Artificial intelligence (AI) and natural language processing (NLP) are increasingly used to extract, integrate, and interpret biomedical knowledge relevant to cancer genomics, yet their translation into routine clinical oncology has been comparatively slow. The central challenge is not computational capability alone, but trustworthy integration into clinical workflows. This review examines how NLP and AI support the cancer genomics pipeline, from literature mining and automated variant interpretation to clinical trial matching, knowledge graph construction, and multimodal data integration. We identify four interrelated translational failure domains: evidence inconsistency, explainability and uncertainty, data governance and reproducibility, and interoperability. Rather than considering these challenges in isolation, we take a systems-level view, focusing on their interaction across the translational pathway. We propose a conceptual framework and roadmap for addressing these domains through rigorous validation, uncertainty-aware methods, interoperable infrastructures, regulatory alignment, and human oversight across the AI lifecycle. Progress toward routine clinical use will depend less on further improving model capability than on systematically addressing these interacting failure domains from development through deployment and post-deployment monitoring.
The integration of Large Language Models (LLMs) into cybersecurity has transformed vulnerability assessment, but it has also produced a trustworthiness crisis driven by the unchecked proliferation of "AI slop." These artifacts, hallucinated vulnerabilities, plausible but incorrect patches, and semantically repackaged bug reports, impose a cognitive burden on human triage pipelines that mirrors a denial-of-service attack. This paper surveys the empirical evidence, identifies a unifying mechanism, and traces a path toward trustworthy triage. We formalize a taxonomy of AI slop grounded in a structured literature review and dissect its root cause: the gap between the causal deductive reasoning of security experts and the autoregressive probabilistic generation of current LLMs. We operationalize this gap through a measurable proxy, the Deductive Coverage Score, and show that chain-of-thought prompting and tool-using agents narrow but do not close it. We review mitigation strategies and argue that passive detection and watermarking target provenance rather than correctness, facing fundamental entropy constraints. We instead advocate for active neuro-symbolic verification, mapping each pipeline component to prior systems with documented limits on security inputs. Finally, we specify two evaluation instruments, CVE-Bench and Slop-Score, including dataset construction, metric formulas, and anti-gaming provisions. By shifting evaluation from linguistic fluency to mathematical verifiability, this survey provides a roadmap for securing emerging AI-driven triage systems.
Nataliya Shakhovska, Ivan Izonin, Stergios-Aristoteles Mitouliscs.AI
Artificial intelligence systems increasingly make consequential judgments - which patient is deteriorating, which building is safe to enter, whether an image is authentic and are trusted on the strength of how accurately and confidently they predict. The safeguards that certify them are correspondingly prediction-based: accuracy, calibration and conformal coverage all measure how well a model performs. Whether such checks are sufficient to establish model trustworthiness has remained unclear. Here we prove that they cannot. We establish a separation theorem showing that a reliable model and a compromised one can be identical under every prediction-side certificate, including accuracy, calibration and coverage, yet differ arbitrarily in explanation fidelity and deployment behaviour. Detecting this failure requires access to the model's decision mechanism in addition to its predictions. We introduce the competence envelope as an operational framework that combines prediction and explanation certification into a single deployable criterion. Across diverse datasets and model classes, the proposed framework reveals failure modes that prediction-side certification alone does not capture. Certification against failures that are invisible in prediction behaviour therefore requires evidence about the model's decision mechanism as well as its outputs.
Artificial intelligence (AI) is becoming part of the working infrastructure of the biosciences. AI models can predict biomolecular structures, design proteins, rank variants, annotate images, recommend strains and optimise experimental conditions. We argue that the decision to use an AI output to guide laboratory action is a key juncture for trustworthy research and should follow a defined, reviewable process. We propose Traceable Trust as a proportionate assessment-and-design framework for this output-to-action boundary. It asks what evidence supports the output, what capability is being claimed, what agency has been delegated, what threshold authorises action, who can override it and how outcomes inform later decisions. We illustrate the framework through three case studies spanning ecosystem resources, project design and laboratory action. Together, the cases show how trust can be documented where AI outputs begin to shape scientific work.
Agnese Chiatti, Michael Cochez, Cristina Cornelio +14cs.AI cs.LG
Neurosymbolic AI systems that integrate machine learning and symbolic reasoning are rapidly gaining attention. They complement the data-intensive statistical approaches of neural networks and language models with symbolic reasoning algorithms to function in high-stakes domains or in low-data regimes that characterize many real-world applications. We argue that the neurosymbolic combination of machine learning and formal reasoning is not a niche approach within AI, but rather includes many already successful techniques that are of crucial importance to the development of reliable, efficient and, ultimately, trustworthy systems. This perspective prompts a re-examination of the design of current AI systems. We show that many leading AI systems, including some that are not traditionally considered as neurosymbolic, can be analysed from the perspective of four principles of neurosymbolic AI design: Reasoning, Assurances, Interfacing and Learning (RAIL). Applying the RAIL framework offers a unified view of seemingly disparate AI systems, ranging from physics-aware machine learning to neuro-guided search (such as Google DeepMind's Alpha-* suite), causal learning and tool-augmented Large Language Models. Importantly, the RAIL principles will enable engineers to make better-informed and more principled decisions about the design and deployment of production-level AI systems. In this article, we introduce the RAIL principles, examine how they can be applied across major areas of AI, and illustrate how they may guide practitioners to integrate neurosymbolic methods into next-generation AI technologies.
Abdullah Mamun, Shovito Barua Soumma, Hassan Ghasemzadehcs.AI cs.LG
Ensuring trust in AI systems is essential for the safe and ethical integration of machine learning systems into high-stakes domains such as digital health. Key dimensions, including robustness, explainability, fairness, accountability, and privacy, need to be addressed throughout the AI lifecycle, from problem formulation and data collection to model deployment and human interaction. While various contributions address different aspects of trustworthy AI, a focused synthesis on robustness and explainability, especially tailored to the healthcare context, remains limited. This review addresses that need by organizing recent advancements into an accessible framework, highlighting both technical and practical considerations. We present a structured overview of methods, challenges, and solutions, aiming to support researchers and practitioners in developing reliable and explainable AI solutions for digital health. This review article is organized into three main parts. First, we introduce the pillars of trustworthy AI and discuss the technical and ethical challenges, particularly in the context of digital health. Second, we explore application-specific trust considerations across domains such as intensive care, neonatal health, and metabolic health, highlighting how robustness and explainability support trust. Lastly, we present recent advancements in techniques aimed at improving robustness under data scarcity and distributional shifts, as well as explainable AI methods ranging from feature attribution to gradient-based interpretations and counterfactual explanations. This paper is further enriched with detailed discussions of the contributions toward robustness and explainability in digital health, the development of trustworthy AI systems in the era of LLMs, and various evaluation metrics for measuring trust and related parameters such as validity, fidelity, and diversity.
Bogdan Raduta, Horia Velicu, Alexandru Preda +1cs.CL cs.AI
Enterprises will not deploy AI agents they cannot trust, and the most-cited reason for distrust is hallucination: confident, fluent output that is simply not true. The common response is to wait for a model that does not hallucinate. We argue that this is the wrong target. Large language models are, by construction, capable of generating unsupported text, and no amount of scale removes the possibility; a faithfulness judge bolted onto a raw model catches some errors but still ships others, and even well-curated retrieval pipelines have been shown to fabricate citations. We reframe the goal: "zero hallucination" is not a property a model possesses but a property a system enforces. We present HALO (Hallucination-Aware Layered Oversight), an assurance architecture which treats hallucination as a containable failure mode rather than an eliminable one. HALO composes six layers of defense: grounded generation over retrieved, approved content; constrained, deterministic execution that bounds where the model can err; multi-signal verification that scores every output for groundedness and hallucination using both an LLM judge and evidence-based checks against the source text; calibrated abstention, so the system declines rather than guesses when grounding is insufficient; total traceability of every retrieval, tool call, and generation; and continuous oversight that detects drift, alerts on threshold breaches, and closes the loop by regenerating and statistically validating improved agents. We detail each layer, give particular attention to evidence-based confidence (which verifies extractions against the source document rather than trusting the model's self-reported certainty), and illustrate the architecture on a regulated claims-extraction workload.
Over the past decade, responsible AI (RAI) has produced a substantial body of practice for identifying and mitigating the risks AI poses in high-stakes settings. Yet this work has not produced a market that rewards trustworthiness. Firms that invest seriously in safety, fairness, and oversight cannot consistently prove to consumers, regulators, and shareholders that their systems go beyond the bare minimum of compliance. What is missing is a way for society to recognize or compare the difference. The result is a trust gap: a structural condition in which responsible development efforts happen inside organizations but produce no external, independently recognized and verifiable signal of trustworthy outcomes. We argue this gap is sustained in part because of a focus on responsible AI (a matter of internal process) as opposed to trustworthy AI (a matter of independently verifiable real-world outcomes), and that it persists because of three compounding failures: (1) the market cannot distinguish trustworthy systems from their imitations; (2) evaluation targets models and outputs rather than deployed sociotechnical systems and their outcomes; (3) the measurement ecosystem is oriented toward avoiding harm rather than demonstrating benefit. Reviewing existing AI governance instruments and comparing them to certification regimes in healthcare, sustainability, and security, we show that none integrate a governance baseline, independently verified positive-outcome evidence, and market signaling in a single framework. We propose independent, outcome-oriented certification as the connective layer that can close the trust gap, complementing regulation and internal governance by making trustworthiness measurable, comparable, and commercially rewarded.
Michael Papademas, Xenia Ziouvelou, Kostas Karpouzis +1cs.AI
As artificial intelligence (AI) systems increasingly impact society, ensuring their ethical and trustworthy deployment has become a global priority. While a myriad of high-level ethical guidelines have emerged, criticism persists that these frameworks remain abstract and lack concrete mechanisms for implementation. This paper conducts a critical analysis of tools and trust mark frameworks intended to operationalize trustworthy AI (TAI), drawing on a comprehensive dataset from the OECD. Through empirical mapping and descriptive comparative analysis, we identify significant asymmetries in ethical focus, lifecycle coverage, stakeholder targeting, and tool typology. Our findings show a strong emphasis on fairness, transparency, and robustness, with comparatively little attention paid to explainability, digital security, and environmental sustainability. Moreover, most tools and certifications concentrate on post-development stages, with limited guidance for early design or data collection phases. Educational initiatives and policy engagement are notably underdeveloped, suggesting that current TAI efforts are dominated by technical and procedural measures within industry contexts. We argue that bridging the persistent chasm between AI principles and practice requires expanding ethical objectives, embedding ethics across the AI lifecycle, and fostering broader multi-stakeholder participation. This study provides both a diagnosis of existing implementation gaps and actionable recommendations for advancing more holistic, inclusive, and enforceable AI governance
Ahmed M Salih, Oliver Díaz, Alejandro Guzman +6cs.CY cs.LG
Background: AI/ML-enabled medical devices are increasingly deployed in healthcare under evolving regulatory frameworks. As these systems become more integrated into clinical decision-making, there is growing expectation that they demonstrate key dimensions of trustworthy AI to support clinician, patient, and public trust. Whether publicly available regulatory documentation provides sufficient evidence to independently assess the trustworthiness of cleared AI systems remains unclear. Methods: We analysed FDA AI/ML-enabled medical device summary reports published between 2021 and 2025. Reports underwent automated keyword screening followed by multi-stage manual consensus review to identify documented evidence for the six FUTURE-AI principles: Fairness, Universality, Traceability, Usability, Robustness, and Explainability. Descriptive, temporal, and clinical-domain analyses were performed. Multivariable logistic regression assessed whether year of clearance or clinical domain predicted higher reporting transparency, defined as evidence reported for three or more principles. Results: Of 1,105 FDA summary reports screened, 519 were included. Trustworthy AI reporting was limited and uneven. Nearly one quarter (24.7%) provided no evidence for any principle, and none documented evidence across all six. Robustness was most frequently reported (57.6%), while Traceability (8.3%) and Explainability (3.5%) were the most pronounced gaps. Neither year of clearance (OR 1.02, 95% CI 0.88-1.19) nor clinical domain (OR 0.73, 95% CI 0.46-1.15) predicted higher reporting transparency. Interpretation: Substantial, persistent trustworthy AI reporting gaps exist in FDA documentation. Regulatory approval alone should not be considered a proxy for trustworthiness. Standardised, audit-ready reporting across the AI lifecycle is needed to support independent assessment and responsible adoption of healthcare AI.
AI systems are becoming autonomous research agents that generate hypotheses, design experiments, and produce discoveries at scales beyond human oversight. As seen by increased submissions to ML venues, the verification gap between scientific output and our ability to check it is already widening, and autonomous agents make it worse by magnitudes given human-agent asymmetry. We argue that science must evolve its verification infrastructure, as it has before with peer review. However, while historical adaptations assumed human contributors who could be questioned and sanctioned, AI agents break this assumption. We propose criteria for an adapted verification infrastructure that emphasizes observable-by-default workflows, scalable verification, and clear attribution. We argue that without adaptation, ML and any scientific domain using agents face dangerous failures: experimental results that no person can verify, optimization for metrics over understanding, and accountability vacuums that erode scientific trust.
Ahmed Qayyum, Madison Werner, Kathryn Youngblood +2cs.HC cs.AI
We present SpheriCity, an expert-grounded conversational prototype designed to support trustworthy knowledge sensemaking from sustainability reports. City-level circularity assessment reports contain rich information about materials, infrastructure, and policy interventions, yet their length and heterogeneous structure make cross-document synthesis and comparison difficult for practitioners and researchers working on circular economy initiatives. While large language models (LLM) promise faster knowledge access and synthesis, their opaque reasoning, hallucinations, and lack of source transparency introduce risks for trust and interpretability, and require verification in high-stakes sustainability contexts. SpheriCity addresses these challenges through a provenance-first conversational agent that foregrounds evidence traceability, structured synthesis, and interaction scaffolds to support exploratory querying and cross-document synthesis across sustainability reports. We conducted a formative expert review with six sustainability experts using representative queries spanning cross-city comparison, policy summarization, and recommendation-oriented tasks. Experts evaluated responses across dimensions and provided qualitative reflections on the system's usefulness for sustainability knowledge work. Our results reveal that transparent sourcing, contextual explanation, interpretability, and alignment with expert workflow strongly shape expert trust and judgments of system usefulness. This work contributes (1) a conversational prototype for sustainability knowledge sensemaking, (2) an expert-grounded evaluation framework for assessing AI responses in high-stakes knowledge domains, and (3) design insights into how provenance, uncertainty communication, and integration in workflow influence expert users' trust in AI assistance for sustainability decision support.
Recent advances in deep learning have significantly enhanced the capabilities of Natural Language Processing (NLP) and Vision-Language Models (VLMs). However, these advancements come with increased vulnerabilities, notably through backdoor attacks that pose severe security threats. This thesis addresses two critical dimensions of Trustworthy AI and Efficient Multimodal Representation Learning: (1) security through analyzing, detecting, and designing backdoor attacks in NLP and VLMs, and (2) efficiency through advanced multimodal representation methods tailored for clinical and medical imaging applications.
As artificial intelligence (AI), including machine learning (ML) models and foundation models (FMs), is increasingly deployed in high-stakes domains, ensuring their trustworthiness has become a central challenge. However, the core trustworthy AI objectives, such as fairness, robustness, privacy, and explainability, are hard to achieve simultaneously, especially while preserving utility. This position paper argues that causality is necessary to understand and balance trade-offs in performance and multiple objectives of trustworthy AI. We ground our arguments in re-interpreting trustworthy AI trade-offs as incompatible invariance requirements under different changes to the data-generating process. We then illustrate that causality provides a unifying framework for understanding how trade-offs in trustworthy AI arise, and how they can be softened or resolved through selective invariance. This perspective applies to both classical ML models and large-scale FMs. Our paper discusses how causal assumptions may be applied explicitly or implicitly in modern large-scale systems. Finally, we outline open challenges and opportunities for using causality to build more trustworthy AI.
Aaron J. Li, Nicolas Sanchez, Hao Huang +8cs.CL cs.AI
Large language models (LLMs) are increasingly deployed, yet their outputs can be highly sensitive to routine, non-adversarial variation in how users phrase queries, a gap not well addressed by existing red-teaming efforts. We propose Green Shielding, a user-centric agenda for building evidence-backed deployment guidance by characterizing how benign input variation shifts model behavior. We operationalize this agenda through the CUE criteria: benchmarks with authentic Context, reference standards and metrics that capture true Utility, and perturbations that reflect realistic variations in the Elicitation of model behavior. Guided by the PCS framework and developed with practicing physicians, we instantiate Green Shielding in medical diagnosis through HealthCareMagic-Diagnosis (HCM-Dx), a benchmark of patient-authored queries, together with structured reference diagnosis sets and clinically grounded metrics for evaluating differential diagnosis lists. We also study perturbation regimes that capture routine input variation and show that prompt-level factors shift model behavior along clinically meaningful dimensions. Across multiple frontier LLMs, these shifts trace out Pareto-like tradeoffs. In particular, neutralization, which removes common user-level factors while preserving clinical content, increases plausibility and yields more concise, clinician-like differentials, but reduces coverage of highly likely and safety-critical conditions. Together, these results show that interaction choices can systematically shift task-relevant properties of model outputs and support user-facing guidance for safer deployment in high-stakes domains. Although instantiated here in medical diagnosis, the agenda extends naturally to other decision-support settings and agentic AI systems.