When More Evidence Hurts: Publication-Bias Drift and Principled Stopping for Biomedical Causal Search

Abstract

Automated biomedical evidence synthesis depends on retrieving published studies, but the biomedical literature is systematically skewed toward positive findings. Deeper retrieval can therefore make a system \emph{more} likely to falsely infer benefit when the true effect is null. We formalise this phenomenon as \emph{evidence drift} and prove that, under a standard publication-bias model, the false-positive probability on null-effect queries follows a strictly increasing large-sample envelope in retrieval depth, approaching one. Empirically, on a held-out test set of 140 Cochrane-derived queries, drift rises monotonically from 7.9\% to 15.7\% as the retrieval budget grows from 3 to 20 steps, and concentrates in the null-effect class. We present DACG-agent, a drift-aware causal-graph agent that incrementally builds a causal knowledge graph from PubMed abstracts and applies a two-layer stopping policy with complementary roles: a KL-divergence monitor that detects posterior convergence (the accuracy layer), and a Bradley--Terry process reward model (PRM) whose online decline detection halts retrieval once evidence quality peaks (the efficiency layer). Against full-budget retrieval, DACG-agent reduces evidence drift from 15.7\% to 6.4\% and improves null-effect accuracy by 21 percentage points (40.0\%$\to$61.4\%) while using 67\% fewer retrieval steps; overall accuracy rises from 61.4\% to 69.3\% (95\% CI 61--77). A simulation confirms the drift result transfers from the analysed vote-counting aggregator to the deployed noisy-OR one.