Quality & methodology

Fidelity you can trust, over a reward you can't game

The hard part of dynamic clinical evaluation is fidelity: faithful state for whatever a model does, and a reward over the trajectory you can trust. Physicians who author the case and grade it clear that bar.

Physician-authored state

Each case is an interactive environment with an initial presentation, a hidden ground-truth state, and faithful transitions for every clinically sensible action across history, examination, investigation, treatment, and referral. If a model acts outside the authored space, the authoring physician adjudicates the step and folds it back in.

Multi-physician adjudication

Every rubric criterion is written and checked by at least three physicians, with an error taxonomy that separates reasoning-process failures from factual and safety ones, each carrying a severity grade.

Held-out splits & IRR

Held-out splits and inter-rater reliability targets are fixed in the pilot spec up front, so quality is measurable rather than asserted.

Provenance & compliance

Physicians write the cases, so nothing comes from identifiable records. Fold in real cases later under the usual consent, ethics approval, de-identification, and HIPAA/GDPR-aware licensing.

Why not model-judges

Model graders aren't ground truth

On clinical answers, automated judges barely beat chance. That is why grading, not just authoring, has to be physician work.

AUC 0.49-0.66

LLM judges separate complete from incomplete clinical answers only marginally above chance. Even when they agree with a clinician, they cite the same reasoning just 24.6% of the time.

Independent evaluations of LLM clinical graders, 2025 to 2026

See a case before you commit

Book a demo and we'll build one case end to end: the environment, the hidden ground-truth state, the grading rubric, and a graded model rollout, in your evaluation format, at no cost. Your team judges the fidelity first.