Hur vi utvärderar risken för hallucinationer i klinisk AI

Notats bevisberättelse är inte en magisk noggrannhetsprocent. Det är en transparent metodik: extrahera kliniska fakta först, generera anteckningar från dessa fakta, visa den råa kontexten för kliniken och granska varje utdata mot bevisen.

Utvärderingsmetod

1. Build the reference facts

A reviewer reads the encounter material and creates a reference set of clinical facts: symptoms, negatives, medication changes, assessment, plan, safety-netting, and coding-relevant details.

2. Compare transcript-direct output

We generate a note from transcript-style input and mark unsupported statements, missing high-salience facts, incorrect attribution, and invented certainty.

3. Compare FactsContext output

We generate documentation from extracted facts and review whether each sentence is supported by a visible fact. The clinician-facing fact list is evaluated as part of the output, not hidden.

4. Record limits, not magic numbers

We do not publish fake accuracy percentages. Each evaluation note includes dataset scope, review date, known limitations, and examples of what the system still requires clinicians to verify.

Vad granskare markerar

Unsupported clinical assertion

Wrong medication, dose, frequency, or route

Missing red-flag negative or safety-net advice

Wrong diagnosis certainty: possible vs established

Wrong speaker attribution

Unsupported ICD-10 suggestion

Clinician-visible evidence for each key statement

Facts reusable for notes, codes, referrals, and patient instructions

Daterad intern anteckning

Aktuell utvärderingsanteckning, 2026-07-01: denna sida dokumenterar metoden och kvalitativa exempel som använts för att utvärdera FactsContext-arkitekturen. Den gör inte anspråk på extern validering eller universell noggrannhet. Nästa bevissteg bör vara en blindad, specialitetsstratifierad granskning med datasetstorlek, granskarnas överensstämmelse och andel ostödda påståenden öppet redovisade.

Faktextrahering vs transkriptdirekt generering

Medication change discussed twice

Transkriptdirekt risk

“Increase amlodipine to 10 mg and stop lisinopril.” The transcript contained a correction: the clinician first considered stopping lisinopril, then decided to continue it after reviewing renal function.

FactsContext-utdata

Facts: amlodipine increased to 10 mg daily; lisinopril continued; renal function normal; review in 6 weeks. Note generated from those facts only.

Varför det spelar roll

Transcript-direct generation can smooth over corrections. FactsContext preserves the final decision as a discrete fact before writing.

Negative finding matters

Transkriptdirekt risk

“No neurological symptoms.” The actual encounter only documented no saddle anesthesia and no bladder symptoms; leg radiation was present.

FactsContext-utdata

Facts: left leg radiation to calf; SLR positive left; no saddle anesthesia; no bladder or bowel symptoms. Note keeps the negatives specific.

Varför det spelar roll

Broad negative statements are risky. The fact list keeps the clinical context granular and reviewable.

Code suggestion requires evidence

Transkriptdirekt risk

Suggested J44.1 for COPD exacerbation without showing the symptom or treatment evidence.

FactsContext-utdata

Facts: increased breathlessness, purulent sputum, prednisolone burst, antibiotics started. Suggested J44.1 with those facts as evidence.

Varför det spelar roll

The code is easier to verify because the reason for the suggestion is visible, not buried in prose.

Kända begränsningar

Clinician review remains mandatory. Notat drafts; clinicians verify and sign.

The method reduces unsupported statements by architecture, but no clinical AI should claim zero hallucinations.

Small internal evaluations are useful for engineering direction, not a substitute for external clinical validation.

Specialty, language, audio quality, speaker overlap, and local coding rules can change performance.

Läs bevisen, inspektera sedan dina egna fakta.

Utvärderingsmetoden är enkel eftersom produkten är utformad för att vara inspekterbar: fakta först, anteckning andra, klinisk granskning alltid.

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