Cohort-Anchored Foundation Models for Electronic Health Records: From Risk Scores to Auditable Peer Cohorts (opens in new tab)

Foundation models have achieved remarkable performance across medical question answering, imaging, and electronic health record (EHR) tasks, yet reliable clinical deployment remains challenging due to limited interpretability, vulnerability to distribution shift, and weak alignment with clinician reasoning. We argue that these limitations arise because existing approaches prioritize representation learning while treating patient comparison as ...