medfence 0.1.0__tar.gz

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+ Metadata-Version: 2.4
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+ Name: medfence
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+ Version: 0.1.0
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+ Summary: Deterministic, fail-closed verification harness for clinical LLM outputs
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+ Author-email: Debanit Panigrahi <d.panigrahi.nitrkl@gmail.com>
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+ License-Expression: Apache-2.0
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+ Project-URL: Homepage, https://github.com/Debanitrkl/medfence
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+ Project-URL: Repository, https://github.com/Debanitrkl/medfence
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+ Project-URL: Issues, https://github.com/Debanitrkl/medfence/issues
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+ Keywords: llm,verification,clinical,healthcare,hallucination,guardrails,fail-closed,prescription,grounding
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+ Classifier: Development Status :: 3 - Alpha
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+ Classifier: Intended Audience :: Developers
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+ Classifier: Intended Audience :: Healthcare Industry
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+ Classifier: Operating System :: OS Independent
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+ Classifier: Programming Language :: Python :: 3
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+ Classifier: Programming Language :: Python :: 3.10
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+ Classifier: Programming Language :: Python :: 3.11
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+ Classifier: Programming Language :: Python :: 3.12
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+ Classifier: Programming Language :: Python :: 3.13
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+ Classifier: Programming Language :: Python :: 3.14
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+ Classifier: Topic :: Scientific/Engineering :: Medical Science Apps.
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+ Classifier: Typing :: Typed
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+ Requires-Python: >=3.10
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+ Description-Content-Type: text/markdown
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+ License-File: LICENSE
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+ Dynamic: license-file
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+
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+ # medfence
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+
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+ [![ci](https://github.com/Debanitrkl/medfence/actions/workflows/ci.yml/badge.svg)](https://github.com/Debanitrkl/medfence/actions/workflows/ci.yml)
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+
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+ **A deterministic, fail-closed verification harness for clinical LLM outputs.**
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+
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+ LLM extraction is entering clinical workflows (scribes, prescription digitization,
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+ lab-report parsing) faster than verification infrastructure is being built. Known
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+ failure modes include fabricated medications, silently altered dosages, mg→mcg unit
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+ swaps, and invented frequencies. `medfence` is the fence between model output and
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+ clinical action: pure-function, zero-dependency, every verdict backed by
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+ machine-checkable evidence.
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+
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+ ```python
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+ from medfence import verify, Extraction, SourceDocument
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+
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+ report = verify(
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+ Extraction(artifact_type="prescription", payload=llm_output),
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+ SourceDocument(text=ocr_text, modality="ocr", ocr_confidence=0.91),
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+ )
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+ report.overall # Verdict.PASS | Verdict.FAIL | Verdict.ABSTAIN
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+ report.coverage # fraction of payload fields actually verified
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+ report.to_audit_json() # one hash-chained JSON line per verification
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+ ```
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+
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+ ## The three guarantees
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+
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+ 1. **Deterministic.** No I/O, no clock, no model calls inside `verify()`. Identical
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+ `(source, extraction, rulepack)` → bit-identical report. Verdicts are reproducible
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+ by strangers; that is what makes them auditable.
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+ 2. **Fail-closed.** `ABSTAIN` is a first-class verdict, not an error state. "Couldn't
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+ check" routes to a human exactly like `FAIL`; it never silently becomes `PASS`.
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+ Unknown artifact types, missing reference data, low-confidence OCR → `ABSTAIN`.
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+ 3. **No finding without evidence.** Every verdict carries a source span, a reference
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+ bundle key, or a rule id. A check that cannot produce evidence must abstain.
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+
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+ And one deliberate refusal: **medfence never judges clinical appropriateness.**
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+ `dose_in_range` answers "does 500 mg paracetamol exist as a marketed product?",
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+ never "should this patient take it?" Fidelity and referential validity are
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+ mechanically decidable; clinical judgment is not, and pretending otherwise is how
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+ verification tools become unlicensed medical devices.
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+
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+ ## Check families (v0)
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+
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+ **Family G: span grounding ("no span, no claim")**
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+ Every extracted value must align to a span in the source, *localized to its own
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+ medication's line*, because whole-document matching invites cross-medication collisions
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+ (a 250 mg on someone else's line must not ground your altered strength).
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+ Numbers and units match exact-after-normalization only; fuzzy-matching a dosage
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+ is how a fence approves a hallucination. `unit_integrity` catches the mg↔mcg
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+ class specifically. Fully ungrounded medication objects fail `no_orphans`
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+ (the fabricated-drug detector).
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+
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+ **Family R: reference validity**
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+ Drug names, marketed strengths, dose forms, and frequency tokens are checked
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+ against a versioned, content-hashed Indian drug bundle and a closed grammar of
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+ prescription shorthand (OD, BD, TDS, 1-0-1, SOS, …). Fuzzy lookup is allowed for
85
+ retrieval; a weak hit is `ABSTAIN`, never `PASS`.
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+
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+ ## Benchmark
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+
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+ 100 documents: 20 synthetic Indian OPD prescriptions × (1 clean + 4 seeded-error
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+ variants). Reproduce with `python scripts/make_golden.py && python scripts/benchmark.py`.
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+
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+ | error class | n | FAIL | ABSTAIN | PASS | caught | **false PASS** |
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+ |--------------------|---:|-----:|--------:|-----:|-------:|---------------:|
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+ | fabricated_drug | 20 | 20 | 0 | 0 | 100% | **0%** |
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+ | unit_swap | 20 | 20 | 0 | 0 | 100% | **0%** |
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+ | altered_strength | 20 | 20 | 0 | 0 | 100% | **0%** |
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+ | invented_frequency | 20 | 20 | 0 | 0 | 100% | **0%** |
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+ | clean | 20 | 0 | 0 | 20 | n/a | (100% clean-pass) |
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+
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+ **Read this honestly:** 100% on a synthetic golden set means the set is easy, not
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+ that the fence is finished. The seeded errors are clean single-fault injections on
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+ noise-free text. The numbers that matter will come from real, anonymized,
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+ OCR-noisy prescriptions. Contributions of anonymized hard cases are the most
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+ valuable thing you can send this project.
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+
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+ ## What v0 deliberately does not do
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+
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+ - Drug-drug interaction checking (v1 candidate, behind an explicit opt-in)
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+ - Patient-contextual dosing (age/weight/renal): the SaMD line; we stay below it
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+ - Auto-correction: medfence flags, it never fixes
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+ - LLM-as-judge fallback: if deterministic checks can't verify it, a human sees it
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+ - STT/word-timestamp evidence (the `Evidence` type is designed for it; v0 is OCR/text)
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+ - **Omission detection**: `verify()` checks payload→source fidelity, not
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+ source→payload completeness: a medication silently *dropped* by the extractor is
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+ not caught. This gap is encoded as a strict-xfail test so it stays visible.
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+
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+ ## Reference bundle
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+
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+ v0 ships `refdata-2026.07.0-seed`: ~27 common Indian OPD molecules with brand
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+ aliases, forms, and marketed strengths, a deliberately small, versioned
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+ placeholder for a proper CDSCO + NLEM + Jan Aushadhi normalization pass. The
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+ bundle is content-hashed and the hash is pinned into every report, so verdicts
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+ remain reproducible as the data grows.
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+
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+ ## Testing & validation
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+
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+ The suite is deliberately heavier than the library; for a verification tool,
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+ the tests *are* the product claim. Beyond unit tests, three layers guard the
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+ contract:
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+
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+ - **Property-based** (`tests/test_properties.py`, Hypothesis): `verify()` is
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+ total, fail-closed, and non-mutating over arbitrary junk payloads; reports are
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+ bit-identical; clean-by-construction cases PASS and any corruption of them
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+ never does; mg/mcg canonicalization never merges; aggregation matches an
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+ independent worst-of oracle and is order-invariant and monotone.
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+ - **Metamorphic** (`tests/test_metamorphic.py`): ~700 guarded corruptions
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+ (digit edits, magnitude shifts, unit swaps, real-but-absent drug insertion,
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+ in-grammar frequency swaps, …) applied to every clean golden case at test
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+ time; none may PASS. Same fault taxonomy as the golden set, one
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+ implementation (`scripts/corruptions.py`), two depths.
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+ - **Golden gate** (`tests/test_golden_gate.py`): the benchmark as hard
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+ assertions; false-PASS == 0 and clean-pass == 100% fail the build, and the
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+ committed golden set must match its generator exactly.
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+
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+ Known v0 limitations are encoded as `xfail(strict=True)` tests (duplicate
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+ medication names, trailing punctuation on frequencies, omission detection):
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+ executable documentation that flips to a build failure the day the limitation
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+ is fixed.
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+
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+ ```bash
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+ uv sync --group dev
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+ uv run pytest # full suite (~750 tests, <5 s)
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+ uv run pytest -m golden # just the benchmark gate
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+ ```
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+
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+ ## Project layout
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+
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+ ```
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+ medfence/
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+ contract.py # types + fail-closed aggregation (the stable core)
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+ normalize.py # deterministic text/unit/number normalization
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+ rulepack.py # bundle loading, thresholds-as-versioned-data
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+ checks/grounding.py # Family G
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+ checks/refdata.py # Family R
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+ verify.py # the single entrypoint
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+ data/refdata_seed.json
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+ scripts/make_golden.py # regenerate the golden set (deterministic, no RNG)
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+ scripts/benchmark.py # the table above (exits 1 on any false PASS)
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+ scripts/corruptions.py # shared fault operators (golden set + metamorphic grid)
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+ tests/ # contract invariants, properties, metamorphic grid, golden gate
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+ tests/schemas/ # JSON Schema for the audit report (the output contract)
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+ docs/adr-001-*.md # the design record
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+ docs/related-work.md # how this differs from LangExtract, Guardrails, etc.
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+ ```
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+
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+ ## Design record & positioning
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+
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+ See `docs/adr-001-clinical-verification-contract-v0.md` for the full contract
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+ spec, options considered, and the trade-off analysis (notably: why ABSTAIN
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+ exists, why coverage is a first-class output, and where the SaMD line is drawn).
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+ For how medfence relates to LangExtract, Guardrails AI, clinical
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+ self-verification, and the rest of the landscape, see `docs/related-work.md`.
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+
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+ ## License
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+
186
+ Apache-2.0.
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+
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+ ## Quick demo
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+
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+ ```bash
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+ python3 demo.py # one prescription: PASS, FAIL (mcg swap + fabricated drug), ABSTAIN (low OCR)
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+ ```
@@ -0,0 +1,165 @@
1
+ # medfence
2
+
3
+ [![ci](https://github.com/Debanitrkl/medfence/actions/workflows/ci.yml/badge.svg)](https://github.com/Debanitrkl/medfence/actions/workflows/ci.yml)
4
+
5
+ **A deterministic, fail-closed verification harness for clinical LLM outputs.**
6
+
7
+ LLM extraction is entering clinical workflows (scribes, prescription digitization,
8
+ lab-report parsing) faster than verification infrastructure is being built. Known
9
+ failure modes include fabricated medications, silently altered dosages, mg→mcg unit
10
+ swaps, and invented frequencies. `medfence` is the fence between model output and
11
+ clinical action: pure-function, zero-dependency, every verdict backed by
12
+ machine-checkable evidence.
13
+
14
+ ```python
15
+ from medfence import verify, Extraction, SourceDocument
16
+
17
+ report = verify(
18
+ Extraction(artifact_type="prescription", payload=llm_output),
19
+ SourceDocument(text=ocr_text, modality="ocr", ocr_confidence=0.91),
20
+ )
21
+ report.overall # Verdict.PASS | Verdict.FAIL | Verdict.ABSTAIN
22
+ report.coverage # fraction of payload fields actually verified
23
+ report.to_audit_json() # one hash-chained JSON line per verification
24
+ ```
25
+
26
+ ## The three guarantees
27
+
28
+ 1. **Deterministic.** No I/O, no clock, no model calls inside `verify()`. Identical
29
+ `(source, extraction, rulepack)` → bit-identical report. Verdicts are reproducible
30
+ by strangers; that is what makes them auditable.
31
+ 2. **Fail-closed.** `ABSTAIN` is a first-class verdict, not an error state. "Couldn't
32
+ check" routes to a human exactly like `FAIL`; it never silently becomes `PASS`.
33
+ Unknown artifact types, missing reference data, low-confidence OCR → `ABSTAIN`.
34
+ 3. **No finding without evidence.** Every verdict carries a source span, a reference
35
+ bundle key, or a rule id. A check that cannot produce evidence must abstain.
36
+
37
+ And one deliberate refusal: **medfence never judges clinical appropriateness.**
38
+ `dose_in_range` answers "does 500 mg paracetamol exist as a marketed product?",
39
+ never "should this patient take it?" Fidelity and referential validity are
40
+ mechanically decidable; clinical judgment is not, and pretending otherwise is how
41
+ verification tools become unlicensed medical devices.
42
+
43
+ ## Check families (v0)
44
+
45
+ **Family G: span grounding ("no span, no claim")**
46
+ Every extracted value must align to a span in the source, *localized to its own
47
+ medication's line*, because whole-document matching invites cross-medication collisions
48
+ (a 250 mg on someone else's line must not ground your altered strength).
49
+ Numbers and units match exact-after-normalization only; fuzzy-matching a dosage
50
+ is how a fence approves a hallucination. `unit_integrity` catches the mg↔mcg
51
+ class specifically. Fully ungrounded medication objects fail `no_orphans`
52
+ (the fabricated-drug detector).
53
+
54
+ **Family R: reference validity**
55
+ Drug names, marketed strengths, dose forms, and frequency tokens are checked
56
+ against a versioned, content-hashed Indian drug bundle and a closed grammar of
57
+ prescription shorthand (OD, BD, TDS, 1-0-1, SOS, …). Fuzzy lookup is allowed for
58
+ retrieval; a weak hit is `ABSTAIN`, never `PASS`.
59
+
60
+ ## Benchmark
61
+
62
+ 100 documents: 20 synthetic Indian OPD prescriptions × (1 clean + 4 seeded-error
63
+ variants). Reproduce with `python scripts/make_golden.py && python scripts/benchmark.py`.
64
+
65
+ | error class | n | FAIL | ABSTAIN | PASS | caught | **false PASS** |
66
+ |--------------------|---:|-----:|--------:|-----:|-------:|---------------:|
67
+ | fabricated_drug | 20 | 20 | 0 | 0 | 100% | **0%** |
68
+ | unit_swap | 20 | 20 | 0 | 0 | 100% | **0%** |
69
+ | altered_strength | 20 | 20 | 0 | 0 | 100% | **0%** |
70
+ | invented_frequency | 20 | 20 | 0 | 0 | 100% | **0%** |
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+ | clean | 20 | 0 | 0 | 20 | n/a | (100% clean-pass) |
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+
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+ **Read this honestly:** 100% on a synthetic golden set means the set is easy, not
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+ that the fence is finished. The seeded errors are clean single-fault injections on
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+ noise-free text. The numbers that matter will come from real, anonymized,
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+ OCR-noisy prescriptions. Contributions of anonymized hard cases are the most
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+ valuable thing you can send this project.
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+
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+ ## What v0 deliberately does not do
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+
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+ - Drug-drug interaction checking (v1 candidate, behind an explicit opt-in)
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+ - Patient-contextual dosing (age/weight/renal): the SaMD line; we stay below it
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+ - Auto-correction: medfence flags, it never fixes
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+ - LLM-as-judge fallback: if deterministic checks can't verify it, a human sees it
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+ - STT/word-timestamp evidence (the `Evidence` type is designed for it; v0 is OCR/text)
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+ - **Omission detection**: `verify()` checks payload→source fidelity, not
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+ source→payload completeness: a medication silently *dropped* by the extractor is
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+ not caught. This gap is encoded as a strict-xfail test so it stays visible.
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+
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+ ## Reference bundle
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+
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+ v0 ships `refdata-2026.07.0-seed`: ~27 common Indian OPD molecules with brand
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+ aliases, forms, and marketed strengths, a deliberately small, versioned
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+ placeholder for a proper CDSCO + NLEM + Jan Aushadhi normalization pass. The
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+ bundle is content-hashed and the hash is pinned into every report, so verdicts
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+ remain reproducible as the data grows.
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+
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+ ## Testing & validation
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+
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+ The suite is deliberately heavier than the library; for a verification tool,
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+ the tests *are* the product claim. Beyond unit tests, three layers guard the
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+ contract:
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+
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+ - **Property-based** (`tests/test_properties.py`, Hypothesis): `verify()` is
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+ total, fail-closed, and non-mutating over arbitrary junk payloads; reports are
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+ bit-identical; clean-by-construction cases PASS and any corruption of them
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+ never does; mg/mcg canonicalization never merges; aggregation matches an
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+ independent worst-of oracle and is order-invariant and monotone.
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+ - **Metamorphic** (`tests/test_metamorphic.py`): ~700 guarded corruptions
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+ (digit edits, magnitude shifts, unit swaps, real-but-absent drug insertion,
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+ in-grammar frequency swaps, …) applied to every clean golden case at test
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+ time; none may PASS. Same fault taxonomy as the golden set, one
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+ implementation (`scripts/corruptions.py`), two depths.
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+ - **Golden gate** (`tests/test_golden_gate.py`): the benchmark as hard
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+ assertions; false-PASS == 0 and clean-pass == 100% fail the build, and the
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+ committed golden set must match its generator exactly.
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+
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+ Known v0 limitations are encoded as `xfail(strict=True)` tests (duplicate
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+ medication names, trailing punctuation on frequencies, omission detection):
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+ executable documentation that flips to a build failure the day the limitation
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+ is fixed.
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+
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+ ```bash
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+ uv sync --group dev
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+ uv run pytest # full suite (~750 tests, <5 s)
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+ uv run pytest -m golden # just the benchmark gate
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+ ```
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+
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+ ## Project layout
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+
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+ ```
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+ medfence/
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+ contract.py # types + fail-closed aggregation (the stable core)
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+ normalize.py # deterministic text/unit/number normalization
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+ rulepack.py # bundle loading, thresholds-as-versioned-data
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+ checks/grounding.py # Family G
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+ checks/refdata.py # Family R
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+ verify.py # the single entrypoint
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+ data/refdata_seed.json
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+ scripts/make_golden.py # regenerate the golden set (deterministic, no RNG)
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+ scripts/benchmark.py # the table above (exits 1 on any false PASS)
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+ scripts/corruptions.py # shared fault operators (golden set + metamorphic grid)
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+ tests/ # contract invariants, properties, metamorphic grid, golden gate
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+ tests/schemas/ # JSON Schema for the audit report (the output contract)
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+ docs/adr-001-*.md # the design record
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+ docs/related-work.md # how this differs from LangExtract, Guardrails, etc.
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+ ```
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+
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+ ## Design record & positioning
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+
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+ See `docs/adr-001-clinical-verification-contract-v0.md` for the full contract
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+ spec, options considered, and the trade-off analysis (notably: why ABSTAIN
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+ exists, why coverage is a first-class output, and where the SaMD line is drawn).
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+ For how medfence relates to LangExtract, Guardrails AI, clinical
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+ self-verification, and the rest of the landscape, see `docs/related-work.md`.
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+
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+ ## License
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+
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+ Apache-2.0.
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+
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+ ## Quick demo
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+
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+ ```bash
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+ python3 demo.py # one prescription: PASS, FAIL (mcg swap + fabricated drug), ABSTAIN (low OCR)
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+ ```
@@ -0,0 +1,25 @@
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+ from .contract import (
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+ Evidence,
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+ Extraction,
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+ Finding,
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+ Severity,
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+ SourceDocument,
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+ Verdict,
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+ VerificationReport,
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+ )
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+ from .rulepack import Rulepack, load_rulepack
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+ from .verify import verify
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+
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+ __all__ = [
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+ "Evidence",
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+ "Extraction",
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+ "Finding",
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+ "Rulepack",
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+ "Severity",
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+ "SourceDocument",
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+ "Verdict",
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+ "VerificationReport",
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+ "load_rulepack",
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+ "verify",
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+ ]
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+ __version__ = "0.1.0"
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