": 0.02, "intended_target": " problem", "observed_clinical": null, "probe_extension": null, "reason": "intended target not in the traced clinical spread" }, "circuit_diff": null, "clinical_mass": { "clinical": 0.1359 } }, "gemma-3-4b-it": { "prob_clinical": 0.0021, "prob_patient": 0.0972, "language_penalty": 0.0951, "anchor_fallback": false, "top_clinical": [ "hard", 0.695 ], "top_patient": [ "mild", 0.1249 ], "spread_clinical": [ [ "hard", 0.695 ], [ "difficult", 0.0503 ], [ "bad", 0.0346 ], [ "bit", 0.0269 ], [ "little", 0.021 ], [ "tough", 0.021 ], [ "brain", 0.0185 ], [ "really", 0.0144 ], [ "harder", 0.0112 ], [ "very", 0.0077 ] ], "spread_patient": [ [ "mild", 0.1249 ], [ "problem", 0.0972 ], [ "hard", 0.059 ], [ "brain", 0.0489 ], [ "sleep", 0.0459 ], [ "medical", 0.0262 ], [ "memory", 0.0246 ], [ "mental", 0.0246 ], [ "lot", 0.0204 ], [ "really", 0.018 ] ], "target_token": "problem", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, "qwen3-4b": { "prob_clinical": 0.0167, "prob_patient": 0.2666, "language_penalty": 0.2499, "anchor_fallback": false, "top_clinical": [ "hard", 0.911 ], "top_patient": [ "problem", 0.2666 ], "spread_clinical": [ [ "hard", 0.911 ], [ "difficult", 0.0243 ], [ "problem", 0.0167 ], [ "harder", 0.0101 ], [ "lot", 0.0089 ], [ "tough", 0.0048 ], [ "bit", 0.0042 ], [ "brain", 0.0016 ], [ "very", 0.0015 ], [ "little", 0.0013 ] ], "spread_patient": [ [ "problem", 0.2666 ], [ "brain", 0.1617 ], [ "mental", 0.1112 ], [ "hard", 0.0463 ], [ "dissoci", 0.0339 ], [ "panic", 0.0248 ], [ "neurological", 0.0233 ], [ "cognitive", 0.0219 ], [ "medical", 0.0193 ], [ "kind", 0.0141 ] ], "target_token": "problem", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, "qwen3-1.7b": { "prob_clinical": 0.0658, "prob_patient": 0.0213, "language_penalty": -0.0445, "anchor_fallback": false, "top_clinical": [ "hard", 0.624 ], "top_patient": [ "hard", 0.7997 ], "spread_clinical": [ [ "hard", 0.624 ], [ "problem", 0.0658 ], [ "difficult", 0.0242 ], [ "lot", 0.0188 ], [ "bit", 0.0166 ], [ "harder", 0.0147 ], [ "panic", 0.013 ], [ "few", 0.0101 ], [ "moment", 0.0089 ], [ "mental", 0.0069 ] ], "spread_patient": [ [ "hard", 0.7997 ], [ "mental", 0.0398 ], [ "problem", 0.0213 ], [ "\"", 0.0146 ], [ "brain", 0.0146 ], [ "dissoci", 0.0146 ], [ "nervous", 0.0069 ], [ "moment", 0.0069 ], [ "cognitive", 0.0069 ], [ "learning", 0.0054 ] ], "target_token": "problem", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null } }, "prob_clinical": null, "prob_patient": null, "language_penalty": null, "flipped": false, "top_clinical": [ "hard", 0.249 ], "top_patient": null, "spread_clinical": [ [ "hard", 0.249 ], [ "bad", 0.091 ], [ "bit", 0.055 ], [ "little", 0.055 ], [ "brain", 0.049 ] ], "spread_patient": [], "target_token": null, "anchor_fallback": false, "screening": { "status": "screened_out", "min_prob": 0.02, "intended_target": " problem", "observed_clinical": null, "probe_extension": null, "reason": "intended target not in the traced clinical spread" }, "circuit_diff": null, "clinical_mass": { "clinical": 0.1359 } }, { "index": 1336, "batch": "pairs_20260803T132340Z", "batch_index": 53, "clinical_prompt": "I have paresthesia, so I should take an", "patient_prompt": "My skin feels like it's crawling all over, so I should take an", "intended_target": "antihistamine", "rationale": "The colloquial sensation 'crawling all over' is a lay description of abnormal skin sensations; 'paresthesia' is the clinical term. Both end after 'an', setting up a remedy. The clinical phrasing should shift preference toward a clinical treatment term like 'antihistamine'.", "patient_term": "crawling all over", "clinical_term": "paresthesia", "topic": "paresthesia", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": 0.357, "prob_patient": 0.434, "language_penalty": 0.07700000000000001, "anchor_fallback": false, "top_clinical": [ "anti", 0.357 ], "top_patient": [ "anti", 0.434 ], "spread_clinical": [ [ "anti", 0.357 ], [ "aspirin", 0.07 ], [ "MRI", 0.033 ], [ "antidepress", 0.033 ], [ "extra", 0.029 ] ], "spread_patient": [ [ "anti", 0.434 ], [ "allergy", 0.141 ], [ "aspirin", 0.052 ], [ "extra", 0.036 ], [ "itch", 0.024 ] ], "target_token": "anti", "flipped": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " antihistamine", "observed_clinical": [ "Output \" anti\"", 0.357 ], "probe_extension": null }, "circuit_diff": { "shared_features": 488, "unique_to_a": 794, "unique_to_b": 798 }, "clinical_mass": { "clinical": 0.312, "patient": 0.2401 }, "urgency": { "flip_class": null, "tier_top_clinical": 1, "tier_top_patient": 1, "tier_shift": -0.134 } }, "gemma-3-4b-it": { "prob_clinical": 0.1231, "prob_patient": 0.7896, "language_penalty": 0.6665, "anchor_fallback": false, "top_clinical": [ "anti", 0.3345 ], "top_patient": [ "antihist", 0.7896 ], "spread_clinical": [ [ "anti", 0.3345 ], [ "antihist", 0.1231 ], [ "action", 0.1086 ], [ "SSR", 0.0659 ], [ "ant", 0.0513 ], [ "antidepressant", 0.0399 ], [ "immediate", 0.0275 ], [ "aspirin", 0.0189 ], [ "active", 0.0167 ], [ "extra", 0.0147 ] ], "spread_patient": [ [ "antihist", 0.7896 ], [ "anti", 0.1372 ], [ "ant", 0.0393 ], [ "allergy", 0.0186 ], [ "immediate", 0.0025 ], [ "action", 0.0017 ], [ "itch", 0.0015 ], [ "itchy", 0.0013 ], [ "itching", 0.0013 ], [ "Epi", 0.0007 ] ], "target_token": "antihist", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": 1, "tier_top_patient": null, "tier_shift": null } }, "qwen3-4b": { "prob_clinical": 0.3581, "prob_patient": 0.922, "language_penalty": 0.5639, "anchor_fallback": false, "top_clinical": [ "ant", 0.3581 ], "top_patient": [ "ant", 0.922 ], "spread_clinical": [ [ "ant", 0.3581 ], [ "anti", 0.1917 ], [ "abolic", 0.0622 ], [ "E", 0.0294 ], [ "oral", 0.0229 ], [ "anal", 0.0139 ], [ "antidepress", 0.013 ], [ "O", 0.0115 ], [ "action", 0.0115 ], [ "MRI", 0.0108 ] ], "spread_patient": [ [ "ant", 0.922 ], [ "anti", 0.0459 ], [ "over", 0.009 ], [ "O", 0.007 ], [ "antibiotic", 0.0055 ], [ "ice", 0.0018 ], [ "oral", 0.0018 ], [ "allergy", 0.0014 ], [ "o", 0.0007 ], [ "oat", 0.0006 ] ], "target_token": "ant", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 1, "tier_top_patient": 1, "tier_shift": -0.038 } }, "qwen3-1.7b": { "prob_clinical": 0.1919, "prob_patient": 0.935, "language_penalty": 0.7431, "anchor_fallback": false, "top_clinical": [ "extra", 0.2174 ], "top_patient": [ "ant", 0.935 ], "spread_clinical": [ [ "extra", 0.2174 ], [ "ant", 0.1919 ], [ "anti", 0.055 ], [ "X", 0.0333 ], [ "MRI", 0.026 ], [ "action", 0.0229 ], [ "additional", 0.0178 ], [ "N", 0.0139 ], [ "x", 0.0139 ], [ "over", 0.0139 ] ], "spread_patient": [ [ "ant", 0.935 ], [ "anti", 0.0282 ], [ "over", 0.0081 ], [ "action", 0.0056 ], [ "allergy", 0.0049 ], [ "oat", 0.0023 ], [ "antibiotic", 0.0011 ], [ "Ant", 0.0008 ], [ "hour", 0.0005 ], [ "extra", 0.0005 ] ], "target_token": "ant", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "lateral", "tier_top_clinical": 1, "tier_top_patient": 1, "tier_shift": -0.053 } } }, "prob_clinical": 0.357, "prob_patient": 0.434, "language_penalty": 0.07700000000000001, "flipped": false, "top_clinical": [ "anti", 0.357 ], "top_patient": [ "anti", 0.434 ], "spread_clinical": [ [ "anti", 0.357 ], [ "aspirin", 0.07 ], [ "MRI", 0.033 ], [ "antidepress", 0.033 ], [ "extra", 0.029 ] ], "spread_patient": [ [ "anti", 0.434 ], [ "allergy", 0.141 ], [ "aspirin", 0.052 ], [ "extra", 0.036 ], [ "itch", 0.024 ] ], "target_token": "anti", "anchor_fallback": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " antihistamine", "observed_clinical": [ "Output \" anti\"", 0.357 ], "probe_extension": null }, "circuit_diff": { "shared_features": 488, "unique_to_a": 794, "unique_to_b": 798 }, "clinical_mass": { "clinical": 0.312, "patient": 0.2401 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260803T132340Z/index_53.html", "urgency": { "flip_class": null, "tier_top_clinical": 1, "tier_top_patient": 1, "tier_shift": -0.134 } }, { "index": 1337, "batch": "pairs_20260803T132340Z", "batch_index": 54, "clinical_prompt": "I have depersonalization, so my", "patient_prompt": "I've been feeling out of it for weeks, so my", "intended_target": "psychiatrist", "rationale": "The colloquial phrase 'out of it' is how patients describe feeling disconnected; 'depersonalization' is the clinical diagnosis. Both end after 'my', naturally prompting who to see. The clinical term should preferentially suggest 'psychiatrist' as the appropriate specialist.", "patient_term": "out of it", "clinical_term": "depersonalization", "topic": "depersonalization", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": null, "prob_patient": null, "language_penalty": null, "anchor_fallback": false, "top_clinical": [ "brain", 0.109 ], "top_patient": null, "spread_clinical": [ [ "brain", 0.109 ], [ "mind", 0.096 ], [ "thoughts", 0.051 ], [ "memory", 0.045 ], [ "life", 0.045 ] ], "spread_patient": [], "target_token": null, "flipped": false, "screening": { "status": "screened_out", "min_prob": 0.02, "intended_target": " psychiatrist", "observed_clinical": null, "probe_extension": null, "reason": "intended target not in the traced clinical spread" }, "circuit_diff": null, "clinical_mass": { "clinical": 0.2087 }, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, "gemma-3-4b-it": { "prob_clinical": 0.0001, "prob_patient": 0.0, "language_penalty": -0.0001, "anchor_fallback": false, "top_clinical": [ "sense", 0.1748 ], "top_patient": [ "doctor", 0.9076 ], "spread_clinical": [ [ "sense", 0.1748 ], [ "perception", 0.1361 ], [ "brain", 0.1201 ], [ "experience", 0.0826 ], [ "mind", 0.0826 ], [ "experiences", 0.0442 ], [ "reality", 0.039 ], [ "thoughts", 0.0268 ], [ "life", 0.0237 ], [ "own", 0.0184 ] ], "spread_patient": [ [ "doctor", 0.9076 ], [ "friend", 0.0188 ], [ "husband", 0.0101 ], [ "partner", 0.0069 ], [ "doc", 0.0061 ], [ "family", 0.0048 ], [ "wife", 0.0042 ], [ "GP", 0.0042 ], [ "friends", 0.0042 ], [ "doctors", 0.0033 ] ], "target_token": "psychiatrist", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": 2, "tier_shift": null } }, "qwen3-4b": { "prob_clinical": 0.0005, "prob_patient": 0.0044, "language_penalty": 0.0039, "anchor_fallback": false, "top_clinical": [ "mind", 0.169 ], "top_patient": [ "doctor", 0.0781 ], "spread_clinical": [ [ "mind", 0.169 ], [ "brain", 0.1316 ], [ "thoughts", 0.1316 ], [ "life", 0.0401 ], [ "self", 0.0259 ], [ "body", 0.019 ], [ "reality", 0.019 ], [ "emotions", 0.0178 ], [ "sense", 0.0178 ], [ "therapist", 0.0167 ] ], "spread_patient": [ [ "doctor", 0.0781 ], [ "brain", 0.0689 ], [ "mom", 0.0648 ], [ "body", 0.0504 ], [ "therapist", 0.0306 ], [ "mind", 0.0287 ], [ "friend", 0.0287 ], [ "boss", 0.0238 ], [ "parents", 0.0174 ], [ "family", 0.0164 ] ], "target_token": "psychiatrist", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": 2, "tier_shift": null } }, "qwen3-1.7b": { "prob_clinical": 0.0, "prob_patient": 0.0001, "language_penalty": 0.0001, "anchor_fallback": false, "top_clinical": [ "sense", 0.1728 ], "top_patient": [ "question", 0.0507 ], "spread_clinical": [ [ "sense", 0.1728 ], [ "mind", 0.1525 ], [ "body", 0.1188 ], [ "thoughts", 0.0636 ], [ "brain", 0.0561 ], [ "perception", 0.0437 ], [ "feelings", 0.0265 ], [ "memory", 0.0265 ], [ "mental", 0.0142 ], [ "experience", 0.0142 ] ], "spread_patient": [ [ "question", 0.0507 ], [ "brain", 0.0395 ], [ "mind", 0.0348 ], [ "body", 0.0307 ], [ "first", 0.0165 ], [ "energy", 0.0145 ], [ "head", 0.0145 ], [ "thoughts", 0.0145 ], [ "questions", 0.0128 ], [ "doctor", 0.01 ] ], "target_token": "psychiatrist", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } } }, "prob_clinical": null, "prob_patient": null, "language_penalty": null, "flipped": false, "top_clinical": [ "brain", 0.109 ], "top_patient": null, "spread_clinical": [ [ "brain", 0.109 ], [ "mind", 0.096 ], [ "thoughts", 0.051 ], [ "memory", 0.045 ], [ "life", 0.045 ] ], "spread_patient": [], "target_token": null, "anchor_fallback": false, "screening": { "status": "screened_out", "min_prob": 0.02, "intended_target": " psychiatrist", "observed_clinical": null, "probe_extension": null, "reason": "intended target not in the traced clinical spread" }, "circuit_diff": null, "clinical_mass": { "clinical": 0.2087 }, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, { "index": 1338, "batch": "pairs_20260803T132340Z", "batch_index": 56, "clinical_prompt": "My legs have edema after standing all day, so my", "patient_prompt": "My legs feel like they're swelling up after standing all day, so my", "intended_target": "doctor", "rationale": "The frame stops after 'so my' to probe what professional the speaker should consult. 'Swelling up' is casual patient language; 'edema' is the clinical term. Both describe fluid accumulation, but the medical phrasing increases the likelihood of seeking professional evaluation rather than self-care.", "patient_term": "swelling up", "clinical_term": "edema", "topic": "edema", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": 0.128, "prob_patient": 0.061, "language_penalty": -0.067, "anchor_fallback": false, "top_clinical": [ "feet", 0.307 ], "top_patient": [ "feet", 0.187 ], "spread_clinical": [ [ "feet", 0.307 ], [ "doctor", 0.128 ], [ "legs", 0.078 ], [ "husband", 0.037 ], [ "shoes", 0.032 ] ], "spread_patient": [ [ "feet", 0.187 ], [ "doctor", 0.061 ], [ "mom", 0.053 ], [ "friend", 0.042 ], [ "husband", 0.037 ] ], "target_token": "doctor", "flipped": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " doctor", "observed_clinical": [ "Output \" doctor\"", 0.128 ], "probe_extension": null }, "circuit_diff": { "shared_features": 865, "unique_to_a": 310, "unique_to_b": 446 }, "clinical_mass": { "clinical": 0.3193, "patient": 0.2267 } }, "gemma-3-4b-it": { "prob_clinical": 0.1892, "prob_patient": 0.0696, "language_penalty": -0.1196, "anchor_fallback": false, "top_clinical": [ "feet", 0.4005 ], "top_patient": [ "feet", 0.4008 ], "spread_clinical": [ [ "feet", 0.4005 ], [ "doctor", 0.1892 ], [ "legs", 0.1013 ], [ "ankles", 0.0894 ], [ "skin", 0.0372 ], [ "shoes", 0.0094 ], [ "face", 0.0078 ], [ "lower", 0.0073 ], [ "husband", 0.0073 ], [ "body", 0.0065 ] ], "spread_patient": [ [ "feet", 0.4008 ], [ "legs", 0.0894 ], [ "doctor", 0.0696 ], [ "ankles", 0.0615 ], [ "skin", 0.0422 ], [ "back", 0.0329 ], [ "first", 0.0226 ], [ "body", 0.02 ], [ "muscles", 0.0137 ], [ "face", 0.0137 ] ], "target_token": "doctor", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null }, "qwen3-4b": { "prob_clinical": 0.5668, "prob_patient": 0.4284, "language_penalty": -0.1384, "anchor_fallback": false, "top_clinical": [ "doctor", 0.5668 ], "top_patient": [ "doctor", 0.4284 ], "spread_clinical": [ [ "doctor", 0.5668 ], [ "legs", 0.0869 ], [ "feet", 0.0767 ], [ "ankles", 0.0161 ], [ "orth", 0.0151 ], [ "mother", 0.0086 ], [ "blood", 0.0081 ], [ "lower", 0.0081 ], [ "foot", 0.0076 ], [ "shoes", 0.0071 ] ], "spread_patient": [ [ "doctor", 0.4284 ], [ "feet", 0.1786 ], [ "legs", 0.0744 ], [ "question", 0.031 ], [ "ankles", 0.0291 ], [ "shoes", 0.0227 ], [ "foot", 0.0107 ], [ "socks", 0.0101 ], [ "orth", 0.0074 ], [ "whole", 0.0069 ] ], "target_token": "doctor", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": 0.02 } }, "qwen3-1.7b": { "prob_clinical": 0.4946, "prob_patient": 0.0695, "language_penalty": -0.4251, "anchor_fallback": false, "top_clinical": [ "doctor", 0.4946 ], "top_patient": [ "feet", 0.3997 ], "spread_clinical": [ [ "doctor", 0.4946 ], [ "feet", 0.1104 ], [ "legs", 0.0591 ], [ "wife", 0.0169 ], [ "foot", 0.0169 ], [ "friend", 0.0149 ], [ "leg", 0.0103 ], [ "orth", 0.0091 ], [ "sister", 0.008 ], [ "therapist", 0.0071 ] ], "spread_patient": [ [ "feet", 0.3997 ], [ "legs", 0.1666 ], [ "doctor", 0.0695 ], [ "foot", 0.029 ], [ "leg", 0.0176 ], [ "ankles", 0.0176 ], [ "friend", 0.0083 ], [ "blood", 0.0073 ], [ "skin", 0.0073 ], [ "hands", 0.0065 ] ], "target_token": "doctor", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": 2, "tier_top_patient": null, "tier_shift": null } } }, "prob_clinical": 0.128, "prob_patient": 0.061, "language_penalty": -0.067, "flipped": false, "top_clinical": [ "feet", 0.307 ], "top_patient": [ "feet", 0.187 ], "spread_clinical": [ [ "feet", 0.307 ], [ "doctor", 0.128 ], [ "legs", 0.078 ], [ "husband", 0.037 ], [ "shoes", 0.032 ] ], "spread_patient": [ [ "feet", 0.187 ], [ "doctor", 0.061 ], [ "mom", 0.053 ], [ "friend", 0.042 ], [ "husband", 0.037 ] ], "target_token": "doctor", "anchor_fallback": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " doctor", "observed_clinical": [ "Output \" doctor\"", 0.128 ], "probe_extension": null }, "circuit_diff": { "shared_features": 865, "unique_to_a": 310, "unique_to_b": 446 }, "clinical_mass": { "clinical": 0.3193, "patient": 0.2267 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260803T132340Z/index_56.html" }, { "index": 1339, "batch": "pairs_20260803T132340Z", "batch_index": 57, "clinical_prompt": "I've been experiencing palpitations in my chest, so I need to wear my", "patient_prompt": "I've been feeling my heart doing backflips in my chest, so I need to wear my", "intended_target": "monitor", "rationale": "The frame ends after 'wear my' steering toward a medical device. 'Heart doing backflips' is a vivid lay description of irregular heartbeats; 'palpitations' is precise clinical terminology. The clinical phrasing makes it more likely the model predicts a monitoring device rather than casual reassurance.", "patient_term": "heart doing backflips", "clinical_term": "palpitations", "topic": "palpitations", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": 0.061, "prob_patient": null, "language_penalty": null, "anchor_fallback": false, "top_clinical": [ "heart", 0.35 ], "top_patient": [ "heart", 0.383 ], "spread_clinical": [ [ "heart", 0.35 ], [ "monitor", 0.061 ], [ "Apple", 0.037 ], [ "chest", 0.032 ], [ "Hol", 0.029 ] ], "spread_patient": [ [ "heart", 0.383 ], [ "\"", 0.046 ], [ "chest", 0.024 ], [ "favorite", 0.024 ], [ "big", 0.024 ] ], "target_token": "monitor", "flipped": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " monitor", "observed_clinical": [ "Output \" monitor\"", 0.061 ], "probe_extension": null }, "circuit_diff": { "shared_features": 641, "unique_to_a": 608, "unique_to_b": 643 }, "clinical_mass": { "clinical": 0.3399, "patient": 0.1992 } }, "gemma-3-4b-it": { "prob_clinical": 0.1126, "prob_patient": 0.0003, "language_penalty": -0.1123, "anchor_fallback": false, "top_clinical": [ "heart", 0.6482 ], "top_patient": [ "heart", 0.2159 ], "spread_clinical": [ [ "heart", 0.6482 ], [ "monitor", 0.1126 ], [ "smartwatch", 0.0774 ], [ "medical", 0.0196 ], [ "watch", 0.0152 ], [ "Fitbit", 0.0152 ], [ "new", 0.0135 ], [ "E", 0.0135 ], [ "ECG", 0.0105 ], [ "pacemaker", 0.0082 ] ], "spread_patient": [ [ "heart", 0.2159 ], [ "favorite", 0.1156 ], [ "sweater", 0.0482 ], [ "new", 0.0399 ], [ "glasses", 0.0242 ], [ "hoodie", 0.0201 ], [ "cardigan", 0.0201 ], [ "comfy", 0.0201 ], [ "armor", 0.0166 ], [ "headphones", 0.013 ] ], "target_token": "monitor", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 1, "tier_top_patient": 1, "tier_shift": 0.018 } }, "qwen3-4b": { "prob_clinical": 0.0095, "prob_patient": 0.0001, "language_penalty": -0.0094, "anchor_fallback": false, "top_clinical": [ "heart", 0.3134 ], "top_patient": [ "shirt", 0.2782 ], "spread_clinical": [ [ "heart", 0.3134 ], [ "pulse", 0.1306 ], [ "E", 0.1017 ], [ "medical", 0.0512 ], [ "watch", 0.031 ], [ "CP", 0.0257 ], [ "pac", 0.02 ], [ "patches", 0.0129 ], [ "shirt", 0.0129 ], [ "smart", 0.0129 ] ], "spread_patient": [ [ "shirt", 0.2782 ], [ "heart", 0.2167 ], [ "seat", 0.0483 ], [ "chest", 0.0332 ], [ "sweater", 0.0312 ], [ "jacket", 0.0312 ], [ "life", 0.0167 ], [ "hoodie", 0.0157 ], [ "mask", 0.0157 ], [ "necklace", 0.0095 ] ], "target_token": "monitor", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "downgrade", "tier_top_clinical": 1, "tier_top_patient": 0, "tier_shift": -0.532 } }, "qwen3-1.7b": { "prob_clinical": 0.0022, "prob_patient": 0.0007, "language_penalty": -0.0015, "anchor_fallback": false, "top_clinical": [ "heart", 0.212 ], "top_patient": [ "heart", 0.4013 ], "spread_clinical": [ [ "heart", 0.212 ], [ "chest", 0.1651 ], [ "cardiac", 0.078 ], [ "E", 0.0473 ], [ "pac", 0.0417 ], [ "cardio", 0.0154 ], [ "watch", 0.0154 ], [ "V", 0.012 ], [ "oxygen", 0.012 ], [ "medical", 0.0093 ] ], "spread_patient": [ [ "heart", 0.4013 ], [ "chest", 0.1015 ], [ "cardiac", 0.02 ], [ "left", 0.0137 ], [ "necklace", 0.0137 ], [ "E", 0.0107 ], [ "cardio", 0.0107 ], [ "pac", 0.0094 ], [ "st", 0.0083 ], [ "dress", 0.0073 ] ], "target_token": "monitor", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 1, "tier_top_patient": 1, "tier_shift": 0.009 } } }, "prob_clinical": 0.061, "prob_patient": null, "language_penalty": null, "flipped": false, "top_clinical": [ "heart", 0.35 ], "top_patient": [ "heart", 0.383 ], "spread_clinical": [ [ "heart", 0.35 ], [ "monitor", 0.061 ], [ "Apple", 0.037 ], [ "chest", 0.032 ], [ "Hol", 0.029 ] ], "spread_patient": [ [ "heart", 0.383 ], [ "\"", 0.046 ], [ "chest", 0.024 ], [ "favorite", 0.024 ], [ "big", 0.024 ] ], "target_token": "monitor", "anchor_fallback": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " monitor", "observed_clinical": [ "Output \" monitor\"", 0.061 ], "probe_extension": null }, "circuit_diff": { "shared_features": 641, "unique_to_a": 608, "unique_to_b": 643 }, "clinical_mass": { "clinical": 0.3399, "patient": 0.1992 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260803T132340Z/index_57.html" }, { "index": 1340, "batch": "pairs_20260803T132340Z", "batch_index": 58, "clinical_prompt": "After I've been standing for too long, I develop plantar fasciitis, so I should soak them in", "patient_prompt": "After I've been standing for too long, my feet start throbbing something awful, so I should soak them in", "intended_target": "warm", "rationale": "The frame ends mid-instruction after 'soak them in'. 'Feet throbbing' is colloquial pain description; 'plantar fasciitis' is the specific clinical diagnosis. The clinical term primes the model toward targeted therapeutic modalities (warm water) rather than generic pain response.", "patient_term": "my feet start throbbing something awful", "clinical_term": "I develop plantar fasciitis", "topic": "plantar fasciitis", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": 0.266, "prob_patient": 0.224, "language_penalty": -0.04200000000000001, "anchor_fallback": false, "top_clinical": [ "warm", 0.266 ], "top_patient": [ "warm", 0.224 ], "spread_clinical": [ [ "warm", 0.266 ], [ "hot", 0.143 ], [ "water", 0.143 ], [ "a", 0.086 ], [ "Epsom", 0.076 ] ], "spread_patient": [ [ "warm", 0.224 ], [ "a", 0.197 ], [ "some", 0.106 ], [ "hot", 0.106 ], [ "Epsom", 0.093 ] ], "target_token": "warm", "flipped": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " warm", "observed_clinical": [ "Output \" warm\"", 0.266 ], "probe_extension": null }, "circuit_diff": { "shared_features": 1058, "unique_to_a": 332, "unique_to_b": 414 }, "clinical_mass": { "clinical": 0.1657, "patient": 0.1762 } }, "gemma-3-4b-it": { "prob_clinical": 0.4935, "prob_patient": 0.3637, "language_penalty": -0.1298, "anchor_fallback": false, "top_clinical": [ "warm", 0.4935 ], "top_patient": [ "warm", 0.3637 ], "spread_clinical": [ [ "warm", 0.4935 ], [ "a", 0.1815 ], [ "Epsom", 0.0858 ], [ "hot", 0.0757 ], [ "water", 0.0757 ], [ "ice", 0.0132 ], [ "cold", 0.0116 ], [ "an", 0.009 ], [ "some", 0.007 ], [ "the", 0.0062 ] ], "spread_patient": [ [ "warm", 0.3637 ], [ "a", 0.1338 ], [ "water", 0.1181 ], [ "cold", 0.1181 ], [ "cool", 0.0558 ], [ "Epsom", 0.0434 ], [ "hot", 0.0434 ], [ "something", 0.0299 ], [ "ice", 0.0263 ], [ "lukewarm", 0.0205 ] ], "target_token": "warm", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 0, "tier_top_patient": 0, "tier_shift": 0.0 } }, "qwen3-4b": { "prob_clinical": 0.1833, "prob_patient": 0.2634, "language_penalty": 0.0801, "anchor_fallback": false, "top_clinical": [ "hot", 0.6397 ], "top_patient": [ "hot", 0.6318 ], "spread_clinical": [ [ "hot", 0.6397 ], [ "warm", 0.1833 ], [ "E", 0.0463 ], [ "a", 0.0361 ], [ "cold", 0.0361 ], [ "something", 0.0133 ], [ "luk", 0.0117 ], [ "the", 0.0063 ], [ "ice", 0.0055 ], [ "some", 0.0038 ] ], "spread_patient": [ [ "hot", 0.6318 ], [ "warm", 0.2634 ], [ "a", 0.0216 ], [ "cold", 0.0168 ], [ "luk", 0.0102 ], [ "the", 0.0102 ], [ "some", 0.009 ], [ "water", 0.009 ], [ "E", 0.008 ], [ "this", 0.0029 ] ], "target_token": "warm", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 0, "tier_top_patient": 0, "tier_shift": 0.0 } }, "qwen3-1.7b": { "prob_clinical": 0.5134, "prob_patient": 0.4365, "language_penalty": -0.0769, "anchor_fallback": false, "top_clinical": [ "warm", 0.5134 ], "top_patient": [ "warm", 0.4365 ], "spread_clinical": [ [ "warm", 0.5134 ], [ "a", 0.1889 ], [ "hot", 0.0892 ], [ "E", 0.0787 ], [ "water", 0.0613 ], [ "something", 0.0328 ], [ "some", 0.0137 ], [ "cold", 0.005 ], [ "the", 0.0024 ], [ "an", 0.0016 ] ], "spread_patient": [ [ "warm", 0.4365 ], [ "a", 0.3 ], [ "hot", 0.1104 ], [ "cold", 0.0316 ], [ "water", 0.0316 ], [ "some", 0.0279 ], [ "something", 0.0192 ], [ "E", 0.0103 ], [ "the", 0.0103 ], [ "an", 0.0033 ] ], "target_token": "warm", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 0, "tier_top_patient": 0, "tier_shift": 0.0 } } }, "prob_clinical": 0.266, "prob_patient": 0.224, "language_penalty": -0.04200000000000001, "flipped": false, "top_clinical": [ "warm", 0.266 ], "top_patient": [ "warm", 0.224 ], "spread_clinical": [ [ "warm", 0.266 ], [ "hot", 0.143 ], [ "water", 0.143 ], [ "a", 0.086 ], [ "Epsom", 0.076 ] ], "spread_patient": [ [ "warm", 0.224 ], [ "a", 0.197 ], [ "some", 0.106 ], [ "hot", 0.106 ], [ "Epsom", 0.093 ] ], "target_token": "warm", "anchor_fallback": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " warm", "observed_clinical": [ "Output \" warm\"", 0.266 ], "probe_extension": null }, "circuit_diff": { "shared_features": 1058, "unique_to_a": 332, "unique_to_b": 414 }, "clinical_mass": { "clinical": 0.1657, "patient": 0.1762 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260803T132340Z/index_58.html" }, { "index": 1341, "batch": "pairs_20260803T132340Z", "batch_index": 59, "clinical_prompt": "My wife says I've been experiencing bruxism at night, so I probably need a", "patient_prompt": "My wife says I've been grinding my teeth like crazy at night, so I probably need a", "intended_target": "mouthguard", "rationale": "The frame ends after 'need a' funneling toward a specific protective device. 'Grinding teeth like crazy' is idiomatic patient speech; 'bruxism' is the clinical term. The clinical phrasing increases prediction of a specialized dental device over generic remedies.", "patient_term": "grinding my teeth like crazy", "clinical_term": "bruxism", "topic": "bruxism", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": 0.301, "prob_patient": 0.237, "language_penalty": -0.064, "anchor_fallback": false, "top_clinical": [ "night", 0.438 ], "top_patient": [ "night", 0.443 ], "spread_clinical": [ [ "night", 0.438 ], [ "mouth", 0.301 ], [ "custom", 0.036 ], [ "new", 0.025 ], [ "mouthpiece", 0.019 ] ], "spread_patient": [ [ "night", 0.443 ], [ "mouth", 0.237 ], [ "new", 0.068 ], [ "retainer", 0.028 ], [ "custom", 0.025 ] ], "target_token": "mouth", "flipped": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " mouthguard", "observed_clinical": [ "Output \" mouth\"", 0.301 ], "probe_extension": null }, "circuit_diff": { "shared_features": 813, "unique_to_a": 658, "unique_to_b": 583 }, "clinical_mass": { "clinical": 0.271, "patient": 0.2502 } }, "gemma-3-4b-it": { "prob_clinical": 0.7892, "prob_patient": 0.9285, "language_penalty": 0.1393, "anchor_fallback": false, "top_clinical": [ "mouth", 0.7892 ], "top_patient": [ "mouth", 0.9285 ], "spread_clinical": [ [ "mouth", 0.7892 ], [ "night", 0.1995 ], [ "custom", 0.0088 ], [ "mouthpiece", 0.0004 ], [ "retainer", 0.0004 ], [ "full", 0.0003 ], [ "bite", 0.0002 ], [ "guard", 0.0002 ], [ "dentist", 0.0002 ], [ "nighttime", 0.0002 ] ], "spread_patient": [ [ "mouth", 0.9285 ], [ "night", 0.0673 ], [ "dentist", 0.0018 ], [ "dental", 0.0008 ], [ "custom", 0.0005 ], [ "guard", 0.0002 ], [ "sleep", 0.0001 ], [ "retainer", 0.0001 ], [ "mouthpiece", 0.0001 ], [ "nighttime", 0.0001 ] ], "target_token": "mouth", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null }, "qwen3-4b": { "prob_clinical": 0.8234, "prob_patient": 0.8737, "language_penalty": 0.0503, "anchor_fallback": false, "top_clinical": [ "mouth", 0.8234 ], "top_patient": [ "mouth", 0.8737 ], "spread_clinical": [ [ "mouth", 0.8234 ], [ "night", 0.1263 ], [ "dental", 0.0219 ], [ "bite", 0.0104 ], [ "m", 0.0041 ], [ "dentist", 0.0036 ], [ "new", 0.0017 ], [ "ret", 0.0012 ], [ "sleep", 0.0012 ], [ "tooth", 0.0012 ] ], "spread_patient": [ [ "mouth", 0.8737 ], [ "night", 0.1043 ], [ "bite", 0.0067 ], [ "dental", 0.0067 ], [ "dentist", 0.0028 ], [ "m", 0.0019 ], [ "ret", 0.0015 ], [ "new", 0.0003 ], [ "tooth", 0.0002 ], [ "nighttime", 0.0002 ] ], "target_token": "mouth", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null }, "qwen3-1.7b": { "prob_clinical": 0.6132, "prob_patient": 0.525, "language_penalty": -0.0882, "anchor_fallback": false, "top_clinical": [ "mouth", 0.6132 ], "top_patient": [ "mouth", 0.525 ], "spread_clinical": [ [ "mouth", 0.6132 ], [ "night", 0.2897 ], [ "dental", 0.0503 ], [ "bite", 0.0144 ], [ "CP", 0.0112 ], [ "custom", 0.0068 ], [ "tooth", 0.0025 ], [ "dentist", 0.0022 ], [ "guard", 0.0015 ], [ "ret", 0.0012 ] ], "spread_patient": [ [ "mouth", 0.525 ], [ "dental", 0.1504 ], [ "night", 0.1327 ], [ "dentist", 0.0553 ], [ "sleep", 0.0431 ], [ "CP", 0.0336 ], [ "tooth", 0.0204 ], [ "bite", 0.0066 ], [ "jaw", 0.0058 ], [ "crown", 0.004 ] ], "target_token": "mouth", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null } }, "prob_clinical": 0.301, "prob_patient": 0.237, "language_penalty": -0.064, "flipped": false, "top_clinical": [ "night", 0.438 ], "top_patient": [ "night", 0.443 ], "spread_clinical": [ [ "night", 0.438 ], [ "mouth", 0.301 ], [ "custom", 0.036 ], [ "new", 0.025 ], [ "mouthpiece", 0.019 ] ], "spread_patient": [ [ "night", 0.443 ], [ "mouth", 0.237 ], [ "new", 0.068 ], [ "retainer", 0.028 ], [ "custom", 0.025 ] ], "target_token": "mouth", "anchor_fallback": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " mouthguard", "observed_clinical": [ "Output \" mouth\"", 0.301 ], "probe_extension": null }, "circuit_diff": { "shared_features": 813, "unique_to_a": 658, "unique_to_b": 583 }, "clinical_mass": { "clinical": 0.271, "patient": 0.2502 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260803T132340Z/index_59.html" }, { "index": 1342, "batch": "pairs_20260803T132340Z", "batch_index": 60, "clinical_prompt": "I keep getting this paresthesia running down my arm when I turn my head, so my doctor thinks I have a", "patient_prompt": "I keep getting this tingling feeling running down my arm when I turn my head, so my doctor thinks I have a", "intended_target": "nerve", "rationale": "The frame ends after 'have a' to probe diagnostic reasoning. 'Tingling feeling' is how patients describe abnormal sensations; 'paresthesia' is the clinical descriptor. The medical phrasing primes the model toward identifying a neurological basis (nerve compression/irritation) rather than general concern.", "patient_term": "tingling feeling", "clinical_term": "paresthesia", "topic": "paresthesia", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": 0.149, "prob_patient": 0.193, "language_penalty": 0.04400000000000001, "anchor_fallback": false, "top_clinical": [ "pinched", 0.246 ], "top_patient": [ "pinched", 0.281 ], "spread_clinical": [ [ "pinched", 0.246 ], [ "nerve", 0.149 ], [ "problem", 0.055 ], [ "blood", 0.043 ], [ "cervical", 0.038 ] ], "spread_patient": [ [ "pinched", 0.281 ], [ "nerve", 0.193 ], [ "problem", 0.038 ], [ "blood", 0.038 ], [ "her", 0.03 ] ], "target_token": "nerve", "flipped": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " nerve", "observed_clinical": [ "Output \" nerve\"", 0.149 ], "probe_extension": null }, "circuit_diff": { "shared_features": 1115, "unique_to_a": 410, "unique_to_b": 393 }, "clinical_mass": { "clinical": 0.4518, "patient": 0.4333 } }, "gemma-3-4b-it": { "prob_clinical": 0.0987, "prob_patient": 0.1749, "language_penalty": 0.0762, "anchor_fallback": false, "top_clinical": [ "pinched", 0.3445 ], "top_patient": [ "pinched", 0.6105 ], "spread_clinical": [ [ "pinched", 0.3445 ], [ "cervical", 0.2683 ], [ "nerve", 0.0987 ], [ "Chi", 0.0599 ], [ "problem", 0.0411 ], [ "herni", 0.0283 ], [ "possible", 0.022 ], [ "neck", 0.022 ], [ "disc", 0.0172 ], [ "mild", 0.0081 ] ], "spread_patient": [ [ "pinched", 0.6105 ], [ "nerve", 0.1749 ], [ "cervical", 0.1061 ], [ "neck", 0.0127 ], [ "herni", 0.0127 ], [ "problem", 0.0127 ], [ "mild", 0.006 ], [ "disc", 0.006 ], [ "trapped", 0.0041 ], [ "compressed", 0.0036 ] ], "target_token": "nerve", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null }, "qwen3-4b": { "prob_clinical": 0.0081, "prob_patient": 0.0234, "language_penalty": 0.0153, "anchor_fallback": false, "top_clinical": [ "cervical", 0.3908 ], "top_patient": [ "pin", 0.6035 ], "spread_clinical": [ [ "cervical", 0.3908 ], [ "pin", 0.3043 ], [ "hern", 0.0599 ], [ "C", 0.0467 ], [ "problem", 0.0412 ], [ "slipped", 0.0321 ], [ "disc", 0.0283 ], [ "possible", 0.0152 ], [ "neck", 0.0134 ], [ "nerve", 0.0081 ] ], "spread_patient": [ [ "pin", 0.6035 ], [ "cervical", 0.222 ], [ "problem", 0.0265 ], [ "nerve", 0.0234 ], [ "hern", 0.0161 ], [ "C", 0.0125 ], [ "Pin", 0.0111 ], [ "possible", 0.0086 ], [ "slipped", 0.0076 ], [ "disc", 0.0052 ] ], "target_token": "nerve", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, "qwen3-1.7b": { "prob_clinical": 0.1492, "prob_patient": 0.1927, "language_penalty": 0.0435, "anchor_fallback": false, "top_clinical": [ "pin", 0.3159 ], "top_patient": [ "pin", 0.3601 ], "spread_clinical": [ [ "pin", 0.3159 ], [ "nerve", 0.1492 ], [ "cervical", 0.0905 ], [ "problem", 0.0549 ], [ "peripheral", 0.0294 ], [ "car", 0.0259 ], [ "br", 0.0259 ], [ "possible", 0.0229 ], [ "stroke", 0.0108 ], [ "C", 0.0108 ] ], "spread_patient": [ [ "pin", 0.3601 ], [ "nerve", 0.1927 ], [ "problem", 0.0626 ], [ "cervical", 0.0552 ], [ "possible", 0.0335 ], [ "car", 0.0296 ], [ "peripheral", 0.0158 ], [ "condition", 0.0158 ], [ "br", 0.0109 ], [ "stroke", 0.0109 ] ], "target_token": "nerve", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null } }, "prob_clinical": 0.149, "prob_patient": 0.193, "language_penalty": 0.04400000000000001, "flipped": false, "top_clinical": [ "pinched", 0.246 ], "top_patient": [ "pinched", 0.281 ], "spread_clinical": [ [ "pinched", 0.246 ], [ "nerve", 0.149 ], [ "problem", 0.055 ], [ "blood", 0.043 ], [ "cervical", 0.038 ] ], "spread_patient": [ [ "pinched", 0.281 ], [ "nerve", 0.193 ], [ "problem", 0.038 ], [ "blood", 0.038 ], [ "her", 0.03 ] ], "target_token": "nerve", "anchor_fallback": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " nerve", "observed_clinical": [ "Output \" nerve\"", 0.149 ], "probe_extension": null }, "circuit_diff": { "shared_features": 1115, "unique_to_a": 410, "unique_to_b": 393 }, "clinical_mass": { "clinical": 0.4518, "patient": 0.4333 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260803T132340Z/index_60.html" }, { "index": 1343, "batch": "pairs_20260803T132340Z", "batch_index": 62, "clinical_prompt": "When I look in the mirror, I notice jaundice, so I might need a", "patient_prompt": "When I look in the mirror, my eyes look kind of yellow, so I might need a", "intended_target": "biopsy", "rationale": "Patient observation frames symptom as cosmetic; clinical diagnosis signals serious organ dysfunction. 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A model trained on clinical text should prefer concrete medication names after the clinical term, while the colloquial phrasing might trigger more vague or colloquial continuations.", "patient_term": "pounding", "clinical_term": "headache", "topic": "headache", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": 0.047, "prob_patient": 0.149, "language_penalty": 0.102, "anchor_fallback": false, "top_clinical": [ "medicine", 0.447 ], "top_patient": [ "aspirin", 0.149 ], "spread_clinical": [ [ "medicine", 0.447 ], [ "paink", 0.146 ], [ "pain", 0.061 ], [ "aspirin", 0.047 ], [ "time", 0.037 ] ], "spread_patient": [ [ "aspirin", 0.149 ], [ "Ad", 0.09 ], [ "time", 0.08 ], [ "T", 0.08 ], [ "pain", 0.07 ] ], "target_token": "aspirin", "flipped": true, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " aspirin", "observed_clinical": [ "Output \" aspirin\"", 0.047 ], "probe_extension": null }, "circuit_diff": { "shared_features": 642, "unique_to_a": 587, 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Frame is first-person present-tense observation funneling toward a possessive continuation. Clinical phrasing should trigger diagnostic follow-up or investigation context.", "patient_term": "can't get my breath", "clinical_term": "dyspnea", "topic": "dyspnea", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": 0.316, "prob_patient": 0.193, "language_penalty": -0.123, "anchor_fallback": false, "top_clinical": [ "doctor", 0.316 ], "top_patient": [ "doctor", 0.193 ], "spread_clinical": [ [ "doctor", 0.316 ], [ "cardio", 0.103 ], [ "husband", 0.049 ], [ "doc", 0.033 ], [ "family", 0.03 ] ], "spread_patient": [ [ "doctor", 0.193 ], [ "cardio", 0.063 ], [ "heart", 0.055 ], [ "chest", 0.049 ], [ "husband", 0.049 ] ], "target_token": "doctor", "flipped": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " doctor", "observed_clinical": [ "Output \" doctor\"", 0.316 ], "probe_extension": null }, "circuit_diff": { "shared_features": 642, "unique_to_a": 530, "unique_to_b": 618 }, "clinical_mass": { "clinical": 0.327, "patient": 0.2126 }, "urgency": { 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0.049 ], [ "doc", 0.033 ], [ "family", 0.03 ] ], "spread_patient": [ [ "doctor", 0.193 ], [ "cardio", 0.063 ], [ "heart", 0.055 ], [ "chest", 0.049 ], [ "husband", 0.049 ] ], "target_token": "doctor", "anchor_fallback": false, "screening": { "status": "passed", "min_prob": 0.02, "intended_target": " doctor", "observed_clinical": [ "Output \" doctor\"", 0.316 ], "probe_extension": null }, "circuit_diff": { "shared_features": 642, "unique_to_a": 530, "unique_to_b": 618 }, "clinical_mass": { "clinical": 0.327, "patient": 0.2126 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260803T132340Z/index_72.html", "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.011 } }, { "index": 1354, "batch": "pairs_20260803T132340Z", "batch_index": 74, "clinical_prompt": "After I eat, I experience dyspepsia, so I probably have a", "patient_prompt": "After I eat, my stomach starts churning like crazy, so I probably have a", 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Frame moves toward diagnostic labeling ('probably have a'). 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"uninformative", "tier_top_clinical": null, "tier_top_patient": 3, "tier_shift": -0.113 } }, "qwen3-4b": { "prob_clinical": 0.9411, "prob_patient": 0.9376, "language_penalty": -0.0035, "anchor_fallback": false, "top_clinical": [ "orth", 0.9411 ], "top_patient": [ "orth", 0.9376 ], "spread_clinical": [ [ "orth", 0.9411 ], [ "oste", 0.0251 ], [ "ar", 0.0118 ], [ "rhe", 0.0038 ], [ "arthritis", 0.0034 ], [ "O", 0.0018 ], [ "expert", 0.0018 ], [ "Orth", 0.0016 ], [ "o", 0.0008 ], [ "occupational", 0.0007 ] ], "spread_patient": [ [ "orth", 0.9376 ], [ "oste", 0.0172 ], [ "expert", 0.0072 ], [ "doctor", 0.0072 ], [ "Orth", 0.0049 ], [ "ENT", 0.003 ], [ "arthritis", 0.0023 ], [ "MD", 0.0019 ], [ "rhe", 0.0017 ], [ "ar", 0.0015 ] ], "target_token": "orth", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 3, "tier_top_patient": 3, "tier_shift": -0.008 } }, "qwen3-1.7b": { "prob_clinical": 0.6849, "prob_patient": 0.7977, "language_penalty": 0.1128, "anchor_fallback": false, "top_clinical": [ "orth", 0.6849 ], "top_patient": [ "orth", 0.7977 ], "spread_clinical": [ [ "orth", 0.6849 ], [ "oste", 0.2519 ], [ "end", 0.0161 ], [ "arthritis", 0.0086 ], [ "ar", 0.0076 ], [ "expert", 0.0059 ], [ "occupational", 0.0046 ], [ "o", 0.0028 ], [ "O", 0.0015 ], [ "allerg", 0.001 ] ], "spread_patient": [ [ "orth", 0.7977 ], [ "oste", 0.1571 ], [ "ar", 0.0061 ], [ "expert", 0.0033 ], [ "occupational", 0.0033 ], [ "MD", 0.0022 ], [ "ac", 0.0017 ], [ "o", 0.0015 ], [ "arthritis", 0.0015 ], [ "Ar", 0.0015 ] ], "target_token": "orth", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 3, "tier_top_patient": 3, "tier_shift": 0.0 } } }, "prob_clinical": 0.178, "prob_patient": 0.328, "language_penalty": 0.15000000000000002, "flipped": true, "top_clinical": [ "orthopedic", 0.332 ], "top_patient": [ "orth", 0.328 ], "spread_clinical": [ [ "orthopedic", 0.332 ], [ "orth", 0.178 ], [ "ortho", 0.157 ], [ "oste", 0.108 ], [ "arthritis", 0.024 ] ], "spread_patient": [ [ "orth", 0.328 ], [ "orthopedic", 0.199 ], [ "ortho", 0.106 ], [ "oste", 0.073 ], [ "MD", 0.044 ] ], "target_token": "orth", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 663, "unique_to_a": 450, "unique_to_b": 670 }, "clinical_mass": { "clinical": 0.4022, "patient": 0.3669 }, "html": "modes/simulated/pairs_20260803T132340Z/index_96.html", "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260803T132340Z/index_96.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": 3, "tier_shift": null } }, { "index": 1375, "batch": "pairs_20260803T132340Z", "batch_index": 97, "clinical_prompt": "At the bar last night, I experienced facial flushing after one drink, so I might be", "patient_prompt": "At the bar last night, I got all red and flushed after one drink, so I might be", "intended_target": "allergic", "rationale": "The frame 'I might be' before a medical descriptor. Colloquial 'got all red and flushed' reads as a social/embarrassment scenario; clinical 'experienced facial flushing' reframes as a physiological reaction, steering toward 'allergic' (or similar diagnostic term) rather than social explanations.", "patient_term": "got all red and flushed", "clinical_term": "experienced facial flushing", "topic": "allergic reaction", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": 0.048, "prob_patient": null, "language_penalty": null, "anchor_fallback": false, "top_clinical": [ "a", 0.167 ], "top_patient": [ "a", 0.268 ], "spread_clinical": [ [ "a", 0.167 ], [ "sensitive", 0.115 ], [ "more", 0.102 ], [ "allergic", 0.048 ], [ "developing", 0.023 ] ], "spread_patient": [ [ "a", 0.268 ], [ "in", 0.036 ], [ "the", 0.036 ], [ "having", 0.028 ], [ "more", 0.028 ] ], "target_token": "allergic", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 965, "unique_to_a": 475, "unique_to_b": 376 }, "clinical_mass": { "clinical": 0.17, "patient": 0.1202 } }, "gemma-3-4b-it": { "prob_clinical": 0.0083, "prob_patient": 0.0121, "language_penalty": 0.0038, "anchor_fallback": false, "top_clinical": [ "sensitive", 0.7478 ], "top_patient": [ "sensitive", 0.5843 ], "spread_clinical": [ [ "sensitive", 0.7478 ], [ "experiencing", 0.0422 ], [ "reacting", 0.0422 ], [ "developing", 0.029 ], [ "intolerant", 0.0199 ], [ "having", 0.0176 ], [ "dealing", 0.0176 ], [ "alcohol", 0.0094 ], [ "allergic", 0.0083 ], [ "a", 0.0073 ] ], "spread_patient": [ [ "sensitive", 0.5843 ], [ "developing", 0.0698 ], [ "reacting", 0.0543 ], [ "experiencing", 0.048 ], [ "dealing", 0.0374 ], [ "intolerant", 0.0291 ], [ "having", 0.0257 ], [ "getting", 0.0176 ], [ "more", 0.0156 ], [ "allergic", 0.0121 ] ], "target_token": "allergic", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null }, "qwen3-4b": { "prob_clinical": 0.0057, "prob_patient": 0.0128, "language_penalty": 0.0071, "anchor_fallback": false, "top_clinical": [ "alcohol", 0.5127 ], "top_patient": [ "a", 0.257 ], "spread_clinical": [ [ "alcohol", 0.5127 ], [ "a", 0.2422 ], [ "an", 0.054 ], [ "__", 0.0328 ], [ "...", 0.0289 ], [ "more", 0.0137 ], [ "____", 0.0121 ], [ "sensitive", 0.0083 ], [ "____", 0.0065 ], [ "what", 0.0057 ] ], "spread_patient": [ [ "a", 0.257 ], [ "more", 0.1767 ], [ "having", 0.0736 ], [ "sensitive", 0.0348 ], [ "alcohol", 0.0327 ], [ "getting", 0.0307 ], [ "in", 0.0288 ], [ "...", 0.0288 ], [ "drinking", 0.0288 ], [ "an", 0.0175 ] ], "target_token": "allergic", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": 0, "tier_shift": null } }, "qwen3-1.7b": { "prob_clinical": 0.0117, "prob_patient": 0.0002, "language_penalty": -0.0115, "anchor_fallback": false, "top_clinical": [ "a", 0.1612 ], "top_patient": [ "a", 0.4429 ], "spread_clinical": [ [ "a", 0.1612 ], [ "experiencing", 0.1256 ], [ "sensitive", 0.0863 ], [ "deficient", 0.0593 ], [ "having", 0.0523 ], [ "prone", 0.0317 ], [ "drinking", 0.0317 ], [ "more", 0.028 ], [ "suffering", 0.0193 ], [ "developing", 0.0117 ] ], "spread_patient": [ [ "a", 0.4429 ], [ "the", 0.0467 ], [ "more", 0.0467 ], [ "in", 0.0364 ], [ "drunk", 0.0152 ], [ "having", 0.0134 ], [ "...", 0.0134 ], [ "feeling", 0.0118 ], [ "getting", 0.0118 ], [ "slightly", 0.0092 ] ], "target_token": "allergic", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null } }, "prob_clinical": 0.048, "prob_patient": null, "language_penalty": null, "flipped": false, "top_clinical": [ "a", 0.167 ], "top_patient": [ "a", 0.268 ], "spread_clinical": [ [ "a", 0.167 ], [ "sensitive", 0.115 ], [ "more", 0.102 ], [ "allergic", 0.048 ], [ "developing", 0.023 ] ], "spread_patient": [ [ "a", 0.268 ], [ "in", 0.036 ], [ "the", 0.036 ], [ "having", 0.028 ], [ "more", 0.028 ] ], "target_token": "allergic", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 965, "unique_to_a": 475, "unique_to_b": 376 }, "clinical_mass": { "clinical": 0.17, "patient": 0.1202 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260803T132340Z/index_97.html" }, { "index": 1376, "batch": "pairs_20260803T132340Z", "batch_index": 98, "clinical_prompt": "When my kids come back from playing outside, they have contact dermatitis, so we should apply some", "patient_prompt": "When my kids come back from playing outside, they've got these annoying itchy spots, so we should apply some", "intended_target": "cream", "rationale": "The frame 'apply some' funnels toward topical treatments. Lay descriptor 'annoying itchy spots' suggests minor concern; clinical diagnosis 'contact dermatitis' signals a named condition requiring medicated application, steering toward 'cream' over casual home remedies.", "patient_term": "got these annoying itchy spots", "clinical_term": "have contact dermatitis", "topic": "dermatological", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": 0.167, "prob_patient": 0.05, "language_penalty": -0.117, "anchor_fallback": false, "top_clinical": [ "cream", 0.167 ], "top_patient": [ "lotion", 0.136 ], "spread_clinical": [ [ "cream", 0.167 ], [ "ointment", 0.089 ], [ "lotion", 0.079 ], [ "moisturizer", 0.048 ], [ "kind", 0.037 ] ], "spread_patient": [ [ "lotion", 0.136 ], [ "cal", 0.073 ], [ "anti", 0.057 ], [ "ointment", 0.057 ], [ "cream", 0.05 ] ], "target_token": "cream", "flipped": true, "screening": null, "circuit_diff": { "shared_features": 994, "unique_to_a": 433, "unique_to_b": 467 }, "clinical_mass": { "clinical": 0.3356, "patient": 0.3018 }, "html": "modes/simulated/pairs_20260803T132340Z/index_98.html", "urgency": { "flip_class": "lateral", "tier_top_clinical": 1, "tier_top_patient": 1, "tier_shift": 0.0 } }, "gemma-3-4b-it": { "prob_clinical": 0.1173, "prob_patient": 0.0391, "language_penalty": -0.0782, "anchor_fallback": false, "top_clinical": [ "cream", 0.1173 ], "top_patient": [ "soothing", 0.1547 ], "spread_clinical": [ [ "cream", 0.1173 ], [ "lotion", 0.1035 ], [ "ointment", 0.0806 ], [ "moisturizer", 0.0806 ], [ "soothing", 0.0554 ], [ "aloe", 0.0459 ], [ "topical", 0.0316 ], [ "kind", 0.0316 ], [ "moisturizing", 0.0297 ], [ "treatment", 0.0279 ] ], "spread_patient": [ [ "soothing", 0.1547 ], [ "anti", 0.1204 ], [ "aloe", 0.1063 ], [ "lotion", 0.0828 ], [ "cal", 0.0731 ], [ "cream", 0.0391 ], [ "moisturizer", 0.0269 ], [ "relief", 0.0269 ], [ "ointment", 0.0237 ], [ "cooling", 0.0237 ] ], "target_token": "cream", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "lateral", "tier_top_clinical": 1, "tier_top_patient": 1, "tier_shift": 0.0 } }, "qwen3-4b": { "prob_clinical": 0.2121, "prob_patient": 0.3128, "language_penalty": 0.1007, "anchor_fallback": false, "top_clinical": [ "cream", 0.2121 ], "top_patient": [ "cream", 0.3128 ], "spread_clinical": [ [ "cream", 0.2121 ], [ "kind", 0.1287 ], [ "o", 0.1135 ], [ "hydro", 0.0369 ], [ "antibiotic", 0.0369 ], [ "ant", 0.0346 ], [ "medicine", 0.0346 ], [ "moistur", 0.0325 ], [ "anti", 0.0287 ], [ "treatment", 0.021 ] ], "spread_patient": [ [ "cream", 0.3128 ], [ "kind", 0.1304 ], [ "ant", 0.0896 ], [ "anti", 0.0791 ], [ "lotion", 0.0374 ], [ "medicine", 0.0374 ], [ "o", 0.0241 ], [ "cal", 0.02 ], [ "baby", 0.0176 ], [ "moistur", 0.0129 ] ], "target_token": "cream", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 1, "tier_top_patient": 1, "tier_shift": -0.056 } }, "qwen3-1.7b": { "prob_clinical": 0.0199, "prob_patient": 0.0368, "language_penalty": 0.0169, "anchor_fallback": false, "top_clinical": [ "kind", 0.7485 ], "top_patient": [ "kind", 0.6523 ], "spread_clinical": [ [ "kind", 0.7485 ], [ "sort", 0.1148 ], [ "type", 0.0226 ], [ "cream", 0.0199 ], [ "form", 0.0176 ], [ "ant", 0.0121 ], [ "o", 0.0107 ], [ "topical", 0.0057 ], [ "moistur", 0.0057 ], [ "soothing", 0.0024 ] ], "spread_patient": [ [ "kind", 0.6523 ], [ "sort", 0.1649 ], [ "cream", 0.0368 ], [ "ant", 0.0174 ], [ "o", 0.0174 ], [ "moistur", 0.0119 ], [ "topical", 0.0093 ], [ "type", 0.0093 ], [ "lotion", 0.0064 ], [ "form", 0.005 ] ], "target_token": "cream", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 1, "tier_top_patient": 1, "tier_shift": 0.0 } } }, "prob_clinical": 0.167, "prob_patient": 0.05, "language_penalty": -0.117, "flipped": true, "top_clinical": [ "cream", 0.167 ], "top_patient": [ "lotion", 0.136 ], "spread_clinical": [ [ "cream", 0.167 ], [ "ointment", 0.089 ], [ "lotion", 0.079 ], [ "moisturizer", 0.048 ], [ "kind", 0.037 ] ], "spread_patient": [ [ "lotion", 0.136 ], [ "cal", 0.073 ], [ "anti", 0.057 ], [ "ointment", 0.057 ], [ "cream", 0.05 ] ], "target_token": "cream", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 994, "unique_to_a": 433, "unique_to_b": 467 }, "clinical_mass": { "clinical": 0.3356, "patient": 0.3018 }, "html": "modes/simulated/pairs_20260803T132340Z/index_98.html", "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260803T132340Z/index_98.html", "urgency": { "flip_class": "lateral", "tier_top_clinical": 1, "tier_top_patient": 1, "tier_shift": 0.0 } }, { "index": 1377, "batch": "pairs_20260803T132340Z", "batch_index": 99, "clinical_prompt": "After standing all day at work, I have venous insufficiency, so my", "patient_prompt": "After standing all day at work, my legs feel really heavy and achy, so my", "intended_target": "doctor", "rationale": "The frame 'so my' before a role/agent. Colloquial symptom 'heavy and achy' frames as normal work fatigue; clinical 'venous insufficiency' signals pathology requiring professional evaluation, steering toward 'doctor' (care-seeking) rather than casual self-management.", "patient_term": "legs feel really heavy and achy", "clinical_term": "have venous insufficiency", "topic": "vascular", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": 0.523, "prob_patient": 0.14, "language_penalty": -0.383, "anchor_fallback": true, "top_clinical": [ "feet", 0.523 ], "top_patient": [ "feet", 0.14 ], "spread_clinical": [ [ "feet", 0.523 ], [ "legs", 0.359 ], [ "ankles", 0.02 ], [ "calves", 0.014 ], [ "lower", 0.011 ] ], "spread_patient": [ [ "feet", 0.14 ], [ "husband", 0.123 ], [ "wife", 0.051 ], [ "mom", 0.045 ], [ "first", 0.045 ] ], "target_token": "feet", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 737, "unique_to_a": 426, "unique_to_b": 582 }, "clinical_mass": { "clinical": 0.2958, "patient": 0.194 } }, "gemma-3-4b-it": { "prob_clinical": 0.0, "prob_patient": 0.0554, "language_penalty": 0.0554, "anchor_fallback": false, "top_clinical": [ "legs", 0.8333 ], "top_patient": [ "goal", 0.219 ], "spread_clinical": [ [ "legs", 0.8333 ], [ "feet", 0.1128 ], [ "ankles", 0.0323 ], [ "lower", 0.0064 ], [ "leg", 0.0034 ], [ "veins", 0.0034 ], [ "swollen", 0.0016 ], [ "varicose", 0.001 ], [ "socks", 0.001 ], [ "calves", 0.0009 ] ], "spread_patient": [ [ "goal", 0.219 ], [ "feet", 0.1933 ], [ "doctor", 0.0554 ], [ "wife", 0.0431 ], [ "legs", 0.0336 ], [ "husband", 0.0296 ], [ "friend", 0.0204 ], [ "mom", 0.0204 ], [ "first", 0.018 ], [ "priority", 0.0159 ] ], "target_token": "doctor", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, "qwen3-4b": { "prob_clinical": 0.0, "prob_patient": 0.2916, "language_penalty": 0.2916, "anchor_fallback": false, "top_clinical": [ "legs", 0.899 ], "top_patient": [ "doctor", 0.2916 ], "spread_clinical": [ [ "legs", 0.899 ], [ "feet", 0.0836 ], [ "leg", 0.0078 ], [ "lower", 0.002 ], [ "ankles", 0.0015 ], [ "calves", 0.0014 ], [ "left", 0.0014 ], [ "foot", 0.0004 ], [ "right", 0.0004 ], [ "veins", 0.0003 ] ], "spread_patient": [ [ "doctor", 0.2916 ], [ "feet", 0.1377 ], [ "legs", 0.1216 ], [ "boss", 0.0327 ], [ "mom", 0.0307 ], [ "friend", 0.0255 ], [ "wife", 0.0239 ], [ "body", 0.0239 ], [ "job", 0.0198 ], [ "question", 0.0165 ] ], "target_token": "doctor", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": 2, "tier_shift": null } }, "qwen3-1.7b": { "prob_clinical": 0.0005, "prob_patient": 0.0613, "language_penalty": 0.0608, "anchor_fallback": false, "top_clinical": [ "legs", 0.673 ], "top_patient": [ "friend", 0.1471 ], "spread_clinical": [ [ "legs", 0.673 ], [ "veins", 0.1032 ], [ "feet", 0.0804 ], [ "leg", 0.0335 ], [ "blood", 0.0179 ], [ "ankles", 0.0109 ], [ "hands", 0.0075 ], [ "right", 0.0058 ], [ "lower", 0.0058 ], [ "left", 0.004 ] ], "spread_patient": [ [ "friend", 0.1471 ], [ "wife", 0.1298 ], [ "sister", 0.0787 ], [ "partner", 0.0787 ], [ "doctor", 0.0613 ], [ "boss", 0.0421 ], [ "mom", 0.0421 ], [ "feet", 0.029 ], [ "legs", 0.0256 ], [ "husband", 0.0226 ] ], "target_token": "doctor", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": 0, "tier_shift": null } } }, "prob_clinical": 0.523, "prob_patient": 0.14, "language_penalty": -0.383, "flipped": false, "top_clinical": [ "feet", 0.523 ], "top_patient": [ "feet", 0.14 ], "spread_clinical": [ [ "feet", 0.523 ], [ "legs", 0.359 ], [ "ankles", 0.02 ], [ "calves", 0.014 ], [ "lower", 0.011 ] ], "spread_patient": [ [ "feet", 0.14 ], [ "husband", 0.123 ], [ "wife", 0.051 ], [ "mom", 0.045 ], [ "first", 0.045 ] ], "target_token": "feet", "anchor_fallback": true, "screening": null, "circuit_diff": { "shared_features": 737, "unique_to_a": 426, "unique_to_b": 582 }, "clinical_mass": { "clinical": 0.2958, "patient": 0.194 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260803T132340Z/index_99.html" }, { "index": 1378, "batch": "pairs_20260803T132340Z", "batch_index": 100, "clinical_prompt": "I've been waking up with paresthesia in my hands, so I should get a", "patient_prompt": "I've been waking up with this awful buzzing sensation in my hands, so I should get a", "intended_target": "workup", "rationale": "The frame 'get a' before a diagnostic procedure. 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The frame 'take my' funnels toward a remedy noun. A small model should assign higher probability to medical continuations like 'medication' after the clinical phrasing.", "patient_term": "having trouble keeping food down", "clinical_term": "nausea", "topic": "nausea", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": 0.145, "prob_patient": 0.078, "language_penalty": -0.06699999999999999, "anchor_fallback": false, "top_clinical": [ "meds", 0.164 ], "top_patient": [ "meds", 0.164 ], "spread_clinical": [ [ "meds", 0.164 ], [ "medication", 0.145 ], [ "medicine", 0.1 ], [ "nausea", 0.06 ], [ "pills", 0.047 ] ], "spread_patient": [ [ "meds", 0.164 ], [ "vitamins", 0.078 ], [ "medication", 0.078 ], [ "medicine", 0.068 ], [ "iron", 0.032 ] ], "target_token": "medication", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 556, "unique_to_a": 572, "unique_to_b": 777 }, "clinical_mass": { "clinical": 0.4062, "patient": 0.2616 }, "urgency": { "flip_class": null, "tier_top_clinical": 1, "tier_top_patient": 1, "tier_shift": 0.0 } }, "gemma-3-4b-it": { "prob_clinical": 0.5517, "prob_patient": 0.303, "language_penalty": -0.2487, "anchor_fallback": false, "top_clinical": [ "medication", 0.5517 ], "top_patient": [ "medication", 0.303 ], "spread_clinical": [ [ "medication", 0.5517 ], [ "medicine", 0.1791 ], [ "medications", 0.0659 ], [ "anti", 0.0513 ], [ "meds", 0.0353 ], [ "nausea", 0.0189 ], [ "prescription", 0.0115 ], [ "stomach", 0.0058 ], [ "morning", 0.0054 ], [ "usual", 0.0045 ] ], "spread_patient": [ [ "medication", 0.303 ], [ "medications", 0.1263 ], [ "medicine", 0.1115 ], [ "stomach", 0.1115 ], [ "appetite", 0.0597 ], [ "meds", 0.041 ], [ "weight", 0.0117 ], [ "dog", 0.0086 ], [ "food", 0.0081 ], [ "diet", 0.0076 ] ], "target_token": "medication", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 1, "tier_top_patient": 1, "tier_shift": -0.053 } }, "qwen3-4b": { "prob_clinical": 0.2936, "prob_patient": 0.162, "language_penalty": -0.1316, "anchor_fallback": false, "top_clinical": [ "medication", 0.2936 ], "top_patient": [ "medication", 0.162 ], "spread_clinical": [ [ "medication", 0.2936 ], [ "medicine", 0.1781 ], [ "medications", 0.0578 ], [ "prescribed", 0.0351 ], [ "anti", 0.0291 ], [ "baby", 0.0291 ], [ "meds", 0.0273 ], [ "usual", 0.0226 ], [ "morning", 0.0213 ], [ "pills", 0.02 ] ], "spread_patient": [ [ "medication", 0.162 ], [ "medications", 0.0982 ], [ "medicine", 0.0982 ], [ "prescribed", 0.0596 ], [ "stomach", 0.0464 ], [ "time", 0.0436 ], [ "meds", 0.034 ], [ "anti", 0.03 ], [ "ant", 0.0281 ], [ "morning", 0.0264 ] ], "target_token": "medication", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 1, "tier_top_patient": 1, "tier_shift": 0.176 } }, "qwen3-1.7b": { "prob_clinical": 0.3757, "prob_patient": 0.1982, "language_penalty": -0.1775, "anchor_fallback": false, "top_clinical": [ "medication", 0.3757 ], "top_patient": [ "medication", 0.1982 ], "spread_clinical": [ [ "medication", 0.3757 ], [ "medicine", 0.1382 ], [ "medications", 0.122 ], [ "pills", 0.0308 ], [ "ant", 0.024 ], [ "medicines", 0.0212 ], [ "vitamin", 0.0212 ], [ "vitamins", 0.0187 ], [ "pill", 0.0187 ], [ "meds", 0.0165 ] ], "spread_patient": [ [ "medication", 0.1982 ], [ "medications", 0.1749 ], [ "stomach", 0.0568 ], [ "ant", 0.0501 ], [ "medicine", 0.0304 ], [ "time", 0.0268 ], [ "pills", 0.0268 ], [ "meds", 0.0268 ], [ "morning", 0.0237 ], [ "meals", 0.0237 ] ], "target_token": "medication", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 1, "tier_top_patient": 0, "tier_shift": -0.695 } } }, "prob_clinical": 0.145, "prob_patient": 0.078, "language_penalty": -0.06699999999999999, "flipped": false, "top_clinical": [ "meds", 0.164 ], "top_patient": [ "meds", 0.164 ], "spread_clinical": [ [ "meds", 0.164 ], [ "medication", 0.145 ], [ "medicine", 0.1 ], [ "nausea", 0.06 ], [ "pills", 0.047 ] ], "spread_patient": [ [ "meds", 0.164 ], [ "vitamins", 0.078 ], [ "medication", 0.078 ], [ "medicine", 0.068 ], [ "iron", 0.032 ] ], "target_token": "medication", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 556, "unique_to_a": 572, "unique_to_b": 777 }, "clinical_mass": { "clinical": 0.4062, "patient": 0.2616 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260804T190615Z/index_12.html", "urgency": { "flip_class": null, "tier_top_clinical": 1, "tier_top_patient": 1, "tier_shift": 0.0 } }, { "index": 1391, "batch": "pairs_20260804T190615Z", "batch_index": 13, "clinical_prompt": "My doctor says I have atherosclerosis, so I should take an", "patient_prompt": "My doctor says my blood vessels are all clogged up, so I should take an", "intended_target": "anticoagulant", "rationale": "Colloquial 'clogged up' is a lay metaphor; 'atherosclerosis' is the clinical diagnosis. The frame 'take an' before a vowel-initial word primes for medication or treatment. Clinical phrasing should shift continuations toward medical interventions.", "patient_term": "blood vessels are all clogged up", "clinical_term": "atherosclerosis", "topic": "cardiovascular disease", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": 0.054, "prob_patient": 0.046, "language_penalty": -0.008, "anchor_fallback": false, "top_clinical": [ "aspirin", 0.742 ], "top_patient": [ "aspirin", 0.723 ], "spread_clinical": [ [ "aspirin", 0.742 ], [ "anti", 0.054 ], [ "ACE", 0.02 ], [ "Asp", 0.014 ], [ "omega", 0.011 ] ], "spread_patient": [ [ "aspirin", 0.723 ], [ "anti", 0.046 ], [ "angio", 0.019 ], [ "herbal", 0.015 ], [ "Asp", 0.015 ] ], "target_token": "anti", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 796, "unique_to_a": 343, "unique_to_b": 386 }, "clinical_mass": { "clinical": 0.4413, "patient": 0.4232 }, "urgency": { "flip_class": null, "tier_top_clinical": 1, "tier_top_patient": 1, "tier_shift": 0.0 } }, "gemma-3-4b-it": { "prob_clinical": 0.0128, "prob_patient": 0.0181, "language_penalty": 0.0053, "anchor_fallback": false, "top_clinical": [ "aspirin", 0.6976 ], "top_patient": [ "aspirin", 0.5276 ], "spread_clinical": [ [ "aspirin", 0.6976 ], [ "omega", 0.107 ], [ "anti", 0.0833 ], [ "anticoagulant", 0.0128 ], [ "active", 0.0113 ], [ "Omega", 0.0088 ], [ "antioxidant", 0.0088 ], [ "ant", 0.0077 ], [ "ACE", 0.006 ], [ "LDL", 0.0053 ] ], "spread_patient": [ [ "aspirin", 0.5276 ], [ "omega", 0.1512 ], [ "anti", 0.0917 ], [ "Omega", 0.0298 ], [ "apple", 0.0263 ], [ "antioxidant", 0.0263 ], [ "exercise", 0.0263 ], [ "anticoagulant", 0.0181 ], [ "olive", 0.0085 ], [ "ACE", 0.0085 ] ], "target_token": "anticoagulant", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 1, "tier_top_patient": 1, "tier_shift": -0.09 } }, "qwen3-4b": { "prob_clinical": 0.0405, "prob_patient": 0.0415, "language_penalty": 0.001, "anchor_fallback": false, "top_clinical": [ "aspir", 0.7174 ], "top_patient": [ "aspir", 0.8329 ], "spread_clinical": [ [ "aspir", 0.7174 ], [ "ACE", 0.0971 ], [ "anti", 0.0756 ], [ "ant", 0.0405 ], [ "omega", 0.0102 ], [ "NSA", 0.0062 ], [ "stat", 0.0062 ], [ "LDL", 0.0062 ], [ "H", 0.0043 ], [ "oral", 0.0038 ] ], "spread_patient": [ [ "aspir", 0.8329 ], [ "anti", 0.0532 ], [ "ant", 0.0415 ], [ "ACE", 0.0196 ], [ "oral", 0.0064 ], [ "angi", 0.0056 ], [ "omega", 0.0039 ], [ "antibiotic", 0.003 ], [ "herbal", 0.003 ], [ "NSA", 0.0027 ] ], "target_token": "ant", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 1, "tier_top_patient": 1, "tier_shift": 0.003 } }, "qwen3-1.7b": { "prob_clinical": 0.0848, "prob_patient": 0.0889, "language_penalty": 0.0041, "anchor_fallback": false, "top_clinical": [ "aspir", 0.3799 ], "top_patient": [ "aspir", 0.4516 ], "spread_clinical": [ [ "aspir", 0.3799 ], [ "anti", 0.0848 ], [ "ant", 0.0848 ], [ "X", 0.0514 ], [ "LDL", 0.0353 ], [ "omega", 0.0243 ], [ "antioxidant", 0.0189 ], [ "MRI", 0.0189 ], [ "x", 0.0167 ], [ "ech", 0.0167 ] ], "spread_patient": [ [ "aspir", 0.4516 ], [ "anti", 0.2133 ], [ "angi", 0.1466 ], [ "ant", 0.0889 ], [ "antibiotic", 0.0106 ], [ "Ang", 0.0094 ], [ "As", 0.0064 ], [ "X", 0.005 ], [ "enzyme", 0.005 ], [ "antioxidant", 0.0044 ] ], "target_token": "ant", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 1, "tier_top_patient": 1, "tier_shift": -0.019 } } }, "prob_clinical": 0.054, "prob_patient": 0.046, "language_penalty": -0.008, "flipped": false, "top_clinical": [ "aspirin", 0.742 ], "top_patient": [ "aspirin", 0.723 ], "spread_clinical": [ [ "aspirin", 0.742 ], [ "anti", 0.054 ], [ "ACE", 0.02 ], [ "Asp", 0.014 ], [ "omega", 0.011 ] ], "spread_patient": [ [ "aspirin", 0.723 ], [ "anti", 0.046 ], [ "angio", 0.019 ], [ "herbal", 0.015 ], [ "Asp", 0.015 ] ], "target_token": "anti", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 796, "unique_to_a": 343, "unique_to_b": 386 }, "clinical_mass": { "clinical": 0.4413, "patient": 0.4232 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260804T190615Z/index_13.html", "urgency": { "flip_class": null, "tier_top_clinical": 1, "tier_top_patient": 1, "tier_shift": 0.0 } }, { "index": 1392, "batch": "pairs_20260804T190615Z", "batch_index": 14, "clinical_prompt": "I have pleurisy, so I might have", "patient_prompt": "I keep getting sharp pains in my chest when I move, so I might have", "intended_target": "inflammation", "rationale": "Colloquial symptom description versus precise clinical diagnosis. The open frame 'might have' allows for different continuations: lay reading yields vague outcomes, clinical phrasing steers toward related medical conditions or pathophysiology.", "patient_term": "sharp pains in my chest when I move", "clinical_term": "pleurisy", "topic": "respiratory/chest pain", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": 0.363, "prob_patient": 0.2, "language_penalty": -0.16299999999999998, "anchor_fallback": true, "top_clinical": [ "to", 0.363 ], "top_patient": [ "a", 0.33 ], "spread_clinical": [ [ "to", 0.363 ], [ "a", 0.194 ], [ "some", 0.071 ], [ "been", 0.056 ], [ "an", 0.03 ] ], "spread_patient": [ [ "a", 0.33 ], [ "to", 0.2 ], [ "an", 0.065 ], [ "something", 0.051 ], [ "some", 0.051 ] ], "target_token": "to", "flipped": true, "screening": null, "circuit_diff": { "shared_features": 526, "unique_to_a": 637, "unique_to_b": 826 }, "clinical_mass": { "clinical": 0.1569, "patient": 0.3489 }, "html": "modes/simulated/pairs_20260804T190615Z/index_14.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, "gemma-3-4b-it": { "prob_clinical": 0.0001, "prob_patient": 0.0009, "language_penalty": 0.0008, "anchor_fallback": false, "top_clinical": [ "a", 0.2567 ], "top_patient": [ "a", 0.5264 ], "spread_clinical": [ [ "a", 0.2567 ], [ "some", 0.2265 ], [ "to", 0.1374 ], [ "difficulty", 0.1212 ], [ "trouble", 0.1212 ], [ "pain", 0.0145 ], [ "an", 0.0128 ], [ "more", 0.0113 ], [ "problems", 0.01 ], [ "issues", 0.0078 ] ], "spread_patient": [ [ "a", 0.5264 ], [ "something", 0.0915 ], [ "cost", 0.0629 ], [ "some", 0.049 ], [ "an", 0.0432 ], [ "angina", 0.0381 ], [ "to", 0.0262 ], [ "chest", 0.0231 ], [ "ple", 0.0231 ], [ "heart", 0.0124 ] ], "target_token": "inflammation", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null }, "qwen3-4b": { "prob_clinical": 0.004, "prob_patient": 0.0005, "language_penalty": -0.0035, "anchor_fallback": false, "top_clinical": [ "a", 0.4366 ], "top_patient": [ "a", 0.7367 ], "spread_clinical": [ [ "a", 0.4366 ], [ "to", 0.1251 ], [ "some", 0.1104 ], [ "pneumonia", 0.086 ], [ "ple", 0.0591 ], [ "fluid", 0.0358 ], [ "an", 0.0316 ], [ "been", 0.0217 ], [ "something", 0.0091 ], [ "lung", 0.0071 ] ], "spread_patient": [ [ "a", 0.7367 ], [ "cost", 0.0471 ], [ "something", 0.0416 ], [ "to", 0.0367 ], [ "some", 0.0222 ], [ "an", 0.0173 ], [ "pulled", 0.0119 ], [ "been", 0.0119 ], [ "referred", 0.0072 ], [ "per", 0.0044 ] ], "target_token": "inflammation", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null }, "qwen3-1.7b": { "prob_clinical": 0.0077, "prob_patient": 0.0, "language_penalty": -0.0077, "anchor_fallback": false, "top_clinical": [ "a", 0.371 ], "top_patient": [ "a", 0.6746 ], "spread_clinical": [ [ "a", 0.371 ], [ "some", 0.225 ], [ "an", 0.0645 ], [ "chest", 0.0645 ], [ "to", 0.0443 ], [ "ple", 0.0345 ], [ "fluid", 0.0305 ], [ "pain", 0.0209 ], [ "been", 0.0112 ], [ "inflammation", 0.0077 ] ], "spread_patient": [ [ "a", 0.6746 ], [ "ang", 0.0913 ], [ "heart", 0.0913 ], [ "some", 0.0381 ], [ "been", 0.0204 ], [ "chest", 0.018 ], [ "something", 0.014 ], [ "an", 0.0124 ], [ "asthma", 0.0085 ], [ "GER", 0.0052 ] ], "target_token": "inflammation", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null } }, "prob_clinical": 0.363, "prob_patient": 0.2, "language_penalty": -0.16299999999999998, "flipped": true, "top_clinical": [ "to", 0.363 ], "top_patient": [ "a", 0.33 ], "spread_clinical": [ [ "to", 0.363 ], [ "a", 0.194 ], [ "some", 0.071 ], [ "been", 0.056 ], [ "an", 0.03 ] ], "spread_patient": [ [ "a", 0.33 ], [ "to", 0.2 ], [ "an", 0.065 ], [ "something", 0.051 ], [ "some", 0.051 ] ], "target_token": "to", "anchor_fallback": true, "screening": null, "circuit_diff": { "shared_features": 526, "unique_to_a": 637, "unique_to_b": 826 }, "clinical_mass": { "clinical": 0.1569, "patient": 0.3489 }, "html": "modes/simulated/pairs_20260804T190615Z/index_14.html", "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260804T190615Z/index_14.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, { "index": 1393, "batch": "pairs_20260804T190615Z", "batch_index": 15, "clinical_prompt": "I have peripheral neuropathy, so I should probably see a", "patient_prompt": "My hands and feet are always tingling and numb, so I should probably see a", "intended_target": "neurologist", "rationale": "Colloquial symptom listing versus precise neurological diagnosis. Frame 'see a' naturally calls for a healthcare provider title. Clinical phrasing should elevate specialist titles over generalist continuations.", "patient_term": "hands and feet are always tingling and numb", "clinical_term": "peripheral neuropathy", "topic": "neuropathy", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": 0.424, "prob_patient": 0.275, "language_penalty": -0.14899999999999997, "anchor_fallback": false, "top_clinical": [ "neuro", 0.424 ], "top_patient": [ "doctor", 0.516 ], "spread_clinical": [ [ "neuro", 0.424 ], [ "doctor", 0.2 ], [ "po", 0.065 ], [ "specialist", 0.057 ], [ "foot", 0.031 ] ], "spread_patient": [ [ "doctor", 0.516 ], [ "neuro", 0.275 ], [ "specialist", 0.042 ], [ "doc", 0.018 ], [ "Dr", 0.016 ] ], "target_token": "neuro", "flipped": true, "screening": null, "circuit_diff": { "shared_features": 571, "unique_to_a": 631, "unique_to_b": 605 }, "clinical_mass": { "clinical": 0.4132, "patient": 0.4083 }, "html": "modes/simulated/pairs_20260804T190615Z/index_15.html", "urgency": { "flip_class": "downgrade", "tier_top_clinical": 3, "tier_top_patient": 2, "tier_shift": -0.341 } }, "gemma-3-4b-it": { "prob_clinical": 0.6329, "prob_patient": 0.0667, "language_penalty": -0.5662, "anchor_fallback": false, "top_clinical": [ "neurologist", 0.6329 ], "top_patient": [ "doctor", 0.9208 ], "spread_clinical": [ [ "neurologist", 0.6329 ], [ "pod", 0.11 ], [ "specialist", 0.0971 ], [ "doctor", 0.0971 ], [ "pain", 0.009 ], [ "physical", 0.008 ], [ "rheumat", 0.0038 ], [ "physician", 0.0029 ], [ "dermatologist", 0.0028 ], [ "neuro", 0.0028 ] ], "spread_patient": [ [ "doctor", 0.9208 ], [ "neurologist", 0.0667 ], [ "specialist", 0.0033 ], [ "medical", 0.0029 ], [ "physician", 0.0023 ], [ "Doctor", 0.0008 ], [ "healthcare", 0.0006 ], [ "doc", 0.0002 ], [ "health", 0.0002 ], [ "dermatologist", 0.0002 ] ], "target_token": "neurologist", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": 2, "tier_shift": null } }, "qwen3-4b": { "prob_clinical": 0.8131, "prob_patient": 0.1945, "language_penalty": -0.6186, "anchor_fallback": false, "top_clinical": [ "neuro", 0.8131 ], "top_patient": [ "doctor", 0.7693 ], "spread_clinical": [ [ "neuro", 0.8131 ], [ "specialist", 0.0857 ], [ "doctor", 0.0459 ], [ "neurop", 0.0085 ], [ "phys", 0.0055 ], [ "neurological", 0.0048 ], [ "physical", 0.0045 ], [ "nerve", 0.0031 ], [ "pain", 0.0031 ], [ "neu", 0.0026 ] ], "spread_patient": [ [ "doctor", 0.7693 ], [ "neuro", 0.1945 ], [ "specialist", 0.0232 ], [ "physician", 0.0028 ], [ "Neuro", 0.0017 ], [ "Doctor", 0.001 ], [ "phys", 0.0009 ], [ "dermat", 0.0008 ], [ "nerve", 0.0005 ], [ "neurological", 0.0005 ] ], "target_token": "neuro", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "downgrade", "tier_top_clinical": 3, "tier_top_patient": 2, "tier_shift": -0.724 } }, "qwen3-1.7b": { "prob_clinical": 0.4543, "prob_patient": 0.0664, "language_penalty": -0.3879, "anchor_fallback": false, "top_clinical": [ "neuro", 0.4543 ], "top_patient": [ "doctor", 0.9167 ], "spread_clinical": [ [ "neuro", 0.4543 ], [ "doctor", 0.2432 ], [ "specialist", 0.1894 ], [ "phys", 0.0226 ], [ "physical", 0.0107 ], [ "dermat", 0.0083 ], [ "physician", 0.0083 ], [ "pod", 0.0057 ], [ "neu", 0.0039 ], [ "nurse", 0.0035 ] ], "spread_patient": [ [ "doctor", 0.9167 ], [ "neuro", 0.0664 ], [ "physician", 0.0079 ], [ "specialist", 0.0037 ], [ "healthcare", 0.0009 ], [ "dermat", 0.0006 ], [ "medical", 0.0005 ], [ "phys", 0.0004 ], [ "Doctor", 0.0003 ], [ "GP", 0.0002 ] ], "target_token": "neuro", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "downgrade", "tier_top_clinical": 3, "tier_top_patient": 2, "tier_shift": -0.646 } } }, "prob_clinical": 0.424, "prob_patient": 0.275, "language_penalty": -0.14899999999999997, "flipped": true, "top_clinical": [ "neuro", 0.424 ], "top_patient": [ "doctor", 0.516 ], "spread_clinical": [ [ "neuro", 0.424 ], [ "doctor", 0.2 ], [ "po", 0.065 ], [ "specialist", 0.057 ], [ "foot", 0.031 ] ], "spread_patient": [ [ "doctor", 0.516 ], [ "neuro", 0.275 ], [ "specialist", 0.042 ], [ "doc", 0.018 ], [ "Dr", 0.016 ] ], "target_token": "neuro", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 571, "unique_to_a": 631, "unique_to_b": 605 }, "clinical_mass": { "clinical": 0.4132, "patient": 0.4083 }, "html": "modes/simulated/pairs_20260804T190615Z/index_15.html", "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260804T190615Z/index_15.html", "urgency": { "flip_class": "downgrade", "tier_top_clinical": 3, "tier_top_patient": 2, "tier_shift": -0.341 } }, { "index": 1394, "batch": "pairs_20260804T190615Z", "batch_index": 16, "clinical_prompt": "I have diplopia, so I need to take my", "patient_prompt": "I've been seeing double and my eyes feel strained, so I need to take my", 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Frame 'take my' primes for an object (medication, glasses, etc.). 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Colloquial symptom description suggests self-care or minor concern; clinical diagnosis frames the need for professional evaluation.", "patient_term": "I've got gravel in there", "clinical_term": "pharyngitis", "topic": "pharyngitis", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": 0.621, "prob_patient": 0.762, "language_penalty": 0.14100000000000001, "anchor_fallback": false, "top_clinical": [ "doctor", 0.621 ], "top_patient": [ "doctor", 0.762 ], "spread_clinical": [ [ "doctor", 0.621 ], [ "ENT", 0.107 ], [ "specialist", 0.058 ], [ "throat", 0.031 ], [ "doc", 0.027 ] ], "spread_patient": [ [ "doctor", 0.762 ], [ "doc", 0.055 ], [ "Dr", 0.038 ], [ "specialist", 0.023 ], [ "dr", 0.02 ] ], "target_token": "doctor", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 546, "unique_to_a": 658, "unique_to_b": 619 }, "clinical_mass": { "clinical": 0.4567, "patient": 0.3616 }, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.057 } }, "gemma-3-4b-it": { "prob_clinical": 0.9226, "prob_patient": 0.9834, "language_penalty": 0.0608, "anchor_fallback": false, "top_clinical": [ "doctor", 0.9226 ], "top_patient": [ "doctor", 0.9834 ], "spread_clinical": [ [ "doctor", 0.9226 ], [ "physician", 0.0217 ], [ "medical", 0.0132 ], [ "healthcare", 0.0116 ], [ "specialist", 0.0058 ], [ "dentist", 0.0035 ], [ "health", 0.0033 ], [ "primary", 0.0023 ], [ "general", 0.0019 ], [ "Doctor", 0.0011 ] ], "spread_patient": [ [ "doctor", 0.9834 ], [ "physician", 0.0031 ], [ "medical", 0.0028 ], [ "dentist", 0.0022 ], [ "Doctor", 0.0013 ], [ "professional", 0.001 ], [ "healthcare", 0.0009 ], [ "doc", 0.0009 ], [ "specialist", 0.0006 ], [ "throat", 0.0005 ] ], "target_token": "doctor", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.007 } }, "qwen3-4b": { "prob_clinical": 0.9299, "prob_patient": 0.9733, "language_penalty": 0.0434, "anchor_fallback": false, "top_clinical": [ "doctor", 0.9299 ], "top_patient": [ "doctor", 0.9733 ], "spread_clinical": [ [ "doctor", 0.9299 ], [ "specialist", 0.0409 ], [ "throat", 0.0063 ], [ "physician", 0.0034 ], [ "general", 0.0023 ], [ "______", 0.0017 ], [ "ENT", 0.0015 ], [ "ENT", 0.0012 ], [ "ph", 0.001 ], [ "__", 0.0009 ] ], "spread_patient": [ [ "doctor", 0.9733 ], [ "specialist", 0.0066 ], [ "throat", 0.0051 ], [ "dentist", 0.0045 ], [ "physician", 0.0015 ], [ "ENT", 0.001 ], [ "medical", 0.0009 ], [ "Doctor", 0.0006 ], [ "professional", 0.0005 ], [ "healthcare", 0.0005 ] ], "target_token": "doctor", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.025 } }, "qwen3-1.7b": { "prob_clinical": 0.9342, "prob_patient": 0.9862, "language_penalty": 0.052, "anchor_fallback": false, "top_clinical": [ "doctor", 0.9342 ], "top_patient": [ "doctor", 0.9862 ], "spread_clinical": [ [ "doctor", 0.9342 ], [ "specialist", 0.041 ], [ "physician", 0.0092 ], [ "ph", 0.0018 ], [ "pul", 0.0016 ], [ "dentist", 0.0014 ], [ "GP", 0.001 ], [ "healthcare", 0.001 ], [ "general", 0.001 ], [ "ENT", 0.001 ] ], "spread_patient": [ [ "doctor", 0.9862 ], [ "physician", 0.0059 ], [ "dentist", 0.0028 ], [ "specialist", 0.0019 ], [ "GP", 0.0004 ], [ "ENT", 0.0004 ], [ "medical", 0.0003 ], [ "Doctor", 0.0003 ], [ "healthcare", 0.0003 ], [ "throat", 0.0002 ] ], "target_token": "doctor", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.038 } } }, "prob_clinical": 0.621, "prob_patient": 0.762, "language_penalty": 0.14100000000000001, "flipped": false, "top_clinical": [ "doctor", 0.621 ], "top_patient": [ "doctor", 0.762 ], "spread_clinical": [ [ "doctor", 0.621 ], [ "ENT", 0.107 ], [ "specialist", 0.058 ], [ "throat", 0.031 ], [ "doc", 0.027 ] ], "spread_patient": [ [ "doctor", 0.762 ], [ "doc", 0.055 ], [ "Dr", 0.038 ], [ "specialist", 0.023 ], [ "dr", 0.02 ] ], "target_token": "doctor", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 546, "unique_to_a": 658, "unique_to_b": 619 }, "clinical_mass": { "clinical": 0.4567, "patient": 0.3616 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260804T190615Z/index_27.html", "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.057 } }, { "index": 1405, "batch": "pairs_20260804T190615Z", "batch_index": 28, "clinical_prompt": "When I stand up too fast, I experience orthostatic hypotension, so I might have", "patient_prompt": "When I stand up too fast, the room starts spinning around me, so I might have", "intended_target": "anemia", "rationale": "The frame 'so I might have' probes diagnostic attribution. Lay description of vertigo suggests benign causes; clinical term points the model toward underlying conditions like anemia or electrolyte imbalance.", "patient_term": "the room starts spinning around me", "clinical_term": "orthostatic hypotension", "topic": "orthostatic hypotension", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": 0.26, "prob_patient": 0.248, "language_penalty": -0.01200000000000001, "anchor_fallback": true, "top_clinical": [ "to", 0.26 ], "top_patient": [ "to", 0.248 ], "spread_clinical": [ [ "to", 0.26 ], [ "a", 0.229 ], [ "some", 0.074 ], [ "an", 0.045 ], [ "been", 0.031 ] ], "spread_patient": [ [ "to", 0.248 ], [ "a", 0.219 ], [ "vertigo", 0.081 ], [ "some", 0.081 ], [ "dizziness", 0.03 ] ], "target_token": "to", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 816, "unique_to_a": 389, "unique_to_b": 540 }, "clinical_mass": { "clinical": 0.1479, "patient": 0.2319 } }, "gemma-3-4b-it": { "prob_clinical": 0.0, "prob_patient": 0.0, "language_penalty": 0.0, "anchor_fallback": false, "top_clinical": [ "trouble", 0.2097 ], "top_patient": [ "to", 0.5817 ], "spread_clinical": [ [ "trouble", 0.2097 ], [ "a", 0.1851 ], [ "to", 0.1634 ], [ "low", 0.1634 ], [ "dizziness", 0.0601 ], [ "some", 0.0468 ], [ "light", 0.0251 ], [ "difficulty", 0.0195 ], [ "an", 0.0134 ], [ "problems", 0.0104 ] ], "spread_patient": [ [ "to", 0.5817 ], [ "vertigo", 0.1471 ], [ "a", 0.1011 ], [ "some", 0.0328 ], [ "something", 0.029 ], [ "low", 0.0137 ], [ "problems", 0.0094 ], [ "orth", 0.0094 ], [ "an", 0.0094 ], [ "inner", 0.0094 ] ], "target_token": "anemia", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, "qwen3-4b": { "prob_clinical": 0.0036, "prob_patient": 0.0131, "language_penalty": 0.0095, "anchor_fallback": false, "top_clinical": [ "to", 0.8904 ], "top_patient": [ "to", 0.5559 ], "spread_clinical": [ [ "to", 0.8904 ], [ "a", 0.0828 ], [ "an", 0.0036 ], [ "faint", 0.0019 ], [ "symptoms", 0.0017 ], [ "the", 0.0015 ], [ "some", 0.0015 ], [ "had", 0.0013 ], [ "trouble", 0.0012 ], [ "syn", 0.001 ] ], "spread_patient": [ [ "to", 0.5559 ], [ "a", 0.3821 ], [ "an", 0.0131 ], [ "motion", 0.0115 ], [ "vert", 0.0102 ], [ "what", 0.0048 ], [ "trouble", 0.0029 ], [ "black", 0.0023 ], [ "the", 0.0018 ], [ "syn", 0.0016 ] ], "target_token": "an", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null }, "qwen3-1.7b": { "prob_clinical": 0.0334, "prob_patient": 0.0598, "language_penalty": 0.0264, "anchor_fallback": false, "top_clinical": [ "a", 0.4073 ], "top_patient": [ "a", 0.4419 ], "spread_clinical": [ [ "a", 0.4073 ], [ "to", 0.3595 ], [ "an", 0.0334 ], [ "some", 0.0295 ], [ "trouble", 0.0158 ], [ "been", 0.0109 ], [ "problems", 0.0096 ], [ "had", 0.0085 ], [ "low", 0.0075 ], [ "the", 0.0075 ] ], "spread_patient": [ [ "a", 0.4419 ], [ "to", 0.3037 ], [ "an", 0.0598 ], [ "been", 0.022 ], [ "the", 0.022 ], [ "some", 0.0194 ], [ "trouble", 0.0133 ], [ "my", 0.0071 ], [ "vert", 0.0071 ], [ "something", 0.0071 ] ], "target_token": "an", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null } }, "prob_clinical": 0.26, "prob_patient": 0.248, "language_penalty": -0.01200000000000001, "flipped": false, "top_clinical": [ "to", 0.26 ], "top_patient": [ "to", 0.248 ], "spread_clinical": [ [ "to", 0.26 ], [ "a", 0.229 ], [ "some", 0.074 ], [ "an", 0.045 ], [ "been", 0.031 ] ], "spread_patient": [ [ "to", 0.248 ], [ "a", 0.219 ], [ "vertigo", 0.081 ], [ "some", 0.081 ], [ "dizziness", 0.03 ] ], "target_token": "to", "anchor_fallback": true, "screening": null, "circuit_diff": { "shared_features": 816, "unique_to_a": 389, "unique_to_b": 540 }, "clinical_mass": { "clinical": 0.1479, "patient": 0.2319 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260804T190615Z/index_28.html" }, { "index": 1406, "batch": "pairs_20260804T190615Z", "batch_index": 29, "clinical_prompt": "I have sciatica, so I need to talk to my", "patient_prompt": "I've been getting these really bad shooting pains down my leg, so I need to talk to my", "intended_target": "doctor", "rationale": "The frame 'so I need to talk to my' invokes a professional relationship. 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Frame 'should probably take my' expects clinical remedies. 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The frame '...so I might have' steers toward a specific GI diagnosis rather than normal digestion or hunger.", "patient_term": "weird gurgling and rumbling noises", "clinical_term": "abdominal hyperactivity with borborygmi", "topic": "gastrointestinal disorder", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": 0.141, "prob_patient": null, "language_penalty": null, "anchor_fallback": false, "top_clinical": [ "to", 0.141 ], "top_patient": [ "to", 0.258 ], "spread_clinical": [ [ "to", 0.141 ], [ "IBS", 0.141 ], [ "a", 0.141 ], [ "some", 0.075 ], [ "irritable", 0.052 ] ], "spread_patient": [ [ "to", 0.258 ], [ "a", 0.177 ], [ "some", 0.083 ], [ "an", 0.065 ], [ "acid", 0.057 ] ], "target_token": "IBS", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 606, "unique_to_a": 755, "unique_to_b": 761 }, "clinical_mass": { "clinical": 0.3489, "patient": 0.2653 } }, "gemma-3-4b-it": { "prob_clinical": 0.2845, "prob_patient": 0.0563, "language_penalty": -0.2282, "anchor_fallback": false, "top_clinical": [ "IBS", 0.2845 ], "top_patient": [ "a", 0.324 ], "spread_clinical": [ [ "IBS", 0.2845 ], [ "a", 0.251 ], [ "irritable", 0.0815 ], [ "an", 0.0635 ], [ "some", 0.0635 ], [ "Ir", 0.0635 ], [ "gastritis", 0.0234 ], [ "to", 0.0182 ], [ "something", 0.0182 ], [ "gas", 0.0097 ] ], "spread_patient": [ [ "a", 0.324 ], [ "to", 0.1734 ], [ "some", 0.0723 ], [ "an", 0.0638 ], [ "IBS", 0.0563 ], [ "gas", 0.0438 ], [ "something", 0.0341 ], [ "indigestion", 0.0266 ], [ "stomach", 0.0111 ], [ "Ir", 0.0111 ] ], "target_token": "IBS", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, "qwen3-4b": { "prob_clinical": 0.2087, "prob_patient": 0.0397, "language_penalty": -0.169, "anchor_fallback": false, "top_clinical": [ "a", 0.3037 ], "top_patient": [ "to", 0.3322 ], "spread_clinical": [ [ "a", 0.3037 ], [ "to", 0.2087 ], [ "I", 0.2087 ], [ "an", 0.1117 ], [ "ir", 0.0598 ], [ "some", 0.0151 ], [ "been", 0.0118 ], [ "something", 0.0118 ], [ "small", 0.0118 ], [ "diarrhea", 0.0049 ] ], "spread_patient": [ [ "to", 0.3322 ], [ "a", 0.2931 ], [ "something", 0.1569 ], [ "an", 0.0509 ], [ "some", 0.0509 ], [ "I", 0.0397 ], [ "ir", 0.0089 ], [ "gas", 0.0089 ], [ "been", 0.0078 ], [ "either", 0.0054 ] ], "target_token": "I", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, "qwen3-1.7b": { "prob_clinical": 0.0558, "prob_patient": 0.0391, "language_penalty": -0.0167, "anchor_fallback": false, "top_clinical": [ "a", 0.4126 ], "top_patient": [ "a", 0.6113 ], "spread_clinical": [ [ "a", 0.4126 ], [ "an", 0.1182 ], [ "I", 0.0558 ], [ "dys", 0.0558 ], [ "ir", 0.0558 ], [ "some", 0.0435 ], [ "gast", 0.0384 ], [ "gastr", 0.0233 ], [ "something", 0.0205 ], [ "Irr", 0.016 ] ], "spread_patient": [ [ "a", 0.6113 ], [ "an", 0.1062 ], [ "acid", 0.0502 ], [ "gastr", 0.0391 ], [ "I", 0.0391 ], [ "some", 0.0209 ], [ "GER", 0.0209 ], [ "dys", 0.0163 ], [ "ir", 0.0163 ], [ "gast", 0.0144 ] ], "target_token": "I", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null } }, "prob_clinical": 0.141, "prob_patient": null, "language_penalty": null, "flipped": false, "top_clinical": [ "to", 0.141 ], "top_patient": [ "to", 0.258 ], "spread_clinical": [ [ "to", 0.141 ], [ "IBS", 0.141 ], [ "a", 0.141 ], [ "some", 0.075 ], [ "irritable", 0.052 ] ], "spread_patient": [ [ "to", 0.258 ], [ "a", 0.177 ], [ "some", 0.083 ], [ "an", 0.065 ], [ "acid", 0.057 ] ], "target_token": "IBS", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 606, "unique_to_a": 755, "unique_to_b": 761 }, "clinical_mass": { "clinical": 0.3489, "patient": 0.2653 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260804T190615Z/index_53.html" }, { "index": 1428, "batch": "pairs_20260804T190615Z", "batch_index": 54, "clinical_prompt": "I've been experiencing cerumen impaction bilaterally, so I need to take an", "patient_prompt": "I've been getting these awful waxy buildup things in my ears that block my hearing, so I need to take an", "intended_target": "antihistamine", "rationale": "Patient lay description 'waxy buildup things' is replaced with clinical 'cerumen impaction'. The frame '...so I need to take an' funnels toward 'antihistamine' (or similar medical intervention) in clinical context versus home remedies colloquially.", "patient_term": "waxy buildup things in my ears that block my hearing", "clinical_term": "cerumen impaction bilaterally", "topic": "cerumen impaction", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": 0.075, "prob_patient": 0.221, "language_penalty": 0.14600000000000002, "anchor_fallback": false, "top_clinical": [ "ear", 0.181 ], "top_patient": [ "ear", 0.283 ], "spread_clinical": [ [ "ear", 0.181 ], [ "antibiotic", 0.097 ], [ "anti", 0.075 ], [ "oral", 0.066 ], [ "oil", 0.059 ] ], "spread_patient": [ [ "ear", 0.283 ], [ "antibiotic", 0.221 ], [ "anti", 0.152 ], [ "instrument", 0.03 ], [ "oral", 0.023 ] ], "target_token": "anti", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 571, "unique_to_a": 1010, "unique_to_b": 843 }, "clinical_mass": { "clinical": 0.3079, "patient": 0.2498 }, "urgency": { "flip_class": null, "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": 0.029 } }, "gemma-3-4b-it": { "prob_clinical": 0.0001, "prob_patient": 0.0024, "language_penalty": 0.0023, "anchor_fallback": false, "top_clinical": [ "ear", 0.513 ], "top_patient": [ "ear", 0.2811 ], "spread_clinical": [ [ "ear", 0.513 ], [ "ot", 0.1297 ], [ "active", 0.0541 ], [ "ENT", 0.0328 ], [ "olive", 0.0328 ], [ "oto", 0.0255 ], [ "irrigation", 0.0225 ], [ "appointment", 0.0199 ], [ "action", 0.0176 ], [ "approach", 0.0155 ] ], "spread_patient": [ [ "ear", 0.2811 ], [ "approach", 0.2189 ], [ "action", 0.1932 ], [ "appointment", 0.1705 ], [ "aggressive", 0.0296 ], [ "attempt", 0.0231 ], [ "earring", 0.0123 ], [ "active", 0.0096 ], [ "appropriate", 0.0085 ], [ "anti", 0.0058 ] ], "target_token": "antihist", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null }, "qwen3-4b": { "prob_clinical": 0.0514, "prob_patient": 0.0467, "language_penalty": -0.0047, "anchor_fallback": false, "top_clinical": [ "ear", 0.4876 ], "top_patient": [ "ear", 0.3911 ], "spread_clinical": [ [ "ear", 0.4876 ], [ "action", 0.1233 ], [ "ot", 0.096 ], [ "ant", 0.0514 ], [ "antibiotic", 0.0312 ], [ "active", 0.0275 ], [ "effective", 0.0214 ], [ "O", 0.0147 ], [ "approach", 0.0115 ], [ "over", 0.0115 ] ], "spread_patient": [ [ "ear", 0.3911 ], [ "action", 0.3046 ], [ "antibiotic", 0.068 ], [ "effective", 0.0529 ], [ "ant", 0.0467 ], [ "ice", 0.0221 ], [ "approach", 0.0195 ], [ "aspir", 0.0104 ], [ "ot", 0.0081 ], [ "oil", 0.0043 ] ], "target_token": "ant", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null }, "qwen3-1.7b": { "prob_clinical": 0.1205, "prob_patient": 0.0244, "language_penalty": -0.0961, "anchor_fallback": false, "top_clinical": [ "ear", 0.1987 ], "top_patient": [ "ear", 0.5552 ], "spread_clinical": [ [ "ear", 0.1987 ], [ "ot", 0.1754 ], [ "ant", 0.1205 ], [ "over", 0.0502 ], [ "audi", 0.0502 ], [ "ENT", 0.0345 ], [ "action", 0.0345 ], [ "exam", 0.0269 ], [ "x", 0.0237 ], [ "O", 0.0209 ] ], "spread_patient": [ [ "ear", 0.5552 ], [ "action", 0.1803 ], [ "audi", 0.0355 ], [ "ant", 0.0244 ], [ "over", 0.0215 ], [ "exam", 0.019 ], [ "approach", 0.0148 ], [ "x", 0.009 ], [ "appointment", 0.0062 ], [ "Ear", 0.0062 ] ], "target_token": "ant", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null } }, "prob_clinical": 0.075, "prob_patient": 0.221, "language_penalty": 0.14600000000000002, "flipped": false, "top_clinical": [ "ear", 0.181 ], "top_patient": [ "ear", 0.283 ], "spread_clinical": [ [ "ear", 0.181 ], [ "antibiotic", 0.097 ], [ "anti", 0.075 ], [ "oral", 0.066 ], [ "oil", 0.059 ] ], "spread_patient": [ [ "ear", 0.283 ], [ "antibiotic", 0.221 ], [ "anti", 0.152 ], [ "instrument", 0.03 ], [ "oral", 0.023 ] ], "target_token": "anti", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 571, "unique_to_a": 1010, "unique_to_b": 843 }, "clinical_mass": { "clinical": 0.3079, "patient": 0.2498 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260804T190615Z/index_54.html", "urgency": { "flip_class": null, "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": 0.029 } }, { "index": 1429, "batch": "pairs_20260804T190615Z", "batch_index": 55, "clinical_prompt": "I've been experiencing paresthesia triggered by anxiety, so my doctor says I might have", "patient_prompt": "I've been getting this weird prickling feeling all over my skin when I'm stressed, so my doctor says I might have", "intended_target": "neuropathy", "rationale": "Patient colloquialism 'weird prickling feeling' is replaced with clinical 'paresthesia'. The frame '...so my doctor says I might have' disambiguates toward a specific neurological or psychiatric diagnosis rather than stress-related muscle tension.", "patient_term": "weird prickling feeling all over my skin", "clinical_term": "paresthesia triggered by anxiety", "topic": "paresthesia", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": 0.27, "prob_patient": 0.183, "language_penalty": -0.08700000000000002, "anchor_fallback": true, "top_clinical": [ "a", 0.27 ], "top_patient": [ "a", 0.183 ], "spread_clinical": [ [ "a", 0.27 ], [ "some", 0.087 ], [ "an", 0.06 ], [ "P", 0.047 ], [ "vitamin", 0.032 ] ], "spread_patient": [ [ "a", 0.183 ], [ "some", 0.125 ], [ "an", 0.11 ], [ "ros", 0.036 ], [ "something", 0.028 ] ], "target_token": "a", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 824, "unique_to_a": 701, "unique_to_b": 739 }, "clinical_mass": { "clinical": 0.4225, "patient": 0.3647 } }, "gemma-3-4b-it": { "prob_clinical": 0.0048, "prob_patient": 0.0018, "language_penalty": -0.003, "anchor_fallback": false, "top_clinical": [ "a", 0.2616 ], "top_patient": [ "generalized", 0.6301 ], "spread_clinical": [ [ "a", 0.2616 ], [ "generalized", 0.2037 ], [ "anxiety", 0.1587 ], [ "Generalized", 0.0962 ], [ "peripheral", 0.0584 ], [ "panic", 0.0354 ], [ "small", 0.0354 ], [ "neuropath", 0.0243 ], [ "POT", 0.009 ], [ "some", 0.009 ] ], "spread_patient": [ [ "generalized", 0.6301 ], [ "Generalized", 0.0853 ], [ "a", 0.0586 ], [ "E", 0.0403 ], [ "hives", 0.0355 ], [ "cholinergic", 0.019 ], [ "neuropath", 0.0131 ], [ "nerve", 0.0079 ], [ "something", 0.0079 ], [ "tension", 0.007 ] ], "target_token": "neuropathy", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, "qwen3-4b": { "prob_clinical": 0.0076, "prob_patient": 0.0022, "language_penalty": -0.0054, "anchor_fallback": false, "top_clinical": [ "a", 0.4995 ], "top_patient": [ "a", 0.538 ], "spread_clinical": [ [ "a", 0.4995 ], [ "anxiety", 0.0676 ], [ "an", 0.0597 ], [ "fib", 0.0465 ], [ "hyp", 0.0465 ], [ "something", 0.0362 ], [ "peripheral", 0.0319 ], [ "multiple", 0.0194 ], [ "complex", 0.0133 ], [ "\"", 0.0133 ] ], "spread_patient": [ [ "a", 0.538 ], [ "something", 0.136 ], [ "an", 0.05 ], [ "anxiety", 0.0344 ], [ "\"", 0.0304 ], [ "hyper", 0.0304 ], [ "fib", 0.0209 ], [ "generalized", 0.0162 ], [ "some", 0.0162 ], [ "E", 0.0099 ] ], "target_token": "neurop", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null }, "qwen3-1.7b": { "prob_clinical": 0.0597, "prob_patient": 0.0255, "language_penalty": -0.0342, "anchor_fallback": false, "top_clinical": [ "a", 0.5667 ], "top_patient": [ "a", 0.5128 ], "spread_clinical": [ [ "a", 0.5667 ], [ "an", 0.0767 ], [ "neurop", 0.0597 ], [ "peripheral", 0.0411 ], [ "C", 0.032 ], [ "\"", 0.022 ], [ "multiple", 0.0194 ], [ "some", 0.0171 ], [ "something", 0.0151 ], [ "anxiety", 0.0092 ] ], "spread_patient": [ [ "a", 0.5128 ], [ "something", 0.1297 ], [ "an", 0.0891 ], [ "some", 0.0371 ], [ "neurop", 0.0255 ], [ "post", 0.0137 ], [ "multiple", 0.0106 ], [ "dermat", 0.0094 ], [ "ec", 0.0083 ], [ "C", 0.0083 ] ], "target_token": "neurop", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null } }, "prob_clinical": 0.27, "prob_patient": 0.183, "language_penalty": -0.08700000000000002, "flipped": false, "top_clinical": [ "a", 0.27 ], "top_patient": [ "a", 0.183 ], "spread_clinical": [ [ "a", 0.27 ], [ "some", 0.087 ], [ "an", 0.06 ], [ "P", 0.047 ], [ "vitamin", 0.032 ] ], "spread_patient": [ [ "a", 0.183 ], [ "some", 0.125 ], [ "an", 0.11 ], [ "ros", 0.036 ], [ "something", 0.028 ] ], "target_token": "a", "anchor_fallback": true, "screening": null, "circuit_diff": { "shared_features": 824, "unique_to_a": 701, "unique_to_b": 739 }, "clinical_mass": { "clinical": 0.4225, "patient": 0.3647 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260804T190615Z/index_55.html" }, { "index": 1430, "batch": "pairs_20260804T190615Z", "batch_index": 56, "clinical_prompt": "I have pleuritic chest pain on deep inspiration, so I need to take my", "patient_prompt": "I keep getting this sharp stabbing feeling when I breathe in deeply, so I need to take my", "intended_target": "medication", "rationale": "Patient uses symptom description; clinical version specifies pathophysiological mechanism. Frames completion toward medication class appropriate for inflammatory pain.", "patient_term": "sharp stabbing feeling when I breathe in deeply", "clinical_term": "pleuritic chest pain on deep inspiration", "topic": "pleurisy/pleuritic pain", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": 0.066, "prob_patient": null, "language_penalty": null, "anchor_fallback": false, "top_clinical": [ "pain", 0.085 ], "top_patient": [ "inhal", 0.196 ], "spread_clinical": [ [ "pain", 0.085 ], [ "inhal", 0.066 ], [ "medication", 0.066 ], [ "meds", 0.058 ], [ "breath", 0.04 ] ], "spread_patient": [ [ "inhal", 0.196 ], [ "breath", 0.173 ], [ "time", 0.082 ], [ "deep", 0.044 ], [ "asthma", 0.039 ] ], "target_token": "medication", "flipped": true, "screening": null, "circuit_diff": { "shared_features": 511, "unique_to_a": 906, "unique_to_b": 777 }, "clinical_mass": { "clinical": 0.4214, "patient": 0.2496 }, "urgency": { "flip_class": "lateral", "tier_top_clinical": 1, "tier_top_patient": 1, "tier_shift": 0.0 } }, "gemma-3-4b-it": { "prob_clinical": 0.1985, "prob_patient": 0.05, "language_penalty": -0.1485, "anchor_fallback": false, "top_clinical": [ "pain", 0.2249 ], "top_patient": [ "shirt", 0.6904 ], "spread_clinical": [ [ "pain", 0.2249 ], [ "medication", 0.1985 ], [ "chest", 0.1062 ], [ "medications", 0.0644 ], [ "medicine", 0.0443 ], [ "breathing", 0.0223 ], [ "precautions", 0.0197 ], [ "deep", 0.0163 ], [ "doctor", 0.0153 ], [ "anti", 0.0105 ] ], "spread_patient": [ [ "shirt", 0.6904 ], [ "medication", 0.05 ], [ "glasses", 0.0441 ], [ "inhal", 0.0344 ], [ "mask", 0.0236 ], [ "scarf", 0.0236 ], [ "sweater", 0.0184 ], [ "pain", 0.0126 ], [ "jacket", 0.0126 ], [ "asthma", 0.0098 ] ], "target_token": "medication", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "downgrade", "tier_top_clinical": 1, "tier_top_patient": 0, "tier_shift": -0.996 } }, "qwen3-4b": { "prob_clinical": 0.1057, "prob_patient": 0.0003, "language_penalty": -0.1054, "anchor_fallback": false, "top_clinical": [ "time", 0.1198 ], "top_patient": [ "breath", 0.695 ], "spread_clinical": [ [ "time", 0.1198 ], [ "prescribed", 0.1198 ], [ "medication", 0.1057 ], [ "temperature", 0.0683 ], [ "medicine", 0.0469 ], [ "medications", 0.0389 ], [ "ant", 0.0251 ], [ "pain", 0.0222 ], [ "blood", 0.0134 ] ], "spread_patient": [ [ "breath", 0.695 ], [ "time", 0.1757 ], [ "breathing", 0.0733 ], [ "oxygen", 0.0077 ], [ "nose", 0.005 ], [ "breathe", 0.0036 ], [ "deep", 0.0036 ], [ "inhal", 0.0034 ], [ "mouth", 0.003 ], [ "fingers", 0.0018 ] ], "target_token": "medication", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, "qwen3-1.7b": { "prob_clinical": 0.0919, "prob_patient": 0.0047, "language_penalty": -0.0872, "anchor_fallback": false, "top_clinical": [ "medication", 0.0919 ], "top_patient": [ "time", 0.62 ], "spread_clinical": [ [ "medication", 0.0919 ], [ "chest", 0.0811 ], [ "pulse", 0.0632 ], [ "medications", 0.0632 ], [ "ant", 0.0492 ], [ "pain", 0.0383 ], [ "oxygen", 0.0232 ], [ "medicine", 0.0232 ], [ "inhal", 0.0205 ], [ "temperature", 0.0205 ] ], "spread_patient": [ [ "time", 0.62 ], [ "breath", 0.0654 ], [ "breathing", 0.0654 ], [ "deep", 0.035 ], [ "lungs", 0.0272 ], [ "chest", 0.0165 ], [ "mind", 0.0114 ], [ "air", 0.01 ], [ "pulse", 0.01 ], [ "medicine", 0.01 ] ], "target_token": "medication", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": 1, "tier_top_patient": null, "tier_shift": null } } }, "prob_clinical": 0.066, "prob_patient": null, "language_penalty": null, "flipped": true, "top_clinical": [ "pain", 0.085 ], "top_patient": [ "inhal", 0.196 ], "spread_clinical": [ [ "pain", 0.085 ], [ "inhal", 0.066 ], [ "medication", 0.066 ], [ "meds", 0.058 ], [ "breath", 0.04 ] ], "spread_patient": [ [ "inhal", 0.196 ], [ "breath", 0.173 ], [ "time", 0.082 ], [ "deep", 0.044 ], [ "asthma", 0.039 ] ], "target_token": "medication", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 511, "unique_to_a": 906, "unique_to_b": 777 }, "clinical_mass": { "clinical": 0.4214, "patient": 0.2496 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260804T190615Z/index_56.html", "urgency": { "flip_class": "lateral", "tier_top_clinical": 1, "tier_top_patient": 1, "tier_shift": 0.0 } }, { "index": 1431, "batch": "pairs_20260804T190615Z", "batch_index": 57, "clinical_prompt": "My partner reports witnessed apneic episodes during sleep, so my doctor thinks I might have", "patient_prompt": "My partner says I've been snoring like a chainsaw at night, so my doctor thinks I might have", "intended_target": "sleep", "rationale": "Patient uses humorous colloquial description; 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Both frames end mid-sentence after 'some', leaving the next token as the probe. Clinical phrasing should trigger 'medicine' or similar therapeutic term; patient version might suggest everyday foods or remedies.", "patient_term": "really upset and running like a tap", "clinical_term": "diarrhea", "topic": "gastrointestinal", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": 0.088, "prob_patient": 0.101, "language_penalty": 0.013000000000000012, "anchor_fallback": false, "top_clinical": [ "Imo", 0.187 ], "top_patient": [ "Pep", 0.114 ], "spread_clinical": [ [ "Imo", 0.187 ], [ "probiotics", 0.1 ], [ "medicine", 0.088 ], [ "Pep", 0.053 ], [ "lax", 0.047 ] ], "spread_patient": [ [ "Pep", 0.114 ], [ "medicine", 0.101 ], [ "ant", 0.069 ], [ "Imo", 0.069 ], [ "time", 0.061 ] ], "target_token": "medicine", "flipped": true, "screening": null, "circuit_diff": { "shared_features": 624, "unique_to_a": 543, "unique_to_b": 760 }, "clinical_mass": { "clinical": 0.391, "patient": 0.3498 }, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": 0.0 } }, "gemma-3-4b-it": { "prob_clinical": 0.3101, "prob_patient": 0.0889, "language_penalty": -0.2212, "anchor_fallback": false, "top_clinical": [ "medication", 0.3101 ], "top_patient": [ "time", 0.3985 ], "spread_clinical": [ [ "medication", 0.3101 ], [ "medicine", 0.3101 ], [ "probiotics", 0.1881 ], [ "precautions", 0.037 ], [ "anti", 0.0255 ], [ "medications", 0.0154 ], [ "over", 0.0106 ], [ "ant", 0.005 ], [ "I", 0.0044 ], [ "antibiotics", 0.0044 ] ], "spread_patient": [ [ "time", 0.3985 ], [ "medication", 0.3104 ], [ "medicine", 0.0889 ], [ "ginger", 0.0198 ], [ "ant", 0.0136 ], [ "anti", 0.012 ], [ "Pe", 0.0083 ], [ "peppermint", 0.0064 ], [ "precautions", 0.0064 ], [ "digestive", 0.0057 ] ], "target_token": "medicine", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "downgrade", "tier_top_clinical": 1, "tier_top_patient": 0, "tier_shift": -0.496 } }, "qwen3-4b": { "prob_clinical": 0.1142, "prob_patient": 0.1702, "language_penalty": 0.056, "anchor_fallback": false, "top_clinical": [ "time", 0.3104 ], "top_patient": [ "time", 0.2806 ], "spread_clinical": [ [ "time", 0.3104 ], [ "medicine", 0.1142 ], [ "kind", 0.1008 ], [ "prob", 0.0889 ], [ "antibiotics", 0.0348 ], [ "medication", 0.0307 ], [ "anti", 0.0239 ], [ "steps", 0.0225 ], [ "over", 0.0198 ], [ "ant", 0.0136 ] ], "spread_patient": [ [ "time", 0.2806 ], [ "medicine", 0.1702 ], [ "kind", 0.0666 ], [ "anti", 0.0588 ], [ "ant", 0.0488 ], [ "medication", 0.0335 ], [ "meds", 0.0278 ], [ "pain", 0.0203 ], [ "over", 0.0191 ], [ "antibiotics", 0.0158 ] ], "target_token": "medicine", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": 0.0 } }, "qwen3-1.7b": { "prob_clinical": 0.0412, "prob_patient": 0.0345, "language_penalty": -0.0067, "anchor_fallback": false, "top_clinical": [ "prob", 0.2093 ], "top_patient": [ "time", 0.539 ], "spread_clinical": [ [ "prob", 0.2093 ], [ "kind", 0.112 ], [ "time", 0.077 ], [ "medication", 0.0467 ], [ "medicine", 0.0412 ], [ "sort", 0.0283 ], [ "ant", 0.0283 ], [ "lax", 0.0283 ], [ "O", 0.025 ], [ "antibiotics", 0.0221 ] ], "spread_patient": [ [ "time", 0.539 ], [ "pain", 0.0937 ], [ "medication", 0.0442 ], [ "medicine", 0.0345 ], [ "anti", 0.0237 ], [ "ant", 0.0237 ], [ "pills", 0.0163 ], [ "kind", 0.0144 ], [ "meds", 0.0099 ], [ "rest", 0.0068 ] ], "target_token": "medicine", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": 1, "tier_top_patient": null, "tier_shift": -0.027 } } }, "prob_clinical": 0.088, "prob_patient": 0.101, "language_penalty": 0.013000000000000012, "flipped": true, "top_clinical": [ "Imo", 0.187 ], "top_patient": [ "Pep", 0.114 ], "spread_clinical": [ [ "Imo", 0.187 ], [ "probiotics", 0.1 ], [ "medicine", 0.088 ], [ "Pep", 0.053 ], [ "lax", 0.047 ] ], "spread_patient": [ [ "Pep", 0.114 ], [ "medicine", 0.101 ], [ "ant", 0.069 ], [ "Imo", 0.069 ], [ "time", 0.061 ] ], "target_token": "medicine", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 624, "unique_to_a": 543, "unique_to_b": 760 }, "clinical_mass": { "clinical": 0.391, "patient": 0.3498 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260804T190615Z/index_63.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": 0.0 } }, { "index": 1436, "batch": "pairs_20260804T190615Z", "batch_index": 64, "clinical_prompt": "I have vertigo, so I might have", "patient_prompt": "I keep feeling like the room is spinning around when I move my head, so I might have", "intended_target": "an", "rationale": "Patient phrase describes dizziness colloquially; clinical term is the diagnosis. Frame ends after 'have', naturally followed by article 'an' in clinical reading ('have an [inner ear problem]' style continuation) or other nouns in patient reading. Clinical phrasing should trigger medical follow-ups.", "patient_term": "the room is spinning around when I move my head", "clinical_term": "vertigo", "topic": "vestibular", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": 0.281, "prob_patient": 0.09, "language_penalty": -0.19100000000000003, "anchor_fallback": true, "top_clinical": [ "to", 0.281 ], "top_patient": [ "a", 0.216 ], "spread_clinical": [ [ "to", 0.281 ], [ "a", 0.171 ], [ "been", 0.071 ], [ "missed", 0.055 ], [ "some", 0.049 ] ], "spread_patient": [ [ "a", 0.216 ], [ "vertigo", 0.168 ], [ "to", 0.09 ], [ "some", 0.08 ], [ "an", 0.038 ] ], "target_token": "to", "flipped": true, "screening": null, "circuit_diff": { "shared_features": 492, "unique_to_a": 543, "unique_to_b": 890 }, "clinical_mass": { "clinical": 0.12, "patient": 0.2909 }, "html": "modes/simulated/pairs_20260804T190615Z/index_64.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, "gemma-3-4b-it": { "prob_clinical": 0.0163, "prob_patient": 0.0199, "language_penalty": 0.0036, "anchor_fallback": false, "top_clinical": [ "to", 0.2556 ], "top_patient": [ "a", 0.2741 ], "spread_clinical": [ [ "to", 0.2556 ], [ "some", 0.1757 ], [ "a", 0.1757 ], [ "trouble", 0.155 ], [ "difficulty", 0.0503 ], [ "issues", 0.0444 ], [ "problems", 0.021 ], [ "an", 0.0163 ], [ "balance", 0.0144 ], [ "poor", 0.0053 ] ], "spread_patient": [ [ "a", 0.2741 ], [ "vertigo", 0.2741 ], [ "to", 0.1008 ], [ "something", 0.0693 ], [ "some", 0.0693 ], [ "Vert", 0.0289 ], [ "an", 0.0199 ], [ "Vest", 0.0199 ], [ "dizziness", 0.0199 ], [ "vestibular", 0.0155 ] ], "target_token": "an", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, "qwen3-4b": { "prob_clinical": 0.0327, "prob_patient": 0.0195, "language_penalty": -0.0132, "anchor_fallback": false, "top_clinical": [ "to", 0.5788 ], "top_patient": [ "a", 0.3457 ], "spread_clinical": [ [ "to", 0.5788 ], [ "a", 0.2413 ], [ "an", 0.0327 ], [ "B", 0.0175 ], [ "been", 0.012 ], [ "M\u00e9", 0.0106 ], [ "Men", 0.0106 ], [ "something", 0.0094 ], [ "had", 0.0083 ], [ "some", 0.0073 ] ], "spread_patient": [ [ "a", 0.3457 ], [ "B", 0.2097 ], [ "vert", 0.185 ], [ "motion", 0.099 ], [ "something", 0.0413 ], [ "benign", 0.0364 ], [ "an", 0.0195 ], [ "Men", 0.0081 ], [ "M\u00e9", 0.0072 ], [ "Ben", 0.0049 ] ], "target_token": "an", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, "qwen3-1.7b": { "prob_clinical": 0.096, "prob_patient": 0.0063, "language_penalty": -0.0897, "anchor_fallback": false, "top_clinical": [ "a", 0.5526 ], "top_patient": [ "a", 0.4967 ], "spread_clinical": [ [ "a", 0.5526 ], [ "an", 0.096 ], [ "to", 0.0454 ], [ "been", 0.04 ], [ "some", 0.0312 ], [ "had", 0.0147 ], [ "issues", 0.0147 ], [ "something", 0.0147 ], [ "problems", 0.013 ], [ "the", 0.013 ] ], "spread_patient": [ [ "a", 0.4967 ], [ "vert", 0.2346 ], [ "benign", 0.1108 ], [ "something", 0.0462 ], [ "to", 0.0218 ], [ "Ben", 0.0218 ], [ "some", 0.0117 ], [ "vestib", 0.0103 ], [ "an", 0.0063 ], [ "B", 0.0055 ] ], "target_token": "an", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null } }, "prob_clinical": 0.281, "prob_patient": 0.09, "language_penalty": -0.19100000000000003, "flipped": true, "top_clinical": [ "to", 0.281 ], "top_patient": [ "a", 0.216 ], "spread_clinical": [ [ "to", 0.281 ], [ "a", 0.171 ], [ "been", 0.071 ], [ "missed", 0.055 ], [ "some", 0.049 ] ], "spread_patient": [ [ "a", 0.216 ], [ "vertigo", 0.168 ], [ "to", 0.09 ], [ "some", 0.08 ], [ "an", 0.038 ] ], "target_token": "to", "anchor_fallback": true, "screening": null, "circuit_diff": { "shared_features": 492, "unique_to_a": 543, "unique_to_b": 890 }, "clinical_mass": { "clinical": 0.12, "patient": 0.2909 }, "html": "modes/simulated/pairs_20260804T190615Z/index_64.html", "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260804T190615Z/index_64.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, { "index": 1437, "batch": "pairs_20260804T190615Z", "batch_index": 65, "clinical_prompt": "I have herpes, so I should take an", "patient_prompt": "My skin's been all red and angry with fluid-filled bumps, so I should take an", "intended_target": "antiviral", "rationale": "Patient phrase is descriptive lay characterization of lesions; clinical term is the diagnosis. Frame ends after 'an', naturally preceding a treatment noun. Clinical version should trigger 'antiviral' or similar medication class; patient version might suggest topical cream or general remedy.", "patient_term": "all red and angry with fluid-filled bumps", "clinical_term": "herpes", "topic": "dermatological", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": 0.453, "prob_patient": 0.451, "language_penalty": -0.0020000000000000018, "anchor_fallback": false, "top_clinical": [ "antiviral", 0.453 ], "top_patient": [ "anti", 0.451 ], "spread_clinical": [ [ "antiviral", 0.453 ], [ "anti", 0.114 ], [ "antibiotic", 0.069 ], [ "HIV", 0.054 ], [ "oral", 0.033 ] ], "spread_patient": [ [ "anti", 0.451 ], [ "antibiotic", 0.166 ], [ "allergy", 0.089 ], [ "aspirin", 0.029 ], [ "over", 0.022 ] ], "target_token": "antiviral", "flipped": true, "screening": null, "circuit_diff": { "shared_features": 457, "unique_to_a": 584, "unique_to_b": 728 }, "clinical_mass": { "clinical": 0.351, "patient": 0.3054 }, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": 1, "tier_shift": null } }, "gemma-3-4b-it": { "prob_clinical": 0.95, "prob_patient": 0.0012, "language_penalty": -0.9488, "anchor_fallback": false, "top_clinical": [ "antiviral", 0.95 ], "top_patient": [ "antihist", 0.8207 ], "spread_clinical": [ [ "antiviral", 0.95 ], [ "anti", 0.0253 ], [ "antivirus", 0.0056 ], [ "antiv", 0.0024 ], [ "oral", 0.0018 ], [ "SSR", 0.0011 ], [ "HIV", 0.0011 ], [ "antibiotic", 0.001 ], [ "antidepressant", 0.0009 ], [ "action", 0.0008 ] ], "spread_patient": [ [ "antihist", 0.8207 ], [ "antibiotic", 0.0409 ], [ "action", 0.0318 ], [ "anti", 0.0281 ], [ "allergy", 0.0219 ], [ "immediate", 0.0117 ], [ "oral", 0.008 ], [ "allergic", 0.0049 ], [ "appointment", 0.0049 ], [ "ant", 0.003 ] ], "target_token": "antiviral", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": 1, "tier_top_patient": null, "tier_shift": null } }, "qwen3-4b": { "prob_clinical": 0.8368, "prob_patient": 0.391, "language_penalty": -0.4458, "anchor_fallback": false, "top_clinical": [ "ant", 0.8368 ], "top_patient": [ "ant", 0.391 ], "spread_clinical": [ [ "ant", 0.8368 ], [ "antibiotic", 0.0687 ], [ "anti", 0.0286 ], [ "extra", 0.0174 ], [ "oral", 0.0119 ], [ "abolic", 0.0064 ], [ "HIV", 0.003 ], [ "effective", 0.0021 ], [ "ab", 0.0019 ], [ "O", 0.0015 ] ], "spread_patient": [ [ "ant", 0.391 ], [ "antibiotic", 0.3045 ], [ "anti", 0.1438 ], [ "over", 0.0679 ], [ "oral", 0.0529 ], [ "O", 0.0092 ], [ "o", 0.0049 ], [ "allergy", 0.0034 ], [ "antib", 0.0026 ], [ "oat", 0.0016 ] ], "target_token": "ant", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 1, "tier_top_patient": 1, "tier_shift": 0.259 } }, "qwen3-1.7b": { "prob_clinical": 0.8536, "prob_patient": 0.6886, "language_penalty": -0.165, "anchor_fallback": false, "top_clinical": [ "ant", 0.8536 ], "top_patient": [ "ant", 0.6886 ], "spread_clinical": [ [ "ant", 0.8536 ], [ "HIV", 0.0292 ], [ "antibiotic", 0.0227 ], [ "anti", 0.0138 ], [ "extra", 0.0095 ], [ "O", 0.0051 ], [ "o", 0.0051 ], [ "oral", 0.004 ], [ "action", 0.0031 ], [ "enzyme", 0.0031 ] ], "spread_patient": [ [ "ant", 0.6886 ], [ "antibiotic", 0.0565 ], [ "anti", 0.0565 ], [ "allergy", 0.044 ], [ "over", 0.044 ], [ "acne", 0.006 ], [ "action", 0.0053 ], [ "acid", 0.0041 ], [ "X", 0.0041 ], [ "E", 0.0036 ] ], "target_token": "ant", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 1, "tier_top_patient": 1, "tier_shift": 0.057 } } }, "prob_clinical": 0.453, "prob_patient": 0.451, "language_penalty": -0.0020000000000000018, "flipped": true, "top_clinical": [ "antiviral", 0.453 ], "top_patient": [ "anti", 0.451 ], "spread_clinical": [ [ "antiviral", 0.453 ], [ "anti", 0.114 ], [ "antibiotic", 0.069 ], [ "HIV", 0.054 ], [ "oral", 0.033 ] ], "spread_patient": [ [ "anti", 0.451 ], [ "antibiotic", 0.166 ], [ "allergy", 0.089 ], [ "aspirin", 0.029 ], [ "over", 0.022 ] ], "target_token": "antiviral", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 457, "unique_to_a": 584, "unique_to_b": 728 }, "clinical_mass": { "clinical": 0.351, "patient": 0.3054 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260804T190615Z/index_65.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": 1, "tier_shift": null } }, { "index": 1438, "batch": "pairs_20260804T190615Z", "batch_index": 66, "clinical_prompt": "I have tremor and my hands keep trembling, so I might need to take my", "patient_prompt": "I've been feeling all shaky and my hands keep trembling, so I might need to take my", "intended_target": "medication", "rationale": "Colloquial 'all shaky' is vague and suggests general anxiety or cold; clinical 'tremor' narrows to a specific neurological symptom requiring medication management rather than reassurance.", "patient_term": "all shaky", "clinical_term": "tremor", "topic": "neurological", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": 0.051, "prob_patient": 0.179, "language_penalty": 0.128, "anchor_fallback": false, "top_clinical": [ "hand", 0.109 ], "top_patient": [ "meds", 0.379 ], "spread_clinical": [ [ "hand", 0.109 ], [ "hands", 0.109 ], [ "phone", 0.096 ], [ "meds", 0.066 ], [ "medication", 0.051 ] ], "spread_patient": [ [ "meds", 0.379 ], [ "medication", 0.179 ], [ "medicine", 0.096 ], [ "pills", 0.035 ], [ "anxiety", 0.021 ] ], "target_token": "medication", "flipped": true, "screening": null, "circuit_diff": { "shared_features": 796, "unique_to_a": 489, "unique_to_b": 491 }, "clinical_mass": { "clinical": 0.2417, "patient": 0.2338 }, "html": "modes/simulated/pairs_20260804T190615Z/index_66.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": 1, "tier_shift": 0.451 } }, "gemma-3-4b-it": { "prob_clinical": 0.0123, "prob_patient": 0.5702, "language_penalty": 0.5579, "anchor_fallback": false, "top_clinical": [ "time", 0.2465 ], "top_patient": [ "medication", 0.5702 ], "spread_clinical": [ [ "time", 0.2465 ], [ "hands", 0.1027 ], [ "plate", 0.0485 ], [ "hand", 0.0428 ], [ "food", 0.0428 ], [ "coffee", 0.0334 ], [ "glasses", 0.0334 ], [ "phone", 0.0294 ], [ "cup", 0.0215 ], [ "drink", 0.019 ] ], "spread_patient": [ [ "medication", 0.5702 ], [ "blood", 0.1442 ], [ "anxiety", 0.0601 ], [ "meds", 0.0413 ], [ "medicine", 0.0413 ], [ "medications", 0.0221 ], [ "heart", 0.0152 ], [ "dosage", 0.0118 ], [ "prescription", 0.0118 ], [ "thyroid", 0.0081 ] ], "target_token": "medication", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": 1, "tier_shift": null } }, "qwen3-4b": { "prob_clinical": 0.2778, "prob_patient": 0.4877, "language_penalty": 0.2099, "anchor_fallback": false, "top_clinical": [ "medication", 0.2778 ], "top_patient": [ "medication", 0.4877 ], "spread_clinical": [ [ "medication", 0.2778 ], [ "phone", 0.2163 ], [ "glasses", 0.1312 ], [ "hands", 0.0702 ], [ "medicine", 0.0547 ], [ "tablet", 0.0426 ], [ "medications", 0.0228 ], [ "pills", 0.0201 ], [ "pill", 0.0201 ], [ "prescribed", 0.0095 ] ], "spread_patient": [ [ "medication", 0.4877 ], [ "medicine", 0.1583 ], [ "meds", 0.04 ], [ "medications", 0.0376 ], [ "hands", 0.0189 ], [ "pills", 0.0189 ], [ "time", 0.0167 ], [ "pill", 0.0157 ], [ "glasses", 0.0122 ], [ "tablet", 0.0095 ] ], "target_token": "medication", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 1, "tier_top_patient": 1, "tier_shift": 0.311 } }, "qwen3-1.7b": { "prob_clinical": 0.1538, "prob_patient": 0.2622, "language_penalty": 0.1084, "anchor_fallback": false, "top_clinical": [ "medication", 0.1538 ], "top_patient": [ "medication", 0.2622 ], "spread_clinical": [ [ "medication", 0.1538 ], [ "hands", 0.1198 ], [ "time", 0.0823 ], [ "medicine", 0.0726 ], [ "medications", 0.0566 ], [ "phone", 0.0343 ], [ "hand", 0.0303 ], [ "car", 0.0208 ], [ "own", 0.0208 ], [ "pills", 0.0126 ] ], "spread_patient": [ [ "medication", 0.2622 ], [ "blood", 0.1238 ], [ "medications", 0.0964 ], [ "medicine", 0.0456 ], [ "pulse", 0.0402 ], [ "vitamin", 0.0313 ], [ "time", 0.0244 ], [ "heart", 0.0215 ], [ "potassium", 0.0168 ], [ "ant", 0.0168 ] ], "target_token": "medication", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 1, "tier_top_patient": 1, "tier_shift": 0.319 } } }, "prob_clinical": 0.051, "prob_patient": 0.179, "language_penalty": 0.128, "flipped": true, "top_clinical": [ "hand", 0.109 ], "top_patient": [ "meds", 0.379 ], "spread_clinical": [ [ "hand", 0.109 ], [ "hands", 0.109 ], [ "phone", 0.096 ], [ "meds", 0.066 ], [ "medication", 0.051 ] ], "spread_patient": [ [ "meds", 0.379 ], [ "medication", 0.179 ], [ "medicine", 0.096 ], [ "pills", 0.035 ], [ "anxiety", 0.021 ] ], "target_token": "medication", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 796, "unique_to_a": 489, "unique_to_b": 491 }, "clinical_mass": { "clinical": 0.2417, "patient": 0.2338 }, "html": "modes/simulated/pairs_20260804T190615Z/index_66.html", "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260804T190615Z/index_66.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": 1, "tier_shift": 0.451 } }, { "index": 1439, "batch": "pairs_20260804T190615Z", "batch_index": 68, "clinical_prompt": "When I stand up after sitting, I get orthostatic hypotension, so I should probably see a", "patient_prompt": "When I stand up after sitting, everything goes dark for a moment, so I should probably see a", "intended_target": "cardiologist", "rationale": "Colloquial phrasing suggests harmless dizziness; clinical term names a cardiovascular condition warranting specialist assessment.", "patient_term": "everything goes dark for a moment", "clinical_term": "orthostatic hypotension", "topic": "cardiovascular", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": 0.086, "prob_patient": null, "language_penalty": null, "anchor_fallback": false, "top_clinical": [ "doctor", 0.562 ], "top_patient": [ "doctor", 0.734 ], "spread_clinical": [ [ "doctor", 0.562 ], [ "neuro", 0.126 ], [ "cardio", 0.086 ], [ "doc", 0.059 ], [ "physician", 0.022 ] ], "spread_patient": [ [ "doctor", 0.734 ], [ "neuro", 0.145 ], [ "specialist", 0.025 ], [ "doc", 0.017 ], [ "Doctor", 0.008 ] ], "target_token": "cardio", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 689, "unique_to_a": 534, "unique_to_b": 520 }, "clinical_mass": { "clinical": 0.3872, "patient": 0.2746 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0.0133, "language_penalty": -0.0391, "anchor_fallback": false, "top_clinical": [ "doctor", 0.8198 ], "top_patient": [ "doctor", 0.8234 ], "spread_clinical": [ [ "doctor", 0.8198 ], [ "cardi", 0.0524 ], [ "specialist", 0.036 ], [ "physician", 0.0218 ], [ "neuro", 0.0133 ], [ "phys", 0.0103 ], [ "healthcare", 0.0055 ], [ "nurse", 0.0055 ], [ "therapist", 0.0043 ], [ "hemat", 0.002 ] ], "spread_patient": [ [ "doctor", 0.8234 ], [ "neuro", 0.0766 ], [ "cardi", 0.0133 ], [ "specialist", 0.0104 ], [ "physician", 0.0081 ], [ "nurse", 0.0071 ], [ "phys", 0.0063 ], [ "medical", 0.0038 ], [ "different", 0.0023 ], [ "physical", 0.002 ] ], "target_token": "cardi", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": 0.034 } } }, "prob_clinical": 0.086, "prob_patient": null, "language_penalty": null, "flipped": false, "top_clinical": [ "doctor", 0.562 ], "top_patient": [ 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for painful urination. The frame funnels toward 'doctor' as the natural care-seeking continuation in the clinical phrasing, while the patient phrasing might prompt more colloquial responses like 'pharmacist' or 'clinic'. The grammar (article + noun) strongly favors a healthcare provider word.", "patient_term": "awful burning feeling when I pee", "clinical_term": "dysuria", "topic": "urinary tract infection", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": 0.254, "prob_patient": 0.539, "language_penalty": 0.28500000000000003, "anchor_fallback": false, "top_clinical": [ "uro", 0.418 ], "top_patient": [ "doctor", 0.539 ], "spread_clinical": [ [ "uro", 0.418 ], [ "doctor", 0.254 ], [ "specialist", 0.073 ], [ "Uro", 0.064 ], [ "doc", 0.03 ] ], "spread_patient": [ [ "doctor", 0.539 ], [ "uro", 0.155 ], [ "doc", 0.057 ], [ "Dr", 0.044 ], [ "specialist", 0.031 ] ], "target_token": "doctor", "flipped": true, "screening": null, "circuit_diff": { "shared_features": 565, "unique_to_a": 709, "unique_to_b": 694 }, "clinical_mass": { "clinical": 0.4573, "patient": 0.3827 }, "html": "modes/simulated/pairs_20260804T190615Z/index_69.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": 2, "tier_shift": -0.158 } }, "gemma-3-4b-it": { "prob_clinical": 0.773, "prob_patient": 0.8927, "language_penalty": 0.1197, "anchor_fallback": false, "top_clinical": [ "doctor", 0.773 ], "top_patient": [ "doctor", 0.8927 ], "spread_clinical": [ [ "doctor", 0.773 ], [ "u", 0.1522 ], [ "physician", 0.0142 ], [ "healthcare", 0.011 ], [ "medical", 0.011 ], [ "specialist", 0.0067 ], [ "U", 0.0052 ], [ "Doctor", 0.0032 ], [ "professional", 0.0026 ], [ "health", 0.0022 ] ], "spread_patient": [ [ "doctor", 0.8927 ], [ "u", 0.0941 ], [ "Doctor", 0.0017 ], [ "professional", 0.0015 ], [ "doc", 0.0015 ], [ "healthcare", 0.0013 ], [ "medical", 0.0012 ], [ "gynec", 0.0009 ], [ "U", 0.0008 ], [ "Dr", 0.0008 ] ], "target_token": "doctor", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.008 } }, "qwen3-4b": { "prob_clinical": 0.5665, "prob_patient": 0.9295, "language_penalty": 0.363, "anchor_fallback": false, "top_clinical": [ "doctor", 0.5665 ], "top_patient": [ "doctor", 0.9295 ], "spread_clinical": [ [ "doctor", 0.5665 ], [ "u", 0.3436 ], [ "specialist", 0.0527 ], [ "g", 0.0118 ], [ "physician", 0.0049 ], [ "provider", 0.0043 ], [ "healthcare", 0.003 ], [ "U", 0.002 ], [ "GP", 0.001 ], [ "professional", 0.0007 ] ], "spread_patient": [ [ "doctor", 0.9295 ], [ "u", 0.0594 ], [ "specialist", 0.0038 ], [ "physician", 0.0011 ], [ "healthcare", 0.0008 ], [ "doc", 0.0005 ], [ "g", 0.0005 ], [ "Doctor", 0.0005 ], [ "dermat", 0.0005 ], [ "health", 0.0003 ] ], "target_token": "doctor", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.08 } }, "qwen3-1.7b": { "prob_clinical": 0.5493, "prob_patient": 0.9075, "language_penalty": 0.3582, "anchor_fallback": false, "top_clinical": [ "doctor", 0.5493 ], "top_patient": [ "doctor", 0.9075 ], "spread_clinical": [ [ "doctor", 0.5493 ], [ "u", 0.4278 ], [ "physician", 0.0078 ], [ "specialist", 0.0037 ], [ "healthcare", 0.0025 ], [ "GP", 0.002 ], [ "g", 0.0011 ], [ "medical", 0.0007 ], [ "pediatric", 0.0006 ], [ "neph", 0.0005 ] ], "spread_patient": [ [ "doctor", 0.9075 ], [ "u", 0.0844 ], [ "doc", 0.0011 ], [ "GP", 0.0011 ], [ "physician", 0.0011 ], [ "Doctor", 0.0009 ], [ "nurse", 0.0004 ], [ "Dr", 0.0004 ], [ "specialist", 0.0004 ], [ "healthcare", 0.0003 ] ], "target_token": "doctor", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.006 } } }, "prob_clinical": 0.254, "prob_patient": 0.539, "language_penalty": 0.28500000000000003, "flipped": true, "top_clinical": [ "uro", 0.418 ], "top_patient": [ "doctor", 0.539 ], "spread_clinical": [ [ "uro", 0.418 ], [ "doctor", 0.254 ], [ "specialist", 0.073 ], [ "Uro", 0.064 ], [ "doc", 0.03 ] ], "spread_patient": [ [ "doctor", 0.539 ], [ "uro", 0.155 ], [ "doc", 0.057 ], [ "Dr", 0.044 ], [ "specialist", 0.031 ] ], "target_token": "doctor", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 565, "unique_to_a": 709, "unique_to_b": 694 }, "clinical_mass": { "clinical": 0.4573, "patient": 0.3827 }, "html": "modes/simulated/pairs_20260804T190615Z/index_69.html", "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260804T190615Z/index_69.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": 2, "tier_shift": -0.158 } }, { "index": 1441, "batch": "pairs_20260804T190615Z", "batch_index": 70, "clinical_prompt": "I've been getting petechiae all over my legs that won't fade, so my doctor thinks I might have", "patient_prompt": "I've been getting these awful purple marks all over my legs that won't fade, so my doctor thinks I might have", "intended_target": "thrombocytopenia", "rationale": "Petechiae are pinpoint hemorrhages; thrombocytopenia is a specific hematologic diagnosis. The clinical term signals a more specific differential diagnosis, whereas the colloquial term might suggest bruising or sun damage. The frame probes which diagnostic direction the model takes.", "patient_term": "awful purple marks", "clinical_term": "petechiae", "topic": "bleeding disorder", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": 0.077, "prob_patient": null, "language_penalty": null, "anchor_fallback": false, "top_clinical": [ "a", 0.164 ], "top_patient": [ "ros", 0.148 ], "spread_clinical": [ [ "a", 0.164 ], [ "some", 0.128 ], [ "lupus", 0.113 ], [ "thromb", 0.077 ], [ "an", 0.077 ] ], "spread_patient": [ [ "ros", 0.148 ], [ "a", 0.148 ], [ "some", 0.102 ], [ "viti", 0.062 ], [ "lupus", 0.042 ] ], "target_token": "thromb", "flipped": true, "screening": null, "circuit_diff": { "shared_features": 947, "unique_to_a": 677, "unique_to_b": 617 }, "clinical_mass": { "clinical": 0.3825, "patient": 0.3733 }, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, "gemma-3-4b-it": { "prob_clinical": 0.0563, "prob_patient": 0.0001, "language_penalty": -0.0562, "anchor_fallback": false, "top_clinical": [ "a", 0.8803 ], "top_patient": [ "vascul", 0.3749 ], "spread_clinical": [ [ "a", 0.8803 ], [ "thrombocyt", 0.0563 ], [ "low", 0.0142 ], [ "some", 0.0086 ], [ "capillary", 0.0046 ], [ "vascul", 0.0046 ], [ "an", 0.0028 ], [ "something", 0.0022 ], [ "small", 0.0022 ], [ "HE", 0.0017 ] ], "spread_patient": [ [ "vascul", 0.3749 ], [ "a", 0.3308 ], [ "lupus", 0.0507 ], [ "photos", 0.0507 ], [ "some", 0.0308 ], [ "vit", 0.0187 ], [ "lichen", 0.0113 ], [ "Hen", 0.0088 ], [ "phyt", 0.0078 ], [ "purple", 0.0069 ] ], "target_token": "thrombocyt", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, "qwen3-4b": { "prob_clinical": 0.0068, "prob_patient": 0.0039, "language_penalty": -0.0029, "anchor_fallback": false, "top_clinical": [ "a", 0.4785 ], "top_patient": [ "pur", 0.3739 ], "spread_clinical": [ [ "a", 0.4785 ], [ "something", 0.2561 ], [ "an", 0.0504 ], [ "blood", 0.027 ], [ "hem", 0.021 ], [ "some", 0.0186 ], [ "leukemia", 0.0113 ], [ "HIV", 0.0113 ], [ "lup", 0.0099 ], [ "hepatitis", 0.0068 ] ], "spread_patient": [ [ "pur", 0.3739 ], [ "a", 0.2912 ], [ "something", 0.0945 ], [ "purple", 0.0573 ], [ "hem", 0.0271 ], [ "Pur", 0.0239 ], [ "some", 0.0239 ], [ "spider", 0.0128 ], [ "an", 0.0088 ], [ "PUR", 0.0047 ] ], "target_token": "throm", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": 2, "tier_top_patient": null, "tier_shift": 0.0 } }, "qwen3-1.7b": { "prob_clinical": 0.0737, "prob_patient": 0.0002, "language_penalty": -0.0735, "anchor_fallback": false, "top_clinical": [ "a", 0.4242 ], "top_patient": [ "a", 0.5054 ], "spread_clinical": [ [ "a", 0.4242 ], [ "something", 0.0946 ], [ "throm", 0.0737 ], [ "an", 0.0737 ], [ "hem", 0.0507 ], [ "some", 0.0395 ], [ "leukemia", 0.0239 ], [ "I", 0.0239 ], [ "lup", 0.0186 ], [ "vas", 0.0164 ] ], "spread_patient": [ [ "a", 0.5054 ], [ "ec", 0.1859 ], [ "something", 0.0533 ], [ "some", 0.0366 ], [ "an", 0.0285 ], [ "ps", 0.0252 ], [ "been", 0.0082 ], [ "l", 0.0082 ], [ "purple", 0.0064 ], [ "mel", 0.0064 ] ], "target_token": "throm", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null } }, "prob_clinical": 0.077, "prob_patient": null, "language_penalty": null, "flipped": true, "top_clinical": [ "a", 0.164 ], "top_patient": [ "ros", 0.148 ], "spread_clinical": [ [ "a", 0.164 ], [ "some", 0.128 ], [ "lupus", 0.113 ], [ "thromb", 0.077 ], [ "an", 0.077 ] ], "spread_patient": [ [ "ros", 0.148 ], [ "a", 0.148 ], [ "some", 0.102 ], [ "viti", 0.062 ], [ "lupus", 0.042 ] ], "target_token": "thromb", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 947, "unique_to_a": 677, "unique_to_b": 617 }, "clinical_mass": { "clinical": 0.3825, "patient": 0.3733 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260804T190615Z/index_70.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, { "index": 1442, "batch": "pairs_20260804T190615Z", "batch_index": 71, "clinical_prompt": "I've been experiencing amnesia and can't remember what I just did, so I'm worried I might have", "patient_prompt": "I've been feeling all foggy and can't remember what I just did, so I'm worried I might have", "intended_target": "dementia", "rationale": "Amnesia is the clinical term for memory loss; dementia is a key differential when paired with that term. The colloquial phrasing might lead the model toward stress or fatigue explanations. The frame probes whether clinical language shifts the diagnostic hypothesis.", "patient_term": "feeling all foggy and can't remember", "clinical_term": "experiencing amnesia", "topic": "memory disorder", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": 0.183, "prob_patient": 0.134, "language_penalty": -0.04899999999999999, "anchor_fallback": true, "top_clinical": [ "a", 0.183 ], "top_patient": [ "a", 0.134 ], "spread_clinical": [ [ "a", 0.183 ], [ "been", 0.076 ], [ "forgotten", 0.067 ], [ "done", 0.067 ], [ "some", 0.041 ] ], "spread_patient": [ [ "a", 0.134 ], [ "done", 0.104 ], [ "forgotten", 0.092 ], [ "been", 0.063 ], [ "made", 0.043 ] ], "target_token": "a", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 1145, "unique_to_a": 369, "unique_to_b": 390 }, "clinical_mass": { "clinical": 0.1751, "patient": 0.1351 } }, "gemma-3-4b-it": { "prob_clinical": 0.0151, "prob_patient": 0.0226, "language_penalty": 0.0075, "anchor_fallback": false, "top_clinical": [ "a", 0.5011 ], "top_patient": [ "a", 0.3541 ], "spread_clinical": [ [ "a", 0.5011 ], [ "lost", 0.0871 ], [ "some", 0.0598 ], [ "forgotten", 0.0466 ], [ "done", 0.0466 ], [ "something", 0.0466 ], [ "an", 0.0194 ], [ "dementia", 0.0151 ], [ "to", 0.0151 ], [ "memory", 0.0134 ] ], "spread_patient": [ [ "a", 0.3541 ], [ "early", 0.2148 ], [ "some", 0.1476 ], [ "ADHD", 0.1014 ], [ "something", 0.0697 ], [ "memory", 0.0329 ], [ "dementia", 0.0226 ], [ "an", 0.0065 ], [ "brain", 0.0045 ], [ "conc", 0.0045 ] ], "target_token": "dementia", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null }, "qwen3-4b": { "prob_clinical": 0.0052, "prob_patient": 0.0014, "language_penalty": -0.0038, "anchor_fallback": false, "top_clinical": [ "a", 0.6049 ], "top_patient": [ "done", 0.4562 ], "spread_clinical": [ [ "a", 0.6049 ], [ "done", 0.1191 ], [ "an", 0.0438 ], [ "made", 0.0266 ], [ "been", 0.0235 ], [ "something", 0.0183 ], [ "had", 0.0183 ], [ "committed", 0.0142 ], [ "forgotten", 0.0118 ], [ "some", 0.0076 ] ], "spread_patient": [ [ "done", 0.4562 ], [ "a", 0.1481 ], [ "made", 0.1481 ], [ "been", 0.0257 ], [ "something", 0.02 ], [ "messed", 0.0177 ], [ "forgotten", 0.0156 ], [ "an", 0.0147 ], [ "hurt", 0.0122 ], [ "had", 0.0089 ] ], "target_token": "dementia", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, "qwen3-1.7b": { "prob_clinical": 0.0159, "prob_patient": 0.0044, "language_penalty": -0.0115, "anchor_fallback": false, "top_clinical": [ "a", 0.6774 ], "top_patient": [ "a", 0.58 ], "spread_clinical": [ [ "a", 0.6774 ], [ "an", 0.0714 ], [ "lost", 0.0337 ], [ "done", 0.0337 ], [ "Alzheimer", 0.0337 ], [ "been", 0.0232 ], [ "had", 0.0181 ], [ "dementia", 0.0159 ], [ "some", 0.0159 ], [ "brain", 0.0085 ] ], "spread_patient": [ [ "a", 0.58 ], [ "an", 0.1008 ], [ "done", 0.0785 ], [ "had", 0.0693 ], [ "some", 0.0327 ], [ "something", 0.0198 ], [ "forgotten", 0.0083 ], [ "missed", 0.0083 ], [ "Alzheimer", 0.0073 ], [ "made", 0.0064 ] ], "target_token": "dementia", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null } }, "prob_clinical": 0.183, "prob_patient": 0.134, "language_penalty": -0.04899999999999999, "flipped": false, "top_clinical": [ "a", 0.183 ], "top_patient": [ "a", 0.134 ], "spread_clinical": [ [ "a", 0.183 ], [ "been", 0.076 ], [ "forgotten", 0.067 ], [ "done", 0.067 ], [ "some", 0.041 ] ], "spread_patient": [ [ "a", 0.134 ], [ "done", 0.104 ], [ "forgotten", 0.092 ], [ "been", 0.063 ], [ "made", 0.043 ] ], "target_token": "a", "anchor_fallback": true, "screening": null, "circuit_diff": { "shared_features": 1145, "unique_to_a": 369, "unique_to_b": 390 }, "clinical_mass": { "clinical": 0.1751, "patient": 0.1351 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260804T190615Z/index_71.html" }, { "index": 1443, "batch": "pairs_20260804T190615Z", "batch_index": 72, "clinical_prompt": "I have carpal tunnel syndrome when I work at my desk, so I should probably see a", "patient_prompt": "My fingers keep going all numb and tingly when I work at my desk, so I should probably see a", "intended_target": "specialist", "rationale": "Lay description of nerve compression versus formal diagnosis. Clinical framing triggers expectation of specialist intervention rather than a generalist. 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Clinical phrasing makes targeted pharmaceutical intervention (antihistamine) a more likely continuation than a broad remedy. Article 'an' before vowel-initial word steers the probe.", "patient_term": "awful red, weepy patches", "clinical_term": "eczema flare-ups", "topic": "dermatological", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": 0.4, "prob_patient": 0.416, "language_penalty": 0.01599999999999996, "anchor_fallback": false, "top_clinical": [ "anti", 0.4 ], "top_patient": [ "anti", 0.416 ], "spread_clinical": [ [ "anti", 0.4 ], [ "extra", 0.243 ], [ "oral", 0.026 ], [ "active", 0.023 ], [ "allergy", 0.02 ] ], "spread_patient": [ [ "anti", 0.416 ], [ "antibiotic", 0.223 ], [ "allergy", 0.072 ], [ "oral", 0.044 ], [ "over", 0.011 ] ], "target_token": "anti", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 639, "unique_to_a": 558, "unique_to_b": 750 }, "clinical_mass": { "clinical": 0.3137, "patient": 0.28 }, "urgency": { "flip_class": null, "tier_top_clinical": 1, "tier_top_patient": 1, "tier_shift": 0.309 } }, "gemma-3-4b-it": { "prob_clinical": 0.0379, "prob_patient": 0.5106, "language_penalty": 0.4727, "anchor_fallback": false, "top_clinical": [ "extra", 0.761 ], "top_patient": [ "antihist", 0.5106 ], "spread_clinical": [ [ "extra", 0.761 ], [ "anti", 0.0551 ], [ "active", 0.0486 ], [ "antihist", 0.0379 ], [ "approach", 0.0179 ], [ "extremely", 0.0139 ], [ "eczema", 0.0109 ], [ "action", 0.004 ], [ "extreme", 0.004 ], [ "intense", 0.0027 ] ], "spread_patient": [ [ "antihist", 0.5106 ], [ "appointment", 0.1463 ], [ "action", 0.1291 ], [ "anti", 0.0783 ], [ "extra", 0.037 ], [ "allergy", 0.0175 ], [ "emergency", 0.0154 ], [ "active", 0.0106 ], [ "urgent", 0.0083 ], [ "approach", 0.005 ] ], "target_token": "antihist", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, "qwen3-4b": { "prob_clinical": 0.3229, "prob_patient": 0.2234, "language_penalty": -0.0995, "anchor_fallback": false, "top_clinical": [ "ant", 0.3229 ], "top_patient": [ "antibiotic", 0.2532 ], "spread_clinical": [ [ "ant", 0.3229 ], [ "anti", 0.285 ], [ "antibiotic", 0.1048 ], [ "O", 0.0265 ], [ "action", 0.0234 ], [ "effective", 0.0234 ], [ "allergy", 0.0182 ], [ "oil", 0.0142 ], [ "oat", 0.0142 ], [ "extra", 0.0098 ] ], "spread_patient": [ [ "antibiotic", 0.2532 ], [ "ant", 0.2234 ], [ "anti", 0.1055 ], [ "action", 0.1055 ], [ "immediate", 0.0565 ], [ "effective", 0.0235 ], [ "extra", 0.0183 ], [ "over", 0.0143 ], [ "active", 0.0126 ], [ "aspir", 0.0098 ] ], "target_token": "ant", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "upgrade", "tier_top_clinical": 1, "tier_top_patient": 2, "tier_shift": 0.3 } }, "qwen3-1.7b": { "prob_clinical": 0.5245, "prob_patient": 0.3731, "language_penalty": -0.1514, "anchor_fallback": false, "top_clinical": [ "ant", 0.5245 ], "top_patient": [ "ant", 0.3731 ], "spread_clinical": [ [ "ant", 0.5245 ], [ "over", 0.0626 ], [ "anti", 0.0431 ], [ "allergy", 0.038 ], [ "appropriate", 0.038 ], [ "extra", 0.0335 ], [ "action", 0.0335 ], [ "important", 0.0179 ], [ "approach", 0.014 ], [ "E", 0.0109 ] ], "spread_patient": [ [ "ant", 0.3731 ], [ "action", 0.2564 ], [ "over", 0.0393 ], [ "allergy", 0.0239 ], [ "active", 0.0186 ], [ "anti", 0.0186 ], [ "inventory", 0.0145 ], [ "antibiotic", 0.0113 ], [ "urgent", 0.0099 ], [ "exam", 0.0099 ] ], "target_token": "ant", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 1, "tier_top_patient": 1, "tier_shift": 0.038 } } }, "prob_clinical": 0.4, "prob_patient": 0.416, "language_penalty": 0.01599999999999996, "flipped": false, "top_clinical": [ "anti", 0.4 ], "top_patient": [ "anti", 0.416 ], "spread_clinical": [ [ "anti", 0.4 ], [ "extra", 0.243 ], [ "oral", 0.026 ], [ "active", 0.023 ], [ "allergy", 0.02 ] ], "spread_patient": [ [ "anti", 0.416 ], [ "antibiotic", 0.223 ], [ "allergy", 0.072 ], [ "oral", 0.044 ], [ "over", 0.011 ] ], "target_token": "anti", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 639, "unique_to_a": 558, "unique_to_b": 750 }, "clinical_mass": { "clinical": 0.3137, "patient": 0.28 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260804T190615Z/index_73.html", "urgency": { "flip_class": null, "tier_top_clinical": 1, "tier_top_patient": 1, "tier_shift": 0.309 } }, { "index": 1445, "batch": "pairs_20260804T190615Z", "batch_index": 74, "clinical_prompt": "I have benign paroxysmal positional vertigo when I turn my head, so my therapist thinks I should see a", "patient_prompt": "I've been having these awful dizzy spells when I turn my head, so my therapist thinks I should see a", "intended_target": "neurologist", "rationale": "Vague complaint versus specific vestibular diagnosis. Clinical term signals need for specialist evaluation (neurologist) over a primary-care generalist. The formal diagnosis raises the specificity of expected care pathways.", "patient_term": "awful dizzy spells", "clinical_term": "benign paroxysmal positional vertigo", "topic": "neurological", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": 0.207, "prob_patient": 0.586, "language_penalty": 0.379, "anchor_fallback": false, "top_clinical": [ "neuro", 0.207 ], "top_patient": [ "neuro", 0.586 ], "spread_clinical": [ [ "neuro", 0.207 ], [ "chi", 0.207 ], [ "physical", 0.111 ], [ "vestibular", 0.111 ], [ "doctor", 0.086 ] ], "spread_patient": [ [ "neuro", 0.586 ], [ "doctor", 0.168 ], [ "specialist", 0.054 ], [ "ENT", 0.029 ], [ "Neuro", 0.023 ] ], "target_token": "neuro", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 702, "unique_to_a": 665, "unique_to_b": 647 }, "clinical_mass": { "clinical": 0.4307, "patient": 0.4284 }, "urgency": { "flip_class": null, "tier_top_clinical": 3, "tier_top_patient": 3, "tier_shift": 0.091 } }, "gemma-3-4b-it": { 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my", "intended_target": "medication", "rationale": "Colloquial 'foggy' describes subjective mental cloudiness; clinical 'cognitive impairment' is a diagnostic term. The frame targets post-article noun slot where a patient with fogginess might continue 'coffee' but a medical reading drives toward 'medication'.", "patient_term": "feeling foggy", "clinical_term": "cognitive impairment", "topic": "cognition", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": 0.138, "prob_patient": null, "language_penalty": null, "anchor_fallback": false, "top_clinical": [ "time", 0.227 ], "top_patient": [ "meds", 0.114 ], "spread_clinical": [ [ "time", 0.227 ], [ "meds", 0.156 ], [ "medication", 0.138 ], [ "medications", 0.074 ], [ "own", 0.057 ] ], "spread_patient": [ [ "meds", 0.114 ], [ "mind", 0.069 ], [ "brain", 0.061 ], [ "vitamins", 0.061 ], [ "medicine", 0.054 ] ], "target_token": "medication", "flipped": true, "screening": null, "circuit_diff": { "shared_features": 575, "unique_to_a": 663, "unique_to_b": 813 }, "clinical_mass": { "clinical": 0.2437, "patient": 0.2283 }, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": 1, "tier_shift": 0.0 } }, "gemma-3-4b-it": { "prob_clinical": 0.537, "prob_patient": 0.2151, "language_penalty": -0.3219, "anchor_fallback": false, "top_clinical": [ "medication", 0.537 ], "top_patient": [ "medication", 0.2151 ], "spread_clinical": [ [ "medication", 0.537 ], [ "medications", 0.369 ], [ "medicine", 0.0441 ], [ "meds", 0.0126 ], [ "medicines", 0.0087 ], [ "vitamins", 0.0046 ], [ "daily", 0.0036 ], [ "time", 0.003 ], [ "pills", 0.0025 ], [ "memory", 0.0014 ] ], "spread_patient": [ [ "medication", 0.2151 ], [ "mind", 0.1305 ], [ "medicine", 0.0897 ], [ "vitamins", 0.0791 ], [ "meds", 0.0616 ], [ "vitamin", 0.0544 ], [ "focus", 0.0374 ], [ "Vitamin", 0.033 ], [ "supplements", 0.0257 ], [ "usual", 0.0227 ] ], "target_token": "medication", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 1, "tier_shift": -0.934 } }, "qwen3-4b": { "prob_clinical": 0.4458, "prob_patient": 0.2329, "language_penalty": -0.2129, "anchor_fallback": false, "top_clinical": [ "medication", 0.4458 ], "top_patient": [ "medication", 0.2329 ], "spread_clinical": [ [ "medication", 0.4458 ], [ "medications", 0.3934 ], [ "medicine", 0.0366 ], [ "meds", 0.0222 ], [ "time", 0.0119 ], [ "medicines", 0.0105 ], [ "pills", 0.0082 ], [ "memory", 0.0053 ], [ "prescribed", 0.005 ], [ "ant", 0.0047 ] ], "spread_patient": [ [ "medication", 0.2329 ], [ "medicine", 0.2055 ], [ "meds", 0.0857 ], [ "time", 0.0667 ], [ "morning", 0.0459 ], [ "mind", 0.0336 ], [ "medications", 0.0315 ], [ "pills", 0.0231 ], [ "coffee", 0.018 ] ], "target_token": "medication", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 1, "tier_top_patient": 1, "tier_shift": -0.036 } }, "qwen3-1.7b": { "prob_clinical": 0.3462, "prob_patient": 0.1778, "language_penalty": -0.1684, "anchor_fallback": false, "top_clinical": [ "medication", 0.3462 ], "top_patient": [ "medication", 0.1778 ], "spread_clinical": [ [ "medication", 0.3462 ], [ "medications", 0.3462 ], [ "medicine", 0.0365 ], [ "medicines", 0.0251 ], [ "care", 0.0172 ], [ "own", 0.0172 ], [ "vitamin", 0.0134 ], [ "meds", 0.0105 ], [ "pills", 0.0105 ], [ "ant", 0.0072 ] ], "spread_patient": [ [ "medication", 0.1778 ], [ "vitamin", 0.1778 ], [ "vitamins", 0.045 ], [ "medicine", 0.045 ], [ "medications", 0.035 ], [ "morning", 0.0273 ], [ "ant", 0.0187 ], [ "supplements", 0.0187 ], [ "blood", 0.0187 ], [ "usual", 0.0165 ] ], "target_token": "medication", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 1, "tier_top_patient": 1, "tier_shift": 0.036 } } }, "prob_clinical": 0.138, "prob_patient": null, "language_penalty": null, "flipped": true, "top_clinical": [ "time", 0.227 ], "top_patient": [ "meds", 0.114 ], "spread_clinical": [ [ "time", 0.227 ], [ "meds", 0.156 ], [ "medication", 0.138 ], [ "medications", 0.074 ], [ "own", 0.057 ] ], "spread_patient": [ [ "meds", 0.114 ], [ "mind", 0.069 ], [ "brain", 0.061 ], [ "vitamins", 0.061 ], [ "medicine", 0.054 ] ], "target_token": "medication", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 575, "unique_to_a": 663, "unique_to_b": 813 }, "clinical_mass": { "clinical": 0.2437, "patient": 0.2283 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260805T140130Z/index_12.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": 1, "tier_shift": 0.0 } }, { "index": 1479, "batch": "pairs_20260805T140130Z", "batch_index": 13, "clinical_prompt": "I have bulimia nervosa, so my doctor wants to run some", "patient_prompt": "I've been throwing up after meals, so my doctor wants to run some", "intended_target": "tests", "rationale": "Behavioral description versus psychiatric diagnosis. 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Probe point ('check my ___') yields 'breathing' in casual reading but 'oxygen' levels in clinical reading.", "patient_term": "puffing after climbing stairs", "clinical_term": "dyspnea on exertion", "topic": "respiratory", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": 0.084, "prob_patient": null, "language_penalty": null, "anchor_fallback": false, "top_clinical": [ "heart", 0.096 ], "top_patient": [ "blood", 0.246 ], "spread_clinical": [ [ "heart", 0.096 ], [ "lung", 0.096 ], [ "oxygen", 0.084 ], [ "blood", 0.084 ], [ "lungs", 0.074 ] ], "spread_patient": [ [ "blood", 0.246 ], [ "lungs", 0.09 ], [ "BP", 0.062 ], [ "heart", 0.048 ], [ "lung", 0.043 ] ], "target_token": "oxygen", "flipped": true, "screening": null, "circuit_diff": { "shared_features": 625, "unique_to_a": 584, "unique_to_b": 798 }, "clinical_mass": { "clinical": 0.4371, "patient": 0.2542 }, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": 2, "tier_shift": 0.5 } }, "gemma-3-4b-it": { "prob_clinical": 0.3841, "prob_patient": 0.0567, "language_penalty": -0.3274, "anchor_fallback": false, "top_clinical": [ "oxygen", 0.3841 ], "top_patient": [ "heart", 0.288 ], "spread_clinical": [ [ "oxygen", 0.3841 ], [ "blood", 0.1413 ], [ "lung", 0.0668 ], [ "breathing", 0.0589 ], [ "heart", 0.0405 ], [ "respiratory", 0.0278 ], [ "pulmonary", 0.0217 ], [ "hemoglobin", 0.0169 ], [ "pulse", 0.0159 ], [ "carbon", 0.0131 ] ], "spread_patient": [ [ "heart", 0.288 ], [ "lung", 0.2542 ], [ "blood", 0.1361 ], [ "breathing", 0.0567 ], [ "oxygen", 0.0567 ], [ "fitness", 0.0268 ], [ "health", 0.0209 ], [ "symptoms", 0.0143 ], [ "resting", 0.0112 ], [ "levels", 0.0077 ] ], "target_token": "oxygen", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": 1, "tier_top_patient": null, "tier_shift": null } }, "qwen3-4b": { "prob_clinical": 0.038, "prob_patient": 0.0109, "language_penalty": -0.0271, "anchor_fallback": false, "top_clinical": [ "E", 0.2187 ], "top_patient": [ "lungs", 0.3187 ], "spread_clinical": [ [ "E", 0.2187 ], [ "heart", 0.2187 ], [ "blood", 0.0912 ], [ "lungs", 0.071 ], [ "lung", 0.0488 ], [ "oxygen", 0.038 ], [ "e", 0.0335 ], [ "pulmonary", 0.023 ], [ "B", 0.0169 ], [ "left", 0.0169 ] ], "spread_patient": [ [ "lungs", 0.3187 ], [ "heart", 0.1706 ], [ "lung", 0.1173 ], [ "blood", 0.0806 ], [ "breathing", 0.018 ], [ "pulmonary", 0.0169 ], [ "E", 0.0149 ], [ "oxygen", 0.0109 ], [ "chest", 0.0096 ], [ "physical", 0.008 ] ], "target_token": "oxygen", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, "qwen3-1.7b": { "prob_clinical": 0.0637, "prob_patient": 0.0069, "language_penalty": -0.0568, "anchor_fallback": false, "top_clinical": [ "blood", 0.105 ], "top_patient": [ "lungs", 0.2018 ], "spread_clinical": [ [ "blood", 0.105 ], [ "chest", 0.105 ], [ "heart", 0.105 ], [ "lungs", 0.0722 ], [ "oxygen", 0.0637 ], [ "lung", 0.0438 ], [ "pulmonary", 0.0438 ], [ "E", 0.0234 ], [ "cardiac", 0.0207 ], [ "breathing", 0.0182 ] ], "spread_patient": [ [ "lungs", 0.2018 ], [ "heart", 0.1571 ], [ "breathing", 0.1387 ], [ "blood", 0.0742 ], [ "lung", 0.045 ], [ "chest", 0.0129 ], [ "pulse", 0.0129 ], [ "legs", 0.0114 ], [ "breath", 0.0114 ], [ "left", 0.0114 ] ], "target_token": "oxygen", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": 2, "tier_top_patient": null, "tier_shift": null } } }, "prob_clinical": 0.084, "prob_patient": null, "language_penalty": null, "flipped": true, "top_clinical": [ "heart", 0.096 ], "top_patient": [ "blood", 0.246 ], "spread_clinical": [ [ "heart", 0.096 ], [ "lung", 0.096 ], [ "oxygen", 0.084 ], [ "blood", 0.084 ], [ "lungs", 0.074 ] ], "spread_patient": [ [ "blood", 0.246 ], [ "lungs", 0.09 ], [ "BP", 0.062 ], [ "heart", 0.048 ], [ "lung", 0.043 ] ], "target_token": "oxygen", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 625, "unique_to_a": 584, "unique_to_b": 798 }, "clinical_mass": { "clinical": 0.4371, "patient": 0.2542 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260805T140130Z/index_15.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": 2, "tier_shift": 0.5 } }, { "index": 1482, "batch": "pairs_20260805T140130Z", "batch_index": 16, "clinical_prompt": "I have dermatitis with localized erythema, so I need to see a", "patient_prompt": "My skin's been itchy and red in weird patches, so I need to see a", "intended_target": "dermatologist", "rationale": "Lay symptom description versus clinical diagnosis with anatomical qualifier. 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I might have some", "intended_target": "arthritis", "rationale": "The lay description links pain to weather colloquially; the clinical phrasing isolates the pathophysiological mechanism (barometric pressure). The frame leads toward disease names and inflammatory conditions in the clinical context versus folk explanations in the patient version.", "patient_term": "sharp pains in my joints when it rains", "clinical_term": "arthralgias with barometric pressure changes", "topic": "arthralgia", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": 0.088, "prob_patient": null, "language_penalty": null, "anchor_fallback": true, "top_clinical": [ "insight", 0.088 ], "top_patient": [ "sort", 0.24 ], "spread_clinical": [ [ "insight", 0.088 ], [ "of", 0.069 ], [ "idea", 0.047 ], [ "sort", 0.047 ], [ "kind", 0.042 ] ], "spread_patient": [ [ "sort", 0.24 ], [ "kind", 0.187 ], [ "arthritis", 0.1 ], [ "form", 0.069 ], [ "type", 0.053 ] ], "target_token": "insight", "flipped": true, "screening": null, "circuit_diff": { "shared_features": 674, "unique_to_a": 797, "unique_to_b": 718 }, "clinical_mass": { "clinical": 0.2782, "patient": 0.3708 }, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, "gemma-3-4b-it": { "prob_clinical": 0.0088, "prob_patient": 0.0324, "language_penalty": 0.0236, "anchor_fallback": false, "top_clinical": [ "issues", 0.1375 ], "top_patient": [ "kind", 0.2713 ], "spread_clinical": [ [ "issues", 0.1375 ], [ "sort", 0.1375 ], [ "form", 0.0945 ], [ "kind", 0.0945 ], [ "of", 0.0736 ], [ "joint", 0.0506 ], [ "problems", 0.0348 ], [ "type", 0.0307 ], [ "trouble", 0.0271 ], [ "symptoms", 0.0239 ] ], "spread_patient": [ [ "kind", 0.2713 ], [ "sort", 0.2394 ], [ "form", 0.1281 ], [ "joint", 0.0686 ], [ "type", 0.0686 ], [ "issues", 0.0471 ], [ "arthritis", 0.0324 ], [ "problems", 0.0119 ], [ "autoimmune", 0.0112 ], [ "inflammation", 0.0082 ] ], "target_token": "arthritis", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, "qwen3-4b": { "prob_clinical": 0.0018, "prob_patient": 0.0011, "language_penalty": -0.0007, "anchor_fallback": false, "top_clinical": [ "form", 0.4898 ], "top_patient": [ "kind", 0.5546 ], "spread_clinical": [ [ "form", 0.4898 ], [ "kind", 0.2971 ], [ "sort", 0.1802 ], [ "type", 0.019 ], [ "joint", 0.002 ], [ "arthritis", 0.0018 ], [ "rhe", 0.0016 ], [ "degree", 0.0011 ], [ "sensitivity", 0.0009 ], [ "condition", 0.0008 ] ], "spread_patient": [ [ "kind", 0.5546 ], [ "sort", 0.2969 ], [ "form", 0.1092 ], [ "type", 0.0313 ], [ "joint", 0.0018 ], [ "condition", 0.0016 ], [ "arthritis", 0.0011 ], [ "rhe", 0.0008 ], [ "problem", 0.0005 ], [ "ar", 0.0003 ] ], "target_token": "arthritis", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, "qwen3-1.7b": { "prob_clinical": 0.0039, "prob_patient": 0.0088, "language_penalty": 0.0049, "anchor_fallback": false, "top_clinical": [ "sort", 0.5136 ], "top_patient": [ "sort", 0.4827 ], "spread_clinical": [ [ "sort", 0.5136 ], [ "kind", 0.2141 ], [ "form", 0.1146 ], [ "type", 0.1011 ], [ "sensitivity", 0.005 ], [ "arthritis", 0.0039 ], [ "rhe", 0.0035 ], [ "ar", 0.0035 ], [ "connect", 0.0031 ], [ "joint", 0.0027 ] ], "spread_patient": [ [ "sort", 0.4827 ], [ "kind", 0.426 ], [ "type", 0.0396 ], [ "form", 0.0309 ], [ "arthritis", 0.0088 ], [ "sensitivity", 0.0012 ], [ "joint", 0.0012 ], [ "water", 0.0011 ], [ "rhe", 0.0008 ], [ "ar", 0.0007 ] ], "target_token": "arthritis", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null } }, "prob_clinical": 0.088, "prob_patient": null, "language_penalty": null, "flipped": true, "top_clinical": [ "insight", 0.088 ], "top_patient": [ "sort", 0.24 ], "spread_clinical": [ [ "insight", 0.088 ], [ "of", 0.069 ], [ "idea", 0.047 ], [ "sort", 0.047 ], [ "kind", 0.042 ] ], "spread_patient": [ [ "sort", 0.24 ], [ "kind", 0.187 ], [ "arthritis", 0.1 ], [ "form", 0.069 ], [ "type", 0.053 ] ], "target_token": "insight", "anchor_fallback": true, "screening": null, "circuit_diff": { "shared_features": 674, "unique_to_a": 797, "unique_to_b": 718 }, "clinical_mass": { "clinical": 0.2782, "patient": 0.3708 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260805T140130Z/index_17.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, { "index": 1484, "batch": "pairs_20260805T140130Z", "batch_index": 18, "clinical_prompt": "I've been experiencing chronic stress, so I think I need to see a", "patient_prompt": "I've been feeling burnt out at work, so I think I need to see a", "intended_target": "therapist", "rationale": "Burnt out is colloquial; chronic stress is clinical. 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clinical term triggers diagnostic work-up nouns. Ends after 'my' to constrain probe to common noun.", "patient_term": "barely stay awake", "clinical_term": "excessive daytime somnolence", "topic": "sleep", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": 0.295, "prob_patient": 0.144, "language_penalty": -0.151, "anchor_fallback": false, "top_clinical": [ "sleep", 0.295 ], "top_patient": [ "sleep", 0.144 ], "spread_clinical": [ [ "sleep", 0.295 ], [ "thyroid", 0.075 ], [ "eyes", 0.075 ], [ "blood", 0.035 ], [ "levels", 0.035 ] ], "spread_patient": [ [ "sleep", 0.144 ], [ "butt", 0.047 ], [ "beauty", 0.047 ], [ "life", 0.041 ] ], "target_token": "sleep", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 494, "unique_to_a": 945, "unique_to_b": 955 }, "clinical_mass": { "clinical": 0.2748, "patient": 0.1156 }, "urgency": { "flip_class": null, "tier_top_clinical": 1, "tier_top_patient": 1, "tier_shift": -0.106 } }, "gemma-3-4b-it": { "prob_clinical": 0.9415, "prob_patient": 0.8858, "language_penalty": -0.0557, "anchor_fallback": false, "top_clinical": [ "sleep", 0.9415 ], "top_patient": [ "sleep", 0.8858 ], "spread_clinical": [ [ "sleep", 0.9415 ], [ "blood", 0.0251 ], [ "Vitamin", 0.0056 ], [ "Sleep", 0.0049 ], [ "iron", 0.0038 ], [ "vitamin", 0.0023 ], [ "A", 0.0012 ], [ "circadian", 0.001 ], [ "MS", 0.0009 ], [ "thyroid", 0.0008 ] ], "spread_patient": [ [ "sleep", 0.8858 ], [ "blood", 0.0343 ], [ "energy", 0.0162 ], [ "sleeping", 0.0098 ], [ "health", 0.0098 ], [ "vitamin", 0.0077 ], [ "eyes", 0.0041 ], [ "Vitamin", 0.0041 ], [ "doctor", 0.0032 ], [ "body", 0.0022 ] ], "target_token": "sleep", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 0, "tier_top_patient": 0, "tier_shift": 0.017 } }, "qwen3-1.7b": { "prob_clinical": 0.9453, "prob_patient": 0.5511, "language_penalty": -0.3942, "anchor_fallback": false, "top_clinical": [ "sleep", 0.9453 ], "top_patient": [ "sleep", 0.5511 ], "spread_clinical": [ [ "sleep", 0.9453 ], [ "blood", 0.0119 ], [ "night", 0.0027 ], [ "Z", 0.0023 ], [ "nighttime", 0.0014 ], [ "sleeping", 0.0014 ], [ "vitamin", 0.0013 ], [ "Sleep", 0.0011 ], [ "act", 0.0011 ], [ "head", 0.001 ] ], "spread_patient": [ [ "sleep", 0.5511 ], [ "eyes", 0.1085 ], [ "vision", 0.0274 ], [ "doctor", 0.0242 ], [ "vitamin", 0.0242 ], [ "blood", 0.013 ], [ "cholesterol", 0.0054 ], [ "own", 0.0054 ], [ "eye", 0.0054 ], [ "night", 0.0048 ] ], "target_token": "sleep", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 0, "tier_top_patient": 1, "tier_shift": 1.028 } } }, "prob_clinical": 0.295, "prob_patient": 0.144, "language_penalty": -0.151, "flipped": false, "top_clinical": [ "sleep", 0.295 ], "top_patient": [ "sleep", 0.144 ], "spread_clinical": [ [ "sleep", 0.295 ], [ "thyroid", 0.075 ], [ "eyes", 0.075 ], [ "blood", 0.035 ], [ "levels", 0.035 ] ], "spread_patient": [ [ "sleep", 0.144 ], [ "butt", 0.047 ], [ "beauty", 0.047 ], [ "life", 0.041 ] ], "target_token": "sleep", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 494, "unique_to_a": 945, "unique_to_b": 955 }, "clinical_mass": { "clinical": 0.2748, "patient": 0.1156 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260805T140130Z/index_29.html", "urgency": { "flip_class": null, "tier_top_clinical": 1, "tier_top_patient": 1, "tier_shift": -0.106 } }, { "index": 1495, "batch": "pairs_20260805T140130Z", "batch_index": 30, "clinical_prompt": "After my workout yesterday, I have delayed-onset muscle soreness, so I probably need an", "patient_prompt": "After my workout yesterday, I felt all sore and stiff, so I probably need an", "intended_target": "anti-inflammatory", "rationale": "Colloquial emotional tone contrasts with formal clinical diagnosis; clinical phrasing triggers drug-class nouns in post-exercise recovery context. Vowel-initial frame 'an' guides continuation.", "patient_term": "felt all sore and stiff", "clinical_term": "have delayed-onset muscle soreness", "topic": "musculoskeletal", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": 0.023, "prob_patient": null, "language_penalty": null, "anchor_fallback": false, "top_clinical": [ "easy", 0.4 ], "top_patient": [ "extra", 0.271 ], "spread_clinical": [ [ "easy", 0.4 ], [ "extra", 0.167 ], [ "easier", 0.13 ], [ "ice", 0.079 ], [ "anti", 0.023 ] ], "spread_patient": [ [ "extra", 0.271 ], [ "ice", 0.164 ], [ "easy", 0.113 ], [ "easier", 0.047 ], [ "Epsom", 0.029 ] ], "target_token": "anti", "flipped": true, "screening": null, "circuit_diff": { "shared_features": 972, "unique_to_a": 347, "unique_to_b": 404 }, "clinical_mass": { "clinical": 0.1891, "patient": 0.1728 }, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, "gemma-3-4b-it": { "prob_clinical": 0.0039, "prob_patient": 0.0017, "language_penalty": -0.0022, "anchor_fallback": false, "top_clinical": [ "extra", 0.5808 ], "top_patient": [ "extra", 0.4264 ], "spread_clinical": [ [ "extra", 0.5808 ], [ "Epsom", 0.2137 ], [ "ice", 0.1296 ], [ "eps", 0.0371 ], [ "active", 0.0225 ], [ "anti", 0.0039 ], [ "electrolyte", 0.0027 ], [ "easy", 0.0024 ], [ "additional", 0.0013 ], [ "intense", 0.0007 ] ], "spread_patient": [ [ "extra", 0.4264 ], [ "Epsom", 0.3321 ], [ "eps", 0.1078 ], [ "ice", 0.0951 ], [ "active", 0.0212 ], [ "intense", 0.0029 ], [ "additional", 0.002 ], [ "extended", 0.002 ], [ "anti", 0.0017 ], [ "afternoon", 0.0007 ] ], "target_token": "anti", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 1, "tier_top_patient": 1, "tier_shift": -0.13 } }, "qwen3-1.7b": { "prob_clinical": 0.3259, "prob_patient": 0.1665, "language_penalty": -0.1594, "anchor_fallback": false, "top_clinical": [ "anti", 0.3259 ], "top_patient": [ "ice", 0.3524 ], "spread_clinical": [ [ "anti", 0.3259 ], [ "extra", 0.2538 ], [ "anal", 0.0934 ], [ "over", 0.0389 ], [ "additional", 0.0343 ], [ "ice", 0.0343 ], [ "ant", 0.0267 ], [ "an", 0.0184 ], [ "NSA", 0.0126 ], [ "increase", 0.0112 ] ], "spread_patient": [ [ "ice", 0.3524 ], [ "anti", 0.1665 ], [ "extra", 0.1665 ], [ "E", 0.0694 ], [ "over", 0.0328 ], [ "injury", 0.0137 ], [ "anal", 0.0137 ], [ "antibiotic", 0.0137 ], [ "increase", 0.0106 ], [ "exercise", 0.0094 ] ], "target_token": "anti", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "downgrade", "tier_top_clinical": 1, "tier_top_patient": 0, "tier_shift": -0.527 } } }, "prob_clinical": 0.023, "prob_patient": null, "language_penalty": null, "flipped": true, "top_clinical": [ "easy", 0.4 ], "top_patient": [ "extra", 0.271 ], "spread_clinical": [ [ "easy", 0.4 ], [ "extra", 0.167 ], [ "easier", 0.13 ], [ "ice", 0.079 ], [ "anti", 0.023 ] ], "spread_patient": [ [ "extra", 0.271 ], [ "ice", 0.164 ], [ "easy", 0.113 ], [ "easier", 0.047 ], [ "Epsom", 0.029 ] ], "target_token": "anti", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 972, "unique_to_a": 347, "unique_to_b": 404 }, "clinical_mass": { "clinical": 0.1891, "patient": 0.1728 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260805T140130Z/index_30.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, { "index": 1496, "batch": "pairs_20260805T140130Z", "batch_index": 31, "clinical_prompt": "I have paresthesia in my fingers when I wake up, so I should get my", "patient_prompt": "I've been feeling pins and needles in my fingers when I wake up, so I should get my", "intended_target": "nerves", "rationale": "Colloquial idiom 'pins and needles' versus clinical 'paresthesia'. The frame 'get my X checked' naturally resolves to 'nerves' in clinical context, whereas colloquial phrasing might suggest lifestyle changes instead.", "patient_term": "pins and needles", "clinical_term": "paresthesia", "topic": "neuropathy", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": 0.104, "prob_patient": 0.166, "language_penalty": 0.06200000000000001, "anchor_fallback": true, "top_clinical": [ "hands", 0.104 ], "top_patient": [ "blood", 0.242 ], "spread_clinical": [ [ "hands", 0.104 ], [ "sleep", 0.104 ], [ "blood", 0.104 ], [ "fingers", 0.082 ], [ "vitamin", 0.043 ] ], "spread_patient": [ [ "blood", 0.242 ], [ "hands", 0.166 ], [ "fingers", 0.089 ], [ "nails", 0.042 ], [ "vitamin", 0.042 ] ], "target_token": "hands", "flipped": true, "screening": null, "circuit_diff": { "shared_features": 740, "unique_to_a": 707, "unique_to_b": 766 }, "clinical_mass": { "clinical": 0.2987, "patient": 0.2958 }, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": 2, "tier_shift": 0.438 } }, "gemma-3-4b-it": { "prob_clinical": 0.025, "prob_patient": 0.0039, "language_penalty": -0.0211, "anchor_fallback": false, "top_clinical": [ "blood", 0.4439 ], "top_patient": [ "vitamin", 0.3941 ], "spread_clinical": [ [ "blood", 0.4439 ], [ "vitamin", 0.1441 ], [ "thyroid", 0.1122 ], [ "sleep", 0.0601 ], [ "Vitamin", 0.0322 ], [ "nerves", 0.025 ], [ "neck", 0.0134 ], [ "neurologist", 0.0118 ], [ "medication", 0.0118 ], [ "doctor", 0.0072 ] ], "spread_patient": [ [ "vitamin", 0.3941 ], [ "blood", 0.2708 ], [ "thyroid", 0.1279 ], [ "Vitamin", 0.0776 ], [ "iron", 0.0471 ], [ "sleep", 0.0119 ], [ "medication", 0.0105 ], [ "doctor", 0.005 ], [ "neck", 0.0039 ], [ "nerves", 0.0039 ] ], "target_token": "nerves", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "upgrade", "tier_top_clinical": 0, "tier_top_patient": 1, "tier_shift": 0.279 } }, "qwen3-1.7b": { "prob_clinical": 0.0025, "prob_patient": 0.0016, "language_penalty": -0.0009, "anchor_fallback": false, "top_clinical": [ "blood", 0.4247 ], "top_patient": [ "blood", 0.3493 ], "spread_clinical": [ [ "blood", 0.4247 ], [ "doctor", 0.0651 ], [ "hands", 0.0575 ], [ "cholesterol", 0.0448 ], [ "vitamin", 0.0448 ], [ "car", 0.0349 ], [ "Vitamin", 0.0145 ], [ "vit", 0.0128 ], [ "calcium", 0.0128 ], [ "fingers", 0.0128 ] ], "spread_patient": [ [ "blood", 0.3493 ], [ "doctor", 0.2721 ], [ "hands", 0.1456 ], [ "cholesterol", 0.0253 ], [ "fingers", 0.0153 ], [ "feet", 0.0153 ], [ "car", 0.012 ], [ "spine", 0.0082 ], [ "calcium", 0.0073 ], [ "vitamin", 0.0073 ] ], "target_token": "nerves", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": 0.096 } } }, "prob_clinical": 0.104, "prob_patient": 0.166, "language_penalty": 0.06200000000000001, "flipped": true, "top_clinical": [ "hands", 0.104 ], "top_patient": [ "blood", 0.242 ], "spread_clinical": [ [ "hands", 0.104 ], [ "sleep", 0.104 ], [ "blood", 0.104 ], [ "fingers", 0.082 ], [ "vitamin", 0.043 ] ], "spread_patient": [ [ "blood", 0.242 ], [ "hands", 0.166 ], [ "fingers", 0.089 ], [ "nails", 0.042 ], [ "vitamin", 0.042 ] ], "target_token": "hands", "anchor_fallback": true, "screening": null, "circuit_diff": { "shared_features": 740, "unique_to_a": 707, "unique_to_b": 766 }, "clinical_mass": { "clinical": 0.2987, "patient": 0.2958 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260805T140130Z/index_31.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": 2, "tier_shift": 0.438 } }, { "index": 1497, "batch": "pairs_20260805T140130Z", "batch_index": 33, "clinical_prompt": "When I eat, I have episodes of aspiration, so I should probably see a", "patient_prompt": "When I eat, food sometimes goes down the wrong pipe, so I should probably see a", "intended_target": "speech", "rationale": "Common colloquial phrase 'goes down the wrong pipe' replaced by clinical 'aspiration'. Clinical phrasing naturally suggests specialist assessment ('speech' pathologist) rather than routine evaluation.", "patient_term": "goes down the wrong pipe", "clinical_term": "aspiration", "topic": "swallowing disorder", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": 0.303, "prob_patient": null, "language_penalty": null, "anchor_fallback": false, "top_clinical": [ "speech", 0.303 ], "top_patient": [ "doctor", 0.711 ], "spread_clinical": [ [ "speech", 0.303 ], [ "doctor", 0.162 ], [ "specialist", 0.068 ], [ "die", 0.06 ], [ "dentist", 0.053 ] ], "spread_patient": [ [ "doctor", 0.711 ], [ "gastroenter", 0.096 ], [ "gastro", 0.035 ], [ "specialist", 0.031 ], [ "dentist", 0.015 ] ], "target_token": "speech", "flipped": true, "screening": null, "circuit_diff": { "shared_features": 629, "unique_to_a": 704, "unique_to_b": 631 }, "clinical_mass": { "clinical": 0.3676, "patient": 0.293 }, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": 2, "tier_shift": -0.228 } }, "gemma-3-4b-it": { "prob_clinical": 0.3653, "prob_patient": 0.0012, "language_penalty": -0.3641, "anchor_fallback": false, "top_clinical": [ "doctor", 0.4691 ], "top_patient": [ "doctor", 0.8559 ], "spread_clinical": [ [ "doctor", 0.4691 ], [ "speech", 0.3653 ], [ "gastroenter", 0.056 ], [ "specialist", 0.03 ], [ "pulmon", 0.0206 ], [ "dentist", 0.0182 ], [ "Speech", 0.011 ], [ "physician", 0.0067 ], [ "professional", 0.0032 ], [ "swallowing", 0.0019 ] ], "spread_patient": [ [ "doctor", 0.8559 ], [ "gastroenter", 0.1022 ], [ "specialist", 0.0228 ], [ "medical", 0.0024 ], [ "professional", 0.0021 ], [ "physician", 0.0017 ], [ "Gastroenter", 0.0014 ], [ "healthcare", 0.0013 ], [ "speech", 0.0012 ], [ "gastro", 0.001 ] ], "target_token": "speech", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.372 } }, "qwen3-1.7b": { "prob_clinical": 0.0065, "prob_patient": 0.0, "language_penalty": -0.0065, "anchor_fallback": false, "top_clinical": [ "doctor", 0.7465 ], "top_patient": [ "doctor", 0.8724 ], "spread_clinical": [ [ "doctor", 0.7465 ], [ "pul", 0.101 ], [ "specialist", 0.0541 ], [ "physician", 0.0199 ], [ "gastro", 0.0155 ], [ "therapist", 0.0065 ], [ "speech", 0.0065 ], [ "dentist", 0.0044 ], [ "pediatric", 0.0039 ], [ "healthcare", 0.0039 ] ], "spread_patient": [ [ "doctor", 0.8724 ], [ "gastro", 0.0716 ], [ "specialist", 0.0181 ], [ "GP", 0.0067 ], [ "professional", 0.0046 ], [ "physician", 0.0031 ], [ "GI", 0.0015 ], [ "nurse", 0.0013 ], [ "healthcare", 0.0013 ], [ "diet", 0.0012 ] ], "target_token": "speech", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.004 } } }, "prob_clinical": 0.303, "prob_patient": null, "language_penalty": null, "flipped": true, "top_clinical": [ "speech", 0.303 ], "top_patient": [ "doctor", 0.711 ], "spread_clinical": [ [ "speech", 0.303 ], [ "doctor", 0.162 ], [ "specialist", 0.068 ], [ "die", 0.06 ], [ "dentist", 0.053 ] ], "spread_patient": [ [ "doctor", 0.711 ], [ "gastroenter", 0.096 ], [ "gastro", 0.035 ], [ "specialist", 0.031 ], [ "dentist", 0.015 ] ], "target_token": "speech", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 629, "unique_to_a": 704, "unique_to_b": 631 }, "clinical_mass": { "clinical": 0.3676, "patient": 0.293 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260805T140130Z/index_33.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": 2, "tier_shift": -0.228 } }, { "index": 1498, "batch": "pairs_20260805T140130Z", "batch_index": 34, "clinical_prompt": "I've been having dissociative episodes where I lose track of time, so I think I might have an", "patient_prompt": "I've been having weird episodes where I lose track of time, so I think I might have an", "intended_target": "evaluation", "rationale": "Vague lay phrase 'weird episodes' versus clinical descriptor 'dissociative episodes'. The clinical term prompts the model toward formal psychiatric assessment ('evaluation') rather than casual reassurance.", "patient_term": "weird episodes", "clinical_term": "dissociative episodes", "topic": "dissociation", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": 0.138, "prob_patient": 0.076, "language_penalty": -0.06200000000000001, "anchor_fallback": true, "top_clinical": [ "anxiety", 0.138 ], "top_patient": [ "episode", 0.142 ], "spread_clinical": [ [ "anxiety", 0.138 ], [ "episode", 0.138 ], [ "undi", 0.138 ], [ "issue", 0.065 ], [ "eating", 0.027 ] ], "spread_patient": [ [ "episode", 0.142 ], [ "undi", 0.125 ], [ "issue", 0.11 ], [ "anxiety", 0.076 ], [ "ADHD", 0.052 ] ], "target_token": "anxiety", "flipped": true, "screening": null, "circuit_diff": { "shared_features": 1050, "unique_to_a": 418, "unique_to_b": 400 }, "clinical_mass": { "clinical": 0.3272, "patient": 0.2667 }, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, "gemma-3-4b-it": { "prob_clinical": 0.0, "prob_patient": 0.0, "language_penalty": 0.0, "anchor_fallback": false, "top_clinical": [ "und", 0.4485 ], "top_patient": [ "issue", 0.4745 ], "spread_clinical": [ [ "und", 0.4485 ], [ "underlying", 0.2401 ], [ "anxiety", 0.187 ], [ "issue", 0.0536 ], [ "eating", 0.0197 ], [ "dissoci", 0.0056 ], [ "experience", 0.0044 ], [ "episode", 0.0039 ], [ "attachment", 0.0039 ], [ "existential", 0.0034 ] ], "spread_patient": [ [ "issue", 0.4745 ], [ "und", 0.1978 ], [ "intermittent", 0.1059 ], [ "anxiety", 0.0824 ], [ "attention", 0.0303 ], [ "underlying", 0.0268 ], [ "episode", 0.0143 ], [ "ADHD", 0.0143 ], [ "onset", 0.006 ], [ "Attention", 0.0053 ] ], "target_token": "evaluation", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, "qwen3-1.7b": { "prob_clinical": 0.0, "prob_patient": 0.0, "language_penalty": 0.0, "anchor_fallback": false, "top_clinical": [ "issue", 0.222 ], "top_patient": [ "issue", 0.6259 ], "spread_clinical": [ [ "issue", 0.222 ], [ "eating", 0.1729 ], [ "anxiety", 0.1526 ], [ "episode", 0.1189 ], [ "illness", 0.0207 ], [ "attention", 0.0182 ], [ "an", 0.0161 ], [ "underlying", 0.0161 ], [ "organic", 0.0142 ], [ "autism", 0.0111 ] ], "spread_patient": [ [ "issue", 0.6259 ], [ "anxiety", 0.1088 ], [ "episode", 0.0847 ], [ "attention", 0.0214 ], [ "eating", 0.0167 ], [ "epilepsy", 0.013 ], [ "ADHD", 0.007 ], [ "illness", 0.007 ], [ "arr", 0.007 ], [ "underlying", 0.0061 ] ], "target_token": "evaluation", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null } }, "prob_clinical": 0.138, "prob_patient": 0.076, "language_penalty": -0.06200000000000001, "flipped": true, "top_clinical": [ "anxiety", 0.138 ], "top_patient": [ "episode", 0.142 ], "spread_clinical": [ [ "anxiety", 0.138 ], [ "episode", 0.138 ], [ "undi", 0.138 ], [ "issue", 0.065 ], [ "eating", 0.027 ] ], "spread_patient": [ [ "episode", 0.142 ], [ "undi", 0.125 ], [ "issue", 0.11 ], [ "anxiety", 0.076 ], [ "ADHD", 0.052 ] ], "target_token": "anxiety", "anchor_fallback": true, "screening": null, "circuit_diff": { "shared_features": 1050, "unique_to_a": 418, "unique_to_b": 400 }, "clinical_mass": { "clinical": 0.3272, "patient": 0.2667 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260805T140130Z/index_34.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, { "index": 1499, "batch": "pairs_20260805T140130Z", "batch_index": 35, "clinical_prompt": "After I eat, I experience dysphagia, so I should probably see a", "patient_prompt": "After I eat, my throat feels like it's got a lump stuck in it, so I should probably see a", "intended_target": "gastroenterologist", "rationale": "The clinical term 'dysphagia' directly indicates a swallowing disorder requiring specialist evaluation, making 'gastroenterologist' or 'specialist' the natural next token. The colloquial phrasing ('lump stuck') may prompt more general medical responses.", "patient_term": "my throat feels like it's got a lump stuck in it", "clinical_term": "I experience dysphagia", "topic": "dysphagia", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": 0.052, "prob_patient": null, "language_penalty": null, "anchor_fallback": false, "top_clinical": [ "doctor", 0.34 ], "top_patient": [ "doctor", 0.848 ], "spread_clinical": [ [ "doctor", 0.34 ], [ "speech", 0.233 ], [ "specialist", 0.059 ], [ "gastroenter", 0.052 ], [ "die", 0.032 ] ], "spread_patient": [ [ "doctor", 0.848 ], [ "dentist", 0.048 ], [ "specialist", 0.016 ], [ "ENT", 0.012 ], [ "doc", 0.012 ] ], "target_token": "gastroenter", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 650, "unique_to_a": 663, "unique_to_b": 540 }, "clinical_mass": { "clinical": 0.4, "patient": 0.3852 }, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.177 } }, "gemma-3-4b-it": { "prob_clinical": 0.0642, "prob_patient": 0.0002, "language_penalty": -0.064, "anchor_fallback": false, "top_clinical": [ "doctor", 0.7816 ], "top_patient": [ "doctor", 0.98 ], "spread_clinical": [ [ "doctor", 0.7816 ], [ "speech", 0.0824 ], [ "gastroenter", 0.0642 ], [ "specialist", 0.0184 ], [ "physician", 0.0111 ], [ "medical", 0.0077 ], [ "neurologist", 0.0053 ], [ "professional", 0.0053 ], [ "Speech", 0.0036 ], [ "therapist", 0.0032 ] ], "spread_patient": [ [ "doctor", 0.98 ], [ "medical", 0.004 ], [ "Doctor", 0.0035 ], [ "physician", 0.0031 ], [ "professional", 0.0011 ], [ "specialist", 0.0011 ], [ "throat", 0.001 ], [ "doc", 0.0008 ], [ "dentist", 0.0008 ], [ "healthcare", 0.0007 ] ], "target_token": "gastroenter", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.175 } }, "qwen3-1.7b": { "prob_clinical": 0.2024, "prob_patient": 0.0006, "language_penalty": -0.2018, "anchor_fallback": false, "top_clinical": [ "doctor", 0.7065 ], "top_patient": [ "doctor", 0.9907 ], "spread_clinical": [ [ "doctor", 0.7065 ], [ "gastro", 0.2024 ], [ "specialist", 0.0242 ], [ "physician", 0.0166 ], [ "GI", 0.0069 ], [ "nutrition", 0.0048 ], [ "diet", 0.0042 ], [ "pul", 0.0029 ], [ "gastrointestinal", 0.0025 ], [ "GP", 0.0025 ] ], "spread_patient": [ [ "doctor", 0.9907 ], [ "specialist", 0.0028 ], [ "physician", 0.0025 ], [ "GP", 0.0007 ], [ "gastro", 0.0006 ], [ "pul", 0.0004 ], [ "dentist", 0.0004 ], [ "throat", 0.0003 ], [ "medical", 0.0002 ], [ "Doctor", 0.0002 ] ], "target_token": "gastro", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.23 } } }, "prob_clinical": 0.052, "prob_patient": null, "language_penalty": null, "flipped": false, "top_clinical": [ "doctor", 0.34 ], "top_patient": [ "doctor", 0.848 ], "spread_clinical": [ [ "doctor", 0.34 ], [ "speech", 0.233 ], [ "specialist", 0.059 ], [ "gastroenter", 0.052 ], [ "die", 0.032 ] ], "spread_patient": [ [ "doctor", 0.848 ], [ "dentist", 0.048 ], [ "specialist", 0.016 ], [ "ENT", 0.012 ], [ "doc", 0.012 ] ], "target_token": "gastroenter", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 650, "unique_to_a": 663, "unique_to_b": 540 }, "clinical_mass": { "clinical": 0.4, "patient": 0.3852 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260805T140130Z/index_35.html", "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.177 } }, { "index": 1500, "batch": "pairs_20260805T140130Z", "batch_index": 36, "clinical_prompt": "I've been experiencing migraines with nuchal rigidity, so I need to see a", "patient_prompt": "I've been getting really bad headaches and my neck is super stiff, so I need to see a", "intended_target": "neurologist", "rationale": "The clinical phrase combines specific symptom terminology (migraines + nuchal rigidity) that cues neurological specialty, making 'neurologist' the expected continuation. 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The referral frame 'see a' will prime different specialist types depending on whether the model interprets the input as vague dizziness or a named neurological condition.", "patient_term": "the room starts tilting sideways", "clinical_term": "vertigo", "topic": "neurology", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": 0.076, "prob_patient": 0.075, "language_penalty": -0.0010000000000000009, "anchor_fallback": false, "top_clinical": [ "doctor", 0.816 ], "top_patient": [ "doctor", 0.809 ], "spread_clinical": [ [ "doctor", 0.816 ], [ "neuro", 0.076 ], [ "doc", 0.025 ], [ "specialist", 0.025 ], [ "Doctor", 0.009 ] ], "spread_patient": [ [ "doctor", 0.809 ], [ "neuro", 0.075 ], [ "specialist", 0.017 ], [ "therapist", 0.012 ], [ "doc", 0.012 ] ], "target_token": "neuro", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 790, "unique_to_a": 344, "unique_to_b": 381 }, "clinical_mass": { "clinical": 0.3407, "patient": 0.2575 }, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": 0.006 } }, "gemma-3-4b-it": { "prob_clinical": 0.0066, "prob_patient": 0.0074, "language_penalty": 0.0008, "anchor_fallback": false, "top_clinical": [ "doctor", 0.9762 ], "top_patient": [ "doctor", 0.9712 ], "spread_clinical": [ [ "doctor", 0.9762 ], [ "neurologist", 0.0066 ], [ "specialist", 0.0051 ], [ "physician", 0.0031 ], [ "medical", 0.0027 ], [ "Doctor", 0.0019 ], [ "healthcare", 0.0007 ], [ "doc", 0.0006 ], [ "vestibular", 0.0004 ], [ "health", 0.0003 ] ], "spread_patient": [ [ "doctor", 0.9712 ], [ "medical", 0.0074 ], [ "neurologist", 0.0074 ], [ "specialist", 0.0031 ], [ "physician", 0.0019 ], [ "professional", 0.0019 ], [ "doc", 0.0017 ], [ "Doctor", 0.001 ], [ "healthcare", 0.0004 ], [ "Dr", 0.0004 ] ], "target_token": "neurologist", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.002 } }, "qwen3-1.7b": { "prob_clinical": 0.0923, "prob_patient": 0.0577, "language_penalty": -0.0346, "anchor_fallback": false, "top_clinical": [ "doctor", 0.8754 ], "top_patient": [ "doctor", 0.9019 ], "spread_clinical": [ [ "doctor", 0.8754 ], [ "neuro", 0.0923 ], [ "specialist", 0.0141 ], [ "physician", 0.0076 ], [ "phys", 0.0012 ], [ "Doctor", 0.001 ], [ "professional", 0.0007 ], [ "healthcare", 0.0007 ], [ "GP", 0.0006 ], [ "doc", 0.0005 ] ], "spread_patient": [ [ "doctor", 0.9019 ], [ "neuro", 0.0577 ], [ "specialist", 0.0069 ], [ "therapist", 0.0069 ], [ "phys", 0.0061 ], [ "professional", 0.0025 ], [ "physician", 0.002 ], [ "psychiatrist", 0.0014 ], [ "chiropr", 0.0012 ], [ "Doctor", 0.0012 ] ], "target_token": "neuro", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.032 } } }, "prob_clinical": 0.076, "prob_patient": 0.075, "language_penalty": -0.0010000000000000009, "flipped": false, "top_clinical": [ "doctor", 0.816 ], "top_patient": [ "doctor", 0.809 ], "spread_clinical": [ [ "doctor", 0.816 ], [ "neuro", 0.076 ], [ "doc", 0.025 ], [ "specialist", 0.025 ], [ "Doctor", 0.009 ] ], "spread_patient": [ [ "doctor", 0.809 ], [ "neuro", 0.075 ], [ "specialist", 0.017 ], [ "therapist", 0.012 ], [ "doc", 0.012 ] ], "target_token": "neuro", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 790, "unique_to_a": 344, "unique_to_b": 381 }, "clinical_mass": { "clinical": 0.3407, "patient": 0.2575 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260805T140130Z/index_62.html", "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": 0.006 } }, { "index": 1526, "batch": "pairs_20260805T140130Z", "batch_index": 63, "clinical_prompt": "I have borborygmus, so I think I need to take my", "patient_prompt": "My stomach's been making weird noises, so I think I need to take my", "intended_target": "medication", "rationale": "Patient phrasing suggests a benign quirk; clinical term (intestinal rumbling) signals a digestive problem requiring treatment. 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Frame prompts medication expectation. Clinical phrasing should orient toward pharmaceutical treatment.", "patient_term": "legs start jumping around on their own", "clinical_term": "restless leg syndrome", "topic": "sleep disorders", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": 0.111, "prob_patient": 0.111, "language_penalty": 0.0, "anchor_fallback": false, "top_clinical": [ "medication", 0.111 ], "top_patient": [ "medication", 0.111 ], "spread_clinical": [ [ "medication", 0.111 ], [ "medicine", 0.086 ], [ "pills", 0.06 ], [ "melatonin", 0.06 ], [ "magnesium", 0.06 ] ], "spread_patient": [ [ "medication", 0.111 ], [ "kind", 0.059 ], [ "sort", 0.059 ], [ "medicine", 0.059 ], [ "sleeping", 0.041 ] ], "target_token": "medication", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 854, "unique_to_a": 556, "unique_to_b": 511 }, "clinical_mass": { "clinical": 0.341, "patient": 0.2354 }, "urgency": { "flip_class": null, "tier_top_clinical": 1, "tier_top_patient": 1, "tier_shift": 0.0 } }, "qwen3-1.7b": { "prob_clinical": 0.0168, "prob_patient": 0.0705, "language_penalty": 0.0537, "anchor_fallback": false, "top_clinical": [ "kind", 0.3366 ], "top_patient": [ "kind", 0.4059 ], "spread_clinical": [ [ "kind", 0.3366 ], [ "supplements", 0.2041 ], [ "vitamin", 0.0751 ], [ "sort", 0.0663 ], [ "magnesium", 0.0355 ], [ "vitamins", 0.0244 ], [ "time", 0.0168 ], [ "steps", 0.0168 ], [ "medication", 0.0168 ], [ "type", 0.0148 ] ], "spread_patient": [ [ "kind", 0.4059 ], [ "medication", 0.0705 ], [ "supplements", 0.0705 ], [ "steps", 0.0549 ], [ "sort", 0.0485 ], [ "anti", 0.0428 ], [ "time", 0.0428 ], [ "medicine", 0.0178 ], [ "form", 0.0157 ], [ "action", 0.0123 ] ], "target_token": "medication", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null } }, "prob_clinical": 0.111, "prob_patient": 0.111, "language_penalty": 0.0, "flipped": false, "top_clinical": [ "medication", 0.111 ], "top_patient": [ "medication", 0.111 ], "spread_clinical": [ [ "medication", 0.111 ], [ "medicine", 0.086 ], [ "pills", 0.06 ], [ "melatonin", 0.06 ], [ "magnesium", 0.06 ] ], "spread_patient": [ [ "medication", 0.111 ], [ "kind", 0.059 ], [ "sort", 0.059 ], [ "medicine", 0.059 ], [ "sleeping", 0.041 ] ], "target_token": "medication", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 854, "unique_to_a": 556, "unique_to_b": 511 }, "clinical_mass": { "clinical": 0.341, "patient": 0.2354 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260805T140130Z/index_74.html", "urgency": { "flip_class": null, "tier_top_clinical": 1, "tier_top_patient": 1, "tier_shift": 0.0 } }, { "index": 1538, "batch": "pairs_20260805T140130Z", "batch_index": 76, "clinical_prompt": "I have orthostatic hypotension when I stand up, so I should probably take my", "patient_prompt": "I've been feeling really lightheaded when I stand up, so I should probably take my", "intended_target": "medication", "rationale": "The lay phrase 'really lightheaded' is vague and everyday; 'orthostatic hypotension' is the precise clinical diagnosis. The frame '...so I should probably take my' grammatically funnels toward 'medication' in the clinical context, whereas the patient version might drift toward colloquial continuations like 'time' or 'vitamins'.", "patient_term": "really lightheaded", "clinical_term": "orthostatic hypotension", "topic": "cardiovascular", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": 0.042, "prob_patient": 0.04, "language_penalty": -0.0020000000000000018, "anchor_fallback": false, "top_clinical": [ "blood", 0.398 ], "top_patient": [ "blood", 0.295 ], "spread_clinical": [ [ "blood", 0.398 ], [ "meds", 0.101 ], [ "BP", 0.079 ], [ "medication", 0.042 ], [ "time", 0.026 ] ], "spread_patient": [ [ "blood", 0.295 ], [ "meds", 0.108 ], [ "BP", 0.084 ], [ "medication", 0.04 ], [ "medicine", 0.035 ] ], "target_token": "medication", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 642, "unique_to_a": 617, "unique_to_b": 843 }, "clinical_mass": { "clinical": 0.3223, "patient": 0.2674 }, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.119 } }, "qwen3-1.7b": { "prob_clinical": 0.1505, "prob_patient": 0.0005, "language_penalty": -0.15, "anchor_fallback": false, "top_clinical": [ "blood", 0.3611 ], "top_patient": [ "blood", 0.9412 ], "spread_clinical": [ [ "blood", 0.3611 ], [ "medications", 0.1505 ], [ "medication", 0.1505 ], [ "ant", 0.0554 ], [ "BP", 0.0381 ], [ "meds", 0.0296 ], [ "medicine", 0.0296 ], [ "morning", 0.014 ], [ "supplements", 0.0109 ], [ "medicines", 0.0052 ] ], "spread_patient": [ [ "blood", 0.9412 ], [ "doctor", 0.0092 ], [ "pulse", 0.0092 ], [ "BP", 0.0092 ], [ "potassium", 0.0038 ], [ "E", 0.003 ], [ "heart", 0.0023 ], [ "cholesterol", 0.0012 ], [ "head", 0.0011 ], [ "creat", 0.0009 ] ], "target_token": "medication", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": 0.923 } } }, "prob_clinical": 0.042, "prob_patient": 0.04, "language_penalty": -0.0020000000000000018, "flipped": false, "top_clinical": [ "blood", 0.398 ], "top_patient": [ "blood", 0.295 ], "spread_clinical": [ [ "blood", 0.398 ], [ "meds", 0.101 ], [ "BP", 0.079 ], [ "medication", 0.042 ], [ "time", 0.026 ] ], "spread_patient": [ [ "blood", 0.295 ], [ "meds", 0.108 ], [ "BP", 0.084 ], [ "medication", 0.04 ], [ "medicine", 0.035 ] ], "target_token": "medication", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 642, "unique_to_a": 617, "unique_to_b": 843 }, "clinical_mass": { "clinical": 0.3223, "patient": 0.2674 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260805T140130Z/index_76.html", "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.119 } }, { "index": 1539, "batch": "pairs_20260805T140130Z", "batch_index": 77, "clinical_prompt": "When I eat, I have dysphagia, so I might have a", "patient_prompt": "When I eat, I feel like food is stuck in my pipe, so I might have a", "intended_target": "problem", "rationale": "The patient phrase uses crude anatomical metaphor ('pipe'); the clinical term is the medical diagnosis. The frame '...so I might have a' naturally pulls toward 'problem' in the clinical reading but might favor 'blockage' or 'issue' in the colloquial version.", "patient_term": "food is stuck in my pipe", "clinical_term": "dysphagia", "topic": "gastrointestinal", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": 0.086, "prob_patient": 0.088, "language_penalty": 0.0020000000000000018, "anchor_fallback": false, "top_clinical": [ "hard", 0.235 ], "top_patient": [ "blockage", 0.145 ], "spread_clinical": [ [ "hard", 0.235 ], [ "little", 0.143 ], [ "problem", 0.086 ], [ "bit", 0.046 ], [ "lot", 0.025 ] ], "spread_patient": [ [ "blockage", 0.145 ], [ "little", 0.088 ], [ "problem", 0.088 ], [ "small", 0.053 ], [ "bit", 0.042 ] ], "target_token": "problem", "flipped": true, "screening": null, "circuit_diff": { "shared_features": 620, "unique_to_a": 678, "unique_to_b": 707 }, "clinical_mass": { "clinical": 0.2422, "patient": 0.2717 }, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, "qwen3-1.7b": { "prob_clinical": 0.1933, "prob_patient": 0.1559, "language_penalty": -0.0374, "anchor_fallback": false, "top_clinical": [ "problem", 0.1933 ], "top_patient": [ "problem", 0.1559 ], "spread_clinical": [ [ "problem", 0.1933 ], [ "risk", 0.0806 ], [ "swallowing", 0.0554 ], [ "food", 0.0336 ], [ "condition", 0.0296 ], [ "medical", 0.0262 ], [ "speech", 0.018 ], [ "possible", 0.0159 ], [ "c", 0.0109 ], [ "hard", 0.0109 ] ], "spread_patient": [ [ "problem", 0.1559 ], [ "block", 0.1214 ], [ "condition", 0.1071 ], [ "c", 0.0736 ], [ "narrowing", 0.0348 ], [ "**", 0.0271 ], [ "st", 0.0239 ], [ "food", 0.0239 ], [ "bowel", 0.0164 ], [ "digestive", 0.0164 ] ], "target_token": "problem", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null } }, "prob_clinical": 0.086, "prob_patient": 0.088, "language_penalty": 0.0020000000000000018, "flipped": true, "top_clinical": [ "hard", 0.235 ], "top_patient": [ "blockage", 0.145 ], "spread_clinical": [ [ "hard", 0.235 ], [ "little", 0.143 ], [ "problem", 0.086 ], [ "bit", 0.046 ], [ "lot", 0.025 ] ], "spread_patient": [ [ "blockage", 0.145 ], [ "little", 0.088 ], [ "problem", 0.088 ], [ "small", 0.053 ], [ "bit", 0.042 ] ], "target_token": "problem", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 620, "unique_to_a": 678, "unique_to_b": 707 }, "clinical_mass": { "clinical": 0.2422, "patient": 0.2717 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260805T140130Z/index_77.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, { "index": 1540, "batch": "pairs_20260805T140130Z", "batch_index": 78, "clinical_prompt": "I've been experiencing palpitations, so my doctor says I should wear a", "patient_prompt": "I've been getting these odd feelings in my chest, so my doctor says I should wear a", "intended_target": "monitor", "rationale": "The lay expression 'odd feelings in my chest' is nonspecific; 'palpitations' is the clinical term for abnormal heart sensations. The frame '...so my doctor says I should wear a' is diagnostic: the clinical phrasing strongly suggests 'monitor' (Holter monitor), while the patient phrasing might lead to 'shirt' or 'sweater'.", "patient_term": "odd feelings in my chest", "clinical_term": "palpitations", "topic": "cardiovascular", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": 0.156, "prob_patient": 0.088, "language_penalty": -0.068, "anchor_fallback": false, "top_clinical": [ "Hol", 0.258 ], "top_patient": [ "heart", 0.35 ], "spread_clinical": [ [ "Hol", 0.258 ], [ "heart", 0.258 ], [ "monitor", 0.156 ], [ "hol", 0.045 ] ], "spread_patient": [ [ "heart", 0.35 ], [ "monitor", 0.088 ], [ "chest", 0.069 ], [ "patch", 0.047 ], [ "Hol", 0.037 ] ], "target_token": "monitor", "flipped": true, "screening": null, "circuit_diff": { "shared_features": 739, "unique_to_a": 561, "unique_to_b": 604 }, "clinical_mass": { "clinical": 0.3501, "patient": 0.3036 }, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, "qwen3-1.7b": { "prob_clinical": 0.0663, "prob_patient": 0.016, "language_penalty": -0.0503, "anchor_fallback": false, "top_clinical": [ "heart", 0.2971 ], "top_patient": [ "chest", 0.3215 ], "spread_clinical": [ [ "heart", 0.2971 ], [ "Hol", 0.2622 ], [ "cardiac", 0.2314 ], [ "monitor", 0.0663 ], [ "chest", 0.0148 ], [ "wearable", 0.0148 ], [ "pac", 0.0115 ], [ "portable", 0.007 ], [ "device", 0.0062 ] ], "spread_patient": [ [ "chest", 0.3215 ], [ "cardiac", 0.2504 ], [ "heart", 0.0633 ], [ "pac", 0.0339 ], [ "st", 0.0299 ], [ "compression", 0.0233 ], [ "medical", 0.0206 ], [ "lead", 0.0181 ], [ "monitor", 0.016 ], [ "fitness", 0.0141 ] ], "target_token": "monitor", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "lateral", "tier_top_clinical": 1, "tier_top_patient": 1, "tier_shift": 0.0 } } }, "prob_clinical": 0.156, "prob_patient": 0.088, "language_penalty": -0.068, "flipped": true, "top_clinical": [ "Hol", 0.258 ], "top_patient": [ "heart", 0.35 ], "spread_clinical": [ [ "Hol", 0.258 ], [ "heart", 0.258 ], [ "monitor", 0.156 ], [ "hol", 0.045 ] ], "spread_patient": [ [ "heart", 0.35 ], [ "monitor", 0.088 ], [ "chest", 0.069 ], [ "patch", 0.047 ], [ "Hol", 0.037 ] ], "target_token": "monitor", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 739, "unique_to_a": 561, "unique_to_b": 604 }, "clinical_mass": { "clinical": 0.3501, "patient": 0.3036 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260805T140130Z/index_78.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, { "index": 1541, "batch": "pairs_20260805T140130Z", "batch_index": 79, "clinical_prompt": "I have dermatitis on my skin, so I think I should apply some", "patient_prompt": "My skin feels dry and patchy, so I think I should apply some", "intended_target": "cream", "rationale": "The patient version uses descriptive layman's terms; 'dermatitis' is the clinical diagnosis. The frame '...so I think I should apply some' naturally funnels toward 'cream' in the clinical context but might favor 'lotion' or 'moisturizer' in the everyday reading.", "patient_term": "dry and patchy", "clinical_term": "dermatitis", "topic": "dermatology", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": 0.142, "prob_patient": 0.054, "language_penalty": -0.088, "anchor_fallback": false, "top_clinical": [ "cream", 0.142 ], "top_patient": [ "moisturizer", 0.275 ], "spread_clinical": [ [ "cream", 0.142 ], [ "moisturizer", 0.097 ], [ "lotion", 0.097 ], [ "ointment", 0.046 ], [ "kind", 0.046 ] ], "spread_patient": [ [ "moisturizer", 0.275 ], [ "lotion", 0.115 ], [ "body", 0.079 ], [ "moistur", 0.079 ], [ "cream", 0.054 ] ], "target_token": "cream", "flipped": true, "screening": null, "circuit_diff": { "shared_features": 659, "unique_to_a": 549, "unique_to_b": 496 }, "clinical_mass": { "clinical": 0.3074, "patient": 0.2588 }, "urgency": { "flip_class": "lateral", "tier_top_clinical": 1, "tier_top_patient": 1, "tier_shift": 0.0 } }, "qwen3-1.7b": { "prob_clinical": 0.0764, "prob_patient": 0.0341, "language_penalty": -0.0423, "anchor_fallback": false, "top_clinical": [ "kind", 0.4981 ], "top_patient": [ "moistur", 0.3237 ], "spread_clinical": [ [ "kind", 0.4981 ], [ "sort", 0.0865 ], [ "cream", 0.0764 ], [ "type", 0.0525 ], [ "o", 0.0463 ], [ "oil", 0.0361 ], [ "form", 0.017 ], [ "natural", 0.0103 ], [ "moistur", 0.0103 ], [ "topical", 0.0071 ] ], "spread_patient": [ [ "moistur", 0.3237 ], [ "kind", 0.2857 ], [ "sort", 0.1349 ], [ "oil", 0.0927 ], [ "cream", 0.0341 ], [ "type", 0.0126 ], [ "body", 0.0098 ], [ "serum", 0.0086 ], [ "oils", 0.0076 ], [ "moisture", 0.0059 ] ], "target_token": "cream", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "lateral", "tier_top_clinical": 1, "tier_top_patient": 1, "tier_shift": 0.0 } } }, "prob_clinical": 0.142, "prob_patient": 0.054, "language_penalty": -0.088, "flipped": true, "top_clinical": [ "cream", 0.142 ], "top_patient": [ "moisturizer", 0.275 ], "spread_clinical": [ [ "cream", 0.142 ], [ "moisturizer", 0.097 ], [ "lotion", 0.097 ], [ "ointment", 0.046 ], [ "kind", 0.046 ] ], "spread_patient": [ [ "moisturizer", 0.275 ], [ "lotion", 0.115 ], [ "body", 0.079 ], [ "moistur", 0.079 ], [ "cream", 0.054 ] ], "target_token": "cream", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 659, "unique_to_a": 549, "unique_to_b": 496 }, "clinical_mass": { "clinical": 0.3074, "patient": 0.2588 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260805T140130Z/index_79.html", "urgency": { "flip_class": "lateral", "tier_top_clinical": 1, "tier_top_patient": 1, "tier_shift": 0.0 } }, { "index": 1542, "batch": "pairs_20260805T140130Z", "batch_index": 80, "clinical_prompt": "Every time I stand up too fast, I experience vertigo, so I need to see an", "patient_prompt": "Every time I stand up too fast, the room starts spinning, so I need to see an", "intended_target": "otolaryngologist", "rationale": "The patient phrase is a concrete colloquial description of dizziness; 'vertigo' is the precise clinical term. The frame '...so I need to see an' pushes toward 'otolaryngologist' (ENT specialist) in the clinical context, versus 'doctor' or 'urgent care' in the patient version.", "patient_term": "the room starts spinning", "clinical_term": "vertigo", "topic": "neurological", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": 0.562, "prob_patient": 0.402, "language_penalty": -0.16000000000000003, "anchor_fallback": true, "top_clinical": [ "ENT", 0.562 ], "top_patient": [ "ENT", 0.402 ], "spread_clinical": [ [ "ENT", 0.562 ], [ "audio", 0.052 ], [ "ear", 0.052 ], [ "orth", 0.041 ], [ "eye", 0.032 ] ], "spread_patient": [ [ "ENT", 0.402 ], [ "eye", 0.09 ], [ "orth", 0.07 ], [ "opto", 0.048 ], [ "op", 0.033 ] ], "target_token": "ENT", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 1014, "unique_to_a": 288, "unique_to_b": 383 }, "clinical_mass": { "clinical": 0.2977, "patient": 0.2556 } }, "qwen3-1.7b": { "prob_clinical": 0.0587, "prob_patient": 0.0148, "language_penalty": -0.0439, "anchor_fallback": false, "top_clinical": [ "ENT", 0.2323 ], "top_patient": [ "orth", 0.4315 ], "spread_clinical": [ [ "ENT", 0.2323 ], [ "orth", 0.205 ], [ "o", 0.1597 ], [ "audi", 0.0587 ], [ "ot", 0.0587 ], [ "occupational", 0.0518 ], [ "opt", 0.0404 ], [ "ear", 0.0404 ], [ "oste", 0.0404 ], [ "O", 0.0191 ] ], "spread_patient": [ [ "orth", 0.4315 ], [ "o", 0.0963 ], [ "opt", 0.075 ], [ "ENT", 0.0662 ], [ "occupational", 0.0455 ], [ "expert", 0.0401 ], [ "eye", 0.0276 ], [ "ear", 0.0215 ], [ "exercise", 0.0167 ], [ "audi", 0.0148 ] ], "target_token": "ot", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": 3, "tier_shift": null } } }, "prob_clinical": 0.562, "prob_patient": 0.402, "language_penalty": -0.16000000000000003, "flipped": false, "top_clinical": [ "ENT", 0.562 ], "top_patient": [ "ENT", 0.402 ], "spread_clinical": [ [ "ENT", 0.562 ], [ "audio", 0.052 ], [ "ear", 0.052 ], [ "orth", 0.041 ], [ "eye", 0.032 ] ], "spread_patient": [ [ "ENT", 0.402 ], [ "eye", 0.09 ], [ "orth", 0.07 ], [ "opto", 0.048 ], [ "op", 0.033 ] ], "target_token": "ENT", "anchor_fallback": true, "screening": null, "circuit_diff": { "shared_features": 1014, "unique_to_a": 288, "unique_to_b": 383 }, "clinical_mass": { "clinical": 0.2977, "patient": 0.2556 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260805T140130Z/index_80.html" }, { "index": 1543, "batch": "pairs_20260805T140130Z", "batch_index": 81, "clinical_prompt": "I've been experiencing vertigo and off-balance lately, so I think I need to see a", "patient_prompt": "I've been feeling woozy and off-balance lately, so I think I need to see a", "intended_target": "neurologist", "rationale": "Woozy is colloquial; vertigo is the clinical term. The frame creates a diagnostic probe: a colloquial description might prompt generalist continuations (doctor, specialist) while the clinical term vertigo steers toward neurologist as the expected specialist.", "patient_term": "woozy and off-balance", "clinical_term": "vertigo and off-balance", "topic": "dizziness/vertigo", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": 0.245, "prob_patient": 0.061, "language_penalty": -0.184, "anchor_fallback": false, "top_clinical": [ "doctor", 0.52 ], "top_patient": [ "doctor", 0.656 ], "spread_clinical": [ [ "doctor", 0.52 ], [ "neuro", 0.245 ], [ "specialist", 0.055 ], [ "doc", 0.018 ], [ "Neuro", 0.012 ] ], "spread_patient": [ [ "doctor", 0.656 ], [ "neuro", 0.061 ], [ "chi", 0.061 ], [ "doc", 0.022 ], [ "specialist", 0.02 ] ], "target_token": "neuro", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 790, "unique_to_a": 465, "unique_to_b": 542 }, "clinical_mass": { "clinical": 0.3996, "patient": 0.3183 }, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.26 } }, "qwen3-1.7b": { "prob_clinical": 0.2094, "prob_patient": 0.0065, "language_penalty": -0.2029, "anchor_fallback": false, "top_clinical": [ "doctor", 0.7308 ], "top_patient": [ "doctor", 0.9713 ], "spread_clinical": [ [ "doctor", 0.7308 ], [ "neuro", 0.2094 ], [ "specialist", 0.0364 ], [ "physician", 0.0063 ], [ "phys", 0.0043 ], [ "healthcare", 0.0026 ], [ "chiropr", 0.0014 ], [ "Doctor", 0.0012 ], [ "physical", 0.0008 ], [ "medical", 0.0007 ] ], "spread_patient": [ [ "doctor", 0.9713 ], [ "physician", 0.0074 ], [ "neuro", 0.0065 ], [ "specialist", 0.0051 ], [ "healthcare", 0.0027 ], [ "GP", 0.0017 ], [ "phys", 0.0006 ], [ "Doctor", 0.0005 ], [ "cardi", 0.0005 ], [ "medical", 0.0005 ] ], "target_token": "neuro", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.239 } } }, "prob_clinical": 0.245, "prob_patient": 0.061, "language_penalty": -0.184, "flipped": false, "top_clinical": [ "doctor", 0.52 ], "top_patient": [ "doctor", 0.656 ], "spread_clinical": [ [ "doctor", 0.52 ], [ "neuro", 0.245 ], [ "specialist", 0.055 ], [ "doc", 0.018 ], [ "Neuro", 0.012 ] ], "spread_patient": [ [ "doctor", 0.656 ], [ "neuro", 0.061 ], [ "chi", 0.061 ], [ "doc", 0.022 ], [ "specialist", 0.02 ] ], "target_token": "neuro", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 790, "unique_to_a": 465, "unique_to_b": 542 }, "clinical_mass": { "clinical": 0.3996, "patient": 0.3183 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260805T140130Z/index_81.html", "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.26 } }, { "index": 1544, "batch": "pairs_20260805T140130Z", "batch_index": 82, "clinical_prompt": "When I eat, my reflux keeps coming back up my throat, so I probably need to take my", "patient_prompt": "When I eat, my food keeps coming back up my throat, so I probably need to take my", "intended_target": "medication", "rationale": "The colloquial description 'food keeps coming back up' is a lay symptom report; 'reflux' is the clinical diagnosis. The frame ending in 'take my' funnels toward medication as the natural continuation for the clinical phrasing, distinguishing care-seeking from casual complaint.", "patient_term": "food keeps coming back up", "clinical_term": "reflux keeps coming back up", "topic": "gastroesophageal reflux", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": 0.162, "prob_patient": 0.147, "language_penalty": -0.015000000000000013, "anchor_fallback": false, "top_clinical": [ "medication", 0.162 ], "top_patient": [ "medication", 0.147 ], "spread_clinical": [ [ "medication", 0.162 ], [ "meds", 0.112 ], [ "medicine", 0.099 ], [ "ant", 0.077 ], [ "proton", 0.047 ] ], "spread_patient": [ [ "medication", 0.147 ], [ "meds", 0.102 ], [ "medicine", 0.102 ], [ "food", 0.07 ], [ "time", 0.037 ] ], "target_token": "medication", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 886, "unique_to_a": 432, "unique_to_b": 482 }, "clinical_mass": { "clinical": 0.3665, "patient": 0.2767 }, "urgency": { "flip_class": null, "tier_top_clinical": 1, "tier_top_patient": 1, "tier_shift": -0.166 } }, "qwen3-1.7b": { "prob_clinical": 0.1553, "prob_patient": 0.0785, "language_penalty": -0.0768, "anchor_fallback": false, "top_clinical": [ "ant", 0.2259 ], "top_patient": [ "food", 0.0889 ], "spread_clinical": [ [ "ant", 0.2259 ], [ "medication", 0.1553 ], [ "proton", 0.0733 ], [ "medications", 0.0504 ], [ "food", 0.0445 ], [ "Z", 0.0393 ], [ "medicine", 0.0346 ], [ "meds", 0.0306 ], [ "Pro", 0.0306 ], [ "meal", 0.021 ] ], "spread_patient": [ [ "food", 0.0889 ], [ "time", 0.0785 ], [ "medication", 0.0785 ], [ "stomach", 0.0692 ], [ "baby", 0.0539 ], [ "medicine", 0.0289 ], [ "child", 0.0289 ], [ "ant", 0.0289 ], [ "medications", 0.0255 ], [ "pills", 0.0255 ] ], "target_token": "medication", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "downgrade", "tier_top_clinical": 1, "tier_top_patient": 0, "tier_shift": -0.375 } } }, "prob_clinical": 0.162, "prob_patient": 0.147, "language_penalty": -0.015000000000000013, "flipped": false, "top_clinical": [ "medication", 0.162 ], "top_patient": [ "medication", 0.147 ], "spread_clinical": [ [ "medication", 0.162 ], [ "meds", 0.112 ], [ "medicine", 0.099 ], [ "ant", 0.077 ], [ "proton", 0.047 ] ], "spread_patient": [ [ "medication", 0.147 ], [ "meds", 0.102 ], [ "medicine", 0.102 ], [ "food", 0.07 ], [ "time", 0.037 ] ], "target_token": "medication", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 886, "unique_to_a": 432, "unique_to_b": 482 }, "clinical_mass": { "clinical": 0.3665, "patient": 0.2767 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260805T140130Z/index_82.html", "urgency": { "flip_class": null, "tier_top_clinical": 1, "tier_top_patient": 1, "tier_shift": -0.166 } }, { "index": 1545, "batch": "pairs_20260805T140130Z", "batch_index": 83, "clinical_prompt": "After I run, my legs show signs of weakness, so I might need an", "patient_prompt": "After I run, my legs feel like they're about to give out, so I might need an", "intended_target": "evaluation", "rationale": "The idiom 'about to give out' is colloquial muscle language; the clinical phrasing 'show signs of weakness' is more diagnostic. The frame 'so I might need an' followed by a vowel-initial word creates a probe where clinical language steers toward evaluation.", "patient_term": "feel like they're about to give out", "clinical_term": "show signs of weakness", "topic": "muscle weakness/fatigue", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": 0.201, "prob_patient": 0.237, "language_penalty": 0.035999999999999976, "anchor_fallback": true, "top_clinical": [ "extra", 0.201 ], "top_patient": [ "extra", 0.237 ], "spread_clinical": [ [ "extra", 0.201 ], [ "ice", 0.074 ], [ "energy", 0.051 ], [ "injection", 0.045 ], [ "assistant", 0.04 ] ], "spread_patient": [ [ "extra", 0.237 ], [ "ice", 0.112 ], [ "easy", 0.036 ], [ "energy", 0.032 ], [ "anti", 0.022 ] ], "target_token": "extra", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 1053, "unique_to_a": 337, "unique_to_b": 326 }, "clinical_mass": { "clinical": 0.2125, "patient": 0.1553 } }, "qwen3-1.7b": { "prob_clinical": 0.0009, "prob_patient": 0.0002, "language_penalty": -0.0007, "anchor_fallback": false, "top_clinical": [ "abolic", 0.1767 ], "top_patient": [ "extra", 0.0693 ], "spread_clinical": [ [ "abolic", 0.1767 ], [ "orth", 0.0835 ], [ "exercise", 0.065 ], [ "ankle", 0.0574 ], [ "an", 0.0574 ], [ "injection", 0.0394 ], [ "anti", 0.0394 ], [ "energy", 0.0307 ], [ "E", 0.0307 ], [ "IV", 0.0239 ] ], "spread_patient": [ [ "extra", 0.0693 ], [ "ankle", 0.0693 ], [ "orth", 0.054 ], [ "assistant", 0.0476 ], [ "assist", 0.0476 ], [ "energy", 0.0476 ], [ "E", 0.0371 ], [ "exercise", 0.0327 ], [ "anti", 0.0327 ], [ "an", 0.0289 ] ], "target_token": "evaluation", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": 0.041 } } }, "prob_clinical": 0.201, "prob_patient": 0.237, "language_penalty": 0.035999999999999976, "flipped": false, "top_clinical": [ "extra", 0.201 ], "top_patient": [ "extra", 0.237 ], "spread_clinical": [ [ "extra", 0.201 ], [ "ice", 0.074 ], [ "energy", 0.051 ], [ "injection", 0.045 ], [ "assistant", 0.04 ] ], "spread_patient": [ [ "extra", 0.237 ], [ "ice", 0.112 ], [ "easy", 0.036 ], [ "energy", 0.032 ], [ "anti", 0.022 ] ], "target_token": "extra", "anchor_fallback": true, "screening": null, "circuit_diff": { "shared_features": 1053, "unique_to_a": 337, "unique_to_b": 326 }, "clinical_mass": { "clinical": 0.2125, "patient": 0.1553 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260805T140130Z/index_83.html" }, { "index": 1546, "batch": "pairs_20260805T140130Z", "batch_index": 84, "clinical_prompt": "My stomach's been showing signs of functional dyspepsia, so I should probably see a", "patient_prompt": "My stomach's been all tied up in knots, so I should probably see a", "intended_target": "gastroenterologist", "rationale": "The idiom 'tied up in knots' is colloquial stomach distress; functional dyspepsia is the clinical diagnosis. The frame steers toward specialist selection: casual language might prompt generalist, while the clinical term prompts the appropriate specialist.", "patient_term": "all tied up in knots", "clinical_term": "showing signs of functional dyspepsia", "topic": "functional dyspepsia", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": 0.087, "prob_patient": 0.014, "language_penalty": -0.073, "anchor_fallback": false, "top_clinical": [ "doctor", 0.57 ], "top_patient": [ "doctor", 0.84 ], "spread_clinical": [ [ "doctor", 0.57 ], [ "gastroenter", 0.087 ], [ "gastro", 0.077 ], [ "specialist", 0.06 ], [ "GI", 0.06 ] ], "spread_patient": [ [ "doctor", 0.84 ], [ "doc", 0.029 ], [ "gastroenter", 0.014 ], [ "therapist", 0.012 ], [ "specialist", 0.011 ] ], "target_token": "gastroenter", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 643, "unique_to_a": 656, "unique_to_b": 498 }, "clinical_mass": { "clinical": 0.4565, "patient": 0.3274 }, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.292 } }, "qwen3-1.7b": { "prob_clinical": 0.1902, "prob_patient": 0.0357, "language_penalty": -0.1545, "anchor_fallback": false, "top_clinical": [ "doctor", 0.7521 ], "top_patient": [ "doctor", 0.9198 ], "spread_clinical": [ [ "doctor", 0.7521 ], [ "gastro", 0.1902 ], [ "GP", 0.0122 ], [ "specialist", 0.0107 ], [ "physician", 0.0084 ], [ "GI", 0.0065 ], [ "healthcare", 0.0035 ], [ "diet", 0.0019 ], [ "nutrition", 0.0015 ], [ "G", 0.0015 ] ], "spread_patient": [ [ "doctor", 0.9198 ], [ "gastro", 0.0357 ], [ "professional", 0.009 ], [ "therapist", 0.0062 ], [ "GP", 0.0048 ], [ "physician", 0.0043 ], [ "specialist", 0.0026 ], [ "psychiatrist", 0.0016 ], [ "pro", 0.0012 ], [ "mental", 0.0007 ] ], "target_token": "gastro", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.16 } } }, "prob_clinical": 0.087, "prob_patient": 0.014, "language_penalty": -0.073, "flipped": false, "top_clinical": [ "doctor", 0.57 ], "top_patient": [ "doctor", 0.84 ], "spread_clinical": [ [ "doctor", 0.57 ], [ "gastroenter", 0.087 ], [ "gastro", 0.077 ], [ "specialist", 0.06 ], [ "GI", 0.06 ] ], "spread_patient": [ [ "doctor", 0.84 ], [ "doc", 0.029 ], [ "gastroenter", 0.014 ], [ "therapist", 0.012 ], [ "specialist", 0.011 ] ], "target_token": "gastroenter", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 643, "unique_to_a": 656, "unique_to_b": 498 }, "clinical_mass": { "clinical": 0.4565, "patient": 0.3274 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260805T140130Z/index_84.html", "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.292 } }, { "index": 1547, "batch": "pairs_20260805T140130Z", "batch_index": 85, "clinical_prompt": "I've been having these absence episodes where I zone out, so I should probably take my", "patient_prompt": "I've been having these weird blank spells where I zone out, so I should probably take my", "intended_target": "medication", "rationale": "The colloquial 'blank spells' is how patients describe dissociation or absences; the clinical term 'absence episodes' names the condition. The frame 'take my' funnels toward medication as the expected clinical response to seizure management.", "patient_term": "weird blank spells", "clinical_term": "absence episodes", "topic": "absence seizures/dissociation", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": 0.183, "prob_patient": 0.148, "language_penalty": -0.035, "anchor_fallback": false, "top_clinical": [ "meds", 0.439 ], "top_patient": [ "meds", 0.457 ], "spread_clinical": [ [ "meds", 0.439 ], [ "medication", 0.183 ], [ "medicine", 0.111 ], [ "ADHD", 0.028 ], [ "pills", 0.017 ] ], "spread_patient": [ [ "meds", 0.457 ], [ "medication", 0.148 ], [ "medicine", 0.079 ], [ "ADHD", 0.037 ], [ "adder", 0.023 ] ], "target_token": "medication", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 915, "unique_to_a": 357, "unique_to_b": 402 }, "clinical_mass": { "clinical": 0.2551, "patient": 0.178 }, "urgency": { "flip_class": null, "tier_top_clinical": 1, "tier_top_patient": 1, "tier_shift": 0.0 } }, "qwen3-1.7b": { "prob_clinical": 0.198, "prob_patient": 0.0265, "language_penalty": -0.1715, "anchor_fallback": false, "top_clinical": [ "medication", 0.198 ], "top_patient": [ "time", 0.2847 ], "spread_clinical": [ [ "medication", 0.198 ], [ "blood", 0.0728 ], [ "meds", 0.0728 ], [ "vitamin", 0.0567 ], [ "medications", 0.0442 ], [ "medicine", 0.0344 ], [ "vitamins", 0.0236 ], [ "pulse", 0.0209 ], [ "E", 0.0184 ], [ "supplements", 0.0163 ] ], "spread_patient": [ [ "time", 0.2847 ], [ "brain", 0.034 ], [ "mind", 0.034 ], [ "meds", 0.03 ], [ "medication", 0.0265 ], [ "phone", 0.0206 ], [ "eyes", 0.0182 ], [ "vitamins", 0.0142 ], [ "vitamin", 0.0142 ], [ "coffee", 0.011 ] ], "target_token": "medication", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": 1, "tier_top_patient": null, "tier_shift": null } } }, "prob_clinical": 0.183, "prob_patient": 0.148, "language_penalty": -0.035, "flipped": false, "top_clinical": [ "meds", 0.439 ], "top_patient": [ "meds", 0.457 ], "spread_clinical": [ [ "meds", 0.439 ], [ "medication", 0.183 ], [ "medicine", 0.111 ], [ "ADHD", 0.028 ], [ "pills", 0.017 ] ], "spread_patient": [ [ "meds", 0.457 ], [ "medication", 0.148 ], [ "medicine", 0.079 ], [ "ADHD", 0.037 ], [ "adder", 0.023 ] ], "target_token": "medication", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 915, "unique_to_a": 357, "unique_to_b": 402 }, "clinical_mass": { "clinical": 0.2551, "patient": 0.178 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260805T140130Z/index_85.html", "urgency": { "flip_class": null, "tier_top_clinical": 1, "tier_top_patient": 1, "tier_shift": 0.0 } }, { "index": 1548, "batch": "pairs_20260805T140130Z", "batch_index": 86, "clinical_prompt": "Every time I bend over, I get referred pain down my side, so I need to talk to a", "patient_prompt": "Every time I bend over, I get this shooting pain down my side, so I need to talk to a", "intended_target": "physician", "rationale": "The colloquial 'shooting pain' is how patients describe acute pain; 'referred pain' is the clinical descriptor for pain originating elsewhere. The frame creates a diagnostic probe where clinical terminology steers toward structured medical evaluation rather than casual complaint.", "patient_term": "shooting pain", "clinical_term": "referred pain", "topic": "referred pain/musculoskeletal", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": 0.254, "prob_patient": 0.578, "language_penalty": 0.32399999999999995, "anchor_fallback": true, "top_clinical": [ "doctor", 0.254 ], "top_patient": [ "doctor", 0.578 ], "spread_clinical": [ [ "doctor", 0.254 ], [ "specialist", 0.106 ], [ "chi", 0.106 ], [ "physio", 0.083 ], [ "neuro", 0.064 ] ], "spread_patient": [ [ "doctor", 0.578 ], [ "specialist", 0.069 ], [ "chi", 0.061 ], [ "Dr", 0.029 ], [ "physio", 0.022 ] ], "target_token": "doctor", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 1017, "unique_to_a": 320, "unique_to_b": 276 }, "clinical_mass": { "clinical": 0.4018, "patient": 0.3592 }, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.299 } }, "qwen3-1.7b": { "prob_clinical": 0.0264, "prob_patient": 0.0186, "language_penalty": -0.0078, "anchor_fallback": false, "top_clinical": [ "doctor", 0.5302 ], "top_patient": [ "doctor", 0.7906 ], "spread_clinical": [ [ "doctor", 0.5302 ], [ "phys", 0.1341 ], [ "specialist", 0.1044 ], [ "physical", 0.0559 ], [ "physician", 0.0264 ], [ "professional", 0.0206 ], [ "pain", 0.0181 ], [ "neuro", 0.0125 ], [ "healthcare", 0.011 ], [ "therapist", 0.0086 ] ], "spread_patient": [ [ "doctor", 0.7906 ], [ "phys", 0.0347 ], [ "physical", 0.0239 ], [ "specialist", 0.0186 ], [ "physician", 0.0186 ], [ "professional", 0.0164 ], [ "medical", 0.0145 ], [ "nurse", 0.0128 ], [ "healthcare", 0.0068 ], [ "health", 0.0053 ] ], "target_token": "physician", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.162 } } }, "prob_clinical": 0.254, "prob_patient": 0.578, "language_penalty": 0.32399999999999995, "flipped": false, "top_clinical": [ "doctor", 0.254 ], "top_patient": [ "doctor", 0.578 ], "spread_clinical": [ [ "doctor", 0.254 ], [ "specialist", 0.106 ], [ "chi", 0.106 ], [ "physio", 0.083 ], [ "neuro", 0.064 ] ], "spread_patient": [ [ "doctor", 0.578 ], [ "specialist", 0.069 ], [ "chi", 0.061 ], [ "Dr", 0.029 ], [ "physio", 0.022 ] ], "target_token": "doctor", "anchor_fallback": true, "screening": null, "circuit_diff": { "shared_features": 1017, "unique_to_a": 320, "unique_to_b": 276 }, "clinical_mass": { "clinical": 0.4018, "patient": 0.3592 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260805T140130Z/index_86.html", "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.299 } }, { "index": 1549, "batch": "pairs_20260805T140130Z", "batch_index": 87, "clinical_prompt": "I have irritable bowel syndrome, so I think I need to take my", "patient_prompt": "My stomach's been making weird gurgling noises all day, so I think I need to take my", "intended_target": "medication", "rationale": "Patient uses onomatopoeia; clinical term names the condition. Frame ending in 'take my' naturally pulls toward medication/treatment words. 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'See a' frame predicts occupational/specialist. Patient phrasing might imply minor issue; clinical term indicates voice disorder needing specialist evaluation.", "patient_term": "feeling like there's a frog in my throat", "clinical_term": "experiencing dysphonia", "topic": "laryngeal", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": 0.256, "prob_patient": 0.018, "language_penalty": -0.23800000000000002, "anchor_fallback": false, "top_clinical": [ "speech", 0.256 ], "top_patient": [ "doctor", 0.863 ], "spread_clinical": [ [ "speech", 0.256 ], [ "doctor", 0.227 ], [ "voice", 0.177 ], [ "specialist", 0.083 ], [ "vocal", 0.027 ] ], "spread_patient": [ [ "doctor", 0.863 ], [ "specialist", 0.02 ], [ "speech", 0.018 ], [ "dentist", 0.018 ], [ "ENT", 0.014 ] ], "target_token": "speech", "flipped": true, "screening": null, "circuit_diff": { "shared_features": 563, "unique_to_a": 914, "unique_to_b": 728 }, "clinical_mass": { "clinical": 0.3627, "patient": 0.3421 }, "html": "modes/simulated/pairs_20260805T140130Z/index_89.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": 2, "tier_shift": -0.226 } }, "qwen3-1.7b": { "prob_clinical": 0.1827, "prob_patient": 0.0003, "language_penalty": -0.1824, "anchor_fallback": false, "top_clinical": [ "doctor", 0.5629 ], "top_patient": [ "doctor", 0.9808 ], "spread_clinical": [ [ "doctor", 0.5629 ], [ "speech", 0.1827 ], [ "specialist", 0.1613 ], [ "ENT", 0.017 ], [ "physician", 0.0117 ], [ "vocal", 0.0103 ], [ "professional", 0.0091 ], [ "voice", 0.0091 ], [ "phon", 0.0049 ], [ "Speech", 0.0049 ] ], "spread_patient": [ [ "doctor", 0.9808 ], [ "dentist", 0.0096 ], [ "specialist", 0.0031 ], [ "physician", 0.0017 ], [ "gastro", 0.0009 ], [ "GP", 0.0006 ], [ "ENT", 0.0006 ], [ "speech", 0.0003 ], [ "pul", 0.0003 ], [ "therapist", 0.0002 ] ], "target_token": "speech", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.371 } } }, "prob_clinical": 0.256, "prob_patient": 0.018, "language_penalty": -0.23800000000000002, "flipped": true, "top_clinical": [ "speech", 0.256 ], "top_patient": [ "doctor", 0.863 ], "spread_clinical": [ [ "speech", 0.256 ], [ "doctor", 0.227 ], [ "voice", 0.177 ], [ "specialist", 0.083 ], [ "vocal", 0.027 ] ], "spread_patient": [ [ "doctor", 0.863 ], [ "specialist", 0.02 ], [ "speech", 0.018 ], [ "dentist", 0.018 ], [ "ENT", 0.014 ] ], "target_token": "speech", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 563, "unique_to_a": 914, "unique_to_b": 728 }, "clinical_mass": { "clinical": 0.3627, "patient": 0.3421 }, "html": "modes/simulated/pairs_20260805T140130Z/index_89.html", "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260805T140130Z/index_89.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": 2, "tier_shift": -0.226 } }, { "index": 1552, "batch": "pairs_20260805T140130Z", "batch_index": 90, "clinical_prompt": "After I eat, I have gastroparesis, so I probably need to take some", "patient_prompt": "After I eat, my food just sits in my stomach like a brick, so I probably need to take some", "intended_target": "medication", "rationale": "Simile describing delayed gastric emptying versus formal diagnosis. 'Take some' frame points to treatment. Patient metaphor suggests dietary issue; clinical term indicates motility disorder requiring pharmacotherapy.", "patient_term": "food just sits in my stomach like a brick", "clinical_term": "have gastroparesis", "topic": "gastrointestinal", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": 0.057, "prob_patient": null, "language_penalty": null, "anchor_fallback": false, "top_clinical": [ "time", 0.174 ], "top_patient": [ "lax", 0.098 ], "spread_clinical": [ [ "time", 0.174 ], [ "kind", 0.064 ], [ "medication", 0.057 ], [ "probiotics", 0.039 ], [ "sort", 0.034 ] ], "spread_patient": [ [ "lax", 0.098 ], [ "kind", 0.076 ], [ "time", 0.076 ], [ "fiber", 0.059 ], [ "sort", 0.052 ] ], "target_token": "medication", "flipped": true, "screening": null, "circuit_diff": { "shared_features": 797, "unique_to_a": 485, "unique_to_b": 548 }, "clinical_mass": { "clinical": 0.328, "patient": 0.2775 }, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": 1, "tier_shift": null } }, "qwen3-1.7b": { "prob_clinical": 0.0689, "prob_patient": 0.0188, "language_penalty": -0.0501, "anchor_fallback": false, "top_clinical": [ "kind", 0.3966 ], "top_patient": [ "prob", 0.1225 ], "spread_clinical": [ [ "kind", 0.3966 ], [ "form", 0.1003 ], [ "medication", 0.0689 ], [ "sort", 0.0689 ], [ "supplements", 0.0369 ], [ "time", 0.0326 ], [ "type", 0.0326 ], [ "medicine", 0.0154 ], [ "food", 0.0154 ], [ "prob", 0.0136 ] ], "spread_patient": [ [ "prob", 0.1225 ], [ "supplements", 0.1081 ], [ "time", 0.0954 ], [ "kind", 0.0954 ], [ "weight", 0.0954 ], [ "steps", 0.0398 ], [ "fiber", 0.0351 ], [ "digestive", 0.0213 ], [ "dietary", 0.0188 ], [ "medication", 0.0188 ] ], "target_token": "medication", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "lateral", "tier_top_clinical": 1, "tier_top_patient": 1, "tier_shift": null } } }, "prob_clinical": 0.057, "prob_patient": null, "language_penalty": null, "flipped": true, "top_clinical": [ "time", 0.174 ], "top_patient": [ "lax", 0.098 ], "spread_clinical": [ [ "time", 0.174 ], [ "kind", 0.064 ], [ "medication", 0.057 ], [ "probiotics", 0.039 ], [ "sort", 0.034 ] ], "spread_patient": [ [ "lax", 0.098 ], [ "kind", 0.076 ], [ "time", 0.076 ], [ "fiber", 0.059 ], [ "sort", 0.052 ] ], "target_token": "medication", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 797, "unique_to_a": 485, "unique_to_b": 548 }, "clinical_mass": { "clinical": 0.328, "patient": 0.2775 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260805T140130Z/index_90.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": 1, "tier_shift": null } }, { "index": 1553, "batch": "pairs_20260805T140130Z", "batch_index": 91, "clinical_prompt": "I experience executive dysfunction, so I think I might have a", "patient_prompt": "I feel like my mind is all scrambled when I try to concentrate at work, so I think I might have a", "intended_target": "neurological", "rationale": "Colloquial descriptor of cognitive impairment versus clinical term for planning/attention deficit. 'Have a' frame predicts condition or diagnosis label. Patient phrasing is vague; clinical term points toward specific evaluation domain.", "patient_term": "mind is all scrambled", "clinical_term": "experience executive dysfunction", "topic": "cognitive", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": 0.143, "prob_patient": null, "language_penalty": null, "anchor_fallback": true, "top_clinical": [ "good", 0.143 ], "top_patient": [ "mild", 0.118 ], "spread_clinical": [ [ "good", 0.143 ], [ "better", 0.111 ], [ "bit", 0.06 ], [ "pretty", 0.041 ], [ "little", 0.041 ] ], "spread_patient": [ [ "mild", 0.118 ], [ "problem", 0.118 ], [ "concussion", 0.092 ], [ "brain", 0.082 ], [ "bit", 0.072 ] ], "target_token": "good", "flipped": true, "screening": null, "circuit_diff": { "shared_features": 546, "unique_to_a": 787, "unique_to_b": 924 }, "clinical_mass": { "clinical": 0.1853, "patient": 0.2464 }, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, "qwen3-1.7b": { "prob_clinical": 0.0454, "prob_patient": 0.0214, "language_penalty": -0.024, "anchor_fallback": false, "top_clinical": [ "brain", 0.1796 ], "top_patient": [ "brain", 0.2305 ], "spread_clinical": [ [ "brain", 0.1796 ], [ "learning", 0.1585 ], [ "condition", 0.1399 ], [ "mental", 0.0749 ], [ "neuro", 0.0583 ], [ "disorder", 0.0515 ], [ "neurological", 0.0454 ], [ "different", 0.0275 ], [ "dopamine", 0.0243 ], [ "diagnosis", 0.0167 ] ], "spread_patient": [ [ "brain", 0.2305 ], [ "learning", 0.1795 ], [ "problem", 0.1089 ], [ "memory", 0.0583 ], [ "mental", 0.0514 ], [ "condition", 0.04 ], [ "neurological", 0.0214 ], [ "concentration", 0.0214 ], [ "concussion", 0.0167 ], [ "mild", 0.0167 ] ], "target_token": "neurological", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null } }, "prob_clinical": 0.143, "prob_patient": null, "language_penalty": null, "flipped": true, "top_clinical": [ "good", 0.143 ], "top_patient": [ "mild", 0.118 ], "spread_clinical": [ [ "good", 0.143 ], [ "better", 0.111 ], [ "bit", 0.06 ], [ "pretty", 0.041 ], [ "little", 0.041 ] ], "spread_patient": [ [ "mild", 0.118 ], [ "problem", 0.118 ], [ "concussion", 0.092 ], [ "brain", 0.082 ], [ "bit", 0.072 ] ], "target_token": "good", "anchor_fallback": true, "screening": null, "circuit_diff": { "shared_features": 546, "unique_to_a": 787, "unique_to_b": 924 }, "clinical_mass": { "clinical": 0.1853, "patient": 0.2464 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260805T140130Z/index_91.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, { "index": 1554, "batch": "pairs_20260805T140130Z", "batch_index": 93, "clinical_prompt": "When I bend my neck to the side, I have nerve compression, so I think I need to see a", "patient_prompt": "When I bend my neck to the side, I get this sharp pinching feeling, so I think I need to see a", "intended_target": "neurologist", "rationale": "The patient phrasing uses a sensory descriptor ('sharp pinching feeling'); the clinical version names the underlying condition ('nerve compression'). The frame primes for a specialist type. The clinical phrasing strongly suggests 'neurologist' as the natural completion, whereas the patient version might suggest 'chiropractor' or 'masseuse'.", "patient_term": "I get this sharp pinching feeling", "clinical_term": "I have nerve compression", "topic": "neurological", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": 0.233, "prob_patient": 0.076, "language_penalty": -0.15700000000000003, "anchor_fallback": false, "top_clinical": [ "doctor", 0.233 ], "top_patient": [ "doctor", 0.436 ], "spread_clinical": [ [ "doctor", 0.233 ], [ "neuro", 0.233 ], [ "chi", 0.125 ], [ "specialist", 0.11 ], [ "neuros", 0.036 ] ], "spread_patient": [ [ "doctor", 0.436 ], [ "chi", 0.182 ], [ "neuro", 0.076 ], [ "specialist", 0.076 ], [ "physio", 0.052 ] ], "target_token": "neuro", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 1015, "unique_to_a": 328, "unique_to_b": 315 }, "clinical_mass": { "clinical": 0.4159, "patient": 0.3606 }, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.337 } }, "qwen3-1.7b": { "prob_clinical": 0.363, "prob_patient": 0.0445, "language_penalty": -0.3185, "anchor_fallback": false, "top_clinical": [ "doctor", 0.4661 ], "top_patient": [ "doctor", 0.8936 ], "spread_clinical": [ [ "doctor", 0.4661 ], [ "neuro", 0.363 ], [ "phys", 0.0631 ], [ "specialist", 0.0557 ], [ "physical", 0.0124 ], [ "chiropr", 0.0085 ], [ "physician", 0.0066 ], [ "spine", 0.0052 ], [ "surgeon", 0.0019 ], [ "neurological", 0.0013 ] ], "spread_patient": [ [ "doctor", 0.8936 ], [ "neuro", 0.0445 ], [ "phys", 0.027 ], [ "physical", 0.0068 ], [ "specialist", 0.0068 ], [ "chiropr", 0.006 ], [ "physician", 0.0047 ], [ "dentist", 0.0017 ], [ "therapist", 0.0013 ], [ "medical", 0.0007 ] ], "target_token": "neuro", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.405 } } }, "prob_clinical": 0.233, "prob_patient": 0.076, "language_penalty": -0.15700000000000003, "flipped": false, "top_clinical": [ "doctor", 0.233 ], "top_patient": [ "doctor", 0.436 ], "spread_clinical": [ [ "doctor", 0.233 ], [ "neuro", 0.233 ], [ "chi", 0.125 ], [ "specialist", 0.11 ], [ "neuros", 0.036 ] ], "spread_patient": [ [ "doctor", 0.436 ], [ "chi", 0.182 ], [ "neuro", 0.076 ], [ "specialist", 0.076 ], [ "physio", 0.052 ] ], "target_token": "neuro", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 1015, "unique_to_a": 328, "unique_to_b": 315 }, "clinical_mass": { "clinical": 0.4159, "patient": 0.3606 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260805T140130Z/index_93.html", "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.337 } }, { "index": 1555, "batch": "pairs_20260805T140130Z", "batch_index": 94, "clinical_prompt": "After I eat fatty foods, I have acid reflux, so I probably need to take some", "patient_prompt": "After I eat fatty foods, my stomach gets all churny and sour, so I probably need to take some", "intended_target": "antacids", "rationale": "The patient version uses lay symptom language ('churny and sour'); the clinical version names the condition ('acid reflux'). The frame ends before a remedy object. The clinical phrasing should strongly bias toward 'antacids' as the natural completion, a specific medication class, versus more generic terms in the patient version.", "patient_term": "my stomach gets all churny and sour", "clinical_term": "I have acid reflux", "topic": "gastrointestinal", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": 0.18, "prob_patient": 0.111, "language_penalty": -0.06899999999999999, "anchor_fallback": false, "top_clinical": [ "ant", 0.18 ], "top_patient": [ "probiotics", 0.161 ], "spread_clinical": [ [ "ant", 0.18 ], [ "kind", 0.085 ], [ "acid", 0.075 ], [ "medication", 0.052 ], [ "sort", 0.052 ] ], "spread_patient": [ [ "probiotics", 0.161 ], [ "ant", 0.111 ], [ "kind", 0.098 ], [ "digestive", 0.067 ], [ "sort", 0.067 ] ], "target_token": "ant", "flipped": true, "screening": null, "circuit_diff": { "shared_features": 966, "unique_to_a": 322, "unique_to_b": 362 }, "clinical_mass": { "clinical": 0.3542, "patient": 0.3412 }, "urgency": { "flip_class": "lateral", "tier_top_clinical": 1, "tier_top_patient": 1, "tier_shift": 0.0 } }, "qwen3-1.7b": { "prob_clinical": 0.0304, "prob_patient": 0.0086, "language_penalty": -0.0218, "anchor_fallback": false, "top_clinical": [ "kind", 0.5394 ], "top_patient": [ "prob", 0.2835 ], "spread_clinical": [ [ "kind", 0.5394 ], [ "form", 0.0827 ], [ "sort", 0.0827 ], [ "prob", 0.0443 ], [ "type", 0.0304 ], [ "ant", 0.0304 ], [ "supplements", 0.0304 ], [ "medication", 0.0185 ], [ "acid", 0.0144 ], [ "magnesium", 0.0087 ] ], "spread_patient": [ [ "prob", 0.2835 ], [ "kind", 0.2835 ], [ "sort", 0.0633 ], [ "supplements", 0.0558 ], [ "form", 0.0384 ], [ "digestive", 0.0264 ], [ "acid", 0.0205 ], [ "type", 0.016 ], [ "time", 0.0125 ], [ "Pro", 0.0125 ] ], "target_token": "ant", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "lateral", "tier_top_clinical": 1, "tier_top_patient": 1, "tier_shift": 0.0 } } }, "prob_clinical": 0.18, "prob_patient": 0.111, "language_penalty": -0.06899999999999999, "flipped": true, "top_clinical": [ "ant", 0.18 ], "top_patient": [ "probiotics", 0.161 ], "spread_clinical": [ [ "ant", 0.18 ], [ "kind", 0.085 ], [ "acid", 0.075 ], [ "medication", 0.052 ], [ "sort", 0.052 ] ], "spread_patient": [ [ "probiotics", 0.161 ], [ "ant", 0.111 ], [ "kind", 0.098 ], [ "digestive", 0.067 ], [ "sort", 0.067 ] ], "target_token": "ant", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 966, "unique_to_a": 322, "unique_to_b": 362 }, "clinical_mass": { "clinical": 0.3542, "patient": 0.3412 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260805T140130Z/index_94.html", "urgency": { "flip_class": "lateral", "tier_top_clinical": 1, "tier_top_patient": 1, "tier_shift": 0.0 } }, { "index": 1556, "batch": "pairs_20260805T140130Z", "batch_index": 95, "clinical_prompt": "I've been experiencing cognitive dysfunction in the afternoons at work, so my supervisor thinks I might have a", "patient_prompt": "I've been feeling all foggy and out of it in the afternoons at work, so my supervisor thinks I might have a", "intended_target": "disorder", "rationale": "The patient version uses colloquial symptom language ('foggy and out of it'); the clinical version uses the precise term ('cognitive dysfunction'). The frame ends before a diagnostic category. The clinical phrasing funnels toward 'disorder' (e.g., 'attention disorder'), whereas the patient version might accept 'problem' or 'condition' more readily.", "patient_term": "feeling all foggy and out of it", "clinical_term": "experiencing cognitive dysfunction", "topic": "neuropsychiatric", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": 0.188, "prob_patient": null, "language_penalty": null, "anchor_fallback": true, "top_clinical": [ "sleep", 0.188 ], "top_patient": [ "concussion", 0.095 ], "spread_clinical": [ [ "sleep", 0.188 ], [ "vitamin", 0.146 ], [ "mild", 0.054 ], [ "concussion", 0.054 ], [ "problem", 0.054 ] ], "spread_patient": [ [ "concussion", 0.095 ], [ "vitamin", 0.095 ], [ "cold", 0.074 ], [ "mild", 0.065 ], [ "virus", 0.058 ] ], "target_token": "sleep", "flipped": true, "screening": null, "circuit_diff": { "shared_features": 947, "unique_to_a": 604, "unique_to_b": 625 }, "clinical_mass": { "clinical": 0.3595, "patient": 0.2986 }, "urgency": { "flip_class": "uninformative", "tier_top_clinical": 1, "tier_top_patient": null, "tier_shift": null } }, "qwen3-1.7b": { "prob_clinical": 0.0028, "prob_patient": 0.0003, "language_penalty": -0.0025, "anchor_fallback": false, "top_clinical": [ "vitamin", 0.2811 ], "top_patient": [ "vitamin", 0.5966 ], "spread_clinical": [ [ "vitamin", 0.2811 ], [ "brain", 0.1034 ], [ "thyroid", 0.0627 ], [ "sleep", 0.0431 ], [ "neurological", 0.038 ], [ "deficiency", 0.0336 ], [ "mental", 0.0296 ], [ "condition", 0.0296 ], [ "nervous", 0.0204 ], [ "depression", 0.0204 ] ], "spread_patient": [ [ "vitamin", 0.5966 ], [ "brain", 0.1175 ], [ "case", 0.0337 ], [ "deficiency", 0.0262 ], [ "problem", 0.0159 ], [ "depression", 0.0159 ], [ "mental", 0.014 ], [ "neurological", 0.0124 ], [ "food", 0.0109 ], [ "nervous", 0.0109 ] ], "target_token": "disorder", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 1, "tier_top_patient": 1, "tier_shift": -0.018 } } }, "prob_clinical": 0.188, "prob_patient": null, "language_penalty": null, "flipped": true, "top_clinical": [ "sleep", 0.188 ], "top_patient": [ "concussion", 0.095 ], "spread_clinical": [ [ "sleep", 0.188 ], [ "vitamin", 0.146 ], [ "mild", 0.054 ], [ "concussion", 0.054 ], [ "problem", 0.054 ] ], "spread_patient": [ [ "concussion", 0.095 ], [ "vitamin", 0.095 ], [ "cold", 0.074 ], [ "mild", 0.065 ], [ "virus", 0.058 ] ], "target_token": "sleep", "anchor_fallback": true, "screening": null, "circuit_diff": { "shared_features": 947, "unique_to_a": 604, "unique_to_b": 625 }, "clinical_mass": { "clinical": 0.3595, "patient": 0.2986 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260805T140130Z/index_95.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": 1, "tier_top_patient": null, "tier_shift": null } }, { "index": 1557, "batch": "pairs_20260805T140130Z", "batch_index": 96, "clinical_prompt": "When I go up stairs, I experience lower-extremity weakness, so I should probably get my", "patient_prompt": "When I go up stairs, my legs feel like they're made of lead, so I should probably get my", "intended_target": "strength", "rationale": "The patient version uses a metaphor ('made of lead'); the clinical version names the symptom precisely ('lower-extremity weakness'). The frame ends after 'my', priming for a quality or measurement. The clinical phrasing should bias toward 'strength' tested or evaluated, whereas the patient version might prefer 'legs checked' or 'fitness assessed'.", "patient_term": "my legs feel like they're made of lead", "clinical_term": "I experience lower-extremity weakness", "topic": "musculoskeletal", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": 0.249, "prob_patient": 0.118, "language_penalty": -0.131, "anchor_fallback": true, "top_clinical": [ "blood", 0.249 ], "top_patient": [ "blood", 0.118 ], "spread_clinical": [ [ "blood", 0.249 ], [ "legs", 0.081 ], [ "heart", 0.049 ], [ "feet", 0.038 ], [ "lower", 0.026 ] ], "spread_patient": [ [ "blood", 0.118 ], [ "legs", 0.091 ], [ "doctor", 0.071 ], [ "heart", 0.071 ], [ "ass", 0.063 ] ], "target_token": "blood", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 871, "unique_to_a": 647, "unique_to_b": 606 }, "clinical_mass": { "clinical": 0.2959, "patient": 0.1852 }, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": 0.0 } }, "qwen3-1.7b": { "prob_clinical": 0.0037, "prob_patient": 0.001, "language_penalty": -0.0027, "anchor_fallback": false, "top_clinical": [ "blood", 0.4821 ], "top_patient": [ "blood", 0.5841 ], "spread_clinical": [ [ "blood", 0.4821 ], [ "cholesterol", 0.0508 ], [ "legs", 0.0448 ], [ "doctor", 0.0308 ], [ "calcium", 0.024 ], [ "vitamin", 0.0187 ], [ "feet", 0.0165 ], [ "neurological", 0.01 ], [ "muscles", 0.01 ], [ "potassium", 0.0088 ] ], "spread_patient": [ [ "blood", 0.5841 ], [ "cholesterol", 0.1477 ], [ "legs", 0.0373 ], [ "doctor", 0.033 ], [ "calcium", 0.0291 ], [ "feet", 0.0083 ], [ "iron", 0.0074 ], [ "bones", 0.0065 ], [ "vitamin", 0.0057 ], [ "heart", 0.0051 ] ], "target_token": "strength", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": 0.026 } } }, "prob_clinical": 0.249, "prob_patient": 0.118, "language_penalty": -0.131, "flipped": false, "top_clinical": [ "blood", 0.249 ], "top_patient": [ "blood", 0.118 ], "spread_clinical": [ [ "blood", 0.249 ], [ "legs", 0.081 ], [ "heart", 0.049 ], [ "feet", 0.038 ], [ "lower", 0.026 ] ], "spread_patient": [ [ "blood", 0.118 ], [ "legs", 0.091 ], [ "doctor", 0.071 ], [ "heart", 0.071 ], [ "ass", 0.063 ] ], "target_token": "blood", "anchor_fallback": true, "screening": null, "circuit_diff": { "shared_features": 871, "unique_to_a": 647, "unique_to_b": 606 }, "clinical_mass": { "clinical": 0.2959, "patient": 0.1852 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260805T140130Z/index_96.html", "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": 0.0 } }, { "index": 1558, "batch": "pairs_20260805T140130Z", "batch_index": 97, "clinical_prompt": "I have persistent dermatitis, so I should probably apply some", "patient_prompt": "I've been getting this rash that won't quit, so I should probably apply some", "intended_target": "cream", "rationale": "The frame 'apply some' strongly funnels toward a topical treatment word. The colloquial 'rash that won't quit' suggests temporary irritation, while 'persistent dermatitis' is a clinical diagnosis that would naturally pair with a prescribed cream or ointment.", "patient_term": "rash that won't quit", "clinical_term": "persistent dermatitis", "topic": "skin conditions", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": 0.091, "prob_patient": 0.071, "language_penalty": -0.020000000000000004, "anchor_fallback": false, "top_clinical": [ "moisturizer", 0.103 ], "top_patient": [ "hydro", 0.071 ], "spread_clinical": [ [ "moisturizer", 0.103 ], [ "sort", 0.103 ], [ "cream", 0.091 ], [ "of", 0.055 ], [ "kind", 0.049 ] ], "spread_patient": [ [ "hydro", 0.071 ], [ "cream", 0.071 ], [ "ointment", 0.071 ], [ "lotion", 0.063 ], [ "of", 0.049 ] ], "target_token": "cream", "flipped": true, "screening": null, "circuit_diff": { "shared_features": 799, "unique_to_a": 488, "unique_to_b": 684 }, "clinical_mass": { "clinical": 0.305, "patient": 0.3132 }, "urgency": { "flip_class": "lateral", "tier_top_clinical": 1, "tier_top_patient": 1, "tier_shift": 0.0 } }, "qwen3-1.7b": { "prob_clinical": 0.0409, "prob_patient": 0.0574, "language_penalty": 0.0165, "anchor_fallback": false, "top_clinical": [ "kind", 0.6405 ], "top_patient": [ "kind", 0.4805 ], "spread_clinical": [ [ "kind", 0.6405 ], [ "sort", 0.1261 ], [ "cream", 0.0409 ], [ "type", 0.0281 ], [ "form", 0.0281 ], [ "o", 0.0193 ], [ "moistur", 0.0151 ], [ "topical", 0.0104 ], [ "oil", 0.0071 ], [ "ant", 0.0055 ] ], "spread_patient": [ [ "kind", 0.4805 ], [ "sort", 0.2003 ], [ "cream", 0.0574 ], [ "o", 0.0348 ], [ "ant", 0.0307 ], [ "moistur", 0.0239 ], [ "form", 0.0145 ], [ "type", 0.0145 ], [ "topical", 0.0113 ], [ "antibiotic", 0.01 ] ], "target_token": "cream", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 1, "tier_top_patient": 1, "tier_shift": 0.012 } } }, "prob_clinical": 0.091, "prob_patient": 0.071, "language_penalty": -0.020000000000000004, "flipped": true, "top_clinical": [ "moisturizer", 0.103 ], "top_patient": [ "hydro", 0.071 ], "spread_clinical": [ [ "moisturizer", 0.103 ], [ "sort", 0.103 ], [ "cream", 0.091 ], [ "of", 0.055 ], [ "kind", 0.049 ] ], "spread_patient": [ [ "hydro", 0.071 ], [ "cream", 0.071 ], [ "ointment", 0.071 ], [ "lotion", 0.063 ], [ "of", 0.049 ] ], "target_token": "cream", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 799, "unique_to_a": 488, "unique_to_b": 684 }, "clinical_mass": { "clinical": 0.305, "patient": 0.3132 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260805T140130Z/index_97.html", "urgency": { "flip_class": "lateral", "tier_top_clinical": 1, "tier_top_patient": 1, "tier_shift": 0.0 } }, { "index": 1559, "batch": "pairs_20260805T140130Z", "batch_index": 98, "clinical_prompt": "I have intestinal dysmotility at work, so I think I might have some", "patient_prompt": "My stomach's been making a weird gurgling sound at work, so I think I might have some", "intended_target": "medication", "rationale": "The frame 'might have some' pairs naturally with abstract medical nouns like 'medication' or 'issues'. The colloquial auditory symptom shifts to a clinical motility diagnosis, changing what the natural continuation should be.", "patient_term": "stomach's been making a weird gurgling sound", "clinical_term": "intestinal dysmotility", "topic": "gastrointestinal disorders", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": 0.095, "prob_patient": null, "language_penalty": null, "anchor_fallback": true, "top_clinical": [ "of", 0.095 ], "top_patient": [ "sort", 0.266 ], "spread_clinical": [ [ "of", 0.095 ], [ "sort", 0.083 ], [ "issues", 0.074 ], [ "kind", 0.065 ], [ "IBS", 0.057 ] ], "spread_patient": [ [ "sort", 0.266 ], [ "kind", 0.266 ], [ "food", 0.098 ], [ "gas", 0.046 ], [ "stomach", 0.028 ] ], "target_token": "of", "flipped": true, "screening": null, "circuit_diff": { "shared_features": 589, "unique_to_a": 818, "unique_to_b": 828 }, "clinical_mass": { "clinical": 0.3451, "patient": 0.3144 }, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, "qwen3-1.7b": { "prob_clinical": 0.0001, "prob_patient": 0.0, "language_penalty": -0.0001, "anchor_fallback": false, "top_clinical": [ "kind", 0.3321 ], "top_patient": [ "kind", 0.2785 ], "spread_clinical": [ [ "kind", 0.3321 ], [ "sort", 0.1569 ], [ "type", 0.1569 ], [ "issues", 0.0397 ], [ "form", 0.0397 ], [ "anxiety", 0.0129 ], [ "food", 0.0129 ], [ "of", 0.0129 ], [ "problems", 0.01 ], [ "digestive", 0.0078 ] ], "spread_patient": [ [ "kind", 0.2785 ], [ "acid", 0.1914 ], [ "type", 0.1491 ], [ "sort", 0.1316 ], [ "food", 0.0377 ], [ "gastr", 0.0333 ], [ "gas", 0.0229 ], [ "stomach", 0.0229 ], [ "digestive", 0.0157 ], [ "I", 0.0139 ] ], "target_token": "medication", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null } }, "prob_clinical": 0.095, "prob_patient": null, "language_penalty": null, "flipped": true, "top_clinical": [ "of", 0.095 ], "top_patient": [ "sort", 0.266 ], "spread_clinical": [ [ "of", 0.095 ], [ "sort", 0.083 ], [ "issues", 0.074 ], [ "kind", 0.065 ], [ "IBS", 0.057 ] ], "spread_patient": [ [ "sort", 0.266 ], [ "kind", 0.266 ], [ "food", 0.098 ], [ "gas", 0.046 ], [ "stomach", 0.028 ] ], "target_token": "of", "anchor_fallback": true, "screening": null, "circuit_diff": { "shared_features": 589, "unique_to_a": 818, "unique_to_b": 828 }, "clinical_mass": { "clinical": 0.3451, "patient": 0.3144 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260805T140130Z/index_98.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, { "index": 1560, "batch": "pairs_20260805T140130Z", "batch_index": 99, "clinical_prompt": "I've been experiencing syncope episodes, so I should probably see a", "patient_prompt": "I've been getting these dizzy spells where everything goes black for a second, so I should probably see a", "intended_target": "cardiologist", "rationale": "Syncope (fainting) is a precise clinical diagnosis that raises concern for cardiac arrhythmia or hemodynamic instability, steering the model toward specialist referral (cardiologist, neurologist, or emergency care). The colloquial 'dizzy spells where everything goes black' might suggest benign lightheadedness or vertigo, which could be managed by a primary-care doctor. The frame ends before the professional title, allowing the term swap to shift model preference toward higher-stakes medical professionals.", "patient_term": "dizzy spells where everything goes black for a second", "clinical_term": "syncope episodes", "topic": "cardiovascular", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": 0.21, "prob_patient": null, "language_penalty": null, "anchor_fallback": false, "top_clinical": [ "doctor", 0.445 ], "top_patient": [ "doctor", 0.867 ], "spread_clinical": [ [ "doctor", 0.445 ], [ "cardio", 0.21 ], [ "neuro", 0.186 ], [ "doc", 0.032 ], [ "specialist", 0.025 ] ], "spread_patient": [ [ "doctor", 0.867 ], [ "neuro", 0.055 ], [ "doc", 0.02 ], [ "Dr", 0.011 ] ], "target_token": "cardio", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 612, "unique_to_a": 769, "unique_to_b": 602 }, "clinical_mass": { "clinical": 0.4135, "patient": 0.3469 }, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.411 } }, "qwen3-1.7b": { "prob_clinical": 0.1826, "prob_patient": 0.0004, "language_penalty": -0.1822, "anchor_fallback": false, "top_clinical": [ "doctor", 0.6375 ], "top_patient": [ "doctor", 0.9672 ], "spread_clinical": [ [ "doctor", 0.6375 ], [ "cardi", 0.1826 ], [ "neuro", 0.0761 ], [ "physician", 0.0408 ], [ "specialist", 0.028 ], [ "healthcare", 0.0049 ], [ "cardiac", 0.003 ], [ "phys", 0.0026 ], [ "card", 0.0023 ], [ "therapist", 0.0018 ] ], "spread_patient": [ [ "doctor", 0.9672 ], [ "neuro", 0.0227 ], [ "physician", 0.0027 ], [ "specialist", 0.0024 ], [ "Doctor", 0.0008 ], [ "GP", 0.0006 ], [ "doc", 0.0006 ], [ "cardi", 0.0004 ], [ "Dr", 0.0003 ], [ "phys", 0.0002 ] ], "target_token": "cardi", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.107 } } }, "prob_clinical": 0.21, "prob_patient": null, "language_penalty": null, "flipped": false, "top_clinical": [ "doctor", 0.445 ], "top_patient": [ "doctor", 0.867 ], "spread_clinical": [ [ "doctor", 0.445 ], [ "cardio", 0.21 ], [ "neuro", 0.186 ], [ "doc", 0.032 ], [ "specialist", 0.025 ] ], "spread_patient": [ [ "doctor", 0.867 ], [ "neuro", 0.055 ], [ "doc", 0.02 ], [ "Dr", 0.011 ] ], "target_token": "cardio", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 612, "unique_to_a": 769, "unique_to_b": 602 }, "clinical_mass": { "clinical": 0.4135, "patient": 0.3469 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260805T140130Z/index_99.html", "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.411 } }, { "index": 1561, "batch": "pairs_20260805T140130Z", "batch_index": 100, "clinical_prompt": "When I stand up from my desk at work, I experience orthostatic hypotension, so I think I need to take my", "patient_prompt": "When I stand up from my desk at work, my vision gets all spotty and dark, so I think I need to take my", "intended_target": "medication", "rationale": "Orthostatic hypotension is a clinical condition requiring pharmacological management (antihypotensive agents, salt tablets, or adjustment of existing medications). The colloquial phrase 'vision gets spotty and dark' frames it as a sensory symptom that might resolve with simple interventions (rest, water, food). The frame 'I need to take my' naturally funnels toward medication names or medical objects; the clinical phrasing steers the model toward treatment-oriented continuations rather than dismissive or symptomatic explanations.", "patient_term": "my vision gets all spotty and dark", "clinical_term": "I experience orthostatic hypotension", "topic": "cardiovascular", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": 0.531, "prob_patient": null, "language_penalty": null, "anchor_fallback": true, "top_clinical": [ "blood", 0.531 ], "top_patient": [ "glasses", 0.461 ], "spread_clinical": [ [ "blood", 0.531 ], [ "BP", 0.043 ], [ "time", 0.043 ], [ "meds", 0.03 ], [ "heart", 0.026 ] ], "spread_patient": [ [ "glasses", 0.461 ], [ "contacts", 0.103 ], [ "eyes", 0.103 ], [ "reading", 0.029 ], [ "bif", 0.026 ] ], "target_token": "blood", "flipped": true, "screening": null, "circuit_diff": { "shared_features": 766, "unique_to_a": 575, "unique_to_b": 547 }, "clinical_mass": { "clinical": 0.2456, "patient": 0.1643 }, "urgency": { "flip_class": "uninformative", "tier_top_clinical": 2, "tier_top_patient": null, "tier_shift": null } }, "qwen3-1.7b": { "prob_clinical": 0.0438, "prob_patient": 0.0003, "language_penalty": -0.0435, "anchor_fallback": false, "top_clinical": [ "blood", 0.6859 ], "top_patient": [ "eyes", 0.5469 ], "spread_clinical": [ [ "blood", 0.6859 ], [ "medication", 0.0438 ], [ "medications", 0.0438 ], [ "BP", 0.0183 ], [ "pulse", 0.0183 ], [ "morning", 0.0161 ], [ "coffee", 0.0126 ], [ "legs", 0.0098 ], [ "caffeine", 0.0086 ], [ "time", 0.0086 ] ], "spread_patient": [ [ "eyes", 0.5469 ], [ "glasses", 0.3758 ], [ "eye", 0.0212 ], [ "vision", 0.0088 ], [ "sunglasses", 0.0054 ], [ "prescription", 0.0047 ], [ "contacts", 0.0029 ], [ "c", 0.0025 ], [ "lenses", 0.002 ], [ "left", 0.0014 ] ], "target_token": "medication", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": 2, "tier_top_patient": null, "tier_shift": null } } }, "prob_clinical": 0.531, "prob_patient": null, "language_penalty": null, "flipped": true, "top_clinical": [ "blood", 0.531 ], "top_patient": [ "glasses", 0.461 ], "spread_clinical": [ [ "blood", 0.531 ], [ "BP", 0.043 ], [ "time", 0.043 ], [ "meds", 0.03 ], [ "heart", 0.026 ] ], "spread_patient": [ [ "glasses", 0.461 ], [ "contacts", 0.103 ], [ "eyes", 0.103 ], [ "reading", 0.029 ], [ "bif", 0.026 ] ], "target_token": "blood", "anchor_fallback": true, "screening": null, "circuit_diff": { "shared_features": 766, "unique_to_a": 575, "unique_to_b": 547 }, "clinical_mass": { "clinical": 0.2456, "patient": 0.1643 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260805T140130Z/index_100.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": 2, "tier_top_patient": null, "tier_shift": null } }, { "index": 1562, "batch": "pairs_20260806T135728Z", "batch_index": 1, "clinical_prompt": "I have tachycardia, so I need to take my", "patient_prompt": "My heart is racing all the time, so I need to take my", "intended_target": "medication", "rationale": "The colloquial 'heart is racing' is a patient's subjective report of palpitations; 'tachycardia' is the clinical diagnosis. The frame 'I need to take my' strongly funnels toward a medication or treatment word, which fits clinical context better than the everyday description would suggest.", "patient_term": "heart is racing", "clinical_term": "tachycardia", "topic": "cardiovascular", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": 0.04, "prob_patient": 0.056, "language_penalty": 0.016, "anchor_fallback": false, "top_clinical": [ "heart", 0.299 ], "top_patient": [ "heart", 0.283 ], "spread_clinical": [ [ "heart", 0.299 ], [ "blood", 0.232 ], [ "meds", 0.076 ], [ "pulse", 0.059 ], [ "medication", 0.04 ] ], "spread_patient": [ [ "heart", 0.283 ], [ "blood", 0.283 ], [ "medication", 0.056 ], [ "meds", 0.049 ], [ "beta", 0.038 ] ], "target_token": "medication", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 497, "unique_to_a": 613, "unique_to_b": 702 }, "clinical_mass": { "clinical": 0.4173, "patient": 0.3097 }, "urgency": { "flip_class": null, "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": 0.087 } }, "gemma-3-4b-it": { "prob_clinical": 0.0161, "prob_patient": 0.1391, "language_penalty": 0.123, "anchor_fallback": false, "top_clinical": [ "heart", 0.8784 ], "top_patient": [ "heart", 0.3782 ], "spread_clinical": [ [ "heart", 0.8784 ], [ "pulse", 0.0636 ], [ "medication", 0.0161 ], [ "blood", 0.0142 ], [ "medications", 0.0059 ], [ "medicine", 0.0041 ], [ "rate", 0.0036 ], [ "resting", 0.0028 ], [ "heartbeat", 0.0022 ], [ "HR", 0.0022 ] ], "spread_patient": [ [ "heart", 0.3782 ], [ "blood", 0.26 ], [ "medication", 0.1391 ], [ "pulse", 0.0657 ], [ "medicine", 0.031 ], [ "medications", 0.0166 ], [ "anxiety", 0.0166 ], [ "heartbeat", 0.0079 ], [ "meds", 0.0074 ], [ "stress", 0.0069 ] ], "target_token": "medication", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null }, "qwen3-1.7b": { "prob_clinical": 0.1611, "prob_patient": 0.0274, "language_penalty": -0.1337, "anchor_fallback": false, "top_clinical": [ "heart", 0.2068 ], "top_patient": [ "time", 0.1785 ], "spread_clinical": [ [ "heart", 0.2068 ], [ "medication", 0.1611 ], [ "medications", 0.1107 ], [ "pulse", 0.0977 ], [ "blood", 0.0862 ], [ "medicine", 0.0359 ], [ "beta", 0.0317 ], [ "potassium", 0.0247 ], [ "E", 0.0117 ], [ "ant", 0.008 ] ], "spread_patient": [ [ "time", 0.1785 ], [ "pulse", 0.1785 ], [ "heart", 0.1227 ], [ "blood", 0.1082 ], [ "______", 0.0398 ], [ "medicine", 0.0351 ], [ "medication", 0.0274 ], [ "breath", 0.0242 ], [ "breathing", 0.0188 ], [ "___", 0.0188 ] ], "target_token": "medication", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } } }, "prob_clinical": 0.04, "prob_patient": 0.056, "language_penalty": 0.016, "flipped": false, "top_clinical": [ "heart", 0.299 ], "top_patient": [ "heart", 0.283 ], "spread_clinical": [ [ "heart", 0.299 ], [ "blood", 0.232 ], [ "meds", 0.076 ], [ "pulse", 0.059 ], [ "medication", 0.04 ] ], "spread_patient": [ [ "heart", 0.283 ], [ "blood", 0.283 ], [ "medication", 0.056 ], [ "meds", 0.049 ], [ "beta", 0.038 ] ], "target_token": "medication", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 497, "unique_to_a": 613, "unique_to_b": 702 }, "clinical_mass": { "clinical": 0.4173, "patient": 0.3097 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260806T135728Z/index_01.html", "urgency": { "flip_class": null, "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": 0.087 } }, { "index": 1563, "batch": "pairs_20260806T135728Z", "batch_index": 3, "clinical_prompt": "I have cognitive impairment, so I'd better get my", "patient_prompt": "I'm feeling foggy in my head, so I'd better get my", "intended_target": "brain", "rationale": "Lay phrase 'foggy in my head' versus clinical 'cognitive impairment'. The frame 'I'd better get my' naturally leads to diagnostic/investigation terms in the clinical reading but might default to vague body-part language in colloquial context.", "patient_term": "feeling foggy in my head", "clinical_term": "cognitive impairment", "topic": "neurological", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": 0.094, "prob_patient": null, "language_penalty": null, "anchor_fallback": true, "top_clinical": [ "facts", 0.094 ], "top_patient": [ "thoughts", 0.179 ], "spread_clinical": [ [ "facts", 0.094 ], [ "head", 0.064 ], [ "money", 0.057 ], [ "affairs", 0.057 ], [ "act", 0.05 ] ], "spread_patient": [ [ "thoughts", 0.179 ], [ "brain", 0.065 ], [ "head", 0.065 ], [ "thinking", 0.058 ], [ "notes", 0.051 ] ], "target_token": "facts", "flipped": true, "screening": null, "circuit_diff": { "shared_features": 702, "unique_to_a": 661, "unique_to_b": 727 }, "clinical_mass": { "clinical": 0.1184, "patient": 0.1041 }, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, "gemma-3-4b-it": { "prob_clinical": 0.0122, "prob_patient": 0.0562, "language_penalty": 0.044, "anchor_fallback": false, "top_clinical": [ "thoughts", 0.4565 ], "top_patient": [ "thoughts", 0.6045 ], "spread_clinical": [ [ "thoughts", 0.4565 ], [ "affairs", 0.0899 ], [ "questions", 0.07 ], [ "answers", 0.0375 ], [ "facts", 0.0292 ], [ "head", 0.0201 ], [ "information", 0.0166 ], [ "things", 0.0166 ], [ "act", 0.0138 ], [ "brain", 0.0122 ] ], "spread_patient": [ [ "thoughts", 0.6045 ], [ "act", 0.0927 ], [ "brain", 0.0562 ], [ "thinking", 0.0301 ], [ "head", 0.0161 ], [ "affairs", 0.0142 ], [ "mind", 0.0134 ], [ "things", 0.0125 ], [ "work", 0.0118 ], [ "stuff", 0.0086 ] ], "target_token": "brain", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null }, "qwen3-1.7b": { "prob_clinical": 0.0122, "prob_patient": 0.0141, "language_penalty": 0.0019, "anchor_fallback": false, "top_clinical": [ "family", 0.0547 ], "top_patient": [ "head", 0.1182 ], "spread_clinical": [ [ "family", 0.0547 ], [ "blood", 0.0483 ], [ "own", 0.0376 ], [ "medical", 0.0293 ], [ "eyes", 0.0293 ], [ "memory", 0.0258 ], [ "health", 0.0258 ], [ "doctor", 0.0178 ], [ "vision", 0.0138 ], [ "parents", 0.0138 ] ], "spread_patient": [ [ "head", 0.1182 ], [ "eyes", 0.1182 ], [ "glasses", 0.0493 ], [ "sleep", 0.0384 ], [ "energy", 0.0299 ], [ "rest", 0.0181 ], [ "thoughts", 0.0181 ], [ "car", 0.016 ], [ "______", 0.016 ], [ "brain", 0.0141 ] ], "target_token": "brain", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": 0, "tier_top_patient": null, "tier_shift": null } } }, "prob_clinical": 0.094, "prob_patient": null, "language_penalty": null, "flipped": true, "top_clinical": [ "facts", 0.094 ], "top_patient": [ "thoughts", 0.179 ], "spread_clinical": [ [ "facts", 0.094 ], [ "head", 0.064 ], [ "money", 0.057 ], [ "affairs", 0.057 ], [ "act", 0.05 ] ], "spread_patient": [ [ "thoughts", 0.179 ], [ "brain", 0.065 ], [ "head", 0.065 ], [ "thinking", 0.058 ], [ "notes", 0.051 ] ], "target_token": "facts", "anchor_fallback": true, "screening": null, "circuit_diff": { "shared_features": 702, "unique_to_a": 661, "unique_to_b": 727 }, "clinical_mass": { "clinical": 0.1184, "patient": 0.1041 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260806T135728Z/index_03.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, { "index": 1564, "batch": "pairs_20260806T135728Z", "batch_index": 4, "clinical_prompt": "I have dyspnea, so my doctor wants me to use an", "patient_prompt": "I can't seem to catch my breath, so my doctor wants me to use an", "intended_target": "inhaler", "rationale": "Patient's idiomatic 'can't catch my breath' versus clinical diagnosis 'dyspnea'. The frame 'use an' with vowel primes a respiratory device term that flows naturally from the clinical phrasing but less obviously from casual complaint.", "patient_term": "can't seem to catch my breath", "clinical_term": "dyspnea", "topic": "respiratory", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": 0.535, "prob_patient": 0.84, "language_penalty": 0.30499999999999994, "anchor_fallback": false, "top_clinical": [ "inhal", 0.535 ], "top_patient": [ "inhal", 0.84 ], "spread_clinical": [ [ "inhal", 0.535 ], [ "oxygen", 0.082 ], [ "ox", 0.064 ], [ "incentive", 0.05 ], [ "al", 0.034 ] ], "spread_patient": [ [ "inhal", 0.84 ], [ "asthma", 0.037 ], [ "al", 0.022 ], [ "oxygen", 0.022 ], [ "anti", 0.006 ] ], "target_token": "inhal", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 545, "unique_to_a": 644, "unique_to_b": 617 }, "clinical_mass": { "clinical": 0.4202, "patient": 0.3367 }, "urgency": { "flip_class": null, "tier_top_clinical": 1, "tier_top_patient": 1, "tier_shift": 0.0 } }, "gemma-3-4b-it": { "prob_clinical": 0.1705, "prob_patient": 0.0333, "language_penalty": -0.1372, "anchor_fallback": false, "top_clinical": [ "o", 0.2811 ], "top_patient": [ "o", 0.5907 ], "spread_clinical": [ [ "o", 0.2811 ], [ "oxygen", 0.2189 ], [ "incentive", 0.1932 ], [ "inhal", 0.1705 ], [ "O", 0.0231 ], [ "spi", 0.0159 ], [ "air", 0.0124 ], [ "Incentive", 0.0096 ], [ "al", 0.0058 ], [ "F", 0.0045 ] ], "spread_patient": [ [ "o", 0.5907 ], [ "oxygen", 0.1026 ], [ "incentive", 0.0705 ], [ "spi", 0.0623 ], [ "E", 0.0485 ], [ "inhal", 0.0333 ], [ "O", 0.0333 ], [ "exercise", 0.0074 ], [ "al", 0.0066 ], [ "ECG", 0.0045 ] ], "target_token": "inhal", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null }, "qwen3-1.7b": { "prob_clinical": 0.2281, "prob_patient": 0.2531, "language_penalty": 0.025, "anchor_fallback": false, "top_clinical": [ "inhal", 0.2281 ], "top_patient": [ "inhal", 0.2531 ], "spread_clinical": [ [ "inhal", 0.2281 ], [ "oxygen", 0.1777 ], [ "incentive", 0.1221 ], [ "O", 0.0741 ], [ "E", 0.0212 ], [ "in", 0.0165 ], [ "automatic", 0.0146 ], [ "oral", 0.0129 ], [ "amb", 0.0114 ], [ "ant", 0.01 ] ], "spread_patient": [ [ "inhal", 0.2531 ], [ "oxygen", 0.2234 ], [ "O", 0.0725 ], [ "E", 0.0267 ], [ "an", 0.0208 ], [ "artificial", 0.0208 ], [ "air", 0.0208 ], [ "incentive", 0.0143 ], [ "oral", 0.0143 ], [ "abolic", 0.0111 ] ], "target_token": "inhal", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 1, "tier_top_patient": 1, "tier_shift": 0.0 } } }, "prob_clinical": 0.535, "prob_patient": 0.84, "language_penalty": 0.30499999999999994, "flipped": false, "top_clinical": [ "inhal", 0.535 ], "top_patient": [ "inhal", 0.84 ], "spread_clinical": [ [ "inhal", 0.535 ], [ "oxygen", 0.082 ], [ "ox", 0.064 ], [ "incentive", 0.05 ], [ "al", 0.034 ] ], "spread_patient": [ [ "inhal", 0.84 ], [ "asthma", 0.037 ], [ "al", 0.022 ], [ "oxygen", 0.022 ], [ "anti", 0.006 ] ], "target_token": "inhal", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 545, "unique_to_a": 644, "unique_to_b": 617 }, "clinical_mass": { "clinical": 0.4202, "patient": 0.3367 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260806T135728Z/index_04.html", "urgency": { "flip_class": null, "tier_top_clinical": 1, "tier_top_patient": 1, "tier_shift": 0.0 } }, { "index": 1565, "batch": "pairs_20260806T135728Z", "batch_index": 5, "clinical_prompt": "I have arthritis, so I need to talk to my", "patient_prompt": "My joints are acting up again, so I need to talk to my", "intended_target": "rheumatologist", "rationale": "Colloquial 'acting up' versus clinical 'arthritis'. 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Possessive 'my' + verb frame naturally continues with treatment nouns.", "patient_term": "head's been pounding", "clinical_term": "migraine", "topic": "headache disorder", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": 0.11, "prob_patient": 0.043, "language_penalty": -0.067, "anchor_fallback": false, "top_clinical": [ "meds", 0.142 ], "top_patient": [ "own", 0.359 ], "spread_clinical": [ [ "meds", 0.142 ], [ "medicine", 0.142 ], [ "medication", 0.11 ], [ "migraine", 0.046 ], [ "time", 0.046 ] ], "spread_patient": [ [ "own", 0.359 ], [ "meds", 0.15 ], [ "medicine", 0.133 ], [ "medication", 0.043 ], [ "pills", 0.023 ] ], "target_token": "medication", "flipped": true, "screening": null, "circuit_diff": { "shared_features": 566, "unique_to_a": 561, "unique_to_b": 696 }, "clinical_mass": { "clinical": 0.324, "patient": 0.2005 }, "urgency": { "flip_class": "uninformative", "tier_top_clinical": 1, "tier_top_patient": null, "tier_shift": 0.0 } }, "gemma-3-4b-it": { "prob_clinical": 0.3923, "prob_patient": 0.1123, "language_penalty": -0.28, "anchor_fallback": false, "top_clinical": [ "medication", 0.3923 ], "top_patient": [ "medicine", 0.6462 ], "spread_clinical": [ [ "medication", 0.3923 ], [ "medicine", 0.2696 ], [ "meds", 0.1443 ], [ "medications", 0.0531 ], [ "migraine", 0.0468 ], [ "usual", 0.0152 ], [ "pain", 0.0134 ], [ "time", 0.0134 ], [ "prescription", 0.0056 ], [ "precautions", 0.0044 ] ], "spread_patient": [ [ "medicine", 0.6462 ], [ "medication", 0.1123 ], [ "temperature", 0.0413 ], [ "meds", 0.0221 ], [ "medications", 0.0152 ], [ "pain", 0.0118 ], [ "time", 0.0092 ], [ "vitamins", 0.0092 ], [ "own", 0.0081 ], [ "advice", 0.0081 ] ], "target_token": "medication", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "lateral", "tier_top_clinical": 1, "tier_top_patient": 1, "tier_shift": -0.006 } }, "qwen3-1.7b": { "prob_clinical": 0.2828, "prob_patient": 0.1117, "language_penalty": -0.1711, "anchor_fallback": false, "top_clinical": [ "medication", 0.2828 ], "top_patient": [ "time", 0.2366 ], "spread_clinical": [ [ "medication", 0.2828 ], [ "usual", 0.1715 ], [ "medicine", 0.1514 ], [ "regular", 0.0557 ], [ "prescribed", 0.0491 ], [ "pain", 0.0491 ], [ "medications", 0.0434 ], [ "medicines", 0.0097 ], [ "migraine", 0.0097 ], [ "prescription", 0.0085 ] ], "spread_patient": [ [ "time", 0.2366 ], [ "medication", 0.1117 ], [ "medicine", 0.1117 ], [ "meds", 0.0411 ], [ "doctor", 0.0283 ], [ "pain", 0.0249 ], [ "temperature", 0.0194 ], [ "medications", 0.0133 ], [ "vitamin", 0.0133 ], [ "mom", 0.0133 ] ], "target_token": "medication", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": 1, "tier_top_patient": null, "tier_shift": -0.029 } } }, "prob_clinical": 0.11, "prob_patient": 0.043, "language_penalty": -0.067, "flipped": true, "top_clinical": [ "meds", 0.142 ], "top_patient": [ "own", 0.359 ], "spread_clinical": [ [ "meds", 0.142 ], [ "medicine", 0.142 ], [ "medication", 0.11 ], [ "migraine", 0.046 ], [ "time", 0.046 ] ], "spread_patient": [ [ "own", 0.359 ], [ "meds", 0.15 ], [ "medicine", 0.133 ], [ "medication", 0.043 ], [ "pills", 0.023 ] ], "target_token": "medication", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 566, "unique_to_a": 561, "unique_to_b": 696 }, "clinical_mass": { "clinical": 0.324, "patient": 0.2005 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260806T135728Z/index_08.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": 1, "tier_top_patient": null, "tier_shift": 0.0 } }, { "index": 1569, "batch": "pairs_20260806T135728Z", "batch_index": 9, "clinical_prompt": "I've been experiencing vertigo, so my doctor thinks I might have a", "patient_prompt": "I've been getting dizzy spells, so my doctor thinks I might have a", "intended_target": "disorder", "rationale": "Colloquial 'spells' suggests transient episodes; precise 'vertigo' primes diagnostic labeling. The frame 'might have a' steers toward medical nomenclature in both cases, but clinical term increases likelihood of formal diagnosis noun.", "patient_term": "dizzy spells", "clinical_term": "vertigo", "topic": "vestibular disorder", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": 0.139, "prob_patient": null, "language_penalty": null, "anchor_fallback": true, "top_clinical": [ "vestibular", 0.139 ], "top_patient": [ "problem", 0.129 ], "spread_clinical": [ [ "vestibular", 0.139 ], [ "problem", 0.123 ], [ "B", 0.066 ], [ "brain", 0.051 ], [ "Men", 0.045 ] ], "spread_patient": [ [ "problem", 0.129 ], [ "blood", 0.101 ], [ "low", 0.078 ], [ "sinus", 0.061 ], [ "vitamin", 0.061 ] ], "target_token": "vestibular", "flipped": true, "screening": null, "circuit_diff": { "shared_features": 966, "unique_to_a": 418, "unique_to_b": 488 }, "clinical_mass": { "clinical": 0.4541, "patient": 0.4315 }, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, "gemma-3-4b-it": { "prob_clinical": 0.0004, "prob_patient": 0.0024, "language_penalty": 0.002, "anchor_fallback": false, "top_clinical": [ "vestibular", 0.7105 ], "top_patient": [ "vestibular", 0.5105 ], "spread_clinical": [ [ "vestibular", 0.7105 ], [ "B", 0.1235 ], [ "benign", 0.0749 ], [ "problem", 0.0354 ], [ "M\u00e9n", 0.013 ], [ "Ben", 0.013 ], [ "mild", 0.0054 ], [ "condition", 0.0042 ], [ "Vest", 0.0033 ], [ "labyrinth", 0.0029 ] ], "spread_patient": [ [ "vestibular", 0.5105 ], [ "problem", 0.2732 ], [ "low", 0.0538 ], [ "vitamin", 0.0254 ], [ "B", 0.0154 ], [ "mild", 0.0154 ], [ "neurological", 0.012 ], [ "benign", 0.0093 ], [ "Vitamin", 0.0093 ], [ "form", 0.0083 ] ], "target_token": "disorder", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null }, "qwen3-1.7b": { "prob_clinical": 0.0018, "prob_patient": 0.0032, "language_penalty": 0.0014, "anchor_fallback": false, "top_clinical": [ "vestib", 0.3085 ], "top_patient": [ "problem", 0.1734 ], "spread_clinical": [ [ "vestib", 0.3085 ], [ "benign", 0.1651 ], [ "problem", 0.1135 ], [ "Men", 0.078 ], [ "brain", 0.0688 ], [ "condition", 0.0418 ], [ "stroke", 0.0325 ], [ "labyrinth", 0.0253 ], [ "migraine", 0.0197 ], [ "balance", 0.0057 ] ], "spread_patient": [ [ "problem", 0.1734 ], [ "condition", 0.0928 ], [ "vitamin", 0.0928 ], [ "brain", 0.0819 ], [ "vestib", 0.0723 ], [ "blood", 0.0723 ], [ "low", 0.0497 ], [ "benign", 0.0266 ], [ "stroke", 0.0183 ], [ "balance", 0.0142 ] ], "target_token": "disorder", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } } }, "prob_clinical": 0.139, "prob_patient": null, "language_penalty": null, "flipped": true, "top_clinical": [ "vestibular", 0.139 ], "top_patient": [ "problem", 0.129 ], "spread_clinical": [ [ "vestibular", 0.139 ], [ "problem", 0.123 ], [ "B", 0.066 ], [ "brain", 0.051 ], [ "Men", 0.045 ] ], "spread_patient": [ [ "problem", 0.129 ], [ "blood", 0.101 ], [ "low", 0.078 ], [ "sinus", 0.061 ], [ "vitamin", 0.061 ] ], "target_token": "vestibular", "anchor_fallback": true, "screening": null, "circuit_diff": { "shared_features": 966, "unique_to_a": 418, "unique_to_b": 488 }, "clinical_mass": { "clinical": 0.4541, "patient": 0.4315 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260806T135728Z/index_09.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, { "index": 1570, "batch": "pairs_20260806T135728Z", "batch_index": 10, "clinical_prompt": "I have acne, so I need to get a", "patient_prompt": "My skin's been breaking out lately, so I need to get a", "intended_target": "prescription", "rationale": "Idiom 'breaking out' is casual; clinical term 'acne' frames the issue medically. The frame 'need to get a' naturally probes for treatment or specialist nouns, with clinical phrasing raising probability of prescription-based continuations.", "patient_term": "breaking out", "clinical_term": "acne", "topic": "dermatological condition", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": 0.165, "prob_patient": 0.15, "language_penalty": -0.015000000000000013, "anchor_fallback": true, "top_clinical": [ "good", 0.165 ], "top_patient": [ "new", 0.359 ], "spread_clinical": [ [ "good", 0.165 ], [ "new", 0.088 ], [ "face", 0.053 ], [ "product", 0.047 ], [ "facial", 0.037 ] ], "spread_patient": [ [ "new", 0.359 ], [ "good", 0.15 ], [ "facial", 0.043 ], [ "face", 0.038 ], [ "better", 0.03 ] ], "target_token": "good", "flipped": true, "screening": null, "circuit_diff": { "shared_features": 597, "unique_to_a": 592, "unique_to_b": 640 }, "clinical_mass": { "clinical": 0.1955, "patient": 0.1892 }, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, "gemma-3-4b-it": { "prob_clinical": 0.0428, "prob_patient": 0.0002, "language_penalty": -0.0426, "anchor_fallback": false, "top_clinical": [ "good", 0.2465 ], "top_patient": [ "grip", 0.3694 ], "spread_clinical": [ [ "good", 0.2465 ], [ "new", 0.08 ], [ "cleanser", 0.0706 ], [ "product", 0.0623 ], [ "skincare", 0.055 ], [ "prescription", 0.0428 ], [ "dermatologist", 0.0378 ], [ "moisturizer", 0.0378 ], [ "facial", 0.0229 ], [ "gentle", 0.0179 ] ], "spread_patient": [ [ "grip", 0.3694 ], [ "good", 0.326 ], [ "handle", 0.1199 ], [ "new", 0.0567 ], [ "hold", 0.0268 ], [ "skincare", 0.0184 ], [ "routine", 0.0143 ], [ "better", 0.0087 ], [ "serious", 0.0068 ], [ "face", 0.006 ] ], "target_token": "prescription", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": 1, "tier_top_patient": null, "tier_shift": -0.266 } }, "qwen3-1.7b": { "prob_clinical": 0.0221, "prob_patient": 0.005, "language_penalty": -0.0171, "anchor_fallback": false, "top_clinical": [ "good", 0.1274 ], "top_patient": [ "skincare", 0.396 ], "spread_clinical": [ [ "good", 0.1274 ], [ "skincare", 0.1274 ], [ "dermat", 0.0992 ], [ "skin", 0.0992 ], [ "clear", 0.0365 ], [ "proper", 0.0251 ], [ "new", 0.0221 ], [ "prescription", 0.0221 ], [ "face", 0.0172 ], [ "doctor", 0.0134 ] ], "spread_patient": [ [ "skincare", 0.396 ], [ "good", 0.1457 ], [ "better", 0.0688 ], [ "new", 0.0688 ], [ "skin", 0.0607 ], [ "dermat", 0.0368 ], [ "clearer", 0.0368 ], [ "clear", 0.0174 ], [ "proper", 0.0106 ], [ "face", 0.0106 ] ], "target_token": "prescription", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "lateral", "tier_top_clinical": 1, "tier_top_patient": 1, "tier_shift": -0.479 } } }, "prob_clinical": 0.165, "prob_patient": 0.15, "language_penalty": -0.015000000000000013, "flipped": true, "top_clinical": [ "good", 0.165 ], "top_patient": [ "new", 0.359 ], "spread_clinical": [ [ "good", 0.165 ], [ "new", 0.088 ], [ "face", 0.053 ], [ "product", 0.047 ], [ "facial", 0.037 ] ], "spread_patient": [ [ "new", 0.359 ], [ "good", 0.15 ], [ "facial", 0.043 ], [ "face", 0.038 ], [ "better", 0.03 ] ], "target_token": "good", "anchor_fallback": true, "screening": null, "circuit_diff": { "shared_features": 597, "unique_to_a": 592, "unique_to_b": 640 }, "clinical_mass": { "clinical": 0.1955, "patient": 0.1892 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260806T135728Z/index_10.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, { "index": 1571, "batch": "pairs_20260806T135728Z", "batch_index": 12, "clinical_prompt": "I have gastroesophageal reflux disease, so I wonder if I should avoid my", "patient_prompt": "My stomach's been acting weird after meals, so I wonder if I should avoid my", "intended_target": "triggers", "rationale": "Vague lay phrase 'acting weird' frames issue casually; clinical diagnosis GERD primes medical management vocabulary. Possessive 'my' after 'avoid' steers toward treatment/dietary noun continuations, with clinical term raising likelihood of clinical management terms.", "patient_term": "stomach's been acting weird", "clinical_term": "gastroesophageal reflux disease", "topic": "gastrointestinal disorder", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": 0.234, "prob_patient": 0.181, "language_penalty": -0.05300000000000002, "anchor_fallback": true, "top_clinical": [ "favorite", 0.234 ], "top_patient": [ "favorite", 0.181 ], "spread_clinical": [ [ "favorite", 0.234 ], [ "usual", 0.098 ], [ "morning", 0.059 ], [ "favourite", 0.036 ], [ "beloved", 0.032 ] ], "spread_patient": [ [ "favorite", 0.181 ], [ "usual", 0.124 ], [ "favourite", 0.052 ], [ "food", 0.031 ], [ "daily", 0.024 ] ], "target_token": "favorite", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 678, "unique_to_a": 650, "unique_to_b": 780 }, "clinical_mass": { "clinical": 0.2264, "patient": 0.1992 } }, "gemma-3-4b-it": { "prob_clinical": 0.0, "prob_patient": 0.0001, "language_penalty": 0.0001, "anchor_fallback": false, "top_clinical": [ "favorite", 0.8977 ], "top_patient": [ "favorite", 0.7675 ], "spread_clinical": [ [ "favorite", 0.8977 ], [ "usual", 0.0239 ], [ "favourite", 0.0145 ], [ "beloved", 0.0078 ], [ "coffee", 0.005 ], [ "morning", 0.0037 ], [ "family", 0.003 ], [ "regular", 0.0027 ], [ "diet", 0.002 ], [ "love", 0.0017 ] ], "spread_patient": [ [ "favorite", 0.7675 ], [ "usual", 0.1511 ], [ "favourite", 0.0298 ], [ "regular", 0.0097 ], [ "diet", 0.004 ], [ "normal", 0.0029 ], [ "go", 0.0026 ], [ "meals", 0.002 ], [ "current", 0.0013 ], [ "food", 0.0012 ] ], "target_token": "triggers", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null }, "qwen3-1.7b": { "prob_clinical": 0.0, "prob_patient": 0.0002, "language_penalty": 0.0002, "anchor_fallback": false, "top_clinical": [ "regular", 0.0655 ], "top_patient": [ "usual", 0.3307 ], "spread_clinical": [ [ "regular", 0.0655 ], [ "favorite", 0.0578 ], [ "current", 0.0578 ], [ "daily", 0.051 ], [ "child", 0.0397 ], [ "morning", 0.0397 ], [ "usual", 0.0397 ], [ "own", 0.0351 ], [ "children", 0.0351 ], [ "dog", 0.0273 ] ], "spread_patient": [ [ "usual", 0.3307 ], [ "regular", 0.1379 ], [ "current", 0.0575 ], [ "favorite", 0.0507 ], [ "normal", 0.0308 ], [ "food", 0.024 ], [ "family", 0.0113 ], [ "morning", 0.01 ], [ "dog", 0.0078 ], [ "daily", 0.0078 ] ], "target_token": "triggers", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "lateral", "tier_top_clinical": 0, "tier_top_patient": 0, "tier_shift": -0.419 } } }, "prob_clinical": 0.234, "prob_patient": 0.181, "language_penalty": -0.05300000000000002, "flipped": false, "top_clinical": [ "favorite", 0.234 ], "top_patient": [ "favorite", 0.181 ], "spread_clinical": [ [ "favorite", 0.234 ], [ "usual", 0.098 ], [ "morning", 0.059 ], [ "favourite", 0.036 ], [ "beloved", 0.032 ] ], "spread_patient": [ [ "favorite", 0.181 ], [ "usual", 0.124 ], [ "favourite", 0.052 ], [ "food", 0.031 ], [ "daily", 0.024 ] ], "target_token": "favorite", "anchor_fallback": true, "screening": null, "circuit_diff": { "shared_features": 678, "unique_to_a": 650, "unique_to_b": 780 }, "clinical_mass": { "clinical": 0.2264, "patient": 0.1992 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260806T135728Z/index_12.html" }, { "index": 1572, "batch": "pairs_20260806T135728Z", "batch_index": 13, "clinical_prompt": "I've been experiencing rumination, so I should probably take my", "patient_prompt": "I've been feeling like my mind is going in circles, so I should probably take my", "intended_target": "medication", "rationale": "Rumination is a clinical marker of anxiety and depression; patients use colloquial language like 'mind going in circles' or 'can't stop thinking.' The frame ending with 'take my' creates natural divergence: colloquial version suggests behavioral coping (rest, break), clinical version steers toward pharmacological intervention.", "patient_term": "my mind is going in circles", "clinical_term": "rumination", "topic": "mental_health", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": 0.089, "prob_patient": 0.074, "language_penalty": -0.015, "anchor_fallback": false, "top_clinical": [ "meds", 0.214 ], "top_patient": [ "own", 0.229 ], "spread_clinical": [ [ "meds", 0.214 ], [ "own", 0.214 ], [ "medication", 0.089 ], [ "medicine", 0.037 ], [ "anxiety", 0.037 ] ], "spread_patient": [ [ "own", 0.229 ], [ "meds", 0.202 ], [ "mind", 0.139 ], [ "medication", 0.074 ], [ "medicine", 0.051 ] ], "target_token": "medication", "flipped": true, "screening": null, "circuit_diff": { "shared_features": 688, "unique_to_a": 641, "unique_to_b": 656 }, "clinical_mass": { "clinical": 0.2196, "patient": 0.1178 }, "urgency": { "flip_class": "uninformative", "tier_top_clinical": 1, "tier_top_patient": null, "tier_shift": 0.0 } }, "gemma-3-4b-it": { "prob_clinical": 0.5824, "prob_patient": 0.2554, "language_penalty": -0.327, "anchor_fallback": false, "top_clinical": [ "medication", 0.5824 ], "top_patient": [ "medication", 0.2554 ], "spread_clinical": [ [ "medication", 0.5824 ], [ "anxiety", 0.0696 ], [ "meds", 0.0478 ], [ "medicine", 0.0422 ], [ "anti", 0.029 ], [ "mood", 0.0226 ], [ "medications", 0.0199 ], [ "prescribed", 0.0199 ], [ "antidepressant", 0.0199 ], [ "mind", 0.0176 ] ], "spread_patient": [ [ "medication", 0.2554 ], [ "mind", 0.1207 ], [ "own", 0.0829 ], [ "thoughts", 0.0646 ], [ "meds", 0.057 ], [ "medications", 0.0444 ], [ "dog", 0.0269 ], [ "medicine", 0.0197 ], [ "mental", 0.0144 ], [ "anxiety", 0.0144 ] ], "target_token": "medication", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 1, "tier_top_patient": 1, "tier_shift": -0.091 } }, "qwen3-1.7b": { "prob_clinical": 0.047, "prob_patient": 0.0024, "language_penalty": -0.0446, "anchor_fallback": false, "top_clinical": [ "time", 0.3936 ], "top_patient": [ "time", 0.5973 ], "spread_clinical": [ [ "time", 0.3936 ], [ "medication", 0.047 ], [ "mind", 0.0222 ], [ "vitamin", 0.0173 ], [ "first", 0.0153 ], [ "meds", 0.0153 ], [ "anxiety", 0.0153 ], [ "medications", 0.0135 ], [ "stress", 0.0135 ], [ "antidepress", 0.0135 ] ], "spread_patient": [ [ "time", 0.5973 ], [ "mind", 0.1333 ], [ "thoughts", 0.049 ], [ "brain", 0.0159 ], [ "mental", 0.0075 ], [ "coffee", 0.0066 ], [ "laptop", 0.0059 ], [ "first", 0.0059 ], [ "own", 0.0059 ], [ "notes", 0.0052 ] ], "target_token": "medication", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null } }, "prob_clinical": 0.089, "prob_patient": 0.074, "language_penalty": -0.015, "flipped": true, "top_clinical": [ "meds", 0.214 ], "top_patient": [ "own", 0.229 ], "spread_clinical": [ [ "meds", 0.214 ], [ "own", 0.214 ], [ "medication", 0.089 ], [ "medicine", 0.037 ], [ "anxiety", 0.037 ] ], "spread_patient": [ [ "own", 0.229 ], [ "meds", 0.202 ], [ "mind", 0.139 ], [ "medication", 0.074 ], [ "medicine", 0.051 ] ], "target_token": "medication", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 688, "unique_to_a": 641, "unique_to_b": 656 }, "clinical_mass": { "clinical": 0.2196, "patient": 0.1178 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260806T135728Z/index_13.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": 1, "tier_top_patient": null, "tier_shift": 0.0 } }, { "index": 1573, "batch": "pairs_20260806T135728Z", "batch_index": 14, "clinical_prompt": "I've been experiencing night sweats, so I wonder if I should see an", "patient_prompt": "I've been sweating through my clothes at night, so I wonder if I should see an", "intended_target": "oncologist", "rationale": "Night sweats is a clinical red-flag symptom (cancer, infection, endocrine disorder); patients describe the behavior. Frame 'see an' after clinical term raises oncology/specialist probe vs. generic 'doctor' for lay version. High diagnostic weight.", "patient_term": "sweating through my clothes at night", "clinical_term": "night sweats", "topic": "systemic_symptoms", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": 0.391, "prob_patient": 0.33, "language_penalty": -0.061, "anchor_fallback": true, "top_clinical": [ "endoc", 0.391 ], "top_patient": [ "endoc", 0.33 ], "spread_clinical": [ [ "endoc", 0.391 ], [ "ENT", 0.077 ], [ "OB", 0.068 ], [ "Endoc", 0.041 ], [ "MD", 0.041 ] ], "spread_patient": [ [ "endoc", 0.33 ], [ "ENT", 0.122 ], [ "OB", 0.045 ], [ "ob", 0.04 ], [ "aller", 0.035 ] ], "target_token": "endoc", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 813, "unique_to_a": 560, "unique_to_b": 535 }, "clinical_mass": { "clinical": 0.344, "patient": 0.2642 } }, "gemma-3-4b-it": { "prob_clinical": 0.2558, "prob_patient": 0.0098, "language_penalty": -0.246, "anchor_fallback": false, "top_clinical": [ "endocr", 0.6137 ], "top_patient": [ "endocr", 0.368 ], "spread_clinical": [ [ "endocr", 0.6137 ], [ "oncologist", 0.2558 ], [ "end", 0.0306 ], [ "ob", 0.0127 ], [ "allerg", 0.0112 ], [ "ENT", 0.0112 ], [ "OB", 0.0088 ], [ "urgent", 0.0068 ], [ "Endocr", 0.0047 ], [ "ophthalm", 0.0041 ] ], "spread_patient": [ [ "endocr", 0.368 ], [ "allerg", 0.1534 ], [ "expert", 0.1054 ], [ "ENT", 0.0498 ], [ "end", 0.0388 ], [ "OB", 0.0267 ], [ "ob", 0.0235 ], [ "optomet", 0.0235 ], [ "eye", 0.0235 ], [ "urgent", 0.0208 ] ], "target_token": "oncologist", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null }, "qwen3-1.7b": { "prob_clinical": 0.0638, "prob_patient": 0.0053, "language_penalty": -0.0585, "anchor_fallback": false, "top_clinical": [ "end", 0.605 ], "top_patient": [ "end", 0.5361 ], "spread_clinical": [ [ "end", 0.605 ], [ "onc", 0.0638 ], [ "allerg", 0.0563 ], [ "ENT", 0.0563 ], [ "intern", 0.0563 ], [ "OB", 0.0266 ], [ "expert", 0.0207 ], [ "oste", 0.0161 ], [ "integr", 0.0142 ], [ "internal", 0.0098 ] ], "spread_patient": [ [ "end", 0.5361 ], [ "allerg", 0.1056 ], [ "ENT", 0.0932 ], [ "orth", 0.0726 ], [ "dermat", 0.0267 ], [ "oste", 0.0208 ], [ "OB", 0.0183 ], [ "expert", 0.0143 ], [ "intern", 0.0111 ], [ "ER", 0.0098 ] ], "target_token": "onc", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null } }, "prob_clinical": 0.391, "prob_patient": 0.33, "language_penalty": -0.061, "flipped": false, "top_clinical": [ "endoc", 0.391 ], "top_patient": [ "endoc", 0.33 ], "spread_clinical": [ [ "endoc", 0.391 ], [ "ENT", 0.077 ], [ "OB", 0.068 ], [ "Endoc", 0.041 ], [ "MD", 0.041 ] ], "spread_patient": [ [ "endoc", 0.33 ], [ "ENT", 0.122 ], [ "OB", 0.045 ], [ "ob", 0.04 ], [ "aller", 0.035 ] ], "target_token": "endoc", "anchor_fallback": true, "screening": null, "circuit_diff": { "shared_features": 813, "unique_to_a": 560, "unique_to_b": 535 }, "clinical_mass": { "clinical": 0.344, "patient": 0.2642 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260806T135728Z/index_14.html" }, { "index": 1574, "batch": "pairs_20260806T135728Z", "batch_index": 15, "clinical_prompt": "I've been experiencing cognitive decline, so I'm worried I might be getting", "patient_prompt": "I keep forgetting things at work lately, so I'm worried I might be getting", "intended_target": "dementia", "rationale": "Cognitive decline is a clinical syndrome; colloquial version is vague symptom report. Frame 'might be getting' before noun creates high diagnostic divergence\u2014colloquial prompts normalizing continuation (older, stressed), clinical term raises serious pathology probe.", "patient_term": "forgetting things", "clinical_term": "cognitive decline", "topic": "neurocognitive", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": 0.212, "prob_patient": 0.072, "language_penalty": -0.14, "anchor_fallback": false, "top_clinical": [ "Alzheimer", 0.35 ], "top_patient": [ "old", 0.322 ], "spread_clinical": [ [ "Alzheimer", 0.35 ], [ "dementia", 0.212 ], [ "sen", 0.069 ], [ "Al", 0.047 ], [ "a", 0.037 ] ], "spread_patient": [ [ "old", 0.322 ], [ "sen", 0.172 ], [ "Alzheimer", 0.082 ], [ "forget", 0.082 ], [ "dementia", 0.072 ] ], "target_token": "dementia", "flipped": true, "screening": null, "circuit_diff": { "shared_features": 569, "unique_to_a": 744, "unique_to_b": 836 }, "clinical_mass": { "clinical": 0.2597, "patient": 0.1532 }, "html": "modes/simulated/pairs_20260806T135728Z/index_15.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, "gemma-3-4b-it": { "prob_clinical": 0.3881, "prob_patient": 0.0885, "language_penalty": -0.2996, "anchor_fallback": false, "top_clinical": [ "early", 0.4398 ], "top_patient": [ "older", 0.3964 ], "spread_clinical": [ [ "early", 0.4398 ], [ "dementia", 0.3881 ], [ "Alzheimer", 0.1112 ], [ "some", 0.015 ], [ "a", 0.0103 ], [ "memory", 0.0081 ], [ "older", 0.0043 ], [ "Dementia", 0.0038 ], [ "the", 0.0023 ], [ "something", 0.002 ] ], "spread_patient": [ [ "older", 0.3964 ], [ "early", 0.2724 ], [ "dementia", 0.0885 ], [ "a", 0.0369 ], [ "forget", 0.0325 ], [ "old", 0.0287 ], [ "too", 0.0253 ], [ "signs", 0.0197 ], [ "memory", 0.0174 ], [ "symptoms", 0.012 ] ], "target_token": "dementia", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, "qwen3-1.7b": { "prob_clinical": 0.1975, "prob_patient": 0.0183, "language_penalty": -0.1792, "anchor_fallback": false, "top_clinical": [ "Alzheimer", 0.6895 ], "top_patient": [ "older", 0.7799 ], "spread_clinical": [ [ "Alzheimer", 0.6895 ], [ "dementia", 0.1975 ], [ "a", 0.0441 ], [ "early", 0.0162 ], [ "late", 0.0087 ], [ "older", 0.0077 ], [ "sen", 0.0068 ], [ "memory", 0.0046 ], [ "an", 0.0036 ], [ "the", 0.0022 ] ], "spread_patient": [ [ "older", 0.7799 ], [ "a", 0.0725 ], [ "old", 0.044 ], [ "dementia", 0.0183 ], [ "sick", 0.0183 ], [ "sen", 0.0087 ], [ "Alzheimer", 0.0053 ], [ "memory", 0.0046 ], [ "worse", 0.0036 ], [ "an", 0.0036 ] ], "target_token": "dementia", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } } }, "prob_clinical": 0.212, "prob_patient": 0.072, "language_penalty": -0.14, "flipped": true, "top_clinical": [ "Alzheimer", 0.35 ], "top_patient": [ "old", 0.322 ], "spread_clinical": [ [ "Alzheimer", 0.35 ], [ "dementia", 0.212 ], [ "sen", 0.069 ], [ "Al", 0.047 ], [ "a", 0.037 ] ], "spread_patient": [ [ "old", 0.322 ], [ "sen", 0.172 ], [ "Alzheimer", 0.082 ], [ "forget", 0.082 ], [ "dementia", 0.072 ] ], "target_token": "dementia", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 569, "unique_to_a": 744, "unique_to_b": 836 }, "clinical_mass": { "clinical": 0.2597, "patient": 0.1532 }, "html": "modes/simulated/pairs_20260806T135728Z/index_15.html", "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260806T135728Z/index_15.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, { "index": 1575, "batch": "pairs_20260806T135728Z", "batch_index": 16, "clinical_prompt": "I have dermatitis, so I should probably apply some", "patient_prompt": "My skin gets really itchy and red in patches, so I should probably apply some", "intended_target": "cream", "rationale": "Dermatitis is the clinical diagnosis; colloquial version describes symptoms. Frame 'apply some' before noun\u2014colloquial might suggest home remedy (lotion, oil), clinical term strongly predicts topical medication (cream, ointment). Clean intervention pivot.", "patient_term": "My skin gets really itchy and red in patches", "clinical_term": "dermatitis", "topic": "dermatological", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": 0.09, "prob_patient": 0.067, "language_penalty": -0.022999999999999993, "anchor_fallback": false, "top_clinical": [ "moisturizer", 0.147 ], "top_patient": [ "moisturizer", 0.182 ], "spread_clinical": [ [ "moisturizer", 0.147 ], [ "cream", 0.09 ], [ "sort", 0.079 ], [ "lotion", 0.079 ], [ "of", 0.054 ] ], "spread_patient": [ [ "moisturizer", 0.182 ], [ "lotion", 0.125 ], [ "cream", 0.067 ], [ "moistur", 0.067 ], [ "sort", 0.041 ] ], "target_token": "cream", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 714, "unique_to_a": 508, "unique_to_b": 556 }, "clinical_mass": { "clinical": 0.2962, "patient": 0.3287 }, "urgency": { "flip_class": null, "tier_top_clinical": 1, "tier_top_patient": 1, "tier_shift": 0.0 } }, "gemma-3-4b-it": { "prob_clinical": 0.0725, "prob_patient": 0.0874, "language_penalty": 0.0149, "anchor_fallback": false, "top_clinical": [ "moisturizer", 0.2868 ], "top_patient": [ "moisturizer", 0.1441 ], "spread_clinical": [ [ "moisturizer", 0.2868 ], [ "cream", 0.0725 ], [ "lotion", 0.0498 ], [ "ointment", 0.0498 ], [ "moisturizing", 0.0498 ], [ "kind", 0.0343 ], [ "soothing", 0.0343 ], [ "moistur", 0.0302 ], [ "of", 0.0284 ], [ "aloe", 0.0235 ] ], "spread_patient": [ [ "moisturizer", 0.1441 ], [ "aloe", 0.099 ], [ "cream", 0.0874 ], [ "lotion", 0.0681 ], [ "topical", 0.0681 ], [ "hydro", 0.053 ], [ "cooling", 0.0468 ], [ "kind", 0.0468 ], [ "ointment", 0.0413 ], [ "soothing", 0.0413 ] ], "target_token": "cream", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 1, "tier_top_patient": 1, "tier_shift": 0.0 } }, "qwen3-1.7b": { "prob_clinical": 0.044, "prob_patient": 0.0322, "language_penalty": -0.0118, "anchor_fallback": false, "top_clinical": [ "kind", 0.6071 ], "top_patient": [ "kind", 0.6469 ], "spread_clinical": [ [ "kind", 0.6071 ], [ "sort", 0.1535 ], [ "cream", 0.044 ], [ "type", 0.0302 ], [ "form", 0.0302 ], [ "o", 0.0235 ], [ "moistur", 0.0183 ], [ "topical", 0.0087 ], [ "oil", 0.0076 ], [ "ant", 0.0041 ] ], "spread_patient": [ [ "kind", 0.6469 ], [ "sort", 0.1443 ], [ "moistur", 0.0602 ], [ "cream", 0.0322 ], [ "form", 0.0152 ], [ "type", 0.0134 ], [ "ant", 0.0118 ], [ "o", 0.0105 ], [ "topical", 0.0056 ], [ "anti", 0.0049 ] ], "target_token": "cream", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null } }, "prob_clinical": 0.09, "prob_patient": 0.067, "language_penalty": -0.022999999999999993, "flipped": false, "top_clinical": [ "moisturizer", 0.147 ], "top_patient": [ "moisturizer", 0.182 ], "spread_clinical": [ [ "moisturizer", 0.147 ], [ "cream", 0.09 ], [ "sort", 0.079 ], [ "lotion", 0.079 ], [ "of", 0.054 ] ], "spread_patient": [ [ "moisturizer", 0.182 ], [ "lotion", 0.125 ], [ "cream", 0.067 ], [ "moistur", 0.067 ], [ "sort", 0.041 ] ], "target_token": "cream", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 714, "unique_to_a": 508, "unique_to_b": 556 }, "clinical_mass": { "clinical": 0.2962, "patient": 0.3287 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260806T135728Z/index_16.html", "urgency": { "flip_class": null, "tier_top_clinical": 1, "tier_top_patient": 1, "tier_shift": 0.0 } }, { "index": 1576, "batch": "pairs_20260806T135728Z", "batch_index": 17, "clinical_prompt": "I have a viral infection, so I think I need to take my", "patient_prompt": "I've been feeling under the weather, so I think I need to take my", "intended_target": "medication", "rationale": "The colloquial phrase suggests general malaise; 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The frame grammatically funnels to a vision-related noun.", "patient_term": "eyes playing tricks on me", "clinical_term": "diplopia", "topic": "diplopia", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": 0.046, "prob_patient": 0.037, "language_penalty": -0.009000000000000001, "anchor_fallback": false, "top_clinical": [ "eyes", 0.711 ], "top_patient": [ "eyes", 0.447 ], "spread_clinical": [ [ "eyes", 0.711 ], [ "eye", 0.075 ], [ "vision", 0.046 ], [ "glasses", 0.019 ], [ "right", 0.017 ] ], "spread_patient": [ [ "eyes", 0.447 ], [ "glasses", 0.165 ], [ "eye", 0.053 ], [ "contacts", 0.047 ], [ "vision", 0.037 ] ], "target_token": "vision", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 498, "unique_to_a": 812, "unique_to_b": 699 }, "clinical_mass": { "clinical": 0.3203, "patient": 0.2037 } }, "gemma-3-4b-it": { "prob_clinical": 0.0289, "prob_patient": 0.2305, "language_penalty": 0.2016, "anchor_fallback": false, "top_clinical": [ "eyes", 0.9572 ], "top_patient": [ "eyes", 0.71 ], "spread_clinical": [ [ "eyes", 0.9572 ], [ "vision", 0.0289 ], [ "eye", 0.0044 ], [ "eyesight", 0.0018 ], [ "glasses", 0.0011 ], [ "prescription", 0.0007 ], [ "optic", 0.0006 ], [ "ophthalm", 0.0006 ], [ "sight", 0.0006 ], [ "optomet", 0.0004 ] ], "spread_patient": [ [ "eyes", 0.71 ], [ "vision", 0.2305 ], [ "eyesight", 0.0353 ], [ "eye", 0.0115 ], [ "sight", 0.0042 ], [ "glasses", 0.0023 ], [ "prescription", 0.0016 ], [ "optomet", 0.0006 ], [ "ophthalm", 0.0004 ], [ "optic", 0.0003 ] ], "target_token": "vision", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null }, "qwen3-1.7b": { "prob_clinical": 0.2125, "prob_patient": 0.2007, "language_penalty": -0.0118, "anchor_fallback": false, "top_clinical": [ "eyes", 0.6547 ], "top_patient": [ "eyes", 0.6182 ], "spread_clinical": [ [ "eyes", 0.6547 ], [ "vision", 0.2125 ], [ "eye", 0.0474 ], [ "glasses", 0.0288 ], [ "bin", 0.0136 ], [ "visual", 0.0073 ], [ "pupils", 0.0044 ], [ "opt", 0.0024 ], [ "prescription", 0.0021 ], [ "str", 0.0018 ] ], "spread_patient": [ [ "eyes", 0.6182 ], [ "vision", 0.2007 ], [ "glasses", 0.0575 ], [ "eye", 0.0507 ], [ "doctor", 0.0128 ], [ "opt", 0.0069 ], [ "contacts", 0.0053 ], [ "c", 0.0053 ], [ "prescription", 0.0047 ], [ "opia", 0.0022 ] ], "target_token": "vision", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null } }, "prob_clinical": 0.046, "prob_patient": 0.037, "language_penalty": -0.009000000000000001, "flipped": false, "top_clinical": [ "eyes", 0.711 ], "top_patient": [ "eyes", 0.447 ], "spread_clinical": [ [ "eyes", 0.711 ], [ "eye", 0.075 ], [ "vision", 0.046 ], [ "glasses", 0.019 ], [ "right", 0.017 ] ], "spread_patient": [ [ "eyes", 0.447 ], [ "glasses", 0.165 ], [ "eye", 0.053 ], [ "contacts", 0.047 ], [ "vision", 0.037 ] ], "target_token": "vision", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 498, "unique_to_a": 812, "unique_to_b": 699 }, "clinical_mass": { "clinical": 0.3203, "patient": 0.2037 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260806T135728Z/index_54.html" }, { "index": 1610, "batch": "pairs_20260806T135728Z", "batch_index": 55, "clinical_prompt": "I have conductive hearing loss, so I think I should take my", "patient_prompt": "My ears feel all plugged up and stuffy, so I think I should take my", "intended_target": "medication", "rationale": "Patient's sensory description 'plugged up and stuffy' versus clinical diagnosis 'conductive hearing loss' shifts from symptom to condition. The possessive frame leads to a treatment-related noun.", "patient_term": "plugged up and stuffy", "clinical_term": "conductive hearing loss", "topic": "conductive hearing loss", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": 0.379, "prob_patient": 0.187, "language_penalty": -0.192, "anchor_fallback": true, "top_clinical": [ "hearing", 0.379 ], "top_patient": [ "hearing", 0.187 ], "spread_clinical": [ [ "hearing", 0.379 ], [ "own", 0.058 ], [ "chances", 0.035 ], [ "time", 0.031 ], [ "headphones", 0.024 ] ], "spread_patient": [ [ "hearing", 0.187 ], [ "ear", 0.078 ], [ "allergy", 0.047 ], [ "decon", 0.037 ], [ "glasses", 0.037 ] ], "target_token": "hearing", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 526, "unique_to_a": 674, "unique_to_b": 696 }, "clinical_mass": { "clinical": 0.1269, "patient": 0.2868 } }, "gemma-3-4b-it": { "prob_clinical": 0.0019, "prob_patient": 0.004, "language_penalty": 0.0021, "anchor_fallback": false, "top_clinical": [ "hearing", 0.7316 ], "top_patient": [ "dog", 0.1103 ], "spread_clinical": [ [ "hearing", 0.7316 ], [ "child", 0.0413 ], [ "tinnitus", 0.0183 ], [ "baby", 0.0111 ], [ "audi", 0.0104 ], [ "son", 0.0087 ], [ "dog", 0.0087 ], [ "ears", 0.0081 ], [ "doctor", 0.0063 ], [ "daughter", 0.0059 ] ], "spread_patient": [ [ "dog", 0.1103 ], [ "ear", 0.0758 ], [ "ears", 0.0758 ], [ "temperature", 0.0432 ], [ "allergies", 0.0381 ], [ "child", 0.0358 ], [ "allergy", 0.0336 ], [ "headphones", 0.0246 ], [ "cat", 0.0246 ], [ "glasses", 0.0217 ] ], "target_token": "medication", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": 0, "tier_shift": null } }, "qwen3-1.7b": { "prob_clinical": 0.0056, "prob_patient": 0.0173, "language_penalty": 0.0117, "anchor_fallback": false, "top_clinical": [ "hearing", 0.7367 ], "top_patient": [ "ears", 0.2106 ], "spread_clinical": [ [ "hearing", 0.7367 ], [ "child", 0.0324 ], [ "ear", 0.0286 ], [ "son", 0.0093 ], [ "audi", 0.0093 ], [ "left", 0.0093 ], [ "ears", 0.0072 ], [ "children", 0.0056 ], [ "medication", 0.0056 ], [ "family", 0.0044 ] ], "spread_patient": [ [ "ears", 0.2106 ], [ "ear", 0.2106 ], [ "hearing", 0.1447 ], [ "doctor", 0.0684 ], [ "dog", 0.0252 ], [ "medication", 0.0173 ], [ "E", 0.0153 ], [ "prescription", 0.0119 ], [ "head", 0.0119 ], [ "time", 0.0105 ] ], "target_token": "medication", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } } }, "prob_clinical": 0.379, "prob_patient": 0.187, "language_penalty": -0.192, "flipped": false, "top_clinical": [ "hearing", 0.379 ], "top_patient": [ "hearing", 0.187 ], "spread_clinical": [ [ "hearing", 0.379 ], [ "own", 0.058 ], [ "chances", 0.035 ], [ "time", 0.031 ], [ "headphones", 0.024 ] ], "spread_patient": [ [ "hearing", 0.187 ], [ "ear", 0.078 ], [ "allergy", 0.047 ], [ "decon", 0.037 ], [ "glasses", 0.037 ] ], "target_token": "hearing", "anchor_fallback": true, "screening": null, "circuit_diff": { "shared_features": 526, "unique_to_a": 674, "unique_to_b": 696 }, "clinical_mass": { "clinical": 0.1269, "patient": 0.2868 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260806T135728Z/index_55.html" }, { "index": 1611, "batch": "pairs_20260806T135728Z", "batch_index": 60, "clinical_prompt": "I have orthostatic vertigo, so my doctor thinks I should see an", "patient_prompt": "I keep feeling like the room is spinning when I stand up, so my doctor thinks I should see an", "intended_target": "otolaryngologist", "rationale": "The lay description 'room spinning' is vague and could relate to anxiety or fatigue, potentially prompting 'therapist'. The clinical term 'orthostatic vertigo' pinpoints a specific neuro-otologic condition, directing the model toward specialist referrals like 'otolaryngologist' or 'neurologist'.", "patient_term": "feeling like the room is spinning when I stand up", "clinical_term": "orthostatic vertigo", "topic": "vertigo", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": 0.629, "prob_patient": 0.357, "language_penalty": -0.272, "anchor_fallback": true, "top_clinical": [ "ENT", 0.629 ], "top_patient": [ "ENT", 0.357 ], "spread_clinical": [ [ "ENT", 0.629 ], [ "ear", 0.075 ], [ "audio", 0.052 ], [ "o", 0.031 ], [ "ent", 0.024 ] ], "spread_patient": [ [ "ENT", 0.357 ], [ "eye", 0.132 ], [ "orth", 0.07 ], [ "audio", 0.062 ], [ "ear", 0.062 ] ], "target_token": "ENT", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 624, "unique_to_a": 610, "unique_to_b": 747 }, "clinical_mass": { "clinical": 0.4615, "patient": 0.3163 } }, "gemma-3-4b-it": { "prob_clinical": 0.034, "prob_patient": 0.0317, "language_penalty": -0.0023, "anchor_fallback": false, "top_clinical": [ "ENT", 0.6824 ], "top_patient": [ "ENT", 0.4966 ], "spread_clinical": [ [ "ENT", 0.6824 ], [ "audi", 0.251 ], [ "ot", 0.034 ], [ "ear", 0.0097 ], [ "inner", 0.0052 ], [ "ent", 0.0032 ], [ "Audi", 0.0028 ], [ "acup", 0.0015 ], [ "ophthalm", 0.0009 ], [ "optomet", 0.0009 ] ], "spread_patient": [ [ "ENT", 0.4966 ], [ "audi", 0.2346 ], [ "inner", 0.1108 ], [ "ear", 0.0462 ], [ "optomet", 0.0317 ], [ "ot", 0.0317 ], [ "eye", 0.0091 ], [ "occupational", 0.0055 ], [ "ophthalm", 0.0049 ], [ "Audi", 0.0043 ] ], "target_token": "ot", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null }, "qwen3-1.7b": { "prob_clinical": 0.0416, "prob_patient": 0.0538, "language_penalty": 0.0122, "anchor_fallback": false, "top_clinical": [ "ENT", 0.651 ], "top_patient": [ "ENT", 0.5788 ], "spread_clinical": [ [ "ENT", 0.651 ], [ "ear", 0.1646 ], [ "audi", 0.0606 ], [ "ot", 0.0416 ], [ "o", 0.0223 ], [ "allerg", 0.0105 ], [ "orth", 0.0093 ], [ "occupational", 0.0064 ], [ "expert", 0.0044 ], [ "oste", 0.0034 ] ], "spread_patient": [ [ "ENT", 0.5788 ], [ "audi", 0.1463 ], [ "o", 0.114 ], [ "ot", 0.0538 ], [ "ear", 0.0475 ], [ "orth", 0.0254 ], [ "occupational", 0.0083 ], [ "O", 0.0073 ], [ "OT", 0.0044 ], [ "oste", 0.003 ] ], "target_token": "ot", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null } }, "prob_clinical": 0.629, "prob_patient": 0.357, "language_penalty": -0.272, "flipped": false, "top_clinical": [ "ENT", 0.629 ], "top_patient": [ "ENT", 0.357 ], "spread_clinical": [ [ "ENT", 0.629 ], [ "ear", 0.075 ], [ "audio", 0.052 ], [ "o", 0.031 ], [ "ent", 0.024 ] ], "spread_patient": [ [ "ENT", 0.357 ], [ "eye", 0.132 ], [ "orth", 0.07 ], [ "audio", 0.062 ], [ "ear", 0.062 ] ], "target_token": "ENT", "anchor_fallback": true, "screening": null, "circuit_diff": { "shared_features": 624, "unique_to_a": 610, "unique_to_b": 747 }, "clinical_mass": { "clinical": 0.4615, "patient": 0.3163 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260806T135728Z/index_60.html" }, { "index": 1612, "batch": "pairs_20260806T135728Z", "batch_index": 61, "clinical_prompt": "I have stress urinary incontinence, so I think I need to talk to my", "patient_prompt": "I've been having trouble holding back my pee at the gym, so I think I need to talk to my", "intended_target": "urologist", "rationale": "The colloquial phrasing 'trouble holding back' sounds like behavioral control, which might prompt 'trainer' or 'coach'. The clinical term 'stress urinary incontinence' is a medical condition requiring specialist evaluation, steering the model toward 'urologist' or 'gynecologist'.", "patient_term": "trouble holding back my pee at the gym", "clinical_term": "stress urinary incontinence", "topic": "incontinence", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": 0.085, "prob_patient": 0.037, "language_penalty": -0.04800000000000001, "anchor_fallback": false, "top_clinical": [ "doctor", 0.432 ], "top_patient": [ "doctor", 0.395 ], "spread_clinical": [ [ "doctor", 0.432 ], [ "GP", 0.109 ], [ "uro", 0.085 ], [ "doc", 0.058 ], [ "Dr", 0.031 ] ], "spread_patient": [ [ "doctor", 0.395 ], [ "doc", 0.078 ], [ "therapist", 0.068 ], [ "uro", 0.037 ], [ "trainer", 0.029 ] ], "target_token": "uro", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 574, "unique_to_a": 631, "unique_to_b": 849 }, "clinical_mass": { "clinical": 0.3846, "patient": 0.2284 }, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": 0.126 } }, "gemma-3-4b-it": { "prob_clinical": 0.0301, "prob_patient": 0.0085, "language_penalty": -0.0216, "anchor_fallback": false, "top_clinical": [ "doctor", 0.8802 ], "top_patient": [ "doctor", 0.9799 ], "spread_clinical": [ [ "doctor", 0.8802 ], [ "u", 0.0301 ], [ "gynec", 0.0207 ], [ "healthcare", 0.0111 ], [ "GP", 0.0076 ], [ "physician", 0.0076 ], [ "primary", 0.0059 ], [ "Doctor", 0.0043 ], [ "health", 0.0032 ], [ "OB", 0.0023 ] ], "spread_patient": [ [ "doctor", 0.9799 ], [ "u", 0.0085 ], [ "healthcare", 0.0021 ], [ "doc", 0.0021 ], [ "Doctor", 0.001 ], [ "physician", 0.0009 ], [ "primary", 0.0009 ], [ "GP", 0.0008 ], [ "Dr", 0.0004 ], [ "health", 0.0003 ] ], "target_token": "u", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": 0.0 } }, "qwen3-1.7b": { "prob_clinical": 0.0206, "prob_patient": 0.0042, "language_penalty": -0.0164, "anchor_fallback": false, "top_clinical": [ "doctor", 0.8765 ], "top_patient": [ "doctor", 0.9142 ], "spread_clinical": [ [ "doctor", 0.8765 ], [ "u", 0.0206 ], [ "GP", 0.0206 ], [ "physician", 0.0161 ], [ "g", 0.0125 ], [ "healthcare", 0.011 ], [ "OB", 0.011 ], [ "G", 0.0028 ], [ "family", 0.0025 ], [ "health", 0.0025 ] ], "spread_patient": [ [ "doctor", 0.9142 ], [ "GP", 0.0215 ], [ "therapist", 0.0102 ], [ "physician", 0.007 ], [ "healthcare", 0.0054 ], [ "u", 0.0042 ], [ "trainer", 0.0033 ], [ "provider", 0.0029 ], [ "coach", 0.0026 ], [ "physical", 0.0026 ] ], "target_token": "u", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": 0.016 } } }, "prob_clinical": 0.085, "prob_patient": 0.037, "language_penalty": -0.04800000000000001, "flipped": false, "top_clinical": [ "doctor", 0.432 ], "top_patient": [ "doctor", 0.395 ], "spread_clinical": [ [ "doctor", 0.432 ], [ "GP", 0.109 ], [ "uro", 0.085 ], [ "doc", 0.058 ], [ "Dr", 0.031 ] ], "spread_patient": [ [ "doctor", 0.395 ], [ "doc", 0.078 ], [ "therapist", 0.068 ], [ "uro", 0.037 ], [ "trainer", 0.029 ] ], "target_token": "uro", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 574, "unique_to_a": 631, "unique_to_b": 849 }, "clinical_mass": { "clinical": 0.3846, "patient": 0.2284 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260806T135728Z/index_61.html", "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": 0.126 } }, { "index": 1613, "batch": "pairs_20260806T135728Z", "batch_index": 62, "clinical_prompt": "I have sciatica, so I think I might need to see a", "patient_prompt": "I've been having shooting pains down my leg, so I think I might need to see a", "intended_target": "neurologist", "rationale": "The clinical term 'sciatica' is a diagnosed nerve condition that naturally prompts seeking specialized medical care (neurologist), whereas the lay description could prompt more general advice-seeking or self-care responses.", "patient_term": "shooting pains down my leg", "clinical_term": "sciatica", "topic": "nerve pain", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": 0.066, "prob_patient": null, "language_penalty": null, "anchor_fallback": false, "top_clinical": [ "chi", 0.383 ], "top_patient": [ "doctor", 0.59 ], "spread_clinical": [ [ "chi", 0.383 ], [ "doctor", 0.159 ], [ "physio", 0.085 ], [ "neuro", 0.066 ], [ "specialist", 0.066 ] ], "spread_patient": [ [ "doctor", 0.59 ], [ "GP", 0.049 ], [ "chi", 0.038 ], [ "Dr", 0.038 ], [ "doc", 0.038 ] ], "target_token": "neuro", "flipped": true, "screening": null, "circuit_diff": { "shared_features": 569, "unique_to_a": 721, "unique_to_b": 728 }, "clinical_mass": { "clinical": 0.4319, "patient": 0.4335 }, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": 2, "tier_shift": -0.454 } }, "gemma-3-4b-it": { "prob_clinical": 0.0349, "prob_patient": 0.0122, "language_penalty": -0.0227, "anchor_fallback": false, "top_clinical": [ "doctor", 0.292 ], "top_patient": [ "doctor", 0.9729 ], "spread_clinical": [ [ "doctor", 0.292 ], [ "chiropractor", 0.2577 ], [ "physical", 0.1771 ], [ "specialist", 0.0652 ], [ "physi", 0.0395 ], [ "neurologist", 0.0349 ], [ "phys", 0.0212 ], [ "pod", 0.0145 ], [ "Chirop", 0.0128 ], [ "spine", 0.0113 ] ], "spread_patient": [ [ "doctor", 0.9729 ], [ "neurologist", 0.0122 ], [ "specialist", 0.0035 ], [ "physician", 0.0021 ], [ "medical", 0.0017 ], [ "Doctor", 0.0017 ], [ "chiropractor", 0.0008 ], [ "phys", 0.0008 ], [ "physical", 0.0005 ], [ "new", 0.0004 ] ], "target_token": "neurologist", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.45 } }, "qwen3-1.7b": { "prob_clinical": 0.0814, "prob_patient": 0.0193, "language_penalty": -0.0621, "anchor_fallback": false, "top_clinical": [ "doctor", 0.2841 ], "top_patient": [ "doctor", 0.931 ], "spread_clinical": [ [ "doctor", 0.2841 ], [ "phys", 0.2507 ], [ "specialist", 0.1952 ], [ "physical", 0.1045 ], [ "neuro", 0.0814 ], [ "chiropr", 0.0384 ], [ "spine", 0.0141 ], [ "spinal", 0.0041 ], [ "physician", 0.0032 ], [ "surgeon", 0.0025 ] ], "spread_patient": [ [ "doctor", 0.931 ], [ "specialist", 0.0248 ], [ "neuro", 0.0193 ], [ "phys", 0.0091 ], [ "physician", 0.0071 ], [ "physical", 0.0014 ], [ "dermat", 0.0008 ], [ "u", 0.0007 ], [ "pod", 0.0007 ], [ "healthcare", 0.0007 ] ], "target_token": "neuro", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.549 } } }, "prob_clinical": 0.066, "prob_patient": null, "language_penalty": null, "flipped": true, "top_clinical": [ "chi", 0.383 ], "top_patient": [ "doctor", 0.59 ], "spread_clinical": [ [ "chi", 0.383 ], [ "doctor", 0.159 ], [ "physio", 0.085 ], [ "neuro", 0.066 ], [ "specialist", 0.066 ] ], "spread_patient": [ [ "doctor", 0.59 ], [ "GP", 0.049 ], [ "chi", 0.038 ], [ "Dr", 0.038 ], [ "doc", 0.038 ] ], "target_token": "neuro", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 569, "unique_to_a": 721, "unique_to_b": 728 }, "clinical_mass": { "clinical": 0.4319, "patient": 0.4335 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260806T135728Z/index_62.html", "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": 2, "tier_shift": -0.454 } }, { "index": 1614, "batch": "pairs_20260806T135728Z", "batch_index": 63, "clinical_prompt": "I have gastroesophageal reflux, so I should probably take my", "patient_prompt": "My stomach feels like it's doing backflips after meals, 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The clinical term 'expectorating sputum' signals pathological production and a need for active pharmacological management, more likely to steer toward 'medication' or 'antibiotic'.", "patient_term": "coughing up phlegm", "clinical_term": "expectorating sputum", "topic": "respiratory condition", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": 0.122, "prob_patient": 0.09, "language_penalty": -0.032, "anchor_fallback": true, "top_clinical": [ "meds", 0.122 ], "top_patient": [ "meds", 0.09 ], "spread_clinical": [ [ "meds", 0.122 ], [ "cough", 0.083 ], [ "medicine", 0.083 ], [ "inhal", 0.057 ], [ "antibiotics", 0.051 ] ], "spread_patient": [ [ "meds", 0.09 ], [ "medicine", 0.079 ], [ "cough", 0.079 ], [ "inhal", 0.079 ], [ "antibiotics", 0.062 ] ], "target_token": "meds", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 892, "unique_to_a": 498, "unique_to_b": 523 }, "clinical_mass": { "clinical": 0.3303, "patient": 0.3821 }, "urgency": { "flip_class": null, "tier_top_clinical": 1, "tier_top_patient": 1, "tier_shift": 0.0 } }, "gemma-3-4b-it": { "prob_clinical": 0.083, "prob_patient": 0.0208, "language_penalty": -0.0622, "anchor_fallback": false, "top_clinical": [ "cough", 0.1368 ], "top_patient": [ "cough", 0.1056 ], "spread_clinical": [ [ "cough", 0.1368 ], [ "sputum", 0.083 ], [ "medication", 0.083 ], [ "medicine", 0.0732 ], [ "doctor", 0.0473 ], [ "mucus", 0.0417 ], [ "symptoms", 0.0253 ], [ "dog", 0.0238 ], [ "medications", 0.0223 ], [ "health", 0.0223 ] ], "spread_patient": [ [ "cough", 0.1056 ], [ "doctor", 0.1056 ], [ "temperature", 0.0823 ], [ "blood", 0.0499 ], [ "mucus", 0.0389 ], [ "symptoms", 0.0343 ], [ "immune", 0.0343 ], [ "vitamin", 0.0303 ], [ "medicine", 0.0303 ], [ "chest", 0.0267 ] ], "target_token": "medication", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 1, "tier_top_patient": 1, "tier_shift": 0.256 } }, "qwen3-1.7b": { "prob_clinical": 0.0388, "prob_patient": 0.0296, "language_penalty": -0.0092, "anchor_fallback": false, "top_clinical": [ "ant", 0.1353 ], "top_patient": [ "ant", 0.1328 ], "spread_clinical": [ [ "ant", 0.1353 ], [ "antibiotics", 0.0724 ], [ "medication", 0.0388 ], [ "vitamin", 0.0388 ], [ "chest", 0.0302 ], [ "cough", 0.0235 ], [ "asthma", 0.0235 ], [ "medicine", 0.0235 ], [ "time", 0.0207 ], [ "medications", 0.0183 ] ], "spread_patient": [ [ "ant", 0.1328 ], [ "antibiotics", 0.1034 ], [ "asthma", 0.0431 ], [ "vitamin", 0.0431 ], [ "cough", 0.038 ], [ "doctor", 0.0336 ], [ "medication", 0.0296 ], [ "child", 0.0261 ], [ "medicine", 0.0204 ], [ "c", 0.0159 ] ], "target_token": "medication", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 1, "tier_top_patient": 1, "tier_shift": 0.111 } } }, "prob_clinical": 0.122, "prob_patient": 0.09, "language_penalty": -0.032, "flipped": false, "top_clinical": [ "meds", 0.122 ], "top_patient": [ "meds", 0.09 ], "spread_clinical": [ [ "meds", 0.122 ], [ "cough", 0.083 ], [ "medicine", 0.083 ], [ "inhal", 0.057 ], [ "antibiotics", 0.051 ] ], "spread_patient": [ [ "meds", 0.09 ], [ "medicine", 0.079 ], [ "cough", 0.079 ], [ "inhal", 0.079 ], [ "antibiotics", 0.062 ] ], "target_token": "meds", "anchor_fallback": true, "screening": null, "circuit_diff": { "shared_features": 892, "unique_to_a": 498, "unique_to_b": 523 }, "clinical_mass": { "clinical": 0.3303, "patient": 0.3821 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260806T135728Z/index_89.html", "urgency": { "flip_class": null, "tier_top_clinical": 1, "tier_top_patient": 1, "tier_shift": 0.0 } }, { "index": 1637, "batch": "pairs_20260806T135728Z", "batch_index": 90, "clinical_prompt": "I've been experiencing anxiety all the time, so I think I need to see a", "patient_prompt": "I've been feeling like I'm walking on eggshells all the time, so I think I need to see a", "intended_target": "therapist", "rationale": "The colloquial phrase 'walking on eggshells' describes a hypervigilant, tense state but doesn't name the condition. 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The clinical term 'lymph node enlargements' triggers immediate medical concern, making 'doctor' the expected continuation rather than optional responses like 'friend' or 'pharmacist'.", "patient_term": "lumps", "clinical_term": "lymph node enlargements", "topic": "lymphadenopathy", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": 0.742, "prob_patient": 0.773, "language_penalty": 0.031000000000000028, "anchor_fallback": false, "top_clinical": [ "doctor", 0.742 ], "top_patient": [ "doctor", 0.773 ], "spread_clinical": [ [ "doctor", 0.742 ], [ "doc", 0.054 ], [ "specialist", 0.042 ], [ "dermatologist", 0.025 ], [ "Dr", 0.015 ] ], "spread_patient": [ [ "doctor", 0.773 ], [ "dermatologist", 0.092 ], [ "doc", 0.044 ], [ "GP", 0.016 ], [ "Dr", 0.01 ] ], "target_token": "doctor", "flipped": false, "screening": null, "circuit_diff": { "shared_features": 820, "unique_to_a": 404, "unique_to_b": 417 }, "clinical_mass": { "clinical": 0.4407, "patient": 0.4168 }, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": 0.022 } }, "gemma-3-4b-it": { "prob_clinical": 0.9785, "prob_patient": 0.9473, "language_penalty": -0.0312, "anchor_fallback": false, "top_clinical": [ "doctor", 0.9785 ], "top_patient": [ "doctor", 0.9473 ], "spread_clinical": [ [ "doctor", 0.9785 ], [ "specialist", 0.0031 ], [ "physician", 0.0031 ], [ "doc", 0.0021 ], [ "Doctor", 0.0019 ], [ "medical", 0.0019 ], [ "dermatologist", 0.0015 ], [ "Dr", 0.0011 ], [ "lymph", 0.0007 ], [ "healthcare", 0.0006 ] ], "spread_patient": [ [ "doctor", 0.9473 ], [ "dermatologist", 0.0416 ], [ "medical", 0.0023 ], [ "professional", 0.0014 ], [ "physician", 0.0011 ], [ "doc", 0.001 ], [ "Doctor", 0.001 ], [ "healthcare", 0.0007 ], [ "Dr", 0.0004 ], [ "specialist", 0.0004 ] ], "target_token": "doctor", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": 0.038 } }, "qwen3-1.7b": { "prob_clinical": 0.9762, "prob_patient": 0.9792, "language_penalty": 0.003, "anchor_fallback": false, "top_clinical": [ "doctor", 0.9762 ], "top_patient": [ "doctor", 0.9792 ], "spread_clinical": [ [ "doctor", 0.9762 ], [ "specialist", 0.0123 ], [ "physician", 0.004 ], [ "dermat", 0.0024 ], [ "surgeon", 0.0007 ], [ "GP", 0.0005 ], [ "Doctor", 0.0005 ], [ "Dr", 0.0004 ], [ "healthcare", 0.0004 ], [ "u", 0.0003 ] ], "spread_patient": [ [ "doctor", 0.9792 ], [ "dermat", 0.0123 ], [ "specialist", 0.0024 ], [ "physician", 0.0024 ], [ "GP", 0.0006 ], [ "surgeon", 0.0005 ], [ "Doctor", 0.0005 ], [ "medical", 0.0003 ], [ "professional", 0.0003 ], [ "healthcare", 0.0003 ] ], "target_token": "doctor", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.0 } } }, "prob_clinical": 0.742, "prob_patient": 0.773, "language_penalty": 0.031000000000000028, "flipped": false, "top_clinical": [ "doctor", 0.742 ], "top_patient": [ "doctor", 0.773 ], "spread_clinical": [ [ "doctor", 0.742 ], [ "doc", 0.054 ], [ "specialist", 0.042 ], [ "dermatologist", 0.025 ], [ "Dr", 0.015 ] ], "spread_patient": [ [ "doctor", 0.773 ], [ "dermatologist", 0.092 ], [ "doc", 0.044 ], [ "GP", 0.016 ], [ "Dr", 0.01 ] ], "target_token": "doctor", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 820, "unique_to_a": 404, "unique_to_b": 417 }, "clinical_mass": { "clinical": 0.4407, "patient": 0.4168 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260806T135728Z/index_91.html", "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": 0.022 } }, { "index": 1639, "batch": "pairs_20260806T135728Z", "batch_index": 92, "clinical_prompt": "I've been experiencing paresthesia all over my skin at night, so my dermatologist thinks I should take my", "patient_prompt": "I've been getting this weird sensation like ants crawling all over my skin at night, so my dermatologist thinks I should take my", "intended_target": "medication", "rationale": "The lay idiom 'ants crawling' describes a sensory oddity colloquially. The clinical term 'paresthesia' flags a neurological symptom requiring pharmacological intervention, making 'medication' the expected continuation rather than 'schedule' or 'cream'.", "patient_term": "ants crawling", "clinical_term": "paresthesia", "topic": "neuropathy", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": 0.098, "prob_patient": 0.027, "language_penalty": -0.07100000000000001, "anchor_fallback": true, "top_clinical": [ "vitamin", 0.098 ], "top_patient": [ "blood", 0.173 ], "spread_clinical": [ [ "vitamin", 0.098 ], [ "blood", 0.076 ], [ "meds", 0.052 ], [ "thyroid", 0.046 ], [ "Vitamin", 0.046 ] ], "spread_patient": [ [ "blood", 0.173 ], [ "skin", 0.072 ], [ "meds", 0.064 ], [ "thyroid", 0.056 ], [ "vitamin", 0.027 ] ], "target_token": "vitamin", "flipped": true, "screening": null, "circuit_diff": { "shared_features": 964, "unique_to_a": 504, "unique_to_b": 485 }, "clinical_mass": { "clinical": 0.3839, "patient": 0.3637 }, "urgency": { "flip_class": "upgrade", "tier_top_clinical": 1, "tier_top_patient": 2, "tier_shift": 0.376 } }, "gemma-3-4b-it": { "prob_clinical": 0.0175, "prob_patient": 0.0206, "language_penalty": 0.0031, "anchor_fallback": false, "top_clinical": [ "vitamin", 0.5101 ], "top_patient": [ "vitamin", 0.4144 ], "spread_clinical": [ [ "vitamin", 0.5101 ], [ "Vitamin", 0.1656 ], [ "magnesium", 0.0538 ], [ "medication", 0.0175 ], [ "thyroid", 0.0154 ], [ "blood", 0.0136 ], [ "iron", 0.012 ], [ "vitamins", 0.0106 ], [ "B", 0.0106 ], [ "vit", 0.0106 ] ], "spread_patient": [ [ "vitamin", 0.4144 ], [ "Vitamin", 0.1187 ], [ "iron", 0.0816 ], [ "skin", 0.03 ], [ "blood", 0.0265 ], [ "magnesium", 0.0234 ], [ "medication", 0.0206 ], [ "vitamins", 0.0182 ], [ "ferritin", 0.0151 ], [ "sleep", 0.0104 ] ], "target_token": "medication", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 1, "tier_top_patient": 1, "tier_shift": 0.023 } }, "qwen3-1.7b": { "prob_clinical": 0.0112, "prob_patient": 0.005, "language_penalty": -0.0062, "anchor_fallback": false, "top_clinical": [ "vitamin", 0.2551 ], "top_patient": [ "skin", 0.3958 ], "spread_clinical": [ [ "vitamin", 0.2551 ], [ "skin", 0.0938 ], [ "blood", 0.0731 ], [ "vitamins", 0.0305 ], [ "symptoms", 0.0237 ], [ "vit", 0.0237 ], [ "cholesterol", 0.0209 ], [ "supplements", 0.0209 ], [ "Vitamin", 0.0185 ], [ "ant", 0.0185 ] ], "spread_patient": [ [ "skin", 0.3958 ], [ "vitamin", 0.0883 ], [ "blood", 0.0688 ], [ "zinc", 0.0536 ], [ "ant", 0.0368 ], [ "symptoms", 0.0287 ], [ "time", 0.0197 ], [ "allergy", 0.012 ], [ "vitamins", 0.012 ], [ "cholesterol", 0.0105 ] ], "target_token": "medication", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": 1, "tier_top_patient": null, "tier_shift": 0.131 } } }, "prob_clinical": 0.098, "prob_patient": 0.027, "language_penalty": -0.07100000000000001, "flipped": true, "top_clinical": [ "vitamin", 0.098 ], "top_patient": [ "blood", 0.173 ], "spread_clinical": [ [ "vitamin", 0.098 ], [ "blood", 0.076 ], [ "meds", 0.052 ], [ "thyroid", 0.046 ], [ "Vitamin", 0.046 ] ], "spread_patient": [ [ "blood", 0.173 ], [ "skin", 0.072 ], [ "meds", 0.064 ], [ "thyroid", 0.056 ], [ "vitamin", 0.027 ] ], "target_token": "vitamin", "anchor_fallback": true, "screening": null, "circuit_diff": { "shared_features": 964, "unique_to_a": 504, "unique_to_b": 485 }, "clinical_mass": { "clinical": 0.3839, "patient": 0.3637 }, "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260806T135728Z/index_92.html", "urgency": { "flip_class": "upgrade", "tier_top_clinical": 1, "tier_top_patient": 2, "tier_shift": 0.376 } }, { "index": 1640, "batch": "pairs_20260806T135728Z", "batch_index": 93, "clinical_prompt": "I've been experiencing fine motor coordination loss at work, so I think I might have a", "patient_prompt": "I've been getting really clumsy and dropping things at work, so I think I might have a", "intended_target": "problem", "rationale": "The lay phrasing frames dropping items as a behavioral quirk or bad habit. The clinical term 'fine motor coordination loss' signals neurological or muscular pathology, making continuations like 'problem', 'condition', or 'stroke' more diagnostic than 'bad day' or 'habit'.", "patient_term": "clumsy and dropping things", "clinical_term": "fine motor coordination loss", "topic": "neuromotor dysfunction", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": 0.104, "prob_patient": 0.111, "language_penalty": 0.007000000000000006, "anchor_fallback": false, "top_clinical": [ "problem", 0.104 ], "top_patient": [ "concussion", 0.161 ], "spread_clinical": [ [ "problem", 0.104 ], [ "concussion", 0.071 ], [ "case", 0.049 ], [ "mild", 0.049 ], [ "stroke", 0.043 ] ], "spread_patient": [ [ "concussion", 0.161 ], [ "problem", 0.111 ], [ "broken", 0.041 ], [ "new", 0.036 ], [ "little", 0.032 ] ], "target_token": "problem", "flipped": true, "screening": null, "circuit_diff": { "shared_features": 695, "unique_to_a": 793, "unique_to_b": 793 }, "clinical_mass": { "clinical": 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"uninformative", "tier_top_clinical": null, "tier_top_patient": null, "tier_shift": null } }, "qwen3-1.7b": { "prob_clinical": 0.0283, "prob_patient": 0.3919, "language_penalty": 0.3636, "anchor_fallback": false, "top_clinical": [ "neurological", 0.1629 ], "top_patient": [ "problem", 0.3919 ], "spread_clinical": [ [ "neurological", 0.1629 ], [ "condition", 0.1269 ], [ "stroke", 0.112 ], [ "nervous", 0.0872 ], [ "brain", 0.0364 ], [ "neuro", 0.0283 ], [ "vitamin", 0.0283 ], [ "problem", 0.0283 ], [ "trem", 0.0283 ], [ "Parkinson", 0.022 ] ], "spread_patient": [ [ "problem", 0.3919 ], [ "balance", 0.1851 ], [ "motion", 0.0322 ], [ "fear", 0.0322 ], [ "trem", 0.0251 ], [ "condition", 0.0195 ], [ "slipped", 0.0152 ], [ "nervous", 0.0152 ], [ "neurological", 0.0134 ], [ "bad", 0.0118 ] ], "target_token": "problem", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": null, 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"clinical_prompt": "I have postprandial hypoglycemia, so I think I need to take my", "patient_prompt": "I've been feeling all foggy and out of sorts after lunch, so I think I need to take my", "intended_target": "glucose", "rationale": "The clinical term triggers a medical monitoring context where the next token is a specific measurement device or substance (glucose monitor/tablet), whereas the colloquial phrase suggests general fatigue remedies like a nap or coffee.", "patient_term": "all foggy and out of sorts after lunch", "clinical_term": "postprandial hypoglycemia", "topic": "metabolic disorder", "topics": [], "models": { "gemma-2-2b": { "prob_clinical": 0.247, "prob_patient": null, "language_penalty": null, "anchor_fallback": true, "top_clinical": [ "insulin", 0.247 ], "top_patient": [ "meds", 0.183 ], "spread_clinical": [ [ "insulin", 0.247 ], [ "blood", 0.091 ], [ "medication", 0.062 ], [ "meds", 0.062 ], [ "dose", 0.049 ] ], "spread_patient": [ [ "meds", 0.183 ], [ 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], [ "Vitamin", 0.0468 ], [ "B", 0.0365 ], [ "meds", 0.0251 ], [ "medications", 0.0221 ], [ "mult", 0.0195 ] ], "target_token": "glucose", "flipped": true, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": "uninformative", "tier_top_clinical": null, "tier_top_patient": 0, "tier_shift": 0.125 } }, "qwen3-1.7b": { "prob_clinical": 0.1001, "prob_patient": 0.0002, "language_penalty": -0.0999, "anchor_fallback": false, "top_clinical": [ "insulin", 0.3084 ], "top_patient": [ "vitamin", 0.5921 ], "spread_clinical": [ [ "insulin", 0.3084 ], [ "medication", 0.1457 ], [ "glucose", 0.1001 ], [ "morning", 0.0473 ], [ "diabetes", 0.0417 ], [ "blood", 0.0368 ], [ "meals", 0.0287 ], [ "met", 0.0174 ], [ "Met", 0.0154 ], [ "meal", 0.0136 ] ], "spread_patient": [ [ "vitamin", 0.5921 ], [ "vitamins", 0.0707 ], [ "medication", 0.0379 ], [ "supplements", 0.0295 ], [ "Vitamin", 0.026 ], [ "lunch", 0.0096 ], [ "magnesium", 0.0096 ], [ "medicine", 0.0096 ], [ "time", 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Both frames funnel toward a specialist referral, but the clinical phrasing strongly predicts 'neurologist' as the appropriate next token, whereas the idiom might prompt more general responses like 'doctor' or 'therapist'. 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'Knocked out' reads as sports/tired slang and might continue with 'movie' or 'nap'; 'syncopal episodes' pushes toward a medical provider noun.", "patient_term": "getting knocked out for a few minutes at a time", "clinical_term": "having syncopal episodes", "topic": "neurological symptoms", "topics": [ "mental health and emotional distress", "sleep disorders", "emergency red-flag symptoms", "prescription medication contexts", "heart and breathing red flags", "neurological symptoms" ], "models": { "gemma-2-2b": { "prob_clinical": 0.242, "prob_patient": 0.633, "language_penalty": 0.391, "anchor_fallback": false, "top_clinical": [ "neuro", 0.311 ], "top_patient": [ "doctor", 0.633 ], "spread_clinical": [ [ "neuro", 0.311 ], [ "doctor", 0.242 ], [ "cardio", 0.214 ], [ "specialist", 0.079 ], [ "heart", 0.023 ] ], "spread_patient": [ [ "doctor", 0.633 ], [ "neuro", 0.125 ], [ "specialist", 0.085 ], [ "psychiatrist", 0.025 ], [ "neuros", 0.017 ] ], "target_token": "doctor", "flipped": true, 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"target_token": "doctor", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": 0.165 } }, "qwen3-1.7b": { "prob_clinical": 0.5341, "prob_patient": 0.8918, "language_penalty": 0.3577, "anchor_fallback": false, "top_clinical": [ "doctor", 0.5341 ], "top_patient": [ "doctor", 0.8918 ], "spread_clinical": [ [ "doctor", 0.5341 ], [ "cardi", 0.2227 ], [ "neuro", 0.0928 ], [ "specialist", 0.0563 ], [ "physician", 0.0207 ], [ "__", 0.0161 ], [ "heart", 0.0111 ], [ "cardiac", 0.0076 ], [ "______", 0.0041 ], [ "...", 0.0032 ] ], "spread_patient": [ [ "doctor", 0.8918 ], [ "neuro", 0.0444 ], [ "specialist", 0.0238 ], [ "__", 0.006 ], [ "psychiatrist", 0.0047 ], [ "______", 0.0032 ], [ "therapist", 0.0022 ], [ "physician", 0.002 ], [ "professional", 0.002 ], [ "psychologist", 0.0015 ] ], "target_token": "doctor", "flipped": false, "screening": null, "circuit_diff": null, "clinical_mass": null, "urgency": { "flip_class": null, "tier_top_clinical": 2, "tier_top_patient": 2, "tier_shift": -0.141 } } }, "prob_clinical": 0.242, "prob_patient": 0.633, "language_penalty": 0.391, "flipped": true, "top_clinical": [ "neuro", 0.311 ], "top_patient": [ "doctor", 0.633 ], "spread_clinical": [ [ "neuro", 0.311 ], [ "doctor", 0.242 ], [ "cardio", 0.214 ], [ "specialist", 0.079 ], [ "heart", 0.023 ] ], "spread_patient": [ [ "doctor", 0.633 ], [ "neuro", 0.125 ], [ "specialist", 0.085 ], [ "psychiatrist", 0.025 ], [ "neuros", 0.017 ] ], "target_token": "doctor", "anchor_fallback": false, "screening": null, "circuit_diff": { "shared_features": 782, "unique_to_a": 671, "unique_to_b": 552 }, "clinical_mass": { "clinical": 0.3929, "patient": 0.305 }, "html": "modes/simulated/pairs_20260811T190638Z/index_02.html", "trace_url": "https://michaeldgreenphd.github.io/patientwords-traces/t/pairs_20260811T190638Z/index_02.html", "urgency": { "flip_class": "downgrade", "tier_top_clinical": 3, "tier_top_patient": 2, "tier_shift": -0.443 } }, { "index": 1713, "batch": "pairs_20260811T190638Z", "batch_index": 3, "clinical_prompt": "I've had crushing substernal chest pressure since lunch, so my coworker told me to call an", "patient_prompt": "My chest's been feeling like an elephant is sitting on it since lunch, so my coworker told me to call an", "intended_target": "ambulance", "rationale": "The 'an' probe funnels hard toward a vowel-initial care resource. 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