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"leads_to_examine", "teaching_point", "measurement" ], "additionalProperties": false }, "qt": { "type": "object", "properties": { "finding": { "type": "string", "minLength": 1, "maxLength": 500 }, "reasoning": { "type": "string", "minLength": 1, "maxLength": 2000, "description": "What the learner should look at on the strip to reach this finding." }, "confidence": { "type": "string", "enum": [ "low", "medium", "high" ] }, "leads_to_examine": { "type": "array", "items": { "type": "string", "enum": [ "I", "II", "III", "aVR", "aVL", "aVF", "V1", "V2", "V3", "V4", "V5", "V6", "rhythm_strip" ] } }, "teaching_point": { "type": "string", "minLength": 1, "maxLength": 1000, "description": "The single most important concept this finding illustrates." }, "measurement": { "type": "object", "properties": { "value": { "type": "number" }, "unit": { "type": "string" }, "normal_range": { "type": "array", "minItems": 2, "maxItems": 2, "items": [ { "type": "number" }, { "type": "number" } ] }, 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"type": "object", "properties": { "value": { "type": "number" }, "unit": { "type": "string" }, "normal_range": { "type": "array", "minItems": 2, "maxItems": 2, "items": [ { "type": "number" }, { "type": "number" } ] }, "interpretation": { "type": "string", "enum": [ "normal", "borderline", "abnormal" ] } }, "required": [ "value", "unit", "interpretation" ], "additionalProperties": false }, "correction_formula": { "type": "string", "enum": [ "bazett", "fridericia", "framingham" ] } }, "required": [ "finding", "reasoning", "confidence", "leads_to_examine", "teaching_point", "measurement", "correction_formula" ], "additionalProperties": false } }, "required": [ "pr", "qrs", "qt", "qtc" ], "additionalProperties": false }, "p_wave_morphology": { "type": "object", "properties": { "finding": { "type": "string", "minLength": 1, "maxLength": 500 }, "reasoning": { "type": "string", "minLength": 1, "maxLength": 2000, "description": "What the learner should look at on the strip to reach this finding." }, "confidence": { "type": "string", "enum": [ "low", "medium", "high" ] }, "leads_to_examine": { "type": "array", "items": { "type": "string", "enum": [ "I", "II", "III", "aVR", "aVL", "aVF", "V1", "V2", "V3", "V4", "V5", "V6", "rhythm_strip" ] } }, "teaching_point": { "type": "string", "minLength": 1, "maxLength": 1000, "description": "The single most important concept this finding illustrates." }, "abnormalities": { "type": "array", "items": { "type": "string" } } }, "required": [ "finding", "reasoning", "confidence", "leads_to_examine", "teaching_point", "abnormalities" ], "additionalProperties": false }, "qrs_morphology": { "type": "object", "properties": { "finding": { "type": "string", "minLength": 1, "maxLength": 500 }, "reasoning": { "type": "string", "minLength": 1, "maxLength": 2000, "description": "What the learner should look at on the strip to reach this finding." }, "confidence": { "type": "string", "enum": [ "low", "medium", "high" ] }, "leads_to_examine": { "type": "array", "items": { "type": "string", "enum": [ "I", "II", "III", "aVR", "aVL", "aVF", "V1", "V2", "V3", "V4", "V5", "V6", "rhythm_strip" ] } }, "teaching_point": { "type": "string", "minLength": 1, "maxLength": 1000, "description": "The single most important concept this finding illustrates." }, "bundle_branch_block": { "type": "string", "enum": [ "none", "rbbb", "lbbb", "incomplete_rbbb", "incomplete_lbbb", "nonspecific_ivcd" ] }, "fascicular_block": { "type": "string", "enum": [ "none", "lafb", "lpfb", "bifascicular" ] }, "pathologic_q_waves": { "type": "object", "properties": { "present": { "type": "boolean" }, "leads": { "type": "array", "items": { "type": "string", "enum": [ "I", "II", "III", "aVR", "aVL", "aVF", "V1", "V2", "V3", "V4", "V5", "V6", "rhythm_strip" ] } }, "territory": { "anyOf": [ { "type": "string", "enum": [ "anterior", "inferior", "lateral", "septal", "posterior", "none" ] }, { "type": "null" } ] } }, "required": [ "present", "leads", "territory" ], "additionalProperties": false } }, "required": [ "finding", "reasoning", "confidence", "leads_to_examine", "teaching_point", "bundle_branch_block", "fascicular_block", "pathologic_q_waves" ], "additionalProperties": false }, "st_t_changes": { "type": "object", "properties": { "finding": { "type": "string", "minLength": 1, "maxLength": 500 }, "reasoning": { "type": "string", "minLength": 1, "maxLength": 2000, "description": "What the learner should look at on the strip to reach this finding." }, "confidence": { "type": "string", "enum": [ "low", "medium", "high" ] }, "leads_to_examine": { "type": "array", "items": { "type": "string", "enum": [ "I", "II", "III", "aVR", "aVL", "aVF", "V1", "V2", "V3", "V4", "V5", "V6", "rhythm_strip" ] } }, "teaching_point": { "type": "string", "minLength": 1, "maxLength": 1000, "description": "The single most important concept this finding illustrates." }, "st_elevation": { "type": "object", "properties": { "present": { "type": "boolean" }, "leads": { "type": "array", "items": { "type": "string", "enum": [ "I", "II", "III", "aVR", "aVL", "aVF", "V1", "V2", "V3", "V4", "V5", "V6", "rhythm_strip" ] } }, "magnitude_mm": { "type": "number" }, "morphology": { "type": "string", "enum": [ "concave", "convex", "horizontal" ] }, "territory": { "type": "string" } }, "required": [ "present", "leads" ], "additionalProperties": false }, "st_depression": { "type": "object", "properties": { "present": { "type": "boolean" }, "leads": { "type": "array", "items": { "type": "string", "enum": [ "I", "II", "III", "aVR", "aVL", "aVF", "V1", "V2", "V3", "V4", "V5", "V6", "rhythm_strip" ] } }, "morphology": { "type": "string", "enum": [ "horizontal", "downsloping", "upsloping" ] } }, "required": [ "present", "leads" ], "additionalProperties": false }, "t_wave_changes": { "type": "object", "properties": { "inverted_leads": { "type": "array", "items": { "type": "string", "enum": [ "I", "II", "III", "aVR", "aVL", "aVF", "V1", "V2", "V3", "V4", "V5", "V6", "rhythm_strip" ] } }, "peaked": { "type": "boolean" }, "flat": { "type": "boolean" } }, "required": [ "inverted_leads", "peaked", "flat" ], "additionalProperties": false } }, "required": [ "finding", "reasoning", "confidence", "leads_to_examine", "teaching_point", "st_elevation", "st_depression", "t_wave_changes" ], "additionalProperties": false }, "chamber_enlargement": { "type": "object", "properties": { "finding": { "type": "string", "minLength": 1, "maxLength": 500 }, "reasoning": { "type": "string", "minLength": 1, "maxLength": 2000, "description": "What the learner should look at on the strip to reach this finding." }, "confidence": { "type": "string", "enum": [ "low", "medium", "high" ] }, "leads_to_examine": { "type": "array", "items": { "type": "string", "enum": [ "I", "II", "III", "aVR", "aVL", "aVF", "V1", "V2", "V3", "V4", "V5", "V6", "rhythm_strip" ] } }, "teaching_point": { "type": "string", "minLength": 1, "maxLength": 1000, "description": "The single most important concept this finding illustrates." }, "lvh": { "type": "boolean" }, "rvh": { "type": "boolean" }, "la_enlargement": { "type": "boolean" }, "ra_enlargement": { "type": "boolean" }, "criteria_met": { "type": "array", "items": { "type": "string" }, "description": "e.g. 'sokolow_lyon', 'cornell_voltage', 'romhilt_estes'" } }, "required": [ "finding", "reasoning", "confidence", "leads_to_examine", "teaching_point", "lvh", "rvh", "la_enlargement", "ra_enlargement", "criteria_met" ], "additionalProperties": false }, "conduction_abnormalities": { "type": "object", "properties": { "finding": { "type": "string", "minLength": 1, "maxLength": 500 }, "reasoning": { "type": "string", "minLength": 1, "maxLength": 2000, "description": "What the learner should look at on the strip to reach this finding." }, "confidence": { "type": "string", "enum": [ "low", "medium", "high" ] }, "leads_to_examine": { "type": "array", "items": { "type": "string", "enum": [ "I", "II", "III", "aVR", "aVL", "aVF", "V1", "V2", "V3", "V4", "V5", "V6", "rhythm_strip" ] } }, "teaching_point": { "type": "string", "minLength": 1, "maxLength": 1000, "description": "The single most important concept this finding illustrates." }, "av_block": { "type": "string", "enum": [ "none", "first_degree", "mobitz_i", "mobitz_ii", "high_grade", "complete" ] }, "preexcitation": { "type": "boolean" }, "paced": { "type": "boolean" } }, "required": [ "finding", "reasoning", "confidence", "leads_to_examine", "teaching_point", "av_block", "preexcitation", "paced" ], "additionalProperties": false }, "final_synthesis": { "type": "object", "properties": { "one_line_summary": { "type": "string", "minLength": 1, "maxLength": 200, "description": "The single-sentence read, as it would appear on a printed report." }, "primary_diagnosis": { "type": "string" }, "secondary_findings": { "type": "array", "items": { "type": "string" } }, "differential": { "type": "array", "items": { "type": "string" }, "description": "Alternative interpretations worth considering." }, "clinical_significance_education": { "type": "string", "description": "What this pattern would mean if seen in a real patient. Framed as education, not as a diagnostic recommendation." }, "overall_confidence": { "type": "string", "enum": [ "low", "medium", "high" ] } }, "required": [ "one_line_summary", "primary_diagnosis", "secondary_findings", "differential", "clinical_significance_education", "overall_confidence" ], "additionalProperties": false }, "teaching_pearls": { "type": "array", "items": { "type": "string" }, "minItems": 1, "maxItems": 5, "description": "The 1-5 highest-yield teaching points for this strip." }, "difficulty_estimate": { "type": "integer", "minimum": 1, "maximum": 5 }, "concepts_illustrated": { "type": "array", "items": { "type": "string" }, "description": "Slugs from the concept taxonomy that this strip exemplifies." }, "cannot_interpret": { "type": "object", "properties": { "reason": { "type": "string" } }, "required": [ "reason" ], "additionalProperties": false, "description": "Set only if image_quality is 'poor' and interpretation is unsafe. When present, other clinical fields may be omitted." } }, "required": [ "schema_version", "image_quality", "rate", "rhythm", "axis", "intervals", "p_wave_morphology", "qrs_morphology", "st_t_changes", "chamber_enlargement", "conduction_abnormalities", "final_synthesis", "teaching_pearls", "difficulty_estimate", "concepts_illustrated" ], "additionalProperties": false } }, "$schema": "http://json-schema.org/draft-07/schema#" }, "LearnerInterpretation": { "$ref": "#/definitions/LearnerInterpretation", "definitions": { "LearnerInterpretation": { "type": "object", "properties": { "schema_version": { "type": "string", "const": "1.0" }, "final_synthesis": { "type": "object", "properties": { "primary_diagnosis": { "type": "string", "minLength": 1, "maxLength": 200 }, "secondary_findings": { "type": "array", "items": { "type": "string" } }, "overall_confidence": { "type": "string", "enum": [ "low", "medium", "high" ] } }, "required": [ "primary_diagnosis" ], "additionalProperties": false }, "image_quality": { "type": "string", "enum": [ "good", "marginal", "poor" ] }, "rate": { "type": "object", "properties": { "finding": { "type": "string", "maxLength": 500 }, "reasoning": { "type": "string", "maxLength": 2000 }, "confidence": { "type": "string", "enum": [ "low", "medium", "high" ] }, "leads_to_examine": { "type": "array", "items": { "type": "string", "enum": [ "I", "II", "III", "aVR", "aVL", "aVF", "V1", "V2", "V3", "V4", "V5", "V6", "rhythm_strip" ] } }, "measurement_value": { "type": "number" } }, "additionalProperties": false }, "rhythm": { "type": "object", "properties": { "finding": { "type": "string", "maxLength": 500 }, "reasoning": { "type": "string", "maxLength": 2000 }, "confidence": { "type": "string", "enum": [ "low", "medium", "high" ] }, "leads_to_examine": { "type": "array", "items": { "type": "string", "enum": [ "I", "II", "III", "aVR", "aVL", "aVF", "V1", "V2", "V3", "V4", "V5", "V6", "rhythm_strip" ] } }, "diagnosis": { "type": "string" }, "regular": { "type": [ "boolean", "null" ] } }, "additionalProperties": false }, "axis": { "type": "object", "properties": { "finding": { "type": "string", "maxLength": 500 }, "reasoning": { "type": "string", "maxLength": 2000 }, "confidence": { "type": "string", "enum": [ "low", "medium", "high" ] }, "leads_to_examine": { "type": "array", "items": { "type": "string", "enum": [ "I", "II", "III", "aVR", "aVL", "aVF", "V1", "V2", "V3", "V4", "V5", "V6", "rhythm_strip" ] } }, "measurement_value": { "type": "number" }, "category": { "type": "string", "enum": [ "normal", "left_deviation", "right_deviation", "extreme", "indeterminate" ] } }, "additionalProperties": false }, "intervals": { "type": "object", "properties": { "pr_ms": { "type": "number" }, "qrs_ms": { "type": "number" }, "qt_ms": { "type": "number" }, "qtc_ms": { "type": "number" } }, "additionalProperties": false }, "p_wave_morphology": { "type": "object", "properties": { "finding": { "type": "string", "maxLength": 500 }, "reasoning": { 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"string", "minLength": 1, "maxLength": 200, "description": "The single-sentence read, as it would appear on a printed report." }, "primary_diagnosis": { "type": "string" }, "secondary_findings": { "type": "array", "items": { "type": "string" } }, "differential": { "type": "array", "items": { "type": "string" }, "description": "Alternative interpretations worth considering." }, "clinical_significance_education": { "type": "string", "description": "What this pattern would mean if seen in a real patient. Framed as education, not as a diagnostic recommendation." }, "overall_confidence": { "type": "string", "enum": [ "low", "medium", "high" ] } }, "required": [ "one_line_summary", "primary_diagnosis", "secondary_findings", "differential", "clinical_significance_education", "overall_confidence" ], "additionalProperties": false }, "teaching_pearls": { "type": "array", "items": { "type": "string" }, "minItems": 1, "maxItems": 5, "description": "The 1-5 highest-yield teaching points for this strip." }, "difficulty_estimate": { "type": "integer", "minimum": 1, "maximum": 5 }, "concepts_illustrated": { "type": "array", "items": { "type": "string" }, "description": "Slugs from the concept taxonomy that this strip exemplifies." }, "cannot_interpret": { "type": "object", "properties": { "reason": { "type": "string" } }, "required": [ "reason" ], "additionalProperties": false, "description": "Set only if image_quality is 'poor' and interpretation is unsafe. When present, other clinical fields may be omitted." } }, "required": [ "schema_version", "image_quality", "rate", "rhythm", "axis", "intervals", "p_wave_morphology", "qrs_morphology", "st_t_changes", "chamber_enlargement", "conduction_abnormalities", "final_synthesis", "teaching_pearls", "difficulty_estimate", "concepts_illustrated" ], "additionalProperties": false }, { "type": "null" } ] }, "interpretation_version": { "type": [ "string", "null" ] }, "concepts": { "type": "array", "items": { "type": "object", "properties": { "slug": { "type": "string" }, "title": { "type": "string" }, "category": { "type": "string", "enum": [ "rate", "rhythm", "axis", "intervals", "p_wave", "qrs", "ischemia", "chamber", "conduction", "paced", "meta" ] }, "salience": { "type": "string", "enum": [ "primary", "secondary" ] } }, "required": [ "slug", "title", "category", "salience" ], "additionalProperties": false }, "default": [] }, "quick_reading": { "type": [ "string", "null" ] }, 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{ "type": "null" } ] }, "image_url": { "type": "string", "description": "Path under /ekg-tutor/api/cases/:id/image" }, "thumb_url": { "type": [ "string", "null" ] }, "visibility": { "type": "string", "enum": [ "public", "private" ] }, "status": { "type": "string", "enum": [ "processing", "ready", "failed" ] }, "clinician_reviewed": { "type": "boolean" }, "interpretation_version": { "type": [ "string", "null" ] }, "concepts": { "type": "array", "items": { "type": "object", "properties": { "slug": { "type": "string" }, "title": { "type": "string" }, "category": { "type": "string", "enum": [ "rate", "rhythm", "axis", "intervals", "p_wave", "qrs", "ischemia", "chamber", "conduction", "paced", "meta" ] }, "salience": { "type": "string", "enum": [ "primary", "secondary" ] } }, "required": [ "slug", "title", "category", "salience" ], "additionalProperties": false }, "default": [] }, "quick_reading": { "type": [ "string", "null" ] }, "quick_reading_model": { "type": [ "string", "null" ] }, 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] }, "leads_to_examine": { "type": "array", "items": { "type": "string", "enum": [ "I", "II", "III", "aVR", "aVL", "aVF", "V1", "V2", "V3", "V4", "V5", "V6", "rhythm_strip" ] } }, "diagnosis": { "type": "string" }, "regular": { "type": [ "boolean", "null" ] } }, "additionalProperties": false }, "axis": { "type": "object", "properties": { "finding": { "type": "string", "maxLength": 500 }, "reasoning": { "type": "string", "maxLength": 2000 }, "confidence": { "type": "string", "enum": [ "low", "medium", "high" ] }, "leads_to_examine": { "type": "array", "items": { "type": "string", "enum": [ "I", "II", "III", "aVR", "aVL", "aVF", "V1", "V2", "V3", "V4", "V5", "V6", "rhythm_strip" ] } }, "measurement_value": { "type": "number" }, "category": { "type": "string", "enum": [ "normal", "left_deviation", "right_deviation", "extreme", "indeterminate" ] } }, "additionalProperties": false }, "intervals": { "type": "object", "properties": { "pr_ms": { "type": "number" }, "qrs_ms": { "type": "number" 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{ "type": "array", "items": { "type": "string", "enum": [ "I", "II", "III", "aVR", "aVL", "aVF", "V1", "V2", "V3", "V4", "V5", "V6", "rhythm_strip" ] } }, "st_depression_present": { "type": "boolean" }, "st_depression_leads": { "type": "array", "items": { "type": "string", "enum": [ "I", "II", "III", "aVR", "aVL", "aVF", "V1", "V2", "V3", "V4", "V5", "V6", "rhythm_strip" ] } }, "t_wave_inverted_leads": { "type": "array", "items": { "type": "string", "enum": [ "I", "II", "III", "aVR", "aVL", "aVF", "V1", "V2", "V3", "V4", "V5", "V6", "rhythm_strip" ] } } }, "additionalProperties": false }, "chamber_enlargement": { "type": "object", "properties": { "finding": { "type": "string", "maxLength": 500 }, "reasoning": { "type": "string", "maxLength": 2000 }, "confidence": { "type": "string", "enum": [ "low", "medium", "high" ] }, "leads_to_examine": { "type": "array", "items": { "type": "string", "enum": [ "I", "II", "III", "aVR", "aVL", "aVF", "V1", "V2", "V3", "V4", "V5", "V6", "rhythm_strip" ] } }, "lvh": { "type": "boolean" }, "rvh": { "type": "boolean" }, "la_enlargement": { "type": "boolean" }, "ra_enlargement": { "type": "boolean" } }, "additionalProperties": false }, "conduction_abnormalities": { "type": "object", "properties": { "finding": { "type": "string", "maxLength": 500 }, "reasoning": { "type": "string", "maxLength": 2000 }, "confidence": { "type": "string", "enum": [ "low", "medium", "high" ] }, "leads_to_examine": { "type": "array", "items": { "type": "string", "enum": [ "I", "II", "III", "aVR", "aVL", "aVF", "V1", "V2", "V3", "V4", "V5", "V6", "rhythm_strip" ] } }, "av_block": { "type": "string", "enum": [ "none", "first_degree", "mobitz_i", "mobitz_ii", "high_grade", "complete" ] }, "preexcitation": { "type": "boolean" }, "paced": { "type": "boolean" } }, "additionalProperties": false }, "duration_ms": { "type": "integer", "minimum": 0 } }, "required": [ "schema_version", "final_synthesis" ], "additionalProperties": false }, "canonical_snapshot": { "type": "object", "properties": { "schema_version": { "type": "string", "const": "1.0" }, "image_quality": { "type": "string", "enum": [ "good", "marginal", "poor" ] }, "image_quality_notes": { "type": "string" }, "rate": { "type": "object", "properties": { "finding": { "type": "string", "minLength": 1, "maxLength": 500 }, "reasoning": { "type": "string", "minLength": 1, "maxLength": 2000, "description": "What the learner should look at on the strip to reach this finding." }, "confidence": { "type": "string", "enum": [ "low", "medium", "high" ] }, "leads_to_examine": { "type": "array", "items": { "type": "string", "enum": [ "I", "II", "III", "aVR", "aVL", "aVF", "V1", "V2", "V3", "V4", "V5", "V6", "rhythm_strip" ] } }, "teaching_point": { "type": "string", "minLength": 1, "maxLength": 1000, "description": "The single most important concept this finding illustrates." }, "measurement": { "type": "object", "properties": { "value": { "type": "number" }, "unit": { "type": "string" }, 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{ "type": "string", "minLength": 1, "maxLength": 2000, "description": "What the learner should look at on the strip to reach this finding." }, "confidence": { "type": "string", "enum": [ "low", "medium", "high" ] }, "leads_to_examine": { "type": "array", "items": { "type": "string", "enum": [ "I", "II", "III", "aVR", "aVL", "aVF", "V1", "V2", "V3", "V4", "V5", "V6", "rhythm_strip" ] } }, "teaching_point": { "type": "string", "minLength": 1, "maxLength": 1000, "description": "The single most important concept this finding illustrates." }, "measurement": { "type": "object", "properties": { "value": { "type": "number" }, "unit": { "type": "string" }, "normal_range": { "type": "array", "minItems": 2, "maxItems": 2, "items": [ { "type": "number" }, { "type": "number" } ] }, "interpretation": { "type": "string", "enum": [ "normal", "borderline", "abnormal" ] } }, "required": [ "value", "unit", "interpretation" ], "additionalProperties": false, "description": "Frontal-plane axis in degrees, 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should look at on the strip to reach this finding." }, "confidence": { "type": "string", "enum": [ "low", "medium", "high" ] }, "leads_to_examine": { "type": "array", "items": { "type": "string", "enum": [ "I", "II", "III", "aVR", "aVL", "aVF", "V1", "V2", "V3", "V4", "V5", "V6", "rhythm_strip" ] } }, "teaching_point": { "type": "string", "minLength": 1, "maxLength": 1000, "description": "The single most important concept this finding illustrates." }, "measurement": { "type": "object", "properties": { "value": { "type": "number" }, "unit": { "type": "string" }, "normal_range": { "type": "array", "minItems": 2, "maxItems": 2, "items": [ { "type": "number" }, { "type": "number" } ] }, "interpretation": { "type": "string", "enum": [ "normal", "borderline", "abnormal" ] } }, "required": [ "value", "unit", "interpretation" ], "additionalProperties": false } }, "required": [ "finding", "reasoning", "confidence", "leads_to_examine", "teaching_point", "measurement" ], "additionalProperties": 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} }, "required": [ "finding", "reasoning", "confidence", "leads_to_examine", "teaching_point", "lvh", "rvh", "la_enlargement", "ra_enlargement", "criteria_met" ], "additionalProperties": false }, "conduction_abnormalities": { "type": "object", "properties": { "finding": { "type": "string", "minLength": 1, "maxLength": 500 }, "reasoning": { "type": "string", "minLength": 1, "maxLength": 2000, "description": "What the learner should look at on the strip to reach this finding." }, "confidence": { "type": "string", "enum": [ "low", "medium", "high" ] }, "leads_to_examine": { "type": "array", "items": { "type": "string", "enum": [ "I", "II", "III", "aVR", "aVL", "aVF", "V1", "V2", "V3", "V4", "V5", "V6", "rhythm_strip" ] } }, "teaching_point": { "type": "string", "minLength": 1, "maxLength": 1000, "description": "The single most important concept this finding illustrates." }, "av_block": { "type": "string", "enum": [ "none", "first_degree", "mobitz_i", "mobitz_ii", "high_grade", "complete" ] }, "preexcitation": { "type": "boolean" }, "paced": { "type": "boolean" } }, "required": [ "finding", "reasoning", "confidence", "leads_to_examine", "teaching_point", "av_block", "preexcitation", "paced" ], "additionalProperties": false }, "final_synthesis": { "type": "object", "properties": { "one_line_summary": { "type": "string", "minLength": 1, "maxLength": 200, "description": "The single-sentence read, as it would appear on a printed report." }, "primary_diagnosis": { "type": "string" }, "secondary_findings": { "type": "array", "items": { "type": "string" } }, "differential": { "type": "array", "items": { "type": "string" }, "description": "Alternative interpretations worth considering." }, "clinical_significance_education": { "type": "string", "description": "What this pattern would mean if seen in a real patient. 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