Abstract
This paper introduces a novel AI framework, NetraAI, which integrates dynamical systems learning with foundational large language models (LLMs) to address challenges in clinical trial analysis. NetraAI is designed for small, high-dimensional, and sensitive clinical datasets, prioritizing stability, interpretability, and domain knowledge integration over brute-force predictive performance. The framework employs contraction mappings, information geometry, and evolutionary algorithms to identify stable and interpretable patient subgroups, termed 'Personas,' which are defined by compact sets of 2–4 variables. These Personas are clinically meaningful and actionable for trial enrichment. The framework also incorporates a meta-evolutionary layer, where an LLM acts as a 'Strategist,' guiding the discovery process by injecting domain knowledge, prioritizing variables, and ensuring robustness. This two-tier architecture mirrors the human scientific process, with NetraAI functioning as the experimentalist and the LLM as the theorist. Case studies in schizophrenia, depression, and pancreatic cancer demonstrate that NetraAI can transform weak baseline models into near-perfect classifiers by uncovering high-effect-size subpopulations. The paper positions NetraAI as a step toward adaptive, self-reflective AI systems that align with emerging paradigms like concept-level reasoning and embedding-based prediction.
Methodology
NetraAI uses a dynamical systems approach, employing contraction mappings to iteratively cluster patient data into stable attractors that represent latent subgroups. These subgroups are refined using evolutionary algorithms to identify compact, interpretable feature sets ('Personas'). An LLM serves as a meta-evolutionary layer, guiding the process by injecting domain knowledge, prioritizing variables, and validating outputs. The framework embeds principles of reliability engineering to ensure traceable and trustworthy results.
Results
NetraAI demonstrated its effectiveness in case studies involving schizophrenia, depression, and pancreatic cancer. It identified small, high-effect-size subpopulations that transformed weak baseline models (AUC ≈ 0.50–0.68) into near-perfect classifiers using only a few features. This highlights its potential for uncovering actionable insights in clinical trials with limited data.
Implications
NetraAI offers a new paradigm for clinical trial analysis, enabling the discovery of interpretable and actionable patient subgroups in small, high-dimensional datasets. Its emphasis on stability and explainability makes it particularly valuable for high-stakes domains like biomedicine, where transparency and reliability are critical. The framework also exemplifies a symbiotic approach to AI development, where specialized systems and LLMs collaborate, potentially accelerating scientific discovery in other fields.
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