From Static Risk to Dynamic Trajectories: Toward World-Model-Inspired Clinical Prediction

Computer Science > Artificial Intelligence [Submitted on 16 May 2026] From Static Risk to Dynamic Trajectories: Toward World-Model-Inspired Clinical Prediction Pujun Feng, Xiaoyu Guo, Seyed Ehsan Saffari, Min Hun Lee, Siew-Kei Lam, Erik Cambria, Xibin Sun, Yangtao Zhou, Tong Yang, Xiaoyu Zhang, Tao Tan, Yue Sun, Bin Cui Clinical decision-making is a feedback system where risk estimates influence treatment, which in turn changes disease trajectories, and both shape clinicians' measurement practices. Static prediction often fails clinically: models trained on observational care logs conflate disease biology with clinician behavior, particularly under treatment confounder feedback and irregular or informative observation. This Review focuses on intervention-aware disease trajectory modeling in clinical AI--methods estimating patient-specific longitudinal disease evolution and assessing trajectory changes under alternative treatments. We organize the field around six linked components: three decision tasks (factual forecasting, counterfactual estimation, policy evaluation) and three data-generating mechanisms (disease evolution, treatment assignment, observation process) that determine identifiability. We present the first unified framework bridging forecasting, counterfactual trajectories, and policy evaluation across discrete/continuous time, explicitly addressing treatment assignment, time-varying confounding, and observation bias. We synthesize key method families (multistate/joint models, temporal point-process, deep sequence architectures, longitudinal causal inference), map them to relevant components, and align evaluation with claim strength via overlap diagnostics, uncertainty quantification, off-policy robustness, and target-trial validation. This synthesis advances benchmark prediction to decision-grade clinical evidence, enabling treatment-sensitive individualized futures, pre-deployment policy stress-testing, and safer closed-loop learning health systems that adapt/abstain when evidence is insufficient. Subjects: Artificial Intelligence (cs.AI) Cite as: arXiv:2605.16927 [cs.AI]   (or arXiv:2605.16927v1 [cs.AI] for this version)   https://doi.org/10.48550/arXiv.2605.16927 Focus to learn more Submission history From: Pujun Feng [view email] [v1] Sat, 16 May 2026 10:45:26 UTC (27,383 KB) Access Paper: view license Current browse context: cs.AI < prev   |   next > new | recent | 2026-05 Change to browse by: cs References & Citations NASA ADS Google Scholar Semantic Scholar Export BibTeX Citation Bookmark Bibliographic Tools Bibliographic and Citation Tools Bibliographic Explorer Toggle Bibliographic Explorer (What is the Explorer?) Connected Papers Toggle Connected Papers (What is Connected Papers?) Litmaps Toggle Litmaps (What is Litmaps?) scite.ai Toggle scite Smart Citations (What are Smart Citations?) Code, Data, Media Demos Related Papers About arXivLabs Which authors of this paper are endorsers? | Disable MathJax (What is MathJax?)