stemedb/uat/consumer-health/anecdotal-signal-precedence.md

# UAT: Anecdotal Signal Precedence (Cluster Escalation)

**Date:** YYYY-MM-DD
**Feature:** Escalation Signals
**Status:** [ ] PASS / [ ] FAIL / [ ] BLOCKED

## Scenario

When 500+ Tier 5 (Anecdotal) reports cluster around a subject with NO Tier 0-2 coverage, this should trigger an **escalation signal**. This represents "something the community is seeing that hasn't been validated yet."

Key validation: The system detects an information gap that needs expert investigation.

## Acceptance Criteria

| Criterion | Expected | Met? |
|-----------|----------|------|
| 500+ Tier 5 assertions exist | All ingested | [ ] |
| No Tier 0-2 for same subject | Verified | [ ] |
| Escalation signal created | event_type = "anecdotal_cluster" | [ ] |
| Signal includes cluster metadata | count, subject, predicate | [ ] |
| Threshold is configurable | Can adjust 500 limit | [ ] |

## Test Matrix

| Step | Action | Expected | Actual | Status |
|------|--------|----------|--------|--------|
| 1 | Ingest 500 Tier 5 assertions | 500 hashes returned | | [ ] |
| 2 | Verify no Tier 0-2 exists | Empty result | | [ ] |
| 3 | Query escalation events | Signal present | | [ ] |
| 4 | Check signal metadata | count >= 500 | | [ ] |
| 5 | Add Tier 1 assertion | Signal resolved | | [ ] |

## Escalation Logic

```
IF count(subject, predicate, tier=5) >= threshold
AND count(subject, predicate, tier IN [0,1,2]) == 0
THEN create_escalation_signal({
    event_type: "anecdotal_cluster",
    level: "investigate",
    subject: subject,
    predicate: predicate,
    cluster_count: count,
    message: "High-volume anecdotal reports with no authoritative coverage"
})
```

## Setup Commands

```bash
# Start StemeDB
cargo run --bin stemedb-api &
sleep 2
```

## Test Commands

### Step 1: Ingest 500 Anecdotal Reports (New Symptom)

```bash
# A new symptom not yet documented by FDA/clinical
for i in $(seq 1 500); do
  HASH=$(printf '%064d' $((1000 + i)))
  curl -s -X POST http://localhost:18180/v1/assertions \
    -H "Content-Type: application/json" \
    -d "{
      \"subject\": \"Semaglutide\",
      \"predicate\": \"hair_loss_reported\",
      \"object\": {\"Boolean\": true},
      \"confidence\": 0.70,
      \"source_class\": \"Anecdotal\",
      \"source_hash\": \"$HASH\"
    }" > /dev/null
done
echo "Created 500 anecdotal hair loss reports"
```

**Expected:** 500 assertions created
**Actual:**
**Status:** [ ]

### Step 2: Verify No Authoritative Coverage

```bash
# Check for Tier 0-2 assertions on hair_loss
curl "http://localhost:18180/v1/query?subject=Semaglutide&predicate=hair_loss_reported&source_class=Regulatory"
curl "http://localhost:18180/v1/query?subject=Semaglutide&predicate=hair_loss_reported&source_class=Clinical"
curl "http://localhost:18180/v1/query?subject=Semaglutide&predicate=hair_loss_reported&source_class=Observational"
```

**Expected:** All queries return empty results
**Actual:**
**Status:** [ ]

### Step 3: Query Escalation Events

```bash
curl "http://localhost:18180/v1/escalations?subject=Semaglutide"
```

**Expected:**
```json
{
  "events": [
    {
      "event_type": "anecdotal_cluster",
      "level": "investigate",
      "subject": "Semaglutide",
      "predicate": "hair_loss_reported",
      "cluster_count": 500,
      "message": "High-volume anecdotal reports with no authoritative coverage",
      "created_at": "..."
    }
  ]
}
```
**Actual:**
**Status:** [ ]

### Step 4: Check Signal Metadata

From Step 3 response, verify:
- `cluster_count >= 500`
- `subject` and `predicate` match
- `level` is "investigate"

**Expected:** All metadata correct
**Actual:**
**Status:** [ ]

### Step 5: Resolve by Adding Authoritative Source

```bash
# Clinical study addresses the hair loss question
curl -X POST http://localhost:18180/v1/assertions \
  -H "Content-Type: application/json" \
  -d '{
    "subject": "Semaglutide",
    "predicate": "hair_loss_reported",
    "object": {"Text": "Post-hoc analysis shows 2.3% incidence, similar to placebo"},
    "confidence": 0.88,
    "source_class": "Clinical",
    "source_hash": "0000000000000000000000000000000000000000000000000000000000000099"
  }'

# Check if escalation is resolved
curl "http://localhost:18180/v1/escalations?subject=Semaglutide&status=active"
```

**Expected:** Escalation marked as "resolved" or removed from active list
**Actual:**
**Status:** [ ]

## Sign-Off Checklist

- [ ] 500 anecdotal assertions ingested
- [ ] Escalation triggered for coverage gap
- [ ] Signal includes cluster count and metadata
- [ ] Adding authoritative source resolves signal
- [ ] Threshold is configurable (default 500)

## Notes

*Escalation signals are for investigation workflow. They don't change assertion storage or query results - they're a separate alert system.*

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**Tester:**
**Date:**
**Result:**