An empirical evaluation of the risks of AI model updates using clinical data: stability, arbitrariness, and fairness

The Artificial Intelligence (AI) life cycle requires a thorough understanding of the underlying data dynamics for robust, safe and cost-effective AI development and use. Dataset shifts are defined as changes between train and test data distributions. Whether occurring over time (temporal) or across different sites (multi-source), they can severely degrade model performance and compromise data quality. This is particularly important in health AI, where the safety and fundamental rights of patients can be severely affected by uncontrolled shifts both at training and operational stages. While the theoretical foundations of covariate, prior, and concept shifts are well established, there is a lack of accessible and comprehensive software tools to perform their analysis. We introduce dashi, an open-source Python library designed for the exploration, quantification, and characterization of dataset shifts. dashi provides a dual approach: an unsupervised approach that leverages information geometry and non-parametric statistical manifolds to data variability characterization and analysis (e.g., Information Geometric Temporal plots and Multi-Source Variability metrics like Global Probabilistic Deviation and Source Probabilistic Outlyingness), and a supervised approach that quantifies and characterizes model performance degradation. Both unsupervised and supervised approaches work across user-defined temporal and domain/source batches. We demonstrate the utility of dashi on three simulated and real-world health AI case studies on gestational diabetes mellitus, COVID-19 and emergency medical dispatch. By providing interactive visual analytics and variability metrics, dashi supports trustworthiness of AI life cycle stages enabling robust and safe machine learning pipelines through the assessment of data coherence and AI performance.

Large language models (LLMs) offer promising clinical decision support but remain vulnerable to hallucinated facts, unsupported recommendations, and citation errors. We present DIASENTINEL, a fully on-premise multi-agent system for one-year type 2 diabetes mellitus (T2DM) risk screening and guideline-grounded report generation from electronic health records (EHRs). The system integrates calibrated risk prediction, deterministic clinical signal extraction, Reciprocal Rank Fusion over American Diabetes Association (ADA) guidelines, and a hybrid verification layer combining rule-based checks with LLM entailment. The demonstration provides a real-time batch-screening dashboard and an interactive patient report interface with cited recommendations, verification results, and raw EHR comparison. DIASENTINEL demonstrates a practical framework for reliable, auditable, and privacy-preserving LLM-based clinical decision support.

As artificial intelligence (AI)-generated content proliferates, models are increasingly trained on their own outputs, risking progressive degradation or collapse. In this article, we provide the first positive, rigorous theoretical results, to the best of our knowledge, showing that under model-agnostic mild conditions, the model converges to the true data-generating distribution. The convergence rate is the minimum of the model's intrinsic rate and the fraction of real data at each training iteration, revealing a phase transition between data-limited and model-limited regimes. We further show that, for biased real data, correcting the bias prevents the persistence and amplification of early bias over training iteration. Extensive experiments across simulations, real images and texts validate our theoretical framework, establishing quantitative conditions for long-term AI stability in contaminated environments.