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Oct 16

A rubric landscape for evaluating clinical reasoning in large language models: what exists, what is missing, and what needs to be combined

Exam-style accuracy does not establish whether large language models (LLMs) reason well over clinical records. We define clinical reasoning as integrating and updating evidence across time and sources to form, revise and justify a patient's problem representation and a defensible plan. This structured narrative review maps three literatures: medical education assessment instruments, clinical LLM benchmarks published from 2023 onwards, and general-domain methods for evaluating long-form generation. We examine six dimensions: problem representation, temporal synthesis, differential and management reasoning, counterfactual reasoning, calibrated uncertainty, and reasoning faithfulness. Preprints are included and flagged. No single instrument covers all six dimensions. Problem representation and differential or management reasoning are reasonably covered, although reliability varies by instrument and setting. TIMER-Eval targets temporal synthesis, and ER-Reason assesses sequential diagnostic belief updating. Dedicated uncertainty and counterfactual evaluations are emerging, but their applicability to longitudinal free-text reasoning remains limited. Factual completeness is well theorised in general-domain evaluation, with early clinical evidence of important omissions. Faithfulness remains the weakest dimension, with one identified clinical causal-ablation study on multiple-choice questions. Existing tools should be combined through binary rubric items, separate completeness and correctness scores, case-specific importance weighting with non-compensable safety caps, temporal order-consistency checks, and chance-corrected reliability reporting. Further design work is needed for calibrated uncertainty, counterfactual reasoning and faithfulness over longitudinal free-text records. This review provides a design rationale, not a validated instrument.

  • 3 authors
·
Sep 30

Gemini Robotics: Bringing AI into the Physical World

Recent advancements in large multimodal models have led to the emergence of remarkable generalist capabilities in digital domains, yet their translation to physical agents such as robots remains a significant challenge. This report introduces a new family of AI models purposefully designed for robotics and built upon the foundation of Gemini 2.0. We present Gemini Robotics, an advanced Vision-Language-Action (VLA) generalist model capable of directly controlling robots. Gemini Robotics executes smooth and reactive movements to tackle a wide range of complex manipulation tasks while also being robust to variations in object types and positions, handling unseen environments as well as following diverse, open vocabulary instructions. We show that with additional fine-tuning, Gemini Robotics can be specialized to new capabilities including solving long-horizon, highly dexterous tasks, learning new short-horizon tasks from as few as 100 demonstrations and adapting to completely novel robot embodiments. This is made possible because Gemini Robotics builds on top of the Gemini Robotics-ER model, the second model we introduce in this work. Gemini Robotics-ER (Embodied Reasoning) extends Gemini's multimodal reasoning capabilities into the physical world, with enhanced spatial and temporal understanding. This enables capabilities relevant to robotics including object detection, pointing, trajectory and grasp prediction, as well as multi-view correspondence and 3D bounding box predictions. We show how this novel combination can support a variety of robotics applications. We also discuss and address important safety considerations related to this new class of robotics foundation models. The Gemini Robotics family marks a substantial step towards developing general-purpose robots that realizes AI's potential in the physical world.

  • 118 authors
·
Mar 25, 2025 2

PRISM: A Multi-View Multi-Capability Retail Video Dataset for Embodied Vision-Language Models

A critical gap exists between the general-purpose visual understanding of state-of-the-art physical AI models and the specialized perceptual demands of structured real-world deployment environments. We present PRISM, a 270K-sample multi-view video supervised fine-tuning (SFT) corpus for embodied vision-language-models (VLMs) in real-world retail environments. PRISM is motivated by a simple observation - physical AI systems fail not because of poor visual recognition, but because they do not understand space, physical dynamics and embodied action well enough to operate reliably in the world. To this end, PRISM is grounded in a novel three-dimensional knowledge ontology that spans spatial knowledge, temporal and physical knowledge, and embodied action knowledge. It covers 20+ capability probes across four evaluation dimensions - Embodied Reasoning (ER), Common Sense (CS), Spatial Perception (SP), and Intuitive Physics (IP), and to our knowledge, PRISM is the first dataset to instantiate all three knowledge dimensions within a single real-world deployment domain. The corpus captures data from egocentric, exocentric and 360° viewpoints across five supermarket locations and includes open-ended, chain-of-thought, and multiple-choice supervision. At 4 fps, PRISM spans approximately 11.8M video frames and approximately 730M tokens, placing it among the largest domain-specific video SFT corpora. Fine-tuning on PRISM reduces the error rate across all 20+ probes by 66.6% over the pre-trained baseline, with significant gains in embodied action understanding where the accuracy improves by 36.4%. Our results suggest that ontology-structured, domain specific SFT can meaningfully strengthen embodied VLMs for real-world settings. The PRISM dataset and more details are available at https://dreamvu.ai/prism

  • 9 authors
·
Mar 31

NV-Reason-CT: 3D Visual Language Model for CT Analysis

We present NV-Reason-CT, a generative vision--language model for chest and abdominal CT combining native 3D visual encoding with radiologist-guided reasoning. The model couples a native 3D vision transformer with a language model, passing all visual tokens and their explicit 3D coordinates into language decoding without further spatial token merging. This retains volumetric spatial information within the vision encoder and through the language model's positional encoding during joint processing with text. We train on a curated corpus of approximately 550,000 multimodal instruction examples from 70,111 unique CT image inputs, combining standardized reports, abnormality-focused and anatomy-specific questions, multi-turn interactions, and radiologist-authored reasoning from recorded and transcribed expert CT interpretations. Expert annotations provide direct supervision and guide additional report-grounded synthetic reasoning. End-to-end supervised fine-tuning (SFT) is followed by Group Relative Policy Optimization (GRPO), with verifiable rewards over chest and abdominal abnormality sets. The model supports abnormality classification, report generation, and interactive reasoning with reviewable observations, differential diagnoses, and uncertainty. Evaluation spans public CT benchmarks and a held-out NIH cohort. On CT-RATE, NV-Reason-CT achieves a macro-F1 of 0.614 and macro-AUROC of 0.871 without a task-specific classification head; generated reports achieve a report-derived macro-F1 of 0.592. In a preliminary study with expert radiologists, AI-assisted review received favorable confidence ratings and was associated with a 50% reduction in average reported interpretation and reporting time. We release the model and training code to support reproducible research on explainable AI for volumetric medical imaging.

  • 16 authors
·
Sep 22

PRTS: A Primitive Reasoning and Tasking System via Contrastive Representations

Vision-Language-Action (VLA) models advance robotic control via strong visual-linguistic priors. However, existing VLAs predominantly frame pretraining as supervised behavior cloning, overlooking the fundamental nature of robot learning as a goal-reaching process that requires understanding temporal task progress. We present PRTS (Primitive Reasoning and Tasking System), a VLA foundation model that reformulates pretraining through Goal-Conditioned Reinforcement Learning. By treating language instructions as goals and employing contrastive reinforcement learning, PRTS learns a unified embedding space where the inner product of state-action and goal embeddings approximates the log-discounted goal occupancy, the probability of reaching the language-specified goal from the current state-action, quantitatively assessing physical feasibility beyond static semantic matching. PRTS draws this dense goal-reachability supervision directly from offline trajectories without reward annotations, and folds it into the VLM backbone via a role-aware causal mask, incurring negligible overhead over vanilla behavior cloning. This paradigm endows the high-level reasoning system with intrinsic goal reachability awareness, bridging semantic reasoning and temporal task progress, and further benefits goal-conditioned action prediction. Pretrained on 167B tokens of diverse manipulation and embodied-reasoning data, PRTS reaches state-of-the-art performance on LIBERO, LIBERO-Pro, LIBERO-Plus, SimplerEnv, and a real-world suite of 14 complex tasks, with particularly substantial gains on long-horizon, contact-rich, and zero-shot novel-instruction settings, confirming that injecting goal-reachability awareness significantly improves both execution success and long-horizon planning of general-purpose robotic foundation policies.

  • 14 authors
·
Apr 29

MolmoAct2: Action Reasoning Models for Real-world Deployment

Vision-Language-Action (VLA) models aim to provide a single generalist controller for robots, but today's systems fall short on the criteria that matter for real-world deployment. Frontier models are closed, open-weight alternatives are tied to expensive hardware, reasoning-augmented policies pay prohibitive latency for their grounding, and fine-tuned success rates remain below the threshold for dependable use. We present MolmoAct2, a fully open action reasoning model built for practical deployment, advancing its predecessor along five axes. We introduce MolmoER, a VLM backbone specialized for spatial and embodied reasoning, trained on a 3.3M-sample corpus with a specialize-then-rehearse recipe. We release three new datasets spanning low-to-medium cost platforms, including MolmoAct2-BimanualYAM, 720 hours of teleoperated bimanual trajectories that constitute the largest open bimanual dataset to date, together with quality-filtered Franka (DROID) and SO100/101 subsets. We provide OpenFAST, an open-weight, open-data action tokenizer trained on millions of trajectories across five embodiments. We redesign the architecture to graft a flow-matching continuous-action expert onto a discrete-token VLM via per-layer KV-cache conditioning. Finally, we propose MolmoThink, an adaptive-depth reasoning variant that re-predicts depth tokens only for scene regions that change between timesteps, retaining geometric grounding at a fraction of prior latency. In the most extensive empirical study of any open VLA to date, spanning 7 simulation and real-world benchmarks, MolmoAct2 outperforms strong baselines including Pi-05, while MolmoER surpasses GPT-5 and Gemini Robotics ER-1.5 across 13 embodied-reasoning benchmarks. We release model weights, training code, and complete training data. Project page: https://allenai.org/blog/molmoact2

allenai Ai2
·
May 3 6

Retro-Search: Exploring Untaken Paths for Deeper and Efficient Reasoning

Large reasoning models exhibit remarkable reasoning capabilities via long, elaborate reasoning trajectories. Supervised fine-tuning on such reasoning traces, also known as distillation, can be a cost-effective way to boost reasoning capabilities of student models. However, empirical observations reveal that these reasoning trajectories are often suboptimal, switching excessively between different lines of thought, resulting in under-thinking, over-thinking, and even degenerate responses. We introduce Retro-Search, an MCTS-inspired search algorithm, for distilling higher quality reasoning paths from large reasoning models. Retro-Search retrospectively revises reasoning paths to discover better, yet shorter traces, which can then lead to student models with enhanced reasoning capabilities with shorter, thus faster inference. Our approach can enable two use cases: self-improvement, where models are fine-tuned on their own Retro-Search-ed thought traces, and weak-to-strong improvement, where a weaker model revises stronger model's thought traces via Retro-Search. For self-improving, R1-distill-7B, fine-tuned on its own Retro-Search-ed traces, reduces the average reasoning length by 31.2% while improving performance by 7.7% across seven math benchmarks. For weak-to-strong improvement, we retrospectively revise R1-671B's traces from the OpenThoughts dataset using R1-distill-32B as the Retro-Search-er, a model 20x smaller. Qwen2.5-32B, fine-tuned on this refined data, achieves performance comparable to R1-distill-32B, yielding an 11.3% reduction in reasoning length and a 2.4% performance improvement compared to fine-tuning on the original OpenThoughts data. Our work counters recently emergent viewpoints that question the relevance of search algorithms in the era of large reasoning models, by demonstrating that there are still opportunities for algorithmic advancements, even for frontier models.

  • 11 authors
·
Apr 6, 2025

Beyond the Exploration-Exploitation Trade-off: A Hidden State Approach for LLM Reasoning in RLVR

A prevailing view in Reinforcement Learning for Verifiable Rewards (RLVR) interprets recent progress through the lens of an exploration-exploitation trade-off, a perspective largely shaped by token-level metrics. We re-examine this perspective, proposing that this perceived trade-off may not be a fundamental constraint but rather an artifact of the measurement level. To investigate this, we shift the analysis to the semantically rich hidden-state space, adopting Effective Rank (ER) to quantify exploration and proposing its novel first- and second-order derivatives, named Effective Rank Velocity (ERV) and Effective Rank Acceleration (ERA), to capture exploitation dynamics. Our analysis reveals that at the hidden-state level, exploration and exploitation could be decoupled (Sec. 4). This finding reveals an opportunity to enhance both capacities simultaneously. This insight motivates our method, Velocity-Exploiting Rank-Learning (VERL), the first to operationalize the principle of synergistic exploration-exploitation enhancement by directly shaping the RL advantage function. The key innovation is leveraging the theoretically stable ERA as a predictive meta-controller to create a synergistic, dual-channel incentive structure. Instead of forcing a trade-off, VERL prospectively amplifies rewards for exploration to preempt overconfidence and reinforces exploitative gains to consolidate reasoning. Experiments across diverse LLMs and reasoning benchmarks show consistent gains, including up to 21.4% absolute accuracy improvement on the challenging Gaokao 2024 dataset.

Tsinghua Tsinghua University
·
Sep 28, 2025 2

DeepTumorVQA: A Hierarchical 3D CT Benchmark for Stage-Wise Evaluation of Medical VLMs and Tool-Augmented Agents

Medical vision-language models (VLMs) and AI agents have made significant progress in learning to analyze and reason about clinical images. However, existing medical visual question answering (VQA) benchmarks collapse model capabilities into a single accuracy score, obscuring where and why models fail. We propose DeepTumorVQA, a hierarchical benchmark that follows the multi-stage evidence chain in tumor diagnosis and decomposes 3D CT reasoning into four stages: recognition, measurement, visual reasoning, and medical reasoning. Higher-level questions remain independently scorable, while their ground-truth evidence chains are defined over lower-level primitives. The benchmark contains 476K questions across 42 clinical subtypes on 9,262 3D CT volumes. In addition to a direct reasoning mode for VLMs, DeepTumorVQA provides tool-interaction environments for agent evaluation, where a model can call external tools, including segmentation models, measurement programs, and medical knowledge modules, before answering the question. Evaluating over 30 model configurations, we find that reliable quantitative measurement is the primary bottleneck, making later-stage visual and medical reasoning harder for VLMs, while tool augmentation substantially mitigates this issue. When tools are available, leveraging medical knowledge and tools to reason about medical images becomes a new challenge. We further show that ground-truth step-by-step tool-use traces from DeepTumorVQA can supervise agents and reduce tool-use and reasoning failures. This stage-wise progression from recognition to measurement to visual and medical reasoning provides a concrete roadmap for future medical VLM and AI agent studies. All data and code are released at https://github.com/Schuture/DeepTumorVQA.

  • 10 authors
·
May 9

Are Vision Language Models Ready for Clinical Diagnosis? A 3D Medical Benchmark for Tumor-centric Visual Question Answering

Vision-Language Models (VLMs) have shown promise in various 2D visual tasks, yet their readiness for 3D clinical diagnosis remains unclear due to stringent demands for recognition precision, reasoning ability, and domain knowledge. To systematically evaluate these dimensions, we present DeepTumorVQA, a diagnostic visual question answering (VQA) benchmark targeting abdominal tumors in CT scans. It comprises 9,262 CT volumes (3.7M slices) from 17 public datasets, with 395K expert-level questions spanning four categories: Recognition, Measurement, Visual Reasoning, and Medical Reasoning. DeepTumorVQA introduces unique challenges, including small tumor detection and clinical reasoning across 3D anatomy. Benchmarking four advanced VLMs (RadFM, M3D, Merlin, CT-CHAT), we find current models perform adequately on measurement tasks but struggle with lesion recognition and reasoning, and are still not meeting clinical needs. Two key insights emerge: (1) large-scale multimodal pretraining plays a crucial role in DeepTumorVQA testing performance, making RadFM stand out among all VLMs. (2) Our dataset exposes critical differences in VLM components, where proper image preprocessing and design of vision modules significantly affect 3D perception. To facilitate medical multimodal research, we have released DeepTumorVQA as a rigorous benchmark: https://github.com/Schuture/DeepTumorVQA.

  • 8 authors
·
May 24, 2025

LightNav-0: Eliciting VLM Spatial Intelligence for Generalist Embodied Navigation

Embodied navigation requires agents to translate heterogeneous goals and visual observations into actions across tasks, environments, and robot embodiments. Modern vision-language models (VLMs) already encode spatial priors for visual grounding, spatial reasoning, and pointing, but these capabilities are rarely elicited directly for robot control. Existing navigation systems instead rely on task- or embodiment-specific components, fragmenting perception, reasoning, and action while offering limited generalization. Here we present LightNav-0, a compact generalist embodied navigation model that elicits the spatial intelligence of a pretrained VLM and aligns it with navigation, without task-specific prediction heads. LightNav-0 represents diverse navigation tasks through a unified token interface: dual-channel pointing expresses task-, scene-, and embodiment-agnostic spatial intent, while a residual vector-quantized action tokenizer maps this intent to precise, embodiment-specific trajectories. Together with temporally aware visual history compression, ER mid-training, supervised fine-tuning, and reinforcement learning, this formulation supports instruction following, open-vocabulary object navigation, and visual tracking within a single model. The navigation training corpus spans 2K+ scenes and 4K+ hours of embodied navigation data. LightNav-ER, the embodied-reasoning checkpoint used to initialize LightNav-0, attains the highest complete-set average across 8 embodied-reasoning benchmarks, while LightNav-0 achieves state-of-the-art monocular success rates across all 10 public navigation simulation settings. Real-world evaluations further demonstrate zero-shot generalization across robot embodiments, diverse scenes, and static and dynamic targets. These results establish compact VLMs as a unified and transferable backbone for generalist embodied navigation.

OneOcc: Semantic Occupancy Prediction for Legged Robots with a Single Panoramic Camera

Robust 3D semantic occupancy is crucial for legged/humanoid robots, yet most semantic scene completion (SSC) systems target wheeled platforms with forward-facing sensors. We present OneOcc, a vision-only panoramic SSC framework designed for gait-introduced body jitter and 360° continuity. OneOcc combines: (i) Dual-Projection fusion (DP-ER) to exploit the annular panorama and its equirectangular unfolding, preserving 360° continuity and grid alignment; (ii) Bi-Grid Voxelization (BGV) to reason in Cartesian and cylindrical-polar spaces, reducing discretization bias and sharpening free/occupied boundaries; (iii) a lightweight decoder with Hierarchical AMoE-3D for dynamic multi-scale fusion and better long-range/occlusion reasoning; and (iv) plug-and-play Gait Displacement Compensation (GDC) learning feature-level motion correction without extra sensors. We also release two panoramic occupancy benchmarks: QuadOcc (real quadruped, first-person 360°) and Human360Occ (H3O) (CARLA human-ego 360° with RGB, Depth, semantic occupancy; standardized within-/cross-city splits). OneOcc sets a new state of the art on QuadOcc, outperforming strong vision baselines and remaining competitive with classical LiDAR baselines; on H3O it gains +3.83 mIoU (within-city) and +8.08 (cross-city). Modules are lightweight, enabling deployable full-surround perception for legged/humanoid robots. Datasets and code will be publicly available at https://github.com/MasterHow/OneOcc.

  • 9 authors
·
Mar 14

SMART: Self-Aware Agent for Tool Overuse Mitigation

Current Large Language Model (LLM) agents demonstrate strong reasoning and tool use capabilities, but often lack self-awareness, failing to balance these approaches effectively. This imbalance leads to Tool Overuse, where models unnecessarily rely on external tools for tasks solvable with parametric knowledge, increasing computational overhead. Inspired by human metacognition, we introduce SMART (Strategic Model-Aware Reasoning with Tools), a paradigm that enhances an agent's self-awareness to optimize task handling and reduce tool overuse. To support this paradigm, we introduce SMART-ER, a dataset spanning three domains, where reasoning alternates between parametric knowledge and tool-dependent steps, with each step enriched by rationales explaining when tools are necessary. Through supervised training, we develop SMARTAgent, a family of models that dynamically balance parametric knowledge and tool use. Evaluations show that SMARTAgent reduces tool use by 24% while improving performance by over 37%, enabling 7B-scale models to match its 70B counterpart and GPT-4o. Additionally, SMARTAgent generalizes to out-of-distribution test data like GSM8K and MINTQA, maintaining accuracy with just one-fifth the tool calls. These highlight the potential of strategic tool use to enhance reasoning, mitigate overuse, and bridge the gap between model size and performance, advancing intelligent and resource-efficient agent designs.

  • 8 authors
·
Feb 16, 2025

RoboReward: General-Purpose Vision-Language Reward Models for Robotics

A well-designed reward is critical for effective reinforcement learning-based policy improvement. In real-world robotic domains, obtaining such rewards typically requires either labor-intensive human labeling or brittle, handcrafted objectives. Vision-language models (VLMs) have shown promise as automatic reward models, yet their effectiveness on real robot tasks is poorly understood. In this work, we aim to close this gap by introducing (1) RoboReward, a robotics reward dataset and benchmark built on large-scale real-robot corpora from Open X-Embodiment (OXE) and RoboArena, and (2) vision-language reward models trained on this dataset (RoboReward 4B/8B). Because OXE is success-heavy and lacks failure examples, we propose a negative examples data augmentation pipeline that generates calibrated negatives and near-misses via counterfactual relabeling of successful episodes and temporal clipping to create partial-progress outcomes from the same videos. Using this framework, we produce an extensive training and evaluation dataset that spans diverse tasks and embodiments and enables systematic evaluation of whether state-of-the-art VLMs can reliably provide rewards for robotics. Our evaluation of leading open-weight and proprietary VLMs reveals that no model excels across all tasks, underscoring substantial room for improvement. We then train general-purpose 4B- and 8B-parameter models that outperform much larger VLMs in assigning rewards for short-horizon robotic tasks. Finally, we deploy the 8B-parameter reward VLM in real-robot reinforcement learning and find that it improves policy learning over Gemini Robotics-ER 1.5, a frontier physical reasoning VLM trained on robotics data, by a large margin, while substantially narrowing the gap to RL training with human-provided rewards.

  • 6 authors
·
Jan 2