An evidence-citing LLM pipeline beat trained models on pediatric diabetes outcomes, and 99.9 percent of its citations checked out
AspireAI community · arXiv
LLM agents are proposed for clinical prediction but rarely tested in pediatrics, where cohorts are small and outcomes uncommon. Using records from 2,489 youths with type 2 diabetes and 4,018 with type 1 diabetes, spanning structured data, note-derived social determinants and, for type 1, continuous glucose monitoring data, this study predicts seven type 2 outcomes and four also in type 1 at 24 months from 18 months of follow-up. CEDAR, an evidence-citing, self-auditing pipeline, outperformed trained machine learning in both cohorts, with pooled AUROC of 0.815 versus 0.656 to 0.700 in type 2 and 0.756 versus 0.603 to 0.631 in type 1, most of the gain on sparsely screened outcomes. Only 4 of 70,246 cited values failed to match the chart, and two pediatric endocrinologists reading only CEDAR's cited evidence and reasoning agreed with it about nine times in ten.
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Two sparse-autoencoder analyses have resisted scaling: matching semantically similar features across layers, and compressing large feature circuits into interpretable supernodes. This paper argues both are the same underlying problem, estimating semantic distances between SAE features that sit on different activation manifolds. Its representation treats each feature not as a single decoder vector but as an activation-weighted distribution over the hidden states expressing it, projects those distributions into a shared reference space, and compares them with Wasserstein distance. The representation is proved invariant to activation rescaling and stable under perturbation, and recovers true matches under finite-sample margin conditions. Empirically it outperformed decoder-vector and LLM-based baselines and captured subtle functional distinctions between related features, and it compressed large feature circuits into interpretable supernodes automatically. The limitation is that this is interpretability tooling: the paper demonstrates better feature matching and circuit compression, not that downstream interpretability claims become more accurate.