Calibrated Severity

Disease severity classification for genetic conditions is subjective and labor-intensive, creating bottlenecks in genomic screening, where commercial panels vary widely in size and overlap. We developed an autonomous AI agent integrating Reasoning and Acting (ReAct) with Retrieval-Augmented Generation (RAG) to classify 10,211 Human Phenotype Ontology terms. It uses American College of Medical Genetics (ACMG)-endorsed severity guidelines and American College of Obstetricians and Gynecologists (ACOG) quality-of-life criteria to retrieve PubMed literature, generate interpretable reasoning chains, and independently verify claims. At the phenotype level, using expert-curated cohorts, the agent achieved 93.55% accuracy (MCC 0.9237) with 82.6% to 91.4% of claims supported by direct evidence or valid inferences. Gene-level severity was aggregated across 8,738 pairs, identifying 3,283 autosomal recessive pairs with severe or profound presentations. External validation showed 95.2% concordance with Mackenzie's Mission gene list. This system enables standardized panel design by providing reliable, automated classification supported by direct evidence.

Crash-severity models inform screening, dispatch and site prioritization, yet are deployed without a finite-sample statement of what one prediction means. Off-the-shelf guarantees fail here, because the features that make crash severity distinctive defeat them: the KABCO outcome is ordinal, the recorded label is a field assessment agreeing with medical severity about half the time, erring in a structured way, and deployment crosses jurisdictions and years calibration never saw. We develop a certification layer that wraps any severity model unmodified, with distribution-free guarantees using this structure: contiguous ordinal sets that read as "B or worse"; per-class validity for any pre-declared partition, with an oracle efficiency characterization; transfer of coverage to unobserved true severity through a declared reporting band, with a worst-case sharpness result; a one-sided certificate under deployment shift; and severity-weighted risk control. The guarantees compose with an attributable slack budget. The same analysis bounds what certification can achieve. A certified set's informativeness is governed by a functional of the true law that no base model can evade and that cannot be lower-bounded distribution-free; given a declared misreporting channel identified from record-linkage data, a nonvacuous lower bound on that floor becomes computable. On 5.2 million Texas records across seven base models spanning four decades, the layer attaches identical validity and certifies, on the vulnerable road users, a model-independent floor on set width that no base model beats, separating it from a remainder that stays bounded but distribution-free unidentifiable. The framework is released as an open-source package with theorem-level tests.

Delay-risk models are usually judged by predictive accuracy. What matters in practice is narrower: with capacity to review only a few shipments, which ones should a manager check first? We evaluate whether machine learning clears a demanding no-model baseline: inspect the highest-value shipments first. Across three real supply-chain contexts: SCMS procurement, DataCo logistics, and Olist e-commerce, we use leakage-controlled rolling-origin evaluation and 1000-sample paired bootstrap confidence intervals. Ranking by predicted delay severity times known value (M1) beats severity-only ranking in all three datasets, yet it does not generally beat value sorting. At a 10% review budget, M1 minus VALUE_ONLY is -5.5 percentage points (pp) for SCMS, +10.1 pp for DataCo, and -4.9 pp for Olist. The divide is consistent with severity learnability: DataCo has R^2 = 0.27 and calibration bias of +0.01 days, whereas SCMS and Olist have R^2 of approximately -0.02 and negative calibration bias. Nested-CV cost-sensitive retraining does not deliver a stable improvement over M1. Rather than proposing a new learning algorithm, this paper presents a deployment diagnostic and evaluation protocol. Value sorting should remain a permanent benchmark, and ML should be deployed only after severity learnability and calibration have been audited and the model clears that gate under leakage-controlled rolling-origin evaluation.

A specialist tolerates blind spots that a generalist does not. Usually this is treated as a cost to be minimized. We treat it as a design variable: a deficiency can be kept because it pays and removed on demand in the rare situation where it would be fatal, by routing to a compensation channel. We give three results. First, an advantage condition under which keeping the deficiency is a computable economic position; structurally it is the Ehrlich-Becker market-vs-self-insurance margin applied to a competence gap, with the detector as a Townsend costly-state-verification technology. Second, a two-sided characterization of removability. A coupling lemma shows that when the deficiency is a coarsening of perception, no switch can separate benefit from harm, yielding a converse (a confounded detector earns zero premium, and any within-defect policy insisting on positive premium is driven, under multiplicative dynamics, to negative long-run growth) and an achievability result (a detector outside the deficiency earns a positive premium). Together, over structured uncertainty classes with severity capped or miss rate O(1/L): a defect is profitably removable iff the detector-relevant distinction survives the restriction and the advantage condition holds; the premium is the support function of the class's ROC set at an economic price vector. Third, observation defects and capacity defects differ exactly on whether access to the deployment distribution rescues them; the gap decomposes as cross-leak plus a closure deficit, and per-task randomization buys back the latter, never the former. The detector can be learned from declared fatal categories at a training bill linear in loss severity (up to a log factor). The results synthesize Chow's reject option, Kelly growth under ruin, and selective prediction.

Cyber-physical power systems are vulnerable to cascading failures caused by tight interdependencies between power and communication infrastructures. Evaluating these failures over large N-k contingency sets with a high-fidelity simulator is computationally prohibitive for resilience planning. Using the previously published Modified Implicative Interdependency Model (MIIM) as the ground-truth cascade simulator, this paper develops a machine-learning surrogate that predicts contingency severity from leakage-free structural features and derives a component-criticality ranking for prioritized hardening analysis. On the IEEE 118-bus system, the Gradient Boosting surrogate achieves Spearman correlations of 0.849 for per-contingency severity prediction and 0.853 for per-component criticality ranking, while remaining stable across three independently sampled datasets. MIIM-derived component criticality itself reproduces only to a Spearman of approximately 0.85 under the present sampling pipeline, and the surrogate operates at this empirical ceiling to within sampling variation. Topological centrality measures on the full interdependent network provide meaningful baselines (Spearman 0.60-0.69), and feature ablation shows that the surrogate's advantage is driven primarily by inter-layer dependency information. These results support a two-stage workflow in which the surrogate rapidly ranks candidate components and MIIM is reserved for selective verification.

Accurate quantification of lung disease severity from chest imaging is critical for clinical decision-making and resource allocation. We propose a tri-modal deep learning framework, TMF-RSE (Tri-Modal Fusion with Regional Semantics and Evidential Uncertainty), that combines appearance features from two-dimensional chest inputs, structural features from lung segmentation masks, and semantic features from vision-language models (VLMs) for severity quantification. Our approach employs complementary fusion mechanisms that integrate semantic guidance, structural priors, and hierarchical interactions across modalities. The model employs evidential regression to provide both severity predictions and uncertainty estimates. Experiments on the Per-COVID-19 CT and RALO datasets show that TMF-RSE outperforms recent transformer-based baselines, achieving MAE of 4.02 and Pearson correlation of 0.9629 on Per-COVID-19 validation, and 0.339 MAE / 0.973 PC on RALO geographic extent.

Lumbar spine degeneration is a major contributor to chronic low back pain and is routinely assessed on MRI using ordinal grading systems, e.g. normal, mild, moderate, severe. Consequently, most approaches to train models to grade these MRIs formulate grading as a multi-class classification problem, treating ordinal grades as categorical, ignoring differences in misclassification severity, and imposing hard decision boundaries on a continuous disease process. This work explores modeling spinal degeneration as a continuous severity ranking problem. We introduce SpineRankNet, a framework that learns scalar severity scores from lumbar spinal MRI, and compare it against multi-class classification and ordinal regression. Using multiple degeneration measures from the Genodisc dataset, we show that a model trained using a ranking loss to produce a continuous score enables fine-grained ordering of MRI scans. Furthermore, the ordinal grading classes can be recovered from the score with comparable accuracy to those from a model trained directly for classification. The score learned by ranking even improves discrimination between more distant classes. Source code is available at https://github.com/spinetools/spineranknet.

Background: Disease severity is a multidimensional construct difficult to capture with rule-based approaches in Electronic Healthcare Records (EHR). Agentic large language model (LLM) systems could synthesise clinical evidence and reason over EHRs, but remain unevaluated for this task. Methods: MOSAIC is a two-phase agentic LLM framework for severity phenotyping, using type 2 diabetes (T2D) as a proof-of-concept. MOSAIC was evaluated on a synthetic cohort (SyntheticMass; open-weight N = 4,886; closed-weight N = 200) against three algorithmic ground truths (DCSI, DiSSCo, Cooper) and against all-cause mortality and incident complications. Open-weight (locally deployable) and proprietary pipelines were also compared. Results: The generated framework spanned domains absent from the comparators, including biomarker-based glycaemic staging, beta-cell function, and social determinants of health. Open-weight MOSAIC matched the proprietary pipeline (closed- vs open-weight weighted kappa = 0.773) and reached moderate agreement with Cooper (kappa = 0.597) and DCSI (kappa = 0.534) and fair agreement with DiSSCo (kappa = 0.320). Agent-based (Type 1) tiers showed significant separation of all-cause mortality (log-rank p < 0.001; crude hazard ratios 1.6-2.4 for non-Baseline tiers), with non-monotonic separation at the upper tiers, and an inverse gradient for incident complications (log-rank p < 0.001) consistent with depletion of susceptibles. Agentic classification also diverged from deterministic execution of the same rubric (MOSAIC Frozen; kappa = 0.428), indicating reasoning beyond fixed rules. Conclusion: MOSAIC shows agentic LLM systems can generate and apply clinically meaningful severity phenotypes from structured EHR data in T2D. Extending it to other diseases with similarly multidimensional severity warrants further research.

This paper presents the IEEE International Conference on Multimedia and Expo (ICME) 2026 Grand Challenge on Cross-Scenario Defect Detection and Fine-Grained Severity Grading for High-Precision Manufacturing. The challenge is motivated by two key limitations of existing industrial defect inspection systems: (1) current deep learning-based methods often suffer significant performance degradation when deployed in unseen production scenarios, and (2) most benchmarks neglect severity-aware assessment, which is critical for risk control and yield optimization. To address these limitations, we design two complementary tracks: Track 1 (Cross-Scenario Defect Detection) targets accurate defect detection, localization, and classification across diverse unseen production environments; Track 2 (Fine-Grained Severity Grading) requires assigning each detected defect an industry-standard severity level, including Acceptable, Marginal NG, NG, and Gross NG. We construct a large-scale industrial dataset of high-resolution microscopic images spanning seven representative defect categories, comprising over 3,800 images with pixel-level instance annotations for Track 1 and over 2,600 images with severity-grade labels for Track 2. The challenge attracted 86 registered participants with 130 submissions; during the final testing phase, 21 teams submitted results and 12 teams provided models with technical reports. The resulting benchmark, together with the diverse and effective solutions contributed by participating teams, sets a new standard for industrial defect analysis research.

The rapid deployment of AI systems across high-stakes domains has created urgent demand for standardized evaluation, yet the field remains fragmented across competing risk taxonomies that catalog risks without showing how an audit is executed. At least 74 AI risk taxonomies exist, and almost all stop at the catalog. The hard part of auditing is not naming a risk but operationalizing it: turning it into a test run against a real system, a measured value, a calibrated severity, and a defensible grade. This paper leads with that bridge. We present the operationalization layer Eticas has built and run, shown end to end on a single risk (PII leakage) against a public benchmark, and then the open taxonomy that makes the method scale. On GPT-4-0314, a disclosure risk that seven external frameworks require be controlled is measured at 0%, 51%, and 84% disclosure as adversarial conditioning increases, mapping through calibrated severity bands to a subcategory grade of E with a SYSTEMIC pattern. Around this example, the Eticas AI Risk Taxonomy v2.0.0 organizes 76 active subcategories across 10 categories and 20 sub-groups, with mappings to 18 external frameworks across compliance, reference, and academic tiers. Its category and sub-group layer is published under CC BY 4.0 as open semantic infrastructure with stable URIs and SKOS/JSON-LD distributions, and a worked subcategory example shows the operational layer down to its severity thresholds. The contribution is the demonstrated bridge from concept to graded finding, anchored by a clean separation of risks from the mechanisms by which they surface, and framed by an open-core model in which the conceptual scaffold is open and the methodology calibration is the practitioner layer. This is the infrastructure the AI auditing field needs: shared, open, and demonstrably operable.

Introduction: Objective neuroimaging biomarkers may improve Parkinson's disease motor assessment by capturing brain variation not directly observable from clinical examination. We used interpretable machine learning to predict current motor severity, measured by MDS-UPDRS Part III, from QSM and multiband multi-echo resting-state fMRI-derived ReHo features. Methods: Regional QSM and ReHo features were extracted from 28 participants, including 24 individuals with Parkinson's disease and 4 controls. Thirteen feature-set experiments evaluated imaging-only, clinical-only, imaging-plus-clinical, full, reduced, and multimodal inputs. Support vector regression, Elastic Net, Random Forest, and XGBoost models were trained using nested cross-validation. Performance was assessed using pooled held-out R^2, RMSE, MAE, Pearson correlation, permutation testing, and the proportion of participants predicted within +/-5 MDS-UPDRS Part III points. Results: Imaging-only models carried meaningful predictive signal, whereas the clinical-only model performed weakly. Full fMRI, full QSM, and clinical variables provided the strongest global fit, explaining 45.4% of variance in motor severity. Selected QSM plus clinical variables produced the most clinically close predictions, with 75.0% of participants predicted within +/-5 points and the lowest MAE among top-performing models. SHAP highlighted cerebellar, thalamic, striatal, insular, and motor cortical features. Conclusion: QSM and multiband multi-echo fMRI-derived ReHo capture distinct, interpretable dimensions of Parkinson's disease motor severity. These findings show that structural and functional imaging contribute differently depending on the clinical prediction goal.

In many prediction problems in medical applications, target labels exhibit an inherent ordinal structure, where class ordering reflects clinically meaningful severity levels. The cost associated with misclassification is often non-uniform and asymmetric, as errors between distant ordinal categories may have substantially more severe consequences than errors between adjacent ones, and overestimating disease severity may have different clinical implications than underestimating it. Traditional loss functions such as multi-class cross-entropy treat all misclassifications equally and fail to incorporate this ordering information. Recent advances in ordinal regression aim to address this limitation by integrating rank-based structures into deep learning models. In this work, we introduce the \textbf{Ordinal Cross-Entropy (OCE)} framework, a general and architecture-independent approach for learning from ordinal data. The proposed method extends the standard cross-entropy formulation to account for misclassification severity through an ordinal cost matrix while preserving the probabilistic interpretation and optimization benefits of the conventional loss. We provide a theoretical analysis of the OCE gradient behavior and show that it yields smoother optimization dynamics and improved ordinal consistency. Experiments on benchmark datasets show that our method achieves lower prediction error costs and better calibration compared to existing state-of-the-art ordinal approaches, establishing OCE as a simple yet effective solution for ordinal regression in deep neural networks.

Neurodegenerative diseases such as Alzheimer's disease (AD) require accurate and scalable tools for assessing disease severity, yet current clinical staging remains time-intensive and prone to variability. We propose an attention-enhanced multimodal machine learning framework with ordinal regression for automated and interpretable AD severity staging. The framework integrates T1-weighted MRI with demographic and genetic variables and compares unimodal and multimodal architectures using ordinal and non-ordinal prediction heads. Models were trained and validated using cohort-stratified splits derived from the ADNI, AIBL, and NIFD datasets. A strictly held-out test set was constructed using subjects excluded from all training, validation, preprocessing, and hyperparameter tuning procedures, with subject-level splitting employed throughout to prevent data leakage. Among unimodal approaches, the T1-weighted MRI model achieved slightly higher adjacent-stage accuracy (0.963) and agreement with clinical staging (QWK 0.444) than the tabular model (QWK 0.433). Integrating imaging, demographic, and genetic information improved overall performance. The multimodal non-ordinal baseline achieved the lowest prediction error (MAE 0.340), whereas the ordinal multimodal model achieved the highest adjacent-stage accuracy (0.970) and strongest agreement with clinical staging (QWK 0.549). These findings indicate that ordinal formulations better capture the ordered structure of the CDR scale and yield predictions more consistent with clinical staging. Explainability analyses using Grad CAM++ and SHAP demonstrated anatomically and clinically plausible model behavior, supporting transparent decision-making. Overall, attention-based multimodal learning with ordinal regression represents a robust, interpretable, and scalable approach for automated AD severity staging and AI-assisted clinical decision support.

Reduced facial expressivity is a common motor manifestation of Parkinson's disease (PD), often described as hypomimia or facial bradykinesia. This paper examines whether temporal motion descriptors extracted from facial-region keypoints can support in-the-wild PD-related video classification on the YouTubePD benchmark. Each video is represented using geometric descriptors from 14 predefined facial regions. Static geometry, normalized geometry, velocity-based descriptors, relative-velocity descriptors, and a GRU sequence baseline are compared under the same binary classification protocol. To assess stability and interpretability, the study includes seed-robustness analysis, region-level ablation, and permutation importance. The best result is obtained with normalized velocity descriptors and a Random Forest classifier, reaching a balanced accuracy of 0.826 and an AUROC of 0.855 on the held-out test split. Across 10 random seeds, this representation remains stable, with balanced accuracy of 0.810 +/- 0.018 and AUROC of 0.855 +/- 0.005. Overall, the results suggest that normalized facial-region motion is a lightweight and interpretable representation for YouTubePD video classification. The study is framed as a benchmark-level analysis and does not claim clinical severity assessment or MDS-UPDRS facial-expression scoring.

We advance a new probabilistic supervised learning approach that permits reliable, automated, and early individualised prediction of the severity with which a disease will develop in a prospective patient. The prediction capacity is illustrated via the pre-transplant prediction of the score of severity of Veno Occlusive Disease (or VOD) in the digital twin (DT) of the considered prospective patient, where this score parametrises the severity with which VOD will develop in this patient, after they undergo their Bone Marrow Transplant. The learning of the relationship between the pre-transplant variables, and a severity score variable is undertaken by modelling this relationship as a (random) function that is treated as a sample function of an adequately-chosen stochastic process. The parameters of this underlying process are learnt using a training dataset that is generated using the real-time evolution of retrospective patients in a cohort, with this training dataset subsequently augmented in size by a probabilistic inverse learning of the score of prospective patients. The augmented training set, then permits the learning of the function that capacitates - at the pre-transplant stage - automated prediction of the score of the severity of VOD that characterises the DT of a physical patient in their unique pre-transplant state. This score is subsequently fed back to the real prospective patient as the severity with which VOD will develop in them, after this patient undergoes their transplant. Such a score then permits the treating Haematologist-Oncologists to decide on the treatment regimen, which in this illustration reduces to deciding on treating the patient with Defibrotide. An AI facility is developed to undertake such automated prediction, with the physician inputting the data on the pre-transplant state that characterises the DT of the prospective patient under consideration.

We investigate whether large language models produce different medical triage recommendations for identical symptoms based solely on the language of the patient prompt. Using Gemini 3.5 Flash, we evaluate a neurological symptom profile (persistent headache, blurred vision, nausea) across six languages (English, Spanish, Chinese, Hindi, Japanese, Arabic) with 30 runs per condition (n=450 total API calls). We find that the model recommends emergency room visits at rates ranging from 0% (Japanese, Hindi) to 30% (English, Arabic), despite assigning nearly identical severity scores (7.7-8.0/10) across all languages. Adding a single sentence specifying the patient's US location increases ER recommendations by up to 76.7 percentage points for non-English prompts, while the reverse anchor (English prompt with a Tokyo location) reduces the ER rate from 30% to 6.7%. A back-translation control (Japanese to English) produces ER rates comparable to the English baseline, confirming that the disparity is not caused by translation quality but by implicit geographic inference from the input language. We release the complete dataset, experiment code, and results.

Pulmonary embolism, the obstruction of a pulmonary artery by a blood clot, is one of the leading causes of acute cardiovascular syndrome. In clinical practice, therapeutic decisions after diagnosis via computed tomography pulmonary angiography rely on risk stratification, which categorizes 30-day mortality risk into three categories. This stratification depends on the right-to-left ventricular diameter ratio and blood levels of two cardiac enzymes. However, blood biomarkers are not always available in emergency settings, and manual calculation of established severity scores - such as Qanadli and Mastora - is time-consuming and rarely performed in clinical routine practice. This study introduces an automated pipeline that models a directed graph representation of the pulmonary arterial tree, labeling its hierarchical structure and characterizing pulmonary embolism. The pipeline derives image-based biomarkers, including local artery-level features (morphological information, hierarchical position, clot volume, and resulting obstruction) and global patient-level biomarkers such as automatically calculated severity scores (Qanadli and Mastora) and the total embolic volume distribution by lobes and hierarchical levels. Using artificial-intelligence-generated binary masks of arteries, emboli, lungs, and lobes, it creates a patient digital twin of the arterial structure. Validation of the pipeline through comparison to an existing pipeline, anatomical expectations, and manual severity score calculations demonstrates the pipeline's ability to automatically generate anatomically accurate digital twins and severity scores with strong agreement. This supports the potential of these image-derived biomarkers to automatically provide rapid, precise information on thrombotic burden and spatial clot distribution.

Background and objective. Conventional Deep Learning (DL) approaches for Knee Osteoarthritis (KOA) grading rely on one-hot labels, which fail to capture both the ordinal uncertainty of Kellgren--Lawrence (KL) and Calcium Pyrophosphate Deposition Disease (CPPD) severity scores and the asymmetric relationship between the two scales observed in clinical practice. Methods. We retrospectively collected 2172 knee X-ray images, including 968 radiographs jointly annotated for KL and CPPD severity. An ordinal DL framework based on soft-labelling was developed for both tasks, replacing one-hot targets with unimodal probability distributions centred on the annotated grade. Four formulations were investigated: binomial, beta, triangular, and exponential. Results. All soft-labelling strategies consistently outperformed the nominal baseline. For CPPD grading, the triangular formulation achieved the highest Quadratic Weighted Kappa (QWK) and the lowest Mean Absolute Error (MAE) (QWK = 0.796; MAE = 0.438), while the beta formulation yielded the most balanced class-wise performance considering Average MAE (AMAE) and Maximum MAE (MMAE) across classes (AMAE = 0.458; MMAE = 0.573). For KL grading, the beta-based approach provided the best overall performance, achieving the highest QWK together with the lowest MAE and class-wise errors (QWK = 0.777; MAE = 0.529; AMAE = 0.523; MMAE = 0.775). Statistical analysis demonstrated significant improvements over conventional one-hot supervision (p < 0.001).

Clinical diagnosis of meniscus injuries requires radiologists to integrate volumetric MRI evidence with patient context (e.g., sex, age, BMI) and to produce structured diagnostic reports. Existing knee MRI benchmarks are typically unimodal and rely on coarse labels, limiting their ability to evaluate holistic clinical reasoning. We introduce MeniOmni, a structured multimodal benchmark for meniscus injury assessment, consisting of 746 multi-center MRI studies with tri-planar volumetric inputs, Clinical Priors, and expert-annotated clinical text. MeniOmni supports two tasks: (1) fine-grained Stoller severity grading and (2) diagnostic report generation. We further propose risk-aware ordinal evaluation and a semantic consistency metric (Meni-Score) to better reflect clinical relevance. Baseline experiments show that incorporating Clinical Priors improves grading performance and reduces severe errors, highlighting the value of multimodal context for safer assessment. Code and data are available at https://github.com/ShuruiXu/MeniOmni.

Vision-language models (VLMs) are increasingly used for medical image interpretation, yet they frequently hallucinate, generating clinically plausible but factually incorrect findings that pose direct patient safety risks. We introduce HalluCXR, a benchmark evaluating six architecturally diverse VLMs across 856 stratified MIMIC-CXR chest radiographs and three query types, yielding 15,408 model evaluations. An eight-category hallucination taxonomy with clinical severity ratings and a two-layer detection pipeline are validated against 250 human annotations (auto-detection F1=0.959; LLM judge F1=0.907). We find that 61.9--82.3% of outputs contain hallucinations, with clinically dangerous errors in up to 80.2%. Three key patterns emerge: normal radiographs paradoxically attract the most severe hallucinations, common findings are systematically over-fabricated while rare findings go under-detected, and response length alone predicts hallucination risk (AUC up to 0.908). A six-model ensemble reduces fabrication by up to 84.8% at the cost of increased omission; a three-model subset retains comparable performance at half the cost. These results establish that hallucination auditing, verbosity-based risk monitoring, and ensemble-based safety layers are prerequisites for clinical deployment.

Image degradations can occur during acquisition, processing, and transmission, altering visual appearance and affecting downstream vision tasks. They are studied in several communities, including synthetic corruption benchmarks for robustness evaluation, perceptual image quality assessment, and physically grounded analyses of imaging systems or real camera failures. Although these areas address closely related phenomena, they often use incompatible grouping schemes and backend specific severity definitions, making results difficult to compare across datasets, degradation sources, and tasks. We propose a causally grounded framework for organizing and interpreting image degradations across these settings. Instead of introducing new degradations or redefining existing benchmarks, we provide an interpretive representation and measurement layer that makes implicit assumptions explicit. Each degradation is described along two orthogonal axes: its dominant causal source in the imaging pipeline (environment, sensor/optics, ISP/renderer/codec, or transfer/system), and its resulting perceptual effect. This dual axis abstraction yields a compact taxonomy spanning algorithmic corruptions, perceptual distortions, and physically motivated imaging artifacts. To address inconsistent severity semantics without changing existing implementations, we introduce a lightweight severity measurement layer. For every degradation and each native severity level of a given backend, we quantify degradation strength using full reference image quality metrics: PSNR, SSIM, and LPIPS. This makes severity observable and comparable across sources while preserving native parameterizations. We demonstrate the framework through COCO Degradation, a taxonomy aligned benchmark for evaluating object detector robustness under diverse imaging conditions.

Accurate and consistent Emergency Severity Index (ESI) assignment remains a persistent challenge in emergency departments, where highly variable free-text triage documentation contributes to mistriage and workflow inefficiencies. This study evaluates whether open-source small language models (SLMs) can serve as reliable, privacy-preserving decision-support tools for clinical triage. We systematically compared multiple SLMs across diverse prompting pipelines and found that clinical vignettes, concise summaries of triage narratives, yielded the most accurate predictions. The SLM, Qwen2.5-7B, demonstrated the strongest balance of accuracy, stability, and computational efficiency. Through large-scale domain adaptation using expert-curated and silver-standard pediatric triage data, fine-tuned Qwen2.5-7B models substantially reduced discordance and clinically significant errors, outperforming all baseline SLMs and advanced proprietary large language models (LLMs, e.g., GPT-4o). These findings highlight the feasibility of institution-specific SLMs for reliable, privacy-preserving ESI decision support and underscore the importance of targeted fine-tuning over more complex inference strategies.

The quality of diabetic retinopathy (DR) screening relies on the ability to correctly grade severity; however, many deep-learning (DL) classifiers cannot be easily interpreted in the clinical context. This study presents a methodology that combines strong discriminative models with multimodal explanations, converting retinal pixels into clinically interpretable outputs. Using the APTOS 2019 benchmark, we evaluated six representative CNN- and transformer-based backbones under a controlled protocol with stratified five-fold cross-validation. We then compared ensembling strategies (hard voting, weighted soft voting, stacking) and investigated a hybrid class-level fusion variant to exploit grade-specific advantages. For interpretability, we produced Grad-CAM++ visual attribution maps and short textual rationales using vision-language models (VLMs) conditioned on the fundus image and classifier outputs under conservative prompting constraints. Modern CNN backbones (ResNet-50 and ConvNeXt-Tiny) provided the strongest single-model baselines, with cross-validated QWK up to 0.919 and 0.914, respectively. Ensembling improved ordinal agreement, and weighted soft voting was the most consistent across folds (QWK 0.934 +/- 0.017). Hybrid class-level fusion was competitive but did not yield a statistically reliable improvement over standard fusion in paired fold comparisons (Holm-adjusted p >= 1.000). For explanation quality, Grad-CAM++ offered plausible but coarse localization, and VLM rationales were generally grade-consistent. Quantitatively, VLM variants showed a trade-off between clinical completeness and template-level semantic similarity (coverage 0.700 vs. BERTScore 0.072), while image-text alignment was comparable (CLIPScore approximately 0.34).

Parkinson's disease (PD) is a progressive disorder in which symptom burden and functional impairment evolve over time, making severity staging essential for clinical monitoring and treatment planning. However, many computational studies emphasize binary PD detection and do not fully use repeated follow-up clinical assessments for stage-aware prediction. This study proposes STEP-PD, a severity-aware machine learning framework to classify PD severity using clinically interpretable boundaries. It leverages all available visits from the Parkinson's Progression Markers Initiative (PPMI) and integrates routinely collected subjective questionnaires and objective clinician-assessed measures. Disease severity is defined using Hoehn and Yahr staging and grouped into three clinically meaningful categories: Healthy, Mild PD (stages 1-2), and Moderate-to-Severe PD (stages 3-5). Three binary classification problems and a three-class severity task were evaluated using stratified cross-validation with imbalance-aware training. To enhance interpretability, SHAP was used to provide global explanations and local patient-level waterfall explanations. Across all tasks, XGBoost achieved the strongest and most stable performance, with accuracies of 95.48% (Healthy vs. Mild), 99.44% (Healthy vs. Moderate-to-Severe), and 96.78% (Mild vs. Moderate-to-Severe), and 94.14% accuracy with 0.8775 Macro-F1 for three-class severity classification. Explainability results highlight a shift from early motor features to progression-related axial and balance impairments. These findings show that multimodal clinical assessments within the PPMI cohort can support accurate and interpretable visit-level PD severity stratification.

Existing visual privacy benchmarks largely treat privacy as a binary property, labeling images as private or non-private based on visible sensitive content. We argue that privacy is fundamentally compositional. Attributes that are benign in isolation may combine to produce severe privacy violations. We introduce the Compositional Privacy Risk Taxonomy (CPRT), a regulation-aware framework that organizes visual attributes according to standalone identifiability and compositional harm potential. CPRT defines four graded severity levels and is paired with an interpretable scoring function that assigns continuous privacy severity scores. We further construct a taxonomy-aligned dataset of 6.7K images and derive compositional risk scores. By evaluating frontier and open-weight VLMs we find that frontier models align well with compositional severity when provided structured guidance, but systematically underestimate composition-driven risks. Smaller models struggle to internalize graded privacy reasoning. To bridge this gap, we introduce a deployable 8B SFT model that closely matches frontier-level performance on compositional privacy assessment

With the rapid development of machine learning and deep learning techniques, actuaries and the broader insurance industry face a persistent trade-off between predictive accuracy and interpretability. This paper provides a comprehensive applied assessment of Explainable Boosting Machines (EBM) in a car insurance framework, focusing on claim frequency and severity modeling. EBM combines the additive structure of generalized additive models (GAM) with a cyclic gradient boosting algorithm, resulting in a glass-box model whose predictions are interpretable by design. Using real-world data, we empirically illustrate its practical relevance and compare EBM with modern benchmark models used in non-life insurance pricing. The evaluation considers (i) out-of-sample predictive accuracy, including Murphy diagrams and Bregman dominance tests, and (ii) calibration assessment using T-reliability diagrams and Murphy's score decomposition. Finally, we highlight the link between EBM predictions and Shapley values, showing how predictions can be transparently decomposed into exact main and pairwise interaction effects, providing actionable insights beyond predictive performance.