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.