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The Evaluation Gap in Medicine, AI and LLMs: Navigating Elusive Ground Truth & Uncertainty via a Probabilistic Paradigm

arXiv:2601.05500v1 Announce Type: new Abstract: Benchmarking the relative capabilities of AI systems, including Large Language Models (LLMs) and Vision Models, typically ignores the impact of uncertainty in the underlying ground truth answers from experts. This ambiguity is particularly consequential in medicine where uncertainty is pervasive. In this paper, we introduce a probabilistic paradigm to theoretically explain how high certainty in ground truth answers is almost always necessary for even an expert to achieve high scores, whereas in datasets with high variation in ground truth answers there may be little difference between a random labeller and an expert. Therefore, ignoring uncertainty in ground truth evaluation data can result in the misleading conclusion that a non-expert has similar performance to that of an expert. Using the probabilistic paradigm, we thus bring forth the concepts of expected accuracy and expected F1 to estimate the score an expert human or system can achieve given ground truth answer variability. Our work leads to the recommendation that when establishing the capability of a system, results should be stratified by probability of the ground truth answer, typically measured by the agreement rate of ground truth experts. Stratification becomes critical when the overall performance drops below a threshold of 80%. Under stratified evaluation, performance comparison becomes more reliable in high certainty bins, mitigating the effect of the key confounding factor -- uncertainty.

A Survey of Agentic AI and Cybersecurity: Challenges, Opportunities and Use-case Prototypes

arXiv:2601.05293v1 Announce Type: cross Abstract: Agentic AI marks an important transition from single-step generative models to systems capable of reasoning, planning, acting, and adapting over long-lasting tasks. By integrating memory, tool use, and iterative decision cycles, these systems enable continuous, autonomous workflows in real-world environments. This survey examines the implications of agentic AI for cybersecurity. On the defensive side, agentic capabilities enable continuous monitoring, autonomous incident response, adaptive threat hunting, and fraud detection at scale. Conversely, the same properties amplify adversarial power by accelerating reconnaissance, exploitation, coordination, and social-engineering attacks. These dual-use dynamics expose fundamental gaps in existing governance, assurance, and accountability mechanisms, which were largely designed for non-autonomous and short-lived AI systems. To address these challenges, we survey emerging threat models, security frameworks, and evaluation pipelines tailored to agentic systems, and analyze systemic risks including agent collusion, cascading failures, oversight evasion, and memory poisoning. Finally, we present three representative use-case implementations that illustrate how agentic AI behaves in practical cybersecurity workflows, and how design choices shape reliability, safety, and operational effectiveness.

Personalizing Treatment for Pancreatic Ductal Adenocarcinoma: The Emerging Role of Minimal Residual Disease in Perioperative Decision-Making

Cancers (Basel). 2025 Dec 27;18(1):94. doi: 10.3390/cancers18010094.

ABSTRACT

Pancreatic ductal adenocarcinoma (PDAC) is a highly aggressive malignancy with poor long-term survival despite advances in surgical techniques, systemic therapies, and perioperative management. High rates of systemic recurrence following curative-intent resection suggest that many patients harbor minimal residual disease (MRD), microscopic tumor burden that persists postoperatively and remains undetectable by conventional diagnostic tools. Recent advances in liquid biopsy technologies, particularly circulating tumor DNA (ctDNA) analysis, alongside detailed characterization of the PDAC mutational landscape, offer a promising non-invasive approach for MRD detection. Emerging evidence indicates that MRD status can serve as a sensitive prognostic biomarker, identify patients at high risk of relapse, and guide personalized perioperative therapy, including optimization of adjuvant treatment. This review summarizes current knowledge on the biology and detection of MRD in PDAC, its implications for perioperative risk stratification and treatment decision-making, and discusses future directions for integrating MRD assessment into clinical practice to enable more precise, individualized patient management.

PMID:41514607 | PMC:PMC12784771 | DOI:10.3390/cancers18010094

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