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However, coupled evaluation conflates the quality of the policy-elicited history with policy-specific terminal diagnosis generation: strong generation can compensate for a thin history, while weaker generation can obscure a rich one. We introduce MedDDC-Eval, a diagnosis-decoupled testbed that treats elicited history as the comparison object and holds the history-to-diagnosis mapping constant through a shared frozen reader. Across two held-out sources, a grounded interface and an auditable diagnosis-trajectory-efficiency (D/T/E) harness measure diagnostic usefulness, information acquisition, and efficiency. 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