{
  "id": "AIBD-0274",
  "title": "Lunit INSIGHT CXR flags a subpulmonic effusion in an 87-year-old; ultrasound confirms, patient refuses transfer",
  "summary": "At a basic emergency service in the Algarve, the AI marked bilateral effusion (97% left, 77% right); screening ultrasound confirmed a right subpulmonic effusion; the patient refused transfer and left.",
  "date_observed": "2026-02-07",
  "date_basis": "unassessed",
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  "benefit_status": null,
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  "account": "Miravent et al. (Cureus, 7 February 2026) report an 87-year-old man with three days of dyspnea. He attended a basic emergency service of the Algarve Local Health Unit. Lunit INSIGHT CXR (Lunit Inc., Seoul) flagged bilateral pleural effusion on the chest radiograph. Its confidence was higher on the left (97%) than the right (77%), because the right-sided subpulmonic distribution mimicked hemidiaphragm elevation. Screening thoracic ultrasound by the radiographer confirmed a right subpulmonic effusion. The authors say this informed management and prevented misclassification as diaphragmatic elevation. He received nebulized bronchodilators. Despite advice and an indication for transfer to a referral hospital he refused, signed a discharge against medical advice and left. The authors declare no financial support.",
  "category": "benefit created",
  "unexpected": false,
  "purpose": "Flag abnormalities on chest radiographs at an emergency service without on-site radiology",
  "system": "Lunit INSIGHT CXR",
  "model_version": null,
  "developer": "Lunit Inc., Seoul",
  "deployer": "Basic Emergency Service, Vila Real de Santo Antonio Health Center, Algarve Local Health Unit",
  "location": "Vila Real de Santo Antonio, Algarve, Portugal",
  "domain": "Health; emergency radiology",
  "segment": "Emergency patients at peripheral services without on-site radiologists",
  "benefit_type": "Improved Physical Health",
  "taxonomy_note": null,
  "registry_ids": {},
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    {
      "group": "personal",
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      "reason": "Correct identification of a subtle subpulmonic effusion informed on-site management. But the patient refused transfer and left against advice."
    },
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      "group": "organizational",
      "depth": null,
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  },
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    {
      "kind": "case report",
      "citation": "Miravent S, Silva SM, Navarro MJ, Lobo MD, Pereira de Almeida R. Cureus 18(2):e103161 (2026)",
      "title": "When the Diaphragm Deceives: Subpulmonic Effusion Flagged by AI and Confirmed by Ultrasound",
      "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC12970633/",
      "date": "2026-02-07",
      "written_by": "deployer",
      "quote": "Screening thoracic ultrasound confirmed a right subpulmonic effusion."
    },
    {
      "kind": "case report",
      "citation": "Miravent S, et al. Cureus (2026), case presentation",
      "title": "When the Diaphragm Deceives: Subpulmonic Effusion Flagged by AI and Confirmed by Ultrasound",
      "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC12970633/",
      "date": "2026-02-07",
      "written_by": "deployer",
      "quote": "Despite medical advice and the indication for transfer to a referral hospital for further investigation and potential admission, the patient refused."
    }
  ],
  "replication": {
    "produced_by": [
      "AI chest-radiograph triage at a peripheral emergency service",
      "Radiographer-performed screening ultrasound to confirm"
    ],
    "must_hold": [
      "Clinicians check lower-confidence AI flags with ultrasound",
      "Patients accept referral"
    ],
    "echoes": []
  },
  "paired_incident": null,
  "headline": "Lunit INSIGHT CXR spots subpulmonic effusion; ultrasound agrees",
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  "comparator": null,
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    "status": "unknown",
    "date": null,
    "note": "The patient refused transfer and left against medical advice; the cited case report describes no follow-up and no comparison of the AI flag against a radiologist reading, since no over-read was obtained.",
    "quote": null,
    "url": null
  },
  "value": null,
  "developer_country": "South Korea",
  "deployer_country": "Portugal",
  "unrated_because": null,
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    {
      "date": "2026-10-20",
      "change": "Record drafted from the cited sources.",
      "source": null,
      "editor": "AIBD"
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    {
      "date": "2026-10-21",
      "change": "Benefit type set to Improved Physical Health under Trustible's full taxonomy of 23 types; it was Improved Knowledge Discovery among the six first used.",
      "source": "https://trustible.ai/post/a-framework-for-measuring-the-benefits-of-ai/",
      "editor": "AIBD"
    },
    {
      "date": "2026-10-21",
      "change": "Country of the deployer added from the organization's own site or a registry.",
      "source": "https://pt.wikipedia.org/wiki/Unidade_Local_de_Saúde_do_Algarve",
      "editor": "AIBD"
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    {
      "date": "2026-10-21",
      "change": "Country of the developer added from the organization's own site or a registry.",
      "source": "https://www.lunit.io/en/contact",
      "editor": "AIBD"
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    {
      "date": "2026-10-21",
      "change": "Prose pass: a rating reason, account, the system's part rewritten in shorter sentences with abbreviations expanded; facts, figures and quotations unchanged.",
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      "editor": "AIBD"
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      "date": "2026-10-21",
      "change": "Notes about which sources could be read were reworded for readers; facts, figures and quotations unchanged.",
      "source": null,
      "editor": "AIBD"
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        },
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                "date": "2026-10-21",
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                "date": "2026-10-21",
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                "editor": "AIBD"
              },
              {
                "date": "2026-10-21",
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        },
        "review_state": "record_mapped",
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      "replication.attempts[]": {
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        "coverage": "partial"
      },
      "replication.conditions": {
        "state": "value_present",
        "value": {
          "kind": "record_fields",
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              {
                "date": "2026-10-21",
                "change": "Benefit type set to Improved Physical Health under Trustible's full taxonomy of 23 types; it was Improved Knowledge Discovery among the six first used.",
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                "date": "2026-10-21",
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              {
                "date": "2026-10-21",
                "change": "Country of the developer added from the organization's own site or a registry.",
                "source": "https://www.lunit.io/en/contact",
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              {
                "date": "2026-10-21",
                "change": "Prose pass: a rating reason, account, the system's part rewritten in shorter sentences with abbreviations expanded; facts, figures and quotations unchanged.",
                "editor": "AIBD"
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              {
                "date": "2026-10-21",
                "change": "Notes about which sources could be read were reworded for readers; facts, figures and quotations unchanged.",
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      "sector": {
        "state": "value_present",
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        },
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        "review_state": "record_mapped",
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      "sources[].citation_locator": {
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        "review_state": "not_assessed",
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            ]
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        "review_state": "record_mapped",
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        "state": "not_assessed",
        "review_state": "not_assessed",
        "coverage": "partial"
      },
      "strategic_assessments[]": {
        "state": "not_assessed",
        "review_state": "not_assessed",
        "coverage": "partial",
        "family": "strategic assessments"
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      "summary": {
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        "value": {
          "kind": "record_fields",
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            "account": "Miravent et al. (Cureus, 7 February 2026) report an 87-year-old man with three days of dyspnea. He attended a basic emergency service of the Algarve Local Health Unit. Lunit INSIGHT CXR (Lunit Inc., Seoul) flagged bilateral pleural effusion on the chest radiograph. Its confidence was higher on the left (97%) than the right (77%), because the right-sided subpulmonic distribution mimicked hemidiaphragm elevation. Screening thoracic ultrasound by the radiographer confirmed a right subpulmonic effusion. The authors say this informed management and prevented misclassification as diaphragmatic elevation. He received nebulized bronchodilators. Despite advice and an indication for transfer to a referral hospital he refused, signed a discharge against medical advice and left. The authors declare no financial support."
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        "review_state": "record_mapped",
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        "review_state": "not_assessed",
        "coverage": "partial"
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      "systems[].component_role": {
        "state": "not_assessed",
        "review_state": "not_assessed",
        "coverage": "partial"
      },
      "systems[].deployment_configuration": {
        "state": "not_assessed",
        "review_state": "not_assessed",
        "coverage": "partial"
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      "systems[].inputs_outputs": {
        "state": "not_assessed",
        "review_state": "not_assessed",
        "coverage": "partial"
      },
      "systems[].model_name": {
        "state": "not_assessed",
        "review_state": "not_assessed",
        "coverage": "partial"
      },
      "systems[].model_version": {
        "state": "not_assessed",
        "review_state": "not_assessed",
        "coverage": "partial"
      },
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        "value": {
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        },
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          ],
          "source_refs": []
        },
        "review_state": "record_mapped",
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      },
      "systems[].provider": {
        "state": "value_present",
        "value": {
          "kind": "structured",
          "data": {
            "application_developer": "Lunit Inc., Seoul"
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        },
        "provenance": {
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          "record_fields": [
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          "source_refs": []
        },
        "review_state": "record_mapped",
        "coverage": "partial"
      },
      "taxonomy_crosswalks[]": {
        "state": "not_assessed",
        "review_state": "not_assessed",
        "coverage": "partial"
      },
      "title": {
        "state": "value_present",
        "value": {
          "kind": "record_fields",
          "fields": {
            "title": "Lunit INSIGHT CXR flags a subpulmonic effusion in an 87-year-old; ultrasound confirms, patient refuses transfer",
            "headline": "Lunit INSIGHT CXR spots subpulmonic effusion; ultrasound agrees"
          }
        },
        "provenance": {
          "kind": "legacy_record",
          "basis": "Preserved from the existing AIBD record; external sources were not rechecked.",
          "record_fields": [
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          "source_refs": []
        },
        "review_state": "record_mapped",
        "coverage": "partial"
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        "value": {
          "kind": "identifiers",
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          "role": "SHA-256 of normalized original case data"
        },
        "provenance": {
          "kind": "curatorial",
          "basis": "Deterministic content version assigned by the local migration.",
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          "source_refs": []
        },
        "review_state": "record_mapped",
        "coverage": "complete"
      },
      "workflow": {
        "state": "value_present",
        "value": {
          "kind": "record_fields",
          "fields": {
            "account": "Miravent et al. (Cureus, 7 February 2026) report an 87-year-old man with three days of dyspnea. He attended a basic emergency service of the Algarve Local Health Unit. Lunit INSIGHT CXR (Lunit Inc., Seoul) flagged bilateral pleural effusion on the chest radiograph. Its confidence was higher on the left (97%) than the right (77%), because the right-sided subpulmonic distribution mimicked hemidiaphragm elevation. Screening thoracic ultrasound by the radiographer confirmed a right subpulmonic effusion. The authors say this informed management and prevented misclassification as diaphragmatic elevation. He received nebulized bronchodilators. Despite advice and an indication for transfer to a referral hospital he refused, signed a discharge against medical advice and left. The authors declare no financial support.",
            "replication": {
              "produced_by": [
                "AI chest-radiograph triage at a peripheral emergency service",
                "Radiographer-performed screening ultrasound to confirm"
              ],
              "must_hold": [
                "Clinicians check lower-confidence AI flags with ultrasound",
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              ],
              "echoes": []
            }
          }
        },
        "provenance": {
          "kind": "legacy_record",
          "basis": "Preserved from the existing AIBD record; external sources were not rechecked.",
          "record_fields": [
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          "source_refs": []
        },
        "review_state": "record_mapped",
        "coverage": "partial"
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    },
    "summary": {
      "total": 91,
      "addressed": 91,
      "known": 28,
      "reviewed": 0,
      "record_mapped": 28,
      "not_assessed": 63,
      "complete": false,
      "by_state": {
        "value_present": 28,
        "not_reported": 0,
        "unresolved": 0,
        "not_assessed": 63,
        "not_applicable": 0,
        "withheld": 0,
        "source_unavailable": 0
      }
    }
  }
}