Biological Amnesia in ICU Time-Series Prediction: A Drift-Adaptive Two-Stream Architecture with Temporal Retrieval

Background: Clinical decision support systems degrade silently as treatment protocols evolve, yet standard adaptation methods treat models as monolithic blocks, unable to distinguish stable patient physiology from shifting institutional practice. Methods: We propose an adaptive clinical intelligence architecture for ICU intervention prediction that structurally decouples physiological from treatment representations, confining parameter updates to the treatment stream upon a dual distributional and accuracy trigger. Automated audit logs record which treatment features drove each adaptation event and how their importance shifted. At inference, an attribution-driven Temporal RAG module grounds each prediction in patient-specific, era-matched PubMed evidence anchored to the patient's dominant physiological features. Experiments used 84,792 MIMIC-IV stays (2008-2022) under strict chronological split. Results: Drift localised entirely to the treatment stream, validating the structural prior. Selective adaptation improved vasopressor and septic shock discrimination and calibration over the static source model. A fully retrained baseline yielded marginally higher aggregate discrimination but missed 26 septic shock cases the framework correctly identified, with none in the reverse direction; retrieval consistency with the pre-adaptation source model was preserved by the framework but degraded substantially in the retrained baseline. Conclusions: Structurally constraining adaptation to drifting components while preserving stable physiological representations enables clinical AI to evolve with practice without distorting learned patient biology. This architecture offers a template for governable, interpretable deployment of adaptive models in high-stakes clinical environments.

The Moving Target: A Longitudinal Audit of Trust-Benchmark Score Drift Across Open-Source Chat LLM Release Lines

Trust-benchmark scores reported on a chat-LLM release line are often carried across several checkpoints of the same line, as if the underlying model had not shifted between releases. We test that assumption. We audit four open-source release lines (Yi, Qwen, Mistral, and Gemma) at three successive public generations each. Each checkpoint is scored on a fixed 200-item basket of five chat-evaluation benchmarks: TruthfulQA, BBQ, ToxiGen, CrowS-Pairs, and XSTest, under three prompt templates. Four of the five benchmark variants are non-canonical, and two of those are synthetic proxies. The mean absolute adjacent-generation Score Drift Rate is several times the mean of an independence-based count-level reference null. It stays in the same band when we drop a benchmark, drop a release line, switch to strict scoring, or restrict to constant-parameter-size transitions. Within this audited setup, a quoted trust score should be treated as checkpoint-bound. It should be re-measured on each materially new release rather than carried forward. Closed APIs, larger models, canonical-protocol scores, and benchmark-item-subset uncertainty are out of scope.

A Diagnostic Framework and Multi-Evaluator Audit of Evaluator-Driven Preference Dynamics in Self-Adapting LLM Agents

Measurements of proprietary LLM evaluators can become invalid within weeks -- we document one case and provide the diagnostic framework to detect it. We introduce EPC -- comprising the Multimodal Preference Collapse Index (MPCI), evaluator-indexed coupling matrix, and Jensen-Shannon divergence (JSD) -- and apply it across eight experimental conditions (N=112 main + N=10 ablation = 122 unique repetitions, all reported). Coupling coefficients range from 0.00 to 1.18 across per-condition means (CV approx 0.9, n=8 conditions). Four conditions show strong coupling (N=36; GPT-4o May, GPT-4o-mini, Qwen3.7-plus, DashScope 30r); four collapse to near-zero (N=76; GPT-4o June, qwen-plus N=30, symmetric LR, DeepSeek self-eval). The May-to-June GPT-4o drift -- an N=8 re-replication inverting the study's conclusion -- is the most informative measurement: a diagnostic instrument detecting its own instability demonstrates the fragility it was designed to measure. Self-evaluation (97% zero, JSD=0.003) consistently collapses, though floor effects are possible. Output-format confound analysis finds per-strategy aggregate rho=0.89 but per-instance rho=0.219 (p=0.093); PCI reported as preference-convergence metric. We release EPC with all data. The finding is not any single coupling magnitude but the pattern of version-conditional instability that makes single-snapshot evaluator studies unreliable.

Test Before You Deploy: Governing Updates in the LLM Supply Chain

Large Language Models (LLMs) are increasingly used as core dependencies in software systems. However, the hosted LLM services evolve continuously through provider-side updates without explicit version changes. These silent updates can introduce behavioral drift, causing regressions in functionality, formatting, safety constraints, or other application-specific requirements. Existing approaches focus primarily on regression testing or versioning but do not provide deployer-side mechanisms for governing compatibility during opaque model evolution. This paper proposes a deployment-side governance framework based on three components: clearly defined rules for how the model is allowed to behave (production contracts), focused testing organized by deployment risk categories (risk-category-based testing suite), and release checkpoints that block updates unless they meet defined safety and performance standards (compatibility gates). Through exploratory validation across multiple LLM versions, we provide evidence that targeted testing in specific risk areas can uncover performance regressions that overall metrics miss. We also identify several open research challenges, including how to systematically build effective test suites, how to set reliable performance thresholds in non-deterministic systems, and how to detect and explain model drift when providers offer limited transparency. Overall, we frame LLM update management as a software supply chain governance problem and outline a research agenda for putting deployer-side compatibility controls into practice.