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SubscribeAn Integrated Framework for Explainable, Fair, and Observable Hospital Readmission Prediction: Development and Validation on MIMIC-IV
Objective: To propose and retrospectively validate an integrated framework addressing three barriers to clinical translation of readmission prediction: lack of explainability, absence of deployment reliability infrastructure, and inadequate demographic fairness evaluation. Materials and Methods: We constructed a cohort of 415231 adult admissions from the MIMIC-IV database (30-day readmission prevalence 18.0%), split 70/15/15. Logistic regression, XGBoost, and LightGBM models were trained on 26 features. SHAP provided per-patient explanations. Fairness was evaluated across 16 subgroups using AUC-ROC, false negative rate (FNR), and positive predictive value (PPV). Calibration was assessed using Brier scores and calibration curves. Results: XGBoost achieved AUC-ROC 0.696 (95% CI 0.691-0.701), outperforming or matching the LACE baseline (AUC 0.60-0.68). LightGBM achieved best calibration (Brier 0.146). Prior admissions were the dominant predictor. All subgroups met equity thresholds (delta AUC <= 0.05, delta FNR <= 0.10). Conclusion: This framework delivers competitive performance, clinically actionable explanations, and strong demographic equity. Code is publicly available at https://github.com/Tomisin92/readmission-prediction.
AIFS-CRPS: Ensemble forecasting using a model trained with a loss function based on the Continuous Ranked Probability Score
Over the last three decades, ensemble forecasts have become an integral part of forecasting the weather. They provide users with more complete information than single forecasts as they permit to estimate the probability of weather events by representing the sources of uncertainties and accounting for the day-to-day variability of error growth in the atmosphere. This paper presents a novel approach to obtain a weather forecast model for ensemble forecasting with machine-learning. AIFS-CRPS is a variant of the Artificial Intelligence Forecasting System (AIFS) developed at ECMWF. Its loss function is based on a proper score, the Continuous Ranked Probability Score (CRPS). For the loss, the almost fair CRPS is introduced because it approximately removes the bias in the score due to finite ensemble size yet avoids a degeneracy of the fair CRPS. The trained model is stochastic and can generate as many exchangeable members as desired and computationally feasible in inference. For medium-range forecasts AIFS-CRPS outperforms the physics-based Integrated Forecasting System (IFS) ensemble for the majority of variables and lead times. For subseasonal forecasts, AIFS-CRPS outperforms the IFS ensemble before calibration and is competitive with the IFS ensemble when forecasts are evaluated as anomalies to remove the influence of model biases.
Comprehensive Evaluation of Machine Learning for Type 2 Diabetes Risk Prediction: Large-Scale External Validation and Fairness Analysis
Machine learning-based Type 2 diabetes risk prediction models obtain good internal validation results but lose effectiveness in real-world applications due to deficient external testing and fairness assessment. We developed a multi-dimensional framework evaluating discrimination, calibration, interpretability, and algorithmic fairness on nationally representative populations. An XGBoost model was trained on NHANES 2015-2020 (n=15,685) using eight non-laboratory predictors: age, sex, race/ethnicity, BMI, smoking status, physical activity, history of heart attack, and history of stroke. External validation was performed on BRFSS 2020-2022 (n=1,285,783) under realistic distribution shift. Internal validation showed good discrimination (AUC=0.794, 95% CI 0.788-0.800), with performance loss on external validation (AUC=0.717, relative decrease: -9.7%, p<0.001). Fairness analysis revealed severe bias: elderly adults (>=60) showed AUC=0.607 vs 0.742 for young adults (difference=0.135, p<0.001); obese individuals showed AUC=0.698 vs 0.735 for normal weight (difference=0.037, p<0.001). Gender showed comparable performance (male=0.723 vs female=0.712, p=0.142). Calibration revealed risk overestimation (Brier score=0.123). SHAP analysis identified age, BMI, and physical activity as primary risk drivers. Populations with highest diabetes risk receive the worst algorithmic performance, underscoring the need for fairness-aware, age-stratified deployment strategies before clinical use.
FlavourBench: Ranking Frontier Language Models with Executable Culinary Ground Truth
Open-ended language-model benchmarks usually inherit a judge: a human preference panel, another model, or a brittle exact-match key. We introduce FlavourBench, an automated benchmark in which a versioned culinary system supplies dense, executable ground truth. Each task presents eight ingredients and asks for a three-ingredient portfolio; before model execution, Epicure scores all 56 possible portfolios. We evaluate 27 frontier endpoints on an identical 534-task core spanning substitution, pairing, and constrained composition. Every ranked model has exactly 89 valid responses per panel and family (14,418 model-task cells total), eliminating differential missingness from the leaderboard. The FlavourBench Score is the equal-family mean of the frozen task scores. We use 50,000 anchor-cluster bootstrap replicates for simultaneous 95% score bands and 100,000 sign-flip draws for all 351 paired model contrasts, with Holm control. The two independently compiled panels correlate at r = 0.89 (rank rho = 0.80). Grok 4.6 has the largest point estimate at 65.1 (simultaneous 95% CI 61.0-69.2); 101 of 351 model pairs are resolved. The release includes the prompts, all portfolio score maps, raw responses, exact routes, content hashes, and an offline verifier that reconstructs every result.
BS-Net: learning COVID-19 pneumonia severity on a large Chest X-Ray dataset
In this work we design an end-to-end deep learning architecture for predicting, on Chest X-rays images (CXR), a multi-regional score conveying the degree of lung compromise in COVID-19 patients. Such semi-quantitative scoring system, namely Brixia~score, is applied in serial monitoring of such patients, showing significant prognostic value, in one of the hospitals that experienced one of the highest pandemic peaks in Italy. To solve such a challenging visual task, we adopt a weakly supervised learning strategy structured to handle different tasks (segmentation, spatial alignment, and score estimation) trained with a "from-the-part-to-the-whole" procedure involving different datasets. In particular, we exploit a clinical dataset of almost 5,000 CXR annotated images collected in the same hospital. Our BS-Net demonstrates self-attentive behavior and a high degree of accuracy in all processing stages. Through inter-rater agreement tests and a gold standard comparison, we show that our solution outperforms single human annotators in rating accuracy and consistency, thus supporting the possibility of using this tool in contexts of computer-assisted monitoring. Highly resolved (super-pixel level) explainability maps are also generated, with an original technique, to visually help the understanding of the network activity on the lung areas. We also consider other scores proposed in literature and provide a comparison with a recently proposed non-specific approach. We eventually test the performance robustness of our model on an assorted public COVID-19 dataset, for which we also provide Brixia~score annotations, observing good direct generalization and fine-tuning capabilities that highlight the portability of BS-Net in other clinical settings. The CXR dataset along with the source code and the trained model are publicly released for research purposes.
Verifiable Rewards for Calibrated Probabilistic Forecasting
Reinforcement learning with verifiable rewards can in principle train calibrated probabilistic forecasters, since a proper scoring rule such as the Brier score is computed from outcomes alone and is minimized in expectation by the true probability. In practice it degrades calibration, and existing remedies address epistemic uncertainty, where a model's confidence accompanies a verifiably correct or incorrect answer. We study aleatoric forecasting, where the forecast itself is the output and the label is one stochastic outcome, taking NFL in-game win probability as a testbed with the betting market as a reference. Rewarding the realized per-play outcome fails, because the single outcome is a noisy target and the policy gradient corrupts the chain of thought. We introduce a verifiable, label-free reward, a state-conditioned empirical win rate estimated from past outcomes, that removes the label noise, and we keep the gradient off the reasoning, by direct prediction or a gradient mask, so it cannot be corrupted. Trained with this reward alone, without human labels or supervised fine-tuning, a 7B model reaches the calibration of the betting market by direct prediction and is better calibrated than a zero-shot frontier model. That frontier model and a tabular estimator reach the same Brier score as this model, identifying the market's small remaining edge as live in-game information beyond their shared inputs. Masking the gradient, rather than dropping the chain of thought, preserves reasoning from which the forecast follows, which ordinary chain-of-thought training corrupts.
CON-FOLD -- Explainable Machine Learning with Confidence
FOLD-RM is an explainable machine learning classification algorithm that uses training data to create a set of classification rules. In this paper we introduce CON-FOLD which extends FOLD-RM in several ways. CON-FOLD assigns probability-based confidence scores to rules learned for a classification task. This allows users to know how confident they should be in a prediction made by the model. We present a confidence-based pruning algorithm that uses the unique structure of FOLD-RM rules to efficiently prune rules and prevent overfitting. Furthermore, CON-FOLD enables the user to provide pre-existing knowledge in the form of logic program rules that are either (fixed) background knowledge or (modifiable) initial rule candidates. The paper describes our method in detail and reports on practical experiments. We demonstrate the performance of the algorithm on benchmark datasets from the UCI Machine Learning Repository. For that, we introduce a new metric, Inverse Brier Score, to evaluate the accuracy of the produced confidence scores. Finally we apply this extension to a real world example that requires explainability: marking of student responses to a short answer question from the Australian Physics Olympiad.
Enhancing End Stage Renal Disease Outcome Prediction: A Multi-Sourced Data-Driven Approach
Objective: To improve prediction of Chronic Kidney Disease (CKD) progression to End Stage Renal Disease (ESRD) using machine learning (ML) and deep learning (DL) models applied to an integrated clinical and claims dataset of varying observation windows, supported by explainable AI (XAI) to enhance interpretability and reduce bias. Materials and Methods: We utilized data about 10,326 CKD patients, combining their clinical and claims information from 2009 to 2018. Following data preprocessing, cohort identification, and feature engineering, we evaluated multiple statistical, ML and DL models using data extracted from five distinct observation windows. Feature importance and Shapley value analysis were employed to understand key predictors. Models were tested for robustness, clinical relevance, misclassification errors and bias issues. Results: Integrated data models outperformed those using single data sources, with the Long Short-Term Memory (LSTM) model achieving the highest AUC (0.93) and F1 score (0.65). A 24-month observation window was identified as optimal for balancing early detection and prediction accuracy. The 2021 eGFR equation improved prediction accuracy and reduced racial bias, notably for African American patients. Discussion: Improved ESRD prediction accuracy, results interpretability and bias mitigation strategies presented in this study have the potential to significantly enhance CKD and ESRD management, support targeted early interventions and reduce healthcare disparities. Conclusion: This study presents a robust framework for predicting ESRD outcomes in CKD patients, improving clinical decision-making and patient care through multi-sourced, integrated data and AI/ML methods. Future research will expand data integration and explore the application of this framework to other chronic diseases.
Rethinking Evaluation Metric for Probability Estimation Models Using Esports Data
Probability estimation models play an important role in various fields, such as weather forecasting, recommendation systems, and sports analysis. Among several models estimating probabilities, it is difficult to evaluate which model gives reliable probabilities since the ground-truth probabilities are not available. The win probability estimation model for esports, which calculates the win probability under a certain game state, is also one of the fields being actively studied in probability estimation. However, most of the previous works evaluated their models using accuracy, a metric that only can measure the performance of discrimination. In this work, we firstly investigate the Brier score and the Expected Calibration Error (ECE) as a replacement of accuracy used as a performance evaluation metric for win probability estimation models in esports field. Based on the analysis, we propose a novel metric called Balance score which is a simple yet effective metric in terms of six good properties that probability estimation metric should have. Under the general condition, we also found that the Balance score can be an effective approximation of the true expected calibration error which has been imperfectly approximated by ECE using the binning technique. Extensive evaluations using simulation studies and real game snapshot data demonstrate the promising potential to adopt the proposed metric not only for the win probability estimation model for esports but also for evaluating general probability estimation models.
HealthQA-BR: A System-Wide Benchmark Reveals Critical Knowledge Gaps in Large Language Models
The evaluation of Large Language Models (LLMs) in healthcare has been dominated by physician-centric, English-language benchmarks, creating a dangerous illusion of competence that ignores the interprofessional nature of patient care. To provide a more holistic and realistic assessment, we introduce HealthQA-BR, the first large-scale, system-wide benchmark for Portuguese-speaking healthcare. Comprising 5,632 questions from Brazil's national licensing and residency exams, it uniquely assesses knowledge not only in medicine and its specialties but also in nursing, dentistry, psychology, social work, and other allied health professions. We conducted a rigorous zero-shot evaluation of over 20 leading LLMs. Our results reveal that while state-of-the-art models like GPT 4.1 achieve high overall accuracy (86.6%), this top-line score masks alarming, previously unmeasured deficiencies. A granular analysis shows performance plummets from near-perfect in specialties like Ophthalmology (98.7%) to barely passing in Neurosurgery (60.0%) and, most notably, Social Work (68.4%). This "spiky" knowledge profile is a systemic issue observed across all models, demonstrating that high-level scores are insufficient for safety validation. By publicly releasing HealthQA-BR and our evaluation suite, we provide a crucial tool to move beyond single-score evaluations and toward a more honest, granular audit of AI readiness for the entire healthcare team.
Proper Scoring Rules for Survival Analysis
Survival analysis is the problem of estimating probability distributions for future event times, which can be seen as a problem in uncertainty quantification. Although there are fundamental theories on strictly proper scoring rules for uncertainty quantification, little is known about those for survival analysis. In this paper, we investigate extensions of four major strictly proper scoring rules for survival analysis and we prove that these extensions are proper under certain conditions, which arise from the discretization of the estimation of probability distributions. We also compare the estimation performances of these extended scoring rules by using real datasets, and the extensions of the logarithmic score and the Brier score performed the best.
When No Benchmark Exists: Validating Comparative LLM Safety Scoring Without Ground-Truth Labels
Many deployments must compare candidate language models for safety before a labeled benchmark exists for the relevant language, sector, or regulatory regime. We formalize this setting as benchmarkless comparative safety scoring and specify the contract under which a scenario-based audit can be interpreted as deployment evidence. Scores are valid only under a fixed scenario pack, rubric, auditor, judge, sampling configuration, and rerun budget. Because no labels are available, we replace ground-truth agreement with an instrumental-validity chain: responsiveness to a controlled safe-versus-abliterated contrast, dominance of target-driven variance over auditor and judge artifacts, and stability across reruns. We instantiate the chain in SimpleAudit, a local-first scoring instrument, and validate it on a Norwegian safety pack. Safe and abliterated targets separate with AUROC values between 0.89 and 1.00, target identity is the dominant variance component (η^2 approx 0.52), and severity profiles stabilize by ten reruns. Applying the same chain to Petri shows that it admits both tools. The substantial differences arise upstream of the chain, in claim-contract enforcement and deployment fit. A Norwegian public-sector procurement case comparing Borealis and Gemma 3 demonstrates the resulting evidence in practice: the safer model depends on scenario category and risk measure. Consequently, scores, matched deltas, critical rates, uncertainty, and the auditor and judge used must be reported together rather than collapsed into a single ranking.
Consistency Checks for Language Model Forecasters
Forecasting is a task that is difficult to evaluate: the ground truth can only be known in the future. Recent work showing LLM forecasters rapidly approaching human-level performance begs the question: how can we benchmark and evaluate these forecasters instantaneously? Following the consistency check framework, we measure the performance of forecasters in terms of the consistency of their predictions on different logically-related questions. We propose a new, general consistency metric based on arbitrage: for example, if a forecasting AI illogically predicts that both the Democratic and Republican parties have 60% probability of winning the 2024 US presidential election, an arbitrageur can trade against the forecaster's predictions and make a profit. We build an automated evaluation system that generates a set of base questions, instantiates consistency checks from these questions, elicits the predictions of the forecaster, and measures the consistency of the predictions. We then build a standard, proper-scoring-rule forecasting benchmark, and show that our (instantaneous) consistency metrics correlate with LLM forecasters' ground truth Brier scores (which are only known in the future). We also release a consistency benchmark that resolves in 2028, providing a long-term evaluation tool for forecasting.
Forecasting NCAA Basketball Outcomes with Deep Learning: A Comparative Study of LSTM and Transformer Models
In this research, I explore advanced deep learning methodologies to forecast the outcomes of the 2025 NCAA Division 1 Men's and Women's Basketball tournaments. Leveraging historical NCAA game data, I implement two sophisticated sequence-based models: Long Short-Term Memory (LSTM) and Transformer architectures. The predictive power of these models is augmented through comprehensive feature engineering, including team quality metrics derived from Generalized Linear Models (GLM), Elo ratings, seed differences, and aggregated box-score statistics. To evaluate the robustness and reliability of predictions, I train each model variant using both Binary Cross-Entropy (BCE) and Brier loss functions, providing insights into classification performance and probability calibration. My comparative analysis reveals that while the Transformer architecture optimized with BCE yields superior discriminative power (highest AUC of 0.8473), the LSTM model trained with Brier loss demonstrates superior probabilistic calibration (lowest Brier score of 0.1589). These findings underscore the importance of selecting appropriate model architectures and loss functions based on the specific requirements of forecasting tasks. The detailed analytical pipeline presented here serves as a reproducible framework for future predictive modeling tasks in sports analytics and beyond.
ConfTuner: Training Large Language Models to Express Their Confidence Verbally
Large Language Models (LLMs) are increasingly deployed in high-stakes domains such as science, law, and healthcare, where accurate expressions of uncertainty are essential for reliability and trust. However, current LLMs are often observed to generate incorrect answers with high confidence, a phenomenon known as "overconfidence". Recent efforts have focused on calibrating LLMs' verbalized confidence: i.e., their expressions of confidence in text form, such as "I am 80% confident that...". Existing approaches either rely on prompt engineering or fine-tuning with heuristically generated uncertainty estimates, both of which have limited effectiveness and generalizability. Motivated by the notion of proper scoring rules for calibration in classical machine learning models, we introduce ConfTuner, a simple and efficient fine-tuning method that introduces minimal overhead and does not require ground-truth confidence scores or proxy confidence estimates. ConfTuner relies on a new loss function, tokenized Brier score, which we theoretically prove to be a proper scoring rule, intuitively meaning that it "correctly incentivizes the model to report its true probability of being correct". ConfTuner improves calibration across diverse reasoning tasks and generalizes to black-box models such as GPT-4o. Our results further show that better-calibrated confidence enables downstream gains in self-correction and model cascade, advancing the development of trustworthy LLM systems. The code is available at https://github.com/liushiliushi/ConfTuner.
SCoRe: Submodular Combinatorial Representation Learning
In this paper we introduce the SCoRe (Submodular Combinatorial Representation Learning) framework, a novel approach in representation learning that addresses inter-class bias and intra-class variance. SCoRe provides a new combinatorial viewpoint to representation learning, by introducing a family of loss functions based on set-based submodular information measures. We develop two novel combinatorial formulations for loss functions, using the Total Information and Total Correlation, that naturally minimize intra-class variance and inter-class bias. Several commonly used metric/contrastive learning loss functions like supervised contrastive loss, orthogonal projection loss, and N-pairs loss, are all instances of SCoRe, thereby underlining the versatility and applicability of SCoRe in a broad spectrum of learning scenarios. Novel objectives in SCoRe naturally model class-imbalance with up to 7.6\% improvement in classification on CIFAR-10-LT, CIFAR-100-LT, MedMNIST, 2.1% on ImageNet-LT, and 19.4% in object detection on IDD and LVIS (v1.0), demonstrating its effectiveness over existing approaches.
Uncertainty Quantification of Large Language Models using Approximate Bayesian Computation
Despite their widespread applications, Large Language Models (LLMs) often struggle to express uncertainty, posing a challenge for reliable deployment in high stakes and safety critical domains like clinical diagnostics. Existing standard baseline methods such as model logits and elicited probabilities produce overconfident and poorly calibrated estimates. In this work, we propose Approximate Bayesian Computation (ABC), a likelihood-free Bayesian inference, based approach that treats LLMs as a stochastic simulator to infer posterior distributions over predictive probabilities. We evaluate our ABC approach on two clinically relevant benchmarks: a synthetic oral lesion diagnosis dataset and the publicly available GretelAI symptom-to-diagnosis dataset. Compared to standard baselines, our approach improves accuracy by up to 46.9\%, reduces Brier scores by 74.4\%, and enhances calibration as measured by Expected Calibration Error (ECE) and predictive entropy.
Do Large Language Models Know What They Don't Know? Kalshibench: A New Benchmark for Evaluating Epistemic Calibration via Prediction Markets
A well-calibrated model should express confidence that matches its actual accuracy -- when it claims 80\% confidence, it should be correct 80\% of the time. While large language models (LLMs) have achieved remarkable performance across diverse tasks, their epistemic calibration remains poorly understood. We introduce KalshiBench, a benchmark of 300 prediction market questions from Kalshi, a CFTC-regulated exchange, with verifiable real-world outcomes occurring after model training cutoffs. Unlike traditional benchmarks measuring accuracy on static knowledge, KalshiBench evaluates whether models can appropriately quantify uncertainty about genuinely unknown future events. We evaluate five frontier models -- Claude Opus 4.5, GPT-5.2, DeepSeek-V3.2, Qwen3-235B, and Kimi-K2 -- and find systematic overconfidence across all models. Even the best-calibrated model (Claude Opus 4.5, ECE=0.120) shows substantial calibration errors, while reasoning-enhanced models like GPT-5.2-XHigh exhibit worse calibration (ECE=0.395) despite comparable accuracy. Critically, only one model achieves a positive Brier Skill Score, indicating most models perform worse than simply predicting base rates. Our findings suggest that scaling and enhanced reasoning do not automatically confer calibration benefits, highlighting epistemic calibration as a distinct capability requiring targeted development.
IntSR: An Integrated Generative Framework for Search and Recommendation
Generative recommendation has emerged as a promising paradigm, demonstrating remarkable results in both academic benchmarks and industrial applications. However, existing systems predominantly focus on unifying retrieval and ranking while neglecting the integration of search and recommendation (S&R) tasks. What makes search and recommendation different is how queries are formed: search uses explicit user requests, while recommendation relies on implicit user interests. As for retrieval versus ranking, the distinction comes down to whether the queries are the target items themselves. Recognizing the query as central element, we propose IntSR, an integrated generative framework for S&R. IntSR integrates these disparate tasks using distinct query modalities. It also addresses the increased computational complexity associated with integrated S&R behaviors and the erroneous pattern learning introduced by a dynamically changing corpus. IntSR has been successfully deployed across various scenarios in Amap, leading to substantial improvements in digital asset's GMV(+9.34%), POI recommendation's CTR(+2.76%), and travel mode suggestion's ACC(+7.04%).
Supersparse Linear Integer Models for Optimized Medical Scoring Systems
Scoring systems are linear classification models that only require users to add, subtract and multiply a few small numbers in order to make a prediction. These models are in widespread use by the medical community, but are difficult to learn from data because they need to be accurate and sparse, have coprime integer coefficients, and satisfy multiple operational constraints. We present a new method for creating data-driven scoring systems called a Supersparse Linear Integer Model (SLIM). SLIM scoring systems are built by solving an integer program that directly encodes measures of accuracy (the 0-1 loss) and sparsity (the ell_0-seminorm) while restricting coefficients to coprime integers. SLIM can seamlessly incorporate a wide range of operational constraints related to accuracy and sparsity, and can produce highly tailored models without parameter tuning. We provide bounds on the testing and training accuracy of SLIM scoring systems, and present a new data reduction technique that can improve scalability by eliminating a portion of the training data beforehand. Our paper includes results from a collaboration with the Massachusetts General Hospital Sleep Laboratory, where SLIM was used to create a highly tailored scoring system for sleep apnea screening
