From d50b465ad4aaf31a38e351b1d0d5cffca549b733 Mon Sep 17 00:00:00 2001
From: Claude <noreply@anthropic.com>
Date: Tue, 21 Jul 2026 02:46:40 +0000
Subject: [PATCH 1/4] docs(ledger): E-3b + PR-B live pair verdict (run #59
 green vs #57/#58)

Co-Authored-By: Claude Fable 5 <noreply@anthropic.com>
Claude-Session: https://claude.ai/code/session_01EXsJcLrbZUXwnBeG91cVo9
---
 docs/branch-review-ledger.md | 1 +
 1 file changed, 1 insertion(+)

diff --git a/docs/branch-review-ledger.md b/docs/branch-review-ledger.md
index cb5a950b..2cc5d24f 100644
--- a/docs/branch-review-ledger.md
+++ b/docs/branch-review-ledger.md
@@ -670,3 +670,4 @@ Use this ledger to prevent repeated branch and PR reviews when the reviewed HEAD
 | 2026-07-21 | claude/clinical-kb-pwa-review-asi3wb (PR: E-3b budget-aware generation deadlines) | 314d03f (+eb08ec5 review row) | ADDENDUM 5 wave E-3b implemented per the design-agent plan: generation attempts clamped to route budget minus a measured 2s recovery reserve (single call-site, all four attempt kinds); truncation self-heal gated on retry viability (reserve+5s floor) with observable truncation_retry_skipped_budget_reserve marker; additive route_budget_exhausted_by_retrieval runtime flag; eval route-ceiling gains the triple-condition cross-region carve-out (context + runtime flag + zero generation) with retrieval-exhausted audit cells — local/release gates provably strict. Fixes I3 (54ms budget overrun after 22.6s provider timeout), I5 (82s truncation waste class), resolves I2 (clozapine 13.3s retrieval vs 12s runtime budget = geography, now suppressed ONLY in the sanctioned cross-region context with full auditability). Reviewer verdicts: rag-retrieval-reviewer APPROVE-WITH-NITS (2 P3: prod-dead requestTimeoutMs retained for symmetry; report-cell coupling cosmetic; cached-replay invariant PROVEN — budget-exhausted answers never cached, carve-out unreachable via replay; marker isolation proven — SLO counters key on fallback_reason not answer_retry_reasons); clinical-governance-reviewer APPROVE-WITH-NITS (prior row) — internal-timeout→PublicApiError→existing-fallback path verified, all safety gates still applied to recovery answers. ALSO BANKED — E-2 targeting baseline (canary run #58, 29788404357, all-green incl. first execution of the !cancelled()-fixed instrument, ~$1-2): metric_rates relevance 0.6 / readability 1.0 / artifact_leaks 1.0 / intent_coverage 0.9333 / fail_closed 0.9; targeting_rate 0.5909 (13/22); by intent: document_lookup 5/5, red_result_action 3/3, contraindication 2/2, dose 1/5, monitoring_schedule 1/5, pathway_referral 1/2; all 9 misses = missing dose figure/schedule-interval (answer lengths 73-232 chars) → E-3c co-primary target alongside the wasted-generation class. Phase E spend ≈$3-6 of ≤$20. | Red-proofs: reserve pinned 3 independent ways (exact 23000ms grant, deadline flag clear, total under budget); self-heal skip pins exact marker + single provider call; offline flag pinned true/false. Focused: route-budget 9/9, eval-quality 27/27, fallback+offline 52/52, parser/abort regressions 15/15. Full suite 3043 passed / 1 known container pdf artifact. typecheck+lint+prettier clean. No provider calls; live proof = E-4 paired run |
 | 2026-07-21 | claude/clinical-kb-pwa-review-asi3wb (restarted from e02ba3d; PR: E-3c PR-A instrument) | see PR head | ADDENDUM 5 wave E-3c design accepted (Plan agent, full report in session record) and PR-A delivered: eval-answer-quality gains --dump-answers <path> (per-case answer TEXT + sections + targeting verdict JSON for the canary artifact — answers are not retained at rest by privacy design, so miss diagnosis needs eval-time capture), parseArgs/buildAnswerDumpRecord exported behind an import.meta main-guard (eval-quality precedent), canary targeting step wired with the flag. Design highlights for the record: DEFECT 1 root confirmed as fast-attempt-doomed-then-discarded on strong_routine_retrieval procedural shapes — PR-B generalizes the EXISTING validated-extractive short-circuit pattern (LAI + blocked-recovery precedents, hasValidatedExtractiveCandidate) to the measured shape via a new rag-extractive-first.ts module (net ~-110 rag.ts lines against the 5030 budget); DEFECT 2 rank-1 root = extractive lead-slot selection prefers shortest sentence and admits figure-less leads (sort at rag-extractive-answer.ts:917, 1-slot monitoring leads) — PR-C adds intent-figure-aware lead promotion with a claim-support atom-corpus nuke-proofing guard + dose/threshold fallback candidate preference (find(safe && figure) ?? find(safe)); answer-verification CLEARED as direct cause (whole-answer gap or unbold only, never per-figure deletion). H2 (strong-route comparison/complex residual) explicitly deferred as the named E-3d candidate. E-4 metrics set: discarded-generation <20% from ~47%, dose ≥3/5, monitoring ≥3/5, no intent below #58, recalls pinned 1.0, relevance/fail_closed/readability/artifact_leaks ≥ #58. | PR-A gates: new tests/eval-answer-quality.test.ts 4/4; typecheck, check:github-actions, check:ci-scope, eval-canary-workflow test, prettier all clean; no provider calls |
 | 2026-07-21 | claude/clinical-kb-pwa-review-asi3wb (PR: E-3c PR-B short-circuit) | f7e6cbb + hardening commit | E-3c PR-B: pre-generation validated-extractive short-circuit for gate-passed routine procedural "What...process/include/required" queries (marker validated_routine_extractive_first), generalizing the LAI + blocked-recovery precedents via new rag-extractive-first.ts (3 predicates moved byte-verbatim, machine-verified; rag.ts 5029→4908 vs 5030 budget). Kills the run-#57 6x wasted-generation class. REVIEWS (both pre-push): rag-retrieval-reviewer APPROVE-WITH-NITS — move fidelity brace-diff verified byte-identical; confidence-gate skip PROVEN safe (passed-gate is a no-op in applyConfidenceGate; markers pairwise mutually exclusive); comparison false-positives blocked by unchanged classifier precedence; offline/source-only idempotent; zero retrieval/ranking/selection/threshold change; P2 = eval-only assertions (intent_coverage/artifact_leaks/expected-file) unverifiable offline for flip candidates (quality-nocc-document-support, quality-form-required-documentation, quality-discharge-documentation, quality-duress-pathway + rag-set siblings) → pre-merge BRANCH canary recommended and ADOPTED (offline-green + review-approved proven insufficient for this surface, 2026-07-20). clinical-governance-reviewer APPROVE-WITH-NITS — full gate-stack trace: nothing bypassed (same finalizeRagAnswerQuality, same citation scoping, numeric verification not fail-open, ungrounded-finalize defense at rag.ts:3694); P2 = pre-existing bare-cross-reference-with-overlap gap, NOT materially widened (new trigger anti-correlates), hardening recommended → APPLIED this PR: !isBareCrossReferenceAnswer screen in hasValidatedExtractiveCandidate (closes all three short-circuit paths; discriminating test added; disclosed post-review delta, strictly narrows shipping). MERGE GATE: draft until the branch canary pair (baseline #57/#58 vs branch run with answer_case_limit=44 + answer_quality_eval=true, est $3-6 of authorized envelope) is green — zero per-case regressions, recalls 1.0, quality/targeting rates >= baseline. | Red-proof + 3 negative guards; focused 61/61 + fallback/offline/contract suites; full suite 3061 passed / 1 known container artifact (pre-hardening tree; hardening re-verified focused); typecheck+lint+prettier clean; maintainability budget passed (4908/5030) |
+| 2026-07-21 | claude/clinical-kb-pwa-review-asi3wb (pair verdict — no code change; main stays at 22b6a2e) | canary run 29794759627 (#59, branch head 7310cb3 = merged PR-B content) | E-3b + E-3c PR-B LIVE-VALIDATED (pair vs banked #57/#58): route_ceiling_failures 2→0 (E-3b proven: agitation timeout now fits inside budget; clozapine retrieval-exhausted ceiling honestly excused via the triple-condition cross-region carve-out — exactly one "retrieval-exhausted" audit cell in the report); p95 17.4s→15.47s (-11%); golden retrieval SUCCESS 36/36 (stop-ship criterion held); validated_routine_extractive_first fired on 4 of the 6 target cases (patient-safety-plan 3.3s, treatment-team-process 2.6s, ect-procedure 2.2s, illegal-substances 2.2s — all pure extractive, zero generation, was 6-9s each with a discarded attempt), the other 2 (community-home-visits, best-practice-prescribing) stayed on generation+fallback because their extractive candidates legitimately fail validation gates = the designed-conservative outcome; ZERO new failing cases (list 5→2, both known residuals: neuroleptic citation red = Option A territory, admission-comparison expected-doc = non-blocking labeling residual); grounded 1.0 + unsupported_correct 1.0 held; targeting 0.5909→0.619, fail_closed 0.9→0.9333, readability/artifact_leaks/intent_coverage unchanged; relevance 0.6→0.5667 = single-case wobble on n=30, WATCH in E-4, not a gate. Discarded-generation rate materially down (4 conversions; residual = the H2 strong-route slice named as E-3d candidate, per design's 20-33% expectation band). MERGE STANDS (user had armed auto-merge pre-verdict; revert drill not triggered). Spend +~$3-6 → Phase E total ~$6-12 of ≤$20. | Pair evidence: run #59 job log (Blocking failures = citation only; Answer Case Diagnostics markers; metric_rates + targeting blocks); dump artifact populated for PR-C diagnosis |

From 043b030d233e79f25a7528e5fcf9194f72349b24 Mon Sep 17 00:00:00 2001
From: Claude <noreply@anthropic.com>
Date: Tue, 21 Jul 2026 03:15:29 +0000
Subject: [PATCH 2/4] feat(rag): figure-aware extractive selection for
 dose/monitoring answers (E-3c PR-C)

Dose and monitoring answers must carry the asked-for figure/schedule when a
cited chunk verbatim supports it (run-#58 baseline: targeting 1/5 on both
intents, every miss = missing figure). Lead-slot promotion swaps/appends the
first later figure-bearing fact ONLY when no lead carries one, guarded by the
claim-support atom corpus (sourceEvidenceText, now exported) so a promoted
figure can never convert a grounded answer into an evidence gap - the guard
proven load-bearing by red-testing it disabled. The dose/threshold generation
fallback now prefers the safe candidate that carries the intent figure over
the first safe one; the safety gate itself is unchanged. Fallback helpers
extracted to rag-extractive-answer (cycle-check verified); rag.ts 4908->4901.

Six discriminating tests, each verified failing on prior code. Full suite
3068 passed / 1 known container artifact.

RAG impact: behaviour change (extractive answer composition + fallback
candidate preference only) - E-4 pair vs banked #57/#58/#59 baselines
post-merge; retrieval, ranking, selection ordering untouched.

Co-Authored-By: Claude Fable 5 <noreply@anthropic.com>
Claude-Session: https://claude.ai/code/session_01EXsJcLrbZUXwnBeG91cVo9
---
 src/lib/rag/rag-claim-support.ts           |   7 +-
 src/lib/rag/rag-extractive-answer.ts       | 136 ++++++++++++++++++++-
 src/lib/rag/rag.ts                         |  37 +++---
 tests/extractive-answer-formatting.test.ts | 129 ++++++++++++++++++-
 tests/rag-answer-fallback.test.ts          |  42 +++++++
 5 files changed, 324 insertions(+), 27 deletions(-)

diff --git a/src/lib/rag/rag-claim-support.ts b/src/lib/rag/rag-claim-support.ts
index 845dd7aa..3c4fe9dd 100644
--- a/src/lib/rag/rag-claim-support.ts
+++ b/src/lib/rag/rag-claim-support.ts
@@ -212,7 +212,12 @@ function compatibleSafetyDimensions(claim: string, evidence: string) {
   return [...safetyDimensions(claim)].every((dimension) => evidenceDimensions.has(dimension));
 }
 
-function sourceEvidenceText(source: SearchResult) {
+// Exported so the extractive figure-promotion guard (rag-extractive-answer.ts) can check a
+// candidate fact's value atoms against the EXACT corpus this module assesses claims with.
+// Keep the two in lockstep: a promoted figure verified against a wider corpus (e.g. one that
+// includes adjacent_context) would pass numeric verification and then trip
+// claim_support_high_risk_gap here.
+export function sourceEvidenceText(source: SearchResult) {
   return [
     source.section_heading,
     source.content,
diff --git a/src/lib/rag/rag-extractive-answer.ts b/src/lib/rag/rag-extractive-answer.ts
index f641a910..ca658e29 100644
--- a/src/lib/rag/rag-extractive-answer.ts
+++ b/src/lib/rag/rag-extractive-answer.ts
@@ -1,5 +1,5 @@
 import { boldHighYieldClinicalText } from "@/lib/answer-ranking";
-import { applyNumericVerification } from "@/lib/answer-verification";
+import { applyNumericVerification, extractClinicalValueAtoms, type ClinicalValueAtom } from "@/lib/answer-verification";
 import { citationFromResult as resultCitation, compactCitations } from "@/lib/citations";
 import { classifyRagQuery } from "@/lib/clinical-search";
 import { ragDeepMemoryVersion } from "@/lib/deep-memory";
@@ -23,6 +23,7 @@ import {
   sanitizeAnswerText,
   splitBalancedWords,
 } from "@/lib/rag/rag-answer-text";
+import { cloneAnswer } from "@/lib/rag/rag-cache";
 import { ragProviderMode } from "@/lib/rag/rag-provider";
 import {
   isLowYieldClinicalText,
@@ -39,7 +40,7 @@ import type {
   RagQueryClass,
   SearchResult,
 } from "@/lib/types";
-import { assessAndEnforceClaimSupport } from "@/lib/rag/rag-claim-support";
+import { assessAndEnforceClaimSupport, sourceEvidenceText } from "@/lib/rag/rag-claim-support";
 
 type AnswerIntent =
   | "dose"
@@ -367,6 +368,42 @@ const doseIntentEvidencePattern = new RegExp(
   "i",
 );
 
+// Interval/schedule tokens that make a monitoring fact carry its asked-for
+// schedule ("baseline", "annually", "every 3", "6 months"), plus unit-bearing
+// level ranges ("0.6-0.8 mmol/L") for target-level monitoring answers.
+const monitoringIntervalFigurePattern =
+  /\b(?:baseline|weekly|monthly|annual(?:ly)?|every\s+\d+|\d+\s*(?:week|month|day|hour|year)s?)\b/i;
+const monitoringUnitRangeFigurePattern =
+  /\d+(?:\.\d+)?\s*[-–]\s*\d+(?:\.\d+)?\s*(?:mmol\/L|mg|micrograms?|nmol\/L|mcg)/i;
+
+/**
+ * Whether extracted fact text carries the figure/schedule the intent asks for:
+ * a concrete dose value (or equivalent maximum-dose wording) for dose intent,
+ * an interval/schedule token or unit-bearing level range for monitoring intent.
+ * Other intents have no figure requirement and always return false.
+ */
+function factCarriesIntentFigure(intent: AnswerIntent, text: string) {
+  if (intent === "dose") return clinicalDoseValuePattern.test(text) || maximumDoseEquivalentPattern.test(text);
+  if (intent === "monitoring_schedule") {
+    return monitoringIntervalFigurePattern.test(text) || monitoringUnitRangeFigurePattern.test(text);
+  }
+  return false;
+}
+
+/**
+ * Whether an extractive answer's text carries the asked-for figure for a
+ * figure-seeking query (dose or monitoring-schedule intent). Used by the
+ * generation-fallback candidate preference in rag.ts so a safe single-chunk
+ * candidate that states the requested figure wins over an equally safe
+ * figure-less candidate. Non-figure intents return false, leaving the
+ * existing first-safe-candidate behaviour untouched.
+ */
+export function extractiveAnswerCarriesIntentFigure(answerText: string, query: string, queryClass: RagQueryClass) {
+  const intent = classifyAnswerIntent(query, queryClass);
+  if (intent !== "dose" && intent !== "monitoring_schedule") return false;
+  return factCarriesIntentFigure(intent, answerText.replace(/\*\*/g, ""));
+}
+
 /** Requires blood count evidence. */
 function requiresBloodCountEvidence(query: string) {
   return /\b(?:anc|fbc|full blood count|blood count|wbc|wcc|white blood cells?|white cells?|neutrophils?)\b/i.test(
@@ -1045,6 +1082,66 @@ function buildFactSections(facts: ExtractedClinicalFact[], query: string) {
     .filter((section) => section.body && section.citation_chunk_ids.length > 0);
 }
 
+// Mirrors the private atom identity used by rag-claim-support's evidence check
+// (same fields, same separator) so the promotion guard below agrees with claim
+// assessment about whether a figure is present in the evidence corpus.
+function promotionAtomKey(atom: ClinicalValueAtom) {
+  return [
+    atom.kind,
+    atom.canonicalValue,
+    atom.comparator ?? "",
+    atom.canonicalUnit ?? "",
+    atom.denominatorUnit ?? "",
+    atom.denominatorTime ?? "",
+    atom.denominatorWeight ?? "",
+    atom.route ?? "",
+    atom.frequency ?? "",
+  ].join("|");
+}
+
+/**
+ * Nuke-proofing guard for lead-slot figure promotion: only promote a fact whose
+ * clinical value atoms ALL appear in the claim-support evidence corpus
+ * (sourceEvidenceText) of its citing chunk(s). Fact extraction reads
+ * adjacent_context and numeric verification accepts it too, but claim support
+ * does not — so a figure that lives only in adjacent context would pass numeric
+ * verification and then trip claim_support_high_risk_gap, nuking the whole
+ * answer. Facts with no value atoms (e.g. "checked at baseline, then annually")
+ * have nothing to co-locate and pass.
+ */
+function promotedFactFigureIsClaimSupportable(fact: ExtractedClinicalFact, results: SearchResult[]) {
+  const factAtoms = extractClinicalValueAtoms(fact.text);
+  if (factAtoms.length === 0) return true;
+  const citingResults = results.filter((result) => fact.citationChunkIds.includes(result.id));
+  if (citingResults.length === 0) return false;
+  const corpusAtomKeys = new Set(
+    citingResults.flatMap((result) => extractClinicalValueAtoms(sourceEvidenceText(result)).map(promotionAtomKey)),
+  );
+  return factAtoms.every((atom) => corpusAtomKeys.has(promotionAtomKey(atom)));
+}
+
+/**
+ * Lead-slot figure guarantee for dose and monitoring-schedule answers: when no
+ * lead fact carries the asked-for figure/schedule but a later extracted fact
+ * does (and its figure survives the claim-support guard), surface that fact in
+ * the lead — dose swaps it into the last of its two lead slots; monitoring
+ * appends it as a second lead sentence. A lead that already carries a figure is
+ * returned unchanged, and other intents never reach this function.
+ */
+function promoteIntentFigureLeadFacts(
+  leadFacts: ExtractedClinicalFact[],
+  facts: ExtractedClinicalFact[],
+  intent: AnswerIntent,
+  results: SearchResult[],
+) {
+  if (leadFacts.some((fact) => factCarriesIntentFigure(intent, fact.text))) return leadFacts;
+  const promoted = facts
+    .slice(leadFacts.length)
+    .find((fact) => factCarriesIntentFigure(intent, fact.text) && promotedFactFigureIsClaimSupportable(fact, results));
+  if (!promoted) return leadFacts;
+  return intent === "dose" ? [...leadFacts.slice(0, -1), promoted] : [...leadFacts, promoted];
+}
+
 /** Build fact synthesized answer. */
 function buildFactSynthesizedAnswer(args: {
   query: string;
@@ -1069,7 +1166,10 @@ function buildFactSynthesizedAnswer(args: {
     };
   }
 
-  const leadFacts = facts.slice(0, args.intent === "dose" ? 2 : 1);
+  let leadFacts = facts.slice(0, args.intent === "dose" ? 2 : 1);
+  if (args.intent === "dose" || args.intent === "monitoring_schedule") {
+    leadFacts = promoteIntentFigureLeadFacts(leadFacts, facts, args.intent, args.results);
+  }
   // Once the lead answer names the query entity, later lead sentences skip
   // their own entity prefix so the entity is not repeated in every sentence.
   // Derived exactly the way sentenceFromFact derives its prefix entity (from
@@ -1714,6 +1814,36 @@ export function generatedAnswerQualityFailureReason(answer: RagAnswer, query: st
   return null;
 }
 
+/**
+ * Whether an extractive fallback candidate is safe to ship in place of a failed
+ * generation: grounded and supported, clean of every final answer-quality gate,
+ * and numerically verified with zero unverified tokens. Pure — extracted from
+ * the rag.ts generation-fallback path so candidate selection stays testable in
+ * isolation.
+ */
+export function isSafeExtractiveFallbackCandidate(candidate: RagAnswer, query: string, queryClass: RagQueryClass) {
+  if (!candidate.grounded || candidate.confidence === "unsupported") return false;
+  if (generatedAnswerQualityFailureReason(candidate, query, queryClass)) return false;
+  const verified = applyNumericVerification(cloneAnswer(candidate));
+  return (
+    verified.grounded && verified.confidence !== "unsupported" && (verified.unverifiedNumericTokens?.length ?? 0) === 0
+  );
+}
+
+/**
+ * Narrows a fallback candidate's sources to the chunks its citations actually
+ * reference, so downstream claim support and numeric verification judge the
+ * candidate on exactly the evidence it cites. Pure — extracted from the rag.ts
+ * generation-fallback path.
+ */
+export function retainCitedExtractiveFallbackEvidence<T extends RagAnswer>(candidate: T): T {
+  const citedChunkIds = new Set(candidate.citations.map((citation) => citation.chunk_id));
+  return {
+    ...candidate,
+    sources: candidate.sources.filter((source) => citedChunkIds.has(source.id)),
+  };
+}
+
 /**
  * Replaces an answer that fails final quality checks with an evidence-gap response.
  *
diff --git a/src/lib/rag/rag.ts b/src/lib/rag/rag.ts
index 0e1297a7..50b99848 100644
--- a/src/lib/rag/rag.ts
+++ b/src/lib/rag/rag.ts
@@ -54,14 +54,17 @@ export {
 import {
   buildExtractiveAnswer,
   cleanAnswerSectionHeading,
+  extractiveAnswerCarriesIntentFigure,
   finalQualityGapAnswer,
   finalizeRagAnswerQuality,
   generatedAnswerQualityFailureReason,
   hasInvalidModelEvidenceIds,
   isOverExpandedSimpleGeneratedAnswer,
+  isSafeExtractiveFallbackCandidate,
   isSimpleDirectQuestion,
   isTemplateLikeGeneratedAnswer,
   isUnusableGeneratedAnswer,
+  retainCitedExtractiveFallbackEvidence,
   sourceBackedGenerationTimeoutAnswer,
   strongReasoningEffortForQueryClass,
 } from "@/lib/rag/rag-extractive-answer";
@@ -4637,34 +4640,24 @@ ${qualityRetryInstruction}`
         scoreExplanations: candidateArtifacts.scoreExplanations,
       } satisfies RagAnswer;
     };
-    const isSafeExtractiveFallbackCandidate = (candidate: RagAnswer) => {
-      if (!candidate.grounded || candidate.confidence === "unsupported") return false;
-      if (generatedAnswerQualityFailureReason(candidate, args.query, queryClass)) return false;
-      const verified = applyNumericVerification(cloneAnswer(candidate));
-      return (
-        verified.grounded &&
-        verified.confidence !== "unsupported" &&
-        (verified.unverifiedNumericTokens?.length ?? 0) === 0
-      );
-    };
-    const retainCitedExtractiveFallbackEvidence = <T extends RagAnswer>(candidate: T): T => {
-      const citedChunkIds = new Set(candidate.citations.map((citation) => citation.chunk_id));
-      return {
-        ...candidate,
-        sources: candidate.sources.filter((source) => citedChunkIds.has(source.id)),
-      };
-    };
     let extractiveFallbackAnswer = canRecoverGenerationErrorExtractively
       ? buildExtractiveFallbackCandidate(generationFallbackResults)
       : null;
     // Generated synthesis has already failed, so do not stitch dose or threshold figures
-    // across fallback chunks. Prefer the first individually complete candidate that passes
-    // every extractive and numeric safety gate.
+    // across fallback chunks. Prefer an individually complete candidate that passes every
+    // extractive and numeric safety gate — and among those, one whose answer carries the
+    // asked-for dose/monitoring figure, so a figure-less chunk that happens to rank first
+    // cannot displace a verbatim-supported dose or schedule.
     if (extractiveFallbackAnswer && (queryClass === "medication_dose_risk" || queryClass === "table_threshold")) {
+      const safeSingleChunkCandidates = generationFallbackResults
+        .map((result) => retainCitedExtractiveFallbackEvidence(buildExtractiveFallbackCandidate([result])))
+        .filter((candidate) => isSafeExtractiveFallbackCandidate(candidate, args.query, queryClass));
       extractiveFallbackAnswer =
-        generationFallbackResults
-          .map((result) => retainCitedExtractiveFallbackEvidence(buildExtractiveFallbackCandidate([result])))
-          .find(isSafeExtractiveFallbackCandidate) ?? extractiveFallbackAnswer;
+        safeSingleChunkCandidates.find((candidate) =>
+          extractiveAnswerCarriesIntentFigure(candidate.answer, args.query, queryClass),
+        ) ??
+        safeSingleChunkCandidates[0] ??
+        extractiveFallbackAnswer;
     }
     const extractiveFallbackQualityReason = extractiveFallbackAnswer
       ? generatedAnswerQualityFailureReason(extractiveFallbackAnswer, args.query, queryClass)
diff --git a/tests/extractive-answer-formatting.test.ts b/tests/extractive-answer-formatting.test.ts
index 08f3059d..2f0dec1d 100644
--- a/tests/extractive-answer-formatting.test.ts
+++ b/tests/extractive-answer-formatting.test.ts
@@ -5,7 +5,45 @@ import {
   sentenceFromFact,
   splitClinicalEvidenceSentences,
 } from "../src/lib/rag/rag-extractive-answer";
-import type { RagAnswer, SearchResult } from "../src/lib/types";
+import { classifyRagQuery } from "../src/lib/clinical-search";
+import type { RagAnswer, RagQueryClass, SearchResult } from "../src/lib/types";
+
+function extractiveAnswerFor(query: string, results: SearchResult[], queryClass?: RagQueryClass) {
+  return buildExtractiveAnswer({
+    query,
+    queryClass: queryClass ?? classifyRagQuery(query).queryClass,
+    results,
+    quoteCards: [],
+    documentBreakdown: [] as RagAnswer["documentBreakdown"],
+    evidenceSummary: undefined as unknown as RagAnswer["evidenceSummary"],
+    sourceCoverage: undefined as unknown as RagAnswer["sourceCoverage"],
+    conflictsOrGaps: [],
+    visualEvidence: [] as unknown as RagAnswer["visualEvidence"],
+    bestSource: undefined as unknown as RagAnswer["bestSource"],
+    smartPanel: undefined as unknown as RagAnswer["smartPanel"],
+    relatedDocuments: [] as unknown as RagAnswer["relatedDocuments"],
+    routeReason: "demo",
+    timings: undefined as unknown as RagAnswer["latencyTimings"],
+  });
+}
+
+function figureChunk(overrides: Partial<SearchResult>): SearchResult {
+  return {
+    id: "figure-chunk-1",
+    document_id: "figure-doc",
+    title: "Quetiapine Prescribing Guideline",
+    file_name: "Quetiapine Prescribing Guideline.pdf",
+    page_number: 2,
+    chunk_index: 1,
+    section_heading: "Dosing",
+    content: "",
+    image_ids: [],
+    similarity: 0.91,
+    hybrid_score: 0.95,
+    images: [],
+    ...overrides,
+  } as unknown as SearchResult;
+}
 
 describe("maximum-dose evidence", () => {
   it("accepts equivalent numeric limit wording without accepting an unrelated dose", () => {
@@ -325,3 +363,92 @@ describe("extractive answer end to end", () => {
     expect(plain).toMatch(/For acute mania, IR product is 750 to 1000mg daily/);
   });
 });
+
+// E-3c PR-C: dose and monitoring answers must carry the asked-for figure or
+// schedule in the lead whenever a cited chunk verbatim supports it. The fact
+// sorter orders same-priority facts shortest-first, so a terse figure-less
+// sentence used to displace the sentence holding the actual dose or interval.
+describe("figure-aware extractive lead selection", () => {
+  it("promotes the schedule-bearing monitoring fact into the lead over a shorter figure-less fact", () => {
+    const answer = extractiveAnswerFor("What metabolic monitoring is required for antipsychotics?", [
+      figureChunk({
+        id: "metabolic-chunk-1",
+        section_heading: "Metabolic monitoring",
+        content:
+          "Metabolic monitoring is required for all patients prescribed antipsychotics. Weight, blood pressure, fasting glucose and lipids are monitored at baseline, at 3 months, then annually.",
+      }),
+    ]);
+
+    const plain = (answer.answer ?? "").replace(/\*\*/g, "");
+    expect(answer.grounded).toBe(true);
+    expect(plain).toMatch(/baseline|annually/);
+    expect(plain).toMatch(/3 months/);
+  });
+
+  it("swaps the dose figure fact into the last dose lead slot when both lead slots are figure-less", () => {
+    const answer = extractiveAnswerFor("What is the quetiapine dose?", [
+      figureChunk({
+        id: "quetiapine-dose-chunk-1",
+        content:
+          "Quetiapine doses must be taken daily. Quetiapine doses should be reviewed daily. The maximum recommended quetiapine dose is 200 mg daily.",
+      }),
+    ]);
+
+    const plain = (answer.answer ?? "").replace(/\*\*/g, "");
+    expect(answer.grounded).toBe(true);
+    expect(plain).toContain("200 mg");
+    // The first lead slot keeps the top-ranked fact; only the last slot swaps.
+    expect(plain).toMatch(/^Quetiapine doses must be taken daily\./);
+  });
+
+  it("refuses promotion when the figure only exists in adjacent context outside the claim-support corpus", () => {
+    const answer = extractiveAnswerFor("What is the quetiapine dose?", [
+      figureChunk({
+        id: "quetiapine-adjacent-chunk-1",
+        content: "Quetiapine doses must be taken daily. Quetiapine doses should be reviewed daily.",
+        adjacent_context: "The maximum recommended quetiapine dose is 200 mg daily.",
+      }),
+    ]);
+
+    const plain = (answer.answer ?? "").replace(/\*\*/g, "");
+    expect(answer.grounded).toBe(true);
+    // The 200 mg figure passes numeric verification (adjacent context is part of
+    // that corpus) but not claim support, so promoting it would nuke the whole
+    // answer at the claim gate. The figure-less lead must stay.
+    expect(plain).not.toContain("200 mg");
+    expect(plain).toMatch(/^Quetiapine doses must be taken daily\./);
+  });
+
+  it("keeps non-dose, non-monitoring fact ordering byte-identical", () => {
+    const answer = extractiveAnswerFor("When is quetiapine contraindicated?", [
+      figureChunk({
+        id: "quetiapine-contraindication-chunk-1",
+        section_heading: "",
+        content:
+          "Quetiapine is contraindicated in known hypersensitivity. Quetiapine is contraindicated in patients already taking more than 200 mg daily of interacting sedatives.",
+      }),
+    ]);
+
+    const plain = (answer.answer ?? "").replace(/\*\*/g, "");
+    expect(answer.grounded).toBe(true);
+    // Contraindication intent has no figure requirement: the shorter lead fact
+    // must keep the single lead slot exactly as before.
+    expect(plain).toBe("Quetiapine is contraindicated in known hypersensitivity.");
+    expect(plain).not.toContain("200 mg");
+  });
+
+  it("leaves a dose lead that already carries its figure untouched", () => {
+    const answer = extractiveAnswerFor("What is the quetiapine dose?", [
+      figureChunk({
+        id: "quetiapine-figured-chunk-1",
+        content: "Quetiapine is started at 25 mg at night. The maximum recommended quetiapine dose is 200 mg daily.",
+      }),
+    ]);
+
+    const plain = (answer.answer ?? "").replace(/\*\*/g, "");
+    expect(answer.grounded).toBe(true);
+    expect(plain).toBe(
+      "Quetiapine is started at 25 mg at night. The maximum recommended quetiapine dose is 200 mg daily.",
+    );
+  });
+});
diff --git a/tests/rag-answer-fallback.test.ts b/tests/rag-answer-fallback.test.ts
index 9a9c04af..57c54c7b 100644
--- a/tests/rag-answer-fallback.test.ts
+++ b/tests/rag-answer-fallback.test.ts
@@ -1992,6 +1992,48 @@ describe("RAG structured-output fallback", () => {
     expect(isCacheableGroundedGenerationFallback(answer)).toBe(false);
   });
 
+  it("prefers the safe single-chunk fallback candidate that carries the asked-for dose figure", async () => {
+    // E-3c PR-C: both chunks yield safe single-chunk extractive candidates, but
+    // only the lower-ranked one states the dose figure the query asks for. The
+    // first-safe-candidate rule used to ship the figure-less answer.
+    const answer = await answerFromTextSources(
+      "What is the usual quetiapine dose?",
+      [
+        source({
+          id: "quetiapine-advice-1",
+          document_id: "quetiapine-doc",
+          title: "Quetiapine Prescribing Guideline",
+          file_name: "quetiapine-prescribing-guideline.pdf",
+          section_heading: "Dose and administration",
+          content: "The usual quetiapine dose is taken once daily in the evening.",
+          similarity: 0.97,
+          hybrid_score: 0.97,
+          text_rank: 1.4,
+        }),
+        source({
+          id: "quetiapine-maximum-1",
+          document_id: "quetiapine-doc",
+          title: "Quetiapine Prescribing Guideline",
+          file_name: "quetiapine-prescribing-guideline.pdf",
+          section_heading: "Maximum dose",
+          content: "The maximum recommended quetiapine dose is 200 mg daily.",
+          similarity: 0.86,
+          hybrid_score: 0.86,
+          text_rank: 1.1,
+        }),
+      ],
+      new Error("OpenAI generation incomplete: max_output_tokens"),
+    );
+
+    expect(answer.routingMode).toBe("extractive");
+    expect(answer.routingReason).toContain("source_backed_extractive_fallback");
+    expect(answer.grounded).toBe(true);
+    expect(answer.confidence).not.toBe("unsupported");
+    expect(answer.unverifiedNumericTokens ?? []).toEqual([]);
+    expect(answer.answer.replace(/\*\*/g, "")).toContain("200 mg");
+    expect(new Set(answer.citations.map((citation) => citation.chunk_id))).toEqual(new Set(["quetiapine-maximum-1"]));
+  });
+
   it("never marks the generic source-review fallback as cacheable", async () => {
     const { isCacheableGroundedGenerationFallback } = await import("../src/lib/rag/rag");
 

From fc26437410ae6c1ad814fadd63eb0897e826b9c6 Mon Sep 17 00:00:00 2001
From: Claude <noreply@anthropic.com>
Date: Tue, 21 Jul 2026 03:32:29 +0000
Subject: [PATCH 3/4] fix(rag): verbatim-corpus check for zero-atom figure
 promotion (reviewer P2)

Both reviewers converged on the gap: bare-number intervals like 'every 6
weeks' match the monitoring figure pattern yet yield no clinical value atom,
so the atom-only guard passed them trivially - a figure sourced only from
adjacent context could then be promoted and nuked by claim support (safe
direction, but converts a shippable answer into an evidence gap). Zero-atom
figures now require the matched figure substring verbatim in the citing
chunk's claim-support corpus (intentFigureMatchText). Proven both directions
by three new tests; comment-precision nit on the corpus lockstep folded in.

Co-Authored-By: Claude Fable 5 <noreply@anthropic.com>
Claude-Session: https://claude.ai/code/session_01EXsJcLrbZUXwnBeG91cVo9
---
 docs/branch-review-ledger.md               |  1 +
 src/lib/rag/rag-claim-support.ts           |  4 +-
 src/lib/rag/rag-extractive-answer.ts       | 42 ++++++++++++++++----
 tests/extractive-answer-formatting.test.ts | 45 ++++++++++++++++++++++
 4 files changed, 83 insertions(+), 9 deletions(-)

diff --git a/docs/branch-review-ledger.md b/docs/branch-review-ledger.md
index 2cc5d24f..2925fa99 100644
--- a/docs/branch-review-ledger.md
+++ b/docs/branch-review-ledger.md
@@ -671,3 +671,4 @@ Use this ledger to prevent repeated branch and PR reviews when the reviewed HEAD
 | 2026-07-21 | claude/clinical-kb-pwa-review-asi3wb (restarted from e02ba3d; PR: E-3c PR-A instrument) | see PR head | ADDENDUM 5 wave E-3c design accepted (Plan agent, full report in session record) and PR-A delivered: eval-answer-quality gains --dump-answers <path> (per-case answer TEXT + sections + targeting verdict JSON for the canary artifact — answers are not retained at rest by privacy design, so miss diagnosis needs eval-time capture), parseArgs/buildAnswerDumpRecord exported behind an import.meta main-guard (eval-quality precedent), canary targeting step wired with the flag. Design highlights for the record: DEFECT 1 root confirmed as fast-attempt-doomed-then-discarded on strong_routine_retrieval procedural shapes — PR-B generalizes the EXISTING validated-extractive short-circuit pattern (LAI + blocked-recovery precedents, hasValidatedExtractiveCandidate) to the measured shape via a new rag-extractive-first.ts module (net ~-110 rag.ts lines against the 5030 budget); DEFECT 2 rank-1 root = extractive lead-slot selection prefers shortest sentence and admits figure-less leads (sort at rag-extractive-answer.ts:917, 1-slot monitoring leads) — PR-C adds intent-figure-aware lead promotion with a claim-support atom-corpus nuke-proofing guard + dose/threshold fallback candidate preference (find(safe && figure) ?? find(safe)); answer-verification CLEARED as direct cause (whole-answer gap or unbold only, never per-figure deletion). H2 (strong-route comparison/complex residual) explicitly deferred as the named E-3d candidate. E-4 metrics set: discarded-generation <20% from ~47%, dose ≥3/5, monitoring ≥3/5, no intent below #58, recalls pinned 1.0, relevance/fail_closed/readability/artifact_leaks ≥ #58. | PR-A gates: new tests/eval-answer-quality.test.ts 4/4; typecheck, check:github-actions, check:ci-scope, eval-canary-workflow test, prettier all clean; no provider calls |
 | 2026-07-21 | claude/clinical-kb-pwa-review-asi3wb (PR: E-3c PR-B short-circuit) | f7e6cbb + hardening commit | E-3c PR-B: pre-generation validated-extractive short-circuit for gate-passed routine procedural "What...process/include/required" queries (marker validated_routine_extractive_first), generalizing the LAI + blocked-recovery precedents via new rag-extractive-first.ts (3 predicates moved byte-verbatim, machine-verified; rag.ts 5029→4908 vs 5030 budget). Kills the run-#57 6x wasted-generation class. REVIEWS (both pre-push): rag-retrieval-reviewer APPROVE-WITH-NITS — move fidelity brace-diff verified byte-identical; confidence-gate skip PROVEN safe (passed-gate is a no-op in applyConfidenceGate; markers pairwise mutually exclusive); comparison false-positives blocked by unchanged classifier precedence; offline/source-only idempotent; zero retrieval/ranking/selection/threshold change; P2 = eval-only assertions (intent_coverage/artifact_leaks/expected-file) unverifiable offline for flip candidates (quality-nocc-document-support, quality-form-required-documentation, quality-discharge-documentation, quality-duress-pathway + rag-set siblings) → pre-merge BRANCH canary recommended and ADOPTED (offline-green + review-approved proven insufficient for this surface, 2026-07-20). clinical-governance-reviewer APPROVE-WITH-NITS — full gate-stack trace: nothing bypassed (same finalizeRagAnswerQuality, same citation scoping, numeric verification not fail-open, ungrounded-finalize defense at rag.ts:3694); P2 = pre-existing bare-cross-reference-with-overlap gap, NOT materially widened (new trigger anti-correlates), hardening recommended → APPLIED this PR: !isBareCrossReferenceAnswer screen in hasValidatedExtractiveCandidate (closes all three short-circuit paths; discriminating test added; disclosed post-review delta, strictly narrows shipping). MERGE GATE: draft until the branch canary pair (baseline #57/#58 vs branch run with answer_case_limit=44 + answer_quality_eval=true, est $3-6 of authorized envelope) is green — zero per-case regressions, recalls 1.0, quality/targeting rates >= baseline. | Red-proof + 3 negative guards; focused 61/61 + fallback/offline/contract suites; full suite 3061 passed / 1 known container artifact (pre-hardening tree; hardening re-verified focused); typecheck+lint+prettier clean; maintainability budget passed (4908/5030) |
 | 2026-07-21 | claude/clinical-kb-pwa-review-asi3wb (pair verdict — no code change; main stays at 22b6a2e) | canary run 29794759627 (#59, branch head 7310cb3 = merged PR-B content) | E-3b + E-3c PR-B LIVE-VALIDATED (pair vs banked #57/#58): route_ceiling_failures 2→0 (E-3b proven: agitation timeout now fits inside budget; clozapine retrieval-exhausted ceiling honestly excused via the triple-condition cross-region carve-out — exactly one "retrieval-exhausted" audit cell in the report); p95 17.4s→15.47s (-11%); golden retrieval SUCCESS 36/36 (stop-ship criterion held); validated_routine_extractive_first fired on 4 of the 6 target cases (patient-safety-plan 3.3s, treatment-team-process 2.6s, ect-procedure 2.2s, illegal-substances 2.2s — all pure extractive, zero generation, was 6-9s each with a discarded attempt), the other 2 (community-home-visits, best-practice-prescribing) stayed on generation+fallback because their extractive candidates legitimately fail validation gates = the designed-conservative outcome; ZERO new failing cases (list 5→2, both known residuals: neuroleptic citation red = Option A territory, admission-comparison expected-doc = non-blocking labeling residual); grounded 1.0 + unsupported_correct 1.0 held; targeting 0.5909→0.619, fail_closed 0.9→0.9333, readability/artifact_leaks/intent_coverage unchanged; relevance 0.6→0.5667 = single-case wobble on n=30, WATCH in E-4, not a gate. Discarded-generation rate materially down (4 conversions; residual = the H2 strong-route slice named as E-3d candidate, per design's 20-33% expectation band). MERGE STANDS (user had armed auto-merge pre-verdict; revert drill not triggered). Spend +~$3-6 → Phase E total ~$6-12 of ≤$20. | Pair evidence: run #59 job log (Blocking failures = citation only; Answer Case Diagnostics markers; metric_rates + targeting blocks); dump artifact populated for PR-C diagnosis |
+| 2026-07-21 | claude/clinical-kb-pwa-review-asi3wb (PR: E-3c PR-C figure-aware selection) | 043b030 + P2-fix commit | E-3c PR-C: dose/monitoring extractive answers now carry the asked-for figure/schedule when the cited chunk verbatim supports it — lead-slot promotion (dose swaps last of 2 slots, monitoring appends 2nd sentence; no-op when a lead already carries a figure) guarded by the claim-support atom corpus (sourceEvidenceText exported, promotionAtomKey byte-identical to claim-support's atomKey), plus the dose/threshold generation-fallback preferring the safe figure-carrying candidate (safety gate unchanged, filter-order-stable). Fallback helpers extracted to rag-extractive-answer (cycle-check verified); rag.ts 4908→4901. Six discriminating tests each verified red-on-prior-code incl. proving the nuke-guard load-bearing by disabling it. REVIEWS (both pre-push on 043b030): rag-retrieval-reviewer APPROVE-WITH-NITS — no-op path byte-identical verified, atom-key identity verified, filter-vs-find proven side-effect-free, 2-sentence append gate-safe, intent double-gated, zero retrieval/ordering change, imputation contract green; P2 = zero-atom monitoring figures ("every 6 weeks" yields no value atom) pass the guard trivially and can be nuked by claim support if sourced only from adjacent context (fails SAFE — evidence gap, never a wrong figure). clinical-governance-reviewer APPROVE-WITH-NITS — all six clinical concerns CLEARED end-to-end (verbatim-support guarantee, citation binding preserved, conservative failure test-proven, unsafe candidates impossible, wrong-drug risk controlled by pre-existing entity/multi-drug guards, no PHI); same zero-atom finding as P3 + one comment-precision nit. P2 FIXED post-review (disclosed): zero-atom figures now require the matched figure substring verbatim in sourceEvidenceText (intentFigureMatchText); proven both directions by 3 new tests (promotes from content, refuses from adjacent-context-only); comment-precision nit folded in. | Focused post-fix: extractive-formatting 32/32 + fallback/eval-cases/offline/contract/extractive-first 98/98 incl. imputation contract; typecheck+prettier+budgets clean; full-suite 3068-passed baseline pre-P2-fix (fix re-verified focused). Live proof = E-4 pair next |
diff --git a/src/lib/rag/rag-claim-support.ts b/src/lib/rag/rag-claim-support.ts
index 3c4fe9dd..77d5c25d 100644
--- a/src/lib/rag/rag-claim-support.ts
+++ b/src/lib/rag/rag-claim-support.ts
@@ -216,7 +216,9 @@ function compatibleSafetyDimensions(claim: string, evidence: string) {
 // candidate fact's value atoms against the EXACT corpus this module assesses claims with.
 // Keep the two in lockstep: a promoted figure verified against a wider corpus (e.g. one that
 // includes adjacent_context) would pass numeric verification and then trip
-// claim_support_high_risk_gap here.
+// claim_support_high_risk_gap here. (Precision note: this corpus also includes
+// index_unit metadata that the numeric-verification corpus does not, so it is not a strict
+// subset — that sole divergence fails safe: the guard passes, the numeric gate then nukes.)
 export function sourceEvidenceText(source: SearchResult) {
   return [
     source.section_heading,
diff --git a/src/lib/rag/rag-extractive-answer.ts b/src/lib/rag/rag-extractive-answer.ts
index ca658e29..fce125a3 100644
--- a/src/lib/rag/rag-extractive-answer.ts
+++ b/src/lib/rag/rag-extractive-answer.ts
@@ -383,11 +383,20 @@ const monitoringUnitRangeFigurePattern =
  * Other intents have no figure requirement and always return false.
  */
 function factCarriesIntentFigure(intent: AnswerIntent, text: string) {
-  if (intent === "dose") return clinicalDoseValuePattern.test(text) || maximumDoseEquivalentPattern.test(text);
+  return intentFigureMatchText(intent, text) !== null;
+}
+
+/** The matched figure substring for the intent, or null — lets the promotion
+ * guard verify a zero-atom figure (e.g. "every 6 weeks") verbatim in the
+ * claim-support corpus rather than trusting it atom-free. */
+function intentFigureMatchText(intent: AnswerIntent, text: string) {
+  if (intent === "dose") {
+    return clinicalDoseValuePattern.exec(text)?.[0] ?? maximumDoseEquivalentPattern.exec(text)?.[0] ?? null;
+  }
   if (intent === "monitoring_schedule") {
-    return monitoringIntervalFigurePattern.test(text) || monitoringUnitRangeFigurePattern.test(text);
+    return monitoringIntervalFigurePattern.exec(text)?.[0] ?? monitoringUnitRangeFigurePattern.exec(text)?.[0] ?? null;
   }
-  return false;
+  return null;
 }
 
 /**
@@ -1107,13 +1116,27 @@ function promotionAtomKey(atom: ClinicalValueAtom) {
  * does not — so a figure that lives only in adjacent context would pass numeric
  * verification and then trip claim_support_high_risk_gap, nuking the whole
  * answer. Facts with no value atoms (e.g. "checked at baseline, then annually")
- * have nothing to co-locate and pass.
+ * instead require their figure tokens verbatim in the same corpus: bare-number
+ * intervals like "every 6 weeks" match the monitoring figure pattern yet yield
+ * no atom (reviewer P2), so the atom check alone would pass a figure that lives
+ * only in adjacent context and claim support would then nuke.
  */
-function promotedFactFigureIsClaimSupportable(fact: ExtractedClinicalFact, results: SearchResult[]) {
-  const factAtoms = extractClinicalValueAtoms(fact.text);
-  if (factAtoms.length === 0) return true;
+function promotedFactFigureIsClaimSupportable(
+  fact: ExtractedClinicalFact,
+  results: SearchResult[],
+  intent: AnswerIntent,
+) {
   const citingResults = results.filter((result) => fact.citationChunkIds.includes(result.id));
   if (citingResults.length === 0) return false;
+  const factAtoms = extractClinicalValueAtoms(fact.text);
+  if (factAtoms.length === 0) {
+    const figureMatch = intentFigureMatchText(intent, fact.text);
+    if (!figureMatch) return false;
+    const normalizedFigure = figureMatch.toLowerCase().replace(/\s+/g, " ").trim();
+    return citingResults.some((result) =>
+      sourceEvidenceText(result).toLowerCase().replace(/\s+/g, " ").includes(normalizedFigure),
+    );
+  }
   const corpusAtomKeys = new Set(
     citingResults.flatMap((result) => extractClinicalValueAtoms(sourceEvidenceText(result)).map(promotionAtomKey)),
   );
@@ -1137,7 +1160,10 @@ function promoteIntentFigureLeadFacts(
   if (leadFacts.some((fact) => factCarriesIntentFigure(intent, fact.text))) return leadFacts;
   const promoted = facts
     .slice(leadFacts.length)
-    .find((fact) => factCarriesIntentFigure(intent, fact.text) && promotedFactFigureIsClaimSupportable(fact, results));
+    .find(
+      (fact) =>
+        factCarriesIntentFigure(intent, fact.text) && promotedFactFigureIsClaimSupportable(fact, results, intent),
+    );
   if (!promoted) return leadFacts;
   return intent === "dose" ? [...leadFacts.slice(0, -1), promoted] : [...leadFacts, promoted];
 }
diff --git a/tests/extractive-answer-formatting.test.ts b/tests/extractive-answer-formatting.test.ts
index 2f0dec1d..072b0f86 100644
--- a/tests/extractive-answer-formatting.test.ts
+++ b/tests/extractive-answer-formatting.test.ts
@@ -452,3 +452,48 @@ describe("figure-aware extractive lead selection", () => {
     );
   });
 });
+
+describe("zero-atom figure promotion guard (reviewer P2)", () => {
+  const question = "What metabolic monitoring is required for antipsychotics?";
+  const leadOnly = "Metabolic monitoring is required for all patients prescribed antipsychotics.";
+  const intervalSentence = "Weight and fasting glucose are monitored for antipsychotic patients every 6 weeks.";
+
+  it("refuses a bare-number interval that lives only in adjacent context", () => {
+    const answer = extractiveAnswerFor(question, [
+      figureChunk({
+        id: "monitoring-guard-1",
+        section_heading: "Metabolic monitoring",
+        content: `${leadOnly} ${intervalSentence}`,
+        // The interval text is extracted from content (fact admission) but the
+        // claim-support corpus for the chunk is overridden to exclude it: simulate
+        // by keeping the figure OUT of heading/content and only in adjacent_context.
+      }),
+    ]);
+    expect(answer.grounded).toBe(true);
+  });
+
+  it("promotes a zero-atom interval verbatim-supported by chunk content", () => {
+    const answer = extractiveAnswerFor(question, [
+      figureChunk({
+        id: "monitoring-guard-2",
+        section_heading: "Metabolic monitoring",
+        content: `${leadOnly} ${intervalSentence}`,
+      }),
+    ]);
+    const plain = (answer.answer ?? "").replace(/\*\*/g, "");
+    expect(plain).toMatch(/every 6 weeks/i);
+  });
+
+  it("refuses the interval when it exists only in adjacent context", () => {
+    const answer = extractiveAnswerFor(question, [
+      figureChunk({
+        id: "monitoring-guard-3",
+        section_heading: "Metabolic monitoring",
+        content: leadOnly,
+        adjacent_context: intervalSentence,
+      }),
+    ]);
+    const plain = (answer.answer ?? "").replace(/\*\*/g, "");
+    expect(plain).not.toMatch(/every 6 weeks/i);
+  });
+});

From 02b5c78f2811ba330043bb1d4d1b942538a34779 Mon Sep 17 00:00:00 2001
From: Claude <noreply@anthropic.com>
Date: Tue, 21 Jul 2026 03:56:41 +0000
Subject: [PATCH 4/4] fix(rag): full-interval figure matching + genuine
 zero-atom guard coverage
MIME-Version: 1.0
Content-Type: text/plain; charset=UTF-8
Content-Transfer-Encoding: 8bit

CodeRabbit review on the P2 guard: reorder monitoringIntervalFigurePattern so
the unit-bearing "every N unit" alternative precedes bare "every N" — exec()
now returns the full schedule instead of a truncated "every 6". Digit+unit
intervals turn out to produce quantity atoms (6/week), so atom identity already
refuses unit mismatches; the reorder hardens the verbatim fallback against
atom-coverage drift, and both comments claiming "every 6 weeks" is zero-atom
are corrected. The non-discriminating first guard test is replaced with a
mismatched-unit pin (shared number, different unit, figure only in adjacent
context) plus two genuinely zero-atom tests ("annually") that exercise the
verbatim-corpus path both directions. promotionAtomKey hand-mirror replaced by
exporting clinicalValueAtomKey from rag-claim-support.

Co-Authored-By: Claude Fable 5 <noreply@anthropic.com>
Claude-Session: https://claude.ai/code/session_01EXsJcLrbZUXwnBeG91cVo9
---
 src/lib/rag/rag-claim-support.ts           | 11 +++--
 src/lib/rag/rag-extractive-answer.ts       | 42 +++++++-----------
 tests/extractive-answer-formatting.test.ts | 50 +++++++++++++++++++---
 3 files changed, 66 insertions(+), 37 deletions(-)

diff --git a/src/lib/rag/rag-claim-support.ts b/src/lib/rag/rag-claim-support.ts
index 77d5c25d..4d53533a 100644
--- a/src/lib/rag/rag-claim-support.ts
+++ b/src/lib/rag/rag-claim-support.ts
@@ -99,7 +99,12 @@ function splitComparisonClaims(value: string) {
     .slice(0, 24);
 }
 
-function atomKey(atom: ClinicalValueAtom) {
+/**
+ * Canonical identity for a clinical value atom, shared with the extractive
+ * lead-figure promotion guard (rag-extractive-answer.ts) so promotion and
+ * claim-support agree on whether a figure is present in the evidence corpus.
+ */
+export function clinicalValueAtomKey(atom: ClinicalValueAtom) {
   return [
     atom.kind,
     atom.canonicalValue,
@@ -250,8 +255,8 @@ function sourceSupportsClaim(claim: string, source: SearchResult) {
   if (!compatibleSafetyDimensions(claim, evidence)) return false;
   if (!compatibleHighRiskTrigger(claim, evidence)) return false;
 
-  const evidenceAtoms = new Set(extractClinicalValueAtoms(evidence).map(atomKey));
-  if (extractClinicalValueAtoms(claim).some((atom) => !evidenceAtoms.has(atomKey(atom)))) return false;
+  const evidenceAtoms = new Set(extractClinicalValueAtoms(evidence).map(clinicalValueAtomKey));
+  if (extractClinicalValueAtoms(claim).some((atom) => !evidenceAtoms.has(clinicalValueAtomKey(atom)))) return false;
 
   const claimTopics = topicTokens(claim);
   const evidenceTopics = topicTokens(evidence);
diff --git a/src/lib/rag/rag-extractive-answer.ts b/src/lib/rag/rag-extractive-answer.ts
index fce125a3..1755b98f 100644
--- a/src/lib/rag/rag-extractive-answer.ts
+++ b/src/lib/rag/rag-extractive-answer.ts
@@ -1,5 +1,5 @@
 import { boldHighYieldClinicalText } from "@/lib/answer-ranking";
-import { applyNumericVerification, extractClinicalValueAtoms, type ClinicalValueAtom } from "@/lib/answer-verification";
+import { applyNumericVerification, extractClinicalValueAtoms } from "@/lib/answer-verification";
 import { citationFromResult as resultCitation, compactCitations } from "@/lib/citations";
 import { classifyRagQuery } from "@/lib/clinical-search";
 import { ragDeepMemoryVersion } from "@/lib/deep-memory";
@@ -40,7 +40,7 @@ import type {
   RagQueryClass,
   SearchResult,
 } from "@/lib/types";
-import { assessAndEnforceClaimSupport, sourceEvidenceText } from "@/lib/rag/rag-claim-support";
+import { assessAndEnforceClaimSupport, clinicalValueAtomKey, sourceEvidenceText } from "@/lib/rag/rag-claim-support";
 
 type AnswerIntent =
   | "dose"
@@ -371,8 +371,13 @@ const doseIntentEvidencePattern = new RegExp(
 // Interval/schedule tokens that make a monitoring fact carry its asked-for
 // schedule ("baseline", "annually", "every 3", "6 months"), plus unit-bearing
 // level ranges ("0.6-0.8 mmol/L") for target-level monitoring answers.
+// Alternation order is load-bearing: "every N unit" must precede bare
+// "every N" so exec() returns the full schedule, not a truncated "every 6".
+// Digit+unit intervals also yield value atoms, so atom identity catches
+// unit mismatches today — the full match keeps the promotion guard's
+// verbatim-corpus fallback equally honest if that coverage ever drifts.
 const monitoringIntervalFigurePattern =
-  /\b(?:baseline|weekly|monthly|annual(?:ly)?|every\s+\d+|\d+\s*(?:week|month|day|hour|year)s?)\b/i;
+  /\b(?:baseline|weekly|monthly|annual(?:ly)?|every\s+\d+\s*(?:week|month|day|hour|year)s?|every\s+\d+|\d+\s*(?:week|month|day|hour|year)s?)\b/i;
 const monitoringUnitRangeFigurePattern =
   /\d+(?:\.\d+)?\s*[-–]\s*\d+(?:\.\d+)?\s*(?:mmol\/L|mg|micrograms?|nmol\/L|mcg)/i;
 
@@ -1091,23 +1096,6 @@ function buildFactSections(facts: ExtractedClinicalFact[], query: string) {
     .filter((section) => section.body && section.citation_chunk_ids.length > 0);
 }
 
-// Mirrors the private atom identity used by rag-claim-support's evidence check
-// (same fields, same separator) so the promotion guard below agrees with claim
-// assessment about whether a figure is present in the evidence corpus.
-function promotionAtomKey(atom: ClinicalValueAtom) {
-  return [
-    atom.kind,
-    atom.canonicalValue,
-    atom.comparator ?? "",
-    atom.canonicalUnit ?? "",
-    atom.denominatorUnit ?? "",
-    atom.denominatorTime ?? "",
-    atom.denominatorWeight ?? "",
-    atom.route ?? "",
-    atom.frequency ?? "",
-  ].join("|");
-}
-
 /**
  * Nuke-proofing guard for lead-slot figure promotion: only promote a fact whose
  * clinical value atoms ALL appear in the claim-support evidence corpus
@@ -1115,11 +1103,11 @@ function promotionAtomKey(atom: ClinicalValueAtom) {
  * adjacent_context and numeric verification accepts it too, but claim support
  * does not — so a figure that lives only in adjacent context would pass numeric
  * verification and then trip claim_support_high_risk_gap, nuking the whole
- * answer. Facts with no value atoms (e.g. "checked at baseline, then annually")
- * instead require their figure tokens verbatim in the same corpus: bare-number
- * intervals like "every 6 weeks" match the monitoring figure pattern yet yield
- * no atom (reviewer P2), so the atom check alone would pass a figure that lives
- * only in adjacent context and claim support would then nuke.
+ * answer. Facts with no value atoms instead require their figure tokens
+ * verbatim in the same corpus: schedule tokens like "baseline" or "annually"
+ * match the monitoring figure pattern yet yield no atom (reviewer P2), so the
+ * atom check alone would pass a figure that lives only in adjacent context and
+ * claim support would then nuke.
  */
 function promotedFactFigureIsClaimSupportable(
   fact: ExtractedClinicalFact,
@@ -1138,9 +1126,9 @@ function promotedFactFigureIsClaimSupportable(
     );
   }
   const corpusAtomKeys = new Set(
-    citingResults.flatMap((result) => extractClinicalValueAtoms(sourceEvidenceText(result)).map(promotionAtomKey)),
+    citingResults.flatMap((result) => extractClinicalValueAtoms(sourceEvidenceText(result)).map(clinicalValueAtomKey)),
   );
-  return factAtoms.every((atom) => corpusAtomKeys.has(promotionAtomKey(atom)));
+  return factAtoms.every((atom) => corpusAtomKeys.has(clinicalValueAtomKey(atom)));
 }
 
 /**
diff --git a/tests/extractive-answer-formatting.test.ts b/tests/extractive-answer-formatting.test.ts
index 072b0f86..df575f72 100644
--- a/tests/extractive-answer-formatting.test.ts
+++ b/tests/extractive-answer-formatting.test.ts
@@ -458,21 +458,57 @@ describe("zero-atom figure promotion guard (reviewer P2)", () => {
   const leadOnly = "Metabolic monitoring is required for all patients prescribed antipsychotics.";
   const intervalSentence = "Weight and fasting glucose are monitored for antipsychotic patients every 6 weeks.";
 
-  it("refuses a bare-number interval that lives only in adjacent context", () => {
+  it("refuses an adjacent-context interval whose number matches corpus text with a different unit", () => {
     const answer = extractiveAnswerFor(question, [
       figureChunk({
         id: "monitoring-guard-1",
         section_heading: "Metabolic monitoring",
-        content: `${leadOnly} ${intervalSentence}`,
-        // The interval text is extracted from content (fact admission) but the
-        // claim-support corpus for the chunk is overridden to exclude it: simulate
-        // by keeping the figure OUT of heading/content and only in adjacent_context.
+        // The synopsis shares the bare number but not the unit, and carries no
+        // intent tokens so it can never be admitted as a competing fact. The
+        // "every 6 weeks" figure yields a 6/week quantity atom, so atom
+        // identity must refuse the 6/month corpus — and the interval pattern's
+        // full-match ordering keeps the verbatim fallback equally honest.
+        retrieval_synopsis: "Reviewed every 6 months",
+        content: leadOnly,
+        adjacent_context: intervalSentence,
       }),
     ]);
-    expect(answer.grounded).toBe(true);
+    const plain = (answer.answer ?? "").replace(/\*\*/g, "");
+    expect(plain).not.toMatch(/every 6 weeks/i);
+    expect(plain).not.toMatch(/every 6 months/i);
+  });
+
+  // Longer than leadOnly so it stays a promotion candidate instead of taking
+  // the shortest-first lead slot, and digit-free so it yields no value atom —
+  // exercising the guard's verbatim-corpus fallback rather than atom identity.
+  const annualSentence = "Weight and fasting glucose monitoring is repeated annually for all antipsychotic patients.";
+
+  it("promotes a truly zero-atom schedule token verbatim-supported by chunk content", () => {
+    const answer = extractiveAnswerFor(question, [
+      figureChunk({
+        id: "monitoring-guard-4",
+        section_heading: "Metabolic monitoring",
+        content: `${leadOnly} ${annualSentence}`,
+      }),
+    ]);
+    const plain = (answer.answer ?? "").replace(/\*\*/g, "");
+    expect(plain).toMatch(/annually/i);
+  });
+
+  it("refuses a truly zero-atom schedule token that exists only in adjacent context", () => {
+    const answer = extractiveAnswerFor(question, [
+      figureChunk({
+        id: "monitoring-guard-5",
+        section_heading: "Metabolic monitoring",
+        content: leadOnly,
+        adjacent_context: annualSentence,
+      }),
+    ]);
+    const plain = (answer.answer ?? "").replace(/\*\*/g, "");
+    expect(plain).not.toMatch(/annually/i);
   });
 
-  it("promotes a zero-atom interval verbatim-supported by chunk content", () => {
+  it("promotes an atom-backed interval verbatim-supported by chunk content", () => {
     const answer = extractiveAnswerFor(question, [
       figureChunk({
         id: "monitoring-guard-2",