Dmitry Etin | Searcharxiv

arXiv2026

A Semantic Model of Genetic Evidence: A Step Toward Bridging the Basic-Science-Clinic Gap

Scientific and clinical decision-making depends on evidence from the primary literature, but existing standards for representing that evidence (FHIR Evidence, ECO, SEPIO, and the GA4GH Genomic Knowledge Standards) are oriented toward clinical-trial workflows, evidence codes, or single-variant assertions, and do not capture the fine-grained, domain-specific structure of claims in basic and pre-clinical research. We introduce a semantic model for scientific evidence with three core classes, specialize it for genetics, align it structurally to FHIR Evidence with a SEPIO-anchored credibility decomposition, and attach a compact dimensional vocabulary whose conditional-activation rules are validated by a SHACL schema for the implemented constraints. Using clinical variant interpretation as the driving use case, we evaluate the model through a human-AI annotation pilot over six genetics papers, yielding 28 evidence items and 95 source-anchored assertions, with a workflow that keeps curator-authored reference annotations distinct from AI-drafted annotations. Treating the pilot as a feasibility study rather than a benchmark, we argue that the model is a useful increment toward trustworthy, AI-ready infrastructure for variant interpretation: a reference data model and validation schema for representing genetic evidence.

cs.DB↗

arXiv2026

Trustworthy Clinical Decision Support Using Meta-Predicates and Domain-Specific Languages

\textbf{Background:} Regulatory frameworks for AI in healthcare, including the EU AI Act and FDA guidance on AI/ML-based medical devices, require clinical decision support to demonstrate not only accuracy but auditability. Existing formal languages for clinical logic validate syntactic and structural correctness but not whether decision rules use epistemologically appropriate evidence. \textbf{Methods:} Drawing on design-by-contract principles, we introduce meta-predicates -- predicates about predicates -- for asserting epistemological constraints on clinical decision rules expressed in a DSL. An epistemological type system classifies annotations along four dimensions: purpose, knowledge domain, scale, and method of acquisition. Meta-predicates assert which evidence types are permissible in any given rule. The framework is instantiated in AnFiSA, an open-source platform for genetic variant curation, and demonstrated using the Brigham Genomics Medicine protocol on 5.6 million variants from the Genome in a Bottle benchmark. \textbf{Results:} Decision trees used in variant interpretation can be reformulated as unate cascades, enabling per-variant audit trails that identify which rule classified each variant and why. Meta-predicate validation catches epistemological errors before deployment, whether rules are human-written or AI-generated. The approach complements post-hoc methods such as LIME and SHAP: where explanation reveals what evidence was used after the fact, meta-predicates constrain what evidence may be used before deployment, while preserving human readability. \textbf{Conclusions:} Meta-predicate validation is a step toward demonstrating not only that decisions are accurate but that they rest on appropriate evidence in ways that can be independently audited. While demonstrated in genomics, the approach generalises to any domain requiring auditable decision logic.

cs.AI↗