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Agentic Digital Twins: A Taxonomy of Capabilities for Understanding Possible Futures

arXiv:2601.18799v1 Announce Type: cross Abstract: As digital twins (DTs) evolve to become more agentic through the integration of artificial intelligence (AI), they acquire capabilities that extend beyond dynamic representation of their target systems. This paper presents a taxonomy of agentic DTs organised around three fundamental dimensions: the locus of agency (external, internal, distributed), the tightness of coupling (loose, tight, constitutive), and model evolution (static, adaptive, reconstructive). From the resulting 27-configuration space, we identify nine illustrative configurations grouped into three clusters: "The Present" (existing tools and emerging steering systems), "The Threshold" (where emergent properties appear and coupling becomes constitutive), and "The Frontier" (where systems gain reconstructive capabilities). Our analysis explores how agentic DTs exercise performative power--not merely representing physical systems but actively participating in constituting them. Using traffic navigation systems as examples, we show how even passive tools can exhibit emergent performativity, while advanced configurations risk performative lock-in. Drawing on performative prediction theory, we trace a progression from passive tools through active steering to ontological reconstruction, examining how constitutive coupling enables systems to create self-validating realities. Understanding these configurations is essential for navigating the transformation from DTs as mirror worlds to DTs as architects of new ontologies.

Rethinking the AI Scientist: Interactive Multi-Agent Workflows for Scientific Discovery

arXiv:2601.12542v2 Announce Type: replace Abstract: Artificial intelligence systems for scientific discovery have demonstrated remarkable potential, yet existing approaches remain largely proprietary and operate in batch-processing modes requiring hours per research cycle, precluding real-time researcher guidance. This paper introduces Deep Research, a multi-agent system enabling interactive scientific investigation with turnaround times measured in minutes. The architecture comprises specialized agents for planning, data analysis, literature search, and novelty detection, unified through a persistent world state that maintains context across iterative research cycles. Two operational modes support different workflows: semi-autonomous mode with selective human checkpoints, and fully autonomous mode for extended investigations. Evaluation on the BixBench computational biology benchmark demonstrated state-of-the-art performance, achieving 48.8% accuracy on open response and 64.4% on multiple-choice evaluation, exceeding existing baselines by 14 to 26 percentage points. Analysis of architectural constraints, including open access literature limitations and challenges inherent to automated novelty assessment, informs practical deployment considerations for AI-assisted scientific workflows.

CNN-based IoT Device Identification: A Comparative Study on Payload vs. Fingerprint

arXiv:2304.13894v2 Announce Type: replace-cross Abstract: The proliferation of the Internet of Things (IoT) has introduced a massive influx of devices into the market, bringing with them significant security vulnerabilities. In this diverse ecosystem, robust IoT device identification is a critical preventive measure for network security and vulnerability management. This study proposes a deep learning-based method to identify IoT devices using the Aalto dataset. We employ Convolutional Neural Networks (CNN) to classify devices by converting network packet payloads into pseudo-images. Furthermore, we compare the performance of this payload-based approach against a feature-based fingerprinting method. Our results indicate that while the fingerprint-based method is significantly faster (approximately 10x), the payload-based image classification achieves comparable accuracy, highlighting the trade-offs between computational efficiency and data granularity in IoT security.

AI-generated data contamination erodes pathological variability and diagnostic reliability

arXiv:2601.12946v3 Announce Type: replace-cross Abstract: Generative artificial intelligence (AI) is rapidly populating medical records with synthetic content, creating a feedback loop where future models are increasingly at risk of training on uncurated AI-generated data. However, the clinical consequences of this AI-generated data contamination remain unexplored. Here, we show that in the absence of mandatory human verification, this self-referential cycle drives a rapid erosion of pathological variability and diagnostic reliability. By analysing more than 800,000 synthetic data points across clinical text generation, vision-language reporting, and medical image synthesis, we find that models progressively converge toward generic phenotypes regardless of the model architecture. Specifically, rare but critical findings, including pneumothorax and effusions, vanish from the synthetic content generated by AI models, while demographic representations skew heavily toward middle-aged male phenotypes. Crucially, this degradation is masked by false diagnostic confidence; models continue to issue reassuring reports while failing to detect life-threatening pathology, with false reassurance rates tripling to 40%. Blinded physician evaluation confirms that this decoupling of confidence and accuracy renders AI-generated documentation clinically useless after just two generations. We systematically evaluate three mitigation strategies, finding that while synthetic volume scaling fails to prevent collapse, mixing real data with quality-aware filtering effectively preserves diversity. Ultimately, our results suggest that without policy-mandated human oversight, the deployment of generative AI threatens to degrade the very healthcare data ecosystems it relies upon.

Products, Performance, and Technological Development of Ambulatory Oxygen Therapy Devices: Scoping Review

Background: Ambulatory oxygen therapy is prescribed for patients with chronic lung diseases who experience exertional hypoxemia. However, available devices may not adequately meet user requirements, and their performance characteristics are heterogeneous. Objective: This study aims to identify devices available for delivery of ambulatory oxygen therapy, the technologies that they use to generate oxygen, the performance characteristics of each device, and the development status. Methods: We used medical and engineering databases to identify peer-reviewed papers (eg, MEDLINE, IEEE). Gray literature was used to identify additional descriptions of ambulatory oxygen devices in military medicine, space exploration, or patents. The last search was conducted in September 2025. Documents that described a device that can deliver oxygen in an ambulatory context (defined as weighing less than 10 kg) and were written in English were included. Search results were screened for inclusion by 2 independent reviewers. Data were synthesized by descriptively mapping the performance of each product, the technology used, and the development status of emerging technologies. Results: From 9702 records identified, a total of 166 met eligibility criteria (106 scientific publications and 60 gray literature). We identified 33 portable oxygen concentrators (POCs; 29 commercially available), 10 oxygen cylinders, and 6 portable liquid oxygen (LOX) devices. The POC products showed a trade-off between portability and oxygen delivery capacity (maximum flow rate ranging from 2.0 to 6.0 L/min; device weight ranging from 1.0 to 9.1 kg). Pressure swing adsorption with zeolite was the most common oxygen generation technology in POCs on the market. The mean maximum continuous operating time of POCs was 3.8 hours. Two prototype POCs (maximum flow rate of 4-6 L/min and device weight of 8-9 kg) were developed for space exploration using modified adsorbents. LOX devices were the lightest and had the longest continuous operating time. Innovations in delivery included the downsizing of a POC by using nanozeolite as an adsorbent and pulse oximeter oxygen saturation (SpO2)–targeted automatic titration of oxygen delivery based on the user’s SpO2. Conclusions: This scoping review is the first study to integrate medical, engineering, and gray literature on ambulatory oxygen devices and their development. Although prior literature has narratively explained the products and technologies, no previous research has systematically investigated them. This review showed that POCs available to consumers may not meet the needs of patients in terms of flow rate, portability, and operating time. LOX devices offered superior performance but are limited by high costs. Limitations of this review include the difficulty of comparing product performance across oxygen delivery settings and that the records were largely obtained from English-language sources. Innovation in ambulatory oxygen technology has been limited over the past decade, highlighting urgent need for research and development of new lightweight devices with higher oxygen delivery. Clinical Trial: OSF Registries 10.17605/OSF.IO/QS7FX; https://osf.io/qs7fx

Publisher Correction: Best practice recommendations and considerations for designing and electronically implementing event-driven diaries in clinical trials

npj Digital Medicine, Published online: 27 January 2026; doi:10.1038/s41746-026-02396-w

Publisher Correction: Best practice recommendations and considerations for designing and electronically implementing event-driven diaries in clinical trials

High-Fidelity Longitudinal Patient Simulation Using Real-World Data

arXiv:2601.17310v1 Announce Type: new Abstract: Simulation is a powerful tool for exploring uncertainty. Its potential in clinical medicine is transformative and includes personalized treatment planning and virtual clinical trials. However, simulating patient trajectories is challenging because of complex biological and sociocultural influences. Here, we show that real-world clinical records can be leveraged to empirically model patient timelines. We developed a generative simulator model that takes a patient's history as input and synthesizes fine-grained, realistic future trajectories. The model was pretrained on more than 200 million clinical records. It produced high-fidelity future timelines, closely matching event occurrence rates, laboratory test results, and temporal dynamics in real patient future data. It also accurately estimated future event probabilities, with observed-to-expected ratios consistently near 1.0 across diverse outcomes and time horizons. Our results reveal the untapped value of real-world data in electronic health records and introduce a scalable framework for in silico modeling of clinical care.

Federated Proximal Optimization for Privacy-Preserving Heart Disease Prediction: A Controlled Simulation Study on Non-IID Clinical Data

arXiv:2601.17183v1 Announce Type: cross Abstract: Healthcare institutions have access to valuable patient data that could be of great help in the development of improved diagnostic models, but privacy regulations like HIPAA and GDPR prevent hospitals from directly sharing data with one another. Federated Learning offers a way out to this problem by facilitating collaborative model training without having the raw patient data centralized. However, clinical datasets intrinsically have non-IID (non-independent and identically distributed) features brought about by demographic disparity and diversity in disease prevalence and institutional practices. This paper presents a comprehensive simulation research of Federated Proximal Optimization (FedProx) for Heart Disease prediction based on UCI Heart Disease dataset. We generate realistic non-IID data partitions by simulating four heterogeneous hospital clients from the Cleveland Clinic dataset (303 patients), by inducing statistical heterogeneity by demographic-based stratification. Our experimental results show that FedProx with proximal parameter mu=0.05 achieves 85.00% accuracy, which is better than both centralized learning (83.33%) and isolated local models (78.45% average) without revealing patient privacy. Through generous sheer ablation studies with statistical validation on 50 independent runs we demonstrate that proximal regularization is effective in curbing client drift in heterogeneous environments. This proof-of-concept research offers algorithmic insights and practical deployment guidelines for real-world federated healthcare systems, and thus, our results are directly transferable to hospital IT-administrators, implementing privacy-preserving collaborative learning.

Decentralized Multi-Agent Swarms for Autonomous Grid Security in Industrial IoT: A Consensus-based Approach

arXiv:2601.17303v1 Announce Type: cross Abstract: As Industrial Internet of Things (IIoT) environments expand to include tens of thousands of connected devices. The centralization of security monitoring architectures creates serious latency issues that savvy attackers can exploit to compromise an entire manufacturing ecosystem. This paper outlines a new, decentralized multi-agent swarm (DMAS) architecture that includes autonomous artificial intelligence (AI) agents at each edge gateway, functioning as a distributed digital "immune system" for IIoT networks. Instead of using a traditional static firewall approach, the DMAS agents communicate via a lightweight peer-to-peer protocol to cooperatively detect anomalous behavior across the IIoT network without sending data to a cloud infrastructure. The authors also outline a consensus-based threat validation (CVT) process in which agents vote on the threat level of an identified threat, enabling instant quarantine of a compromised node or nodes. The authors conducted experiments on a testbed that simulated an innovative factory environment with 2000 IIoT devices and found that the DMAS demonstrated sub-millisecond response times (average of 0.85ms), 97.3% accuracy in detecting malicious activity under high load, and 87% accuracy in detecting zero-day attacks. All significantly higher than baseline values for both centralized and edge computing. Additionally, the proposed architecture can prevent real-time cascading failures in industrial control systems and reduce network bandwidth use by 89% compared to cloud-based solutions.

Coronary Artery Segmentation and Vessel-Type Classification in X-Ray Angiography

arXiv:2601.17429v1 Announce Type: cross Abstract: X-ray coronary angiography (XCA) is the clinical reference standard for assessing coronary artery disease, yet quantitative analysis is limited by the difficulty of robust vessel segmentation in routine data. Low contrast, motion, foreshortening, overlap, and catheter confounding degrade segmentation and contribute to domain shift across centers. Reliable segmentation, together with vessel-type labeling, enables vessel-specific coronary analytics and downstream measurements that depend on anatomical localization. From 670 cine sequences (407 subjects), we select a best frame near peak opacification using a low-intensity histogram criterion and apply joint super-resolution and enhancement. We benchmark classical Meijering, Frangi, and Sato vesselness filters under per-image oracle tuning, a single global mean setting, and per-image parameter prediction via Support Vector Regression (SVR). Neural baselines include U-Net, FPN, and a Swin Transformer, trained with coronary-only and merged coronary+catheter supervision. A second stage assigns vessel identity (LAD, LCX, RCA). External evaluation uses the public DCA1 cohort. SVR per-image tuning improves Dice over global means for all classical filters (e.g., Frangi: 0.759 vs. 0.741). Among deep models, FPN attains 0.914+/-0.007 Dice (coronary-only), and merged coronary+catheter labels further improve to 0.931+/-0.006. On DCA1 as a strict external test, Dice drops to 0.798 (coronary-only) and 0.814 (merged), while light in-domain fine-tuning recovers to 0.881+/-0.014 and 0.882+/-0.015. Vessel-type labeling achieves 98.5% accuracy (Dice 0.844) for RCA, 95.4% (0.786) for LAD, and 96.2% (0.794) for LCX. Learned per-image tuning strengthens classical pipelines, while high-resolution FPN models and merged-label supervision improve stability and external transfer with modest adaptation.

"Rebuilding" Statistics in the Age of AI: A Town Hall Discussion on Culture, Infrastructure, and Training

arXiv:2601.17510v1 Announce Type: cross Abstract: This article presents the full, original record of the 2024 Joint Statistical Meetings (JSM) town hall, "Statistics in the Age of AI," which convened leading statisticians to discuss how the field is evolving in response to advances in artificial intelligence, foundation models, large-scale empirical modeling, and data-intensive infrastructures. The town hall was structured around open panel discussion and extensive audience Q&A, with the aim of eliciting candid, experience-driven perspectives rather than formal presentations or prepared statements. This document preserves the extended exchanges among panelists and audience members, with minimal editorial intervention, and organizes the conversation around five recurring questions concerning disciplinary culture and practices, data curation and "data work," engagement with modern empirical modeling, training for large-scale AI applications, and partnerships with key AI stakeholders. By providing an archival record of this discussion, the preprint aims to support transparency, community reflection, and ongoing dialogue about the evolving role of statistics in the data- and AI-centric future.

GenAI-Net: A Generative AI Framework for Automated Biomolecular Network Design

arXiv:2601.17582v1 Announce Type: cross Abstract: Biomolecular networks underpin emerging technologies in synthetic biology-from robust biomanufacturing and metabolic engineering to smart therapeutics and cell-based diagnostics-and also provide a mechanistic language for understanding complex dynamics in natural and ecological systems. Yet designing chemical reaction networks (CRNs) that implement a desired dynamical function remains largely manual: while a proposed network can be checked by simulation, the reverse problem of discovering a network from a behavioral specification is difficult, requiring substantial human insight to navigate a vast space of topologies and kinetic parameters with nonlinear and possibly stochastic dynamics. Here we introduce GenAI-Net, a generative AI framework that automates CRN design by coupling an agent that proposes reactions to simulation-based evaluation defined by a user-specified objective. GenAI-Net efficiently produces novel, topologically diverse solutions across multiple design tasks, including dose responses, complex logic gates, classifiers, oscillators, and robust perfect adaptation in deterministic and stochastic settings (including noise reduction). By turning specifications into families of circuit candidates and reusable motifs, GenAI-Net provides a general route to programmable biomolecular circuit design and accelerates the translation from desired function to implementable mechanisms.

Artificial Intelligence and Intellectual Property Rights: Comparative Transnational Policy Analysis

arXiv:2601.17892v1 Announce Type: cross Abstract: Artificial intelligence's rapid integration with intellectual property rights necessitates assessment of its impact on trade secrets, copyrights and patents. This study addresses lacunae in existing laws where India lacks AI-specific provisions, creating doctrinal inconsistencies and enforcement inefficacies. Global discourse on AI-IPR protections remains nascent. The research identifies gaps in Indian IP laws' adaptability to AI-generated outputs: trade secret protection is inadequate against AI threats; standardized inventorship criteria are absent. Employing doctrinal and comparative methodology, it scrutinizes legislative texts, judicial precedents and policy instruments across India, US, UK and EU. Preliminary findings reveal shortcomings: India's contract law creates fragmented trade secret regime; Section 3(k) of Indian Patents Act blocks AI invention patenting; copyright varies in authorship attribution. The study proposes harmonized legal taxonomy accommodating AI's role while preserving innovation incentives. India's National AI Strategy (2024) shows progress but legislative clarity is imperative. This contributes to global discourse with AI-specific IP protections ensuring resilience and equitable innovation. Promising results underscore recalibrating India's IP jurisprudence for global alignment.

Credit Fairness: Online Fairness In Shared Resource Pools

arXiv:2601.17944v1 Announce Type: cross Abstract: We consider a setting in which a group of agents share resources that must be allocated among them in each discrete time period. Agents have time-varying demands and derive constant marginal utility from each unit of resource received up to their demand, with zero utility for any additional resources. In this setting, it is known that independently maximizing the minimum utility in each round satisfies sharing incentives (agents weakly prefer participating in the mechanism to not participating), strategyproofness (agents have no incentive to misreport their demands), and Pareto efficiency (Freeman et al. 2018). However, recent work (Vuppalapati et al. 2023) has shown that this max-min mechanism can lead to large disparities in the total resources received by agents, even when they have the same average demand. In this paper, we introduce credit fairness, a strengthening of sharing incentives that ensures agents who lend resources in early rounds are able to recoup them in later rounds. Credit fairness can be achieved in conjunction with either Pareto efficiency or strategyproofness, but not both. We propose a mechanism that is credit fair and Pareto efficient, and we evaluate its performance in a computational resource-sharing setting.

The Limits of AI Data Transparency Policy: Three Disclosure Fallacies

arXiv:2601.18127v1 Announce Type: cross Abstract: Data transparency has emerged as a rallying cry for addressing concerns about AI: data quality, privacy, and copyright chief among them. Yet while these calls are crucial for accountability, current transparency policies often fall short of their intended aims. Similar to nutrition facts for food, policies aimed at nutrition facts for AI currently suffer from a limited consideration of research on effective disclosures. We offer an institutional perspective and identify three common fallacies in policy implementations of data disclosures for AI. First, many data transparency proposals exhibit a specification gap between the stated goals of data transparency and the actual disclosures necessary to achieve such goals. Second, reform attempts exhibit an enforcement gap between required disclosures on paper and enforcement to ensure compliance in fact. Third, policy proposals manifest an impact gap between disclosed information and meaningful changes in developer practices and public understanding. Informed by the social science on transparency, our analysis identifies affirmative paths for transparency that are effective rather than merely symbolic.

Unheard in the Digital Age: Rethinking AI Bias and Speech Diversity

arXiv:2601.18641v1 Announce Type: cross Abstract: Speech remains one of the most visible yet overlooked vectors of inclusion and exclusion in contemporary society. While fluency is often equated with credibility and competence, individuals with atypical speech patterns are routinely marginalized. Given the current state of the debate, this article focuses on the structural biases that shape perceptions of atypical speech and are now being encoded into artificial intelligence. Automated speech recognition (ASR) systems and voice interfaces, trained predominantly on standardized speech, routinely fail to recognize or respond to diverse voices, compounding digital exclusion. As AI technologies increasingly mediate access to opportunity, the study calls for inclusive technological design, anti-bias training to minimize the impact of discriminatory algorithmic decisions, and enforceable policy reform that explicitly recognize speech diversity as a matter of equity, not merely accessibility. Drawing on interdisciplinary research, the article advocates for a cultural and institutional shift in how we value voice, urging co-created solutions that elevate the rights, representation, and realities of atypical speakers in the digital age. Ultimately, the article reframes speech inclusion as a matter of equity (not accommodation) and advocates for co-created AI systems that reflect the full spectrum of human voices.

Learning temporal embeddings from electronic health records of chronic kidney disease patients

arXiv:2601.18675v1 Announce Type: cross Abstract: We investigate whether temporal embedding models trained on longitudinal electronic health records can learn clinically meaningful representations without compromising predictive performance, and how architectural choices affect embedding quality. Model-guided medicine requires representations that capture disease dynamics while remaining transparent and task agnostic, whereas most clinical prediction models are optimised for a single task. Representation learning facilitates learning embeddings that generalise across downstream tasks, and recurrent architectures are well-suited for modelling temporal structure in observational clinical data. Using the MIMIC-IV dataset, we study patients with chronic kidney disease (CKD) and compare three recurrent architectures: a vanilla LSTM, an attention-augmented LSTM, and a time-aware LSTM (T-LSTM). All models are trained both as embedding models and as direct end-to-end predictors. Embedding quality is evaluated via CKD stage clustering and in-ICU mortality prediction. The T-LSTM produces more structured embeddings, achieving a lower Davies-Bouldin Index (DBI = 9.91) and higher CKD stage classification accuracy (0.74) than the vanilla LSTM (DBI = 15.85, accuracy = 0.63) and attention-augmented LSTM (DBI = 20.72, accuracy = 0.67). For in-ICU mortality prediction, embedding models consistently outperform end-to-end predictors, improving accuracy from 0.72-0.75 to 0.82-0.83, which indicates that learning embeddings as an intermediate step is more effective than direct end-to-end learning.

Trust, Don't Trust, or Flip: Robust Preference-Based Reinforcement Learning with Multi-Expert Feedback

arXiv:2601.18751v1 Announce Type: cross Abstract: Preference-based reinforcement learning (PBRL) offers a promising alternative to explicit reward engineering by learning from pairwise trajectory comparisons. However, real-world preference data often comes from heterogeneous annotators with varying reliability; some accurate, some noisy, and some systematically adversarial. Existing PBRL methods either treat all feedback equally or attempt to filter out unreliable sources, but both approaches fail when faced with adversarial annotators who systematically provide incorrect preferences. We introduce TriTrust-PBRL (TTP), a unified framework that jointly learns a shared reward model and expert-specific trust parameters from multi-expert preference feedback. The key insight is that trust parameters naturally evolve during gradient-based optimization to be positive (trust), near zero (ignore), or negative (flip), enabling the model to automatically invert adversarial preferences and recover useful signal rather than merely discarding corrupted feedback. We provide theoretical analysis establishing identifiability guarantees and detailed gradient analysis that explains how expert separation emerges naturally during training without explicit supervision. Empirically, we evaluate TTP on four diverse domains spanning manipulation tasks (MetaWorld) and locomotion (DM Control) under various corruption scenarios. TTP achieves state-of-the-art robustness, maintaining near-oracle performance under adversarial corruption while standard PBRL methods fail catastrophically. Notably, TTP outperforms existing baselines by successfully learning from mixed expert pools containing both reliable and adversarial annotators, all while requiring no expert features beyond identification indices and integrating seamlessly with existing PBRL pipelines.

Computational Phenomenology of Borderline Personality Disorder: A Comparative Evaluation of LLM-Simulated Expert Personas and Human Clinical Experts

arXiv:2508.19008v2 Announce Type: replace Abstract: Building on a human-led thematic analysis of life-story interviews with inpatients with Borderline Personality Disorder, this study examines the capacity of large language models (OpenAI's GPT, Google's Gemini, and Anthropic's Claude) to support qualitative clinical analysis. The models were evaluated through a mixed procedure. Study A involved blinded and non-blinded expert judges in phenomenology and clinical psychology. Assessments included semantic congruence, Jaccard coefficients for overlap of outputs, multidimensional validity ratings of credibility, coherence, and the substantiveness of results, and their grounding in qualitative data. In Study B, neural methods were used to embed the theme descriptions created by humans and the models in a two-dimensional vector space to provide a computational measure of the difference between human and model semantics and linguistic style. In Study C, complementary non-expert evaluations were conducted to examine the influence of thematic verbosity on the perception of human authorship and content validity. Results of all three studies revealed variable overlap with the human analysis, with models being partly indistinguishable from, and also identifying themes originally omitted by, human researchers. The findings highlight both the variability and potential of AI-augmented thematic qualitative analysis to mitigate human interpretative bias and enhance sensitivity.

MEDIC: Comprehensive Evaluation of Leading Indicators for LLM Safety and Utility in Clinical Applications

arXiv:2409.07314v2 Announce Type: replace-cross Abstract: While Large Language Models (LLMs) achieve superhuman performance on standardized medical licensing exams, these static benchmarks have become saturated and increasingly disconnected from the functional requirements of clinical workflows. To bridge the gap between theoretical capability and verified utility, we introduce MEDIC, a comprehensive evaluation framework establishing leading indicators across various clinical dimensions. Beyond standard question-answering, we assess operational capabilities using deterministic execution protocols and a novel Cross-Examination Framework (CEF), which quantifies information fidelity and hallucination rates without reliance on reference texts. Our evaluation across a heterogeneous task suite exposes critical performance trade-offs: we identify a significant knowledge-execution gap, where proficiency in static retrieval does not predict success in operational tasks such as clinical calculation or SQL generation. Furthermore, we observe a divergence between passive safety (refusal) and active safety (error detection), revealing that models fine-tuned for high refusal rates often fail to reliably audit clinical documentation for factual accuracy. These findings demonstrate that no single architecture dominates across all dimensions, highlighting the necessity of a portfolio approach to clinical model deployment. As part of this investigation, we released a public leaderboard on Hugging Face.\footnote{https://huggingface.co/spaces/m42-health/MEDIC-Benchmark}
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