Proposed decision integrity layer would make pre-AI clinician judgment auditable

Interpretive clinical AI oversight assumes independent clinician judgment before AI influence, but electronic health record audit logs do not verify it. Authors propose a 'decision integrity' layer: a tamper-evident six-event record of pre-AI judgment, post-AI revision, and rati…

• The authors name decision integrity as the missing assurance layer between cybersecurity verification and clinical quality review.
• The proposed candidate architecture uses sequential disclosure to preserve tamper-evident evidence of pre-AI judgment, post-AI revision, and rationale.
• The architecture is a candidate for evaluation, not a validated standard, and aims to make clinician independence auditable rather than assumed.

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