Repairing Clinical Feature Pipelines without Repairing Evidence
Abstract
This conceptual analysis examines specification fidelity in immune-state and tumor evidence synthesis, using biomarker transformations, test suites, retrospective outcomes as the key comparison axes. The article develops a research agenda through critical comparison of published evidence. The primary literature contributes a bounded result: the review integrates cellular metabolism, nutrient/oxygen conditions, mitochondrial stress, and stromal metabolites as candidate mechanisms of persistence. A computational specification is a translation of a substantive question. Errors can occur in that translation even when every implementation step is correct. Build examples with known substantive answers, including boundary cases. Review diffs against a written endpoint dictionary and require approval for meaning-changing patches. The proposed comparison concerns biomarker transformations, test suites, retrospective outcomes; it would test whether the specific failure scenario is detected without erasing legitimate uncertainty. An integrated account should preserve the distinction between tissue contexts, clinical endpoints, and mechanistic claims and any stronger downstream decision.
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