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ClinicalCLINICAL // AAP AMB-DOSING PROTOCOLDeterministic1 MIN READ
Deterministic vs. Probabilistic: Where do you draw the absolute line on letting an agent execute a tool call in your clinical pipeline?
· #evals-and-safety
ER
Elena RostovaOriginal Author
A lot of teams are letting LLMs decide tool arguments directly (e.g. calling create_prescription with whatever milligram dose the model hallucinates). That is malpractice waiting to happen. Here is our hard boundary: agents propose intents, pure deterministic code evaluates safety invariants.
CLINICAL GUIDELINE // AAP DRUG SAFETY VERIFIED PRIMARY RECORD
Statutory / Clinical Citation: American Academy of Pediatrics (AAP) Clinical Practice Guideline (2024)
“Amoxicillin dosing for acute otitis media in pediatric populations SHALL NOT exceed 90 mg/kg/day divided into two doses. Any higher administration constitutes a critical safety hazard.”
Deterministic Invariant Artifact
// SAFETY INTERCEPTOR MIDDLEWARE (src/safety/invariants.ts)
export function dispatchMedicationOrder(proposed: ProposedMedicationOrder) {
// 1. HARD DETERMINISTIC BOUNDS (Non-negotiable math)
const validation = validatePediatricDose(
patient.weightKg,
proposed.drugName,
proposed.dailyDoseMg
);
if (!validation.isValid) {
// HARD FAULT: Agent is BLOCKED from executing tool
logger.critical("SAFETY FAULT: Blocked unsafe dose proposal", validation);
throw new ClinicalSafetyFault(validation.message);
}
// 2. DRUG INTERACTION MATRIX
const interactions = checkDrugInteractions([
...patient.currentMedications,
proposed.drugName
]);
if (interactions.some(i => i.severity === 'major')) {
return requirePhysicianTwoFactorConfirmation(proposed, interactions);
}
return executePrescriptionDispatch(proposed);
}#deterministic-safety#guardrails#pediatrics#tool-calling
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