Every claim ships with the thing that produced it.

AURORA is not built on an external citations library. Each module publishes its own working papers, the code and weights behind them, and the evaluation script that generated every number. If a result stops replicating, the paper says so — that is the whole point of doing this in the open.

Working papers
10drafts
Open RFCs
4of 8
Cohorts described
5federated
Replications
51 failed

Working papers

One paper per subsystem, written by the team that built it. Filter by module, or read the whole set.

Worked examples of the index format. Titles and statuses show how entries will be presented; none is a published paper yet.

  • AURORA-CORE Federation protocol Circulating

    Aggregate-only egress as a design constraint, not a policy

    Why the node protocol has no endpoint that accepts patient records, what that costs in model quality, and how we measured the cost across four sites.

    Protocol spec Reference node Eval script May 2026
  • AURORA-CORE Provenance Circulating

    Signed provenance chains for federated clinical models

    Every dataset, model and result carries a signature that lets a third party verify which code and weights produced a number, without access to the data.

    Sigstore integration Verification CLI May 2026
  • AURORA-CORE Equity gate In review

    Blocking release on subgroup performance: implementation and consequences

    The gate that stops a model shipping when subgroup metrics fall below threshold, and the three models it has blocked so far.

    Gate spec Blocked-model log June 2026
  • AURORA-GLIO GLIO-MMB Draft

    Molecular marker prediction from routine preoperative MRI

    Retrospective performance for IDH and MGMT status estimation, with the failure cases characterised rather than excluded.

    Weights Model card Eval script June 2026
  • AURORA-GLIO GLIO-TME Draft

    Tumour microenvironment features that survive site transfer

    Which imaging-derived features hold up when the scanner and the population change, and which do not.

    Feature set Transfer results June 2026
  • AURORA-HYDRO HYDRO-COMPDECIDE In review

    Shunt versus ETV: what the retrospective record can and cannot tell us

    A cohort description across three sites, and an explicit account of the confounding that makes a causal claim unavailable here.

    Cohort spec OMOP query June 2026
  • AURORA-CRANIO CRANIO-PHYSICS Draft

    Skull mechanics from 3D photogrammetry without ionising radiation

    Whether surface geometry alone tracks the measurements teams currently take from CT, and where the agreement breaks down.

    Pipeline Model card Phantom data July 2026
  • AURORA-CRANIO CRANIO-BIOMARKERS Draft

    Non-invasive indicators of raised intracranial pressure in infants

    A systematic account of what current indicators miss, framed as a negative result worth publishing.

    Review Data dictionary July 2026
  • AURORA-CHIARI CHIARI-CSF Draft

    CSF flow at the craniocervical junction: measurement variance across sites

    How much of the reported variation in flow studies is physiology and how much is protocol, measured on the same patients across two centres.

    Protocol Variance analysis July 2026
  • AURORA-CHIARI CHIARI-SYRINX In review

    Predicting syrinx progression: why millimetres are the wrong unit

    Tonsillar descent correlates poorly with outcome. This paper sets out what correlates better and how much better.

    Cohort spec Weights Eval script July 2026

Papers are listed here once a draft exists. Subsystems still in design do not get a placeholder entry — an empty row would imply work that hasn't happened.

RFC index

Every governance and design decision is proposed in public before it lands. Anyone can open one; the council reads all of them, and patient advocates vote alongside clinical and technical members.

Example RFCs illustrating the format and the kinds of decision that go through it. No RFC below has been ratified by the council — the states shown are illustrative.

RFC
Proposal
Area
State
RFC-001
Aggregate-only egress for all federated computation
No mode may transmit row-level data, including de-identified rows.
Protocol
Accepted
RFC-004
Two permanent patient-advocate seats with voting rights
Observer status was rejected as insufficient during review.
Governance
Accepted
RFC-009
Equity gate blocks release on subgroup failure
Applies even when aggregate metrics meet the target.
Ethics
Accepted
RFC-012
Model cards mandatory before any module leaves alpha
Includes intended use, populations, failure modes, and do-not-use conditions.
Quality
Accepted
RFC-017
Publish replication failures within 30 days of confirmation
Removes the discretion that lets inconvenient results sit unpublished.
Research
In review
RFC-021
Patient-facing guides require clinician sign-off before public alpha
Currently drafts are labelled pending review; this makes sign-off a gate.
Content
In review
RFC-023
Withdrawal procedure for degraded models
Defines who can trigger withdrawal and the notification path to sites.
Safety
Draft
RFC-026
Translation workflow for patient education
Structure exists; this proposes the review process for translated clinical content.
Access
Draft

Datasets & registries

Cohorts are described publicly and queried where they live. No dataset listed here is downloadable from us, because no dataset listed here is held by us — the description is the shared artefact, not the data.

Example cohort descriptions showing the metadata each one carries. Names, site counts and scales are illustrative; no cohort below is currently enrolled.

GLIO-RETRO-4 Glioma 4 sites

Retrospective preoperative MRI with molecular annotation, described in OMOP so the same study definition runs at every participating centre.

DICOM OMOP CDM Federated query
CHIARI-FLOW-2 Chiari 2 sites

Paired CSF flow studies on the same patients at two centres, built specifically to separate protocol variance from physiology.

Phase-contrast MRI Paired design
CRANIO-SURFACE Craniosynostosis 3 sites

3D photogrammetry with matched CT where CT was already clinically indicated. No child was scanned for research purposes.

Photogrammetry Matched CT Paediatric
HYDRO-LIFETIME Hydrocephalus 3 sites

Longitudinal shunt and revision records, including the failures — attrition is reported rather than trimmed.

FHIR Longitudinal Revision history
ENCEPH-PRENATAL Encephalocele 2 sites

Prenatal and postnatal imaging pairs for a condition rare enough that no single centre has a usable cohort alone.

Prenatal US/MRI Rare disease

Replication tracker

The uncomfortable table. Every headline result is re-run at a site that had no part in producing it, and the outcome is published either way — including when performance drops.

The rows below are worked examples, deliberately including a weakened and a failed outcome to show that those get published too. The deltas are not measurements, and sites stay unattributed until a real result exists and that site has agreed to be named.

Claim
Re-run at
Δ vs origin
Verdict
IDH status estimation from routine preoperative MRI
Independent site A
−0.06 AUC
Held
Syrinx progression signal beyond tonsillar descent
Independent site B
−0.04 AUC
Held
Photogrammetry agreement with CT cranial indices
Independent site C
−0.11 ICC
Weakened
TME feature stability across scanner vendors
Independent site D
−0.19 AUC
Failed
Shunt-failure risk stratification at 12 months
Independent site E
pending
Running

Open questions

The things we don't know, stated plainly. Patients ask these constantly and the honest answer is that the field cannot yet answer them — which is exactly why they are the research agenda.

Why do symptoms so often fail to match the size of a Chiari herniation?

AURORA-CHIARI

Millimetres of descent explain remarkably little about how a person feels. Until that gap is understood, surgical selection stays partly a judgement call — and patients are the ones carrying the uncertainty.

Read the patient guide on this

Can raised intracranial pressure in infants be detected without invasive monitoring?

AURORA-CRANIO

Current non-invasive indicators miss cases. Every missed case is a child whose pressure is treated late, and every false positive is an operation that may not have been needed.

What parents are told today

Which patients genuinely benefit from ETV rather than a shunt?

AURORA-HYDRO

The retrospective record is too confounded to answer this causally, and the honest position is that we are choosing between options without the evidence a family would expect us to have.

How this is explained to families

Do imaging-derived tumour features survive a change of scanner?

AURORA-GLIO

Our own replication says: often not. A feature that works only on the scanner it was developed on is a publication, not a tool.

See the replication result

How much of reported CSF flow variation is protocol rather than physiology?

AURORA-CHIARI

If most of it is protocol, a decade of flow-study literature needs re-reading. The paired-site study exists to find out.

Read the working paper

What outcome measures actually matter to patients over a lifetime?

Cross-module

Most registries record what is easy to record. Patient advocates on the council have consistently said the recorded endpoints are not the ones they live with.

Governance & ethics

How to cite AURORA

Cite the module and version you actually used, not the project in general — module behaviour changes between versions, and a citation that can't be pinned to one isn't reproducible.

@software{aurora_chiari_2026,
  title    = {AURORA-CHIARI: federated substrate for Chiari malformation},
  author   = {{AURORA Collective}},
  year     = {2026},
  version  = {0.1.0-pilot},
  note     = {Research use only. Not a certified medical device.},
  url      = {https://aurora.health/modules/chiari}
}

Work with us on this

If you have a cohort, a method, or a disagreement with something above, all three are welcome. Disagreements especially — they are the fastest route to a correct result.

research@aurora.health
rfc@aurora.health
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