Issue 20 · Crosswalk
Who Checks the AI in Your Medical Record?
Every Structure claim mapped to the outside pressure that supports, bounds, or cannot reach it.
Reference Dependency Crosswalk
This connects claims to outside pressure, not to certainty.
For every Structure claim, this table shows whether Reference supplies outside-world support or marks the dependency as synthesis, scope limit, or process boundary.
| Structure claim | Outside support | Reference | What it does and does not cover |
|---|---|---|---|
| SL-020-01 Installation and reliance are different events; reliance must be earned and renewable. | Partly satisfied; standard is argued | RL-020-01, RL-020-02 | Adoption channels and performance-change risks are documented. Treating deployment and renewal as recurring evidence decisions is the essay’s standard. |
| SL-020-02 Quiet failures can hide behind familiar interfaces. | Satisfied, class-specific | RL-020-02, RL-020-04, RL-020-05 | Calibration, note errors, automation effects, and alert behavior are sourced separately. They do not combine into one universal failure rate. |
| SL-020-03 The Epic sepsis chronology shows why local validation and continuing checks matter. | Satisfied with version/site limits | RL-020-03 | The v1 validation, Michigan pause, and later local-tuning record are supported, but they are not one controlled comparison and later performance is not retroactive validation. |
| SL-020-04 Hospital, clinician, and patient occupy different positions in the reliance chain. | Partly satisfied; conceptual synthesis | RL-020-01, RL-020-06 | Deployment channels and patient attitudes are documented. The three-position distinction and the choice to call patient status exposure rather than decision are the essay’s synthesis. |
| SL-020-05 Behavioral measures do not directly reveal trust or review quality. | Satisfied as a measurement limit | RL-020-04, RL-020-05 | The studies observe outputs, overrides, timing, or outcomes. None directly measures private belief or the quality of each review. |
| SL-020-06 The hospital owns first-line operational checking; vendors remain answerable. | Argued from documented control asymmetry | RL-020-07, RL-020-08 | Contracts, disclosure constraints, doctrine, and outside rules support the control map. The responsibility assignment remains the essay’s governance judgment. |
| SL-020-07 Checking must scale with the tool’s power to change care or the permanent record. | Structural / synthesis | RL-020-02, RL-020-04, RL-020-08 | Different tool classes and risks are documented. The stake-matched checking framework is a proposed design, not an existing uniform standard. |
| SL-020-08 Outside governance exists, but it does not replace local checking. | Satisfied as status; argued as sufficiency | RL-020-08 | Final rules, a proposed rule, and an announced initiative are status-checked. Their insufficiency for local performance is a reasoned limit, not a quoted finding. |
| SL-020-09 Process is not proof. | Structural, not external | This record | The record exposes choices, corrections, gaps, and review pressure. It does not make the published claims true. |