MCP server operationalizing the TARGET reporting guideline (Cashin et al., JAMA/BMJ 2025) as a deterministic, provenanced scoring engine for target trial emulation studies
Project description
TARGET Checklist MCP Server
An MCP server that operationalizes the TARGET reporting guideline (TrAnsparent ReportinG of observational studies Emulating a Target trial; Cashin et al., JAMA/BMJ, September 2025) as a deterministic, provenanced scoring engine for target trial emulation (TTE) studies.
This is the executable TARGET: not a manuscript auditor that renders an opinion, but a measurement instrument that produces a structured, item-by-item, evidence-linked matrix with fixed model provenance, so a corpus-scale result is reproducible.
See ../target-mcp-server-design.md for the full design rationale.
Status — vertical slice
Built and proven end-to-end:
- Spec layer — the 21 published items decomposed into 39 scoreable leaf
subitems, encoded as versioned YAML (
target_mcp/specs/target-0.1.0.yaml) with own-words intent, verdict boundaries, signal terms, the 6x↔7x specification/emulation pairing, and applicability rules. Structurally validated on load (spec.py). - Ingestion layer — PDF/text/docx →
SectionMapwith character-offset, source-tagged section spans (main vssupplement:<file>), protocol-table and flow-diagram detection, extractor version + text hash stamps, and whitespace-insensitive quote→span resolution. Supports multi-document bundles (main text + supplements) viabuild_bundle(ingest.py). - Retrieval layer — the corpus/batch and convenience path: fetch
open-access articles by PMCID from Europe PMC (JATS main text plus PMC-hosted
supplementary files, merged into one bundle). Use this when there is no file
in hand or to auto-fetch an OA paper's supplement; for a manuscript you were
given, ingest the file directly (
retrieve.py). - Assessment layer — batched, single-pass scoring of all applicable leaves.
Scaffold mode (default) is the path for reviewing a publication: the agent
already in the loop is the scorer, so the server returns the exact prompt +
schema for it to run, then validates the verdicts it submits. Judge mode
is for the headless/batch case (no LLM in the loop) — the server makes its own
pinned model call so a corpus run is reproducible and caller-independent. Both
share one validation path that enforces leaf coverage, verdict vocabulary, and
mandatory verbatim evidence resolved to spans with a
source_documenttag (assess.py). - Rendering layer —
render_checklistprojects a finalized assessment onto the published TARGET checklist form (all 39 rows, verbatim item wording under CC BY-ND, a Location-reported column from the resolved evidence spans; the enriched view adds verdict + evidence).render_checklist_docxwrites the same as a submission-ready Word file (render.py,render_docx.py). - Corpus & validation layers —
aggregate_corpusrolls many assessments into per-item completeness rates with coverage denominators (corpus.py);validate.pyprovides blind human coding-sheet generation and per-leaf agreement (raw, Cohen's κ, Gwet's AC1, sensitivity/specificity) against a gold standard. - Composition layer — FastMCP server (
server.py) exposing eleven tools. The primary manuscript flow isparse_manuscript(parse the file you were given, withsupplements=when available) →assess_manuscript→submit_scaffold_verdicts→render_checklist(orrender_checklist_docx). Supporting tools:parse_pmcid(corpus/batch or OA-supplement fetch),get_checklist(introspect the spec),aggregate_corpus,build_coding_sheet, andvalidate_against_gold.
Not yet built (see design doc): assess_item, check_emulation_coherence,
export_identifiability_spec, publisher-site supplement retrieval (beyond the
PMC-OA tier), better table extraction, and the separate materiality/design-risk
layer.
Provenance stamped on every assessment
spec_version, resolved model id, temperature, prompt_hash,
prompt_template_version, extractor_version, text_sha256, assessed_at,
full_text_available, supplement_status, and a per-source documents list;
each evidence item carries its resolved span, section, and source_document.
A span is only meaningful alongside the extractor version and text hash, so
they travel together.
Reporting completeness, not a pass/fail verdict
The instrument scores how completely a manuscript reports what the checklist
requires — not study quality, and it issues no pass/fail judgment. TARGET
presents all 21 items as essential minimum items with no tiering, and this
tool follows suit: the output is the 39 per-leaf verdicts with evidence and a
completeness tally. (An earlier "critical floor" — a BSCL pass/fail overlay over
six leaves — was removed in 2026-07-19 as off-message and confusing; see
docs/DECISIONS.md.) Do not present a verdict matrix as TARGET compliance.
Install
The server and the optional orchestration skill ship together in this repo, but they activate through two separate mechanisms — installing one does not enable the other. Getting the files (clone/download) gives you both; then do the two activation steps below.
1. Install the server
git clone https://github.com/Black-Swan-Causal-Labs/target-mcp.git
cd target-mcp
python3 -m venv .venv
.venv/bin/pip install -e .
(Once published to PyPI: pip install target-mcp.)
Run it standalone (stdio transport) to smoke-test:
.venv/bin/target-mcp
2. Register the server with your MCP client
Add it to the client's MCP config with an absolute path. For Claude Desktop
that file is ~/Library/Application Support/Claude/claude_desktop_config.json
(macOS); for a Claude Code project use .mcp.json:
{
"mcpServers": {
"target-checklist": {
"command": "/ABSOLUTE/PATH/TO/target-mcp/.venv/bin/python",
"args": ["-m", "target_mcp.server"]
}
}
}
Restart / reconnect the client. Confirm it exposes 11 tools (a stale process may show fewer — respawn it). The server is now fully usable on its own: any MCP client can run parse → assess → submit → render in a single scaffold pass.
3. (Optional, Claude Code only) Activate the fan-out skill
.claude/skills/target-checklist-fanout/ encodes the parallel-subagent
orchestration that scores the 39 leaves concurrently (~2 min vs ~20 min). It is
an accelerator, not a dependency — it only works in clients that can spawn
subagents (the Claude Code CLI, or the Claude Desktop Code/Cowork tabs; the
plain Chat tab cannot, and non-Claude clients like Codex ignore it). Without
it, everything still works via the single-pass fallback.
A Claude Code session discovers the skill when its working directory is this repo. To make it available in every session regardless of directory, copy it to the user scope:
mkdir -p ~/.claude/skills
cp -R .claude/skills/target-checklist-fanout ~/.claude/skills/
For the skill to actually run, all three must be present: the server (step 2), the skill (this step), and a subagent-capable client.
Judge mode (headless/batch, optional)
Judge mode needs ANTHROPIC_API_KEY in the environment. The pinned model is
claude-sonnet-5 by default; override with TARGET_JUDGE_MODEL.
Batch / corpus runs
Scoring hundreds of papers is a headless job, not an interactive MCP call (a
multi-hour tool call would blow the client's request timeout). Use the
target-mcp-corpus CLI: it fetches + judges a list of PMCIDs concurrently,
isolates per-paper failures, retries transient errors, and rolls up the
aggregate.
# ids.txt: one PMCID per line (#-comments and blanks ignored)
ANTHROPIC_API_KEY=sk-... target-mcp-corpus ids.txt -o out/ -j 12
-j/--workersbounds concurrency (default 8; raise toward your API rate limit). Judge is ~a few minutes/paper, so wall-clock ≈papers / workers × per-paper— e.g. 300 papers at 12 concurrent ≈ 1–1.5h, versus ~10–20h serial.-o/--out-dirwrites one JSON per assessment plusaggregate.jsonandsummary.json(with per-paper stamps, verdict tallies, and any failures). Without-o, the aggregate prints to stdout.--modeloverrides the pinned judge model;--no-supplementsskips supplement retrieval.
Judge mode records the resolved model id per paper, so a corpus aggregate is
truthfully provenanced and caller-independent. Re-roll-up saved assessments any
time with the aggregate_corpus MCP tool.
Tests
.venv/bin/python -m pytest tests/ -q
Covers spec validation, section mapping and quote resolution, the finalize + evidence-resolution path, evidence-required and coverage-mismatch guards, applicability rules, abstract-only full-text gating, corpus aggregation, the validation harness, checklist rendering (Markdown + .docx), and prompt-hash stability.
Licensing / commons hygiene
The encoded checklist is a re-encoding of item intent in own words plus
assessor notes; it does not reproduce the TARGET checklist wording verbatim.
The original checklist is © the TARGET group under CC BY-ND 4.0. When the
Explanation & Elaboration document is released, leaves flagged
e_e_pending: true should be re-checked and the spec bumped to a clean minor
release. Do not copy E&E text verbatim.
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