Large language models (LLMs) offer promising clinical decision support but remain vulnerable to hallucinated facts, unsupported recommendations, and citation errors. We present DIASENTINEL, a fully on-premise multi-agent system for one-year type 2 diabetes mellitus (T2DM) risk screening and guideline-grounded report generation from electronic health records (EHRs). The system integrates calibrated risk prediction, deterministic clinical signal extraction, Reciprocal Rank Fusion over American Diabetes Association (ADA) guidelines, and a hybrid verification layer combining rule-based checks with LLM entailment. The demonstration provides a real-time batch-screening dashboard and an interactive patient report interface with cited recommendations, verification results, and raw EHR comparison. DIASENTINEL demonstrates a practical framework for reliable, auditable, and privacy-preserving LLM-based clinical decision support.
Large language models can convert medical documents into structured data, but plausible output may still be unsupported by the source. Persisting such output in a longitudinal health record, a record that accumulates patient information over time, therefore creates an integrity risk: unverified data may influence later summaries, trends, or preventive-care computations. We introduce an evidence-gated trust-promotion model that keeps generated data provisional until a deterministic monitor verifies it against the source document. The monitor admits a candidate for a specified downstream use only when the source contains a unique supporting quotation, the relevant fields occur within the same laboratory row, and the required provenance is preserved. The generator cannot approve its own output, missing or ambiguous evidence causes refusal, and refused candidates remain available for human review rather than being silently discarded. We implement the model in Medical DataCloud, a personal health-record application, and evaluate it through automated tests and a replay of saved extraction outputs. All 22 conformance and mutation tests pass. The replay covers nine historical laboratory PDF reports containing 102 manually labelled rows. The reports produce 97 numeric candidates: schema validation accepts all 97, an earlier packet-level evidence check accepts 94, and the hardened quotation- and row-level policy admits 72 while retaining 25 for review. The study evaluates system integrity rather than clinical correctness or clinical safety. The results demonstrate the technical feasibility of an enforceable boundary that prevents generated claims from authorizing their own reuse in a longitudinal health record.
Large language models (LLMs) are increasingly paired with verifiers (step checkers, self-consistency filters, tool-based fact checkers, formal proof assistants) that claim to detect the model's errors. Yet the verification literature uses the word "level" to mean at least five different things: verification granularity, concept abstraction, risk tier, system-stack layer, and the epistemic source of the ground truth. We propose Verification Autonomy Levels (VAL), a meta-standard classifying verification schemes along a single axis: where does the verification spec come from, and what does the verdict guarantee? VAL ranges from L0 (LLM self-declaration, no deterministic anchor) through L2 (objective ground truth, correctness only) to L3/L4 (decidable systems with single-property or domain-level completeness), with L5 impossible in the unrestricted case. Central to VAL is the completeness blind spot: substitution- and sampling-based verifiers can confirm that proposed candidates hold, but cannot prove that no candidate was missed. We further identify a dichotomy the literature has not stated: completeness is reachable only for formally specifiable properties, while empirical open-world verification (fact-checking, diagnosis) caps at anchored correctness (L2). We document this across four domains (symbolic mathematics, behavior monitoring, medical diagnosis, and code generation) and in the strongest existing formal-verification baseline, whose authors note the verifier "focuses on the correctness of each step." We show the levels of granularity, concept hierarchy, risk, and system stack are orthogonal to VAL, resolving a systematic conflation across 17 surveyed papers. Code and full assessment are released as supplementary material.
Jim Woodcock, Gabriel Leite, Augusto Sampaio +1cs.SE cs.AI cs.LO
We address the use of large language models (LLMs) to help discover Isabelle proofs. An Isabelle build establishes that the submitted theory is accepted, but not that an LLM changed only what the developer authorised. We present CAPRI, a contract-aware repair workflow in which Isabelle checks the proof and an independent checker enforces a machine-readable edit contract. Prompts, proposals, candidate repositories, diagnostics, verdicts, and hashes are retained for audit. We evaluate five workflows on twelve failed proofs from four developments, with three replicates per task and condition, giving 180 runs and 138 valid repairs. Of 144 terminal candidates accepted by Isabelle, six had modified protected text; all arose in iterative workflows that could edit a complete theory. A proof-body-only interface produced 29/36 valid repairs and no contract violations, compared with 31/36 for the corresponding full-theory workflow. One-shot repair produced 22/36, while a later prospectively frozen iterative workflow produced 32/36; these figures compare complete workflows rather than individual mechanisms. A separate post hoc OpenRouter campaign found no improvement in the designated Luna comparisons. A Sol configuration with matched demonstrations produced 33/36 repairs, compared with 29/36 in the frozen OpenAI Responses condition, but the difference was not statistically significant in a one-sided exact McNemar test ($p=0.0625$).
Large language models are increasingly used to reason about software vulnerabilities, but their outputs can silently violate domain knowledge, limiting their reliability in safety-critical settings such as medical devices. Prior work either treats that output as a prediction to be scored or constrains it to walks within a single knowledge graph; neither checks whether reasoning over a binary is consistent with an independent body of domain knowledge. We present EntailLLM, which validates each LLM-proposed analyst path by entailment: the path is a traversal of the binary's function call graph, the domain knowledge is represented in a separate graph, and verification aligns the two under temporal annotated logic. Across three CWE classes, four LLMs, three prompting strategies, and seven binaries varying in size from 405 to 12,696 function call-graph nodes, domain knowledge raises pooled entailment from 78% to 98%, with entailment decreasing in only 3% of the experiments. EntailLLM is deployed end-to-end on real medical-device binaries, reaching 98% pooled entailment without per-device tuning. Our system inherits the formal guarantees of generalized annotated logic, providing logical verification of LLM output that is both explainable and grounded in well-defined semantics.
Large language models can produce superficially legal twelve-tone scores that collapse into degenerate textures. We introduce a neuro-symbolic harness that wraps a language-model proposer in a generate-verify-repair-trace loop with symbolic verification. The complete pipeline improves event-local consistency without claiming whole-piece legality. Across 40 controlled tasks and four paired models, audited delivery yield rises from 13.3% under raw generation to 48.1% with the harness, which explicitly abstains otherwise. The pass rate of a narrower collision and serialisation-consistency check rises from 33.5% to 58.3%, while degeneracy remains near 0.05, including under exploratory adversarial prompting. A blinded evaluation by five experts also shows a descriptive aggregate preference for harness candidates over raw generation in adherence, perceived legality, coherence, and overall quality.
Large language models can interpret natural-language chemistry questions, but their internal reasoning is difficult to inspect, constrain, and validate. This paper presents ChemOntoRule, a proof-of-concept symbolic core for AI-assisted school-level chemistry problem solving. The central design choice is task-centric ontology engineering: the ontology is constructed around the concepts, properties, relations, and executable procedures required by a defined collection of chemistry problems, rather than as a universal representation of chemistry. The implemented artifact combines a lightweight ontology serialized in JSON and RDF/Turtle with deterministic Python rules for electronic structure, periodic trends, oxidation states, oxide and hydride behavior, and related school-level reasoning patterns. A separate expert-coded fallback handles problem families not yet represented by general rules. The system was examined on 300 human-authored and manually validated chemistry problems. The complete system matched 296 of 300 reference answers (98.67%). The ontology-driven rule subset covered 269 problems and matched 266 references (98.88%); 31 problems were handled by task-specific expert-coded fallbacks, with 30 matches. Because the same collection informed ontology construction and evaluation, these results measure implemented coverage and internal consistency, not independent generalization. We analyze the four mismatches, distinguish structural validation from chemical correctness, and define a future architecture in which a language model acts primarily as a translator from user language into a normalized ontological task frame. Token efficiency is presented as a testable hypothesis for future controlled studies, not as a result of the current work.
Objective. Large language models (LLMs) increasingly draft clinical research manuscripts, but their fluency can hide fabricated citations, numbers that drift from source tables, and unmet reporting-guideline items. Existing tools generate text without verifying it, and self-critique inherits the blind spots that produce confident fabrication. We describe an architecture that pairs generation with verification. Methods. The design rests on three principles: decompose the workflow into self-contained skills, gate every stage transition with halt-on-failure, and resolve each integrity question with the cheapest sufficient mechanism -- a deterministic, re-executable check where one suffices, and a prose-level probe only where interpretation is unavoidable. This determinism-where-possible split, organized as an integrity-gate taxonomy, is the core contribution. It is realized as MedSci Skills, an open-source toolkit of 43 skills coordinated by one orchestrator, whose deterministic tier comprises 21 standard-library detectors. We evaluate it on three reproducible public-dataset pipelines (STARD, PRISMA, STROBE) and a seeded-defect ablation. Results. Across the three pipelines every content-hash manifest verified clean and the gates surfaced real defects. On 27 identical injected defects the deterministic gates detected all 27 with no false positives on the matched clean fixtures, whereas a generic single-prompt LLM reviewer detected 11, its misses concentrated in generated-code, bibliography-internal, and style defects the prose does not expose. Conclusion. Determinism-where-possible verification yields an auditable, re-executable trail that exposes the evidence a human needs to check an LLM-assisted manuscript -- feasibility and reproducibility evidence, not a claim of human-competitive quality, which a separate blinded study addresses. MedSci Skills is MIT-licensed and archived (v3.8.0).