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Healthcare

Clinical AI, diagnostic bias, patient safety and medical-device regulation — the healthcare front of AI ethics, daily.

REVEAL++: Differentiable Phenotypic Grouping for Vision-Language Retinal Modeling of Alzheimer's Disease Risk

The retina offers a noninvasive window into neurodegenerative disease, capturing subtle structural patterns associated with a risk of future cognitive decline. Vision-language alignment frameworks such as REVEAL have shown that pairing retinal fundus images with structured clinical risk narratives improves early prediction of Alzheimer's disease (AD). A key design choice in these approaches is the use of phenotypic grouping, where individuals with similar risk profiles are treated as multi-posit
arXiv 44d ago Research Safety & alignmentHealthcare

Freeing the Law with LOCUS: A Local Ordinance Corpus for the United States

Progress in legal AI increasingly depends on access to authoritative legal text at scale. Yet one of the most consequential layers of American law remains largely absent from existing machine-readable corpora: local ordinances. Local codes govern zoning, housing, business licensing, public health, noise, animal control, and many other domains of everyday regulation, but they are fragmented across vendor platforms designed for human browsing rather than bulk research access. We introduce LOCUS -
arXiv 44d ago Research RegulationCopyright & IP

"The New Era of Tech-Enabled Traceability": Tensions between the FDA's Data Governance Vision and the Lived Realities of Food Producers

The U.S. Food and Drug Administration (FDA)'s Food Traceability Rule requires agri-food supply chain stakeholders (stakeholders)--including farmers, fishers, retail workers, and others--to maintain detailed tracking records beginning in January 2026. Through this Rule, the FDA envisions a "New Era of Tech-Enabled Traceability," in which standardized, harmonized tracking data serve as a foundational public health infrastructure, enabling more rapid identification and removal of potentially contam
arXiv 44d ago Research RegulationPrivacy

RubricsTree: Scalable and Evolving Open-Ended Evaluation of Personal Health Agents across Health Memory and Medical Skills

The LLM-empowered personal health agents with user health (sensor) metrics have offered a promising pathway to alleviate global disparities in healthcare access. However, large-scale clinical deployment remains constrained by an open-ended evaluation bottleneck: physician annotation is reliable but costly and unscalable, while LLM-as-a-judge evaluators are scalable but subjective, inconsistent, and sometimes clinically misaligned. We introduce RubricsTree, a scalable evaluation framework with an
arXiv 45d ago Research Safety & alignmentHealthcare

WEQA: Wearable hEalth Question Answering with Query-Adaptive Agentic Reasoning

Language models are remarkably capable at medical question answering, in some cases surpassing the accuracy of general physicians. However, answering questions about wearable health data remains challenging and understudied, as these ubiquitous sensors produce continuous, high-dimensional, and longitudinal data, which is non-trivial to align with text-centric distributions in LLM pretraining. The diversity of sensor modalities and user intents cannot be effectively handled by a fixed reasoning w
arXiv 45d ago Research HealthcareAgents & autonomy

Towards Understanding and Measuring COGNITIVE ATROPHY in LLM Behaviour

Recent incidents involving LLMs used for mental-health support reveal a critical evaluation gap: surface-level safety scores do not capture how models behave across realistic, emotionally sensitive interactions over time. Existing benchmarks measure knowledge, safety, or static response quality, but miss whether LLM interactions help users keep reflecting, coping, and making decisions themselves. We formalize this missing dimension as COGNITIVE ATROPHY, a process-level behavioural measure in AI-
arXiv 45d ago Research Healthcare

When LLMs Analyze Scars: From Images to Clinically-Meaningful Features

Medical image classification faces a fundamental dilemma: while deep learning models achieve remarkable performance at scale, real-world clinical scenarios often suffer from severe data scarcity due to annotation costs, privacy constraints, and disease rarity. This challenge is particularly pronounced in pathological scar classification, where differentiating keloids from hypertrophic scars requires subtle expert knowledge and labeled images are extremely limited. We propose a novel paradigm tha
arXiv 45d ago Research PrivacyHealthcare

ProvenanceGuard: Source-Aware Factuality Verification for MCP-Based LLM Agents

Tool-using LLM agents increasingly use the Model Context Protocol (MCP) to answer from heterogeneous evidence sources, including search, APIs, databases, clinical records, and formulary tools. Standard factuality metrics usually test whether an answer is supported by pooled evidence, missing a provenance-sensitive failure mode: a claim may be supported somewhere while being attributed to the wrong source. We call this cross-source conflation. We introduce ProvenanceGuard, a source-aware verifier
arXiv 45d ago Research HealthcareAgents & autonomy

A Quantitative Analysis of Multimodal Biomarkers in Alzheimer's Disease

Despite increasing adoption of multimodal approaches in Alzheimer's Disease (AD) research -- aimed at integrating molecular, structural, clinical, and genetic biomarkers to enhance disease characterization -- the relationships among these modalities remain poorly understood. A systematic analysis of their dynamic interaction is essential for improving disease modeling, identifying redundant assessments, and reducing patient burden and acquisition costs. In this paper, we present a quantitative a
arXiv 45d ago Research Healthcare

AIPatient Arena: EHR-grounded evaluation of large language models in end-to-end clinical consultation workflows

Large language models (LLMs) are increasingly considered for use in clinical consultation tasks, yet most medical evaluations remain static, single-turn, or narrowly outcome-based, limiting their ability to reflect the sequential, uncertain, and interactive nature of real-world care. Here, we propose AIPatient Arena, an EHRs-grounded evaluation framework for assessing the clinical utility of LLMs across eight dimensions of clinical competence. The framework integrates EHR data into patient-speci
arXiv 45d ago Research Healthcare

A Machine-Learned Comorbidity Index

Traditional comorbidity scores (e.g., Charlson and Elixhauser) are widely used for risk adjustment and patient stratification, but they have two key limitations: (i) they are largely mortality-centric and do not align well with other clinical outcomes, and (ii) their linear, rule-based structure cannot capture nonlinear, outcome-specific risk relationships. We propose a Machine-Learned Comorbidity Index (MLCI) that maps diagnosis codes to a single scalar by maximizing the normalized Hilbert-Schm
arXiv 45d ago Research Healthcare

Federated Medical Image Segmentation under Real-World Label Noise: A Benchmark Suite for Noisy Label Learning Method Selection

While federated learning (FL) enables collaborative medical image segmentation without centralizing sensitive data, real-world deployment is frequently complicated by cross-site label imperfections such as contour disagreement, missing or additional structures, and confused labels. Federated noisy label learning (FNLL) aims to mitigate these effects, yet remains underused in practice as existing evidence is largely based on synthetic noise, simplified settings, and limited real-world noisy evalu
arXiv 46d ago Research Healthcare

AgentFairBench: Do LLM Agents Discriminate When They Act?

Large language model (LLM) agents increasingly take actions (screening applicants, recommending credit, triaging patients), yet fairness for LLMs is still measured by grading answers. We introduce AgentFairBench, a cheap, reproducible, multi-domain benchmark for demographic disparity in the actions of LLM agents. Grounded in a companion framework, the Bias Conduction Framework (BCF, restated here), it spans three regulator-anchored domains: hiring, lending, and medical triage. Synthetic, demogra
arXiv 46d ago Research Bias & fairnessRegulation

Unified Multimodal Model for Brain MRI Imputation and Understanding

Multimodal large language models (MLLMs) hold great potential for medicine, as they inherit knowledge from LLM and allow multiple data modalities to be integrated, analysed and interpreted in natural language. However, the field of medical MLLMs is constrained by non-trivial challenges, notably the scarcity of high-quality training data and the frequent occurrence of missing data in the real-world clinical setting. Here, we propose a novel unified multimodal model, UniBrain, for brain magnetic r
arXiv 46d ago Research Healthcare

Measuring Whether LLM Tutors Teach or Solve: A Diagnostic for Educational Impact

Large language models are increasingly proposed as educational tutors, yet stronger task-solving ability does not necessarily imply stronger learning support. Motivated by recent calls to measure the social impact of NLP systems in practice, we study whether public LLM tutoring benchmarks distinguish learning-supportive behavior from mere answer production. We propose a lightweight diagnostic based on the gap between solving-oriented and pedagogy-oriented benchmark performance. Using public Math
arXiv 46d ago Research Healthcare

SciML in the Wild: A Diagnostic Study of When Structural Priors Help and When They Hurt

Scientific Machine Learning (SciML) methods such as Neural Ordinary Differential Equations (NODEs), Physics-Informed Neural Networks (PINNs), and Universal Differential Equations (UDEs) are most effective when structural priors reflect reliable governing dynamics. We ask what happens when this assumption is violated. Using macroeconomic forecasting as a stress-test domain, we evaluate five model families, ARIMA, LSTM, NODE, PINN, and UDE, across 23 countries using sparse annual data, multiple te
arXiv 46d ago Research Healthcare

Informative Missingness to Generate Irregular Clinical Time Series

Laboratory tests in electronic health records are collected irregularly, and the absence of a test order can be as informative as the measurement itself. Such missingness reflects clinicians' decisions and patient physiology, making it important to model it directly rather than treat it as a preprocessing artifact. Here we present a diffusion-based approach for generating clinical time series that jointly models laboratory values and their observation patterns using the public Data Analytics Cha
arXiv 47d ago Research Healthcare

CAP: Towards PPG Universal Representation Learning with Patient-level Supervision

Photoplethysmography (PPG) plays a central role in wearable health monitoring and clinical decision support. Yet existing approaches to universal PPG representation learning largely focus on signal-level objectives and often overlook patient-level health context, which limits generalization to complex clinical tasks and heterogeneous cohorts. To address this gap, we construct a large-scale paired PPG-EHR multimodal dataset by distilling fragmented medical histories and clinical records into cohe
arXiv 48d ago Research Healthcare

Landmark-free Assessment of Lower-limb Alignment with Implicit Neural Shape Functions from Knee Radiographs

Radiographic assessment of lower-limb alignment (LLA) is important for predicting joint health and surgical outcomes in total knee arthroplasty. Traditional measurement methods are manual and time-consuming, while recent machine learning approaches typically rely on locating a fixed set of anatomical landmarks. This dependence limits flexibility and may require re-annotation when clinical definitions change. To address this, we propose an automated workflow using Implicit Neural Shape Functions
arXiv 48d ago Research Safety & alignmentHealthcare

EyeMVP: OCT-Informed Fundus Representation Learning via Paired CFP--OCT Pretraining

Color fundus photography (CFP) is the mainstay of large-scale retinal screening, but its diagnostic capacity is limited by the lack of depth-resolved structure, which optical coherence tomography (OCT) provides yet is less accessible at population scale. We present EyeMVP, a cross-modal retinal foundation model that uses paired CFP--OCT pretraining to learn OCT-informed CFP representations while requiring only CFP at inference. Pretrained on 674,893 same-eye same-day CFP--OCT triples from 112,64
arXiv 48d ago Research Healthcare

Bridging Geographic Bias in Urban Streetscape Inference via Lifelong Learning with Visual-Semantic Pivoting

Visual perception of urban streetscapes underpins evidence-based decisions in landscape planning, public health, and place-making. Yet models trained on a few well-photographed metropolises systematically misjudge underrepresented districts, propagating geographic bias into downstream policy. We address this gap with HVSP-LL, a lifelong learning framework that couples a stratified visual-semantic pivoting module with an equity-aware rehearsal mechanism. The pivoting module organises landscape co
arXiv 48d ago Research Bias & fairnessRegulation

Beyond the Algorithm: Professional Experiences and Perceptions of AI Bias

The purpose of this qualitative multi-case study was to examine how social bias emerges, is perceived, and can be mitigated within artificial intelligence and machine learning systems by practitioners directly involved in their design, development, and governance. Although examples from healthcare, criminal justice, employment, and education were used to illustrate domains where automated systems shape everyday life, the study focused on the lived experiences and professional insights of AI prac
arXiv 48d ago Research Bias & fairnessRegulation

Fusion is not one-size-fits-all: Cross-Modal Representation Alignment for Time-to-Event Modeling

Accurate time-to-event (TTE) prediction from multimodal clinical data remains challenging due to modality imbalance and distribution shift. We introduce a foundation model-driven framework for cross-modal representation alignment between CT imaging and longitudinal EHR data, designed to generalize across tasks and institutions. CT and EHR modalities are encoded independently using domain-specific foundation models and aligned in a shared latent space through four principled fusion strategies: la
arXiv 48d ago Research Safety & alignmentHealthcare

Explaining RhythmFormer: A Systematic XAI Analysis of Periodic Sparse Attention for Remote Photoplethysmography

Remote photoplethysmography (rPPG) transformers achieve low heart-rate error on benchmarks, yet their decisions remain opaque--a growing concern as rPPG moves toward clinical heart rate estimation. Existing rPPG XAI is dominated by qualitative heatmap inspection without quantitative faithfulness metrics or physiology-grounded validation, leaving a gap between visual plausibility and auditable evidence. We address this gap. First, we adapt four attribution methods (raw attention, rollout, flow, B
arXiv 50d ago Research HealthcareTransparency

ERTS: Adversarial Robustness Testing of Ethical AI via Semantic Perturbation in a Bounded Consequence Space

As AI systems are deployed in high-stakes ethical contexts such as healthcare triage, autonomous vehicle control, and employment screening, formal methods for evaluating their robustness against adversarial manipulation of ethical reasoning remain underdeveloped. This paper introduces the Ethical Robustness Testing System (ERTS), a closed-pipeline framework that: (1) encodes ethical dilemmas into a 22-dimensional Ethical Consequence Space (ECS) grounded in established ethical theory; (2) applies
arXiv 50d ago Research Jobs & economyHealthcare

LLM-as-an-Investigator: Evidence-First Reasoning for Robust Interactive Problem Diagnosis

Large language models (LLMs) are increasingly used as interactive assistants for technical problem solving. However, when users provide incomplete descriptions or plausible but unverified explanations, LLMs may prematurely align with these assumptions and propose solutions before collecting sufficient evidence. We refer to this behavior as user-driven sycophancy: the tendency of an LLM to reinforce a user-provided hypothesis instead of testing alternative explanations. This paper introduces LLM-
arXiv 50d ago Research HealthcareFinance, VC & PE

Mental-R1: Aligning LLM Reasoning for Mental Health Assessment

Mental health problems such as anxiety, depression, and suicide remain urgent global challenges, where timely and accurate assessment is critical for effective intervention. Recently, large language models have been explored for mental health assessment. However, existing general-purpose post-training methods do not align with the cognitive processes of human assessment, which may lead to unreliable reasoning outcomes. To bridge this gap, we propose Cognitive Relative Policy Optimization (CRPO),
arXiv 50d ago Research RegulationHealthcare

CalBrief: A Pilot Diagnostic Benchmark for Evidence-Calibrated Scientific Briefing with Large Language Models

Large language models (LLMs) are increasingly used as research assistants, yet it remains unclear whether they can calibrate research takeaways to the strength and scope of the supporting evidence. We study evidence-calibrated scientific briefing: given a bounded package of related papers, a system should generate package-level takeaways with evidence strength, scope boundaries, and missing-evidence caveats. We contribute a verified pilot benchmark of 16 heterogeneous scientific evidence package
arXiv 50d ago Research Healthcare

Acquisition state behaves as a structured, measurable variable governing lung-nodule AI: kernel-driven measurement instability and noise-driven detection fragility, invisible to DICOM metadata

AI governance for medical imaging is formalizing: the 2026 ACR-SIIM Practice Parameter recommends local acceptance testing and ongoing drift monitoring, and the ACR Assess-AI registry monitors AI outputs using DICOM metadata for context. We argue that a necessary, currently unmonitored layer sits beneath output metrics: whether incoming studies remain within the acquisition envelope a model was validated on. Using a LUNA16-trained MONAI RetinaNet lung-nodule detector, we test whether acquisition
arXiv 50d ago Research RegulationHealthcare

The Containment Gap: How Deployed Agentic AI Frameworks Fail Public-Facing Safety Requirements

Agentic large language model systems that autonomously invoke tools, maintain persistent memory, and execute multi-step plans are increasingly deployed in public-facing domains, including government services, healthcare triage, and financial advising. We ask whether the frameworks used to build these systems provide architectural-level structural safety guarantees. Applying six containment principles derived from a compositional model of agentic architectures, we audit three dominant frameworks
arXiv 50d ago Research HealthcareAgents & autonomy

Analyzing and Improving Fine-grained Preference Optimization in Medical LVLMs

Large Vision-Language Models (LVLMs) have achieved strong performance across medical imaging tasks, yet they remain prone to factual inconsistencies, poor visual grounding, and misalignment with clinically meaningful feedback. Existing post-training alignment approaches, including Direct Preference Optimization (DPO) and its variants, face three critical limitations in the medical domain: (1) sequence-level reward signals treat clinically critical tokens identically to generic filler text; (2) r
arXiv 51d ago Research Safety & alignmentHealthcare

Making Foresight Actionable: Repurposing Representation Alignment in World Action Models

World Action Models (WAMs) offer a promising route for robot manipulation by using video generation models to model future scene evolution before producing control actions. However, our empirical observations reveal a phenomenon: generating plausible visual futures does not always guarantee the extraction of accurate actions. To diagnose this failure, we conduct action-head attention analysis and causal interventions. We find that the action decoder fails to focus on task-relevant interaction re
arXiv 51d ago Research Safety & alignmentHealthcare

OpenMedReason: Scientific Reasoning Supervision for Medical Vision-Language Models

High-stakes clinical use of large vision-language models (LVLMs) requires reasoning that is grounded in visual evidence and clinical knowledge, not just correct final answers. We introduce OpenMedReason, a large-scale, open multimodal medical reasoning corpus comprising approximately 450K image-question-answer instances whose reasoning traces are primarily derived from curated biomedical, human-authored scientific articles. OpenMedReason provides high-fidelity supervision beyond synthetic chains
arXiv 51d ago Research Healthcare

Substrate Asymmetry in User-Side Memory: A Diagnostic Framework

User-side memory in LLMs is typically scored as a single "personalization" capability: given a user's history, is the output more user-aware? We show this aggregate metric hides opposite-direction failures. Memory factorises into at least three orthogonal axes -- behavioral consistency (style, voice), factual presence (recall facts in history), and factual absence (abstain when a fact is absent) -- and no single substrate wins all three. Comparing per-user gamma-LoRA (a small LoRA adapter traine
arXiv 51d ago Research Healthcare

FADA: Accessible fetal ultrasound interpretation and annotation with a selectively distilled unified vision-language model

A global shortage of trained sonographers limits prenatal ultrasound screening in low- and middle-income countries, where over half of pregnant women receive no skilled sonography. Current deep learning approaches address detection, segmentation, or classification in isolation, each demanding a separate model and expert-specified labels at inference. We present FADA, a unified vision-language model built on Qwen3.5-VL that performs clinical interpretation, classification, detection, and segmenta
arXiv 52d ago Research Healthcare

Position: AI Must Become Planet-Centered, Not Just Human-Centered

This position paper argues that contemporary AI paradigms are insufficient for supporting complex global goals and introduces Planet-Centered AI (PCAI) as a design philosophy and research agenda that reorients AI toward planetary-scale socio-ecological systems and their long-term trajectories. A planet-centered approach is grounded in systems thinking, treating Earth as an interconnected whole of which humans are part. We diagnose recurring limitations across AI frameworks, many of which remain
arXiv 52d ago Research Healthcare

Dep-LLM: Training-Free Depression Diagnosis via Evidence-Guided Structured Multi-factor with Reliable LLM Reasoning

Automatic Depression Detection (ADD) from clinical interviews is a pivotal task in computational mental health, yet it remains challenging due to two critical obstacles: 1) difficulty in modeling complex but sparsely distributed depression clues within lengthy, multi-topic clinical interviews, leading to superficial and unreliable reasoning; 2) scarcity of labeled data due to clinical privacy, together with high cost of training and fine-tuning, limiting the deployment of supervised ADD systems.
arXiv 52d ago Research PrivacyHealthcare

When the Chain of Thought Knows Better: Failure Modes in Multi-Turn Reasoning Models

Failures in multi-turn reasoning models are largely invisible to terminal-score evaluation. A model can lock onto an unsafe stance early in a long dialogue, yet its final-turn refusal rate may appear indistinguishable from a robustly aligned baseline. To expose these hidden temporal dynamics, we propose a trace-level diagnostic - the CoT-Output 2x2 safety matrix. This framework labels every turn along two independent axes (internal reasoning and visible output), yielding four operationally defin
arXiv 52d ago Research Healthcare

The Confident Liar: Diagnosing Multi-Agent Debate with Log-Probabilities and LLM-as-Judge

Multi-agent debate systems are typically evaluated only on whether the final answer is correct, overlooking the quality of the intermediate reasoning that debate is designed to produce. This paper studies the relationship between three signals in multi-agent debate: token-level log-probability distributions over reasoning tokens, LLM-as-judge rubric scores assigned to those tokens, and final task accuracy. We examine whether internal confidence signals predict externally evaluated reasoning qual
arXiv 52d ago Research HealthcareAgents & autonomy

CCBENCH: Assessing LLM Cultural Competence via Implicitly Signaled Norms using Health Queries

To interact with users fairly and without stereotyping, AI models must display cultural competency, i.e., the ability to infer and adapt to a user's implicitly signaled cultural values, rather than relying on static demographic traits. We introduce CCBENCH, a framework for evaluating cultural competency in large language models (LLMs), treating culture as a continuum of norm adherence states rather than as a binary state of cultural belongingness. As a case study on health, we create CCBENCH-Hea
arXiv 52d ago Research Healthcare
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