Accountability means a decision can be examined, justified, and contested. LLMs make this hard: fluent output may be ungrounded, incomplete, or unfaithful to the decision process. Achieving accountability requires verified rationales (how was the decision reached), assumptions (what was assumed rather than known), policy consistency (the same treatment for the same facts), and pivotal conditions (what would change the outcome). We introduce self-faithfulness as an automatic test of accountability: changing the pivotal conditions should change the decision. We examine accountable AI through clinical trial matching, a high-stakes task central to evidence-based medicine. Although LLM-based matchers match patients to trials reasonably accurately, they apply decision policies inconsistently and produce rationales that are unfaithful to their own decisions. We introduce VERDICT, an LLM-based agent that translates a decision task, its constraints, and its policy into Satisfiability Modulo Theories (SMT), then derives the decision with SMT and MaxSMT solvers -- so policies are applied consistently and decisions are accountable by construction. Across a SIGIR 2016-derived dataset and TREC 2021, VERDICT achieves the strongest decision accuracy among LLM-only and neurosymbolic baselines, applies policies with perfect consistency, and produces clinician-preferred rationales grounded in explicit assumptions and pivotal conditions, with improved counterfactual self-faithfulness.
Kavimayil P. Komarasamy, Saurabh Mathur, Ameet Soni +3cs.LG
Adverse Pregnancy Outcomes (APOs) such as preterm birth and gestational diabetes can have long-term consequences for both the mother and child, yet an understanding of their causes remains elusive. Causal discovery in this domain is especially challenging due to a paucity of data and incomplete domain knowledge. As a result, pure data-driven methods fail, and Large Language Model (LLM) outputs remain inconsistent or contradictory. We introduce a neurosymbolic framework for generating plausible causal hypotheses that iteratively combines the broad prior knowledge of LLMs with empirical scoring on data. Our method treats the LLM as an adaptive proposal distribution, generating hypotheses that are scored against empirical data; the resulting high-scoring graphs are then used to update the LLM's context, steering subsequent generations toward more promising regions of the hypothesis space. We evaluate our approach on a real-world clinical dataset for modeling APOs and their risk factors, comparing our results against an expert-constructed causal graph. Our method recovers all expert-validated edges and identifies additional plausible causal relations not previously listed by experts, potentially providing new insights for targeted interventions.
Identifying reliable Alzheimer's disease (AD) markers typically requires manual, labor-intensive transcription and expert analysis, limiting its scale. We introduce an automated pipeline that extracts qualitative knowledge about potential AD progression indicators directly from audio recordings of verbal fluency tests. Our method uses pretrained foundation models to process raw audio and extract clinically relevant variables to construct a Bayesian Network (BN); this BN is used to reason about the AD progression markers and infer their qualitative relationships. Our system successfully recovers known clinical knowledge and identifies novel relationships between linguistic markers.