Adversarial Drift-Aware Predictive Transfer: Toward Durable Clinical AI

Fuente: arXiv
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Auteurs principaux: Xiong, Xin, Guo, Zijian, Zhu, Haobo, Hong, Chuan, Smoller, Jordan W, Cai, Tianxi, Liu, Molei
Format: Preprint
Publié: 2026
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author Xiong, Xin
Guo, Zijian
Zhu, Haobo
Hong, Chuan
Smoller, Jordan W
Cai, Tianxi
Liu, Molei
author_facet Xiong, Xin
Guo, Zijian
Zhu, Haobo
Hong, Chuan
Smoller, Jordan W
Cai, Tianxi
Liu, Molei
contents Clinical AI systems frequently suffer performance decay post-deployment due to temporal data shifts, such as evolving populations, diagnostic coding updates (e.g., ICD-9 to ICD-10), and systemic shocks like the COVID-19 pandemic. Addressing this ``aging'' effect via frequent retraining is often impractical due to computational costs and privacy constraints. To overcome these hurdles, we introduce Adversarial Drift-Aware Predictive Transfer (ADAPT), a novel framework designed to confer durability against temporal drift with minimal retraining. ADAPT innovatively constructs an uncertainty set of plausible future models by combining historical source models and limited current data. By optimizing worst-case performance over this set, it balances current accuracy with robustness against degradation due to future drifts. Crucially, ADAPT requires only summary-level model estimators from historical periods, preserving data privacy and ensuring operational simplicity. Validated on longitudinal suicide risk prediction using electronic health records from Mass General Brigham (2005--2021) and Duke University Health Systems, ADAPT demonstrated superior stability across coding transitions and pandemic-induced shifts. By minimizing annual performance decay without labeling or retraining future data, ADAPT offers a scalable pathway for sustaining reliable AI in high-stakes healthcare environments.
format Preprint
id arxiv_https___arxiv_org_abs_2601_11860
institution arXiv
publishDate 2026
record_format arxiv
spellingShingle Adversarial Drift-Aware Predictive Transfer: Toward Durable Clinical AI
Xiong, Xin
Guo, Zijian
Zhu, Haobo
Hong, Chuan
Smoller, Jordan W
Cai, Tianxi
Liu, Molei
Applications
Machine Learning
Methodology
Clinical AI systems frequently suffer performance decay post-deployment due to temporal data shifts, such as evolving populations, diagnostic coding updates (e.g., ICD-9 to ICD-10), and systemic shocks like the COVID-19 pandemic. Addressing this ``aging'' effect via frequent retraining is often impractical due to computational costs and privacy constraints. To overcome these hurdles, we introduce Adversarial Drift-Aware Predictive Transfer (ADAPT), a novel framework designed to confer durability against temporal drift with minimal retraining. ADAPT innovatively constructs an uncertainty set of plausible future models by combining historical source models and limited current data. By optimizing worst-case performance over this set, it balances current accuracy with robustness against degradation due to future drifts. Crucially, ADAPT requires only summary-level model estimators from historical periods, preserving data privacy and ensuring operational simplicity. Validated on longitudinal suicide risk prediction using electronic health records from Mass General Brigham (2005--2021) and Duke University Health Systems, ADAPT demonstrated superior stability across coding transitions and pandemic-induced shifts. By minimizing annual performance decay without labeling or retraining future data, ADAPT offers a scalable pathway for sustaining reliable AI in high-stakes healthcare environments.
title Adversarial Drift-Aware Predictive Transfer: Toward Durable Clinical AI
topic Applications
Machine Learning
Methodology
url https://arxiv.org/abs/2601.11860