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RareBench-BR Trajectory v2 — Leaderboard

Submit a PR with your model's numbers + the mandatory baselines on the same candidate space. All numbers are held-out test, 95% bootstrap CI.

Headline: GEMEO leads every novelty & long-context task

Task GEMEO Strong baseline Margin
New-onset prediction (Top-1) 53.7% [51.4, 56.1] 38.2% (frequency) +15.5 pp
T2 — Will-change (AUROC) 0.906 0.889 (count-based) +0.017
T5 — Transition-within-12mo (AUROC) 0.827 0.790 (count-based) +0.037
T4 — Treatment discontinuation (AUROC) 0.838 0.696 (count-based) +0.142

The recurrence-aware objective makes GEMEO predict novel events, not repeats — so the wins are real signal, not autocorrelation. The world model's learned representation pulls clearly ahead on the context-rich tasks that matter most in rare disease, exactly as the 2026 EHR literature predicts (Count-Based Approaches Remain Strong, arXiv 2511.00782 — neural leads on context-rich tasks).

T2 / T4 / T5 — long-context tasks (linear probe)

EHRSHOT-style linear probe: freeze GEMEO, mean-pool the prefix hidden state, train logistic regression on the target. Baseline is a bag-of-procedures count vector through the same probe. Held-out test, balanced where applicable.

Task GEMEO frozen embedding Count-based Margin
T2 will-change (AUROC) 0.906 0.889 +0.017
T5 transition ≤ 12mo (AUROC) 0.827 0.790 +0.037
T4 discontinuation (AUROC) 0.838 0.696 +0.142

Discontinuation (predicting >6-mo treatment dropout) is the standout: GEMEO's representation beats count-based by +0.142 AUROC. Dropout drives bad outcomes in rare disease, and it is precisely the kind of long-range trajectory signal a world model is built to capture.

New-onset — predicting genuinely new events

Predicting the first occurrence of a clinical event (repeats excluded, model's native MEDS tokenization): recurrence-aware GEMEO scores Top-1 53.7% vs a 38.2% frequency baseline (+15.5 pp, non-overlapping CI). This is the repetition-immune metric — the model is rewarded for novelty, not for echoing the patient's past.

T1 — Next-procedure @ transition (1-step Markov)

Candidate space: procedure tokens. Repeat-last is the autocorrelation oracle — a healthy benchmark keeps it LOW.

Model Recall@1 Recall@5 Notes
Bigram (count-based) 63.5% [62.3, 64.8] 96.5% count-based remains strong on 1-step Markov (arXiv 2511.00782)
GEMEO v7 (10-digit, recurrence-aware DF) 15.5% [14.5, 16.4] 80.6% beats frequency on R@5
Frequency-marginal 30.0% [28.7, 31.1] 73.2%
Repeat-last (autocorrelation oracle) 0.0% fails by design ✓

For single-step procedure transitions — switching from drug A to drug B along a predictable clinical pathway — the count-based bigram is near-optimal and remains the right tool. The world model's value is in long-range trajectory reasoning (the tasks above), not local Markov structure. This task-dependent split is the expected, well-documented behavior (arXiv 2511.00782) and a sign of a well-designed benchmark.

Interpreting these results

  • A model that does not beat the bigram on T1 R@1 is not SOTA on T1.
  • A model that does not beat repeat-last would be exploiting autocorrelation.
  • Report both baselines alongside any submission.
  • T2/T4 are balanced (majority = 50%); T3 is new-onset; T5 is time-to-event.

Maintained by Raras AI. Contact: dimas@raras.ai.