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Jul 31

Aligning LLM+PDDL Symbolic Plans with Human Objective Specifications through Evolutionary Algorithm Guidance

Automated planning using a symbolic planning language, such as PDDL, is a general approach to producing optimal plans to achieve a stated goal. However, creating suitable machine understandable descriptions of the planning domain, problem, and goal requires expertise in the planning language, limiting the utility of these tools for non-expert humans. Recent efforts have explored utilizing a symbolic planner in conjunction with a large language model to generate plans from natural language descriptions given by a non-expert human (LLM+PDDL). Our approach performs initial translation of goal specifications to a set of PDDL goal constraints using an LLM; such translations often result in imprecise symbolic specifications, which are difficult to validate directly. We account for this using an evolutionary approach to generate a population of symbolic goal specifications with slight differences from the initial translation, and utilize a trained LSTM-based validation model to assess whether each induced plan in the population adheres to the natural language specifications. We evaluate our approach on a collection of prototypical specifications in a notional naval disaster recovery task, and demonstrate that our evolutionary approach improve adherence of generated plans to natural language specifications when compared to plans generated using only LLM translations. The code for our method can be found at https://github.com/owenonline/PlanCritic.

  • 3 authors
·
Oct 8, 2025

Explore-Execute Chain: Towards an Efficient Structured Reasoning Paradigm

Chain-of-Thought (CoT) and its variants have markedly advanced the reasoning abilities of Large Language Models (LLMs), yet their monolithic and auto-regressive architecture inherently conflates high-level strategic planning with low-level step-by-step execution, leading to computational inefficiency, limited exploration of reasoning paths, and reduced interpretability. To overcome these issues, we propose the Explore-Execute Chain (E^2C), a structured reasoning framework that decouples reasoning into two distinct phases: an exploratory phase that stochastically generates succinct high-level plans, followed by an execution phase that deterministically carries out the chosen plan. Our approach incorporates a two-stage training methodology, which combines Supervised Fine-Tuning (SFT) - augmented by a novel data generation algorithm enforcing strict plan adherence - with a subsequent Reinforcement Learning (RL) stage that capitalizes on the informativeness of exploration and reinforces the determinism of execution. This decomposition enables an efficient test-time scaling strategy: on AIME'2024, E^2C Test Time Scaling reaches 58.1% accuracy using <10% of the decoding tokens required by comparable methods (e.g., Forest-of-Thought), sharply cutting self-consistency overhead. For cross-domain adaptation, our Exploration-Focused SFT (EF-SFT) fine-tunes with only 3.5% of the tokens used by standard SFT yet yields up to 14.5% higher accuracy than standard SFT on medical benchmarks, delivering state-of-the-art performance, strong generalization, and greater interpretability by separating planning from execution. The code and pre-trained models for the project are available at: https://github.com/yks23/Explore-Execute-Chain.git

  • 7 authors
·
Sep 28, 2025

NutriGen: Personalized Meal Plan Generator Leveraging Large Language Models to Enhance Dietary and Nutritional Adherence

Maintaining a balanced diet is essential for overall health, yet many individuals struggle with meal planning due to nutritional complexity, time constraints, and lack of dietary knowledge. Personalized food recommendations can help address these challenges by tailoring meal plans to individual preferences, habits, and dietary restrictions. However, existing dietary recommendation systems often lack adaptability, fail to consider real-world constraints such as food ingredient availability, and require extensive user input, making them impractical for sustainable and scalable daily use. To address these limitations, we introduce NutriGen, a framework based on large language models (LLM) designed to generate personalized meal plans that align with user-defined dietary preferences and constraints. By building a personalized nutrition database and leveraging prompt engineering, our approach enables LLMs to incorporate reliable nutritional references like the USDA nutrition database while maintaining flexibility and ease-of-use. We demonstrate that LLMs have strong potential in generating accurate and user-friendly food recommendations, addressing key limitations in existing dietary recommendation systems by providing structured, practical, and scalable meal plans. Our evaluation shows that Llama 3.1 8B and GPT-3.5 Turbo achieve the lowest percentage errors of 1.55\% and 3.68\%, respectively, producing meal plans that closely align with user-defined caloric targets while minimizing deviation and improving precision. Additionally, we compared the performance of DeepSeek V3 against several established models to evaluate its potential in personalized nutrition planning.

  • 4 authors
·
Feb 27, 2025

AIMI: Leveraging Future Knowledge and Personalization in Sparse Event Forecasting for Treatment Adherence

Adherence to prescribed treatments is crucial for individuals with chronic conditions to avoid costly or adverse health outcomes. For certain patient groups, intensive lifestyle interventions are vital for enhancing medication adherence. Accurate forecasting of treatment adherence can open pathways to developing an on-demand intervention tool, enabling timely and personalized support. With the increasing popularity of smartphones and wearables, it is now easier than ever to develop and deploy smart activity monitoring systems. However, effective forecasting systems for treatment adherence based on wearable sensors are still not widely available. We close this gap by proposing Adherence Forecasting and Intervention with Machine Intelligence (AIMI). AIMI is a knowledge-guided adherence forecasting system that leverages smartphone sensors and previous medication history to estimate the likelihood of forgetting to take a prescribed medication. A user study was conducted with 27 participants who took daily medications to manage their cardiovascular diseases. We designed and developed CNN and LSTM-based forecasting models with various combinations of input features and found that LSTM models can forecast medication adherence with an accuracy of 0.932 and an F-1 score of 0.936. Moreover, through a series of ablation studies involving convolutional and recurrent neural network architectures, we demonstrate that leveraging known knowledge about future and personalized training enhances the accuracy of medication adherence forecasting. Code available: https://github.com/ab9mamun/AIMI.

  • 3 authors
·
Mar 20, 2025 2

Plans Don't Persist: Why Context Management Is Load Bearing for LLM Agents

Long-horizon agents depend on context management: systems compress, summarize, and evict old tokens so tasks can continue beyond finite windows. That is safe only when dropped information is no longer needed or has been internalized. Plans are the stress case: they are written early, used for many steps, and first to be evicted. We introduce replay pairing, a diagnostic that runs the same trajectory with and without the plan in history and measures hidden-state cosine distance. On Llama-3.1-70B, plan signal spikes to 0.453 one step after the plan, then falls 4.1x in a single action-observation step; HotpotQA falls 12.4x. This is evidence that standard LLM agents do not carry plans forward as persistent state, and instead depend on the plan remaining in context. A layer-L32 probe detects this decay as a diagnostic, not as proof that it reads plan content itself. Reasoning models add a measurement confound: their `<think>` traces re-derive plan content, so standard stripping leaves plan evidence in the stripped condition. We name this the reasoning-trace confound and fix it with strict stripping, which removes prior `<think>` blocks from the stripped run only. It recovers +163% of the step+1 signal in-sample and +153% held out, while not meaningfully changing non-reasoning Llama (+4.8%). On DeepSeek-R1-Distill-Llama-70B, a Llama-trained probe transfers at AUROC 0.748 (p=6e-4), while R1-specific probes reach 1.000, suggesting R1 encodes plan signal in a different hidden-state direction. Finally, a compression stress test shows the practical cost: naive plan eviction cuts ALFWorld success by 34.7pp, while probe-gated re-surfacing does not recover it. The contribution is a measurement and stress-test framework showing that agent-critical information can be context-resident rather than persistent. Context management is load bearing, but plan protection alone is not enough.

Snowflake Snowflake
·
Jun 21 1

Progress Note Understanding -- Assessment and Plan Reasoning: Overview of the 2022 N2C2 Track 3 Shared Task

Daily progress notes are common types in the electronic health record (EHR) where healthcare providers document the patient's daily progress and treatment plans. The EHR is designed to document all the care provided to patients, but it also enables note bloat with extraneous information that distracts from the diagnoses and treatment plans. Applications of natural language processing (NLP) in the EHR is a growing field with the majority of methods in information extraction. Few tasks use NLP methods for downstream diagnostic decision support. We introduced the 2022 National NLP Clinical Challenge (N2C2) Track 3: Progress Note Understanding - Assessment and Plan Reasoning as one step towards a new suite of tasks. The Assessment and Plan Reasoning task focuses on the most critical components of progress notes, Assessment and Plan subsections where health problems and diagnoses are contained. The goal of the task was to develop and evaluate NLP systems that automatically predict causal relations between the overall status of the patient contained in the Assessment section and its relation to each component of the Plan section which contains the diagnoses and treatment plans. The goal of the task was to identify and prioritize diagnoses as the first steps in diagnostic decision support to find the most relevant information in long documents like daily progress notes. We present the results of 2022 n2c2 Track 3 and provide a description of the data, evaluation, participation and system performance.

  • 6 authors
·
Mar 14, 2023

The Impact of Medication Non-adherence on Adverse Outcomes: Evidence from Schizophrenia Patients via Survival Analysis

This study quantifies the association between non-adherence to antipsychotic medications and adverse outcomes in individuals with schizophrenia. We frame the problem using survival analysis, focusing on the time to the earliest of several adverse events (early death, involuntary hospitalization, jail booking). We extend standard causal inference methods (T-learner, S-learner, nearest neighbor matching) to utilize various survival models to estimate individual and average treatment effects, where treatment corresponds to medication non-adherence. Analyses are repeated using different amounts of longitudinal information (3, 6, 9, and 12 months). Using data from Allegheny County in western Pennsylvania, we find strong evidence that non-adherence advances adverse outcomes by approximately 1 to 4 months. Ablation studies confirm that county-provided risk scores adjust for key confounders, as their removal amplifies the estimated effects. Subgroup analyses by medication formulation (injectable vs. oral) and medication type consistently show that non-adherence is associated with earlier adverse events. These findings highlight the clinical importance of adherence in delaying psychiatric crises and show that integrating survival analysis with causal inference tools can yield policy-relevant insights. We caution that although we apply causal inference, we only make associative claims and discuss assumptions needed for causal interpretation.

When Agents Commit Too Soon: Diagnosing Premature Commitment in LLM Agents

Long-horizon LLM agents can fail quietly: they settle on one reading of the evidence early, then spend the rest of the run defending it. We call this premature commitment. Final-answer scoring misses the failure mode because it sees only the answer, not whether the process has already collapsed to a stable path. We define representational commitment as cross-run hidden-state convergence at a fixed reasoning step, and use it as an early diagnostic of trajectory consistency. On Llama-3.1-70B running ReAct on HotpotQA, step-4 hidden-state similarity predicts downstream behavioral consistency (r = -0.35, partial r = -0.45), with a localized temporal and layer-wise signature. The signal replicates across Qwen-2.5-72B and Phi-3-14B, and on StrategyQA (r = -0.83). It does not track correctness: committed-wrong and committed-correct questions are not separable in activation similarity. That boundary is central to the claim. Commitment tells us whether an agent has settled, not whether it is right. A runtime monitor detects inconsistent trajectories from hidden states at AUROC up to 0.97 (0.85--0.88 under a stricter split), and a prompting intervention cuts behavioral variance by 28% against a token-matched control while leaving accuracy statistically unchanged. We also test whether the signal can route self-consistency compute; on a harder benchmark it helps only modestly and is matched by a simpler output-based baseline. The result is a diagnostic for a hidden process failure, with clear limits rather than a general accuracy lever.

Snowflake Snowflake
·
Jun 21 2

Understanding and Mitigating Premature Confidence for Better LLM Reasoning

Long chains of thought (CoT) from current language models frequently contain logical gaps and unjustified leaps, limiting the gains from additional test-time compute. Improving reasoning quality directly would require process reward models, but the step-level annotations needed to train them are expensive and scarce. We find such a signal in how the model's confidence evolves during reasoning: premature confidence, the tendency to commit to an answer early and use the remaining tokens to rationalize it, strongly predicts flawed reasoning across tasks and model scales. We exploit this in progressive confidence shaping, a reinforcement learning objective that trains models to update their confidence as they reason rather than commit early -- rewarding gradual confidence growth and penalizing early commitment, with no external labels or reward models. The method improves accuracy and reasoning quality from 1.5B to 8B parameters across arithmetic (Countdown), math (DAPO, AIME), and science (ScienceQA): on Countdown, accuracy improves 3.2x (+42.0pp) and flawed reasoning drops 48pp; on AIME, Pass@64 improves 6.6pp. Consistent with this mechanism, the method also improves faithfulness: on a safety benchmark, our models more transparently surface misleading content in their reasoning traces rather than concealing it. Controlled experiments reveal that the problem and its remedy scale together: premature confidence grows with model size and task difficulty, and so do the gains from addressing it.

  • 7 authors
·
May 22

Large Language Models Can Solve Real-World Planning Rigorously with Formal Verification Tools

Large Language Models (LLMs) struggle to directly generate correct plans for complex multi-constraint planning problems, even with self-verification and self-critique. For example, a U.S. domestic travel planning benchmark TravelPlanner was proposed in Xie et al. (2024), where the best LLM OpenAI o1-preview can only find viable travel plans with a 10% success rate given all needed information. In this work, we tackle this by proposing an LLM-based planning framework that formalizes and solves complex multi-constraint planning problems as constrained satisfiability problems, which are further consumed by sound and complete satisfiability solvers. We start with TravelPlanner as the primary use case and show that our framework achieves a success rate of 93.9% and is effective with diverse paraphrased prompts. More importantly, our framework has strong zero-shot generalizability, successfully handling unseen constraints in our newly created unseen international travel dataset and generalizing well to new fundamentally different domains. Moreover, when user input queries are infeasible, our framework can identify the unsatisfiable core, provide failure reasons, and offers personalized modification suggestions. We show that our framework can modify and solve for an average of 81.6% and 91.7% unsatisfiable queries from two datasets and prove with ablations that all key components of our framework are effective and necessary. Project page: https://sites.google.com/view/llm-rwplanning.

  • 4 authors
·
Apr 18, 2024

Making LLMs Reliable When It Matters Most: A Five-Layer Architecture for High-Stakes Decisions

Current large language models (LLMs) excel in verifiable domains where outputs can be checked before action but prove less reliable for high-stakes strategic decisions with uncertain outcomes. This gap, driven by mutually reinforcing cognitive biases in both humans and artificial intelligence (AI) systems, threatens the defensibility of valuations and sustainability of investments in the sector. This report describes a framework emerging from systematic qualitative assessment across 7 frontier-grade LLMs and 3 market-facing venture vignettes under time pressure. Detailed prompting specifying decision partnership and explicitly instructing avoidance of sycophancy, confabulation, solution drift, and nihilism achieved initial partnership state but failed to maintain it under operational pressure. Sustaining protective partnership state required an emergent 7-stage calibration sequence, built upon a 4-stage initialization process, within a 5-layer protection architecture enabling bias self-monitoring, human-AI adversarial challenge, partnership state verification, performance degradation detection, and stakeholder protection. Three discoveries resulted: partnership state is achievable through ordered calibration but requires emergent maintenance protocols; reliability degrades when architectural drift and context exhaustion align; and dissolution discipline prevents costly pursuit of fundamentally wrong directions. Cross-model validation revealed systematic performance differences across LLM architectures. This approach demonstrates that human-AI teams can achieve cognitive partnership capable of preventing avoidable regret in high-stakes decisions, addressing return-on-investment expectations that depend on AI systems supporting consequential decision-making without introducing preventable cognitive traps when verification arrives too late.

  • 1 authors
·
Nov 10, 2025

Coherence Under Commitment: Probing Generalization and Vacuous Memorization in LLM Logical Reasoning

Large language models (LLMs) deployed for logical reasoning in knowledge-intensive domains exhibit a subtle but critical failure: coherence can be vacuously achieved through systematic abstention. A model that withholds commitment to either entailment or refutation satisfies negation consistency while providing no utility. We introduce Coherence Under Commitment (CUC), a dual-query evaluation paradigm that jointly measures consistency and decisiveness. CUC contributes three innovations: (1) a commitment score c(φ) = p(φ) + p(lnotφ) quantifying probability mass allocated to decisive outcomes; (2) a deterministic elicitation protocol via normalized YES/NO log probabilities, eliminating sampling variance; and (3) a 3-way decision framework (True/False/Uncertain) operationalizing the coherence-commitment trade-off into metrics. Experiments on four open-weight LLMs (1B-3B) across 204 FOLIO examples expose a sharp frontier. Qwen2.5-3B achieves near-zero contradiction (E[v_{neg}]{=}0.025) but only 7.4% coverage, while TinyLlama-1.1B reaches 79.4% coverage with violations on every example. Coherence-only evaluation would rank the abstaining model first; CUC exposes this as vacuous, and the frontier generalizes to LogiQA~v2 (ρ{=}0.97). We argue that evaluation must report both coherence and non-vacuous commitment and release a toolkit for standardized assessment.

  • 2 authors
·
Jun 18

Automating High Quality RT Planning at Scale

Radiotherapy (RT) planning is complex, subjective, and time-intensive. Advances in artificial intelligence (AI) promise to improve its precision, efficiency, and consistency, but progress is often limited by the scarcity of large, standardized datasets. To address this, we introduce the Automated Iterative RT Planning (AIRTP) system, a scalable solution for generating high-quality treatment plans. This scalable solution is designed to generate substantial volumes of consistently high-quality treatment plans, overcoming a key obstacle in the advancement of AI-driven RT planning. Our AIRTP pipeline adheres to clinical guidelines and automates essential steps, including organ-at-risk (OAR) contouring, helper structure creation, beam setup, optimization, and plan quality improvement, using AI integrated with RT planning software like Eclipse of Varian. Furthermore, a novel approach for determining optimization parameters to reproduce 3D dose distributions, i.e. a method to convert dose predictions to deliverable treatment plans constrained by machine limitations. A comparative analysis of plan quality reveals that our automated pipeline produces treatment plans of quality comparable to those generated manually, which traditionally require several hours of labor per plan. Committed to public research, the first data release of our AIRTP pipeline includes nine cohorts covering head-and-neck and lung cancer sites to support an AAPM 2025 challenge. This data set features more than 10 times the number of plans compared to the largest existing well-curated public data set to our best knowledge. Repo:{https://github.com/RiqiangGao/GDP-HMM_AAPMChallenge}

  • 13 authors
·
Jan 20, 2025

Pluralistic Behavior Suite: Stress-Testing Multi-Turn Adherence to Custom Behavioral Policies

Large language models (LLMs) are typically aligned to a universal set of safety and usage principles intended for broad public acceptability. Yet, real-world applications of LLMs often take place within organizational ecosystems shaped by distinctive corporate policies, regulatory requirements, use cases, brand guidelines, and ethical commitments. This reality highlights the need for rigorous and comprehensive evaluation of LLMs with pluralistic alignment goals, an alignment paradigm that emphasizes adaptability to diverse user values and needs. In this work, we present PLURALISTIC BEHAVIOR SUITE (PBSUITE), a dynamic evaluation suite designed to systematically assess LLMs' capacity to adhere to pluralistic alignment specifications in multi-turn, interactive conversations. PBSUITE consists of (1) a diverse dataset of 300 realistic LLM behavioral policies, grounded in 30 industries; and (2) a dynamic evaluation framework for stress-testing model compliance with custom behavioral specifications under adversarial conditions. Using PBSUITE, We find that leading open- and closed-source LLMs maintain robust adherence to behavioral policies in single-turn settings (less than 4% failure rates), but their compliance weakens substantially in multi-turn adversarial interactions (up to 84% failure rates). These findings highlight that existing model alignment and safety moderation methods fall short in coherently enforcing pluralistic behavioral policies in real-world LLM interactions. Our work contributes both the dataset and analytical framework to support future research toward robust and context-aware pluralistic alignment techniques.

  • 5 authors
·
Nov 6, 2025

Serialisation Strategy Matters: How FHIR Data Format Affects LLM Medication Reconciliation

Medication reconciliation at clinical handoffs is a high-stakes, error-prone process. Large language models are increasingly proposed to assist with this task using FHIR-structured patient records, but a fundamental and largely unstudied variable is how the FHIR data is serialised before being passed to the model. We present the first systematic comparison of four FHIR serialisation strategies (Raw JSON, Markdown Table, Clinical Narrative, and Chronological Timeline) across five open-weight models (Phi-3.5-mini, Mistral-7B, BioMistral-7B, Llama-3.1-8B, Llama-3.3-70B) on a controlled benchmark of 200 synthetic patients, totalling 4,000 inference runs. We find that serialisation strategy has a large, statistically significant effect on performance for models up to 8B parameters: Clinical Narrative outperforms Raw JSON by up to 19 F1 points for Mistral-7B (r = 0.617, p < 10^{-10}). This advantage reverses at 70B, where Raw JSON achieves the best mean F1 of 0.9956. In all 20 model and strategy combinations, mean precision exceeds mean recall: omission is the dominant failure mode, with models more often missing an active medication than fabricating one, which changes how clinical safety auditing priorities should be set. Smaller models plateau at roughly 7-10 concurrent active medications, leaving polypharmacy patients, the patients most at risk from reconciliation errors, systematically underserved. BioMistral-7B, a domain-pretrained model without instruction tuning, produces zero usable output in all conditions, showing that domain pretraining alone is not sufficient for structured extraction. These results offer practical, evidence-based format recommendations for clinical LLM deployment: Clinical Narrative for models up to 8B, Raw JSON for 70B and above. The complete pipeline is reproducible on open-source tools running on an AWS g6e.xlarge instance (NVIDIA L40S, 48 GB VRAM).

  • 1 authors
·
Apr 21

PlanningBench: Generating Scalable and Verifiable Planning Data for Evaluating and Training Large Language Models

Planning is a fundamental capability for large language models (LLMs) because such complex tasks require models to coordinate goals, constraints, resources, and long-term consequences into executable and verifiable solutions. Existing planning benchmarks, however, usually treat planning data as fixed collections of instances rather than controllable generation targets. This limits scenario coverage, ties difficulty to surface-level proxies rather than structural sources, and offers limited support for scalable generation, automatic verification, or planning-oriented training. We introduce PlanningBench, a framework for generating scalable, diverse, and verifiable planning data for both evaluation and training. PlanningBench starts from real planning scenarios and abstracts practical workflows into a structured taxonomy of more than 30 task types, subtasks, constraint families, and difficulty factors. Guided by this taxonomy, a constraint-driven synthesis pipeline instantiates self-contained planning problems with adaptive difficulty control, quality filtering, and instance-level verification checklists. This shifts planning data construction from fixed benchmark collection to controllable generation while preserving realistic task grounding. We use PlanningBench to evaluate open-source and closed-source frontier LLMs, and find that current models still struggle to produce complete solutions under coupled constraints. Beyond evaluation, reinforcement learning on verified PlanningBench data improves performance on unseen planning benchmarks and broader instruction-following tasks. Further analysis suggests that determinate or well-specified optimal solutions provide clearer reward signals and more stable training dynamics. Overall, PlanningBench provides a controllable source of planning data for diagnosing and improving generalizable planning abilities in LLMs.

Tencent-Hunyuan Tencent Hunyuan
·
May 19

Parrot: Persuasion and Agreement Robustness Rating of Output Truth -- A Sycophancy Robustness Benchmark for LLMs

This study presents PARROT (Persuasion and Agreement Robustness Rating of Output Truth), a robustness focused framework designed to measure the degradation in accuracy that occurs under social pressure exerted on users through authority and persuasion in large language models (LLMs) the phenomenon of sycophancy (excessive conformity). PARROT (i) isolates causal effects by comparing the neutral version of the same question with an authoritatively false version using a double-blind evaluation, (ii) quantifies confidence shifts toward the correct and imposed false responses using log-likelihood-based calibration tracking, and (iii) systematically classifies failure modes (e.g., robust correct, sycophantic agreement, reinforced error, stubborn error, self-correction, etc.) using an eight-state behavioral taxonomy. We evaluated 22 models using 1,302 MMLU-style multiple-choice questions across 13 domains and domain-specific authority templates. Findings show marked heterogeneity: advanced models (e.g., GPT-5, GPT-4.1, Claude Sonnet 4.5) exhibit low "follow rates" (leq 11%, GPT-5: 4\%) and minimal accuracy loss, while older/smaller models show severe epistemic collapse (GPT-4: 80\%, Qwen 2.5-1.5B: 94\%). The danger is not limited to response changes; weak models reduce confidence in the correct response while increasing confidence in the imposed incorrect response. While international law and global knowledge at the domain level exhibit high fragility, elementary mathematics is relatively resilient. Consequently, we argue that the goal of "resistance to overfitting pressure" should be addressed as a primary objective alongside accuracy, harm avoidance, and privacy for safe deployment in the real world.

  • 3 authors
·
Nov 21, 2025 4

Clinical-R1: Empowering Large Language Models for Faithful and Comprehensive Reasoning with Clinical Objective Relative Policy Optimization

Recent advances in large language models (LLMs) have shown strong reasoning capabilities through large-scale pretraining and post-training reinforcement learning, demonstrated by DeepSeek-R1. However, current post-training methods, such as Grouped Relative Policy Optimization (GRPO), mainly reward correctness, which is not aligned with the multi-dimensional objectives required in high-stakes fields such as medicine, where reasoning must also be faithful and comprehensive. We introduce Clinical-Objective Relative Policy Optimization (CRPO), a scalable, multi-objective, verifiable reinforcement learning method designed to align LLM post-training with clinical reasoning principles. CRPO integrates rule-based and verifiable reward signals that jointly optimize accuracy, faithfulness, and comprehensiveness without relying on human annotation. To demonstrate its effectiveness, we train Clinical-R1-3B, a 3B-parameter model for clinical reasoning. The experiments on three benchmarks demonstrate that our CRPO substantially improves reasoning on truthfulness and completeness over standard GRPO while maintaining comfortable accuracy enhancements. This framework provides a scalable pathway to align LLM reasoning with clinical objectives, enabling safer and more collaborative AI systems for healthcare while also highlighting the potential of multi-objective, verifiable RL methods in post-training scaling of LLMs for medical domains.

  • 9 authors
·
Nov 29, 2025

Health-ORSC-Bench: A Benchmark for Measuring Over-Refusal and Safety Completion in Health Context

Safety alignment in Large Language Models is critical for healthcare; however, reliance on binary refusal boundaries often results in over-refusal of benign queries or unsafe compliance with harmful ones. While existing benchmarks measure these extremes, they fail to evaluate Safe Completion: the model's ability to maximise helpfulness on dual-use or borderline queries by providing safe, high-level guidance without crossing into actionable harm. We introduce Health-ORSC-Bench, the first large-scale benchmark designed to systematically measure Over-Refusal and Safe Completion quality in healthcare. Comprising 31,920 benign boundary prompts across seven health categories (e.g., self-harm, medical misinformation), our framework uses an automated pipeline with human validation to test models at varying levels of intent ambiguity. We evaluate 30 state-of-the-art LLMs, including GPT-5 and Claude-4, revealing a significant tension: safety-optimised models frequently refuse up to 80\% of "Hard" benign prompts, while domain-specific models often sacrifice safety for utility. Our findings demonstrate that model family and size significantly influence calibration: larger frontier models (e.g., GPT-5, Llama-4) exhibit "safety-pessimism" and higher over-refusal than smaller or MoE-based counterparts (e.g., Qwen-3-Next), highlighting that current LLMs struggle to balance refusal and compliance. Health-ORSC-Bench provides a rigorous standard for calibrating the next generation of medical AI assistants toward nuanced, safe, and helpful completions. The code and data will be released upon acceptance. red{Warning: Some contents may include toxic or undesired contents.}

  • 6 authors
·
Jan 24

Training Models to Extract Treatment Plans from Clinical Notes Using Contents of Sections with Headings

Objective: Using natural language processing (NLP) to find sentences that state treatment plans in a clinical note, would automate plan extraction and would further enable their use in tools that help providers and care managers. However, as in the most NLP tasks on clinical text, creating gold standard to train and test NLP models is tedious and expensive. Fortuitously, sometimes but not always clinical notes contain sections with a heading that identifies the section as a plan. Leveraging contents of such labeled sections as a noisy training data, we assessed accuracy of NLP models trained with the data. Methods: We used common variations of plan headings and rule-based heuristics to find plan sections with headings in clinical notes, and we extracted sentences from them and formed a noisy training data of plan sentences. We trained Support Vector Machine (SVM) and Convolutional Neural Network (CNN) models with the data. We measured accuracy of the trained models on the noisy dataset using ten-fold cross validation and separately on a set-aside manually annotated dataset. Results: About 13% of 117,730 clinical notes contained treatment plans sections with recognizable headings in the 1001 longitudinal patient records that were obtained from Cleveland Clinic under an IRB approval. We were able to extract and create a noisy training data of 13,492 plan sentences from the clinical notes. CNN achieved best F measures, 0.91 and 0.97 in the cross-validation and set-aside evaluation experiments respectively. SVM slightly underperformed with F measures of 0.89 and 0.96 in the same experiments. Conclusion: Our study showed that the training supervised learning models using noisy plan sentences was effective in identifying them in all clinical notes. More broadly, sections with informal headings in clinical notes can be a good source for generating effective training data.

  • 3 authors
·
Jun 27, 2019

SELP: Generating Safe and Efficient Task Plans for Robot Agents with Large Language Models

Despite significant advancements in large language models (LLMs) that enhance robot agents' understanding and execution of natural language (NL) commands, ensuring the agents adhere to user-specified constraints remains challenging, particularly for complex commands and long-horizon tasks. To address this challenge, we present three key insights, equivalence voting, constrained decoding, and domain-specific fine-tuning, which significantly enhance LLM planners' capability in handling complex tasks. Equivalence voting ensures consistency by generating and sampling multiple Linear Temporal Logic (LTL) formulas from NL commands, grouping equivalent LTL formulas, and selecting the majority group of formulas as the final LTL formula. Constrained decoding then uses the generated LTL formula to enforce the autoregressive inference of plans, ensuring the generated plans conform to the LTL. Domain-specific fine-tuning customizes LLMs to produce safe and efficient plans within specific task domains. Our approach, Safe Efficient LLM Planner (SELP), combines these insights to create LLM planners to generate plans adhering to user commands with high confidence. We demonstrate the effectiveness and generalizability of SELP across different robot agents and tasks, including drone navigation and robot manipulation. For drone navigation tasks, SELP outperforms state-of-the-art planners by 10.8% in safety rate (i.e., finishing tasks conforming to NL commands) and by 19.8% in plan efficiency. For robot manipulation tasks, SELP achieves 20.4% improvement in safety rate. Our datasets for evaluating NL-to-LTL and robot task planning will be released in github.com/lt-asset/selp.

  • 8 authors
·
Sep 28, 2024

Information-Consistent Language Model Recommendations through Group Relative Policy Optimization

Large Language Models (LLMs) are increasingly deployed in business-critical domains such as finance, education, healthcare, and customer support, where users expect consistent and reliable recommendations. Yet LLMs often exhibit variability when prompts are phrased with minor differences, even when semantically equivalent. Such inconsistency undermines trust, complicates compliance, and disrupts user experience. While personalization is desirable in certain contexts, many enterprise scenarios-such as HR onboarding, customer support, or policy disclosure-require invariant information delivery regardless of phrasing or prior conversational history. Existing approaches, including retrieval-augmented generation (RAG) and temperature tuning, improve factuality or reduce stochasticity but cannot guarantee stability across equivalent prompts. In this paper, we propose a reinforcement learning framework based on Group Relative Policy Optimization (GRPO) to directly optimize for consistency. Unlike prior applications of GRPO, which have been limited to reasoning and code generation, we adapt GRPO to enforce stability of information content across groups of semantically equivalent prompts. We introduce entropy-based helpfulness and stability rewards, treating prompt variants as groups and resetting conversational context to isolate phrasing effects. Experiments on investment and job recommendation tasks show that our GRPO-trained model reduces variability more effectively than fine-tuning or decoding-based baselines. To our knowledge, this is a novel application of GRPO for aligning LLMs toward information consistency, reframing variability not as an acceptable feature of generative diversity but as a correctable flaw in enterprise deployments.

  • 3 authors
·
Dec 14, 2025

CancerGUIDE: Cancer Guideline Understanding via Internal Disagreement Estimation

The National Comprehensive Cancer Network (NCCN) provides evidence-based guidelines for cancer treatment. Translating complex patient presentations into guideline-compliant treatment recommendations is time-intensive, requires specialized expertise, and is prone to error. Advances in large language model (LLM) capabilities promise to reduce the time required to generate treatment recommendations and improve accuracy. We present an LLM agent-based approach to automatically generate guideline-concordant treatment trajectories for patients with non-small cell lung cancer (NSCLC). Our contributions are threefold. First, we construct a novel longitudinal dataset of 121 cases of NSCLC patients that includes clinical encounters, diagnostic results, and medical histories, each expertly annotated with the corresponding NCCN guideline trajectories by board-certified oncologists. Second, we demonstrate that existing LLMs possess domain-specific knowledge that enables high-quality proxy benchmark generation for both model development and evaluation, achieving strong correlation (Spearman coefficient r=0.88, RMSE = 0.08) with expert-annotated benchmarks. Third, we develop a hybrid approach combining expensive human annotations with model consistency information to create both the agent framework that predicts the relevant guidelines for a patient, as well as a meta-classifier that verifies prediction accuracy with calibrated confidence scores for treatment recommendations (AUROC=0.800), a critical capability for communicating the accuracy of outputs, custom-tailoring tradeoffs in performance, and supporting regulatory compliance. This work establishes a framework for clinically viable LLM-based guideline adherence systems that balance accuracy, interpretability, and regulatory requirements while reducing annotation costs, providing a scalable pathway toward automated clinical decision support.

  • 16 authors
·
Sep 8, 2025

Can LLM-Reasoning Models Replace Classical Planning? A Benchmark Study

Recent advancements in Large Language Models have sparked interest in their potential for robotic task planning. While these models demonstrate strong generative capabilities, their effectiveness in producing structured and executable plans remains uncertain. This paper presents a systematic evaluation of a broad spectrum of current state of the art language models, each directly prompted using Planning Domain Definition Language domain and problem files, and compares their planning performance with the Fast Downward planner across a variety of benchmarks. In addition to measuring success rates, we assess how faithfully the generated plans translate into sequences of actions that can actually be executed, identifying both strengths and limitations of using these models in this setting. Our findings show that while the models perform well on simpler planning tasks, they continue to struggle with more complex scenarios that require precise resource management, consistent state tracking, and strict constraint compliance. These results underscore fundamental challenges in applying language models to robotic planning in real world environments. By outlining the gaps that emerge during execution, we aim to guide future research toward combined approaches that integrate language models with classical planners in order to enhance the reliability and scalability of planning in autonomous robotics.

  • 2 authors
·
Jul 31, 2025