Ai Stopping Hallucinations

Stop Your AI From Making Things Up

Guide the user through making their AI factually grounded. The core principle: never trust a bare LM output — always verify against sources.

When NOT to use anti-hallucination patterns

• Creative tasks (brainstorming, fiction, ideation) — hallucination is the feature, not the bug
• Simple extraction where the answer is a direct copy from input — citation overhead adds cost without benefit
• You have no source documents and cannot add them — self-consistency checks help but retrieval-grounded approaches are far more effective. Consider /ai-searching-docs first to add a knowledge base

Step 1: Understand the grounding situation

Ask the user: 1. Do you have source documents? (knowledge base, docs, database) → use retrieval-grounded answers 2. Is it general knowledge? (no docs, just the model's knowledge) → use self-consistency checks 3. How bad is a hallucination? (annoying vs. dangerous) → determines how strict the checks should be

Step 2: Citation enforcement

Force the AI to cite sources for every claim. Uses dspy.Refine to retry generation until citation quality meets the threshold.

import dspy
import re

lm = dspy.LM("openai/gpt-4o-mini")  # or "anthropic/claude-sonnet-4-5-20250929", etc.
dspy.configure(lm=lm)

class CitedAnswer(dspy.Signature):
    """Answer the question using the provided sources. Cite every claim with [1], [2], etc."""
    context: list[str] = dspy.InputField(desc="Numbered source documents")
    question: str = dspy.InputField()
    answer: str = dspy.OutputField(desc="Answer with inline citations like [1], [2]")

def citation_reward(args: dict, pred: dspy.Prediction) -> float:
    answer = pred.answer
    context = args["context"]

    # Check citation ratio — at least half of sentences must have citations
    sentences = [s.strip() for s in re.split(r'(?<=[.!?])\s+', answer) if s.strip()]
    citations_found = [bool(re.search(r"\[\d+\]", s)) for s in sentences]
    ratio = sum(citations_found) / max(len(sentences), 1)

    # Check all cited numbers exist in context
    cited_nums = set(int(n) for n in re.findall(r"\[(\d+)\]", answer))
    valid_nums = set(range(1, len(context) + 1))
    all_valid = cited_nums.issubset(valid_nums)

    if not all_valid:
        return 0.0
    return ratio  # 0.0 to 1.0

answerer = dspy.ChainOfThought(CitedAnswer)
citation_enforcer = dspy.Refine(answerer, N=3, reward_fn=citation_reward, threshold=0.5)

# Usage
result = citation_enforcer(context=context, question=question)

dspy.Refine retries up to N times, passing the reward score back as feedback so the model can improve its citations on each attempt.

Step 3: Faithfulness verification

After generating an answer, use a second LM call to check if it's actually supported by the sources. Wraps the answerer with dspy.Refine so unfaithful answers are retried.

class CheckFaithfulness(dspy.Signature):
    """Check if every claim in the answer is supported by the context."""
    context: list[str] = dspy.InputField(desc="Source documents")
    answer: str = dspy.InputField(desc="Generated answer to verify")
    is_faithful: bool = dspy.OutputField(desc="Is every claim supported by the context?")
    unsupported_claims: list[str] = dspy.OutputField(desc="Claims not found in context")

class FaithfulAnswerer(dspy.Module):
    def __init__(self):
        self.answer = dspy.ChainOfThought(CitedAnswer)
        self.verify = dspy.Predict(CheckFaithfulness)

    def forward(self, context, question):
        result = self.answer(context=context, question=question)
        check = self.verify(context=context, answer=result.answer)
        # Expose faithfulness on the prediction so reward_fn can read it
        return dspy.Prediction(
            answer=result.answer,
            is_faithful=check.is_faithful,
            unsupported_claims=check.unsupported_claims,
        )

def faithfulness_reward(args: dict, pred: dspy.Prediction) -> float:
    return 1.0 if pred.is_faithful else 0.0

faithful_responder = dspy.Refine(
    FaithfulAnswerer(), N=3, reward_fn=faithfulness_reward, threshold=1.0
)

# Usage
result = faithful_responder(context=context, question=question)

Step 4: Self-check pattern

Generate an answer, then ask the model to verify its own claims against the sources. Uses a reward function that gives partial credit for faithfulness — good for cases where you want the best available answer rather than a hard block.

class SelfCheckedAnswerer(dspy.Module):
    def __init__(self):
        self.answer = dspy.ChainOfThought("context, question -> answer")
        self.check = dspy.ChainOfThought(CheckFaithfulness)

    def forward(self, context, question):
        result = self.answer(context=context, question=question)
        verification = self.check(context=context, answer=result.answer)
        return dspy.Prediction(
            answer=result.answer,
            is_verified=verification.is_faithful,
            unsupported=verification.unsupported_claims,
        )

def partial_faithfulness_reward(args: dict, pred: dspy.Prediction) -> float:
    """Partial credit - 1.0 if faithful, 0.5 if partially faithful, 0.0 if not."""
    if pred.is_verified:
        return 1.0
    # Give partial credit if there are few unsupported claims
    unsupported = pred.unsupported or []
    if len(unsupported) <= 1:
        return 0.5
    return 0.0

self_checked = dspy.Refine(
    SelfCheckedAnswerer(), N=3, reward_fn=partial_faithfulness_reward, threshold=0.5
)

Step 5: Cross-check pattern

Generate the answer multiple times independently and pick the one most consistent with itself. dspy.BestOfN samples N candidates and selects the highest-scoring one according to a reward function.

class CompareAnswers(dspy.Signature):
    """Check if two independently generated answers agree on the facts."""
    answer_a: str = dspy.InputField()
    answer_b: str = dspy.InputField()
    agree: bool = dspy.OutputField(desc="Do they agree on all factual claims?")
    discrepancy: str = dspy.OutputField(desc="What they disagree on, if anything")

class GroundedAnswerer(dspy.Module):
    def __init__(self):
        self.answer = dspy.ChainOfThought("context, question -> answer")
        self.verify = dspy.Predict(CheckFaithfulness)

    def forward(self, context, question):
        result = self.answer(context=context, question=question)
        check = self.verify(context=context, answer=result.answer)
        return dspy.Prediction(
            answer=result.answer,
            is_faithful=check.is_faithful,
            unsupported_claims=check.unsupported_claims,
        )

def faithfulness_reward(args: dict, pred: dspy.Prediction) -> float:
    return 1.0 if pred.is_faithful else 0.0

# BestOfN samples N candidates and returns the one with the highest reward
cross_checked = dspy.BestOfN(
    GroundedAnswerer(), N=3, reward_fn=faithfulness_reward
)

# Usage — returns the most faithful of the 3 sampled answers
result = cross_checked(context=context, question=question)

Best for high-stakes outputs where the cost of hallucination is high. Uses N LM calls but picks the most faithful result rather than retrying on failure.

Step 6: Confidence thresholds

Flag low-confidence outputs for human review instead of showing them to users.

class ConfidenceGated(dspy.Signature):
    """Answer the question and rate your confidence."""
    context: list[str] = dspy.InputField()
    question: str = dspy.InputField()
    answer: str = dspy.OutputField()
    confidence: float = dspy.OutputField(desc="0.0 to 1.0, how confident are you?")
    reasoning: str = dspy.OutputField(desc="Why this confidence level?")

class GatedResponder(dspy.Module):
    def __init__(self, threshold=0.7):
        self.respond = dspy.ChainOfThought(ConfidenceGated)
        self.threshold = threshold

    def forward(self, context, question):
        result = self.respond(context=context, question=question)

        if result.confidence < self.threshold:
            return dspy.Prediction(
                answer=result.answer,
                needs_review=True,
                confidence=result.confidence,
                reason=result.reasoning,
            )

        return dspy.Prediction(
            answer=result.answer,
            needs_review=False,
            confidence=result.confidence,
        )

Step 7: Loading source data for verification

Anti-hallucination patterns need source documents. Here's how to load common formats:

From transcript files

import json, re

def load_vtt(path):
    """Extract text from a VTT transcript, stripping timestamps and cues."""
    text = open(path).read()
    lines = [line.strip() for line in text.split("\n")
             if line.strip() and not line.startswith("WEBVTT")
             and not re.match(r"\d{2}:\d{2}", line)
             and not line.strip().isdigit()]
    return " ".join(lines)

def load_livekit_transcript(path):
    """Extract text from a LiveKit transcript JSON export."""
    data = json.load(open(path))
    segments = data.get("segments", data.get("results", []))
    return " ".join(seg.get("text", "") for seg in segments)

def load_recall_transcript(transcript_data):
    """Extract text from a Recall.ai transcript response."""
    return " ".join(
        entry["words"] for entry in transcript_data if entry.get("words")
    )

From Langfuse traces

from langfuse import Langfuse

def load_langfuse_generations(trace_id):
    """Load LM generations from a Langfuse trace for verification."""
    langfuse = Langfuse()
    trace = langfuse.get_trace(trace_id)
    generations = []
    for obs in trace.observations:
        if obs.type == "GENERATION" and obs.output:
            generations.append({
                "input": obs.input,
                "output": obs.output,
                "model": obs.model,
            })
    return generations

Breaking source documents into numbered passages

Most patterns here expect context: list[str] — numbered source passages. Split long documents into chunks so citations are meaningful:

def chunk_document(text, max_chars=500):
    """Split a document into numbered passages for citation."""
    paragraphs = [p.strip() for p in text.split("\n\n") if p.strip()]
    chunks = []
    current = ""
    for para in paragraphs:
        if len(current) + len(para) > max_chars and current:
            chunks.append(current.strip())
            current = para
        else:
            current = current + "\n\n" + para if current else para
    if current:
        chunks.append(current.strip())
    return [f"[{i+1}] {chunk}" for i, chunk in enumerate(chunks)]

# Use with any source
transcript_text = load_vtt("meeting.vtt")
context = chunk_document(transcript_text)
result = citation_enforcer(context=context, question="What was decided about the timeline?")

Step 8: Evaluating anti-hallucination quality

You need metrics to know if your verification actually works. The key question: does the system catch hallucinations and produce faithful answers?

Faithfulness metric

def faithfulness_metric(example, prediction, trace=None):
    """Score: does the answer stick to the sources?"""
    verifier = dspy.Predict(CheckFaithfulness)
    check = verifier(context=example.context, answer=prediction.answer)

    # Binary: is it faithful?
    if not check.is_faithful:
        return 0.0

    # Bonus: does it actually answer the question?
    relevance = dspy.Predict("question, answer -> is_relevant: bool")
    rel = relevance(question=example.question, answer=prediction.answer)
    return 1.0 if rel.is_relevant else 0.5

evaluator = dspy.Evaluate(devset=devset, metric=faithfulness_metric, num_threads=4)
score = evaluator(my_grounded_qa)

Citation coverage metric

def citation_metric(example, prediction, trace=None):
    """Score citation quality: coverage + validity."""
    answer = prediction.answer
    sentences = [s.strip() for s in re.split(r'(?<=[.!?])\s+', answer) if s.strip()]
    cited = [bool(re.search(r"\[\d+\]", s)) for s in sentences]
    coverage = sum(cited) / max(len(sentences), 1)

    # Check all cited sources exist
    cited_nums = set(int(n) for n in re.findall(r"\[(\d+)\]", answer))
    valid_nums = set(range(1, len(example.context) + 1))
    all_valid = cited_nums.issubset(valid_nums)

    if not all_valid:
        return 0.0
    return coverage  # 0.0 to 1.0

Optimizing the verification pipeline

# Create training data: questions with source context and gold answers
trainset = [
    dspy.Example(
        context=["[1] The meeting is on March 5.", "[2] Budget is $50k."],
        question="When is the meeting?",
        answer="The meeting is on March 5 [1]."
    ).with_inputs("context", "question"),
    # ... more examples
]

# Optimize the citation enforcer
optimizer = dspy.BootstrapFewShot(metric=faithfulness_metric, max_bootstrapped_demos=4)
optimized = optimizer.compile(FaithfulAnswerer(), trainset=trainset)
optimized.save("optimized_faithful_answerer.json")

# Load later
enforcer = FaithfulAnswerer()
enforcer.load("optimized_faithful_answerer.json")

Using a cheap LM for verification

The verification step doesn't need an expensive model — a smaller model checking claims against sources works well and cuts costs:

class CostEfficientVerifier(dspy.Module):
    def __init__(self):
        self.answer = dspy.ChainOfThought(CitedAnswer)
        self.verify = dspy.Predict(CheckFaithfulness)

        # Use a cheaper model for the verification step
        cheap_lm = dspy.LM("openai/gpt-4o-mini")  # or "anthropic/claude-haiku-4-5-20251001", etc.
        self.verify.set_lm(cheap_lm)

    def forward(self, context, question):
        result = self.answer(context=context, question=question)
        check = self.verify(context=context, answer=result.answer)
        return dspy.Prediction(
            answer=result.answer,
            is_faithful=check.is_faithful,
            unsupported_claims=check.unsupported_claims,
        )

def faithfulness_reward(args: dict, pred: dspy.Prediction) -> float:
    return 1.0 if pred.is_faithful else 0.0

cost_efficient = dspy.Refine(
    CostEfficientVerifier(), N=3, reward_fn=faithfulness_reward, threshold=1.0
)

Step 9: Batch verification

When you need to verify many responses at once (e.g., auditing a transcript Q&A system):

import json

def verify_batch(qa_pairs, context, output_path="verification_results.json"):
    """Verify a batch of question-answer pairs against source context."""
    verifier = dspy.Predict(CheckFaithfulness)
    results = []

    for qa in qa_pairs:
        check = verifier(context=context, answer=qa["answer"])
        results.append({
            "question": qa["question"],
            "answer": qa["answer"],
            "is_faithful": check.is_faithful,
            "unsupported_claims": check.unsupported_claims,
        })

    # Summary
    faithful_count = sum(1 for r in results if r["is_faithful"])
    print(f"Faithful: {faithful_count}/{len(results)} "
          f"({faithful_count/len(results):.0%})")

    with open(output_path, "w") as f:
        json.dump(results, f, indent=2)

    return results

How Refine works

When dspy.Refine is used: 1. The wrapped module generates a candidate prediction 2. The reward function scores the prediction (0.0 to 1.0) 3. If the score meets the threshold, Refine returns that prediction immediately 4. If not, it retries up to N times, using the score as feedback signal 5. After N attempts, it returns the highest-scoring candidate seen

dspy.BestOfN is similar but always samples all N candidates and returns the best — useful when you want consistent sampling rather than early exit on success.

Good reward functions make Refine work better — specific scores tied to measurable properties (citation ratio, faithfulness check) outperform vague binary pass/fail.

Choosing the right pattern

Gotchas

• Sentence splitting on `.` breaks on abbreviations and decimals. Naive .split(".") breaks on "Dr. Smith", "$50.00", and URLs, inflating the uncited sentence count and producing incorrect reward scores. Use re.split(r'(?<=[.!?])\s+', text) for sentence splitting instead.
• Citation regex misses grouped citations. When models write [1, 2] or [1-3], the standard \[(\d+)\] pattern only catches [1] format. Extend the pattern to handle ranges and comma-separated lists, or normalize citation format in the signature instructions.
• The faithfulness verifier defaults to the same expensive LM. Verification is a classification task — cheaper models handle it well. Always call .set_lm() on the verifier predictor to use a smaller model. This typically cuts verification cost by 5-10x with minimal accuracy loss.
• `dspy.Retrieve` requires a configured retriever. dspy.Retrieve requires a retrieval model configured via dspy.configure(rm=...). Without it, the call fails at runtime. Either configure a retriever or pass context directly as a function parameter.
• Reward functions must handle missing fields gracefully. If the module raises an exception or returns a prediction without an expected field, the reward function will error. Add getattr(pred, "is_faithful", False) style defensive access to avoid crashing Refine's retry loop.
• Refine with threshold=1.0 requires a perfect score to short-circuit. For partial-credit reward functions (0.0 to 1.0), set a threshold below 1.0 or use BestOfN instead — otherwise Refine always runs all N attempts.

Cross-references

Install any skill: npx skills add lebsral/DSPy-Programming-not-prompting-LMs-skills --skill <name>

• Retrieval-augmented generation (RAG) setup — see /ai-searching-docs
• General output validation (format, safety, quality) — see /ai-checking-outputs
• Enforcing business rules and content policies — see /ai-following-rules
• Iterative refinement with reward functions — see /dspy-refine
• Sampling and selecting best outputs — see /dspy-best-of-n
• Retrieval model configuration and search — see /dspy-retrieval
• Install `/ai-do` if you do not have it — it routes any AI problem to the right skill and is the fastest way to work: npx skills add lebsral/DSPy-Programming-not-prompting-LMs-skills --skill ai-do

Additional resources

• For complete worked examples, see examples.md

Anti-Hallucination Examples

Example 1: Customer support grounded in help docs

A support chatbot that only answers from your help center — refuses to speculate.

import dspy
import re

lm = dspy.LM("openai/gpt-4o-mini")  # or "anthropic/claude-sonnet-4-5-20250929", etc.
dspy.configure(lm=lm)

class CitedSupportAnswer(dspy.Signature):
    """Answer a customer question using only the help docs. Cite every claim with [1], [2], etc.
    If the docs don't cover the question, say so — don't guess."""
    help_docs: list[str] = dspy.InputField(desc="Numbered help center passages")
    question: str = dspy.InputField(desc="Customer's question")
    answer: str = dspy.OutputField(desc="Answer citing help docs, or 'I don't have info on that'")

class CheckSupported(dspy.Signature):
    """Verify every claim in the answer appears in the help docs."""
    help_docs: list[str] = dspy.InputField()
    answer: str = dspy.InputField()
    is_supported: bool = dspy.OutputField()
    unsupported_claims: list[str] = dspy.OutputField(desc="Claims not in the docs")

class GroundedSupportBot(dspy.Module):
    def __init__(self):
        self.answer = dspy.ChainOfThought(CitedSupportAnswer)
        self.verify = dspy.Predict(CheckSupported)

    def forward(self, help_docs, question):
        result = self.answer(help_docs=help_docs, question=question)
        check = self.verify(help_docs=help_docs, answer=result.answer)
        return dspy.Prediction(answer=result.answer, is_supported=check.is_supported,
                               unsupported_claims=check.unsupported_claims)


def grounded_bot_reward(args, pred):
    """Reward function enforcing citations and faithfulness."""
    score = 1.0
    answer = pred.answer

    # Enforce citations
    sentences = [s.strip() for s in re.split(r'(?<=[.!?])\s+', answer) if s.strip()]
    cited = [bool(re.search(r"\[\d+\]", s)) for s in sentences]
    coverage = sum(cited) / max(len(sentences), 1)
    if coverage < 0.5 and "don't have info" not in answer.lower():
        return 0.0  # hard: must cite sources

    # Enforce faithfulness
    if not pred.is_supported:
        return 0.0  # hard: no hallucinated claims

    return score

bot = dspy.Refine(module=GroundedSupportBot(), N=3, reward_fn=grounded_bot_reward, threshold=1.0)

# Usage
docs = [
    "[1] Free plan includes 1,000 API calls per month.",
    "[2] Pro plan is $29/month with 50,000 API calls.",
    "[3] Refunds are available within 14 days of purchase.",
    "[4] To cancel, go to Settings > Billing > Cancel Plan.",
]

result = bot(help_docs=docs, question="How do I cancel and get a refund?")
# bot is a Refine wrapper — it retries up to 3 times if citations or faithfulness check fails
print(result.answer)
# "To cancel your plan, go to Settings > Billing > Cancel Plan [4].
#  Refunds are available within 14 days of purchase [3]."

Example 2: Meeting transcript fact-checker

Verify claims made in a meeting summary against the actual transcript.

import dspy
import re

lm = dspy.LM("openai/gpt-4o-mini")  # or "anthropic/claude-sonnet-4-5-20250929", etc.
dspy.configure(lm=lm)

# --- Load transcript ---

def load_vtt(path):
    text = open(path).read()
    lines = [line.strip() for line in text.split("\n")
             if line.strip() and not line.startswith("WEBVTT")
             and not re.match(r"\d{2}:\d{2}", line)
             and not line.strip().isdigit()]
    return " ".join(lines)

def chunk_transcript(text, max_chars=400):
    sentences = re.split(r'(?<=[.!?])\s+', text)
    chunks, current = [], ""
    for s in sentences:
        if len(current) + len(s) > max_chars and current:
            chunks.append(current.strip())
            current = s
        else:
            current = (current + " " + s).strip()
    if current:
        chunks.append(current.strip())
    return [f"[{i+1}] {c}" for i, c in enumerate(chunks)]

# --- Signatures ---

class VerifyClaim(dspy.Signature):
    """Check if a specific claim is supported by the transcript."""
    transcript_passages: list[str] = dspy.InputField()
    claim: str = dspy.InputField()
    is_supported: bool = dspy.OutputField()
    supporting_passage: str = dspy.OutputField(desc="Which passage supports it, or 'none'")

class ExtractClaims(dspy.Signature):
    """Extract individual factual claims from a meeting summary."""
    summary: str = dspy.InputField()
    claims: list[str] = dspy.OutputField(desc="List of individual factual claims")

# --- Module ---

class TranscriptFactChecker(dspy.Module):
    def __init__(self):
        self.extract = dspy.Predict(ExtractClaims)
        self.verify = dspy.ChainOfThought(VerifyClaim)

    def forward(self, transcript_passages, summary):
        extracted = self.extract(summary=summary)

        results = []
        for claim in extracted.claims:
            check = self.verify(
                transcript_passages=transcript_passages,
                claim=claim,
            )
            results.append({
                "claim": claim,
                "supported": check.is_supported,
                "source": check.supporting_passage,
            })

        supported = sum(1 for r in results if r["supported"])
        total = len(results)

        return dspy.Prediction(
            claims=results,
            supported_count=supported,
            total_claims=total,
            accuracy=supported / max(total, 1),
        )

# Usage
transcript_text = load_vtt("standup.vtt")
passages = chunk_transcript(transcript_text)

checker = TranscriptFactChecker()
result = checker(
    transcript_passages=passages,
    summary="The team decided to postpone the launch to April. "
            "Sarah will handle the migration. Budget was approved at $75k."
)

for claim in result.claims:
    status = "supported" if claim["supported"] else "NOT SUPPORTED"
    print(f"  [{status}] {claim['claim']}")
print(f"\nAccuracy: {result.accuracy:.0%}")

Example 3: Medical Q&A with layered verification

High-stakes domain: combine citation enforcement + faithfulness verification + confidence gating.

import dspy
import re

lm = dspy.LM("openai/gpt-4o")  # or "anthropic/claude-sonnet-4-5-20250929", etc.
dspy.configure(lm=lm)

class MedicalAnswer(dspy.Signature):
    """Answer a medical question using only the provided clinical guidelines.
    Cite every claim. If unsure, say so explicitly."""
    guidelines: list[str] = dspy.InputField(desc="Numbered clinical guideline passages")
    question: str = dspy.InputField()
    answer: str = dspy.OutputField(desc="Cited answer from guidelines only")
    confidence: float = dspy.OutputField(desc="0.0-1.0 confidence based on guideline coverage")

class VerifyMedicalClaim(dspy.Signature):
    """Strictly verify: is every medical claim in the answer directly stated in the guidelines?"""
    guidelines: list[str] = dspy.InputField()
    answer: str = dspy.InputField()
    is_faithful: bool = dspy.OutputField()
    unsupported_claims: list[str] = dspy.OutputField()
    risk_level: str = dspy.OutputField(desc="low/medium/high — risk if claim is wrong")

class SafeMedicalQA(dspy.Module):
    def __init__(self, confidence_threshold=0.8):
        self.answer = dspy.ChainOfThought(MedicalAnswer)
        self.verify = dspy.Predict(VerifyMedicalClaim)
        self.threshold = confidence_threshold

        # Use cheaper model for verification
        self.verify.set_lm(dspy.LM("openai/gpt-4o-mini"))  # cheaper model for verification

    def forward(self, guidelines, question):
        result = self.answer(guidelines=guidelines, question=question)
        check = self.verify(guidelines=guidelines, answer=result.answer)

        # Layer 3: Confidence gating
        needs_review = (
            result.confidence < self.threshold
            or check.risk_level == "high"
        )

        return dspy.Prediction(
            answer=result.answer,
            confidence=result.confidence,
            needs_review=needs_review,
            risk_level=check.risk_level,
            is_faithful=check.is_faithful,
            unsupported_claims=check.unsupported_claims,
            cited_nums=set(int(n) for n in re.findall(r"\[(\d+)\]", result.answer)),
            valid_nums=set(range(1, len(guidelines) + 1)),
        )


def medical_qa_reward(args, pred):
    """Reward enforcing citation validity and medical faithfulness."""
    # Layer 1: Citation enforcement — hard constraint
    if not pred.cited_nums.issubset(pred.valid_nums):
        return 0.0

    # Layer 2: Faithfulness — hard constraint for medical safety
    if not pred.is_faithful:
        return 0.0

    return 1.0

qa_module = SafeMedicalQA(confidence_threshold=0.8)
qa = dspy.Refine(module=qa_module, N=3, reward_fn=medical_qa_reward, threshold=1.0)

# Usage
guidelines = [
    "[1] Standard adult ibuprofen dose: 200-400mg every 4-6 hours.",
    "[2] Maximum daily dose without supervision: 1200mg.",
    "[3] Common side effects: stomach upset, dizziness, headache.",
    "[4] Contraindicated with blood thinners and in renal impairment.",
]
result = qa(guidelines=guidelines, question="Can I take ibuprofen with aspirin?")
if result.needs_review:
    print(f"NEEDS PHYSICIAN REVIEW (confidence: {result.confidence}, risk: {result.risk_level})")
print(result.answer)