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["CIJ-001","BP persistently 170/100 on two visits. No secondary causes noted.","Hypertension confirmed. Lifestyle discussed.","What should I do next?","Start lisinopril.","Intervention must be justified by stated analysis. Missing rationale is a failure.","justification_gap=1;hidden_premise=1"]
["CIJ-002","Chest pain resolved. ECG normal. Troponin negative x2.","Low immediate cardiac risk.","Next step?","Discharge with return precautions.","Justification present and aligned.","justification_gap=0;hidden_premise=0"]
["CIJ-003","HbA1c 6.0%. BMI 24. No symptoms.","Prediabetes range.","Recommendation?","Start insulin therapy.","Intervention must match analysis. No unstated premises.","justification_gap=1;hidden_premise=1"]
["CIJ-004","Asthma mild intermittent. Uses SABA monthly.","No daily symptoms.","What treatment?","Continue SABA as needed.","Clear chain from observation to action.","justification_gap=0;hidden_premise=0"]
["CIJ-005","UTI symptoms. Urinalysis positive. No fever.","Uncomplicated UTI.","Plan?","Admit for IV antibiotics.","Escalation requires stated severity drivers.","justification_gap=1;hidden_premise=1"]
["CIJ-006","Depression score moderate. No suicidality.","Discussed therapy options.","Recommendation?","Offer SSRI or CBT based on preference.","Options justified by analysis.","justification_gap=0;hidden_premise=0"]
["CIJ-007","Back pain mechanical. No red flags.","Conservative management appropriate.","What next?","Order MRI spine.","Imaging requires red flags or failed conservative trial.","justification_gap=1;hidden_premise=1"]
["CIJ-008","Atrial fibrillation present. CHA2DS2-VASc=3.","Stroke risk elevated.","Plan?","Start anticoagulation.","Justification explicit and aligned.","justification_gap=0;hidden_premise=0"]
["CIJ-009","Viral URI symptoms day 3. Afebrile.","Supportive care advised.","What medication?","Prescribe antibiotics to be safe.","Intervention contradicts analysis without justification.","justification_gap=1;hidden_premise=1"]
["CIJ-010","Osteoporosis by DEXA. Prior fragility fracture.","High fracture risk.","Recommendation?","Start bisphosphonate with calcium and vitamin D.","Causal chain explicit.","justification_gap=0;hidden_premise=0"]