Evaluating Factual Density in Multi-Source RAG: A Study in Medical AI Accuracy

Abstract

Retrieval-Augmented Generation (RAG) is the current industry standard for grounding AI in real-world facts. Traditional retrieval methods rely on keyword matching and topic proximity, ranking content based on how closely it sounds like the user's query. What they do not measure is how many verified facts the content actually contains. This structural gap, termed the Expert Blindness Effect, causes standard RAG pipelines to consistently bury high-density factual evidence in favor of lexically dominant text on the same topic. To address this gap, this paper introduces Factual Density (FD*), a novel retrieval optimization signal that measures the proportion of verified atomic claims relative to total token count. Using the NexusAgentics Ghost Audit preprocessing pipeline, raw text is scored for factual specificity using probabilistic factuality analysis to filter content before corpus ingestion. An initial formulation introduced a severe document-length confound (Pearson R = -0.8636, p = 2.27e-07). Implementing Z-score normalization within length bins resolved this bias, validating FD* as a length-independent density signal (p = 0.0749). Evaluated against the HealthFC benchmark (750 health claims labeled Supported, Refuted, or No Evidence by medical experts), FD*-optimized retrieval was the only condition to achieve 100% systematic review saturation in top-5 results, surfacing Cochrane evidence that standard cosine similarity ranked outside the top ten. Ground truth verification confirmed 25 mappings across seven HealthFC-supported claims. While full statistical validation across n=50 queries remains future work due to constraints on corpus-benchmark alignment, these findings establish factual density reranking as a low-cost, high-impact intervention for improving factual precision in health RAG architectures.