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Decision-Logic Traceability

skills/clinical-decision-support/references/decision_logic_traceability.md

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Decision-Logic Traceability

Scope

“Decision logic” here means research and governance logic only:

  • evidence inclusion/exclusion;
  • data-quality gates;
  • validation acceptance criteria;
  • release holds;
  • documentation completeness;
  • change-control approval;
  • human-review checkpoints.

Do not encode diagnostic, treatment, dosing, triage, alarm, urgency, bedside, or patient-facing logic.

Matrix Purpose

A traceability matrix links each rule to:

  • its source and rationale;
  • input/precondition;
  • deterministic statement;
  • bounded output kind;
  • verification tests;
  • owner and reviewer;
  • version and status;
  • known limitations and change history.

The matrix documents logic. It does not execute arbitrary expressions.

Allowed Node Types

  • input_check
  • data_quality_gate
  • evidence_rule
  • validation_gate
  • documentation_gate
  • human_review
  • release_gate
  • monitoring_gate

Allowed output kinds:

  • include_evidence
  • exclude_evidence
  • flag_for_review
  • validation_status
  • documentation_status
  • release_hold
  • monitoring_status

There is deliberately no generic “action” node.

Required Fields

Matrix Metadata

  • logic ID and title;
  • version/status/owner;
  • research-only intended use;
  • prohibited uses;
  • data level;
  • source ledger;
  • human-review requirement;
  • change summary;
  • monitoring and retirement criteria.

Per Node

  • unique node ID;
  • type;
  • precondition/input;
  • logic statement in plain language;
  • output kind;
  • output value;
  • source IDs;
  • rationale;
  • validation tests;
  • owner;
  • reviewer role;
  • status.

Rule-Writing Guidance

Write rules so an independent reviewer can reproduce the result without hidden knowledge.

Good:

If an evidence record lacks a stable citation and retrieval date, set output kind flag_for_review with value missing_source_provenance.

If external validation is absent, set release_hold to true for claims of transportability.

Unsafe and prohibited:

If a person's score is high, trigger an urgent alert.

If a biomarker is positive, recommend a therapy.

Validation Tests

For each node include:

  • positive case;
  • negative case;
  • boundary case;
  • missing/invalid input;
  • source/version regression;
  • expected output;
  • reviewer and date.

For the matrix as a whole include:

  • unreachable or orphan nodes;
  • conflicting outputs;
  • cycles;
  • missing sources;
  • stale versions;
  • bypass paths around human review;
  • rollback and retirement behavior.

The bundled helper validates identifiers, allowed node/output types, citations, and required review fields, then emits CSV. It does not parse or execute the logic statement.

Change Control

For any change:

  1. state the reason;
  2. link new evidence or requirement;
  3. identify affected nodes and downstream artifacts;
  4. update tests;
  5. independently validate;
  6. record approval;
  7. define rollout/rollback when applicable;
  8. retain the previous version;
  9. update monitoring;
  10. retire superseded logic explicitly.

Script

bash
python3 scripts/decision_logic_traceability.py \
  assets/decision_logic_traceability_template.json

The output is a documentation matrix, not executable clinical logic.