CT Open: An Open-Access, Uncontaminated, Live Platform for the Open Challenge of Clinical Trial Outcome Prediction

Existing benchmarks for autonomous AI scientists evaluate only final outputs---generated code, hypotheses, or papers---yet discard the reasoning process by which those outputs were obtained. This makes it impossible to audit scientific methodology, diagnose failure modes, or distinguish systematic reasoning from fortunate guessing. We present \textbf{OpenDiscoveryTrace}, a public dataset of 558 complete AI scientific agent trajectories that captures how models reason, not just what they produce. Each trajectory records a structured 9-field-per-step trace---including thoughts, tool calls, observations, errors, revision triggers, and self-reported confidence---as models execute 124 scientific tasks spanning drug discovery, materials science, genomics, and scientific literature analysis. The dataset covers seven models: three frontier models (GPT-5.4, Claude Opus 4.6, and Gemini 3.1 Pro; 124 trajectories each, fully balanced across domains and difficulty levels) and four open-weight models (Qwen2.5-7B, Mistral-7B-v0.3, Phi-3.5-mini, and Qwen2.5-1.5B; 30 each), plus 60 live-retrieval variant trajectories. Pilot analysis on 363 LLM-judged trajectories reveals that process traces expose behavioral differences invisible to output-only evaluation: all three frontier models achieve comparable success rates (84--89%), yet Claude Opus 4.6 produces 30$\times$ more errors than GPT-5.4 (2.5 vs. 0.08 per trajectory, $p < 0.0001$, Cliff's $\delta = 0.613$), with qualitatively different error profiles---66.7% tool misuse for Claude versus 83.6% reasoning errors for GPT-5.4. We define five benchmark tasks with baselines from logistic regression, random forests, LSTMs, and Transformer models. The dataset, trace schema, agent harness, and benchmark definitions are publicly available under CC BY 4.0 to support research on process-level evaluation, scientific agent auditing, and AI governance.

Longitudinal clinical notes contain rich evidence of how patients evolve over time, but converting this signal into training supervision for clinical prediction remains challenging. We extend Foresight Learning to clinical prediction by converting time-ordered MIMIC-III notes into examples consisting of past patient context, a natural-language question about a possible future event, and a label resolved from later documentation. This process yields 6,900 prediction examples from 702 admissions across medications, procedures, organ support, microbiology, and mortality. A small LoRA adapter trained on these examples improves over the prompted base model, reducing expected calibration error from 0.1269 to 0.0398 and Brier score from 0.199 to 0.145, while slightly outperforming GPT-5 point estimates on held-out questions. The approach enables reusable clinical prediction supervision from longitudinal notes without hand-engineered structured features or endpoint-specific classifiers.

Scaling test-time compute has proven highly effective for language models, yet this opportunity remains largely unexplored for industrial Click-Through Rate (CTR) prediction. CTR models suffer from a fundamental asymmetry: feature combinations well-represented in training yield confident predictions, while sparsely observed ones produce unreliable outputs. Existing training-phase solutions such as adaptive gating learn a fixed selection function subject to the same sparsity, offering no per-instance recourse at deployment.We propose UTTSI (Uncertainty-Triggered Test-Time Selective Inference), a training-free model-agnostic framework that scales inference depth proportionally to per-instance uncertainty. A dual-signal estimator combining model logit confidence with a data-level frequency prior distinguishes epistemic uncertainty from aleatoric ambiguity. Every instance undergoes adaptive feature filtering to remove unreliable embeddings; uncertain instances additionally receive stochastic feature-path explorations whose predictions are aggregated via consistency-weighted ensembling. Confident instances bypass exploration entirely, keeping average overhead at approximately $2.8\times$ base model cost with worst-case latency unchanged.Experiments on four datasets with three backbone architectures demonstrate consistent, statistically significant gains over all training-phase baselines. A seven-day online A/B test further confirms a 5.3% relative CTR gain ($p < 0.01$), establishing selective test-time compute allocation as a practical complement to training-phase advances for CTR prediction.