Clinibrium

Clinibrium is a clinical decision-support co-pilot for the otoneurology clinic, developed with a subspecialist otolaryngologist. It triages a common complaint — vertigo — that hides a rare emergency: posterior-circulation stroke. Its founding guarantee: the model never makes the safety call. The architecture inverts the usual LLM app — deterministic layers own everything that must be trustworthy. A RedFlagEngine, physically separated from the differential, and hard rails seal the urgency verdict with escalate-only, monotone semantics. A CatBoost + SHAP confidence layer, trained on real clinical cases, doesn't touch urgency — it feeds a recommendation to Claude. Claude reasons over it, grounds its explanation in paraphrased ICVD criteria, and picks its own model (Opus for urgent cases, Sonnet for ambulatory). When Claude catches a subtlety the rules miss, it can raise the alert one level — never lower it. Kill the ML or Claude live and urgency doesn't change; we test exactly that. Our most creative use of Claude Code is the Safety Harness: a hook that reruns invariant tests whenever Claude edits a safety-critical file and blocks the commit if a guarantee breaks, plus a skill that turns a specialist-signed rule into adversarially-tested code. Twelve invariants, +300 tests, multi-model adversarial audits, tamper-evident FHIR, on-device video. Specialist-reviewed; honestly scoped.

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