Review Before Trust: Source-Grounded Integrity Gates for AI-Assisted Personal Health Records

As autonomous research agents and AI co-scientist systems push large language models (LLMs) from drafting toward end-to-end manuscript production, the bottleneck shifts from generation to verification. Fluent LLM output can hide fabricated citations, numbers that drift from source tables, and unmet reporting-guideline items; existing tools generate without verifying, and self-critique inherits the blind spots that produce confident fabrication. We describe an architecture pairing generation with verification, resting on three principles: decompose the workflow into self-contained skills, gate every stage transition with halt-on-failure, and resolve each integrity question with the cheapest sufficient mechanism, a deterministic, re-executable check where one suffices and a prose-level probe only where interpretation is unavoidable. This determinism-where-possible split, organized as an integrity-gate taxonomy, is the core contribution. It is realized as MedSci Skills, an open-source toolkit of 43 skills with a 21-detector deterministic tier, evaluated on three public-dataset pipelines (STARD, PRISMA, STROBE) and a seeded-defect ablation. Across the three pipelines every content-hash manifest verified clean and the gates surfaced real defects; on 27 identical injected defects the deterministic gates detected all 27 with no false positives on the matched clean fixtures, whereas a single-prompt LLM reviewer detected 11, its misses in code, bibliography, and style defects the prose hides. Determinism-where-possible verification yields an auditable, re-executable trail that exposes the evidence a human needs to check an LLM-assisted manuscript: feasibility and reproducibility evidence, not a claim of human-competitive quality, which a separate blinded study addresses. MedSci Skills is MIT-licensed and archived (v3.8.0).

People increasingly use frontier AI models for health advice, but via different access modes (e.g., ChatGPT, ChatGPT Health, APIs) with varying settings. Here, we find systematic differences across access modes. Because evaluations typically rely on APIs while consumers interact through chatbot interfaces, these discrepancies limit evaluation validity. Our findings underscore an urgent need for model providers to enable faithful replication of consumer experiences and settings for rigorous audits.

Long-form research reports generated by large language models drift, contradict themselves, and lose provenance: the same metric appears with different values, and rumor is quoted as confidently as an audited filing. We present a two-tier agentic system that separates a maintained, point-in-time knowledge library from report writing. A deterministic "librarian" ingests timestamped sources into a trust-tiered ontology, layering evidence cards, an authoritative metric ledger, and a claim graph into an always-current source of truth, not per-query RAG over raw chunks. A portable multi-agent "writer" runtime then composes a contradiction-free, evidence-grounded report at any knowledge cutoff T, reading only evidence with as_of <= T (no look-ahead); red-team verdicts flow back into the librarian. We evaluate on a self-collected, public corpus of 6,130 sources yielding 555,926 evidence cards (SEC EDGAR filings across 295 issuers and 11 sectors, U.S. Bureau of Labor Statistics releases, and Wikipedia). From the one library we compose four point-in-time reports on distinct theses and run eight reproducible experiments, whose headline metrics come from a deterministic quality-control gate, itself validated by defect-injection meta-evaluation at recall 1.0 and precision 1.0. A shared metric ledger removes 6,845 cross-section contradictions to zero. Tier-first selection is correct on 22/22 gold cases where a popularity-first baseline scores only 9/22; trust tiering leaks zero media-sourced numbers, and no government statistic displaces a company's own filing. A red-team refutation propagates back and self-corrects a later run with zero manual edits. Replay exhibits zero look-ahead violations across seven cutoffs while the library grows from 235,373 to 555,312 cards. Difficulty-tiered model routing exceeds the all-Opus quality ceiling while running 3.7x faster than serial.