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01.
arXiv (quant-ph) 2026-06-19

Benchmark of quantum algorithms for ground state preparation in the presence of noise

arXiv:2606.20551v1 Announce Type: new Abstract: We compare the performance of representative cooling, adiabatic, and optimization algorithms for ground-state preparation in the presence of noise. Using an exactly solvable family of quadratic fermionic Hamiltonians subject to depolarizing noise, we derive the scaling of the achievable relative energy as a function of the noise rate and support these results with numerical simulations. The Hamiltonian exhibits two phases, separated by a quantum phase transition. As expected, the performance of the different algorithms depends on the phase: adiabatic evolution is favorable in the trivial phase, while a multi-frequency cooling algorithm, as proposed in [1], becomes competitive or superior in the topological phase, where gap-closing limits adiabatic protocols. We further present numerical results for the quantum approximate optimization algorithm [2], showing that it performs competitively with cooling in the trivial phase but is typically outperformed in the topological regime. Finally, we show that for this model the cooling protocol exhibits enhanced robustness to parameter imperfections, highlighting its potential advantage for realistic implementations of noisy quantum state preparation. The analytical approach developed here, in conjunction with numerical validation, establishes an extendable approach to benchmarking ground-state preparation algorithms.

02.
arXiv (CS.LG) 2026-06-19

Towards Modality-imbalanced Federated Graph Learning: A Data Synthesis-based Approach

arXiv:2606.20382v1 Announce Type: new Abstract: MultiModal Federated Graph Learning (MM-FGL) offers a natural collaborative training paradigm, but its practical deployment is challenged by two granularities of modality imbalance. Client-level imbalance occurs when certain clients lack entire modalities, while node-level imbalance occurs when individual nodes exhibit missing visual or textual attributes. While several relevant studies exist, our investigation reveals that they predominantly target graph-agnostic or centralized scenarios, rendering them difficult to adapt directly. To address these challenges, we formalize modality-imbalanced MM-FGL as an implicit graph-aware latent semantic representation synthesis problem. This paradigm recovers missing modal semantics directly within the representation space, thereby maximizing alignment with the original data's semantic distribution and mitigating the high variance induced by missing modalities. To this end, we propose FedMGS (Federated Modality-aware Graph Synthesis), which integrates three core components. The availability-aware graph encoder prevents missing modalities from contaminating local structural propagation. The prototype-guided latent semantic synthesizer establishes cross-client semantic anchors for unavailable modalities. The reliability-calibrated semantic fusion mechanism regulates the impact of recovered latent representations prior to predictive readout. Extensive experiments on four tasks show that FedMGS consistently outperforms competitive baselines with gains up to 17.41% with best efficiency-performance tradeoff.

03.
arXiv (CS.CV) 2026-06-11

MedVeriSeg: Teaching LISA-Like Medical Segmentation Models to Verify Query Validity Without Extra Training

Despite recent progress in text-prompt-based medical image segmentation, existing LISA-like MLLM-based methods typically generate masks regardless of whether the target specified in the query is present, leading to hallucinated segmentation. In this work, we propose MedVeriSeg, a training-free query verification framework that enables LISA-like medical segmentation models to reject false segmentation queries. MedVeriSeg first quantifies the response quality between the [SEG] token and image features through a Similarity Response Quality Scoring Module. To further improve robustness, it employs a Lightweight Routed Multi-Agent Verification Module, which fuses quantitative score evidence with qualitative agent evidence to comprehensively verify the validity of the query. To support systematic evaluation, we construct MedVeriSeg-Bench, a benchmark designed for query verification in medical image segmentation. Experimental results demonstrate that MedVeriSeg effectively identifies false segmentation queries and reduces hallucinated segmentation, while maintaining a high acceptance rate for valid queries, thereby largely preserving the segmentation utility of LISA-like medical segmentation models.

04.
arXiv (CS.LG) 2026-06-15

The Risk Shadow of Principal Component Analysis: When 99.9999% Variance Preservation Causes Catastrophic Decision Errors

arXiv:2606.14533v1 Announce Type: new Abstract: Principal Component Analysis (PCA) preserves variance, not the information needed to detect rare catastrophic events. This paper proves the existence of a {\it Risk Shadow}: PCA can retain over 99.9999 percent of total variance while completely erasing all signal about rare, high-impact failures. When this happens, even the best possible classifier operating on the PCA representation reduces to a constant predictor. The root cause is a fundamental mismatch between variance maximization and tail risk awareness. To break the shadow, we introduce Expectile PCA (ExPCA) and Tail-Preserving PCA (TP-PCA), two methods that reweight the data covariance toward high-impact events. We prove theoretically that ExPCA strictly outperforms PCA in retaining rare-event information, and we validate our claims on synthetic data and a real-world credit card fraud detection benchmark. Our results call for a fundamental rethinking of variance-based dimensionality reduction in high-stakes decisions.

05.
arXiv (quant-ph) 2026-06-12

QuBE/Qubex: an integrated hardware-software system for superconducting qubit experiments with broadband control

arXiv:2606.13010v1 Announce Type: new Abstract: Achieving high-fidelity operation in large-scale superconducting qubit systems requires not only control hardware with broad frequency coverage, low crosstalk, and tight synchronization but also software that coordinates system configuration, experiment execution, and data analysis. Here we present an integrated qubit-control system that combines broadband microwave hardware with a pulse-level software stack for scalable superconducting qubit experiments. The hardware provides broadband microwave coverage, including an instantaneous span of up to 1.6 GHz from a control output, while the software reduces setup and calibration overhead through automated configuration and built-in experiment workflows. We validate the system on a 64-qubit fixed-frequency transmon chip through full-chip frequency identification and representative demonstrations, including multi-unit far-detuned cross-resonance calibration and benchmarking that yields a measured two-qubit gate fidelity of 98.34%, and multilevel readout beyond the computational subspace. By disclosing the hardware architecture and releasing the software stack as open source, this work provides an inspectable hardware-software foundation for scalable superconducting qubit control experiments.

06.
arXiv (CS.CL) 2026-06-18

Low-resource Language Discrimination Towards Chinese Dialects with Transfer learning and Data Augmentation

Chinese dialects discrimination is a challenging natural language processing task due to scarce annotation resource. In this article, we develop a novel Chinese dialects discrimination framework with transfer learning and data augmentation (CDDTLDA) in order to overcome the shortage of resources. To be more specific, we first use a relatively larger Chinese dialects corpus to train a source-side automatic speech recognition (ASR) model. Then, we adopt a simple but effective data augmentation method (i.e., speed, pitch, and noise disturbance) to augment the target-side low-resource Chinese dialects, and fine-tune another target ASR model based on the previous source-side ASR model. Meanwhile, the potential common semantic features between source-side and target-side ASR models can be captured by using self-attention mechanism. Finally, we extract the hidden semantic representation in the target ASR model to conduct Chinese dialects discrimination. Our extensive experimental results demonstrate that our model significantly outperforms state-of-the-art methods on two benchmark Chinese dialects corpora.

07.
arXiv (CS.CL) 2026-06-18

Montreal Forced Aligner and the state of speech-to-text alignment in 2026

The Montreal Forced Aligner (MFA) was released in 2016 and has since become the most widely used tool for forced alignment in research and industry. In the decade since, MFA has undergone substantial development, including expanded coverage across more languages and dialects using larger open-source datasets, harmonized IPA dictionaries, model adaptation, cross-language phone remapping, and support utilities. This paper documents MFA 3.0's developments since version 1.0 and evaluates MFA's performance across English, Japanese, and Korean, benchmarked against classic and neural forced aligners. MFA 3.0 achieves state-of-the-art or near state-of-the-art performance across all four benchmark datasets with mean boundary errors below 15 ms. Adaptation and cross-language remapping are effective for languages outside MFA's training distribution, and pronunciation probability modeling and phonological rules provide gains in specific conditions.

08.
arXiv (CS.CL) 2026-06-12

Localizing Anchoring Pathways in Language Models

Irrelevant numbers in a prompt can shift language model judgments, producing anchoring effects in numerical reasoning. We study where this anchor-sensitive signal is carried inside language models using a controlled multiple-choice setup with shared answer options. We define a logit-difference metric comparing the correct answer option with the answer option corresponding to the anchor, and validate that it tracks behavioral anchoring. Using attribution-based circuit localization on 7B–8B Qwen and Llama base and instruction-tuned models, we find that edge-level methods recover this signal more faithfully than node-level methods. Low- and high-anchor circuits transfer strongly within a model, suggesting shared pathway structure across anchor direction. However, sparse transfer across base and instruction-tuned variants is less reliable, indicating that post-training changes which pathways matter most. Overall, our results provide a mechanistic account of how anchoring-related decision signals are carried inside language models.

09.
arXiv (CS.LG) 2026-06-24

Federated Survival Analysis in Healthcare: A Multi-Model Evaluation on Cross-Institutional Heterogeneous Breast Cancer Data

arXiv:2606.23871v1 Announce Type: new Abstract: Survival analysis is central to clinical decision-making, yet reliable time-to-event models require large, diverse cohorts that are rarely available at a single institution, while privacy regulations restrict the centralization of patient data. Federated learning (FL) offers a privacy-preserving alternative by training shared models without exchanging raw data, but its effectiveness for survival modeling under realistic, heterogeneous conditions remains insufficiently understood. This paper presents a systematic, multi-model evaluation of federated survival analysis on a cross-institutional breast cancer cohort with naturally heterogeneous distributed clients. Three representative survival models, the Cox Proportional Hazards model, DeepSurv, and Random Survival Forest (RSF), are compared across centralized, local, and federated training, and three federated optimization strategies (FedAvg, FedProx, and FedAdam) are assessed for the gradient-based models. Results show that FL consistently outperforms local training and approaches, and occasionally exceeds, centralized performance, while RSF offers the best overall balance of discrimination, calibration, and robustness across heterogeneous clients. We further find that performance depends on the diversity of client distributions, and that FedAvg and FedProx are stronger and more stable than FedAdam. Based on these findings, we derive practical, decision-oriented guidelines mapping data, privacy, interpretability, and resource constraints to recommended model and training-paradigm choices for federated survival modeling in healthcare.

10.
medRxiv (Medicine) 2026-06-15

Multi-domain AD risk burden and plasma biomarkers in cognitively unimpaired adults

Introduction: Alzheimer's disease (AD) pathology accumulates decades before symptom onset, yet how the cumulative effect of genetic, familial, and modifiable lifestyle risk burden jointly affects plasma biomarker levels and trajectories in cognitively unimpaired older adults remains unknown. Methods: We analyzed data from 261 participants in the PREVENT-AD cohort. A composite risk score integrating APOE e4 status, polygenic score, family history, and modifiable/lifestyle risk was examined against six plasma biomarkers using linear regression and linear mixed-effects models. Results: APOE e4 was the strongest predictor of plasma biomarker levels. Higher composite risk burden was associated with elevated ptau181, ptau217, ptau217/Ab42, and GFAP levels, and lower Ab42/40 levels. A higher risk burden was predictive of accelerated ptau181 accumulation. Discussion: Cumulative AD risk burden is broadly associated with plasma biomarker levels and specifically predicts accelerated ptau181 accumulation in cognitively unimpaired older adults, supporting structured composite risk profiling as a framework for AD risk stratification.

11.
arXiv (math.PR) 2026-06-15

Asymptotic analysis of the normal inverse Gaussian cumulative distribution

arXiv:2509.05664v2 Announce Type: replace-cross Abstract: Using a recently derived integral in terms of elementary functions, we derive new asymptotic expansions of the normal inverse Gaussian cumulative distribution function. One of the asymptotic representations is in terms of the normal Gaussian distribution or complementary error function.

12.
arXiv (CS.AI) 2026-06-11

End-to-End Machine Learning for Depressive State Classification via EEG and fNIRS

arXiv:2606.11555v1 Announce Type: cross Abstract: The escalating demand for mental healthcare, driven by rising societal stress, highlights the limitations of traditional psychiatric diagnostics. Conventional methods - relying primarily on clinical interviews and patient self-reports - are inherently vulnerable to subjective bias and the varying empirical judgment of practitioners. To address the need for quantitative evaluation, biological signal-based detection, including electroencephalography (EEG) and functional near-infrared spectroscopy (fNIRS), has emerged as a promising objective alternative. Such technology is particularly vital for identifying latent depressive states that may be unrecognized by the subjects themselves. Furthermore, in aging populations, the high comorbidity between depression and dementia necessitates early differentiation to prevent mutual symptom exacerbation and maintain Quality of Life (QoL). This pilot study of eleven healthy students establishes a framework for biological signal-based depression detection, serving as a foundational step toward automated, objective diagnostic tools for clinical use.

13.
arXiv (CS.CV) 2026-06-17

Graph Neural Networks for Semi-Supervised Image Classification with Multi-Feature Aggregation

Feature extraction involves the identification and extraction of salient characteristics or patterns, including edges, textures, shapes, and color attributes. Contemporary feature extractors predominantly leverage deep learning architectures, such as Convolutional Neural Networks (CNNs) and Vision Transformers (VITs). The availability of diverse feature extractors in the literature provides a wide range of feature representations. Features extracted from an image depend on the specific application, the chosen extractor, and its configuration. Therefore, integrating complementary information by combining distinct extractors offers a promising way to enhance performance. Graph Neural Networks (GNNs), particularly Graph Convolutional Networks (GCNs), have emerged as powerful and widely adopted approaches for semi-supervised image classification, as they effectively leverage both labeled and unlabeled data while exploiting the underlying graph structures that capture relationships among samples. This study proposes a novel approach for GNNs in scenarios where labeled data is scarce, by integrating diverse sets of feature and graph representations derived from various extractors in classification scenarios. Experimental investigations were conducted, encompassing combinations of distinct feature and graph extractors, as well as rank aggregation strategies. The primary contributions of this work are underscored by the experimental findings, which demonstrate that the strategic combination of feature and graph representations, coupled with the application of manifold learning for graph processing, leads to significant improvements in classification accuracy across the majority of experimental conditions. Furthermore, the utilization of rank aggregation techniques to integrate features from different extractors was shown to enhance classification accuracy.

14.
arXiv (CS.CL) 2026-06-15

Rethinking the Trust Region in LLM Reinforcement Learning

Reinforcement learning (RL) has become a cornerstone for fine-tuning Large Language Models (LLMs), with Proximal Policy Optimization (PPO) serving as the de facto standard algorithm. Despite its ubiquity, we argue that the core ratio clipping mechanism in PPO is structurally ill-suited for the large vocabularies inherent to LLMs. PPO constrains policy updates based on the probability ratio of sampled tokens, which serves as a noisy single-sample Monte Carlo estimate of the true policy divergence. This creates a sub-optimal learning dynamic: updates to low-probability tokens are aggressively over-penalized, while potentially catastrophic shifts in high-probability tokens are under-constrained, leading to training inefficiency and instability. To address this, we propose Divergence Proximal Policy Optimization (DPPO), which substitutes heuristic clipping with a more principled constraint based on a direct estimate of policy divergence (e.g., Total Variation or KL). To avoid huge memory footprint, we introduce the efficient Binary and Top-K approximations to capture the essential divergence with negligible overhead. Extensive empirical evaluations demonstrate that DPPO achieves superior training stability and efficiency compared to existing methods, offering a more robust foundation for RL-based LLM fine-tuning. Our code is available at https://github.com/sail-sg/Stable-RL.

15.
arXiv (CS.AI) 2026-06-18

Searching for Synergy in Shared Workspace Human-AI Collaboration

arXiv:2606.18413v1 Announce Type: new Abstract: Automated AI agents are increasingly capable, yet many scientific and professional tasks require human judgment and contextual expertise. We study shared-workspace human-AI teams, where AI agents and human collaborators must coordinate responsibilities before submitting a final answer. Using the Collaborative Gym environment with DiscoveryBench tasks, we examine when adding simulated human collaborators improves performance and when process loss turns additional collaborators into coordination overhead. Across 1,482 sessions, adding relevant collaborators can lower performance when teams lack structure to coordinate their contributions. We then evaluate scaffolding that combines shared group memory with simulated human-in-the-loop (HITL) gates, where selected actions require approval from a designated simulated participant. This scaffolding yields higher mean performance, most clearly in three-person teams, with clearer responsibility signals and stronger routing of expertise to team actions. Overall, how human-AI teams coordinate and integrate expertise matters as much as the capability available to them.

16.
arXiv (CS.CV) 2026-06-16

3D Consistency Optimization for Self-Supervised Monocular Video Depth Estimation

Reliable monocular video depth estimation is crucial for downstream 3D reasoning and embodied AI in endoscopic navigation. However, existing self-supervised approaches typically treat video frames independently or rely on weak temporal regularization. These methods, lacking a holistic perception of the underlying 3D scene, inevitably suffer from geometrically inconsistent predictions and severe cross-frame drift. To address these limitations, we introduce a new paradigm that recasts sequential video depth estimation as an unconstrained multi-view 3D reconstruction problem, enabling full exploitation of the powerful geometric priors embedded in recent 3D foundation models. The core of our approach is a 3D consistency optimization framework driven by three constraints: image-level photometric rendering, explicit world-coordinate geometric alignment, and multi-scale temporal gradient consistency. Such unified optimization elegantly anchors isolated frames to a globally coherent 3D structure. Our method has been validated in both the self-supervised training scenarios and challenging zero-shot clinical environments. Results show that the proposed approach achieves state-of-the-art spatial accuracy, outperforming the frame-based, video-based depth estimators and the multi-view 3D reconstruction baselines.

17.
arXiv (CS.AI) 2026-06-24

VeriPilot: An LLM-Powered Verilog Debugging Framework

arXiv:2606.23759v1 Announce Type: cross Abstract: Verilog debugging remains one of the most time-consuming stages in digital circuit design. Recent advances in Large Language Models (LLMs) have enabled automated debugging; however, most existing approaches rely solely on test outputs and compiler feedback in an end-to-end manner, limiting their effectiveness on complex bugs. A key challenge is that the root cause of an error may be far removed from its observable outputs, making it difficult for LLMs to trace long dependency chains in code. This challenge is further exacerbated in large codebases, where long context lengths hinder efficient reasoning. To address these limitations, we propose VeriPilot, an LLM-powered debugging framework that leverages golden reference models to enable fine-grained bug localization and repair. VeriPilot goes beyond output-level comparison by aligning internal variable semantics between the Verilog design and its corresponding golden model through LLM-based analysis. It then performs step-by-step signal tracing using Control-Data-Flow Graphs (CDFGs) derived from static analysis, identifying a minimal set of suspicious code regions along with their correct counterparts from the golden model. These structured insights are subsequently provided to the LLM to guide reasoning and automated code repair. Experimental results on the Comprehensive Verilog Design Problems (CVDP) benchmark from NVIDIA demonstrate that VeriPilot improves the repair success rate of GPT-4o from 54.3\% to 85.71\%, significantly enhancing both bug localization accuracy and repair effectiveness for complex Verilog designs. The source code and benchmark are publicly available at Github https://github.com/YihanWn/VeriPilot.git.

18.
arXiv (CS.AI) 2026-06-11

TileFuse: A Fused Mixed-Precision Kernel Library for Efficient Quantized LLM Inference on AMD NPUs

arXiv:2606.11357v1 Announce Type: cross Abstract: With the growing demand for on-device LLM inference, edge SoCs increasingly integrate NPUs to improve performance and energy efficiency under tight power and thermal budgets. However, practical LLM deployment on current client NPUs remains difficult: widely used quantization formats such as AWQ do not map cleanly onto many existing NPU software stacks, which are often proprietary and expose limited low-level control. In this work, we present TileFuse, a close-to-metal mixed-precision kernel library for AMD XDNA2 NPUs that targets transformer linear layers in quantized LLM inference. TileFuse brings practical low-bit formats such as AWQ-style W4A16 and W8A16 directly onto XDNA2, rather than forcing the model to be reshaped around an NPU-specific quantization scheme. TileFuse co-designs weight layout, metadata placement, mixed-precision microkernels, and array-level dataflow. Specifically, it fuses unpacking, dequantization, and GEMM/GEMV execution into a single kernel flow, introduces an interleaved pre-tiling layout that supports GEMM dimensions up to 32K, and redesigns GEMV dataflow to utilize the full 4x8 AIE array. Across kernel-level evaluations, TileFuse improves performance by up to 121.6% for GEMM and 281% for GEMV over full-precision baselines, while delivering more than 2x performance and energy-efficiency gains over strong iGPU baselines on GEMM. In end-to-end LLM experiments on Ryzen AI laptops, TileFuse achieves up to 2.0x lower prefilling latency with more than 64.6% lower energy consumption. Together, these results show that XDNA2 is a practical target for AWQ-style edge LLM inference and that native NPU support for off-the-shelf quantization can make NPUs substantially more usable in real client deployments.

19.
Nature (Science) 2026-06-09

Don’t compete, collaborate: why collective funding applications are the future

Scientists with disparate expertise writing grants together can identify knowledge gaps and drive progress — but systems must change to incentivize them. Scientists with disparate expertise writing grants together can identify knowledge gaps and drive progress — but systems must change to incentivize them.

20.
arXiv (CS.CV) 2026-06-17

Revisiting Structural Dependency in Autoregressive Multi-Task Table Recognition via Order-Independent Cell-Level Representations

Multi-task table recognition jointly addresses table structure prediction, cell localization, and cell content recognition within a unified framework. Existing approaches often rely on autoregressive decoders to generate table structures and reuse their hidden states for cell localization and content recognition. This autoregressive generation process can make cell representations order-dependent, degrading global consistency across cells. This paper proposes a structural refinement module that produces order-independent cell features through non-causal attention. This design enables parallel inference of cell contents while conditioning each cell on global context encoded in the refined features. Experiments on two large datasets demonstrate consistent gains in cell localization and end-to-end recognition, while reducing overall inference time by around threefold.

21.
arXiv (CS.AI) 2026-06-12

Benchmarking Counterfactual Prediction in Epidemic Time Series with Time-Varying Interventions

arXiv:2606.05692v2 Announce Type: replace-cross Abstract: Deep learning has enabled significant advances in time-series causal inference, yet progress remains constrained by the lack of realistic benchmarks with observable counterfactual outcomes. Existing datasets either rely on real-world observations without ground-truth counterfactuals or on simplified simulations that fail to capture complex causal dynamics. To address this gap, we develop a large-scale benchmark for counterfactual prediction in epidemic time series under dynamic interventions. Unlike existing benchmarks, it supports static and time-varying treatments, as well as both single-policy and multi-policy intervention settings, enabling evaluation of causal inference methods across a broad range of causal inference scenarios. Leveraging a calibrated agent-based model grounded in real-world demographic, mobility, epidemiological, and policy data, we generate realistic counterfactual trajectories across more than 150 U.S. counties. Using this benchmark, we evaluate widely used and state-of-the-art causal inference methods, revealing substantial performance differences and highlighting the challenges of realistic time-series causal reasoning.

22.
arXiv (CS.AI) 2026-06-17

TrustErase: Auditable Instant Machine Unlearning with Passport-Embedded Representations

arXiv:2606.17122v1 Announce Type: cross Abstract: The demand for privacy-compliant AI has amplified the need for machine unlearning; yet, existing retraining or distillation-based methods remain unverifiable and computationally costly. We introduce TrustErase, a verifiable, data-free unlearning framework leveraging passport-embedded representations for instant, modular, and auditable forgetting. By treating passports as cryptographic keys within parameter-efficient adaptation layers, TrustErase enables the removal of specific classes or datasets through simple deactivation, without retraining, fine-tuning, or access to the original data. A singular value based decomposition conceals passports within model weights, ensuring that unlearning actions remain transparent and provably compliant. Evaluations on MNIST, CIFAR10 and CIFAR100 show that TrustErase matches or exceeds state-of-the-art benchmarks such as DELETE, L2UL, and Boundary Shrink, while operating in a strictly data-free regime. Ultimately, TrustErase establishes a new paradigm for trustworthy, accountable, and instantly forgettable AI systems.

23.
arXiv (CS.AI) 2026-06-18

Towards Understanding What State Space Models Learn About Code

arXiv:2602.06774v2 Announce Type: replace Abstract: State Space Models (SSMs) have emerged as an efficient alternative to the Transformer architecture. Prior work shows that, when trained under comparable conditions, SSMs can match or surpass Transformers on code understanding tasks. However, their internal mechanisms remain a black box. We present the first systematic analysis of what SSM-based code models learn along with the direct comparison between SSM and Transformer models in this domain. Our analysis shows that SSMs capture syntactic and semantic structure more effectively than Transformers during pretraining but forgets certain relations during fine-tuning on some tasks. To investigate this behavior, we introduce SSM-Interpret, a frequency-domain framework that exposes a spectral shift toward short-range dependencies during fine-tuning. Guided by these findings, we propose architectural modifications that significantly improve the performance of SSM-based code model by upto +6 MRR on NLCodeSearch. This demonstrates that our analysis not only explains model behavior but also leads directly to better designs.

24.
medRxiv (Medicine) 2026-06-16

Deployment-readiness audit of calibration, clinical utility, and fairness in perioperative infection prediction

Objective: Clinical risk scores intended to guide patient-level decisions can show strong average performance. However, predicted probabilities can be systematically too high or too low in specific subgroups even when overall performance is strong. We audited deployment readiness of a strong end-of-surgery postoperative infection model across clinically relevant subgroups and tested mitigation strategies in miscalibrated subgroups. Materials and Methods: We analyzed out-of-fold predictions for 10,719 surgical procedures at a Swiss tertiary hospital, with 504 postoperative bacterial infection events. Prespecified axes were recorded sex, age stratum, and an EHR-derived physiological-reserve proxy. Within subgroups and pairwise intersections, we evaluated discrimination, calibration, threshold-specific errors, and decision-curve net benefit at the prespecified operating threshold. We compared group-specific isotonic recalibration with Wasserstein-barycenter postprocessing and demonstrated portability in SUPPORT2. Results: Overall AUROC was 0.876. While sex-marginal discrimination was similar in women and men (0.878 vs 0.875), age and reserve stratification revealed deployment-readiness failures. Calibration-in-the-large ranged from -0.86 in frail patients to -2.47 in non-frail patients. At the 0.10 operating threshold, decision-curve net benefit was positive in frail patients but negative in pre-frail and non-frail patients. Isotonic recalibration corrected average physiological-reserve-stratified calibration without worsening Brier scores, whereas Wasserstein postprocessing worsened calibration in most procedure clusters. Discussion: Discrimination-only or sex-marginal evaluation would have missed subgroup failures with clinical-utility implications. Conclusion: Subgroup fairness audits for clinical deployment should jointly evaluate discrimination, calibration, and utility. We implemented the audit as the open-source isitfair framework for identifying deployment-relevant subgroup failures, comparing mitigation strategies, and generating structured reports.

25.
arXiv (CS.CL) 2026-06-16

In-Domain Supervised Pathology Report Classification: A Reproducible Pipeline from Data Curation to Production-Matched Evaluation

We introduce an in-domain supervised pipeline designed to counter the out-of-distribution performance drop that hampers supervised biomedical NLP models, a problem observed when models trained on pathology reports are moved across cancer registries. Our contribution is a reproducible recipe for training a supervised classifier from routinely collected cancer registry data. It describes how to build the in-domain training set and a production-matched holdout, and to choose operating points that keep the false-negative rate (FNR) very low while keeping reviewer workload manageable. The pipeline standardizes data curation with facility-stratified sampling and separate handling of reports linked to registry cases, and includes a blinded manual audit to estimate positive-case prevalence and label noise. On a 418k-report holdout set, the Kentucky model achieved FNR 0.003 and false-positive rate (FPR) 0.097, improving over the Seattle-trained MOSSAIC OncoID baseline (FNR 0.010, FPR 0.183) and raising F1 from 0.860 to 0.922. In a blinded manual review of 600 reports, estimated positive prevalence declined from 0.500 to 0.398, indicating substantial label noise with errors concentrated in rare primary sites.