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Built on Decision Intelligence

Nabla-X ClinicalSense

An answer clinicians can trust — and defend.

Wraps any clinical AI tool with plain-language reasoning and a defensible audit trail, addressing the top cited barrier to adoption: not knowing who's liable when the model is wrong. Starts with a focused first case — flagging unusual controlled-substance dispensing patterns.

Illustrative flag — target output, not a real run
AlertUnusual controlled-substance dispensing pattern flagged for Dr. Patel, Pharmacy Unit 4
Plain-Language ReasoningDispensing rate for this prescriber is 3.2x the department median for this substance class
Audit TrailComparison baseline: 90-day rolling median across 14 prescribers, same substance class
Liability NoteFlag is advisory — clinician of record retains full decision authority

Core Capabilities

Plain-Language Clinical Reasoning

Wraps any clinical AI tool's output with an explanation a clinician can actually read and act on.

Defensible Audit Trail

Every flag carries the comparison baseline and reasoning behind it, addressing the liability question directly.

Focused First Case

Starts narrow — controlled-substance dispensing patterns — rather than a broad, harder-to-validate clinical claim.

How ClinicalSense Would Work

Planned design — this pipeline does not exist yet.

1. Wrap the Clinical AI Tool's Output

Sits alongside an existing clinical AI tool's risk score or flag, rather than replacing it.

2. Generate Plain-Language Reasoning

Explains the flag in terms a clinician can evaluate and defend, not a bare probability score.

3. Attach a Defensible Audit Trail

Records the baseline, comparison, and reasoning so the flag can be reviewed and justified after the fact.

Audit trail — case #A-2291
Planned — Not Live
09:14:02Clinical AI tool output received

Existing tool's risk score read in, unmodified

09:14:03Baseline & comparison logged

Cohort baseline recorded against the flagged reading

09:14:04Plain-language reasoning generated

Flag translated into terms a clinician can evaluate

09:14:05Audit entry finalized

Baseline, comparison, and reasoning written to the record

09:41:17Reviewed by clinician of record

Escalation decision logged against this entry

This is the record a clinician would pull up to defend the decision later — planned design only, nothing above has been built.

How ClinicalSense Would Think

The reasoning approach this concept is designed around.

How factors would combine into a recommendation
Input signal
Elevated lactate
Input signal
Rising trend vs. baseline
Input signal
Cohort deviation
Recommendation
Escalate to sepsis protocol
Illustrative combination shown for concept only — the actual weighting logic is unspecified until Decision Intelligence's engine exists.

Advisory, Not Authoritative

Every output is explicitly framed as input to a clinician's judgment, never a replacement for it — addressing the liability barrier directly.

  • •Flags carry an explicit advisory framing
  • •Clinician of record retains decision authority

Narrow First Use Case

Starts with one well-scoped problem — controlled-substance dispensing anomalies — rather than general clinical decision support.

  • •Deliberately narrow initial scope
  • •Broader clinical claims deferred until validated

Built on Decision Intelligence

The explainability core is shared with Decision Intelligence, not a separate clinical-specific model.

  • •No independent model to validate from scratch
  • •Blocked on Decision Intelligence's engine existing

Audit-Trail-First Design

The record of why a flag fired is treated as a first-class output, not an afterthought — because that's what a liability question actually needs.

  • •Baseline, comparison, and reasoning all logged
  • •Built to be reviewed after the fact
Concept Architecture

Planned Architecture

Nothing below is built. This describes the intended design and its dependencies.

Clinical Decision Support Panel
Mockup — Not Live
Case (placeholder)
#A-2291
Factors linked
3
Reasoning chain
Elevated lactate
4.2 mmol/L — above cohort baseline
Rising sepsis risk score
trending up across 3 consecutive readings
Recommend escalation
sepsis protocol review
AI Recommendation
Escalate to sepsis protocol
Confidence
Not yet calibrated
Advisory only. Clinician of record retains decision authority.
Dependency: ClinicalSense wraps Decision Intelligence's explainability engine with a clinical-specific interface and starting use case. Decision Intelligence's core engine does not exist yet.
Build status
Baseline ComparisonUnspecified
Audit Trail BuilderUnspecified
Extends Decision IntelligenceNot started
Full buildBlocked on dependency

Addresses the Real Barrier

Targets the #1 cited reason clinicians hesitate — not knowing who's liable.

One Focused Case First

Controlled-substance dispensing patterns, not a broad clinical AI claim.

Built on Decision Intelligence

No separate engine — extends the same core once it exists.

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