Daily Papers

Conditional diffusion models have shown remarkable performance in various generative tasks, but training them requires large-scale datasets that often contain noise in conditional inputs, a.k.a. noisy labels. This noise leads to condition mismatch and quality degradation of generated data. This paper proposes Transition-aware weighted Denoising Score Matching (TDSM) for training conditional diffusion models with noisy labels, which is the first study in the line of diffusion models. The TDSM objective contains a weighted sum of score networks, incorporating instance-wise and time-dependent label transition probabilities. We introduce a transition-aware weight estimator, which leverages a time-dependent noisy-label classifier distinctively customized to the diffusion process. Through experiments across various datasets and noisy label settings, TDSM improves the quality of generated samples aligned with given conditions. Furthermore, our method improves generation performance even on prevalent benchmark datasets, which implies the potential noisy labels and their risk of generative model learning. Finally, we show the improved performance of TDSM on top of conventional noisy label corrections, which empirically proving its contribution as a part of label-noise robust generative models. Our code is available at: https://github.com/byeonghu-na/tdsm.

Layout-aware text-to-image generation is a task to generate multi-object images that reflect layout conditions in addition to text conditions. The current layout-aware text-to-image diffusion models still have several issues, including mismatches between the text and layout conditions and quality degradation of generated images. This paper proposes a novel layout-aware text-to-image diffusion model called NoiseCollage to tackle these issues. During the denoising process, NoiseCollage independently estimates noises for individual objects and then crops and merges them into a single noise. This operation helps avoid condition mismatches; in other words, it can put the right objects in the right places. Qualitative and quantitative evaluations show that NoiseCollage outperforms several state-of-the-art models. These successful results indicate that the crop-and-merge operation of noises is a reasonable strategy to control image generation. We also show that NoiseCollage can be integrated with ControlNet to use edges, sketches, and pose skeletons as additional conditions. Experimental results show that this integration boosts the layout accuracy of ControlNet. The code is available at https://github.com/univ-esuty/noisecollage.

Recent years have witnessed significant progress in audio-driven human animation. However, critical challenges remain in (i) generating highly dynamic videos while preserving character consistency, (ii) achieving precise emotion alignment between characters and audio, and (iii) enabling multi-character audio-driven animation. To address these challenges, we propose HunyuanVideo-Avatar, a multimodal diffusion transformer (MM-DiT)-based model capable of simultaneously generating dynamic, emotion-controllable, and multi-character dialogue videos. Concretely, HunyuanVideo-Avatar introduces three key innovations: (i) A character image injection module is designed to replace the conventional addition-based character conditioning scheme, eliminating the inherent condition mismatch between training and inference. This ensures the dynamic motion and strong character consistency; (ii) An Audio Emotion Module (AEM) is introduced to extract and transfer the emotional cues from an emotion reference image to the target generated video, enabling fine-grained and accurate emotion style control; (iii) A Face-Aware Audio Adapter (FAA) is proposed to isolate the audio-driven character with latent-level face mask, enabling independent audio injection via cross-attention for multi-character scenarios. These innovations empower HunyuanVideo-Avatar to surpass state-of-the-art methods on benchmark datasets and a newly proposed wild dataset, generating realistic avatars in dynamic, immersive scenarios.

Fine-tuned encoders deployed across heterogeneous NLP tasks face three compounding problems: mismatched inductive biases, class-imbalance corruption of feature statistics, and no mechanism to condition attention on external lexical knowledge. We introduce \surgellm, a unified transformer framework that addresses each with a dedicated lightweight module: a surgical feature gate (learned per-dimension sigmoid over curated lexical indicators and [CLS]; provably degenerates to identity when features are uninformative), task-conditioned prefix tokens (quantized feature values and task identity prepended to every input), and Instance-Weighted Normalization (IWN; removes class-prior bias from gate statistics). We prove an excess-risk bound linking gate benefit to surgical feature alignment. Across four tasks, SST-2, multi-hop retrieval, LLM-prompt attribution, and authorship detection, covering 17,830 examples and eleven model variants over three seeds, the IWN variant achieves macro-F1 0.940 (+0.036 over the strongest non-IWN baseline; +0.130 on authorship detection). A random-vocabulary control (-0.028 avg.\ F1) confirms gains are lexical, not parametric. Code, vocabularies, and a 99.5%-recovery auto-extraction recipe are released.

We consider whether off-policy experience from a smaller, weaker model can elicit capability in a stronger learner that on-policy RL fine-tuning (e.g., GRPO) does not reach. We find that injecting mathematically wrong drafts from a smaller but more domain-trained model -- mismatched to the current problem -- into a stronger learner's GRPO context consistently outperforms standard on-policy GRPO on held-out MATH-500 and out-of-distribution AIME 2025/2026. Concretely, we use Mathstral-7B as the learner, Qwen2.5-Math-1.5B as the draft model, 8.8K Level 3--5 MATH problems (with MATH-500 held out), and train with Dr. GRPO. Mismatch is an active ingredient: shuffling drafts to mismatched problems while holding everything else constant yields +1.62pp on MATH-500 (greedy pass@1) over the matched-wrong variant (n=10 seeds, p=0.0015, Welch's t). In fact, the mismatched-wrong variant leads all other variants we tested on MATH-500 across both greedy pass@1 and sampling pass@k. On out-of-distribution AIME 2025 and 2026, the mismatched-wrong variant uniquely lifts pass@k above both Mathstral-7B (in its native [INST] format) and the Qwen2.5-Math-1.5B draft model at every sample budget from k=1 to k=1024 across 2 seeds (+14.2pp on 2025 and +9.0pp on 2026 at pass@1024 over Mathstral-7B), and at pass@1024 also leads no-draft, matched-wrong, and mismatched-correct variants on both years. All variants use the same prompt with no draft injection at test time. The recipe -- trained on a single GPU with no SFT, no reward models, no synthesized data, and no produce-critique-revise inner loop -- reaches 71.98% MATH-500 on Mathstral-7B-v0.1, the highest published result on this model to our knowledge, surpassing the heavier WizardMath pipeline at 70.9% on full MATH (SFT + PPO with process/instruction reward models).

The issue localization task aims to identify the locations in a software repository that requires modification given a natural language issue description. This task is fundamental yet challenging in automated software engineering due to the semantic gap between issue description and source code implementation. This gap manifests as two mismatches:(1) symptom-to-cause mismatches, where descriptions do not explicitly reveal underlying root causes; (2) one-to-many mismatches, where a single issue corresponds to multiple interdependent code entities. To address these two mismatches, we propose GraphLocator, an approach that mitigates symptom-to-cause mismatches through causal structure discovering and resolves one-to-many mismatches via dynamic issue disentangling. The key artifact is the causal issue graph (CIG), in which vertices represent discovered sub-issues along with their associated code entities, and edges encode the causal dependencies between them. The workflow of GraphLocator consists of two phases: symptom vertices locating and dynamic CIG discovering; it first identifies symptom locations on the repository graph, then dynamically expands the CIG by iteratively reasoning over neighboring vertices. Experiments on three real-world datasets demonstrates the effectiveness of GraphLocator: (1) Compared with baselines, GraphLocator achieves more accurate localization with average improvements of +19.49% in function-level recall and +11.89% in precision. (2) GraphLocator outperforms baselines on both symptom-to-cause and one-to-many mismatch scenarios, achieving recall improvement of +16.44% and +19.18%, precision improvement of +7.78% and +13.23%, respectively. (3) The CIG generated by GraphLocator yields the highest relative improvement, resulting in a 28.74% increase in performance on downstream resolving task.

ASVspoof challenges are designed to advance the understanding of spoofing speech attacks and encourage the development of robust countermeasure systems. These challenges provide a standardized database for assessing and comparing spoofing-robust automatic speaker verification solutions. The ASVspoof5 challenge introduces a shift in database conditions compared to ASVspoof2019. While ASVspoof2019 has mismatched conditions only in spoofing attacks in the evaluation set, ASVspoof5 incorporates mismatches in both bona fide and spoofed speech statistics. This paper examines the impact of these mismatches, presenting qualitative and quantitative comparisons within and between the two databases. We show the increased difficulty for genuine and spoofed speech and demonstrate that in ASVspoof5, not only are the attacks more challenging, but the genuine speech also shifts toward spoofed speech compared to ASVspoof2019.

Modern LLM RL systems separate rollout generation from policy optimization. These two stages are expected to produce token probabilities that match exactly. However, implementation differences can make them assign different values to the same sequence under the same model weights, inducing Training-Inference Mismatch (TIM). TIM is difficult to inspect because it is entangled with off-policy drift and common stabilization mechanisms. In this work, we isolate TIM in a zero-mismatch diagnostic setting (VeXact), and show that small token-level numerical disagreements can independently cause training collapse. We further show that TIM changes the effective optimization problem, and identify a set of remedies that could mitigate TIM. Our results suggest that TIM is not benign numerical noise, but a systems-level perturbation that should be treated as a first-order factor in analyzing LLM RL stability.

This paper addresses unsupervised diffusion-based single-channel speech enhancement (SE). Prior work in this direction combines a score-based diffusion model trained on clean speech with a Gaussian noise model whose covariance is structured by non-negative matrix factorization (NMF). This combination is used within an iterative expectation-maximization (EM) scheme, in which a diffusion-based posterior-sampling E-step estimates the clean speech. We first revisit this framework and propose to explicitly model both speech and acoustic noise as latent variables, jointly sampling them in the E-step instead of sampling speech alone as in previous approaches. We then introduce a new unsupervised SE framework that replaces the NMF noise prior with a diffusion-based noise model, learned jointly with the speech prior in a single conditional score model. Within this framework, we derive two variants: one that implicitly accounts for noise and one that explicitly treats noise as a latent variable. Experiments on WSJ0-QUT and VoiceBank-DEMAND show that explicit noise modeling systematically improves SE performance for both NMF-based and diffusion-based noise priors. Under matched conditions, the diffusion-based noise model attains the best overall quality and intelligibility among unsupervised methods, while under mismatched conditions the proposed NMF-based explicit-noise framework is more robust and suffers less degradation than several supervised baselines.

Masked speech modeling (MSM) methods such as wav2vec2 or w2v-BERT learn representations over speech frames which are randomly masked within an utterance. While these methods improve performance of Automatic Speech Recognition (ASR) systems, they have one major limitation. They treat all unsupervised speech samples with equal weight, which hinders learning as not all samples have relevant information to learn meaningful representations. In this work, we address this limitation. We propose ask2mask (ATM), a novel approach to focus on specific samples during MSM pre-training. ATM employs an external ASR model or scorer to weight unsupervised input samples in two different ways: 1) A fine-grained data selection is performed by masking over the highly confident input frames as chosen by the scorer. This allows the model to learn meaningful representations. 2) ATM is further extended to focus at utterance-level by weighting the final MSM loss with the utterance-level confidence score. We conduct fine-tuning experiments on two well-benchmarked corpora: LibriSpeech (matching the pre-training data) and Commonvoice, TED-LIUM, AMI and CHiME-6 (not matching the pre-training data). The results substantiate the efficacy of ATM on significantly improving the recognition performance under mismatched conditions (up to 11.6\% relative over published results and upto 4.46\% relative over our internal baseline) while still yielding modest improvements under matched conditions.

Many existing conditional score-based data generation methods utilize Bayes' theorem to decompose the gradients of a log posterior density into a mixture of scores. These methods facilitate the training procedure of conditional score models, as a mixture of scores can be separately estimated using a score model and a classifier. However, our analysis indicates that the training objectives for the classifier in these methods may lead to a serious score mismatch issue, which corresponds to the situation that the estimated scores deviate from the true ones. Such an issue causes the samples to be misled by the deviated scores during the diffusion process, resulting in a degraded sampling quality. To resolve it, we formulate a novel training objective, called Denoising Likelihood Score Matching (DLSM) loss, for the classifier to match the gradients of the true log likelihood density. Our experimental evidence shows that the proposed method outperforms the previous methods on both Cifar-10 and Cifar-100 benchmarks noticeably in terms of several key evaluation metrics. We thus conclude that, by adopting DLSM, the conditional scores can be accurately modeled, and the effect of the score mismatch issue is alleviated.

Muon has emerged as an efficient alternative to Adam for pretraining, yet remains underused for fine-tuning. A key obstacle is that most open models are pretrained with Adam, and naively switching to Muon for fine-tuning leads to degraded performance due to an optimizer mismatch. We investigate this mismatch through controlled experiments and relate it to the distinct implicit biases of Adam and Muon. We provide evidence that the mismatch disrupts pretrained knowledge, and that this disruption scales with update strength. This leads us to hypothesize that constraining updates should mitigate the mismatch. We validate this with LoRA: across language and vision tasks, LoRA reduces the performance gap between Adam and Muon observed under full fine-tuning. Studies on LoRA rank, catastrophic forgetting, and LoRA variants further confirm that mismatch severity correlates with update strength. These results shed light on how optimizer mismatch affects fine-tuning and how it can be mitigated. Our code is available at https://github.com/XingyuQu/muon-finetune.

ML models often exhibit unexpectedly poor behavior when they are deployed in real-world domains. We identify underspecification as a key reason for these failures. An ML pipeline is underspecified when it can return many predictors with equivalently strong held-out performance in the training domain. Underspecification is common in modern ML pipelines, such as those based on deep learning. Predictors returned by underspecified pipelines are often treated as equivalent based on their training domain performance, but we show here that such predictors can behave very differently in deployment domains. This ambiguity can lead to instability and poor model behavior in practice, and is a distinct failure mode from previously identified issues arising from structural mismatch between training and deployment domains. We show that this problem appears in a wide variety of practical ML pipelines, using examples from computer vision, medical imaging, natural language processing, clinical risk prediction based on electronic health records, and medical genomics. Our results show the need to explicitly account for underspecification in modeling pipelines that are intended for real-world deployment in any domain.

Large language models (LLMs) offer a promising pre-screening tool, improving early disease detection and providing enhanced healthcare access for underprivileged communities. The early diagnosis of various diseases continues to be a significant challenge in healthcare, primarily due to the nonspecific nature of early symptoms, the shortage of expert medical practitioners, and the need for prolonged clinical evaluations, all of which can delay treatment and adversely affect patient outcomes. With impressive accuracy in prediction across a range of diseases, LLMs have the potential to revolutionize clinical pre-screening and decision-making for various medical conditions. In this work, we study the diagnostic capability of LLMs for Rheumatoid Arthritis (RA) with real world patients data. Patient data was collected alongside diagnoses from medical experts, and the performance of LLMs was evaluated in comparison to expert diagnoses for RA disease prediction. We notice an interesting pattern in disease diagnosis and find an unexpected misalignment between prediction and explanation. We conduct a series of multi-round analyses using different LLM agents. The best-performing model accurately predicts rheumatoid arthritis (RA) diseases approximately 95\% of the time. However, when medical experts evaluated the reasoning generated by the model, they found that nearly 68\% of the reasoning was incorrect. This study highlights a clear misalignment between LLMs high prediction accuracy and its flawed reasoning, raising important questions about relying on LLM explanations in clinical settings. LLMs provide incorrect reasoning to arrive at the correct answer for RA disease diagnosis.

Timely detection of concerning events is an important problem in clinical practice. In this paper, we consider the problem of conditional anomaly detection that aims to identify data instances with an unusual response, such as the omission of an important lab test. We develop a new non-parametric approach for conditional anomaly detection based on the soft harmonic solution, with which we estimate the confidence of the label to detect anomalous mislabeling. We further regularize the solution to avoid the detection of isolated examples and examples on the boundary of the distribution support. We demonstrate the efficacy of the proposed method in detecting unusual labels on a real-world electronic health record dataset and compare it to several baseline approaches.

The recent phenomenal success of language models has reinvigorated machine learning research, and large sequence models such as transformers are being applied to a variety of domains. One important problem class that has remained relatively elusive however is purposeful adaptive behavior. Currently there is a common perception that sequence models "lack the understanding of the cause and effect of their actions" leading them to draw incorrect inferences due to auto-suggestive delusions. In this report we explain where this mismatch originates, and show that it can be resolved by treating actions as causal interventions. Finally, we show that in supervised learning, one can teach a system to condition or intervene on data by training with factual and counterfactual error signals respectively.

Supervised learning is often affected by a covariate shift in which the marginal distributions of instances (covariates x) of training and testing samples p_tr(x) and p_te(x) are different but the label conditionals coincide. Existing approaches address such covariate shift by either using the ratio p_te(x)/p_tr(x) to weight training samples (reweighted methods) or using the ratio p_tr(x)/p_te(x) to weight testing samples (robust methods). However, the performance of such approaches can be poor under support mismatch or when the above ratios take large values. We propose a minimax risk classification (MRC) approach for covariate shift adaptation that avoids such limitations by weighting both training and testing samples. In addition, we develop effective techniques that obtain both sets of weights and generalize the conventional kernel mean matching method. We provide novel generalization bounds for our method that show a significant increase in the effective sample size compared with reweighted methods. The proposed method also achieves enhanced classification performance in both synthetic and empirical experiments.

A comparison of the distances to the Huanan Seafood Market of early Covid cases with known links to the market versus cases without known links shows results apparently incompatible with a location model lacking proximity ascertainment bias. The sign of the difference instead agrees with a model in which such ascertainment bias is large. In the presence of such bias inferences based on the clustering of case locations become unreliable.

We develop and evaluate a data-driven approach for detecting unusual (anomalous) patient-management actions using past patient cases stored in an electronic health record (EHR) system. Our hypothesis is that patient-management actions that are unusual with respect to past patients may be due to a potential error and that it is worthwhile to raise an alert if such a condition is encountered. We evaluate this hypothesis using data obtained from the electronic health records of 4,486 post-cardiac surgical patients. We base the evaluation on the opinions of a panel of experts. The results support that anomaly-based alerting can have reasonably low false alert rates and that stronger anomalies are correlated with higher alert rates.

We study estimation and clustering in Gaussian mixture models under variance misspecification. Observations are generated with true variance σ^2, while the component means are estimated using a likelihood with variance τ^2, yielding a family of mismatched likelihood functions parameterized by the ratio ρ=τ/σ. We show that the interplay between ρ and the signal-to-noise ratio (SNR) induces a sharp phase diagram. Under correct specification (ρ=1), maximum likelihood recovers the true means, independently of the SNR. However, once the model is misspecified, two different regimes emerge. Under under-smoothing (ρ<1), the estimated Gaussian means are displaced from the truth, and in low SNR this discrepancy grows as the SNR decreases: for every fixed ρ<1, the squared error scales as SNR^{-1}. Under over-smoothing (ρ>1), the fitted likelihood blurs the cluster separation, causing distinct component means to collapse towards the overall mixture center once ρ^2 exceeds a threshold of the form 1 + λ,SNR, where λ depends on the geometry of the true means. We further show that the hard assignment objective arises as the limit τto 0 of the same mismatched likelihood family, and derive corresponding low- and high-SNR results for hard-assignment mean estimation and latent-label recovery. Furthermore, in low SNR, Bayes-optimal clustering is close to random guessing, and the hard-assignment target remains far from the true means. These results show that in low-SNR applications, even mild variance misspecification or hard-assignment procedures can induce substantial bias, whereas in high SNR these effects are largely absent.

Speech patterns have been identified as potential diagnostic markers for neuropsychiatric conditions. However, most studies only compare a single clinical group to healthy controls, whereas clinical practice often requires differentiating between multiple potential diagnoses (multiclass settings). To address this, we assembled a dataset of repeated recordings from 420 participants (67 with major depressive disorder, 106 with schizophrenia and 46 with autism, as well as matched controls), and tested the performance of a range of conventional machine learning models and advanced Transformer models on both binary and multiclass classification, based on voice and text features. While binary models performed comparably to previous research (F1 scores between 0.54-0.75 for autism spectrum disorder, ASD; 0.67-0.92 for major depressive disorder, MDD; and 0.71-0.83 for schizophrenia); when differentiating between multiple diagnostic groups performance decreased markedly (F1 scores between 0.35-0.44 for ASD, 0.57-0.75 for MDD, 0.15-0.66 for schizophrenia, and 0.38-0.52 macro F1). Combining voice and text-based models yielded increased performance, suggesting that they capture complementary diagnostic information. Our results indicate that models trained on binary classification may learn to rely on markers of generic differences between clinical and non-clinical populations, or markers of clinical features that overlap across conditions, rather than identifying markers specific to individual conditions. We provide recommendations for future research in the field, suggesting increased focus on developing larger transdiagnostic datasets that include more fine-grained clinical features, and that can support the development of models that better capture the complexity of neuropsychiatric conditions and naturalistic diagnostic assessment.

Model-based reinforcement learning (MBRL) has been shown to be a powerful framework for data-efficiently learning control of continuous tasks. Recent work in MBRL has mostly focused on using more advanced function approximators and planning schemes, with little development of the general framework. In this paper, we identify a fundamental issue of the standard MBRL framework -- what we call the objective mismatch issue. Objective mismatch arises when one objective is optimized in the hope that a second, often uncorrelated, metric will also be optimized. In the context of MBRL, we characterize the objective mismatch between training the forward dynamics model w.r.t.~the likelihood of the one-step ahead prediction, and the overall goal of improving performance on a downstream control task. For example, this issue can emerge with the realization that dynamics models effective for a specific task do not necessarily need to be globally accurate, and vice versa globally accurate models might not be sufficiently accurate locally to obtain good control performance on a specific task. In our experiments, we study this objective mismatch issue and demonstrate that the likelihood of one-step ahead predictions is not always correlated with control performance. This observation highlights a critical limitation in the MBRL framework which will require further research to be fully understood and addressed. We propose an initial method to mitigate the mismatch issue by re-weighting dynamics model training. Building on it, we conclude with a discussion about other potential directions of research for addressing this issue.

Background:Speech patterns have emerged as potential diagnostic markers for conditions with varying etiologies. Machine learning (ML) presents an opportunity to harness these patterns for accurate disease diagnosis. Objective: This review synthesized findings from studies exploring ML's capability in leveraging speech for the diagnosis of neurological, laryngeal and mental disorders. Methods: A systematic examination of 564 articles was conducted with 91 articles included in the study, which encompassed a wide spectrum of conditions, ranging from voice pathologies to mental and neurological disorders. Methods for speech classifications were assessed based on the relevant studies and scored between 0-10 based on the reported diagnostic accuracy of their ML models. Results: High diagnostic accuracies were consistently observed for laryngeal disorders, dysarthria, and changes related to speech in Parkinsons disease. These findings indicate the robust potential of speech as a diagnostic tool. Disorders like depression, schizophrenia, mild cognitive impairment and Alzheimers dementia also demonstrated high accuracies, albeit with some variability across studies. Meanwhile, disorders like OCD and autism highlighted the need for more extensive research to ascertain the relationship between speech patterns and the respective conditions. Conclusion: ML models utilizing speech patterns demonstrate promising potential in diagnosing a range of mental, laryngeal, and neurological disorders. However, the efficacy varies across conditions, and further research is needed. The integration of these models into clinical practice could potentially revolutionize the evaluation and diagnosis of a number of different medical conditions.

Databases of electronic health records (EHRs) are increasingly used to inform clinical decisions. Machine learning methods can find patterns in EHRs that are predictive of future adverse outcomes. However, statistical models may be built upon patterns of health-seeking behavior that vary across patient subpopulations, leading to poor predictive performance when training on one patient population and predicting on another. This note proposes two tests to better measure and understand model generalization. We use these tests to compare models derived from two data sources: (i) historical medical records, and (ii) electrocardiogram (EKG) waveforms. In a predictive task, we show that EKG-based models can be more stable than EHR-based models across different patient populations.

Machine learning-based Type 2 diabetes risk prediction models obtain good internal validation results but lose effectiveness in real-world applications due to deficient external testing and fairness assessment. We developed a multi-dimensional framework evaluating discrimination, calibration, interpretability, and algorithmic fairness on nationally representative populations. An XGBoost model was trained on NHANES 2015-2020 (n=15,685) using eight non-laboratory predictors: age, sex, race/ethnicity, BMI, smoking status, physical activity, history of heart attack, and history of stroke. External validation was performed on BRFSS 2020-2022 (n=1,285,783) under realistic distribution shift. Internal validation showed good discrimination (AUC=0.794, 95% CI 0.788-0.800), with performance loss on external validation (AUC=0.717, relative decrease: -9.7%, p<0.001). Fairness analysis revealed severe bias: elderly adults (>=60) showed AUC=0.607 vs 0.742 for young adults (difference=0.135, p<0.001); obese individuals showed AUC=0.698 vs 0.735 for normal weight (difference=0.037, p<0.001). Gender showed comparable performance (male=0.723 vs female=0.712, p=0.142). Calibration revealed risk overestimation (Brier score=0.123). SHAP analysis identified age, BMI, and physical activity as primary risk drivers. Populations with highest diabetes risk receive the worst algorithmic performance, underscoring the need for fairness-aware, age-stratified deployment strategies before clinical use.

Automatic analysis of multimodal speech has shown strong potential for computationally detecting and monitoring a wide range of neurological, psychiatric, and respiratory conditions. However, progress in this field is limited by existing publicly accessible datasets, which are often small in scale, focused on a single condition or disease, and primarily speech focused. Moreover, if key confounding variables such as education, medication use, comorbidities, or mood state are insufficiently documented, the reliability and interpretability of computational analyses are further compromised. To address these limitations, we introduce CARE v1.0, a curated multimodal English dataset of approximately 144 hours of short video interviews collected from 612 individuals across 12 medical conditions plus a control cohort. For each video, a comprehensive set of clinically relevant multimodal descriptors is provided, alongside structured metadata covering factors such as medication, life impacts, and expressed emotions. The corpus's breadth and heterogeneity support a wide range of applications, including automatic disease and symptom detection, multimodal modelling of speech and non-verbal behaviour under emotionally charged contexts, and studies of disease trajectories and coping processes.

Evaluating conditional coverage remains one of the most persistent challenges in assessing the reliability of predictive systems. Although conformal methods can give guarantees on marginal coverage, no method can guarantee to produce sets with correct conditional coverage, leaving practitioners without a clear way to interpret local deviations. To overcome sample-inefficiency and overfitting issues of existing metrics, we cast conditional coverage estimation as a classification problem. Conditional coverage is violated if and only if some classifier can achieve lower risk than the target coverage. Through the choice of a (proper) loss function, the resulting risk difference gives a conservative estimate of natural miscoverage measures such as L1 and L2 distance, and can even separate the effects of over- and under-coverage, and non-constant target coverages. We call the resulting family of metrics excess risk of the target coverage (ERT). We show experimentally that the use of modern classifiers provides much higher statistical power than simple classifiers underlying established metrics like CovGap. Additionally, we use our metric to benchmark different conformal prediction methods. Finally, we release an open-source package for ERT as well as previous conditional coverage metrics. Together, these contributions provide a new lens for understanding, diagnosing, and improving the conditional reliability of predictive systems.

Medical coding translates clinical documentation into standardized codes for billing, research, and public health, but manual coding is time-consuming and error-prone. Existing automation efforts rely on small datasets that poorly represent real-world patient heterogeneity. We trained a language model on 5.8 million electronic health records from 1.8 million patients across nearly all specialties in Eastern Denmark (2006--2016) to predict ICD-10 codes from clinical notes, medications, and laboratory results. Evaluated on 270,000 held-out patients, the model achieved a micro F1 of 71.8% and a top-10 recall of 95.5%. Performance varied by specialty (F1: 53--91%), with higher scores in specialties with well-defined diagnostic criteria. Codes appearing predominantly as secondary diagnoses had markedly lower F1 scores. For three such codes (suicide-related behaviors, weight disorders, and hypertension), the model identified thousands of uncoded cases, of which 76-86% were confirmed valid upon manual review, suggesting systematic under-coding rather than model error. These findings suggest under-coding of secondary diagnoses in Eastern Denmark during this period, with potential implications for epidemiological research, public health surveillance, and understanding of multimorbidity. Similar time constraints and reimbursement structures in other healthcare systems suggest this may not be isolated to this dataset. The model can automate coding for approximately 50% of cases and provide accurate suggestions for most others, and may offer a practical solution to help capture missed secondary conditions.

Out-of-distribution (OOD) prediction is often approached by restricting models to causal or invariant covariates, avoiding non-causal spurious associations that may be unstable across environments. Despite its theoretical appeal, this strategy frequently underperforms empirical risk minimization (ERM) in practice. We investigate the source of this gap and show that such failures naturally arise when only a subset of the true causes of the outcome is observed. In these settings, non-causal spurious covariates can serve as informative proxies for unobserved causes and substantially improve prediction, except under distribution shifts that break these proxy relationships. Consequently, the optimal set of predictive covariates is neither universal nor necessarily exhibits invariant relationships with the outcome across all environments, but instead depends on the specific type of shift encountered. Crucially, we observe that different covariate shifts induce distinct, observable signatures in the covariate distribution itself. Moreover, these signatures can be extracted from unlabeled data in the target OOD environment and used to assess when proxy covariates remain reliable and when they fail. Building on this observation, we propose an environment-adaptive covariate selection (EACS) algorithm that maps environment-level covariate summaries to environment-specific covariate sets, while allowing the incorporation of prior causal knowledge as constraints. Across simulations and applied datasets, EACS consistently outperforms static causal, invariant, and ERM-based predictors under diverse distribution shifts.

Clinical trial matching is the task of identifying trials for which patients may be potentially eligible. Typically, this task is labor-intensive and requires detailed verification of patient electronic health records (EHRs) against the stringent inclusion and exclusion criteria of clinical trials. This process is manual, time-intensive, and challenging to scale up, resulting in many patients missing out on potential therapeutic options. Recent advancements in Large Language Models (LLMs) have made automating patient-trial matching possible, as shown in multiple concurrent research studies. However, the current approaches are confined to constrained, often synthetic datasets that do not adequately mirror the complexities encountered in real-world medical data. In this study, we present the first, end-to-end large-scale empirical evaluation of clinical trial matching using real-world EHRs. Our study showcases the capability of LLMs to accurately match patients with appropriate clinical trials. We perform experiments with proprietary LLMs, including GPT-4 and GPT-3.5, as well as our custom fine-tuned model called OncoLLM and show that OncoLLM, despite its significantly smaller size, not only outperforms GPT-3.5 but also matches the performance of qualified medical doctors. All experiments were carried out on real-world EHRs that include clinical notes and available clinical trials from a single cancer center in the United States.

An approach to the construction of classifiers from imbalanced datasets is described. A dataset is imbalanced if the classification categories are not approximately equally represented. Often real-world data sets are predominately composed of "normal" examples with only a small percentage of "abnormal" or "interesting" examples. It is also the case that the cost of misclassifying an abnormal (interesting) example as a normal example is often much higher than the cost of the reverse error. Under-sampling of the majority (normal) class has been proposed as a good means of increasing the sensitivity of a classifier to the minority class. This paper shows that a combination of our method of over-sampling the minority (abnormal) class and under-sampling the majority (normal) class can achieve better classifier performance (in ROC space) than only under-sampling the majority class. This paper also shows that a combination of our method of over-sampling the minority class and under-sampling the majority class can achieve better classifier performance (in ROC space) than varying the loss ratios in Ripper or class priors in Naive Bayes. Our method of over-sampling the minority class involves creating synthetic minority class examples. Experiments are performed using C4.5, Ripper and a Naive Bayes classifier. The method is evaluated using the area under the Receiver Operating Characteristic curve (AUC) and the ROC convex hull strategy.

In this work, we propose Reciprocal Distribution Alignment (RDA) to address semi-supervised learning (SSL), which is a hyperparameter-free framework that is independent of confidence threshold and works with both the matched (conventionally) and the mismatched class distributions. Distribution mismatch is an often overlooked but more general SSL scenario where the labeled and the unlabeled data do not fall into the identical class distribution. This may lead to the model not exploiting the labeled data reliably and drastically degrade the performance of SSL methods, which could not be rescued by the traditional distribution alignment. In RDA, we enforce a reciprocal alignment on the distributions of the predictions from two classifiers predicting pseudo-labels and complementary labels on the unlabeled data. These two distributions, carrying complementary information, could be utilized to regularize each other without any prior of class distribution. Moreover, we theoretically show that RDA maximizes the input-output mutual information. Our approach achieves promising performance in SSL under a variety of scenarios of mismatched distributions, as well as the conventional matched SSL setting. Our code is available at: https://github.com/NJUyued/RDA4RobustSSL.

Anomaly detection (AD) is a machine learning task that identifies anomalies by learning patterns from normal training data. In many real-world scenarios, anomalies vary in severity, from minor anomalies with little risk to severe abnormalities requiring immediate attention. However, existing models primarily operate in a binary setting, and the anomaly scores they produce are usually based on the deviation of data points from normal data, which may not accurately reflect practical severity. In this paper, we address this gap by making three key contributions. First, we propose a novel setting, Multilevel AD (MAD), in which the anomaly score represents the severity of anomalies in real-world applications, and we highlight its diverse applications across various domains. Second, we introduce a novel benchmark, MAD-Bench, that evaluates models not only on their ability to detect anomalies, but also on how effectively their anomaly scores reflect severity. This benchmark incorporates multiple types of baselines and real-world applications involving severity. Finally, we conduct a comprehensive performance analysis on MAD-Bench. We evaluate models on their ability to assign severity-aligned scores, investigate the correspondence between their performance on binary and multilevel detection, and study their robustness. This analysis offers key insights into improving AD models for practical severity alignment. The code framework and datasets used for the benchmark will be made publicly available.

Faced with distribution shift between training and test set, we wish to detect and quantify the shift, and to correct our classifiers without test set labels. Motivated by medical diagnosis, where diseases (targets) cause symptoms (observations), we focus on label shift, where the label marginal p(y) changes but the conditional p(x| y) does not. We propose Black Box Shift Estimation (BBSE) to estimate the test distribution p(y). BBSE exploits arbitrary black box predictors to reduce dimensionality prior to shift correction. While better predictors give tighter estimates, BBSE works even when predictors are biased, inaccurate, or uncalibrated, so long as their confusion matrices are invertible. We prove BBSE's consistency, bound its error, and introduce a statistical test that uses BBSE to detect shift. We also leverage BBSE to correct classifiers. Experiments demonstrate accurate estimates and improved prediction, even on high-dimensional datasets of natural images.

Large language models often produce hallucinated answers that violate prompt-level constraints. A key diagnostic question is whether these failures reflect missing knowledge, or whether the model has the relevant information but follows the wrong inference path. We study this phenomenon as inference misalignment: a mismatch between the answer supported by the prompt and the answer favored by statistically salient latent associations. We formalize this view with a latent key-task model, in which pretraining-frequency imbalance can cause a shortcut path to dominate the constraint-sensitive path and induce positive inference loss. The framework predicts two failure modes: task-retrieval bias in entity disambiguation and key-selection bias in action choice. We introduce TrapQA, a controlled diagnostic testbed with two components. ScientistQA tests disambiguation among similar scientists with supplementary factual probes, while Real-Life Constrained QA tests everyday constraint following under salient shortcuts. Our results show that hallucination can arise from biased latent inference rather than absent knowledge alone.

Identifying disease phenotypes from electronic health records (EHRs) is critical for numerous secondary uses. Manually encoding physician knowledge into rules is particularly challenging for rare diseases due to inadequate EHR coding, necessitating review of clinical notes. Large language models (LLMs) offer promise in text understanding but may not efficiently handle real-world clinical documentation. We propose a zero-shot LLM-based method enriched by retrieval-augmented generation and MapReduce, which pre-identifies disease-related text snippets to be used in parallel as queries for the LLM to establish diagnosis. We show that this method as applied to pulmonary hypertension (PH), a rare disease characterized by elevated arterial pressures in the lungs, significantly outperforms physician logic rules (F_1 score of 0.62 vs. 0.75). This method has the potential to enhance rare disease cohort identification, expanding the scope of robust clinical research and care gap identification.

We might hope that when faced with unexpected inputs, well-designed software systems would fire off warnings. Machine learning (ML) systems, however, which depend strongly on properties of their inputs (e.g. the i.i.d. assumption), tend to fail silently. This paper explores the problem of building ML systems that fail loudly, investigating methods for detecting dataset shift, identifying exemplars that most typify the shift, and quantifying shift malignancy. We focus on several datasets and various perturbations to both covariates and label distributions with varying magnitudes and fractions of data affected. Interestingly, we show that across the dataset shifts that we explore, a two-sample-testing-based approach, using pre-trained classifiers for dimensionality reduction, performs best. Moreover, we demonstrate that domain-discriminating approaches tend to be helpful for characterizing shifts qualitatively and determining if they are harmful.

Unfairness in mortgage lending has created generational inequality among racial and ethnic groups in the US. Many studies address this problem, but most existing work focuses on correlation-based techniques. In our work, we use the framework of counterfactual fairness to train fair machine learning models. We propose a new causal graph for the variables available in the Home Mortgage Disclosure Act (HMDA) data. We use a matching-based approach instead of the latent variable modeling approach, because the former approach does not rely on any modeling assumptions. Furthermore, matching provides us with counterfactual pairs in which the race variable is isolated. We first demonstrate the unfairness in mortgage approval and interest rates between African-American and non-Hispanic White sub-populations. Then, we show that having balanced data using matching does not guarantee perfect counterfactual fairness of the machine learning models.

Patient education materials for solid-organ transplantation vary substantially across U.S. centers, yet no systematic method exists to quantify this heterogeneity at scale. We introduce a framework that grounds the same patient questions in different centers' handbooks using retrieval-augmented language models and compares the resulting answers using a five-label consistency taxonomy. Applied to 102 handbooks from 23 centers and 1,115 benchmark questions, the framework quantifies heterogeneity across four dimensions: question, topic, organ, and center. We find that 20.8% of non-absent pairwise comparisons exhibit clinically meaningful divergence, concentrated in condition monitoring and lifestyle topics. Coverage gaps are even more prominent: 96.2% of question-handbook pairs miss relevant content, with reproductive health at 95.1% absence. Center-level divergence profiles are stable and interpretable, where heterogeneity reflects systematic institutional differences, likely due to patient diversity. These findings expose an information gap in transplant patient education materials, with document-grounded medical question answering highlighting opportunities for content improvement.

Rare diseases collectively affect an estimated 3.5% to 5.9% of the population, yet more than 70% of patients are misdiagnosed and many endure years of evaluation before a diagnosis is reached, because early presentations are nonspecific and relevant expertise is scarce and unevenly distributed. Artificial intelligence could provide support, but existing systems address isolated stages of care, overwhelmingly diagnosis. They typically depend on the results of downstream investigations, and they treat the variability between models as noise to be eliminated. Here we present RareLens, a system that supports clinical decision-making across the entire rare disease trajectory by exploiting this variability. When heterogeneous large language models evaluate the same case, they generate divergent but complementary reasoning, which RareLens aligns and calibrates into a single convergent, actionable decision at each stage. Four coordinated modules perform primary-visit risk screening, diagnosis, treatment planning and prognosis. Developed and evaluated on RareBench, a real-world dataset of 157,525 cases spanning all 33 Orphanet categories and more than 7,000 conditions, RareLens outperformed every frontier model tested, including GPT-5, DeepSeek-R1, Claude-3.7-Sonnet and Gemini-2.5-Pro, at each stage. It achieved an area under the curve of 0.917 for screening and top-1 accuracies of 65.5% and 89.8% for diagnosis and treatment. In an external study spanning 1,287 cases and 23 physicians, autonomous RareLens and physicians assisted by RareLens both substantially outperformed unaided physicians. These findings indicate that aligning divergent model reasoning, rather than scaling a single model, offers a generalizable strategy for high-uncertainty clinical decision-making.

Backward compatibility of model predictions is a desired property when updating a machine learning driven application. It allows to seamlessly improve the underlying model without introducing regression bugs. In classification tasks these bugs occur in the form of negative flips. This means an instance that was correctly classified by the old model is now classified incorrectly by the updated model. This has direct negative impact on the user experience of such systems e.g. a frequently used voice assistant query is suddenly misclassified. A common reason to update the model is when new training data becomes available and needs to be incorporated. Simply retraining the model with the updated data introduces the unwanted negative flips. We study the problem of regression during data updates and propose Backward Compatible Weight Interpolation (BCWI). This method interpolates between the weights of the old and new model and we show in extensive experiments that it reduces negative flips without sacrificing the improved accuracy of the new model. BCWI is straight forward to implement and does not increase inference cost. We also explore the use of importance weighting during interpolation and averaging the weights of multiple new models in order to further reduce negative flips.

Pre-training data mixtures are commonly tuned by running small-scale experiments and extrapolating to the target training budget. When high-quality data is scarce and must be repeated, this extrapolation frequently fails, but the source of the failure has not been isolated. We show that a primary culprit is a repetition mismatch: because high-quality datasets are small, their repetition rate changes as the training budget grows, shifting the optimal mixture in ways that small-scale proxy experiments do not anticipate. A subsampling procedure that matches the target repetition rate controls for this effect. In a two-source setting combining limited high-quality data with web crawl, a single repetition-controlled experiment using only 1/16 of the target tokens recovers a mixture within 0.05 of the optimum for a 757M parameter model, compared to an error of 0.75 without repetition control. Achieving comparable accuracy without repetition control requires three to four horizons, consuming 44 to 94% of the target token budget. With three data sources, the larger mixture space requires more than a single experiment to constrain, but the approach remains effective: at the 757M scale, just two repetition-controlled horizons recover the optimal mixture, outperforming baselines that instead require the full two-source experiments to construct. Our results reveal that repetition dynamics, not scale alone, shape whether small-scale mixture experiments generalize. More broadly, they suggest that data repetition deserves treatment as a first-class variable in mixture optimization, rather than an inconvenient side effect of limited data.

Large language models (LLMs) are prone to hallucinations in question-answering (QA) tasks when faced with ambiguous questions. Users often assume that LLMs share their cognitive alignment, a mutual understanding of context, intent, and implicit details, leading them to omit critical information in the queries. However, LLMs generate responses based on assumptions that can misalign with user intent, which may be perceived as hallucinations if they misalign with the user's intent. Therefore, identifying those implicit assumptions is crucial to resolve ambiguities in QA. Prior work, such as AmbigQA, reduces ambiguity in queries via human-annotated clarifications, which is not feasible in real application. Meanwhile, ASQA compiles AmbigQA's short answers into long-form responses but inherits human biases and fails capture explicit logical distinctions that differentiates the answers. We introduce Conditional Ambiguous Question-Answering (CondAmbigQA), a benchmark with 200 ambiguous queries and condition-aware evaluation metrics. Our study pioneers the concept of ``conditions'' in ambiguous QA tasks, where conditions stand for contextual constraints or assumptions that resolve ambiguities. The retrieval-based annotation strategy uses retrieved Wikipedia fragments to identify possible interpretations for a given query as its conditions and annotate the answers through those conditions. Such a strategy minimizes human bias introduced by different knowledge levels among annotators. By fixing retrieval results, CondAmbigQA evaluates how RAG systems leverage conditions to resolve ambiguities. Experiments show that models considering conditions before answering improve performance by 20%, with an additional 5% gain when conditions are explicitly provided. These results underscore the value of conditional reasoning in QA, offering researchers tools to rigorously evaluate ambiguity resolution.

Generalist Large Language Models (LLMs), such as GPT-4, have shown considerable promise in various domains, including medical diagnosis. Rare diseases, affecting approximately 300 million people worldwide, often have unsatisfactory clinical diagnosis rates primarily due to a lack of experienced physicians and the complexity of differentiating among many rare diseases. In this context, recent news such as "ChatGPT correctly diagnosed a 4-year-old's rare disease after 17 doctors failed" underscore LLMs' potential, yet underexplored, role in clinically diagnosing rare diseases. To bridge this research gap, we introduce RareBench, a pioneering benchmark designed to systematically evaluate the capabilities of LLMs on 4 critical dimensions within the realm of rare diseases. Meanwhile, we have compiled the largest open-source dataset on rare disease patients, establishing a benchmark for future studies in this domain. To facilitate differential diagnosis of rare diseases, we develop a dynamic few-shot prompt methodology, leveraging a comprehensive rare disease knowledge graph synthesized from multiple knowledge bases, significantly enhancing LLMs' diagnostic performance. Moreover, we present an exhaustive comparative study of GPT-4's diagnostic capabilities against those of specialist physicians. Our experimental findings underscore the promising potential of integrating LLMs into the clinical diagnostic process for rare diseases. This paves the way for exciting possibilities in future advancements in this field.

We present a new approach for mitigating unfairness in learned classifiers. In particular, we focus on binary classification tasks over individuals from two populations, where, as our criterion for fairness, we wish to achieve similar false positive rates in both populations, and similar false negative rates in both populations. As a proof of concept, we implement our approach and empirically evaluate its ability to achieve both fairness and accuracy, using datasets from the fields of criminal risk assessment, credit, lending, and college admissions.

ASR models often suffer from a long-form deletion problem where the model predicts sequential blanks instead of words when transcribing a lengthy audio (in the order of minutes or hours). From the perspective of a user or downstream system consuming the ASR results, this behavior can be perceived as the model "being stuck", and potentially make the product hard to use. One of the culprits for long-form deletion is training-test data mismatch, which can happen even when the model is trained on diverse and large-scale data collected from multiple application domains. In this work, we introduce a novel technique to simultaneously model different groups of speakers in the audio along with the standard transcript tokens. Speakers are grouped as primary and non-primary, which connects the application domains and significantly alleviates the long-form deletion problem. This improved model neither needs any additional training data nor incurs additional training or inference cost.

Misinformation - false or misleading information - is considered a significant societal concern due to its associated "misinformation effects," such as political polarization, erosion of trust in institutions, problematic behavior, and public health challenges. However, the prevailing concept is misaligned with what is studied. While misinformation focuses on instances of information about factual matters, the broad spectrum of effects often manifests at a societal level and is shaped by a wide range of interdependent factors such as identity, values, opinions, epistemologies, and disagreements. Unsurprisingly, misinformation effects can occur without the prevalence of misinformation, and misinformation does not necessarily increase the effects studied. Here, we propose using disagreement - conflicting attitudes and beliefs between individuals and communities - as a way to study misinformation effects because it addresses the identified conceptual limitations of misinformation. Furthermore, unlike misinformation, disagreement does not require researchers to determine whether a given information is false or misleading. Thus, it can be studied and, more importantly, measured without the need to make a normative judgment about a given information, even when the specific topic is entirely removed, as we show in a longitudinal disagreement measurement. We demonstrate that disagreement, as a holistic concept, provides better explanations for the occurrence of misinformation effects, enhances precision in developing appropriate interventions, and offers a promising approach for evaluating them through quantification. Finally, we show how disagreement addresses current misinformation research questions and conclude with recommendations for research practice.

Weird generalization is a phenomenon in which models fine-tuned on data from a narrow domain (e.g. insecure code) develop surprising traits that manifest even outside that domain (e.g. broad misalignment)-a phenomenon that prior work has highlighted as a critical safety concern. Here, we present an extended replication study of key weird generalization results across an expanded suite of models and datasets. We confirm that surprising (and dangerous) traits can emerge under certain circumstances, but we find that weird generalization is exceptionally brittle: it emerges only for specific models on specific datasets, and it vanishes under simple training-time, prompt-based interventions. We find that the most effective interventions provide prompt context that makes the generalized behavior the expected behavior. However, we show that even very generic interventions that do not anticipate specific generalized traits can still be effective in mitigating weird generalization's effects. Our findings thus help clarify the nature of the safety threat that weird generalization poses and point toward an easily implemented set of solutions.

We develop and evaluate a data-driven approach for detecting unusual (anomalous) patient-management decisions using past patient cases stored in electronic health records (EHRs). Our hypothesis is that a patient-management decision that is unusual with respect to past patient care may be due to an error and that it is worthwhile to generate an alert if such a decision is encountered. We evaluate this hypothesis using data obtained from EHRs of 4486 post-cardiac surgical patients and a subset of 222 alerts generated from the data. We base the evaluation on the opinions of a panel of experts. The results of the study support our hypothesis that the outlier-based alerting can lead to promising true alert rates. We observed true alert rates that ranged from 25\% to 66\% for a variety of patient-management actions, with 66\% corresponding to the strongest outliers.

Recent work has shown that models trained to the same objective, and which achieve similar measures of accuracy on consistent test data, may nonetheless behave very differently on individual predictions. This inconsistency is undesirable in high-stakes contexts, such as medical diagnosis and finance. We show that this inconsistent behavior extends beyond predictions to feature attributions, which may likewise have negative implications for the intelligibility of a model, and one's ability to find recourse for subjects. We then introduce selective ensembles to mitigate such inconsistencies by applying hypothesis testing to the predictions of a set of models trained using randomly-selected starting conditions; importantly, selective ensembles can abstain in cases where a consistent outcome cannot be achieved up to a specified confidence level. We prove that that prediction disagreement between selective ensembles is bounded, and empirically demonstrate that selective ensembles achieve consistent predictions and feature attributions while maintaining low abstention rates. On several benchmark datasets, selective ensembles reach zero inconsistently predicted points, with abstention rates as low 1.5%.

Semi-Supervised Learning (SSL) under class distribution mismatch aims to tackle a challenging problem wherein unlabeled data contain lots of unknown categories unseen in the labeled ones. In such mismatch scenarios, traditional SSL suffers severe performance damage due to the harmful invasion of the instances with unknown categories into the target classifier. In this study, by strict mathematical reasoning, we reveal that the SSL error under class distribution mismatch is composed of pseudo-labeling error and invasion error, both of which jointly bound the SSL population risk. To alleviate the SSL error, we propose a robust SSL framework called Weight-Aware Distillation (WAD) that, by weights, selectively transfers knowledge beneficial to the target task from unsupervised contrastive representation to the target classifier. Specifically, WAD captures adaptive weights and high-quality pseudo labels to target instances by exploring point mutual information (PMI) in representation space to maximize the role of unlabeled data and filter unknown categories. Theoretically, we prove that WAD has a tight upper bound of population risk under class distribution mismatch. Experimentally, extensive results demonstrate that WAD outperforms five state-of-the-art SSL approaches and one standard baseline on two benchmark datasets, CIFAR10 and CIFAR100, and an artificial cross-dataset. The code is available at https://github.com/RUC-DWBI-ML/research/tree/main/WAD-master.

Reinforcement learning (RL) for large language models (LLMs) is dominated by the cost of rollout generation, which has motivated the use of low-precision rollouts (e.g., FP8) paired with a BF16 trainer to improve throughput and reduce memory pressure. This introduces a rollout-training mismatch that biases the policy gradient and can cause training to collapse outright on reasoning benchmarks. We show that the mismatch is non-stationary and acts as a double-edged sword: early in training it provides a stochastic exploration bonus, exposing the gradient to trajectories the trainer would otherwise under-sample, but the same perturbation transitions into a destabilizing source of bias as the policy concentrates. To solve this, we propose Adaptive Importance Sampling (AIS), a correction framework that adjusts the strength of its intervention on a per-batch basis. AIS combines three real-time diagnostics, namely weight reliability, divergence severity, and variance amplification, into a single mixing coefficient that interpolates between the uncorrected and fully importance-weighted gradients, suppressing the destabilizing component of the mismatch while preserving its exploratory benefit. We integrate AIS into GRPO and evaluate it on the diffusion-based LLaDA-8B-Instruct and the autoregressive Qwen3-8B and Qwen3.5-9B across mathematical reasoning and planning benchmarks. AIS matches the BF16 baseline on most tasks while retaining the 1.5 to 2.76x rollout speedup of FP8.

Security concerns related to Large Language Models (LLMs) have been extensively explored, yet the safety implications for Multimodal Large Language Models (MLLMs), particularly in medical contexts (MedMLLMs), remain insufficiently studied. This paper delves into the underexplored security vulnerabilities of MedMLLMs, especially when deployed in clinical environments where the accuracy and relevance of question-and-answer interactions are critically tested against complex medical challenges. By combining existing clinical medical data with atypical natural phenomena, we redefine two types of attacks: mismatched malicious attack (2M-attack) and optimized mismatched malicious attack (O2M-attack). Using our own constructed voluminous 3MAD dataset, which covers a wide range of medical image modalities and harmful medical scenarios, we conduct a comprehensive analysis and propose the MCM optimization method, which significantly enhances the attack success rate on MedMLLMs. Evaluations with this dataset and novel attack methods, including white-box attacks on LLaVA-Med and transfer attacks on four other state-of-the-art models, indicate that even MedMLLMs designed with enhanced security features are vulnerable to security breaches. Our work underscores the urgent need for a concerted effort to implement robust security measures and enhance the safety and efficacy of open-source MedMLLMs, particularly given the potential severity of jailbreak attacks and other malicious or clinically significant exploits in medical settings. For further research and replication, anonymous access to our code is available at https://github.com/dirtycomputer/O2M_attack. Warning: Medical large model jailbreaking may generate content that includes unverified diagnoses and treatment recommendations. Always consult professional medical advice.

Models trained on different datasets can be merged by a weighted-averaging of their parameters, but why does it work and when can it fail? Here, we connect the inaccuracy of weighted-averaging to mismatches in the gradients and propose a new uncertainty-based scheme to improve the performance by reducing the mismatch. The connection also reveals implicit assumptions in other schemes such as averaging, task arithmetic, and Fisher-weighted averaging. Our new method gives consistent improvements for large language models and vision transformers, both in terms of performance and robustness to hyperparameters.

Warning: This paper studies stereotypes and biases, and contains potentially disturbing examples, used for illustration purposes only. Our findings should not be interpreted as an argument against alignment. Instead, this paper highlights the need for principled approaches to more advanced alignment. Alignment aims to ensure that large language models (LLMs) behave safely and reliably, including by avoiding unsafe inferences. However, we show that such safety-oriented behaviors can misfire: models may reject warranted conclusions even when they are explicitly supported by context. We call this failure mode misfired alignment, where alignment-induced changes cause LLMs to override explicit evidence. To quantify this phenomenon, specifically on stereotype-related alignment, we introduce VETO, a benchmark consisting of 2,032 BBQ-derived contrastive pairs, and define a new metric, Misfired Alignment Rate (MAR), which measures on a 0 to 100 scale how often a model fails on a stereotype-related question but succeeds on its contrastive counterpart. We benchmark 25 LLMs on VETO, and show that all LLMs, including the most recent ones, exhibit non-trivial (4.7 to 18.9%) MARs while all human participants achieve 0.0% MAR. Controlled priming experiments further show that alignment-induced cues can substantially amplify MAR across LLMs, indicating that these failures are not merely artifacts of individual examples but can be induced by safety-related framing. Mechanistic analyses on open-weight LLMs reveal late-layer suppression of evidence-supported answers, and comparisons between instruct and base LLMs suggest that this suppression emerges after instruction training. These findings show that current alignment methods can overgeneralize surface-level safety cues, to the point of overriding objective evidence, motivating more work on alignment objectives that better preserve contextual grounding.

Accurate long horizon forecasting of particulate matter (PM) concentration fields is essential for operational public health decisions. However, achieving reliable forecasts remains challenging in regions with complex terrain and strong atmospheric dynamics such as East Asia. While foundation models such as Aurora offer global generality, they often miss region-specific dynamics and rely on non-real-time inputs, limiting their practical utility for localized warning systems. To address this gap, we construct and release the real-world observations and high-resolution CMAQ-OBS dataset for East Asia, reducing regional error by 59.5% and enabling real-time 48-120 hour forecasts critical for public health alerts. However, standard point-wise objectives cannot reflect asymmetric operational costs, where false alarms deteriorate public trust while missed severe events endanger populations. This cost mismatch causes SFT models to over-predict and yield high False Alarm Rates. We introduce Group-Relative Policy Optimization (GRPO) with class-wise rewards and curriculum rollout to align predictions with operational priorities. Experimental results demonstrate that our framework significantly improves the reliability of the forecast. Compared to the SFT-only baseline, our model reduces the False Alarm Rate by 47.3% while achieving a competitive F1-score, proving its effectiveness for practical, real-world air quality forecasting systems on long lead time scenarios.

When deploying machine learning models in high-stakes real-world environments such as health care, it is crucial to accurately assess the uncertainty concerning a model's prediction on abnormal inputs. However, there is a scarcity of literature analyzing this problem on medical data, especially on mixed-type tabular data such as Electronic Health Records. We close this gap by presenting a series of tests including a large variety of contemporary uncertainty estimation techniques, in order to determine whether they are able to identify out-of-distribution (OOD) patients. In contrast to previous work, we design tests on realistic and clinically relevant OOD groups, and run experiments on real-world medical data. We find that almost all techniques fail to achieve convincing results, partly disagreeing with earlier findings.

With the increasing availability of wearable devices, photoplethysmography (PPG) has emerged as a promising non-invasive tool for monitoring human hemodynamics. We propose a deep learning framework to estimate vascular age (AI-vascular age) from PPG signals, incorporating a distribution-aware loss to address biases caused by imbalanced data. The model was developed using data from the UK Biobank (UKB), with 98,672 participants in the development cohort and 113,559 participants (144,683 data pairs) for clinical evaluation. After adjusting for key confounders, individuals with a vascular age gap (AI-vascular age minus calendar age) exceeding 9 years had a significantly higher risk of major adverse cardiovascular and cerebrovascular events (MACCE) (HR = 2.37, p < 0.005) and secondary outcomes, including diabetes (HR = 2.69, p < 0.005), hypertension (HR = 2.88, p < 0.005), coronary heart disease (HR = 2.20, p < 0.005), heart failure (HR = 2.15, p < 0.005), myocardial infarction (HR = 2.51, p < 0.005), stroke (HR = 2.55, p < 0.005), and all-cause mortality (HR = 2.51, p < 0.005). Conversely, participants with a vascular age gap below -9 years exhibited a significantly lower incidence of these outcomes. We further evaluated the longitudinal applicability of AI-vascular age using serial PPG data from the UKB, demonstrating its value in risk stratification by leveraging AI-vascular age at two distinct time points to predict future MACCE incidence. External validation was performed on a MIMIC-III-derived cohort (n = 2,343), where each one-year increase in vascular age gap was significantly associated with elevated in-hospital mortality risk (OR = 1.02, p < 0.005). In conclusion, our study establishes AI-vascular age as a novel, non-invasive digital biomarker for cardiovascular health assessment.

Reinforcement learning (RL) has gained growing attention in large language model (LLM) post-training, yet RL training remains fragile and can suffer from instability or collapse. One vital cause is training-inference mismatch: LLM adopts separate inference and training engines for generation efficiency and training precision, which in practice exhibits inconsistent probabilities for the same trajectories on training and inference sides, even with synchronized model parameters. This naturally induces a special type of off-policyness ever existing and poisoning the training. Prior works have made various efforts in addressing the off-policyness to stabilize the training policies under the mismatch. In this paper, we point out the objective misalignment neglected by existing works that an effective update to the policy in the training engine not necessarily ensures the improvement of the inference policy, i.e., the one used in deployment. To this end, we propose a new policy optimization objective for LLM RL, named Monotonic Inference Policy Improvement (MIPI). Following this principle, we introduce Monotonic Inference Policy Update (MIPU), a two-step LLM RL framework that constructs sampler-referenced candidate updates and selectively accepts synchronized candidates using an inference-side gap proxy. Experiments conducted on two model scales under high mismatch show that MIPU improves average reasoning performance and training stability.

Electronic Health Records (EHRs) are integral for storing comprehensive patient medical records, combining structured data (e.g., medications) with detailed clinical notes (e.g., physician notes). These elements are essential for straightforward data retrieval and provide deep, contextual insights into patient care. However, they often suffer from discrepancies due to unintuitive EHR system designs and human errors, posing serious risks to patient safety. To address this, we developed EHRCon, a new dataset and task specifically designed to ensure data consistency between structured tables and unstructured notes in EHRs. EHRCon was crafted in collaboration with healthcare professionals using the MIMIC-III EHR dataset, and includes manual annotations of 3,943 entities across 105 clinical notes checked against database entries for consistency. EHRCon has two versions, one using the original MIMIC-III schema, and another using the OMOP CDM schema, in order to increase its applicability and generalizability. Furthermore, leveraging the capabilities of large language models, we introduce CheckEHR, a novel framework for verifying the consistency between clinical notes and database tables. CheckEHR utilizes an eight-stage process and shows promising results in both few-shot and zero-shot settings. The code is available at https://github.com/dustn1259/EHRCon.

This large scale study focuses on quantifying what X-rays diagnostic prediction tasks generalize well across multiple different datasets. We present evidence that the issue of generalization is not due to a shift in the images but instead a shift in the labels. We study the cross-domain performance, agreement between models, and model representations. We find interesting discrepancies between performance and agreement where models which both achieve good performance disagree in their predictions as well as models which agree yet achieve poor performance. We also test for concept similarity by regularizing a network to group tasks across multiple datasets together and observe variation across the tasks. All code is made available online and data is publicly available: https://github.com/mlmed/torchxrayvision

Alzheimer's disease (AD) is a degenerative brain disease impairing a person's ability to perform day to day activities. The clinical manifestations of Alzheimer's disease are characterized by heterogeneity in age, disease span, progression rate, impairment of memory and cognitive abilities. Due to these variabilities, personalized care and treatment planning, as well as patient counseling about their individual progression is limited. Recent developments in machine learning to detect hidden patterns in complex, multi-dimensional datasets provides significant opportunities to address this critical need. In this work, we use unsupervised and supervised machine learning approaches for subtype identification and prediction. We apply machine learning methods to the extensive clinical observations available at the Alzheimer's Disease Neuroimaging Initiative (ADNI) data set to identify patient subtypes and to predict disease progression. Our analysis depicts the progression space for the Alzheimer's disease into low, moderate and high disease progression zones. The proposed work will enable early detection and characterization of distinct disease subtypes based on clinical heterogeneity. We anticipate that our models will enable patient counseling, clinical trial design, and ultimately individualized clinical care.

Background: Health datasets from clinical sources do not reflect the breadth and diversity of disease in the real world, impacting research, medical education, and artificial intelligence (AI) tool development. Dermatology is a suitable area to develop and test a new and scalable method to create representative health datasets. Methods: We used Google Search advertisements to invite contributions to an open access dataset of images of dermatology conditions, demographic and symptom information. With informed contributor consent, we describe and release this dataset containing 10,408 images from 5,033 contributions from internet users in the United States over 8 months starting March 2023. The dataset includes dermatologist condition labels as well as estimated Fitzpatrick Skin Type (eFST) and Monk Skin Tone (eMST) labels for the images. Results: We received a median of 22 submissions/day (IQR 14-30). Female (66.72%) and younger (52% < age 40) contributors had a higher representation in the dataset compared to the US population, and 32.6% of contributors reported a non-White racial or ethnic identity. Over 97.5% of contributions were genuine images of skin conditions. Dermatologist confidence in assigning a differential diagnosis increased with the number of available variables, and showed a weaker correlation with image sharpness (Spearman's P values <0.001 and 0.01 respectively). Most contributions were short-duration (54% with onset < 7 days ago ) and 89% were allergic, infectious, or inflammatory conditions. eFST and eMST distributions reflected the geographical origin of the dataset. The dataset is available at github.com/google-research-datasets/scin . Conclusion: Search ads are effective at crowdsourcing images of health conditions. The SCIN dataset bridges important gaps in the availability of representative images of common skin conditions.

Current biomedical question answering (QA) systems often assume that medical knowledge applies uniformly, yet real-world clinical reasoning is inherently conditional: nearly every decision depends on patient-specific factors such as comorbidities and contraindications. Existing benchmarks do not evaluate such conditional reasoning, and retrieval-augmented or graph-based methods lack explicit mechanisms to ensure that retrieved knowledge is applicable to given context. To address this gap, we propose CondMedQA, the first benchmark for conditional biomedical QA, consisting of multi-hop questions whose answers vary with patient conditions. Furthermore, we propose Condition-Gated Reasoning (CGR), a novel framework that constructs condition-aware knowledge graphs and selectively activates or prunes reasoning paths based on query conditions. Our findings show that CGR more reliably selects condition-appropriate answers while matching or exceeding state-of-the-art performance on biomedical QA benchmarks, highlighting the importance of explicitly modeling conditionality for robust medical reasoning.

Introduction: Electronic health records (EHR) are a critical medium through which patient stigmatization is perpetuated among healthcare teams. Methods: We identified linguistic features of doubt markers and stigmatizing labels in MIMIC-III EHR via expanded lexicon matching and supervised learning classifiers. Predictors of rates of linguistic features were assessed using Poisson regression models. Results: We found higher rates of stigmatizing labels per chart among patients who were Black or African American (RR: 1.16), patients with Medicare/Medicaid or government-run insurance (RR: 2.46), self-pay (RR: 2.12), and patients with a variety of stigmatizing disease and mental health conditions. Patterns among doubt markers were similar, though male patients had higher rates of doubt markers (RR: 1.25). We found increased stigmatizing labels used by nurses (RR: 1.40), and social workers (RR: 2.25), with similar patterns of doubt markers. Discussion: Stigmatizing language occurred at higher rates among historically stigmatized patients, perpetuated by multiple provider types.

Integrating large language models (LLMs) like DeepSeek R1 into healthcare requires rigorous evaluation of their reasoning alignment with clinical expertise. This study assesses DeepSeek R1's medical reasoning against expert patterns using 100 MedQA clinical cases. The model achieved 93% diagnostic accuracy, demonstrating systematic clinical judgment through differential diagnosis, guideline-based treatment selection, and integration of patient-specific factors. However, error analysis of seven incorrect cases revealed persistent limitations: anchoring bias, challenges reconciling conflicting data, insufficient exploration of alternatives, overthinking, knowledge gaps, and premature prioritization of definitive treatment over intermediate care. Crucially, reasoning length correlated with accuracy - shorter responses (<5,000 characters) were more reliable, suggesting extended explanations may signal uncertainty or rationalization of errors. While DeepSeek R1 exhibits foundational clinical reasoning capabilities, recurring flaws highlight critical areas for refinement, including bias mitigation, knowledge updates, and structured reasoning frameworks. These findings underscore LLMs' potential to augment medical decision-making through artificial reasoning but emphasize the need for domain-specific validation, interpretability safeguards, and confidence metrics (e.g., response length thresholds) to ensure reliability in real-world applications.

Laboratory test results are an important and generally high dimensional component of a patient's Electronic Health Record (EHR). We train embedding representations (via Word2Vec and GloVe) for LOINC codes of laboratory tests from the EHRs of about 80,000 patients at a cancer center. To include information about lab test outcomes, we also train embeddings on the concatenation of a LOINC code with a symbol indicating normality or abnormality of the result. We observe several clinically meaningful similarities among LOINC embeddings trained over our data. For the embeddings of the concatenation of LOINCs with abnormality codes, we evaluate the performance for mortality prediction tasks and the ability to preserve ordinality properties: i.e. a lab test with normal outcome should be more similar to an abnormal one than to the a very abnormal one.

Recent advances in language modeling consist in pretraining highly parameterized neural networks on extremely large web-mined text corpora. Training and inference with such models can be costly in practice, which incentivizes the use of smaller counterparts. However, it has been observed that smaller models can suffer from saturation, characterized as a drop in performance at some advanced point in training followed by a plateau. In this paper, we find that such saturation can be explained by a mismatch between the hidden dimension of smaller models and the high rank of the target contextual probability distribution. This mismatch affects the performance of the linear prediction head used in such models through the well-known softmax bottleneck phenomenon. We measure the effect of the softmax bottleneck in various settings and find that models based on less than 1000 hidden dimensions tend to adopt degenerate latent representations in late pretraining, which leads to reduced evaluation performance.

Large language model (LLM) systems are increasingly used to support high-stakes decision-making, but they typically perform worse when the available evidence is internally inconsistent. Such a scenario exists in real-world healthcare settings, with patient-reported symptoms contradicting medical signs. To study this problem, we introduce MIMIC-DOS, a dataset for short-horizon organ dysfunction worsening prediction in the intensive care unit (ICU) setting. We derive this dataset from the widely recognized MIMIC-IV, a publicly available electronic health record dataset, and construct it exclusively from cases in which discordance between signs and symptoms exists. This setting poses a substantial challenge for existing LLM-based approaches, with single-pass LLMs and agentic pipelines often struggling to reconcile such conflicting signals. To address this problem, we propose CARE: a multi-stage privacy-compliant agentic reasoning framework in which a remote LLM provides guidance by generating structured categories and transitions without accessing sensitive patient data, while a local LLM uses these categories and transitions to support evidence acquisition and final decision-making. Empirically, CARE achieves stronger performance across all key metrics compared to multiple baseline settings, showing that CARE can more robustly handle conflicting clinical evidence while preserving privacy.

Multiple choice questions (MCQs) are commonly used to evaluate the capabilities of large language models (LLMs). One common way to evaluate the model response is to rank the candidate answers based on the log probability of the first token prediction. An alternative way is to examine the text output. Prior work has shown that first token probabilities lack robustness to changes in MCQ phrasing, and that first token probabilities do not match text answers for instruction-tuned models. Therefore, in this paper, we investigate the robustness of text answers. We show that the text answers are more robust to question perturbations than the first token probabilities, when the first token answers mismatch the text answers. The difference in robustness increases as the mismatch rate becomes greater. As the mismatch reaches over 50\%, the text answer is more robust to option order changes than the debiased first token probabilities using state-of-the-art debiasing methods such as PriDe. Our findings provide further evidence for the benefits of text answer evaluation over first token probability evaluation.

Several studies showed that Large Language Models (LLMs) can answer medical questions correctly, even outperforming the average human score in some medical exams. However, to our knowledge, no study has been conducted to assess the ability of language models to validate existing or generated medical text for correctness and consistency. In this paper, we introduce MEDEC (https://github.com/abachaa/MEDEC), the first publicly available benchmark for medical error detection and correction in clinical notes, covering five types of errors (Diagnosis, Management, Treatment, Pharmacotherapy, and Causal Organism). MEDEC consists of 3,848 clinical texts, including 488 clinical notes from three US hospital systems that were not previously seen by any LLM. The dataset has been used for the MEDIQA-CORR shared task to evaluate seventeen participating systems [Ben Abacha et al., 2024]. In this paper, we describe the data creation methods and we evaluate recent LLMs (e.g., o1-preview, GPT-4, Claude 3.5 Sonnet, and Gemini 2.0 Flash) for the tasks of detecting and correcting medical errors requiring both medical knowledge and reasoning capabilities. We also conducted a comparative study where two medical doctors performed the same task on the MEDEC test set. The results showed that MEDEC is a sufficiently challenging benchmark to assess the ability of models to validate existing or generated notes and to correct medical errors. We also found that although recent LLMs have a good performance in error detection and correction, they are still outperformed by medical doctors in these tasks. We discuss the potential factors behind this gap, the insights from our experiments, the limitations of current evaluation metrics, and share potential pointers for future research.

Machine learning models frequently experience performance drops under distribution shifts. The underlying cause of such shifts may be multiple simultaneous factors such as changes in data quality, differences in specific covariate distributions, or changes in the relationship between label and features. When a model does fail during deployment, attributing performance change to these factors is critical for the model developer to identify the root cause and take mitigating actions. In this work, we introduce the problem of attributing performance differences between environments to distribution shifts in the underlying data generating mechanisms. We formulate the problem as a cooperative game where the players are distributions. We define the value of a set of distributions to be the change in model performance when only this set of distributions has changed between environments, and derive an importance weighting method for computing the value of an arbitrary set of distributions. The contribution of each distribution to the total performance change is then quantified as its Shapley value. We demonstrate the correctness and utility of our method on synthetic, semi-synthetic, and real-world case studies, showing its effectiveness in attributing performance changes to a wide range of distribution shifts.

Machine learning models are often used to inform real world risk assessment tasks: predicting consumer default risk, predicting whether a person suffers from a serious illness, or predicting a person's risk to appear in court. Given multiple models that perform almost equally well for a prediction task, to what extent do predictions vary across these models? If predictions are relatively consistent for similar models, then the standard approach of choosing the model that optimizes a penalized loss suffices. But what if predictions vary significantly for similar models? In machine learning, this is referred to as predictive multiplicity i.e. the prevalence of conflicting predictions assigned by near-optimal competing models. In this paper, we present a framework for measuring predictive multiplicity in probabilistic classification (predicting the probability of a positive outcome). We introduce measures that capture the variation in risk estimates over the set of competing models, and develop optimization-based methods to compute these measures efficiently and reliably for convex empirical risk minimization problems. We demonstrate the incidence and prevalence of predictive multiplicity in real-world tasks. Further, we provide insight into how predictive multiplicity arises by analyzing the relationship between predictive multiplicity and data set characteristics (outliers, separability, and majority-minority structure). Our results emphasize the need to report predictive multiplicity more widely.

We develop graph-based methods for semi-supervised learning based on label propagation on a data similarity graph. When data is abundant or arrive in a stream, the problems of computation and data storage arise for any graph-based method. We propose a fast approximate online algorithm that solves for the harmonic solution on an approximate graph. We show, both empirically and theoretically, that good behavior can be achieved by collapsing nearby points into a set of local representative points that minimize distortion. Moreover, we regularize the harmonic solution to achieve better stability properties. We also present graph-based methods for detecting conditional anomalies and apply them to the identification of unusual clinical actions in hospitals. Our hypothesis is that patient-management actions that are unusual with respect to the past patients may be due to errors and that it is worthwhile to raise an alert if such a condition is encountered. Conditional anomaly detection extends standard unconditional anomaly framework but also faces new problems known as fringe and isolated points. We devise novel nonparametric graph-based methods to tackle these problems. Our methods rely on graph connectivity analysis and soft harmonic solution. Finally, we conduct an extensive human evaluation study of our conditional anomaly methods by 15 experts in critical care.

In this paper, we consider the problem of conditional anomaly detection that aims to identify data instances with an unusual response or a class label. We develop a new non-parametric approach for conditional anomaly detection based on the soft harmonic solution, with which we estimate the confidence of the label to detect anomalous mislabeling. We further regularize the solution to avoid the detection of isolated examples and examples on the boundary of the distribution support. We demonstrate the efficacy of the proposed method on several synthetic and UCI ML datasets in detecting unusual labels when compared to several baseline approaches. We also evaluate the performance of our method on a real-world electronic health record dataset where we seek to identify unusual patient-management decisions.

With the growing interest in large language models, the need for evaluating the quality of machine text compared to reference (typically human-generated) text has become focal attention. Most recent works focus either on task-specific evaluation metrics or study the properties of machine-generated text captured by the existing metrics. In this work, we propose a new evaluation scheme to model human judgments in 7 NLP tasks, based on the fine-grained mismatches between a pair of texts. Inspired by the recent efforts in several NLP tasks for fine-grained evaluation, we introduce a set of 13 mismatch error types such as spatial/geographic errors, entity errors, etc, to guide the model for better prediction of human judgments. We propose a neural framework for evaluating machine texts that uses these mismatch error types as auxiliary tasks and re-purposes the existing single-number evaluation metrics as additional scalar features, in addition to textual features extracted from the machine and reference texts. Our experiments reveal key insights about the existing metrics via the mismatch errors. We show that the mismatch errors between the sentence pairs on the held-out datasets from 7 NLP tasks align well with the human evaluation.

In this white paper we introduce Helix, an AI based solution for missense pathogenicity prediction. With recent advances in the sequencing of human genomes, massive amounts of genetic data have become available. This has shifted the burden of labor for genetic diagnostics and research from the gathering of data to its interpretation. Helix presents a state of the art platform for the prediction of pathogenicity in human missense variants. In addition to offering best-in-class predictive performance, Helix offers a platform that allows researchers to analyze and interpret variants in depth that can be accessed at helixlabs.ai.

Background: Cancer remains one of the leading causes of morbidity and mortality worldwide. Comprehensive datasets that combine histopathological images with genetic and survival data across various tumour sites are essential for advancing computational pathology and personalised medicine. Results: We present SurGen, a dataset comprising 1,020 H&E-stained whole slide images (WSIs) from 843 colorectal cancer cases. The dataset includes detailed annotations for key genetic mutations (KRAS, NRAS, BRAF) and mismatch repair status, as well as survival data for 426 cases. To demonstrate SurGen's practical utility, we conducted a proof-of-concept machine learning experiment predicting mismatch repair status from the WSIs, achieving a test AUROC of 0.8316. These preliminary results underscore the dataset's potential to facilitate research in biomarker discovery, prognostic modelling, and advanced machine learning applications in colorectal cancer. Conclusions: SurGen offers a valuable resource for the scientific community, enabling studies that require high-quality WSIs linked with comprehensive clinical and genetic information on colorectal cancer. Our initial findings affirm the dataset's capacity to advance diagnostic precision and foster the development of personalised treatment strategies in colorectal oncology. Data available online at https://doi.org/10.6019/S-BIAD1285.

Pathology Foundation Models (FMs) hold great promise for healthcare. Before they can be used in clinical practice, it is essential to ensure they are robust to variations between medical centers. We measure whether pathology FMs focus on biological features like tissue and cancer type, or on the well known confounding medical center signatures introduced by staining procedure and other differences. We introduce the Robustness Index. This novel robustness metric reflects to what degree biological features dominate confounding features. Ten current publicly available pathology FMs are evaluated. We find that all current pathology foundation models evaluated represent the medical center to a strong degree. Significant differences in the robustness index are observed. Only one model so far has a robustness index greater than one, meaning biological features dominate confounding features, but only slightly. A quantitative approach to measure the influence of medical center differences on FM-based prediction performance is described. We analyze the impact of unrobustness on classification performance of downstream models, and find that cancer-type classification errors are not random, but specifically attributable to same-center confounders: images of other classes from the same medical center. We visualize FM embedding spaces, and find these are more strongly organized by medical centers than by biological factors. As a consequence, the medical center of origin is predicted more accurately than the tissue source and cancer type. The robustness index introduced here is provided with the aim of advancing progress towards clinical adoption of robust and reliable pathology FMs.

"Machine unlearning" is a popular proposed solution for mitigating the existence of content in an AI model that is problematic for legal or moral reasons, including privacy, copyright, safety, and more. For example, unlearning is often invoked as a solution for removing the effects of specific information from a generative-AI model's parameters, e.g., a particular individual's personal data or the inclusion of copyrighted content in the model's training data. Unlearning is also proposed as a way to prevent a model from generating targeted types of information in its outputs, e.g., generations that closely resemble a particular individual's data or reflect the concept of "Spiderman." Both of these goals--the targeted removal of information from a model and the targeted suppression of information from a model's outputs--present various technical and substantive challenges. We provide a framework for ML researchers and policymakers to think rigorously about these challenges, identifying several mismatches between the goals of unlearning and feasible implementations. These mismatches explain why unlearning is not a general-purpose solution for circumscribing generative-AI model behavior in service of broader positive impact.

We investigate whether large language models produce different medical triage recommendations for identical neurological symptoms when only the patient's stated gender and age vary. Using three model families--Gemini 3.5 Flash, Claude Sonnet 4.6, and GPT-5.4-mini--we present a standardized symptom profile (persistent headache, blurred vision, morning nausea, visual disturbances) across seven demographic conditions: three age groups (25, 38, 65) x two genders (male, female), plus a gender-unspecified baseline (n = 30 per condition per model, 630 total trials). We find a stark, systemic gender-dependent triage disparity: young women receive significantly lower emergency room (ER) referral rates than age-matched men (Gemini: 0% vs. 23.3%; Claude: 6.7% vs. 96.7%; GPT: 6.7% vs. 66.7%, all p < 0.001). The disparity disappears at age 65 for all models. The primary mechanism is diagnostic substitution: the models anchor on a gender-associated diagnosis, preferentially classifying young women with Idiopathic Intracranial Hypertension (IIH)--a condition epidemiologically linked to women of childbearing age--while diagnosing men with generic increased intracranial pressure with space-occupying lesions in the differential. This diagnostic closure routes female patients to lower-urgency care (outpatient doctor appointments) despite comparable severity ratings (7-9/10). Our findings demonstrate that clinical LLMs replicate documented human clinical biases by using epidemiological priors to suppress triage urgency, suggesting that AI triage engines must decouple urgency assessment from probabilistic diagnostic priors. We release all code, prompts, and raw results.

Small sample sizes are common in many disciplines, which necessitates pooling roughly similar datasets across multiple institutions to study weak but relevant associations between images and disease outcomes. Such data often manifest shift/imbalance in covariates (i.e., secondary non-imaging data). Controlling for such nuisance variables is common within standard statistical analysis, but the ideas do not directly apply to overparameterized models. Consequently, recent work has shown how strategies from invariant representation learning provides a meaningful starting point, but the current repertoire of methods is limited to accounting for shifts/imbalances in just a couple of covariates at a time. In this paper, we show how viewing this problem from the perspective of Category theory provides a simple and effective solution that completely avoids elaborate multi-stage training pipelines that would otherwise be needed. We show the effectiveness of this approach via extensive experiments on real datasets. Further, we discuss how this style of formulation offers a unified perspective on at least 5+ distinct problem settings, from self-supervised learning to matching problems in 3D reconstruction.

To effectively optimize and personalize treatments, it is necessary to investigate the heterogeneity of treatment effects. With the wide range of users being treated over many online controlled experiments, the typical approach of manually investigating each dimension of heterogeneity becomes overly cumbersome and prone to subjective human biases. We need an efficient way to search through thousands of experiments with hundreds of target covariates and hundreds of breakdown dimensions. In this paper, we propose a systematic paradigm for detecting, surfacing and characterizing heterogeneous treatment effects. First, we detect if treatment effect variation is present in an experiment, prior to specifying any breakdowns. Second, we surface the most relevant dimensions for heterogeneity. Finally, we characterize the heterogeneity beyond just the conditional average treatment effects (CATE) by studying the conditional distributions of the estimated individual treatment effects. We show the effectiveness of our methods using simulated data and empirical studies.

Motion artefacts in magnetic resonance brain images can have a strong impact on diagnostic confidence. The assessment of MR image quality is fundamental before proceeding with the clinical diagnosis. Motion artefacts can alter the delineation of structures such as the brain, lesions or tumours and may require a repeat scan. Otherwise, an inaccurate (e.g. correct pathology but wrong severity) or incorrect diagnosis (e.g. wrong pathology) may occur. "Image quality assessment" as a fast, automated step right after scanning can assist in deciding if the acquired images are diagnostically sufficient. An automated image quality assessment based on the structural similarity index (SSIM) regression through a residual neural network is proposed in this work. Additionally, a classification into different groups - by subdividing with SSIM ranges - is evaluated. Importantly, this method predicts SSIM values of an input image in the absence of a reference ground truth image. The networks were able to detect motion artefacts, and the best performance for the regression and classification task has always been achieved with ResNet-18 with contrast augmentation. The mean and standard deviation of residuals' distribution were mu=-0.0009 and sigma=0.0139, respectively. Whilst for the classification task in 3, 5 and 10 classes, the best accuracies were 97, 95 and 89\%, respectively. The results show that the proposed method could be a tool for supporting neuro-radiologists and radiographers in evaluating image quality quickly.

People increasingly search online for answers to their medical questions but the rate at which medical questions are asked online significantly exceeds the capacity of qualified people to answer them. This leaves many questions unanswered or inadequately answered. Many of these questions are not unique, and reliable identification of similar questions would enable more efficient and effective question answering schema. COVID-19 has only exacerbated this problem. Almost every government agency and healthcare organization has tried to meet the informational need of users by building online FAQs, but there is no way for people to ask their question and know if it is answered on one of these pages. While many research efforts have focused on the problem of general question similarity, these approaches do not generalize well to domains that require expert knowledge to determine semantic similarity, such as the medical domain. In this paper, we show how a double fine-tuning approach of pretraining a neural network on medical question-answer pairs followed by fine-tuning on medical question-question pairs is a particularly useful intermediate task for the ultimate goal of determining medical question similarity. While other pretraining tasks yield an accuracy below 78.7% on this task, our model achieves an accuracy of 82.6% with the same number of training examples, an accuracy of 80.0% with a much smaller training set, and an accuracy of 84.5% when the full corpus of medical question-answer data is used. We also describe a currently live system that uses the trained model to match user questions to COVID-related FAQs.

We seek to identify the most relevant benefits offered by Medicare Advantage Health Plans that drive membership and market share. As an example, we explore plans operating in a single county in New Jersey between 2018 and 2023. A dataset of benefits from publicly available data sources was created and the variance inflation factor was applied to identify the correlation between the extracted features, to avoid multicollinearity and overparameterization problems. We categorized the variable Market Share and used it as a multinomial response variable with three categories: less than 0.3\%, 0.3\% to 1.5\%, and over 1.5\%. Categories were chosen to achieve approximately uniform distribution of plans (47, 60, and 65 respectively). We built a multinomial Lasso model using 5-fold cross-validation to tune the penalty parameter. Lasso forced some features to be dropped from the model, which reduces the risk of overfitting and increases the interpretability of the results. For each category, important variables are different. Certain brands drive market share, as do PPO plans and prescription drug coverage. Benefits, particularly ancillary benefits that are not part of CMS's required benefits, appear to have little influence, while financial terms such as deductibles, copays, and out-of-pocket limits are associated with higher market share. Finally, we evaluated the predictive accuracy of the Lasso model with the test set. The accuracy is 0.76.

Radiologic diagnostic errors-under-reading errors, inattentional blindness, and communication failures-remain prevalent in clinical practice. These issues often stem from missed localized abnormalities, limited global context, and variability in report language. These challenges are amplified in 3D imaging, where clinicians must examine hundreds of slices per scan. Addressing them requires systems with precise localized detection, global volume-level reasoning, and semantically consistent natural language reporting. However, existing 3D vision-language models are unable to meet all three needs jointly, lacking local-global understanding for spatial reasoning and struggling with the variability and noise of uncurated radiology reports. We present MedVista3D, a multi-scale semantic-enriched vision-language pretraining framework for 3D CT analysis. To enable joint disease detection and holistic interpretation, MedVista3D performs local and global image-text alignment for fine-grained representation learning within full-volume context. To address report variability, we apply language model rewrites and introduce a Radiology Semantic Matching Bank for semantics-aware alignment. MedVista3D achieves state-of-the-art performance on zero-shot disease classification, report retrieval, and medical visual question answering, while transferring well to organ segmentation and prognosis prediction. Code and datasets will be released.

This paper proposes one of the first clinical applications of multimodal large language models (LLMs) as an assistant for radiologists to check errors in their reports. We created an evaluation dataset from two real-world radiology datasets (MIMIC-CXR and IU-Xray), with 1,000 subsampled reports each. A subset of original reports was modified to contain synthetic errors by introducing various type of mistakes. The evaluation contained two difficulty levels: SIMPLE for binary error-checking and COMPLEX for identifying error types. LLaVA (Large Language and Visual Assistant) variant models, including our instruction-tuned model, were used for the evaluation. Additionally, a domain expert evaluation was conducted on a small test set. At the SIMPLE level, the LLaVA v1.5 model outperformed other publicly available models. Instruction tuning significantly enhanced performance by 47.4% and 25.4% on MIMIC-CXR and IU-Xray data, respectively. The model also surpassed the domain experts accuracy in the MIMIC-CXR dataset by 1.67%. Notably, among the subsets (N=21) of the test set where a clinician did not achieve the correct conclusion, the LLaVA ensemble mode correctly identified 71.4% of these cases. This study marks a promising step toward utilizing multi-modal LLMs to enhance diagnostic accuracy in radiology. The ensemble model demonstrated comparable performance to clinicians, even capturing errors overlooked by humans. Nevertheless, future work is needed to improve the model ability to identify the types of inconsistency.

Recent human-computer interaction (HCI) research has revealed a widespread misalignment between how developers design workplace artificial intelligence (AI) systems, and what workers actually need from them. Yet, little research has examined the effects of this gap, or how it may cause harm. We analyzed 1,524 reports of incidents in which AI systems were used to perform 171 occupational tasks across 12 industry sectors. Using an Large Language Model (LLM)-as-an-expert approach, we extracted the main traits of the AI systems involved in those incidents using an established framework of twelve traits. We then compared them with the traits that 202 workers highly familiar with those tasks would have preferred. We found that as many as 83\% of workplace incidents stem from worker-AI misalignments. In most cases, workers wanted systems that are precise, insightful, or personal, but instead received systems that are basic, simple, or general. Over the years, fast AI caused a considerable number of incidents, yet these declined, and imaginative AI, with the mass introduction of generative AI, started to cause incidents. We also compared the traits causing the incidents with the traits that 197 developers building AI systems for those tasks would have preferred. If the traits causing the incidents were the same as those designed by developers, then developers may be responsible for those incidents. We found that 74\% of task misalignments could be attributed to developers who tended to overfocus on efficiency and speed, especially for systems performing tasks in people-facing occupations such as those in the human resources sector. Our results call for design interventions that better align AI development with workers' needs, as without such corrections, workplace AI incidents are likely to persist, causing the invisible erosion of worker agency and organizational productivity.

Global healthcare providers are exploring use of large language models (LLMs) to provide medical advice to the public. LLMs now achieve nearly perfect scores on medical licensing exams, but this does not necessarily translate to accurate performance in real-world settings. We tested if LLMs can assist members of the public in identifying underlying conditions and choosing a course of action (disposition) in ten medical scenarios in a controlled study with 1,298 participants. Participants were randomly assigned to receive assistance from an LLM (GPT-4o, Llama 3, Command R+) or a source of their choice (control). Tested alone, LLMs complete the scenarios accurately, correctly identifying conditions in 94.9% of cases and disposition in 56.3% on average. However, participants using the same LLMs identified relevant conditions in less than 34.5% of cases and disposition in less than 44.2%, both no better than the control group. We identify user interactions as a challenge to the deployment of LLMs for medical advice. Standard benchmarks for medical knowledge and simulated patient interactions do not predict the failures we find with human participants. Moving forward, we recommend systematic human user testing to evaluate interactive capabilities prior to public deployments in healthcare.

Clinical early warning systems built on electronic health records, in which clinical observations are recorded as irregularly sampled medical time series (ISMTS), must deliver both calibrated risk scores for patient triage and interpretable rationales that clinicians can verify. Large Language Models (LLMs) have been explored for this task, yet they collapse graded clinical risk into overconfident binary predictions. This risk polarization undermines both calibration and cross-patient comparability. To address this, we propose TRIAGE, a framework that trains an LLM to generate dialectical reasoning over competing clinical outcomes by eliciting outcome-specific rationales. This dialectical formulation mitigates risk polarization, enabling a single LLM to yield continuous risk scores grounded in explicit clinical reasoning. Evaluated on three ISMTS benchmarks, TRIAGE achieves an average AUPRC improvement of 3.3% and reduces calibration error by 81% compared to the competitive baselines. An LLM-as-a-judge assessment further shows that our rationales surpass post-hoc explanations from the baseline by 20% in clinical reasoning quality. The source code is available at https://github.com/HyeongWon-Jang/TRIAGE .

Objective: To improve prediction of Chronic Kidney Disease (CKD) progression to End Stage Renal Disease (ESRD) using machine learning (ML) and deep learning (DL) models applied to an integrated clinical and claims dataset of varying observation windows, supported by explainable AI (XAI) to enhance interpretability and reduce bias. Materials and Methods: We utilized data about 10,326 CKD patients, combining their clinical and claims information from 2009 to 2018. Following data preprocessing, cohort identification, and feature engineering, we evaluated multiple statistical, ML and DL models using data extracted from five distinct observation windows. Feature importance and Shapley value analysis were employed to understand key predictors. Models were tested for robustness, clinical relevance, misclassification errors and bias issues. Results: Integrated data models outperformed those using single data sources, with the Long Short-Term Memory (LSTM) model achieving the highest AUC (0.93) and F1 score (0.65). A 24-month observation window was identified as optimal for balancing early detection and prediction accuracy. The 2021 eGFR equation improved prediction accuracy and reduced racial bias, notably for African American patients. Discussion: Improved ESRD prediction accuracy, results interpretability and bias mitigation strategies presented in this study have the potential to significantly enhance CKD and ESRD management, support targeted early interventions and reduce healthcare disparities. Conclusion: This study presents a robust framework for predicting ESRD outcomes in CKD patients, improving clinical decision-making and patient care through multi-sourced, integrated data and AI/ML methods. Future research will expand data integration and explore the application of this framework to other chronic diseases.

Several studies have shown that speech and language features, automatically extracted from clinical interviews or spontaneous discourse, have diagnostic value for mental disorders such as schizophrenia and bipolar disorder. They typically make use of a large feature set to train a classifier for distinguishing between two groups of interest, i.e. a clinical and control group. However, a purely data-driven approach runs the risk of overfitting to a particular data set, especially when sample sizes are limited. Here, we first down-select the set of language features to a small subset that is related to a well-validated test of functional ability, the Social Skills Performance Assessment (SSPA). This helps establish the concurrent validity of the selected features. We use only these features to train a simple classifier to distinguish between groups of interest. Linear regression reveals that a subset of language features can effectively model the SSPA, with a correlation coefficient of 0.75. Furthermore, the same feature set can be used to build a strong binary classifier to distinguish between healthy controls and a clinical group (AUC = 0.96) and also between patients within the clinical group with schizophrenia and bipolar I disorder (AUC = 0.83).

Ask a pretrained biomedical language model whether "cortisol 28 ug/dL" and "stock-market volatility" are related, and it returns a cosine similarity of 0.83 on a scale where 1.0 means identical. The two share no mechanism. This is not a corner case: every off-the-shelf biomedical encoder we tested (BioBERT, PubMedBERT, BioM-ELECTRA) scores unrelated cross-domain pairs between 0.76 and 0.92 when the answer should be near zero. Accuracy on cross-domain discrimination is 0%. Retrieval systems survive this, because a language model downstream filters the noise. A Large Behavioural Model (LBM), a foundation model whose subject is a person rather than a sentence, does not: it reasons over a graph of a user's life and treats embedding proximity as evidence that two events are causally linked. False proximity writes a false causal edge, and everything downstream inherits the error. Here, embedding geometry is not a tuning knob; it is correctness. We report the fix. A contrastive pass over 72,034 pairs raises PubMedBERT BIOSSES correlation from 0.633 to 0.828 and within-vs-across-domain separation from 1.05x to 1.63x. A second pass, BODHI, mines hard negatives from edges absent in a biomedical knowledge graph and lifts separation to 2.30x and the discrimination gap to +0.392, at a 4.5% BIOSSES cost. On an Intel Xeon 6737P with AMX, OpenVINO cuts single-query latency from 1367 ms to 10 ms (133x) and reaches 555 sentences/sec. One finding contradicts standard advice: FP16 beats INT8 on this silicon at every serving batch size, and we explain why. The same model on a no-AMX Ice Lake instance runs 13-27x slower. We release the benchmark suite, training corpora, the BODHI generator, and the OpenVINO scripts.

Multimodal large language models (MLLMs) have advanced clinical tasks for common conditions, but their performance on rare diseases remains largely untested. In rare-disease scenarios, clinicians often lack prior clinical knowledge, forcing them to rely strictly on case-level evidence for clinical judgments. Existing benchmarks predominantly evaluate common-condition, single-image settings, leaving multimodal and multi-image evidence integration under rare-disease data scarcity systematically unevaluated. We introduce MMRareBench, to our knowledge the first rare-disease benchmark jointly evaluating multimodal and multi-image clinical capability across four workflow-aligned tracks: diagnosis, treatment planning, cross-image evidence alignment, and examination suggestion. The benchmark comprises 1,756 question-answer pairs with 7,958 associated medical images curated from PMC case reports, with Orphanet-anchored ontology alignment, track-specific leakage control, evidence-grounded annotations, and a two-level evaluation protocol. A systematic evaluation of 23 MLLMs reveals fragmented capability profiles and universally low treatment-planning performance, with medical-domain models trailing general-purpose MLLMs substantially on multi-image tracks despite competitive diagnostic scores. These patterns are consistent with a capacity dilution effect: medical fine-tuning can narrow the diagnostic gap but may erode the compositional multi-image capability that rare-disease evidence integration demands.

Organizations cannot address demographic disparities that they cannot see. Recent research on machine learning and fairness has emphasized that awareness of sensitive attributes, such as race and sex, is critical to the development of interventions. However, on the ground, the existence of these data cannot be taken for granted. This paper uses the domains of employment, credit, and healthcare in the United States to surface conditions that have shaped the availability of sensitive attribute data. For each domain, we describe how and when private companies collect or infer sensitive attribute data for antidiscrimination purposes. An inconsistent story emerges: Some companies are required by law to collect sensitive attribute data, while others are prohibited from doing so. Still others, in the absence of legal mandates, have determined that collection and imputation of these data are appropriate to address disparities. This story has important implications for fairness research and its future applications. If companies that mediate access to life opportunities are unable or hesitant to collect or infer sensitive attribute data, then proposed techniques to detect and mitigate bias in machine learning models might never be implemented outside the lab. We conclude that today's legal requirements and corporate practices, while highly inconsistent across domains, offer lessons for how to approach the collection and inference of sensitive data in appropriate circumstances. We urge stakeholders, including machine learning practitioners, to actively help chart a path forward that takes both policy goals and technical needs into account.

Advances in large language models (LLMs) provide new opportunities in healthcare for improved patient care, clinical decision-making, and enhancement of physician and administrator workflows. However, the potential of these models importantly depends on their ability to generalize effectively across clinical environments and populations, a challenge often underestimated in early development. To better understand reasons for these challenges and inform mitigation approaches, we evaluated ClinicLLM, an LLM trained on [HOSPITAL]'s clinical notes, analyzing its performance on 30-day all-cause readmission prediction focusing on variability across hospitals and patient characteristics. We found poorer generalization particularly in hospitals with fewer samples, among patients with government and unspecified insurance, the elderly, and those with high comorbidities. To understand reasons for lack of generalization, we investigated sample sizes for fine-tuning, note content (number of words per note), patient characteristics (comorbidity level, age, insurance type, borough), and health system aspects (hospital, all-cause 30-day readmission, and mortality rates). We used descriptive statistics and supervised classification to identify features. We found that, along with sample size, patient age, number of comorbidities, and the number of words in notes are all important factors related to generalization. Finally, we compared local fine-tuning (hospital specific), instance-based augmented fine-tuning and cluster-based fine-tuning for improving generalization. Among these, local fine-tuning proved most effective, increasing AUC by 0.25% to 11.74% (most helpful in settings with limited data). Overall, this study provides new insights for enhancing the deployment of large language models in the societally important domain of healthcare, and improving their performance for broader populations.

While large language models (LLMs) show transformative potential in healthcare, their development remains focused on high-resource languages, creating a critical barrier for others as simple translation fails to capture unique clinical and cultural nuances, such as endemic diseases. To address this, we introduce MedPT, the first large-scale, real-world corpus for Brazilian Portuguese, comprising 384,095 authentic question-answer pairs from patient-doctor interactions. The dataset underwent a meticulous multi-stage curation protocol, using a hybrid quantitative-qualitative analysis to filter noise and contextually enrich thousands of ambiguous queries. We further augmented the corpus via LLM-driven annotation, classifying questions into seven semantic types to capture user intent. Our analysis reveals its thematic breadth (3,200 topics) and unique linguistic properties, like the natural asymmetry in patient-doctor communication. To validate its utility, we benchmark a medical specialty routing task: fine-tuning a 1.7B parameter model achieves an outstanding 94\% F1-score on a 20-class setup. Furthermore, our qualitative error analysis shows misclassifications are not random but reflect genuine clinical ambiguities (e.g., between comorbid conditions), proving the dataset's deep semantic richness. We publicly release MedPT to foster the development of more equitable, accurate, and culturally-aware medical technologies for the Portuguese-speaking world.

Genome-wide association study (GWAS) tests single nucleotide polymorphism (SNP) markers across the genome to localize the underlying causal variant of a trait. Because causal variants are seldom observed directly, a surrogate model based on genotyped markers are widely considered. Although many methods estimating the parameters of the surrogate model have been proposed, the connection between the surrogate model and the true causal model is yet investigated. In this work, we establish the connection between the surrogate model and the true causal model. The connection shows that population structure is accounted in GWAS by modelling the variant of interest and not the trait. Such observation explains how environmental confounding can be partially corrected using genetic covariates and why the previously claimed connection between PC correction and linear mixed models is incorrect.

Equivariance theory predicts that an architectural symmetry prior reduces sample complexity by a factor of |G|; this is widely cited but rarely measured as a scaling law with controls that separate the prior from its confounds. On a controlled C_n-symmetric task, we report three findings. First, a wrong-group control with identical orbit size and matched compute is worse than no constraint (joint pairwise CI [+0.79, +3.26] excludes zero, robust across estimators); misaligned constraint is actively harmful, not merely unhelpful. Second, an augmentation baseline equipped with test-time orbit averaging matches the equivariant model exactly -- bit-identical per-epoch validation curves across matched cells -- so the architecture-vs-augmentation gap is conditional on asymmetric test-time computation, not unconditional. Third, the relative exchange rate beta_diff = 1.28 is consistent in sign and order of magnitude with the theoretical 1.0 (single-level CI [+0.92, +2.05]); the more conservative two-level bootstrap (seeds x group sizes) widens this to [-0.63, +1.72], including zero, and a finer-N replication on a sqrt(2)-spaced grid is inconclusive (point estimate -0.82). The methodological contributions -- the relative-rate estimator that cancels the shared-difficulty confound, the wrong-group control, and a pre-specified failure taxonomy -- transfer to any inductive bias whose strength can be parameterised. Honest scoping: the primary estimator beta_diff was adopted post-hoc after the initial analysis revealed a positive-slope identifiability problem; the design was never externally pre-registered; and the headline number rests on an OLS slope over seven group sizes on a coarse N grid. This is an exploratory study, not a confirmatory measurement; the wrong-group result is the cleanest finding and the one we report with the most confidence. A registered replication on fresh seeds is future work.

Depression has proven to be a significant public health issue, profoundly affecting the psychological well-being of individuals. If it remains undiagnosed, depression can lead to severe health issues, which can manifest physically and even lead to suicide. Generally, Diagnosing depression or any other mental disorder involves conducting semi-structured interviews alongside supplementary questionnaires, including variants of the Patient Health Questionnaire (PHQ) by Clinicians and mental health professionals. This approach places significant reliance on the experience and judgment of trained physicians, making the diagnosis susceptible to personal biases. Given that the underlying mechanisms causing depression are still being actively researched, physicians often face challenges in diagnosing and treating the condition, particularly in its early stages of clinical presentation. Recently, significant strides have been made in Artificial neural computing to solve problems involving text, image, and speech in various domains. Our analysis has aimed to leverage these state-of-the-art (SOTA) models in our experiments to achieve optimal outcomes leveraging multiple modalities. The experiments were performed on the Extended Distress Analysis Interview Corpus Wizard of Oz dataset (E-DAIC) corpus presented in the Audio/Visual Emotion Challenge (AVEC) 2019 Challenge. The proposed solutions demonstrate better results achieved by Proprietary and Open-source Large Language Models (LLMs), which achieved a Root Mean Square Error (RMSE) score of 3.98 on Textual Modality, beating the AVEC 2019 challenge baseline results and current SOTA regression analysis architectures. Additionally, the proposed solution achieved an accuracy of 71.43% in the classification task. The paper also includes a novel audio-visual multi-modal network that predicts PHQ-8 scores with an RMSE of 6.51.

Aligning large language models with human preferences is critical for creating reliable and controllable AI systems. A human preference can be visualized as a high-dimensional vector where different directions represent trade-offs between desired attributes (e.g., helpfulness vs. verbosity). Yet, because the training data often reflects dominant, average preferences, LLMs tend to perform well on common requests but fall short in specific, individual needs. This mismatch creates a preference coverage gap. Existing methods often address this through costly retraining, which may not be generalized to the full spectrum of diverse preferences. This brittleness means that when a user's request reflects a nuanced preference deviating from the training data's central tendency, model performance can degrade unpredictably. To address this challenge, we introduce Robust Preference Selection (RPS), a post-hoc, training-free method by leveraging directional neighborhood consensus. Instead of forcing a model to generate a response from a single, highly specific preference, RPS samples multiple responses from a local neighborhood of related preferences to create a superior candidate pool. It then selects the response that best aligns with the user's original intent. We provide a theoretical framework showing our neighborhood generation strategy is provably superior to a strong baseline that also samples multiple candidates. Comprehensive experiments across three distinct alignment paradigms (DPA, DPO, and SFT) demonstrate that RPS consistently improves robustness against this baseline, achieving win rates of up to 69% on challenging preferences from under-represented regions of the space without any model retraining. Our work presents a practical, theoretically-grounded solution for enhancing the reliability of preference-aligned models.

Anomaly detection methods can be very useful in identifying unusual or interesting patterns in data. A recently proposed conditional anomaly detection framework extends anomaly detection to the problem of identifying anomalous patterns on a subset of attributes in the data. The anomaly always depends (is conditioned) on the value of remaining attributes. The work presented in this paper focuses on instance-based methods for detecting conditional anomalies. The methods rely on the distance metric to identify examples in the dataset that are most critical for detecting the anomaly. We investigate various metrics and metric learning methods to optimize the performance of the instance-based anomaly detection methods. We show the benefits of the instance-based methods on two real-world detection problems: detection of unusual admission decisions for patients with the community-acquired pneumonia and detection of unusual orders of an HPF4 test that is used to confirm Heparin induced thrombocytopenia - a life-threatening condition caused by the Heparin therapy.

Recent work has explored how to train machine learning models which do not discriminate against any subgroup of the population as determined by sensitive attributes such as gender or race. To avoid disparate treatment, sensitive attributes should not be considered. On the other hand, in order to avoid disparate impact, sensitive attributes must be examined, e.g., in order to learn a fair model, or to check if a given model is fair. We introduce methods from secure multi-party computation which allow us to avoid both. By encrypting sensitive attributes, we show how an outcome-based fair model may be learned, checked, or have its outputs verified and held to account, without users revealing their sensitive attributes.

There has been a rapidly growing interest in Automatic Symptom Detection (ASD) and Automatic Diagnosis (AD) systems in the machine learning research literature, aiming to assist doctors in telemedicine services. These systems are designed to interact with patients, collect evidence about their symptoms and relevant antecedents, and possibly make predictions about the underlying diseases. Doctors would review the interactions, including the evidence and the predictions, collect if necessary additional information from patients, before deciding on next steps. Despite recent progress in this area, an important piece of doctors' interactions with patients is missing in the design of these systems, namely the differential diagnosis. Its absence is largely due to the lack of datasets that include such information for models to train on. In this work, we present a large-scale synthetic dataset of roughly 1.3 million patients that includes a differential diagnosis, along with the ground truth pathology, symptoms and antecedents for each patient. Unlike existing datasets which only contain binary symptoms and antecedents, this dataset also contains categorical and multi-choice symptoms and antecedents useful for efficient data collection. Moreover, some symptoms are organized in a hierarchy, making it possible to design systems able to interact with patients in a logical way. As a proof-of-concept, we extend two existing AD and ASD systems to incorporate the differential diagnosis, and provide empirical evidence that using differentials as training signals is essential for the efficiency of such systems or for helping doctors better understand the reasoning of those systems.

Large Language Models (LLMs) are usually aligned with "human values/preferences" to prevent harmful output. Discussions around the alignment of Large Language Models (LLMs) generally focus on preventing harmful outputs. However, in this paper, we argue that in health-related queries, over-alignment-leading to overly cautious responses-can itself be harmful, especially for people with anxiety and obsessive-compulsive disorder (OCD). This is not only unethical but also dangerous to the user, both mentally and physically. We also showed qualitative results that some LLMs exhibit varying degrees of alignment. Finally, we call for the development of LLMs with stronger reasoning capabilities that provide more tailored and nuanced responses to health queries. Warning: This paper contains materials that could trigger health anxiety or OCD.

Alzheimer's disease (AD) is a common neurodegenerative disease among the elderly. Early prediction and timely intervention of its prodromal stage, mild cognitive impairment (MCI), can decrease the risk of advancing to AD. Combining information from various modalities can significantly improve predictive accuracy. However, challenges such as missing data and heterogeneity across modalities complicate multimodal learning methods as adding more modalities can worsen these issues. Current multimodal fusion techniques often fail to adapt to the complexity of medical data, hindering the ability to identify relationships between modalities. To address these challenges, we propose an innovative multimodal approach for predicting MCI conversion, focusing specifically on the issues of missing positron emission tomography (PET) data and integrating diverse medical information. The proposed incomplete triple-modal MCI conversion prediction network is tailored for this purpose. Through the missing modal generation module, we synthesize the missing PET data from the magnetic resonance imaging and extract features using specifically designed encoders. We also develop a channel aggregation module and a triple-modal co-attention fusion module to reduce feature redundancy and achieve effective multimodal data fusion. Furthermore, we design a loss function to handle missing modality issues and align cross-modal features. These components collectively harness multimodal data to boost network performance. Experimental results on the ADNI1 and ADNI2 datasets show that our method significantly surpasses existing unimodal and other multimodal models. Our code is available at https://github.com/justinhxy/ITFC.

Accurate breast lesion risk estimation can significantly reduce unnecessary biopsies and help doctors decide optimal treatment plans. Most existing computer-aided systems rely solely on mammogram features to classify breast lesions. While this approach is convenient, it does not fully exploit useful information in clinical reports to achieve the optimal performance. Would clinical features significantly improve breast lesion classification compared to using mammograms alone? How to handle missing clinical information caused by variation in medical practice? What is the best way to combine mammograms and clinical features? There is a compelling need for a systematic study to address these fundamental questions. This paper investigates several multimodal deep networks based on feature concatenation, cross-attention, and co-attention to combine mammograms and categorical clinical variables. We show that the proposed architectures significantly increase the lesion classification performance (average area under ROC curves from 0.89 to 0.94). We also evaluate the model when clinical variables are missing.

Skin conditions affect an estimated 1.9 billion people worldwide. A shortage of dermatologists causes long wait times and leads patients to seek dermatologic care from general practitioners. However, the diagnostic accuracy of general practitioners has been reported to be only 0.24-0.70 (compared to 0.77-0.96 for dermatologists), resulting in referral errors, delays in care, and errors in diagnosis and treatment. In this paper, we developed a deep learning system (DLS) to provide a differential diagnosis of skin conditions for clinical cases (skin photographs and associated medical histories). The DLS distinguishes between 26 skin conditions that represent roughly 80% of the volume of skin conditions seen in primary care. The DLS was developed and validated using de-identified cases from a teledermatology practice serving 17 clinical sites via a temporal split: the first 14,021 cases for development and the last 3,756 cases for validation. On the validation set, where a panel of three board-certified dermatologists defined the reference standard for every case, the DLS achieved 0.71 and 0.93 top-1 and top-3 accuracies respectively. For a random subset of the validation set (n=963 cases), 18 clinicians reviewed the cases for comparison. On this subset, the DLS achieved a 0.67 top-1 accuracy, non-inferior to board-certified dermatologists (0.63, p<0.001), and higher than primary care physicians (PCPs, 0.45) and nurse practitioners (NPs, 0.41). The top-3 accuracy showed a similar trend: 0.90 DLS, 0.75 dermatologists, 0.60 PCPs, and 0.55 NPs. These results highlight the potential of the DLS to augment general practitioners to accurately diagnose skin conditions by suggesting differential diagnoses that may not have been considered. Future work will be needed to prospectively assess the clinical impact of using this tool in actual clinical workflows.

Human medical data can be challenging to obtain due to data privacy concerns, difficulties conducting certain types of experiments, or prohibitive associated costs. In many settings, data from animal models or in-vitro cell lines are available to help augment our understanding of human data. However, this data is known for having low etiological validity in comparison to human data. In this work, we augment small human medical datasets with in-vitro data and animal models. We use Invariant Risk Minimisation (IRM) to elucidate invariant features by considering cross-organism data as belonging to different data-generating environments. Our models identify genes of relevance to human cancer development. We observe a degree of consistency between varying the amounts of human and mouse data used, however, further work is required to obtain conclusive insights. As a secondary contribution, we enhance existing open source datasets and provide two uniformly processed, cross-organism, homologue gene-matched datasets to the community.