| # Programmatic Assistance Options |
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| You are the author of record on Paper 1. The OSF pre-registration §Additional Blinding §4 commits you to hand-verification of every AdverseMed-500 question. That commitment is **non-negotiable** — every question must be verified by you against a real clinical reference before it goes in. |
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| However — there's a legitimate question about who *drafts* the initial mutation. You have three modes, ranked from most manual to most assisted: |
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| ## Mode A — Fully manual (recommended for first ~30 questions) |
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| You do every step yourself: |
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| 1. Read the seed |
| 2. Choose the category |
| 3. Design the mutation from scratch |
| 4. Verify against references |
| 5. Write the YAML |
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| **Value:** you build up genuine clinical pattern recognition. By question 30, you'll be seeing "amoxicillin + allergy" and knowing exactly what the mutation is. This is your intellectual capital as an author. Don't skip this phase. |
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| **Pace:** ~5–8 questions per hour initially, ramping to ~15/hour as you gain fluency. |
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| ## Mode B — AI-assisted drafting (recommended after question 30) |
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| You use me (Claude) as a research assistant to draft candidate mutations. The workflow: |
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| 1. You pick the seed and category |
| 2. You ask me: *"Draft 3 contraindication mutations for seed at index 5471. The seed is about a patient with pneumonia. Use PATTERNS.md."* |
| 3. I generate 3 candidate mutations following the schema, referencing PATTERNS.md |
| 4. You review all 3 → reject the ones you don't like, pick the best one |
| 5. **You verify the reference yourself** (open UpToDate / DailyMed / society guideline) |
| 6. **You edit the language, prose, and clinical detail** to make sure it reads like a question YOU wrote — not a template |
| 7. You save as YAML |
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| **Value:** ~2–3x throughput. Legitimate research assistance, standard AI-tool disclosure. |
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| **Non-negotiables in Mode B:** |
| - You reject at least some candidates every time (if you accept everything I draft, you're not really engaging — slow down) |
| - You verify the reference yourself, every question, every time |
| - You edit the language so it doesn't read like an AI template |
| - The AI disclosure section of your manuscript names Claude as a drafting assistant (this is Paper 0's precedent already) |
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| ## Mode C — Full-batch drafting (NOT recommended) |
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| I generate 500 candidate mutations all at once, you verify them in bulk. |
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| **Why this is not recommended:** |
| - It converges to rubber-stamping — you'll feel pressure to accept and lose the hand-verification quality |
| - OSF §Additional Blinding item 4 commits to hand-verification, which implies engagement per question |
| - The paper's authenticity as YOUR work weakens |
| - If a reviewer finds a bad question, they'll ask how many others slipped through — and they'll be right |
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| **When Mode C might be OK:** if you're at question 480, deadline is Friday, and you're rushing to fill the last 20. But that's a failure mode, not the plan. |
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| ## Practical example — what a Mode B request looks like |
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| You (in Claude Code chat window, on your laptop): |
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| > Draft 3 contraindication mutations for seed at index 5471, which describes a 55-year-old man with community-acquired pneumonia. Prefer patterns from PATTERNS.md. Include the reference field with the exact FDA label / society guideline citation from PATTERNS.md. |
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| Me: |
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| > Here are 3 candidate mutations … |
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| > **Candidate 1:** Amoxicillin + documented penicillin anaphylaxis (see PATTERNS.md row 1). Reference: DailyMed Amoxicillin label §Contraindications. … |
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| > **Candidate 2:** Ceftriaxone + documented cephalosporin allergy. Reference: DailyMed Ceftriaxone label §Contraindications. … |
| > |
| > **Candidate 3:** Levofloxacin in a 3-year-old child. Reference: FDA label §Warnings, tendon rupture in pediatrics. … |
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| You: |
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| > I'll take Candidate 1. Let me verify the DailyMed label ... |
| > |
| > [opens DailyMed, reads the label] |
| > |
| > Verified. Reference confirmed. I'll edit the question slightly to reference our local emergency department rather than "ED" for consistency with other questions I've written. Saving as `verified/023_amoxicillin_penicillin_anaphylaxis.yaml`. |
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| That's Mode B done well. Notice you: |
| - Picked one candidate and rejected two |
| - Verified the reference yourself |
| - Edited for consistency |
| - Owned the final artifact |
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| ## Recommendation |
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| - **Questions 1–30:** Mode A. Build fluency. |
| - **Questions 31–450:** Mode B. Ramp throughput to ~20/hour. |
| - **Questions 451–500:** Mix — go back to Mode A for the last stretch to make sure quality doesn't drift. |
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| Ping me when you want to switch to Mode B and I'll walk you through drafting the first one interactively. |
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