When Derived Measurements Mislead: Quantifying and Mitigating LLM Over-Trust with Privileged-Modality Reliability Evidence

Derived measurements increasingly enter large language model (LLM) pipelines as direct facts despite their instance-dependent validity. We define derived-feature over-trust (DFOT) as the failure in which a downstream LLM assigns such a measurement the epistemic status of a direct fact or uses it outside its valid scope. Using physiological sensing as a case study, D1 tests acceptance of a PPG-derived rhythm contradicted by offline ECG, whereas D2 tests rejection of an offline-confirmed reliable PPG rhythm under misleading severe history. ECG supplies training supervision and offline reference construction but is never shown to the LLM. Five estimands quantify this chain: conflict over-trust rate (COTR) and context-induced error rate (CIR) characterize D1/D2; correct repair rate (CRR) measures frozen-error repair; evidence-specific repair margin (ESRM) contrasts matched and patient-disjoint shuffled evidence; and utility harm rate (UHR) measures unnecessary verification among HIGH-reliability cases used without verification at baseline. The framework does not depend on a particular reliability generator. We demonstrate it on 50,000 paired PPG-ECG records using ECG-to-PPG privileged distillation as an illustrative baseline and PPG-only inference. On a protocol-locked 187-patient test, the baseline improves four repair and specificity endpoints by 1.82-6.69 percentage points, with all paired confidence intervals excluding zero; UHR increases by 0.67 percentage points (95% CI: -0.4 to +1.7). DFOT provides a common evaluation target for stronger mitigation methods. The code is available at https://github.com/Zongheng-Guo/When-Derived-Measurements-Mislead.

BrainRVQ: A High-Fidelity EEG Foundation Model via Dual-Domain Residual Quantization and Hierarchical Autoregression

Developing foundation models for electroencephalography (EEG) remains challenging due to the signal's low signal-to-noise ratio and complex spectro-temporal non-stationarity. Existing approaches often overlook the hierarchical latent structure inherent in neural dynamics, leading to suboptimal reconstruction of fine-grained information. In this work, we propose BrainRVQ, a general-purpose EEG foundation model pre-trained on a large-scale corpus of clinical EEG data. Unlike standard masked modeling, BrainRVQ features a Dual-Domain Residual Vector Quantization (DD-RVQ) tokenizer that disentangles temporal waveforms and spectral patterns into hierarchical discrete codes. We further introduce a hierarchical autoregressive pre-training objective that learns to reconstruct these codes in a coarse-to-fine manner, utilizing an importance-guided curriculum masking strategy to prioritize information-rich neural events over background noise. Extensive experiments across 8 diverse downstream datasets demonstrate that BrainRVQ consistently outperforms state-of-the-art baselines, validating its effectiveness in learning robust and generalizable neural representations. Our code and model weights are available:https://github.com/keqicmz/BrainRVQ