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arXiv cs.AI

The Two-Ledger Model: Transaction-Grain Cost Accounting for Multi-Agent AI Systems Across Clouds, Models, and Systems of Record

arXiv:2611.06989v1 Announce Type: new Abstract: Enterprises run business transactions through multi-agent AI systems spanning clouds, large language models (LLMs), orchestration harnesses, and systems of record. Finance receives AI cost only at settlement grain, aggregated by SKU and charge period. The business question (what did this order, claim, or case cost in AI?) cannot be answered from billing data, because providers never see enterprise transaction boundaries. The FinOps Open Cost and Usage Specification (FOCUS) gives billing data one schema across providers but remains settlement-grain even as it adds AI token and requester attribution. We formalize this grain mismatch, derive seven requirements, and propose the Two-Ledger Model: a settlement ledger of FOCUS-conformant billing data joined to an attribution ledger of invocation-grain usage records built on OpenTelemetry GenAI telemetry. A layered correlation spine (trace context, A2A/MCP metadata, business-key correlation, probabilistic matching) assigns each record to its business transaction with recorded method and confidence; a versioned rate card prices usage in near real time; period reconciliation ties both ledgers to the invoice, and the unexplained residual identifies shadow AI. Costs are reported per order, claim, or outcome with agentic cost metrics. A simulation with known ground truth shows the spine sustaining cost coverage above 99% as trace propagation falls to zero, the reconciliation residual recovering planted unmetered spend within 0.24 percentage points while flagging provider billing errors, and mid-flight gating cutting p99 transaction cost by up to 61% at a 2-4% false-pause rate. We propose the attribution ledger as an invocation-grain FOCUS profile for standardization.

arXiv cs.AI

VirtualTrialHarness: Coordinating Agentic Operationalization of Virtual Trial Protocols Across Complex Clinical Schemas

arXiv:2611.05551v1 Announce Type: new Abstract: Virtual trials use routinely collected clinical data to evaluate treatment strategies, but translating a study protocol into an executable analysis requires determining how clinical concepts and study requirements should be represented in the available data and applied consistently across the workflow. These decisions depend on local data representations and operational conventions and can involve source selection, patient and encounter identity, linkage, and temporal interpretation. Here we introduce VirtualTrialHarness (VTHarness), an agent framework that coordinates virtual-trial operationalization by selecting reusable procedural skills for each workflow stage and uses explicit contracts to maintain consistent study decisions across stages. We also introduce VTBenchmark for evaluating source selection and cohort construction. Across three complex synthetic environments, VTHarness successfully produced all required cohort outputs matching the references in 95.1% of workflows after requirement clarification, compared with 60.4% using retrieval from the same procedural corpus. Procedural skills improved source recovery across three language models and increased source overlap with analyst code in 13 Mayo Clinic cases. Site-specific adaptation enabled reference-matched cohort execution across eight MIMIC-IV tasks. Within the Mayo Clinic Virtual Trials Program, the framework supported investigator review of cohort construction and endpoint analysis. These findings support coordinating procedural guidance with workflow decisions to improve virtual-trial implementation across complex clinical schemas.

arXiv cs.CL

Rethinking Next-Visit Diagnosis Prediction Beyond Aggregate Metrics: Retrieval--Memory Multi-Agent Adjudication

arXiv:2611.03826v1 Announce Type: new Abstract: Next-visit diagnosis prediction forecasts the diagnoses documented at a patient's next encounter, turning retrospective electronic health records into prospective clinical prediction. However, conventional aggregate evaluation obscures its multifaceted nature: distributionally, models must handle variable-size diagnosis sets and long-tailed labels; temporally, they must distinguish persistent, newly recorded, and recurrent diagnoses; and both vary with observed history depth. We introduce an evaluation framework along these dimensions and apply it to rule-based heuristics, LLM-based prompting, retrieval, memory, and multi-agent approaches. This reveals that repeating the last visit outperforms most LLM-based approaches overall despite predicting no new or recurrent diagnoses, and that retrieval and memory exhibit distinct profiles whose relative strengths vary across temporal transitions and backbones. Motivated by this, we propose LONGINUS, a retrieval-memory multi-agent adjudication framework combining evidence retrieved from patient records with structured memory of the patient trajectory. Using cross-view agreement as a reliability heuristic, it preserves shared predictions and adjudicates disagreements without revealing their source. Across MIMIC-III and MIMIC-IV with four LLM backbones, LONGINUS achieves the best transition-specific performance among LLM-based methods in nearly all settings while remaining competitive with them on aggregate metrics.

Dify releases

v1.19.0 - Trace Your Workflows, Layer by Layer

Dify 1.19.0 enhances observability with nested workflow tracing, allowing users to follow execution steps inside Workflow Tools, inspect LLM calls, and maintain context across nested invocations. The release also enables portable app packages via App packages, improves Agent file uploads and previews, introduces Skill Hub automation through CLI commands, and upgrades the bundled plugin daemon to version 0.6.14-local. Key changes include support for format v2 app packages, enhanced security, improved editing workflows, and updated environment variables and API endpoints.