arXiv:2512.15783v1 Announce Type: new Abstract: AI Epidemiology is a framework for governing and explaining advanced AI systems by applying population-level surveillance methods to AI outputs. The approach mirrors the way in which epidemiologists enable public health interventions through statistical evidence before molecular mechanisms are understood. This bypasses the problem of model complexity which plagues current interpretability methods (such as SHAP and mechanistic interpretability) at the scale of deployed models. AI Epidemiology achieves this population-level surveillance by standardising capture of AI-expert interactions into structured assessment fields: risk level, alignment score, and accuracy score. These function as exposure variables which predict output failure through statistical associations, much like cholesterol and blood pressure act as exposure variables predicting cardiac events. Output-failure associations are subsequently validated against expert overrides and real-world outcomes. The framework places zero burden on experts and provides automatic audit trails by passively tracking expert convergence and divergence with AI recommendations. Since it analyses outputs rather than internal model computations, it also provides governance continuity when institutions update models and switch vendors. Finally, by providing reliability scores and semantic assessments (e.g. 'this recommendation resembles 500 cases overridden by experts due to guideline violations'), it enables experts and institutions to detect unreliable AI outputs before they cause harm. This democratises AI oversight by enabling domain experts to govern AI systems without requiring machine learning expertise.

arXiv:2511.20680v1 Announce Type: cross Abstract: Despite high performance on clinical benchmarks, large language models may reach correct conclusions through faulty reasoning, a failure mode with safety implications for oncology decision support that is not captured by accuracy-based evaluation. In this two-cohort retrospective study, we developed a hierarchical taxonomy of reasoning errors from GPT-4 chain-of-thought responses to real oncology notes and tested its clinical relevance. Using breast and pancreatic cancer notes from the CORAL dataset, we annotated 600 reasoning traces to define a three-tier taxonomy mapping computational failures to cognitive bias frameworks. We validated the taxonomy on 822 responses from prostate cancer consult notes spanning localized through metastatic disease, simulating extraction, analysis, and clinical recommendation tasks. Reasoning errors occurred in 23 percent of interpretations and dominated overall errors, with confirmation bias and anchoring bias most common. Reasoning failures were associated with guideline-discordant and potentially harmful recommendations, particularly in advanced disease management. Automated evaluators using state-of-the-art language models detected error presence but could not reliably classify subtypes. These findings show that large language models may provide fluent but clinically unsafe recommendations when reasoning is flawed. The taxonomy provides a generalizable framework for evaluating and improving reasoning fidelity before clinical deployment.

Nature Biotechnology, Published online: 08 September 2022; doi:10.1038/s41587-022-01447-3

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