EHR-MPC: Inference-Time Control for Sepsis Treatment with Generative Patient Digital Twins

Sepsis is a leading cause of mortality, yet optimal treatment policies remain contested. Existing reinforcement learning (RL) approaches learn fixed strategies for sepsis treatment, limiting adaptability to changing clinical objectives during inference. We propose EHRMPC, a framework that decouples learning patient dynamics from optimizing treatment by training a patient digital twin in the form of a generative electronic health record (EHR) model. The digital twin predicts clinical trajectories under interventions and enables model predictive control (MPC) to optimize treatments via inference-time planning over simulations. We evaluate EHR-MPC on a multicenter ICU sepsis cohort spanning 8 hospitals in the Mass General Brigham health system using both off-policy importance sampling and on-policy simulation-based evaluation. Relative to RL baselines, EHR-MPC achieves comparable off-policy performance and improved simulation performance. Unlike RL, this work frames sepsis treatment optimization as inference-time control over learned patient dynamics, establishing a general framework for decision making with generative clinical models.

Autonomous LLM-driven research from data to human-verifiable research papers

As AI promises to accelerate scientific discovery, it remains unclear whether fully AI-driven research is possible and whether it can adhere to key scientific values, such as transparency, traceability and verifiability. Mimicking human scientific practices, we built data-to-paper, an automation platform that guides interacting LLM agents through a complete stepwise research process, while programmatically back-tracing information flow and allowing human oversight and interactions. In autopilot mode, provided with annotated data alone, data-to-paper raised hypotheses, designed research plans, wrote and debugged analysis codes, generated and interpreted results, and created complete and information-traceable research papers. Even though research novelty was relatively limited, the process demonstrated autonomous generation of de novo quantitative insights from data. For simple research goals, a fully-autonomous cycle can create manuscripts which recapitulate peer-reviewed publications without major errors in about 80-90%, yet as goal complexity increases, human co-piloting becomes critical for assuring accuracy. Beyond the process itself, created manuscripts too are inherently verifiable, as information-tracing allows to programmatically chain results, methods and data. Our work thereby demonstrates a potential for AI-driven acceleration of scientific discovery while enhancing, rather than jeopardizing, traceability, transparency and verifiability.