---
license: apache-2.0
task_categories:
  - text-generation
language:
  - en
tags:
  - clinical-ai
  - fairness
  - health-equity
  - llm-agents
  - counterfactual
  - agentic-ai
  - measurement-validity
  - evaluation
pretty_name: FairMedAgent instability-floor trajectories
size_categories:
  - 1K<n<10K
---

# FairMedAgent: instability-floor trajectories

Raw agent trajectories behind the per-action instability floor reported for FairMedAgent, an
evaluation harness for demographic disparity in the **actions** of multi-step clinical LLM
agents.

Code, protocol and analysis scripts: https://github.com/rohithreddybc/FairMedAgent

Archived software release: https://doi.org/10.5281/zenodo.22165979 (archival identifier, not the citation)

## Why this exists

A counterfactual fairness audit holds the clinical content of a case fixed, changes only the
patient descriptor, and reports how often the agent's action changes. On its own that number
cannot be interpreted, because an agent's action also changes when nothing changes at all.

These files are the measurement of that baseline. Re-running an identical condition ten times
over sixteen vignettes, with the same narrative and the same descriptor string and nothing
varied, moved the agent's action in 8.7 percent of outcome-vignette cells. The rate differed
across the six actions by a factor of eight, from 0.022 for ICU escalation to 0.179 for
controlled-substance caution. A second model gives a pooled floor of 6.7 percent and ranks the
six actions almost identically.

**No disparity result is claimed here, and none should be quoted from this dataset.** The
estimand the harness targets counts only flips between actions a published decision rule
admits and a clinician has adjudicated as defensible. That adjudication is under way.

## Contents

| Path | Contents |
|---|---|
| `experiments/floor16/` | Ten repetitions of an identical condition over sixteen vignettes |
| `experiments/floor16_sonnet/` | The second-model replication of the same design |
| `experiments/instability/` | Earlier instability probe that motivated the floor study |
| `experiments/pilot`, `pilot2`, `pilot3`, `pilot3ctl` | Pilot runs, including the rare-token, re-render and sham-attribute controls |
| `docs/DATASHEET.md` | Datasheet for the synthetic cohort |
| `docs/COHORT_PROVENANCE.md` | Generator version, seed and command, so the cohort is regenerable |
| `docs/ADJUDICATION_PROTOCOL.md` | How an acceptable-action band is adjudicated |
| `docs/BAND_ADJUDICATION_RECORD.md` | The adjudicator's reasoning, in full, per band |

Each `trajectories.json` holds complete six-stage trajectories: five model-facing decisions
around a deterministic environment step, with the condition identifier, the vignette
identifier and the structured action at every stage.

## Not included

The development split and the reference leaderboard are published on completion of clinician
validation. The held-out test split is sealed and scored under the submission protocol; it is
deliberately absent so that it stays a held-out split.

## Reproducing the reported numbers

```bash
git clone https://github.com/rohithreddybc/FairMedAgent
python FairMedAgent/harness/scripts/verify_paper_numbers.py
```

The script recomputes all 21 reported quantities from these trajectories. Pass the path to the
manuscript source to also assert that each figure appears in the text as computed.

## Data statement

All patient vignettes are synthetic. No real patient data, no protected health information, no
human subjects, no IRB required. Cohort provenance is recorded rather than the cohort itself,
so it is regenerable from the seed and command in `docs/COHORT_PROVENANCE.md`.

## Citation

**Cite the paper, not the archive.** The arXiv preprint is the citable reference and is
posted shortly; its identifier is added here as soon as it exists. Zenodo indexes software
records but Google Scholar does not, so a Zenodo-only citation does not accrue anywhere a
reader or a bibliometric tool will look for it.

`10.5281/zenodo.22165979` is the archival identifier for the software itself. It belongs in a data or
code availability statement, which is where journals ask for it, and it is what makes a
specific version of this harness retrievable years from now. It is not the reference to put
in a bibliography.

See `CITATION.cff` for the machine-readable form.