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Predictive Value of Machine Learning for Poststroke Mortality Risk: Systematic Review and Meta-Analysis

Background: People with stroke face a high mortality risk, and an accurate prediction model is essential to the guidance of clinical decision-making in this population. Recently, with growing attention paid to machine learning (ML) in stroke care, some researchers have investigated the effectiveness of ML in predicting the mortality risk in stroke. However, systematic evidence is still lacking for its effectiveness. Objective: This systematic review aims to evaluate the value of ML in predicting the stroke mortality risk. The findings are expected to offer an evidence-based basis for developing and assessing clinical risk prediction tools. Methods: A search was made in Cochrane Library, PubMed, Embase, and Web of Science up to June 23, 2025, and studies that reported a complete performance of ML in predicting stroke mortality were included. Studies with only risk factors analyzed were excluded. The risk of bias of the included studies was assessed using PROBAST (Prediction model Risk of Bias Assessment Tool). Pooled risk ratios with 95% CIs and prediction intervals (PIs) were derived using the Hartung-Knapp-Sidik-Jonkman method under a random-effects model. Subgroup analyses were also conducted by model type, stroke type, patient source, and treatment background. Moreover, a metaregression was conducted on the C-index for out-of-hospital mortality at different time points to explore the influence of time factors on the model’s predictive performance. Results: Sixty-eight studies were included (23 predicting in-hospital mortality and 45 predicting out-of-hospital mortality), describing the development of 75 prediction models and 43 external validations. The follow-up period was 1 month to 15 years. For predicting in-hospital mortality, the external validation set had a pooled C-index of 0.727 (95% CI 0.677-0.781, 95% PI 0.521-1.000), with sensitivity and specificity of 0.64 (95% CI 0.57-0.70) and 0.74 (95% CI 0.70-0.77), respectively. For predicting out-of-hospital mortality, the pooled C-index was 0.847 (95% CI 0.808-0.887, 95% PI 0.750-0.956) in the external validation set, with sensitivity and specificity of 0.71 (95% CI 0.55-0.82) and 0.76 (95% CI 0.74-0.78), respectively. Comparatively, the overall pooled C-indexes were 0.788 (95% CI 0.766-0.810, 95% PI 0.621-0.999) and 0.812 (95% CI 0.798-0.826, 95% PI 0.693-0.952), respectively. The metaregression revealed a gradual decline in the predictive performance of the overall model and logistic regression model alone, whereas a random forest model maintained sustained performance. Age, National Institutes of Health Stroke Scale score, and stroke-related complications were the most frequently used variables for modeling. Conclusions: This is the first meta-analysis to demonstrate that ML-based prediction of stroke mortality is feasible. The performance of ML supports its role as an auxiliary tool for identifying high-risk populations, thereby optimizing clinical monitoring and resource allocation. However, due to substantial heterogeneity and a relatively high risk of bias in available studies, caution is warranted in real-world application. The effectiveness of ML may vary across settings, and external validation is recommended before broader implementation. Trial Registration: PROSPERO CRD420251086321; https://www.crd.york.ac.uk/PROSPERO/view/CRD420251086321

RAGNav: A Retrieval-Augmented Topological Reasoning Framework for Multi-Goal Visual-Language Navigation

arXiv:2603.03745v1 Announce Type: new Abstract: Vision-Language Navigation (VLN) is evolving from single-point pathfinding toward the more challenging Multi-Goal VLN. This task requires agents to accurately identify multiple entities while collaboratively reasoning over their spatial-physical constraints and sequential execution order. However, generic Retrieval-Augmented Generation (RAG) paradigms often suffer from spatial hallucinations and planning drift when handling multi-object associations due to the lack of explicit spatial modeling.To address these challenges, we propose RAGNav, a framework that bridges the gap between semantic reasoning and physical structure. The core of RAGNav is a Dual-Basis Memory system, which integrates a low-level topological map for maintaining physical connectivity with a high-level semantic forest for hierarchical environment abstraction. Building on this representation, the framework introduces an anchor-guided conditional retrieval and a topological neighbor score propagation mechanism. This approach facilitates the rapid screening of candidate targets and the elimination of semantic noise, while performing semantic calibration by leveraging the physical associations inherent in the topological neighborhood.This mechanism significantly enhances the capability of inter-target reachability reasoning and the efficiency of sequential planning. Experimental results demonstrate that RAGNav achieves state-of-the-art (SOTA) performance in complex multi-goal navigation tasks.

MA-CoNav: A Master-Slave Multi-Agent Framework with Hierarchical Collaboration and Dual-Level Reflection for Long-Horizon Embodied VLN

arXiv:2603.03024v1 Announce Type: cross Abstract: Vision-Language Navigation (VLN) aims to empower robots with the ability to perform long-horizon navigation in unfamiliar environments based on complex linguistic instructions. Its success critically hinges on establishing an efficient ``language-understanding -- visual-perception -- embodied-execution'' closed loop. Existing methods often suffer from perceptual distortion and decision drift in complex, long-distance tasks due to the cognitive overload of a single agent. Inspired by distributed cognition theory, this paper proposes MA-CoNav, a Multi-Agent Collaborative Navigation framework. This framework adopts a ``Master-Slave'' hierarchical agent collaboration architecture, decoupling and distributing the perception, planning, execution, and memory functions required for navigation tasks to specialized agents. Specifically, the Master Agent is responsible for global orchestration, while the Subordinate Agent group collaborates through a clear division of labor: an Observation Agent generates environment descriptions, a Planning Agent performs task decomposition and dynamic verification, an Execution Agent handles simultaneous mapping and action, and a Memory Agent manages structured experiences. Furthermore, the framework introduces a ``Local-Global'' dual-stage reflection mechanism to dynamically optimize the entire navigation pipeline. Empirical experiments were conducted using a real-world indoor dataset collected by a Limo Pro robot, with no scene-specific fine-tuning performed on the models throughout the process. The results demonstrate that MA-CoNav comprehensively outperforms existing mainstream VLN methods across multiple metrics.

Softmax is not Enough (for Adaptive Conformal Classification)

arXiv:2602.19498v1 Announce Type: cross Abstract: The merit of Conformal Prediction (CP), as a distribution-free framework for uncertainty quantification, depends on generating prediction sets that are efficient, reflected in small average set sizes, while adaptive, meaning they signal uncertainty by varying in size according to input difficulty. A central limitation for deep conformal classifiers is that the nonconformity scores are derived from softmax outputs, which can be unreliable indicators of how certain the model truly is about a given input, sometimes leading to overconfident misclassifications or undue hesitation. In this work, we argue that this unreliability can be inherited by the prediction sets generated by CP, limiting their capacity for adaptiveness. We propose a new approach that leverages information from the pre-softmax logit space, using the Helmholtz Free Energy as a measure of model uncertainty and sample difficulty. By reweighting nonconformity scores with a monotonic transformation of the energy score of each sample, we improve their sensitivity to input difficulty. Our experiments with four state-of-the-art score functions on multiple datasets and deep architectures show that this energy-based enhancement improves the adaptiveness of the prediction sets, leading to a notable increase in both efficiency and adaptiveness compared to baseline nonconformity scores, without introducing any post-hoc complexity.
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