Daily Papers

Video multimodal large language models (MLLMs) have made rapid progress on general and long-form video understanding, yet their ability to preserve brief answer-critical visual evidence remains underexplored. Many practical questions are determined by momentary visual events: localized actions or state transitions that may last only a few frames. Such evidence can be skipped by sparse frame sampling, suppressed by visual-token compression, or diluted by coarse temporal aggregation, causing failures that language-side reasoning cannot reliably recover. We introduce Moment-Video, a benchmark for diagnosing the temporal fidelity of video MLLMs through momentary visual event understanding. Each question is grounded in a localized, visually observable, and sampling-sensitive event, requiring models to notice, count, describe, or reason about transient evidence rather than rely on persistent objects, global scene context, or language priors. Moment-Video contains 1,000 human-verified video-QA pairs across 7 domains and 25 fine-grained subcategories, covering four task types: Temporal Occurrence, Temporal Counting, Action Description, and Temporal Reasoning. We evaluate 33 proprietary and open-source MLLMs on Moment-Video. The best-performing model, Seed-2.0-Pro, achieves only 39.6% overall accuracy, while most open-source models remain below 25%, revealing a substantial gap in momentary visual event understanding. Diagnostic analyses show that denser frame sampling improves some models but does not eliminate the bottleneck, and longer videos introduce stronger temporal-localization challenges. These findings suggest that current video MLLMs still lack temporally faithful representations for capturing, preserving, and using brief but decisive visual evidence.

Diffusion large language models promise faster generation by refining many token positions in parallel, but this parallelism introduces a hidden control problem: which proposed tokens should be transferred into the partially decoded sequence at each step? We refer to this decision as token commitment. Existing frozen-generator decoders largely rely on hand-designed confidence rules or block-specific acceptance filters. We argue that token commitment can instead be learned as a reusable trace-state policy. We introduce TraceLock, a lightweight plug-in controller that instantiates this policy for a frozen diffusion language model. Since oracle commitment times are unavailable, TraceLock derives self-supervision from future stability: at decoding step t, a proposed token for position i is labeled stable if it matches the final token at position i after the full decoding trace completes. The controller scores variable-length trace states and decides which active token proposals should be committed to the partially decoded sequence. Once trained for a given frozen backbone, the controller can be deployed across local-window widths, generation lengths, and step budgets without retraining or per-setting calibration. Experiments on question answering, mathematical reasoning, and code generation show that TraceLock improves the quality-step tradeoff over heuristic and learned baselines, with particularly stable behavior under cross-setting deployment. Diagnostic analyses show that its decisions are not reducible to scalar confidence, suggesting that frozen diffusion language models expose a learnable space of commitment trajectories beyond confidence-based decoding. Code is available at https://github.com/BobSun98/TraceLock.

Using multimodal foundation models to analyze table images is a high-value yet challenging application in consumer and enterprise scenarios. Despite its importance, current evaluations rely largely on structured-text tables or clean rendered images, leaving the visual complexity of in-the-wild table images underexplored. Such images feature varied layouts and diverse domains that demand sophisticated structural perception and numerical reasoning. To bridge this gap, we introduce WildTableBench, the first question-answering benchmark for naturally occurring table images from real-world settings. WildTableBench comprises 402 high-information-density table images collected from online forums and websites across diverse domains, together with 928 manually annotated and verified questions spanning 17 subtypes across five categories. We evaluate 21 frontier proprietary and open-source multimodal foundation models on this benchmark. Only one model exceeds 50% accuracy, while all remaining models range from 4.1% to 49.9%. We further conduct diagnostic analyses to characterize model failures and reveal persistent weaknesses in structural perception and reasoning. These results and analyses provide useful insights into current model capabilities and establish WildTableBench as a valuable diagnostic benchmark for table image understanding.

Current Large Language Models have achieved Olympiad-level logic, yet Vision-Language Models paradoxically falter on elementary spatial tasks like block counting. This capability mismatch reveals a critical ``spatial intelligence gap,'' where models fail to construct coherent 3D mental representations from 2D observations. We uncover this gap via diagnostic analyses showing the bottleneck is a missing view-consistent spatial interface rather than insufficient visual features or weak reasoning. To bridge this, we introduce 3ViewSense, a framework that grounds spatial reasoning in Orthographic Views. Drawing on engineering cognition, we propose a ``Simulate-and-Reason'' mechanism that decomposes complex scenes into canonical orthographic projections to resolve geometric ambiguities. By aligning egocentric perceptions with these allocentric references, our method facilitates explicit mental rotation and reconstruction. Empirical results on spatial reasoning benchmarks demonstrate that our method significantly outperforms existing baselines, with consistent gains on occlusion-heavy counting and view-consistent spatial reasoning. The framework also improves the stability and consistency of spatial descriptions, offering a scalable path toward stronger spatial intelligence in multimodal systems.

In classical Reinforcement Learning from Human Feedback (RLHF), Reward Models (RMs) serve as the fundamental signal provider for model alignment. As Large Language Models evolve into agentic systems capable of autonomous tool invocation and complex reasoning, the paradigm of reward modeling faces unprecedented challenges--most notably, the lack of benchmarks specifically designed to assess RM capabilities within tool-integrated environments. To address this gap, we present Plan-RewardBench, a trajectory-level preference benchmark designed to evaluate how well judges distinguish preferred versus distractor agent trajectories in complex tool-using scenarios. Plan-RewardBench covers four representative task families -- (i) Safety Refusal, (ii) Tool-Irrelevance / Unavailability, (iii) Complex Planning, and (iv) Robust Error Recovery -- comprising validated positive trajectories and confusable hard negatives constructed via multi-model natural rollouts, rule-based perturbations, and minimal-edit LLM perturbations. We benchmark representative RMs (generative, discriminative, and LLM-as-Judge) under a unified pairwise protocol, reporting accuracy trends across varying trajectory lengths and task categories. Furthermore, we provide diagnostic analyses of prevalent failure modes. Our results reveal that all three evaluator families face substantial challenges, with performance degrading sharply on long-horizon trajectories, underscoring the necessity for specialized training in agentic, trajectory-level reward modeling. Ultimately, Plan-RewardBench aims to serve as both a practical evaluation suite and a reusable blueprint for constructing agentic planning preference data.

On-policy distillation offers dense, per-token supervision for training reasoning models; however, it remains unclear under which conditions this signal is beneficial and under which it is detrimental. Which teacher model should be used, and in the case of self-distillation, which specific context should serve as the supervisory signal? Does the optimal choice vary from one token to the next? At present, addressing these questions typically requires costly training runs whose aggregate performance metrics obscure the dynamics at the level of individual tokens. We introduce a training-free diagnostic framework that operates at the highest resolution: per token, per question, and per teacher. We derive an ideal per-node gradient defined as the parameter update that maximally increases the student's probability of success. We then develop a scalable targeted-rollout algorithm to estimate this gradient efficiently, even for long chains of intermediate thoughts. The gradient alignment score, defined as the cosine similarity between this ideal gradient and any given distillation gradient, quantifies the extent to which a particular configuration approximates the ideal signal. Across a range of self-distillation settings and external teacher models, we observe that distillation guidance exhibits substantially higher alignment with the ideal on incorrect rollouts than on correct ones, where the student already performs well and the teacher's signal tends to become noisy. Furthermore, we find that the optimal distillation context depends jointly on the student model's capacity and the target task, and that no single universally effective configuration emerges. These findings motivate the use of per-task, per-token diagnostic analyses for distillation.

Electroencephalography foundation models (EEG-FMs) have advanced brain signal analysis, but the lack of standardized evaluation benchmarks impedes model comparison and scientific progress. Current evaluations rely on inconsistent protocols that render cross-model comparisons unreliable, while a lack of diagnostic analyses obscures the internal mechanisms driving transfer efficiency and scaling behaviors. To address this, we introduce EEG-FM-Bench, a unified system for the standardized evaluation of EEG-FMs. The benchmark integrates 14 datasets across 10 paradigms and incorporates diverse experimental settings, including multiple fine-tuning strategies, task organizations, and classifier configurations, supported by tools for gradient and representation analysis. Our experiments and analysis reveal several critical insights: (1) multi-task learning acts as a critical regularizer to mitigate overfitting in data-scarce EEG contexts; (2) pre-training efficiency is currently limited by gradient conflicts between reconstruction objectives and downstream tasks; (3) model scaling deviates from typical laws, as compact architectures with domain-specific inductive biases consistently outperform significantly larger models. This benchmark enables fair comparison and reproducible analysis, shifting the field from fragmented results to interpretable advances. Code is available at https://github.com/xw1216/EEG-FM-Bench.

Instruction-tuned large language models produce helpful, structured responses, but how robust is this helpfulness under trivial constraints? We show that simple lexical constraints (banning a single punctuation character or common word) cause instruction-tuned LLMs to collapse their responses, losing 14--48\% of comprehensiveness across seven models spanning five families (7B--70B, open- and closed-weight). A blinded human evaluation with 10 STEM-trained evaluators confirms genuine content loss, with information criteria degrading 1.5--2.3times more than surface criteria, a finding corroborated by over 4,100 automated pairwise comparisons (77--100\% baseline preference) across three LLM judges from two model families. Diagnostic analysis identifies this as a planning failure: two-pass generation recovers 59--96\% of response length, and linear probes on prompt representations predict response length with R^2 = 0.51--0.94 before generation begins. The same probes yield negative R^2 on base models, confirming that instruction tuning introduces the representational structure underlying the collapse. Base models show no systematic degradation under identical constraints, demonstrating that instruction tuning couples task competence to narrow surface-form templates. The effect extends to realistic deployment constraints (preamble suppression, corporate tone guidelines, legal compliance hedging, accessibility requirements) causing comparable degradation (-22\% to -34\%), with suppressing the conversational opener alone (``Certainly!'') causing 40\% collapse on our most fragile model despite restricting only the opening tokens. We further show that standard independent LLM-as-judge evaluation detects only a 3.5\% quality drop where pairwise evaluation reveals 23\%, exposing a methodological blind spot in current evaluation practice.

Understanding human tasks through video observations is an essential capability of intelligent agents. The challenges of such capability lie in the difficulty of generating a detailed understanding of situated actions, their effects on object states (i.e., state changes), and their causal dependencies. These challenges are further aggravated by the natural parallelism from multi-tasking and partial observations in multi-agent collaboration. Most prior works leverage action localization or future prediction as an indirect metric for evaluating such task understanding from videos. To make a direct evaluation, we introduce the EgoTaskQA benchmark that provides a single home for the crucial dimensions of task understanding through question-answering on real-world egocentric videos. We meticulously design questions that target the understanding of (1) action dependencies and effects, (2) intents and goals, and (3) agents' beliefs about others. These questions are divided into four types, including descriptive (what status?), predictive (what will?), explanatory (what caused?), and counterfactual (what if?) to provide diagnostic analyses on spatial, temporal, and causal understandings of goal-oriented tasks. We evaluate state-of-the-art video reasoning models on our benchmark and show their significant gaps between humans in understanding complex goal-oriented egocentric videos. We hope this effort will drive the vision community to move onward with goal-oriented video understanding and reasoning.

Current evaluations of spatial intelligence can be systematically invalid under modern vision-language model (VLM) settings. First, many benchmarks derive question-answer (QA) pairs from point-cloud-based 3D annotations originally curated for traditional 3D perception. When such annotations are treated as ground truth for video-based evaluation, reconstruction and annotation artifacts can miss objects that are clearly visible in the video, mislabel object identities, or corrupt geometry-dependent answers (e.g., size), yielding incorrect or ambiguous QA pairs. Second, evaluations often assume full-scene access, while many VLMs operate on sparsely sampled frames (e.g., 16-64), making many questions effectively unanswerable under the actual model inputs. We improve evaluation validity by introducing ReVSI, a benchmark and protocol that ensures each QA pair is answerable and correct under the model's actual inputs. To this end, we re-annotate objects and geometry across 381 scenes from 5 datasets to improve data quality, and regenerate all QA pairs with rigorous bias mitigation and human verification using professional 3D annotation tools. We further enhance evaluation controllability by providing variants across multiple frame budgets (16/32/64/all) and fine-grained object visibility metadata, enabling controlled diagnostic analyses. Evaluations of general and domain-specific VLMs on ReVSI reveal systematic failure modes that are obscured by prior benchmarks, yielding a more reliable and diagnostic assessment of spatial intelligence.

Detecting media bias is crucial, specifically in the South Asian region. Despite this, annotated datasets and computational studies for Bangla political bias research remain scarce. Crucially because, political stance detection in Bangla news requires understanding of linguistic cues, cultural context, subtle biases, rhetorical strategies, code-switching, implicit sentiment, and socio-political background. To address this, we introduce the first benchmark dataset of 200 politically significant and highly debated Bangla news articles, labeled for government-leaning, government-critique, and neutral stances, alongside diagnostic analyses for evaluating large language models (LLMs). Our comprehensive evaluation of 28 proprietary and open-source LLMs shows strong performance in detecting government-critique content (F1 up to 0.83) but substantial difficulty with neutral articles (F1 as low as 0.00). Models also tend to over-predict government-leaning stances, often misinterpreting ambiguous narratives. This dataset and its associated diagnostics provide a foundation for advancing stance detection in Bangla media research and offer insights for improving LLM performance in low-resource languages.

Accurate diagnosis with medical large language models is hindered by knowledge gaps and hallucinations. Retrieval and tool-augmented methods help, but their impact is limited by weak use of external knowledge and poor feedback-reasoning traceability. To address these challenges, We introduce Deep-DxSearch, an agentic RAG system trained end-to-end with reinforcement learning (RL) that enables steer tracebale retrieval-augmented reasoning for medical diagnosis. In Deep-DxSearch, we first construct a large-scale medical retrieval corpus comprising patient records and reliable medical knowledge sources to support retrieval-aware reasoning across diagnostic scenarios. More crutially, we frame the LLM as the core agent and the retrieval corpus as its environment, using tailored rewards on format, retrieval, reasoning structure, and diagnostic accuracy, thereby evolving the agentic RAG policy from large-scale data through RL. Experiments demonstrate that our end-to-end agentic RL training framework consistently outperforms prompt-engineering and training-free RAG approaches across multiple data centers. After training, Deep-DxSearch achieves substantial gains in diagnostic accuracy, surpassing strong diagnostic baselines such as GPT-4o, DeepSeek-R1, and other medical-specific frameworks for both common and rare disease diagnosis under in-distribution and out-of-distribution settings. Moreover, ablation studies on reward design and retrieval corpus components confirm their critical roles, underscoring the uniqueness and effectiveness of our approach compared with traditional implementations. Finally, case studies and interpretability analyses highlight improvements in Deep-DxSearch's diagnostic policy, providing deeper insight into its performance gains and supporting clinicians in delivering more reliable and precise preliminary diagnoses. See https://github.com/MAGIC-AI4Med/Deep-DxSearch.

Search-augmented large language models (LLMs) have advanced information-seeking tasks by integrating retrieval into generation, reducing users' cognitive burden compared to traditional search systems. Yet they remain insufficient for fully addressing diverse user needs, which requires recognizing how the same query can reflect different intents across users and delivering information in preferred forms. While recent systems such as ChatGPT and Gemini attempt personalization by leveraging user histories, systematic evaluation of such personalization is under-explored. To address this gap, we propose BESPOKE, the realistic benchmark for evaluating personalization in search-augmented LLMs. BESPOKE is designed to be both realistic, by collecting authentic chat and search histories directly from humans, and diagnostic, by pairing responses with fine-grained preference scores and feedback. The benchmark is constructed through long-term, deeply engaged human annotation, where human annotators contributed their own histories, authored queries with detailed information needs, and evaluated responses with scores and diagnostic feedback. Leveraging BESPOKE, we conduct systematic analyses that reveal key requirements for effective personalization in information-seeking tasks, providing a foundation for fine-grained evaluation of personalized search-augmented LLMs. Our code and data are available at https://augustinlib.github.io/BESPOKE/.

Forensic pathology is critical in determining the cause and manner of death through post-mortem examinations, both macroscopic and microscopic. The field, however, grapples with issues such as outcome variability, laborious processes, and a scarcity of trained professionals. This paper presents SongCi, an innovative visual-language model (VLM) designed specifically for forensic pathology. SongCi utilizes advanced prototypical cross-modal self-supervised contrastive learning to enhance the accuracy, efficiency, and generalizability of forensic analyses. It was pre-trained and evaluated on a comprehensive multi-center dataset, which includes over 16 million high-resolution image patches, 2,228 vision-language pairs of post-mortem whole slide images (WSIs), and corresponding gross key findings, along with 471 distinct diagnostic outcomes. Our findings indicate that SongCi surpasses existing multi-modal AI models in many forensic pathology tasks, performs comparably to experienced forensic pathologists and significantly better than less experienced ones, and provides detailed multi-modal explainability, offering critical assistance in forensic investigations. To the best of our knowledge, SongCi is the first VLM specifically developed for forensic pathological analysis and the first large-vocabulary computational pathology (CPath) model that directly processes gigapixel WSIs in forensic science.

We present PosterIQ, a design-driven benchmark for poster understanding and generation, annotated across composition structure, typographic hierarchy, and semantic intent. It includes 7,765 image-annotation instances and 822 generation prompts spanning real, professional, and synthetic cases. To bridge visual design cognition and generative modeling, we define tasks for layout parsing, text-image correspondence, typography/readability and font perception, design quality assessment, and controllable, composition-aware generation with metaphor. We evaluate state-of-the-art MLLMs and diffusion-based generators, finding persistent gaps in visual hierarchy, typographic semantics, saliency control, and intention communication; commercial models lead on high-level reasoning but act as insensitive automatic raters, while generators render text well yet struggle with composition-aware synthesis. Extensive analyses show PosterIQ is both a quantitative benchmark and a diagnostic tool for design reasoning, offering reproducible, task-specific metrics. We aim to catalyze models' creativity and integrate human-centred design principles into generative vision-language systems.

Magnetic Resonance Imaging (MRI) is a crucial imaging modality for viewing internal body structures. This research work analyses the performance of popular GAN models for accurate and precise MRI reconstruction by enhancing image quality and improving diagnostic accuracy. Three GAN architectures considered in this study are Vanilla GAN, Deep Convolutional GAN (DCGAN), and Wasserstein GAN (WGAN). They were trained and evaluated using knee, brain, and cardiac MRI datasets to assess their generalizability across body regions. While the Vanilla GAN operates on the fundamentals of the adversarial network setup, DCGAN advances image synthesis by securing the convolutional layers, giving a superior appearance to the prevalent spatial features. Training instability is resolved in WGAN through the Wasserstein distance to minimize an unstable regime, therefore, ensuring stable convergence and high-quality images. The GAN models were trained and tested using 1000 MR images of an anonymized knee, 805 images of Heart, 90 images of Brain MRI dataset. The Structural Similarity Index (SSIM) for Vanilla GAN is 0.84, DCGAN is 0.97, and WGAN is 0.99. The Peak Signal to Noise Ratio (PSNR) for Vanilla GAN is 26, DCGAN is 49.3, and WGAN is 43.5. The results were further statistically validated. This study shows that DCGAN and WGAN-based frameworks are promising in MR image reconstruction because of good image quality and superior accuracy. With the first cross-organ benchmark of baseline GANs under a common preprocessing pipeline, this work provides a reproducible benchmark for future hybrid GANs and clinical MRI applications.

Building competitive automatic speech recognition (ASR) models usually requires large-scale au- dio supervision, which makes reproduction and specialization expensive. We study Ark-ASR, a 0.6B- parameter audio-conditioned language model trained with 100k hours of speech, and examine whether a strong Qwen-ASR teacher can transfer additional recognition capability through on-policy distillation. Across Mandarin and English ASR benchmarks, the proposed training recipe consistently improves over supervised fine-tuning alone and outperforms the same-scale Qwen3-ASR-0.6B baseline on four of five evaluation sets. This is achieved with only 100k hours of speech, compared with the 20M hours of super- vised audio reported for the Qwen3-Omni AuT encoder. The larger Qwen3-ASR-1.7B remains stronger, but the results show that teacher-guided on-policy training can substantially close the gap for compact ASR models under a much smaller audio budget. A support-overlap diagnostic further suggests that the teacher-data stage improves local student-teacher compatibility, matching recent analyses of when on-policy distillation is effective.

Electrocardiography (ECG) serves as an indispensable diagnostic tool in clinical practice, yet existing multimodal large language models (MLLMs) remain unreliable for ECG interpretation, often producing plausible but clinically incorrect analyses. To address this, we propose ECG-R1, the first reasoning MLLM designed for reliable ECG interpretation via three innovations. First, we construct the interpretation corpus using Protocol-Guided Instruction Data Generation, grounding interpretation in measurable ECG features and monograph-defined quantitative thresholds and diagnostic logic. Second, we present a modality-decoupled architecture with Interleaved Modality Dropout to improve robustness and cross-modal consistency when either the ECG signal or ECG image is missing. Third, we present Reinforcement Learning with ECG Diagnostic Evidence Rewards to strengthen evidence-grounded ECG interpretation. Additionally, we systematically evaluate the ECG interpretation capabilities of proprietary, open-source, and medical MLLMs, and provide the first quantitative evidence that severe hallucinations are widespread, suggesting that the public should not directly trust these outputs without independent verification. Code and data are publicly available at https://github.com/PKUDigitalHealth/ECG-R1{here}, and an online platform can be accessed at http://ai.heartvoice.com.cn/ECG-R1/{here}.

Clinical diagnosis is critical in medical practice, typically requiring a continuous and evolving process that includes primary diagnosis, differential diagnosis, and final diagnosis. However, most existing clinical diagnostic tasks are single-step processes, which does not align with the complex multi-step diagnostic procedures found in real-world clinical settings. In this paper, we propose a multi-step diagnostic task and annotate a clinical diagnostic dataset (MSDiagnosis). This dataset includes primary diagnosis, differential diagnosis, and final diagnosis questions. Additionally, we propose a novel and effective framework. This framework combines forward inference, backward inference, reflection, and refinement, enabling the LLM to self-evaluate and adjust its diagnostic results. To assess the effectiveness of our proposed method, we design and conduct extensive experiments. The experimental results demonstrate the effectiveness of the proposed method. We also provide a comprehensive experimental analysis and suggest future research directions for this task.

Analogical reasoning tests a fundamental aspect of human cognition: mapping the relation from one pair of objects to another. Existing evaluations of this ability in multimodal large language models (MLLMs) overlook the ability to compose rules from multiple sources, a critical component of higher-order intelligence. To close this gap, we introduce CARV (Compositional Analogical Reasoning in Vision), a novel task together with a 5,500-sample dataset as the first diagnostic benchmark. We extend the analogy from a single pair to multiple pairs, which requires MLLMs to extract symbolic rules from each pair and compose new transformations. Evaluation on the state-of-the-art MLLMs reveals a striking performance gap: even Gemini-2.5 Pro achieving only 40.4% accuracy, far below human-level performance of 100%. Diagnostic analysis shows two consistent failure modes: (1) decomposing visual changes into symbolic rules, and (2) maintaining robustness under diverse or complex settings, highlighting the limitations of current MLLMs on this task.

Tool-augmented large language models (LLMs) are rapidly being integrated into real-world applications. Due to the lack of benchmarks, the community still needs to fully understand the hallucination issues within these models. To address this challenge, we introduce a comprehensive diagnostic benchmark, ToolBH. Specifically, we assess the LLM's hallucinations through two perspectives: depth and breadth. In terms of depth, we propose a multi-level diagnostic process, including (1) solvability detection, (2) solution planning, and (3) missing-tool analysis. For breadth, we consider three scenarios based on the characteristics of the toolset: missing necessary tools, potential tools, and limited functionality tools. Furthermore, we developed seven tasks and collected 700 evaluation samples through multiple rounds of manual annotation. The results show the significant challenges presented by the ToolBH benchmark. The current advanced models Gemini-1.5-Pro and GPT-4o only achieve a total score of 45.3 and 37.0, respectively, on a scale of 100. In this benchmark, larger model parameters do not guarantee better performance; the training data and response strategies also play a crucial role in tool-enhanced LLM scenarios. Our diagnostic analysis indicates that the primary reason for model errors lies in assessing task solvability. Additionally, open-weight models suffer from performance drops with verbose replies, whereas proprietary models excel with longer reasoning.

As large language models (LLMs) are increasingly applied to real-world legal tasks, evaluating the reliability of their open-ended legal responses has become essential. These tasks require context-sensitive answers and allow little room for error, motivating fine-grained and diagnostic evaluation that can identify specific sources of response quality failures. We introduce LexRubric, a rubric-based benchmark for evaluating open-ended Chinese legal tasks. LexRubric contains 649 instances from legal consultation and judicial examination, which reflect both everyday legal needs and professional legal reasoning and cover 14 legal scenarios. It further includes 12,337 expert-written atomic scoring criteria organized under a unified six-dimensional framework, enabling accurate evaluation and diagnostic analysis across tasks and evaluation dimensions. To validate the reliability of the evaluation, we test multiple judge models and compare model-based judgments with human judgments. We further evaluate 18 recent general and legal-domain LLMs on LexRubric. Results show that different models exhibit distinct capability profiles, and that open-ended legal question remains challenging for current LLMs. Data is available at: https://github.com/foggpoy/LexRubric.

Existing online benchmarks for mobile GUI agents remain largely app-centric and task-homogeneous, failing to reflect the diversity and instability of real-world mobile usage. To this end, we introduce VenusBench-Mobile, a challenging online benchmark for evaluating general-purpose mobile GUI agents under realistic, user-centric conditions. VenusBench-Mobile builds two core evaluation pillars: defining what to evaluate via user-intent-driven task design that reflects real mobile usage, and how to evaluate through a capability-oriented annotation scheme for fine-grained agent behavior analysis. Extensive evaluation of state-of-the-art mobile GUI agents reveals large performance gaps relative to prior benchmarks, indicating that VenusBench-Mobile poses substantially more challenging and realistic tasks and that current agents remain far from reliable real-world deployment. Diagnostic analysis further shows that failures are dominated by deficiencies in perception and memory, which are largely obscured by coarse-grained evaluations. Moreover, even the strongest agents exhibit near-zero success under environment variations, highlighting their brittleness in realistic settings. Based on these insights, we believe VenusBench-Mobile provides an important stepping stone toward robust real-world deployment of mobile GUI agents. Code and data are available at https://github.com/inclusionAI/UI-Venus/tree/VenusBench-Mobile.

Planning records define restrictions over geographic areas, but their source documents often provide only indirect spatial evidence rather than machine-readable boundaries. We introduce Plan2Map, a 208-case multimodal benchmark for document-grounded geospatial boundary reconstruction from UK planning records. Given only a source planning document, systems must reconstruct a valid geospatial boundary from notice text, schedules, map plates, map labels, and boundary annotations; the reference GeoJSON is held out for scoring. We propose GeoPlanAgent, a document-grounded, geospatial-tool-in-the-loop system that decomposes the task into evidence extraction, localisation, map registration, boundary segmentation, projection, and verification. On Plan2Map, GeoPlanAgent achieves 0.736 mean IoU and 0.904 median IoU, with 67.8\% of predictions at or above 0.8 IoU, substantially outperforming direct VLM-to-GeoJSON baselines. Diagnostic analysis shows that direct VLM prediction remains unreliable, while remaining errors are concentrated in localisation and map registration, and supervised boundary segmentation substantially improves pixel-level mask quality. Plan2Map provides a concrete testbed for multimodal geospatial reconstruction from public planning records. Project page: https://odeb1.github.io/Plan2Map_Project_Page/.

As the field of artificial intelligence progresses, assistive technologies are becoming more widely used across all industries. The healthcare industry is no different, with numerous studies being done to develop assistive tools for healthcare professionals. Automatic diagnostic systems are one such beneficial tool that can assist with a variety of tasks, including collecting patient information, analyzing test results, and diagnosing patients. However, the idea of developing systems that can provide a differential diagnosis has been largely overlooked in most of these research studies. In this study, we propose a transformer-based approach for providing differential diagnoses based on a patient's age, sex, medical history, and symptoms. We use the DDXPlus dataset, which provides differential diagnosis information for patients based on 49 disease types. Firstly, we propose a method to process the tabular patient data from the dataset and engineer them into patient reports to make them suitable for our research. In addition, we introduce two data modification modules to diversify the training data and consequently improve the robustness of the models. We approach the task as a multi-label classification problem and conduct extensive experiments using four transformer models. All the models displayed promising results by achieving over 97% F1 score on the held-out test set. Moreover, we design additional behavioral tests to get a broader understanding of the models. In particular, for one of our test cases, we prepared a custom test set of 100 samples with the assistance of a doctor. The results on the custom set showed that our proposed data modification modules improved the model's generalization capabilities. We hope our findings will provide future researchers with valuable insights and inspire them to develop reliable systems for automatic differential diagnosis.

MLLM-based GUI grounding methods commonly formulate target localization as autoregressive coordinate generation, enabling models to leverage the strong instruction-following and semantic understanding capabilities of MLLMs. However, this formulation requires the model to retain region-level target evidence while decoding coordinate tokens with the spatial precision demanded by GUI clicking. Our diagnostic analysis reveals that target-region awareness emerges in intermediate decoder layers but is neither retained nor translated into the final coordinate prediction. Existing ZoomIn-style methods address this issue through an external crop-and-rerun pass, which improves localization but increases end-to-end latency and computational cost. To retain the accuracy benefits of two-pass zooming without this extra cost, we propose InnerZoom, a single-forward framework for cross-layer evidence bridging. InnerZoom transforms target-related cues from the original forward pass into a compact cross-layer evidence state, then preserves, refines, and reinjects this state throughout later decoding layers to guide coordinate prediction. Extensive experimental results suggest that InnerZoom-4B achieves state-of-the-art performance on all six GUI grounding benchmarks, obtaining 64.7 on OSWorld-G, 40.2 on UI-Vision, 73.1 on OSWorld-GR, and 87.6 on MMBench-GUI, surpassing the previous best results by 4.1, 3.2, 2.9, and 2.3 points, respectively. Under a controlled 4B setting, InnerZoom improves the same SFT+RL baseline by 5.3 points on average and outperforms two-pass ZoomIn by 1.3 points on average, while reducing end-to-end latency by up to 31.8% and TFLOPs by about 29%. Code and models will be publicly available.

Video instance segmentation (VIS) requires models to detect, segment, and track object identities across frames, and most methods enforce temporal consistency through video-level supervision. Image-only training approaches, with MinVIS as one prominent example, have challenged this assumption, reaching competitive VIS without video training by treating frames as independent images and associating instances only at inference. The field has nonetheless moved toward ever more elaborate video-trained trackers, which depend on costly identity-consistent annotations, leaving the image-only direction under-explored. A diagnostic analysis identifies object query quality as the bottleneck: queries trained only to localize objects within a frame drift apart across frames and destabilize association. QueenVIS introduces a query-centric framework for strengthening image-trained VIS. During single-frame training, we enrich Mask2Former queries with two auxiliary heads: a feature-prediction loss that aligns each query with the pooled backbone descriptor of its instance, and a center-prediction loss that injects spatial structure. Both heads are discarded at inference, adding zero parameters, and temporal identity is maintained by a training-free query-propagation and memory-bank scheme. On YouTube-VIS and OVIS with a ResNet-50 backbone, QueenVIS improves over MinVIS, up to +6.7 AP on YouTube-VIS, +4.8 AP on OVIS, and +10.3 AP on the long-sequence YouTube-VIS split. QueenVIS achieves 50.9 AP on YouTube-VIS and remains competitive with recent video-supervised state-of-the-art, without processing a single video clip during training. Our findings suggest that strengthening the discriminative power and temporal stability of object queries is an important, underexplored axis for VIS. Code and models: https://github.com/ArianKheir/QueenVIS

Unified Multimodal Models (UMMs) have shown remarkable progress in visual generation. Yet, existing benchmarks predominantly assess Crystallized Intelligence, which relies on recalling accumulated knowledge and learned schemas. This focus overlooks Generative Fluid Intelligence (GFI): the capacity to induce patterns, reason through constraints, and adapt to novel scenarios on the fly. To rigorously assess this capability, we introduce GENIUS (GEN Fluid Intelligence EvalUation Suite). We formalize GFI as a synthesis of three primitives. These include Inducing Implicit Patterns (e.g., inferring personalized visual preferences), Executing Ad-hoc Constraints (e.g., visualizing abstract metaphors), and Adapting to Contextual Knowledge (e.g., simulating counter-intuitive physics). Collectively, these primitives challenge models to solve problems grounded entirely in the immediate context. Our systematic evaluation of 12 representative models reveals significant performance deficits in these tasks. Crucially, our diagnostic analysis disentangles these failure modes. It demonstrates that deficits stem from limited context comprehension rather than insufficient intrinsic generative capability. To bridge this gap, we propose a training-free attention intervention strategy. Ultimately, GENIUS establishes a rigorous standard for GFI, guiding the field beyond knowledge utilization toward dynamic, general-purpose reasoning. Our dataset and code will be released at: https://github.com/arctanxarc/GENIUS{https://github.com/arctanxarc/GENIUS}.

Sequential recommendation has increasingly shifted toward generative recommenders that combine sequential patterns with semantic item information. Yet these methods are often evaluated on a small set of widely used benchmarks, raising a key question: do these benchmarks actually require the advanced modeling capabilities that modern generative recommenders claim to provide? We conduct a benchmark audit with an intentionally simple graph heuristic. Starting from only the last one or two interacted items, it retrieves candidates from a few-hop item-transition graph and ranks them by item-feature similarity. Despite using no sequence encoder, generative objective, or training, this heuristic matches or outperforms many modern baselines, with relative NDCG@10 improvements of 38.10% and 44.18% over the best competing baseline on Amazon Review Sports and CDs. We show that this behavior reflects shortcut solvability rather than an artifact of one heuristic. We identify three shortcut structures that can make next-item prediction easier than expected: low-branching local transitions, feature-smooth transitions, and limited dependence on long user histories. These shortcuts need not appear together; even one or two strong signals can make simple local retrieval highly competitive, while weakening them makes the benefits of more sophisticated models clearer. Across 14 datasets, model rankings vary substantially with dataset properties, yet the heuristic remains competitive on 10 of them. Our findings suggest that strong performance on standard benchmarks does not always demonstrate advanced sequential, semantic, or generative modeling ability. We call for more careful dataset selection and dataset-level diagnostic analysis when using benchmarks to support claims about new recommendation models.

We introduce (Classroom Final Exam), a multimodal benchmark for evaluating the reasoning capabilities of large language models across more than 20 STEM domains. is curated from repeatedly used, authentic university homework and exam problems, together with reference solutions provided by course instructors. presents a significant challenge even for frontier models: the newly released Gemini-3.1-pro-preview achieves an overall accuracy of 59.69\%, while the second-best model, Gemini-3-flash-preview, reaches 55.46\%, leaving considerable room for improvement. Beyond leaderboard results, we perform a diagnostic analysis by decomposing reference solutions into reasoning flows. We find that although frontier models can often answer intermediate sub-questions correctly, they struggle to reliably derive and maintain correct intermediate states throughout multi-step solutions. We further observe that model-generated solutions typically have more reasoning steps than those provided by the instructor, indicating suboptimal step efficiency and a higher risk of error accumulation. The data and code are available at https://github.com/Analogy-AI/CFE_Bench.

Current evaluation paradigms for large language models (LLMs) represent a critical blind spot in AI research--relying on opaque numerical metrics that conceal fundamental limitations in spatial reasoning while providing no intuitive understanding of model capabilities. This deficiency creates a dangerous disconnect between reported performance and practical abilities, particularly for applications requiring physical world understanding. We introduce LTD-Bench, a breakthrough benchmark that transforms LLM evaluation from abstract scores to directly observable visual outputs by requiring models to generate drawings through dot matrices or executable code. This approach makes spatial reasoning limitations immediately apparent even to non-experts, bridging the fundamental gap between statistical performance and intuitive assessment. LTD-Bench implements a comprehensive methodology with complementary generation tasks (testing spatial imagination) and recognition tasks (assessing spatial perception) across three progressively challenging difficulty levels, methodically evaluating both directions of the critical language-spatial mapping. Our extensive experiments with state-of-the-art models expose an alarming capability gap: even LLMs achieving impressive results on traditional benchmarks demonstrate profound deficiencies in establishing bidirectional mappings between language and spatial concept--a fundamental limitation that undermines their potential as genuine world models. Furthermore, LTD-Bench's visual outputs enable powerful diagnostic analysis, offering a potential approach to investigate model similarity.

Spoken query retrieval is an important interaction mode in modern information retrieval. However, existing evaluation datasets are often limited to simple queries under constrained noise conditions, making them inadequate for assessing the robustness of spoken query retrieval systems under complex acoustic perturbations. To address this limitation, we present SQuTR, a robustness benchmark for spoken query retrieval that includes a large-scale dataset and a unified evaluation protocol. SQuTR aggregates 37,317 unique queries from six commonly used English and Chinese text retrieval datasets, spanning multiple domains and diverse query types. We synthesize speech using voice profiles from 200 real speakers and mix 17 categories of real-world environmental noise under controlled SNR levels, enabling reproducible robustness evaluation from quiet to highly noisy conditions. Under the unified protocol, we conduct large-scale evaluations on representative cascaded and end-to-end retrieval systems. Experimental results show that retrieval performance decreases as noise increases, with substantially different drops across systems. Even large-scale retrieval models struggle under extreme noise, indicating that robustness remains a critical bottleneck. Overall, SQuTR provides a reproducible testbed for benchmarking and diagnostic analysis, and facilitates future research on robustness in spoken query to text retrieval.

Medical vision-language models (VLMs) have shown promise as clinical assistants across various medical fields. However, specialized dermatology VLM capable of delivering professional and detailed diagnostic analysis remains underdeveloped, primarily due to less specialized text descriptions in current dermatology multimodal datasets. To address this issue, we propose MM-Skin, the first large-scale multimodal dermatology dataset that encompasses 3 imaging modalities, including clinical, dermoscopic, and pathological and nearly 10k high-quality image-text pairs collected from professional textbooks. In addition, we generate over 27k diverse, instruction-following vision question answering (VQA) samples (9 times the size of current largest dermatology VQA dataset). Leveraging public datasets and MM-Skin, we developed SkinVL, a dermatology-specific VLM designed for precise and nuanced skin disease interpretation. Comprehensive benchmark evaluations of SkinVL on VQA, supervised fine-tuning (SFT) and zero-shot classification tasks across 8 datasets, reveal its exceptional performance for skin diseases in comparison to both general and medical VLM models. The introduction of MM-Skin and SkinVL offers a meaningful contribution to advancing the development of clinical dermatology VLM assistants. MM-Skin is available at https://github.com/ZwQ803/MM-Skin

We present a method for diagnosing interpretation in neural networks by identifying an input subspace where a proposed interpretation is highly faithful. Our method is particularly useful for causal-abstraction-style interpretability, where a high-level causal hypothesis is evaluated by interchange interventions. Rather than treating interchange intervention accuracy as a single global summary, we refine this framework by partitioning the input space into well-interpreted and under-interpreted regions according to pairwise interchange-intervention behavior. This turns causal abstraction from a purely global evaluation into a more diagnostic tool: it not only measures whether an interpretation works, but also reveals where it works, where it fails, and what distinguishes the two cases. This diagnostic view also provides practical heuristics for improving interpretations. By analyzing the structure of the well-interpreted and under-interpreted regions, we can identify missing distinctions in a high-level hypothesis, discover previously unmodeled intermediate variables, and combine complementary partial interpretations into a stronger one. We instantiate this idea as a simple four-step recipe and show that it yields informative error analyses across multiple causal abstraction settings. In a toy logic task, recursively applying the recipe recovers a high-level hypothesis from scratch. More broadly, our results suggest that partitioning the input space is a useful step toward more precise, constructive, and scalable mechanistic interpretability.

It is unclear whether strong forecasting performance reflects genuine temporal understanding or the ability to reason under contextual and event-driven conditions. We introduce TemporalBench, a multi-domain benchmark designed to evaluate temporal reasoning behavior under progressively richer informational settings. TemporalBench adopts a four-tier task taxonomy that examines historical structure interpretation, context-free forecasting, contextual temporal reasoning, and event-conditioned prediction across four real-world domains: retail, healthcare, energy, and physical systems. By controlling access to future targets and contextual information, the benchmark enables a diagnostic analysis of whether models can correctly interpret temporal patterns, align them with external context, and adapt predictions when conditions change. Extensive baseline experiments show that strong numerical forecasting accuracy does not reliably translate into robust contextual or event-aware temporal reasoning; instead, existing agent frameworks exhibit fragmented strengths and systematic failure modes that remain largely hidden under forecasting-only benchmarks. The TemporalBench dataset is publicly available at https://huggingface.co/datasets/Melady/TemporalBench, and we additionally provide a public leaderboard at https://huggingface.co/spaces/Melady/TemporalBench_Leaderboard.

Recent advancements in Large Vision-Language Models (LVLMs) have demonstrated remarkable multimodal perception and reasoning capabilities. While numerous benchmarks have evaluated LVLMs from holistic or task-specific perspectives, their capabilities on fine-grained image tasks-fundamental to computer vision-remain insufficiently understood. To address this gap, we introduce FG-BMK, a comprehensive fine-grained evaluation benchmark containing 1.01 million questions and 0.28 million images, covering diverse scenarios from common object-centric domains to specialized domains. FG-BMK jointly evaluates dialogue-level fine-grained semantic recognition and feature-level visual discriminability through human-oriented and machine-oriented paradigms, enabling diagnostic analysis of whether LVLM failures arise from insufficient visual representations, weak visual-to-semantic grounding, or limited fine-grained knowledge. Through extensive experiments on a diverse set of representative LVLMs/VLMs, we find that current LVLMs remain inadequate fine-grained recognizers, with failures arising from intertwined bottlenecks in visual representations, semantic grounding, modality alignment, and category-level knowledge. We further analyze training design factors for improving fine-grained capabilities and examine how visual and linguistic perturbations affect LVLM predictions. These findings provide diagnostic insights into the limitations of current LVLMs and offer guidance for future data construction and model design in developing more reliable LVLMs for fine-grained visual tasks. Our code is open-source and available at https://fg-bmk.github.io/.

Existing works on reasoning segmentation either connect hidden features from a language model directly to a mask decoder or represent positions in text, which limits interpretability and semantic detail. To solve this, we present CoPRS, a Multi-modal Chain-of-Thought (MCoT)-based positional perception model that bridges language reasoning to segmentation through a differentiable and interpretable positional prior instantiated as a heatmap. By making the reasoning process clear via MCoT and expressing it as a dense, differentiable heatmap, this interface enhances interpretability and diagnostic analysis and yields more concentrated evidence on the target. A learnable concentration token aggregates features of the image and reasoning text to generate this positional prior, which is decoded to precise masks through a lightweight decoder, providing a direct connection between reasoning and segmentation. Across the RefCOCO series and ReasonSeg, CoPRS matches or surpasses the best reported metrics on each standard split under comparable protocols, with performance at or above the prior state of the art across both validation and test partitions. Extensive experiments demonstrate a strong positive correlation among the CoT trajectory, the generated heatmap, and the decoded mask, supporting an interpretable alignment between the reasoning output and downstream mask generation. Collectively, these findings support the utility of this paradigm in bridging reasoning and segmentation and show advantages in concentration driven by reasoning and in more precise mask prediction. Code has been released at https://github.com/ZhenyuLU-Heliodore/CoPRS.

Recent advancements in Multimodal Large Language Models (MLLMs) pursue omni-perception capabilities, yet integrating robust sensory grounding with complex reasoning remains a challenge, particularly for underrepresented regions. In this report, we introduce the research preview of MERaLiON2-Omni (Alpha), a 10B-parameter multilingual omni-perception tailored for Southeast Asia (SEA). We present a progressive training pipeline that explicitly decouples and then integrates "System 1" (Perception) and "System 2" (Reasoning) capabilities. First, we establish a robust Perception Backbone by aligning region-specific audio-visual cues (e.g., Singlish code-switching, local cultural landmarks) with a multilingual LLM through orthogonal modality adaptation. Second, to inject cognitive capabilities without large-scale supervision, we propose a cost-effective Generate-Judge-Refine pipeline. By utilizing a Super-LLM to filter hallucinations and resolve conflicts via a consensus mechanism, we synthesize high-quality silver data that transfers textual Chain-of-Thought reasoning to multimodal scenarios. Comprehensive evaluation on our newly introduced SEA-Omni Benchmark Suite reveals an Efficiency-Stability Paradox: while reasoning acts as a non-linear amplifier for abstract tasks (boosting mathematical and instruction-following performance significantly), it introduces instability in low-level sensory processing. Specifically, we identify Temporal Drift in long-context audio, where extended reasoning desynchronizes the model from acoustic timestamps, and Visual Over-interpretation, where logic overrides pixel-level reality. This report details the architecture, the data-efficient training recipe, and a diagnostic analysis of the trade-offs between robust perception and structured reasoning.

Puzzlehunts are a genre of complex, multi-step puzzles lacking well-defined problem definitions. In contrast to conventional reasoning benchmarks consisting of tasks with clear instructions, puzzlehunts require models to discover the underlying problem structure from multimodal evidence and iterative reasoning, mirroring real-world domains such as scientific discovery, exploratory data analysis, or investigative problem-solving. Despite recent progress in foundation models, their performance on such open-ended settings remains largely untested. In this paper, we introduce PuzzleWorld, a large-scale benchmark of 667 puzzlehunt-style problems designed to assess step-by-step, open-ended, and creative multimodal reasoning. Each puzzle is annotated with the final solution, detailed reasoning traces, and cognitive skill labels, enabling holistic benchmarking and fine-grained diagnostic analysis. Most state-of-the-art models achieve only 1-2% final answer accuracy, with the best model solving only 14% of puzzles and reaching 40% stepwise accuracy. To demonstrate the value of our reasoning annotations, we show that fine-tuning a small model on reasoning traces improves stepwise reasoning from 4% to 11%, while training on final answers alone degrades performance to near zero. Our error analysis reveals that current models exhibit myopic reasoning, are bottlenecked by the limitations of language-based inference, and lack sketching capabilities crucial for visual and spatial reasoning. We release PuzzleWorld at https://github.com/MIT-MI/PuzzleWorld to support future work on building more general, open-ended, and creative reasoning systems.

Concepts serve as fundamental abstractions that support human reasoning and categorization. However, it remains unclear whether large language models truly capture such conceptual structures or primarily rely on surface-level pattern memorization. Existing benchmarks are largely static and fact oriented, which limits their ability to probe fine-grained semantic understanding and makes them vulnerable to data leakage and overfitting. To address this limitation, we introduce CK-Arena, a dynamic benchmark for conceptual knowledge evaluation based on a multi agent social deduction game, namely the Undercover game. In this setting, LLM based agents are assigned subtly different concept words and must describe, distinguish, and infer conceptual properties from others' statements. Model performance is evaluated through both game level outcomes and the semantic quality of generated descriptions. Furthermore, CK-Arena leverages the interaction process to automatically construct high quality question answering data for fine grained diagnostic analysis. Experimental results show that conceptual understanding varies substantially across models and categories, and is not strictly aligned with overall model capability. The data and code are available at the project homepage: https://ck-arena.site.

Large language models have exhibited exceptional performance on various Natural Language Processing (NLP) tasks, leveraging techniques such as the pre-training, and instruction fine-tuning. Despite these advances, their effectiveness in medical applications is limited, due to challenges such as factual inaccuracies, reasoning abilities, and lack grounding in real-world experience. In this study, we present ClinicalGPT, a language model explicitly designed and optimized for clinical scenarios. By incorporating extensive and diverse real-world data, such as medical records, domain-specific knowledge, and multi-round dialogue consultations in the training process, ClinicalGPT is better prepared to handle multiple clinical task. Furthermore, we introduce a comprehensive evaluation framework that includes medical knowledge question-answering, medical exams, patient consultations, and diagnostic analysis of medical records. Our results demonstrate that ClinicalGPT significantly outperforms other models in these tasks, highlighting the effectiveness of our approach in adapting large language models to the critical domain of healthcare.

Beneath the stunning visual fidelity of modern AIGC models lies a "logical desert", where systems fail tasks that require physical, causal, or complex spatial reasoning. Current evaluations largely rely on superficial metrics or fragmented benchmarks, creating a ``performance mirage'' that overlooks the generative process. To address this, we introduce ViGoR Vision-G}nerative Reasoning-centric Benchmark), a unified framework designed to dismantle this mirage. ViGoR distinguishes itself through four key innovations: 1) holistic cross-modal coverage bridging Image-to-Image and Video tasks; 2) a dual-track mechanism evaluating both intermediate processes and final results; 3) an evidence-grounded automated judge ensuring high human alignment; and 4) granular diagnostic analysis that decomposes performance into fine-grained cognitive dimensions. Experiments on over 20 leading models reveal that even state-of-the-art systems harbor significant reasoning deficits, establishing ViGoR as a critical ``stress test'' for the next generation of intelligent vision models. The demo have been available at https://vincenthancoder.github.io/ViGoR-Bench/

The emergence of groundbreaking large language models capable of performing complex reasoning tasks holds significant promise for addressing various scientific challenges, including those arising in complex clinical scenarios. To enable their safe and effective deployment in real-world healthcare settings, it is urgently necessary to benchmark the diagnostic capabilities of current models systematically. Given the limitations of existing medical benchmarks in evaluating advanced diagnostic reasoning, we present DiagnosisArena, a comprehensive and challenging benchmark designed to rigorously assess professional-level diagnostic competence. DiagnosisArena consists of 1,113 pairs of segmented patient cases and corresponding diagnoses, spanning 28 medical specialties, deriving from clinical case reports published in 10 top-tier medical journals. The benchmark is developed through a meticulous construction pipeline, involving multiple rounds of screening and review by both AI systems and human experts, with thorough checks conducted to prevent data leakage. Our study reveals that even the most advanced reasoning models, o3-mini, o1, and DeepSeek-R1, achieve only 45.82%, 31.09%, and 17.79% accuracy, respectively. This finding highlights a significant generalization bottleneck in current large language models when faced with clinical diagnostic reasoning challenges. Through DiagnosisArena, we aim to drive further advancements in AIs diagnostic reasoning capabilities, enabling more effective solutions for real-world clinical diagnostic challenges. We provide the benchmark and evaluation tools for further research and development https://github.com/SPIRAL-MED/DiagnosisArena.

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.

Differential diagnosis is crucial for medicine as it helps healthcare providers systematically distinguish between conditions that share similar symptoms. This study assesses the impact of lab test results on differential diagnoses (DDx) made by large language models (LLMs). Clinical vignettes from 50 case reports from PubMed Central were created incorporating patient demographics, symptoms, and lab results. Five LLMs GPT-4, GPT-3.5, Llama-2-70b, Claude-2, and Mixtral-8x7B were tested to generate Top 10, Top 5, and Top 1 DDx with and without lab data. A comprehensive evaluation involving GPT-4, a knowledge graph, and clinicians was conducted. GPT-4 performed best, achieving 55% accuracy for Top 1 diagnoses and 60% for Top 10 with lab data, with lenient accuracy up to 80%. Lab results significantly improved accuracy, with GPT-4 and Mixtral excelling, though exact match rates were low. Lab tests, including liver function, metabolic/toxicology panels, and serology/immune tests, were generally interpreted correctly by LLMs for differential diagnosis.

Diabetic retinopathy (DR) is a growing health problem worldwide and is a leading cause of visual impairment and blindness, especially among working people aged 20-65. Its incidence is increasing along with the number of diabetes cases, and it is more common in developed countries than in developing countries. Recent research in the field of diabetic retinopathy diagnosis is using advanced technologies, such as analysis of images obtained by ophthalmoscopy. Automatic methods for analyzing eye images based on neural networks, deep learning and image analysis algorithms can improve the efficiency of diagnosis. This paper describes an automatic DR diagnosis method that includes processing and analysis of ophthalmoscopic images of the eye. It uses morphological algorithms to identify the optic disc and lesions characteristic of DR, such as microaneurysms, hemorrhages and exudates. Automated DR diagnosis has the potential to improve the efficiency of early detection of this disease and contribute to reducing the number of cases of diabetes-related visual impairment. The final step was to create an application with a graphical user interface that allowed retinal images taken at cooperating ophthalmology offices to be uploaded to the server. These images were then analyzed using a developed algorithm to make a diagnosis.

Medical images and radiology reports are crucial for diagnosing medical conditions, highlighting the importance of quantitative analysis for clinical decision-making. However, the diversity and cross-source heterogeneity of these data challenge the generalizability of current data-mining methods. Multimodal large language models (MLLMs) have recently transformed many domains, significantly affecting the medical field. Notably, Gemini-Vision-series (Gemini) and GPT-4-series (GPT-4) models have epitomized a paradigm shift in Artificial General Intelligence (AGI) for computer vision, showcasing their potential in the biomedical domain. In this study, we evaluated the performance of the Gemini, GPT-4, and 4 popular large models for an exhaustive evaluation across 14 medical imaging datasets, including 5 medical imaging categories (dermatology, radiology, dentistry, ophthalmology, and endoscopy), and 3 radiology report datasets. The investigated tasks encompass disease classification, lesion segmentation, anatomical localization, disease diagnosis, report generation, and lesion detection. Our experimental results demonstrated that Gemini-series models excelled in report generation and lesion detection but faces challenges in disease classification and anatomical localization. Conversely, GPT-series models exhibited proficiency in lesion segmentation and anatomical localization but encountered difficulties in disease diagnosis and lesion detection. Additionally, both the Gemini series and GPT series contain models that have demonstrated commendable generation efficiency. While both models hold promise in reducing physician workload, alleviating pressure on limited healthcare resources, and fostering collaboration between clinical practitioners and artificial intelligence technologies, substantial enhancements and comprehensive validations remain imperative before clinical deployment.

The rapid increase of computed tomography (CT) scans and their time-consuming manual analysis have created an urgent need for robust automated analysis techniques in clinical settings. These aim to assist radiologists and help them managing their growing workload. Existing methods typically generate entire reports directly from 3D CT images, without explicitly focusing on observed abnormalities. This unguided approach often results in repetitive content or incomplete reports, failing to prioritize anomaly-specific descriptions. We propose a new anomaly-guided report generation model, which first predicts abnormalities and then generates targeted descriptions for each. Evaluation on a public dataset demonstrates significant improvements in report quality and clinical relevance. We extend our work by conducting an ablation study to demonstrate its effectiveness.

Clinical diagnosis is a highly specialized discipline requiring both domain expertise and strict adherence to rigorous guidelines. While current AI-driven medical research predominantly focuses on knowledge graphs or natural text pretraining paradigms to incorporate medical knowledge, these approaches primarily rely on implicitly encoded knowledge within model parameters, neglecting task-specific knowledge required by diverse downstream tasks. To address this limitation, we propose Retrieval-Augmented Diagnosis (RAD), a novel framework that explicitly injects external knowledge into multimodal models directly on downstream tasks. Specifically, RAD operates through three key mechanisms: retrieval and refinement of disease-centered knowledge from multiple medical sources, a guideline-enhanced contrastive loss that constrains the latent distance between multi-modal features and guideline knowledge, and the dual transformer decoder that employs guidelines as queries to steer cross-modal fusion, aligning the models with clinical diagnostic workflows from guideline acquisition to feature extraction and decision-making. Moreover, recognizing the lack of quantitative evaluation of interpretability for multimodal diagnostic models, we introduce a set of criteria to assess the interpretability from both image and text perspectives. Extensive evaluations across four datasets with different anatomies demonstrate RAD's generalizability, achieving state-of-the-art performance. Furthermore, RAD enables the model to concentrate more precisely on abnormal regions and critical indicators, ensuring evidence-based, trustworthy diagnosis. Our code is available at https://github.com/tdlhl/RAD.

Traditionally, AI research in medical diagnosis has largely centered on image analysis. While this has led to notable advancements, the absence of patient-reported symptoms continues to hinder diagnostic accuracy. To address this, we propose a Pre-Consultation Dialogue Framework (PCDF) that mimics real-world diagnostic procedures, where doctors iteratively query patients before reaching a conclusion. Specifically, we simulate diagnostic dialogues between two vision-language models (VLMs): a DocVLM, which generates follow-up questions based on the image and dialogue history, and a PatientVLM, which responds using a symptom profile derived from the ground-truth diagnosis. We additionally conducted a small-scale clinical validation of the synthetic symptoms generated by our framework, with licensed clinicians confirming their clinical relevance, symptom coverage, and overall realism. These findings indicate that the resulting DocVLM-PatientVLM interactions form coherent, multi-turn consultations paired with images and diagnoses, which we then use to fine-tune the DocVLM. This dialogue-based supervision leads to substantial gains over image-only training, highlighting the value of realistic symptom elicitation for diagnosis.

The field of medical diagnosis has undergone a significant transformation with the advent of large language models (LLMs), yet the challenges of interpretability within these models remain largely unaddressed. This study introduces Chain-of-Diagnosis (CoD) to enhance the interpretability of LLM-based medical diagnostics. CoD transforms the diagnostic process into a diagnostic chain that mirrors a physician's thought process, providing a transparent reasoning pathway. Additionally, CoD outputs the disease confidence distribution to ensure transparency in decision-making. This interpretability makes model diagnostics controllable and aids in identifying critical symptoms for inquiry through the entropy reduction of confidences. With CoD, we developed DiagnosisGPT, capable of diagnosing 9604 diseases. Experimental results demonstrate that DiagnosisGPT outperforms other LLMs on diagnostic benchmarks. Moreover, DiagnosisGPT provides interpretability while ensuring controllability in diagnostic rigor.

Future short or long-term space missions require a new generation of monitoring and diagnostic systems due to communication impasses as well as limitations in specialized crew and equipment. Machine learning supported diagnostic systems present a viable solution for medical and technical applications. We discuss challenges and applicability of such systems in light of upcoming missions and outline an example use case for a next-generation medical diagnostic system for future space operations. Additionally, we present approach recommendations and constraints for the successful generation and use of machine learning models aboard a spacecraft.

Clinical diagnosis of the eye is performed over multifarious data modalities including scalar clinical labels, vectorized biomarkers, two-dimensional fundus images, and three-dimensional Optical Coherence Tomography (OCT) scans. Clinical practitioners use all available data modalities for diagnosing and treating eye diseases like Diabetic Retinopathy (DR) or Diabetic Macular Edema (DME). Enabling usage of machine learning algorithms within the ophthalmic medical domain requires research into the relationships and interactions between all relevant data over a treatment period. Existing datasets are limited in that they neither provide data nor consider the explicit relationship modeling between the data modalities. In this paper, we introduce the Ophthalmic Labels for Investigating Visual Eye Semantics (OLIVES) dataset that addresses the above limitation. This is the first OCT and near-IR fundus dataset that includes clinical labels, biomarker labels, disease labels, and time-series patient treatment information from associated clinical trials. The dataset consists of 1268 near-IR fundus images each with at least 49 OCT scans, and 16 biomarkers, along with 4 clinical labels and a disease diagnosis of DR or DME. In total, there are 96 eyes' data averaged over a period of at least two years with each eye treated for an average of 66 weeks and 7 injections. We benchmark the utility of OLIVES dataset for ophthalmic data as well as provide benchmarks and concrete research directions for core and emerging machine learning paradigms within medical image analysis.

Rare diseases, including Inborn Errors of Metabolism (IEM), pose significant diagnostic challenges. Case reports serve as key but computationally underutilized resources to inform diagnosis. Clinical dense information extraction refers to organizing medical information into structured predefined categories. Large Language Models (LLMs) may enable scalable information extraction from case reports but are rarely evaluated for this task. We introduce CaseReportBench, an expert-annotated dataset for dense information extraction of case reports, focusing on IEMs. Using this dataset, we assess various models and prompting strategies, introducing novel approaches such as category-specific prompting and subheading-filtered data integration. Zero-shot chain-of-thought prompting offers little advantage over standard zero-shot prompting. Category-specific prompting improves alignment with the benchmark. The open-source model Qwen2.5-7B outperforms GPT-4o for this task. Our clinician evaluations show that LLMs can extract clinically relevant details from case reports, supporting rare disease diagnosis and management. We also highlight areas for improvement, such as LLMs' limitations in recognizing negative findings important for differential diagnosis. This work advances LLM-driven clinical natural language processing and paves the way for scalable medical AI applications.

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.

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.

An accurate differential diagnosis (DDx) is a cornerstone of medical care, often reached through an iterative process of interpretation that combines clinical history, physical examination, investigations and procedures. Interactive interfaces powered by Large Language Models (LLMs) present new opportunities to both assist and automate aspects of this process. In this study, we introduce an LLM optimized for diagnostic reasoning, and evaluate its ability to generate a DDx alone or as an aid to clinicians. 20 clinicians evaluated 302 challenging, real-world medical cases sourced from the New England Journal of Medicine (NEJM) case reports. Each case report was read by two clinicians, who were randomized to one of two assistive conditions: either assistance from search engines and standard medical resources, or LLM assistance in addition to these tools. All clinicians provided a baseline, unassisted DDx prior to using the respective assistive tools. Our LLM for DDx exhibited standalone performance that exceeded that of unassisted clinicians (top-10 accuracy 59.1% vs 33.6%, [p = 0.04]). Comparing the two assisted study arms, the DDx quality score was higher for clinicians assisted by our LLM (top-10 accuracy 51.7%) compared to clinicians without its assistance (36.1%) (McNemar's Test: 45.7, p < 0.01) and clinicians with search (44.4%) (4.75, p = 0.03). Further, clinicians assisted by our LLM arrived at more comprehensive differential lists than those without its assistance. Our study suggests that our LLM for DDx has potential to improve clinicians' diagnostic reasoning and accuracy in challenging cases, meriting further real-world evaluation for its ability to empower physicians and widen patients' access to specialist-level expertise.

Doctors and patients alike increasingly use Large Language Models (LLMs) to diagnose clinical cases. However, unlike domains such as math or coding, where correctness can be objectively defined by the final answer, medical diagnosis requires both the outcome and the reasoning process to be accurate. Currently, widely used medical benchmarks like MedQA and MMLU assess only accuracy in the final answer, overlooking the quality and faithfulness of the clinical reasoning process. To address this limitation, we introduce MedCaseReasoning, the first open-access dataset for evaluating LLMs on their ability to align with clinician-authored diagnostic reasoning. The dataset includes 14,489 diagnostic question-and-answer cases, each paired with detailed reasoning statements derived from open-access medical case reports. We evaluate state-of-the-art reasoning LLMs on MedCaseReasoning and find significant shortcomings in their diagnoses and reasoning: for instance, the top-performing open-source model, DeepSeek-R1, achieves only 48% 10-shot diagnostic accuracy and mentions only 64% of the clinician reasoning statements (recall). However, we demonstrate that fine-tuning LLMs on the reasoning traces derived from MedCaseReasoning significantly improves diagnostic accuracy and clinical reasoning recall by an average relative gain of 29% and 41%, respectively. The open-source dataset, code, and models are available at https://github.com/kevinwu23/Stanford-MedCaseReasoning.

To investigate whether the pleurae, airways and vessels surrounding a nodule on non-contrast computed tomography (CT) can discriminate benign and malignant pulmonary nodules. The LIDC-IDRI dataset, one of the largest publicly available CT database, was exploited for study. A total of 1556 nodules from 694 patients were involved in statistical analysis, where nodules with average scorings <3 and >3 were respectively denoted as benign and malignant. Besides, 339 nodules from 113 patients with diagnosis ground-truth were independently evaluated. Computer algorithms were developed to segment pulmonary structures and quantify the distances to pleural surface, airways and vessels, as well as the counting number and normalized volume of airways and vessels near a nodule. Odds ratio (OR) and Chi-square (\chi^2) testing were performed to demonstrate the correlation between features of surrounding structures and nodule malignancy. A non-parametric receiver operating characteristic (ROC) analysis was conducted in logistic regression to evaluate discrimination ability of each structure. For benign and malignant groups, the average distances from nodules to pleural surface, airways and vessels are respectively (6.56, 5.19), (37.08, 26.43) and (1.42, 1.07) mm. The correlation between nodules and the counting number of airways and vessels that contact or project towards nodules are respectively (OR=22.96, \chi^2=105.04) and (OR=7.06, \chi^2=290.11). The correlation between nodules and the volume of airways and vessels are (OR=9.19, \chi^2=159.02) and (OR=2.29, \chi^2=55.89). The areas-under-curves (AUCs) for pleurae, airways and vessels are respectively 0.5202, 0.6943 and 0.6529. Our results show that malignant nodules are often surrounded by more pulmonary structures compared with benign ones, suggesting that features of these structures could be viewed as lung cancer biomarkers.

Immunotherapy is an effective precision medicine treatment for several cancers. Imaging signatures of the underlying genome (radiogenomics) in glioblastoma patients may serve as preoperative biomarkers of the tumor-host immune apparatus. Validated biomarkers would have the potential to stratify patients during immunotherapy clinical trials, and if trials are beneficial, facilitate personalized neo-adjuvant treatment. The increased use of whole genome sequencing data, and the advances in bioinformatics and machine learning make such developments plausible. We performed a systematic review to determine the extent of development and validation of immune-related radiogenomic biomarkers for glioblastoma. A systematic review was performed following PRISMA guidelines using the PubMed, Medline, and Embase databases. Qualitative analysis was performed by incorporating the QUADAS 2 tool and CLAIM checklist. PROSPERO registered CRD42022340968. Extracted data were insufficiently homogenous to perform a meta-analysis. Results Nine studies, all retrospective, were included. Biomarkers extracted from magnetic resonance imaging volumes of interest included apparent diffusion coefficient values, relative cerebral blood volume values, and image-derived features. These biomarkers correlated with genomic markers from tumor cells or immune cells or with patient survival. The majority of studies had a high risk of bias and applicability concerns regarding the index test performed. Radiogenomic immune biomarkers have the potential to provide early treatment options to patients with glioblastoma. Targeted immunotherapy, stratified by these biomarkers, has the potential to allow individualized neo-adjuvant precision treatment options in clinical trials. However, there are no prospective studies validating these biomarkers, and interpretation is limited due to study bias with little evidence of generalizability.

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.

Automatic disease diagnosis has become increasingly valuable in clinical practice. The advent of large language models (LLMs) has catalyzed a paradigm shift in artificial intelligence, with growing evidence supporting the efficacy of LLMs in diagnostic tasks. Despite the increasing attention in this field, a holistic view is still lacking. Many critical aspects remain unclear, such as the diseases and clinical data to which LLMs have been applied, the LLM techniques employed, and the evaluation methods used. In this article, we perform a comprehensive review of LLM-based methods for disease diagnosis. Our review examines the existing literature across various dimensions, including disease types and associated clinical specialties, clinical data, LLM techniques, and evaluation methods. Additionally, we offer recommendations for applying and evaluating LLMs for diagnostic tasks. Furthermore, we assess the limitations of current research and discuss future directions. To our knowledge, this is the first comprehensive review for LLM-based disease diagnosis.

Medical imaging analysis plays a critical role in the diagnosis and treatment of various medical conditions. This paper focuses on chest X-ray images and their corresponding radiological reports. It presents a new model that learns a joint X-ray image & report representation. The model is based on a novel alignment scheme between the visual data and the text, which takes into account both local and global information. Furthermore, the model integrates domain-specific information of two types -- lateral images and the consistent visual structure of chest images. Our representation is shown to benefit three types of retrieval tasks: text-image retrieval, class-based retrieval, and phrase-grounding.

As machine learning models become increasingly prevalent in medical diagnostics, the need for interpretability and transparency becomes paramount. The XAI Renaissance signifies a significant shift in the field, aiming to redefine the interpretability of medical diagnostic models. This paper explores the innovative approaches and methodologies within the realm of Explainable AI (XAI) that are revolutionizing the interpretability of medical diagnostic models. By shedding light on the underlying decision-making process, XAI techniques empower healthcare professionals to understand, trust, and effectively utilize these models for accurate and reliable medical diagnoses. This review highlights the key advancements in XAI for medical diagnostics and their potential to transform the healthcare landscape, ultimately improving patient outcomes and fostering trust in AI-driven diagnostic systems.

Hardware-aware training (HAT) is widely used to improve the robustness of neural networks on non-ideal AI accelerators, such as analog in-memory computing (IMC) systems. However, not all hardware-induced distortions are equally compensable by training. This paper presents a diagnostic framework that models hardware non-idealities as structured perturbations of the forward operator and evaluates their compatibility with gradient-based optimization. We analyze six representative perturbation classes--read noise, variability, drift, stuck-at faults, IR-drop, and ADC discretization--and identify three key diagnostics: gradient expectation consistency, bounded gradient variance, and non-degenerate sensitivity. Our results show a clear separation between perturbations that can be compensated by HAT and those that consistently break optimization. This provides practical guidance for hardware-software co-design, clarifying which non-idealities can be addressed at the training level and which require circuit-, architecture-, or calibration-level mitigation. This study should be interpreted as a controlled empirical analysis under vanilla forward-perturbation HAT, rather than as a universal theory of hardware-aware training.

Artificial intelligence holds great promise for expanding access to expert medical knowledge and reasoning. However, most evaluations of language models rely on static vignettes and multiple-choice questions that fail to reflect the complexity and nuance of evidence-based medicine in real-world settings. In clinical practice, physicians iteratively formulate and revise diagnostic hypotheses, adapting each subsequent question and test to what they've just learned, and weigh the evolving evidence before committing to a final diagnosis. To emulate this iterative process, we introduce the Sequential Diagnosis Benchmark, which transforms 304 diagnostically challenging New England Journal of Medicine clinicopathological conference (NEJM-CPC) cases into stepwise diagnostic encounters. A physician or AI begins with a short case abstract and must iteratively request additional details from a gatekeeper model that reveals findings only when explicitly queried. Performance is assessed not just by diagnostic accuracy but also by the cost of physician visits and tests performed. We also present the MAI Diagnostic Orchestrator (MAI-DxO), a model-agnostic orchestrator that simulates a panel of physicians, proposes likely differential diagnoses and strategically selects high-value, cost-effective tests. When paired with OpenAI's o3 model, MAI-DxO achieves 80% diagnostic accuracy--four times higher than the 20% average of generalist physicians. MAI-DxO also reduces diagnostic costs by 20% compared to physicians, and 70% compared to off-the-shelf o3. When configured for maximum accuracy, MAI-DxO achieves 85.5% accuracy. These performance gains with MAI-DxO generalize across models from the OpenAI, Gemini, Claude, Grok, DeepSeek, and Llama families. We highlight how AI systems, when guided to think iteratively and act judiciously, can advance diagnostic precision and cost-effectiveness in clinical care.

Diagnosing lung cancer typically involves physicians identifying lung nodules in Computed tomography (CT) scans and generating diagnostic reports based on their morphological features and medical expertise. Although advancements have been made in using multimodal large language models for analyzing lung CT scans, challenges remain in accurately describing nodule morphology and incorporating medical expertise. These limitations affect the reliability and effectiveness of these models in clinical settings. Collaborative multi-agent systems offer a promising strategy for achieving a balance between generality and precision in medical applications, yet their potential in pathology has not been thoroughly explored. To bridge these gaps, we introduce LungNoduleAgent, an innovative collaborative multi-agent system specifically designed for analyzing lung CT scans. LungNoduleAgent streamlines the diagnostic process into sequential components, improving precision in describing nodules and grading malignancy through three primary modules. The first module, the Nodule Spotter, coordinates clinical detection models to accurately identify nodules. The second module, the Radiologist, integrates localized image description techniques to produce comprehensive CT reports. Finally, the Doctor Agent System performs malignancy reasoning by using images and CT reports, supported by a pathology knowledge base and a multi-agent system framework. Extensive testing on two private datasets and the public LIDC-IDRI dataset indicates that LungNoduleAgent surpasses mainstream vision-language models, agent systems, and advanced expert models. These results highlight the importance of region-level semantic alignment and multi-agent collaboration in diagnosing nodules. LungNoduleAgent stands out as a promising foundational tool for supporting clinical analyses of lung nodules.

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).

Depression poses significant challenges to patients and healthcare organizations, necessitating efficient assessment methods. Existing paradigms typically focus on a patient-doctor way that overlooks multi-role interactions, such as family involvement in the evaluation and caregiving process. Moreover, current automatic depression detection (ADD) methods usually model depression detection as a classification or regression task, lacking interpretability for the decision-making process. To address these issues, we developed InterMind, a doctor-patient-family interactive depression assessment system empowered by large language models (LLMs). Our system enables patients and families to contribute descriptions, generates assistive diagnostic reports for doctors, and provides actionable insights, improving diagnostic precision and efficiency. To enhance LLMs' performance in psychological counseling and diagnostic interpretability, we integrate retrieval-augmented generation (RAG) and chain-of-thoughts (CoT) techniques for data augmentation, which mitigates the hallucination issue of LLMs in specific scenarios after instruction fine-tuning. Quantitative experiments and professional assessments by clinicians validate the effectiveness of our system.

Language models excel at diagnostic assessments on currated medical case-studies and vignettes, performing on par with, or better than, clinical professionals. However, existing studies focus on complex scenarios with rich context making it difficult to draw conclusions about how these systems perform for patients reporting symptoms in everyday life. We deployed SymptomAI, a set of conversational AI agents for end-to-end patient interviewing and differential diagnosis (DDx), via the Fitbit app in a study that randomized participants (N=13,917) to interact with five AI agents. This corpus captures diverse communication and a realistic distribution of illnesses from a real world population. A subset of 1,228 participants reported a clinician-provided diagnosis, and 517 of these were further evaluated by a panel of clinicians during over 250 hours of annotation. SymptomAI DDx were significantly more accurate (OR = 2.47, p < 0.001) than those from independent clinicians given the same dialogue in a blinded randomized comparison. Moreover, agentic strategies which conduct a dedicated symptom interview that elicit additional symptom information before providing a diagnosis, perform substantially better than baseline, user-guided conversations (p < 0.001). An auxiliary analysis on 1,509 conversations from a general US population panel validated that these results generalize beyond wearable device users. We used SymptomAI diagnoses as labels for all 13,917 participants to analyze over 500,000 days of wearable metrics across nearly 400 unique conditions. We identified strong associations between acute infections and physiological shifts (e.g., OR > 7 for influenza). While limited by self-reported ground truth, these results demonstrate the benefits of a dedicated and complete symptom interview compared to a user-guided symptom discussion, which is the default of most consumer LLMs.

When building artificial intelligence systems that can reason and answer questions about visual data, we need diagnostic tests to analyze our progress and discover shortcomings. Existing benchmarks for visual question answering can help, but have strong biases that models can exploit to correctly answer questions without reasoning. They also conflate multiple sources of error, making it hard to pinpoint model weaknesses. We present a diagnostic dataset that tests a range of visual reasoning abilities. It contains minimal biases and has detailed annotations describing the kind of reasoning each question requires. We use this dataset to analyze a variety of modern visual reasoning systems, providing novel insights into their abilities and limitations.

The differential diagnosis of neurodegenerative dementias is a challenging clinical task, mainly because of the overlap in symptom presentation and the similarity of patterns observed in structural neuroimaging. To improve diagnostic efficiency and accuracy, deep learning-based methods such as Convolutional Neural Networks and Vision Transformers have been proposed for the automatic classification of brain MRIs. However, despite their strong predictive performance, these models find limited clinical utility due to their opaque decision making. In this work, we propose a framework that integrates two core components to enhance diagnostic transparency. First, we introduce a modular pipeline for converting 3D T1-weighted brain MRIs into textual radiology reports. Second, we explore the potential of modern Large Language Models (LLMs) to assist clinicians in the differential diagnosis between Frontotemporal dementia subtypes, Alzheimer's disease, and normal aging based on the generated reports. To bridge the gap between predictive accuracy and explainability, we employ reinforcement learning to incentivize diagnostic reasoning in LLMs. Without requiring supervised reasoning traces or distillation from larger models, our approach enables the emergence of structured diagnostic rationales grounded in neuroimaging findings. Unlike post-hoc explainability methods that retrospectively justify model decisions, our framework generates diagnostic rationales as part of the inference process-producing causally grounded explanations that inform and guide the model's decision-making process. In doing so, our framework matches the diagnostic performance of existing deep learning methods while offering rationales that support its diagnostic conclusions.

The objective of this paper is to understand what characteristics and features of clinical data influence physician's decision about ordering laboratory tests or prescribing medications the most. We conduct our analysis on data and decisions extracted from electronic health records of 4486 post-surgical cardiac patients. The summary statistics for 335 different lab order decisions and 407 medication decisions are reported. We show that in many cases, physician's lab-order and medication decisions can be well predicted from a small subset of all features.

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.

Curating a large scale medical imaging dataset for machine learning applications is both time consuming and expensive. Balancing the workload between model development, data collection and annotations is difficult for machine learning practitioners, especially under time constraints. Causal analysis is often used in medicine and economics to gain insights about the effects of actions and policies. In this paper we explore the effect of dataset interventions on the output of image classification models. Through a causal approach we investigate the effects of the quantity and type of data we need to incorporate in a dataset to achieve better performance for specific subtasks. The main goal of this paper is to highlight the potential of causal analysis as a tool for resource optimization for developing medical imaging ML applications. We explore this concept with a synthetic dataset and an exemplary use-case for Diabetic Retinopathy image analysis.

A compartmental deterministic model that allows (1) immunity from two stages of infection and carriage, and (2) disease induced death, is used in studying the dynamics of meningitis epidemic process in a closed population. It allows for difference in the transmission rate of infection to a susceptible by a carrier and an infective. It is generalized to allow a proportion ({\phi}) of those susceptibles infected to progress directly to infectives in stage I. Both models are used in this study. The threshold conditions for the spread of carrier and infectives in stage I are derived for the two models. Sensitivity analysis is performed on the reproductive number derived from the next generation matrix. The case-carrier ratio profile for various parameters and threshold values are shown. So also are the graphs of the total number ever infected as influenced by {\epsilon} and {\phi}. The infection transmission rate (eta), the odds in favor of a carrier, over an infective, in transmitting an infection to a susceptible ({\epsilon}) and the carrier conversion rate ({\phi}) to an infective in stage I, are identified as key parameters that should be subject of attention for any control intervention strategy. The case-carrier ratio profiles provide evidence of a critical case-carrier ratio attained before the number of reported cases grows to an epidemic level. They also provide visual evidence of epidemiological context, in this case, epidemic incidence (in later part of dry season) and endemic incidence (during rainy season). Results from total proportion ever infected suggest that the model, in which {\phi}=0 obtained, can adequately represent, in essence, the generalized model for this study.

Vision Language Models (VLMs) are increasingly used for tasks like medical report generation and visual question answering. However, fluent diagnostic text does not guarantee safe visual understanding. In clinical practice, interpretation begins with pre-diagnostic sanity checks: verifying that the input is valid to read (correct modality and anatomy, plausible viewpoint and orientation, and no obvious integrity violations). Existing benchmarks largely assume this step is solved, and therefore miss a critical failure mode: a model can produce plausible narratives even when the input is inconsistent or invalid. We introduce MedObvious, a 1,880-task benchmark that isolates input validation as a set-level consistency capability over small multi-panel image sets: the model must identify whether any panel violates expected coherence. MedObvious spans five progressive tiers, from basic orientation/modality mismatches to clinically motivated anatomy/viewpoint verification and triage-style cues, and includes five evaluation formats to test robustness across interfaces. Evaluating 17 different VLMs, we find that sanity checking remains unreliable: several models hallucinate anomalies on normal (negative-control) inputs, performance degrades when scaling to larger image sets, and measured accuracy varies substantially between multiple-choice and open-ended settings. These results show that pre-diagnostic verification remains unsolved for medical VLMs and should be treated as a distinct, safety-critical capability before deployment.

Developing reliable AI systems to assist human clinicians in multi-modal medical diagnosis has long been a key objective for researchers. Recently, Multi-modal Large Language Models (MLLMs) have gained significant attention and achieved success across various domains. With strong reasoning capabilities and the ability to perform diverse tasks based on user instructions, they hold great potential for enhancing medical diagnosis. However, directly applying MLLMs to the medical domain still presents challenges. They lack detailed perception of visual inputs, limiting their ability to perform quantitative image analysis, which is crucial for medical diagnostics. Additionally, MLLMs often exhibit hallucinations and inconsistencies in reasoning, whereas clinical diagnoses must adhere strictly to established criteria. To address these challenges, we propose MedAgent-Pro, an evidence-based reasoning agentic system designed to achieve reliable, explainable, and precise medical diagnoses. This is accomplished through a hierarchical workflow: at the task level, knowledge-based reasoning generate reliable diagnostic plans for specific diseases following retrieved clinical criteria. While at the case level, multiple tool agents process multi-modal inputs, analyze different indicators according to the plan, and provide a final diagnosis based on both quantitative and qualitative evidence. Comprehensive experiments on both 2D and 3D medical diagnosis tasks demonstrate the superiority and effectiveness of MedAgent-Pro, while case studies further highlight its reliability and interpretability. The code is available at https://github.com/jinlab-imvr/MedAgent-Pro.

Online medical consultation (OMC) restricts doctors to gathering patient information solely through inquiries, making the already complex sequential decision-making process of diagnosis even more challenging. Recently, the rapid advancement of large language models has demonstrated a significant potential to transform OMC. However, most studies have primarily focused on improving diagnostic accuracy under conditions of relatively sufficient information, while paying limited attention to the "inquiry" phase of the consultation process. This lack of focus has left the relationship between "inquiry" and "diagnosis" insufficiently explored. In this paper, we first extract real patient interaction strategies from authentic doctor-patient conversations and use these strategies to guide the training of a patient simulator that closely mirrors real-world behavior. By inputting medical records into our patient simulator to simulate patient responses, we conduct extensive experiments to explore the relationship between "inquiry" and "diagnosis" in the consultation process. Experimental results demonstrate that inquiry and diagnosis adhere to the Liebig's law: poor inquiry quality limits the effectiveness of diagnosis, regardless of diagnostic capability, and vice versa. Furthermore, the experiments reveal significant differences in the inquiry performance of various models. To investigate this phenomenon, we categorize the inquiry process into four types: (1) chief complaint inquiry; (2) specification of known symptoms; (3) inquiry about accompanying symptoms; and (4) gathering family or medical history. We analyze the distribution of inquiries across the four types for different models to explore the reasons behind their significant performance differences. We plan to open-source the weights and related code of our patient simulator at https://github.com/LIO-H-ZEN/PatientSimulator.

In clinical radiology reports, doctors capture important information about the patient's health status. They convey their observations from raw medical imaging data about the inner structures of a patient. As such, formulating reports requires medical experts to possess wide-ranging knowledge about anatomical regions with their normal, healthy appearance as well as the ability to recognize abnormalities. This explicit grasp on both the patient's anatomy and their appearance is missing in current medical image-processing systems as annotations are especially difficult to gather. This renders the models to be narrow experts e.g. for identifying specific diseases. In this work, we recover this missing link by adding human anatomy into the mix and enable the association of content in medical reports to their occurrence in associated imagery (medical phrase grounding). To exploit anatomical structures in this scenario, we present a sophisticated automatic pipeline to gather and integrate human bodily structures from computed tomography datasets, which we incorporate in our PAXRay: A Projected dataset for the segmentation of Anatomical structures in X-Ray data. Our evaluation shows that methods that take advantage of anatomical information benefit heavily in visually grounding radiologists' findings, as our anatomical segmentations allow for up to absolute 50% better grounding results on the OpenI dataset as compared to commonly used region proposals. The PAXRay dataset is available at https://constantinseibold.github.io/paxray/.

Clinical diagnosis prediction models, when provided with a patient's medical history, aim to detect potential diseases early, facilitating timely intervention and improving prognostic outcomes. However, the inherent scarcity of patient data and large disease candidate space often pose challenges in developing satisfactory models for this intricate task. The exploration of leveraging Large Language Models (LLMs) for encapsulating clinical decision processes has been limited. We introduce MERA, a clinical diagnosis prediction model that bridges pertaining natural language knowledge with medical practice. We apply hierarchical contrastive learning on a disease candidate ranking list to alleviate the large decision space issue. With concept memorization through fine-tuning, we bridge the natural language clinical knowledge with medical codes. Experimental results on MIMIC-III and IV datasets show that MERA achieves the state-of-the-art diagnosis prediction performance and dramatically elevates the diagnosis prediction capabilities of generative LMs.

Skin lesion datasets provide essential information for understanding various skin conditions and developing effective diagnostic tools. They aid the artificial intelligence-based early detection of skin cancer, facilitate treatment planning, and contribute to medical education and research. Published large datasets have partially coverage the subclassifications of the skin lesions. This limitation highlights the need for more expansive and varied datasets to reduce false predictions and help improve the failure analysis for skin lesions. This study presents a diverse dataset comprising 12,345 dermatoscopic images with 38 subclasses of skin lesions collected in Turkiye which comprises different skin types in the transition zone between Europe and Asia. Each subgroup contains high-resolution photos and expert annotations, providing a strong and reliable basis for future research. The detailed analysis of each subgroup provided in this study facilitates targeted research endeavors and enhances the depth of understanding regarding the skin lesions. This dataset distinguishes itself through a diverse structure with 5 super classes, 15 main classes, 38 subclasses and its 12,345 high-resolution dermatoscopic images.

Large language models (LLMs) show promise in medical diagnosis, but real-world deployment remains challenging due to high-stakes clinical decisions and imperfect reasoning reliability. As a result, careful inspection of model behavior is essential for assessing whether diagnostic reasoning is reliable and clinically grounded. However, debugging medical LLMs remains difficult. First, developers often lack sufficient medical domain expertise to interpret model errors in clinically meaningful terms. Second, models can fail across a large and diverse set of instances involving different input types, tasks, and reasoning steps, making it challenging for developers to prioritize which errors deserve focused inspection. Third, developers struggle to identify recurring error patterns across cases, as existing debugging practices are largely instance-centric and rely on manual inspection of isolated failures. To address these challenges, we present VeriLLMed, a visual analytics system that integrates external biomedical knowledge to audit and debug medical LLM diagnostic reasoning. VeriLLMed transforms model outputs into comparable reasoning paths, constructs knowledge graph-grounded reference paths, and identifies three recurring classes of diagnosis errors: relation errors, branch errors, and missing errors. Case studies and expert evaluation demonstrate that VeriLLMed helps developers identify clinically implausible reasoning and generate actionable insights that can inform the improvement of medical LLMs.

In this paper, we present a framework for training large language models (LLMs) as diagnostic agents with reinforcement learning, enabling them to manage multi-turn diagnostic processes, adaptively select examinations, and commit to final diagnoses. Unlike instruction-tuned models trained on static case summaries, our method acquires diagnostic strategies through interactive exploration and outcome-based feedback. Our contributions are fourfold: (i) We present DiagGym, a diagnostics world model trained with electronic health records that emits examination outcomes conditioned on patient history and recommended examination, serving as a virtual clinical environment for realistic diagnosis training and evaluation; (ii) We train DiagAgent via end-to-end, multi-turn reinforcement learning to learn diagnostic policies that optimize both information yield and diagnostic accuracy; (iii) We introduce DiagBench, a diagnostic benchmark comprising 750 cases with physician-validated examination recommendations and 99 cases annotated with 973 physician-written rubrics on diagnosis process; (iv) we demonstrate superior performance across diverse diagnostic settings. DiagAgent significantly outperforms 10 state-of-the-art LLMs, including DeepSeek-v3 and GPT-4o, as well as two prompt-engineered agents. In single-turn settings, DiagAgent achieves 9.34% higher diagnostic accuracy and 44.03% improvement in examination recommendation hit ratio. In end-to-end settings, it delivers 15.12% increase in diagnostic accuracy and 23.09% boost in examination recommendation F1 score. In rubric-based evaluation, it surpasses the next-best model, Claude-sonnet-4, by 7.1% in weighted rubric score. These findings indicate that learning policies in interactive clinical environments confers dynamic and clinically meaningful diagnostic management abilities unattainable through passive training alone.

Automated interpretation of electrocardiograms (ECG) has garnered significant attention with the advancements in machine learning methodologies. Despite the growing interest, most current studies focus solely on classification or regression tasks, which overlook a crucial aspect of clinical cardio-disease diagnosis: the diagnostic report generated by experienced human clinicians. In this paper, we introduce a novel approach to ECG interpretation, leveraging recent breakthroughs in Large Language Models (LLMs) and Vision-Transformer (ViT) models. Rather than treating ECG diagnosis as a classification or regression task, we propose an alternative method of automatically identifying the most similar clinical cases based on the input ECG data. Also, since interpreting ECG as images is more affordable and accessible, we process ECG as encoded images and adopt a vision-language learning paradigm to jointly learn vision-language alignment between encoded ECG images and ECG diagnosis reports. Encoding ECG into images can result in an efficient ECG retrieval system, which will be highly practical and useful in clinical applications. More importantly, our findings could serve as a crucial resource for providing diagnostic services in underdeveloped regions.

Assessing scientific claims requires identifying, extracting, and reasoning with multimodal data expressed in information-rich figures in scientific literature. Despite the large body of work in scientific QA, figure captioning, and other multimodal reasoning tasks over chart-based data, there are no readily usable multimodal benchmarks that directly test claim verification abilities. To remedy this gap, we introduce a new benchmark MuSciClaims accompanied by diagnostics tasks. We automatically extract supported claims from scientific articles, which we manually perturb to produce contradicted claims. The perturbations are designed to test for a specific set of claim verification capabilities. We also introduce a suite of diagnostic tasks that help understand model failures. Our results show most vision-language models are poor (~0.3-0.5 F1), with even the best model only achieving 0.72 F1. They are also biased towards judging claims as supported, likely misunderstanding nuanced perturbations within the claims. Our diagnostics show models are bad at localizing correct evidence within figures, struggle with aggregating information across modalities, and often fail to understand basic components of the figure.

Radiology reporting generative AI holds significant potential to alleviate clinical workloads and streamline medical care. However, achieving high clinical accuracy is challenging, as radiological images often feature subtle lesions and intricate structures. Existing systems often fall short, largely due to their reliance on fixed size, patch-level image features and insufficient incorporation of pathological information. This can result in the neglect of such subtle patterns and inconsistent descriptions of crucial pathologies. To address these challenges, we propose an innovative approach that leverages pathology-aware regional prompts to explicitly integrate anatomical and pathological information of various scales, significantly enhancing the precision and clinical relevance of generated reports. We develop an anatomical region detector that extracts features from distinct anatomical areas, coupled with a novel multi-label lesion detector that identifies global pathologies. Our approach emulates the diagnostic process of radiologists, producing clinically accurate reports with comprehensive diagnostic capabilities. Experimental results show that our model outperforms previous state-of-the-art methods on most natural language generation and clinical efficacy metrics, with formal expert evaluations affirming its potential to enhance radiology practice.

Electrocardiogram (ECG) interpretation is essential for cardiovascular disease diagnosis, but current automated systems often struggle with transparency and generalization to unseen conditions. To address this, we introduce ZETA, a zero-shot multimodal framework designed for interpretable ECG diagnosis aligned with clinical workflows. ZETA uniquely compares ECG signals against structured positive and negative clinical observations, which are curated through an LLM-assisted, expert-validated process, thereby mimicking differential diagnosis. Our approach leverages a pre-trained multimodal model to align ECG and text embeddings without disease-specific fine-tuning. Empirical evaluations demonstrate ZETA's competitive zero-shot classification performance and, importantly, provide qualitative and quantitative evidence of enhanced interpretability, grounding predictions in specific, clinically relevant positive and negative diagnostic features. ZETA underscores the potential of aligning ECG analysis with structured clinical knowledge for building more transparent, generalizable, and trustworthy AI diagnostic systems. We will release the curated observation dataset and code to facilitate future research.

Medical Visual Language Models have shown great potential in various healthcare applications, including medical image captioning and diagnostic assistance. However, most existing models rely on text-based instructions, limiting their usability in real-world clinical environments especially in scenarios such as surgery, text-based interaction is often impractical for physicians. In addition, current medical image analysis models typically lack comprehensive reasoning behind their predictions, which reduces their reliability for clinical decision-making. Given that medical diagnosis errors can have life-changing consequences, there is a critical need for interpretable and rational medical assistance. To address these challenges, we introduce an end-to-end speech-driven medical VLM, SilVar-Med, a multimodal medical image assistant that integrates speech interaction with VLMs, pioneering the task of voice-based communication for medical image analysis. In addition, we focus on the interpretation of the reasoning behind each prediction of medical abnormalities with a proposed reasoning dataset. Through extensive experiments, we demonstrate a proof-of-concept study for reasoning-driven medical image interpretation with end-to-end speech interaction. We believe this work will advance the field of medical AI by fostering more transparent, interactive, and clinically viable diagnostic support systems. Our code and dataset are publicly available at SiVar-Med.

Large language models (LLMs) have recently showcased remarkable capabilities, spanning a wide range of tasks and applications, including those in the medical domain. Models like GPT-4 excel in medical question answering but may face challenges in the lack of interpretability when handling complex tasks in real clinical settings. We thus introduce the diagnostic reasoning dataset for clinical notes (DiReCT), aiming at evaluating the reasoning ability and interpretability of LLMs compared to human doctors. It contains 511 clinical notes, each meticulously annotated by physicians, detailing the diagnostic reasoning process from observations in a clinical note to the final diagnosis. Additionally, a diagnostic knowledge graph is provided to offer essential knowledge for reasoning, which may not be covered in the training data of existing LLMs. Evaluations of leading LLMs on DiReCT bring out a significant gap between their reasoning ability and that of human doctors, highlighting the critical need for models that can reason effectively in real-world clinical scenarios.

Microscopic interpretation of histopathology images underlies many important diagnostic and treatment decisions. While advances in vision-language modeling raise new opportunities for analysis of such images, the gigapixel-scale size of whole slide images (WSIs) introduces unique challenges. Additionally, pathology reports simultaneously highlight key findings from small regions while also aggregating interpretation across multiple slides, often making it difficult to create robust image-text pairs. As such, pathology reports remain a largely untapped source of supervision in computational pathology, with most efforts relying on region-of-interest annotations or self-supervision at the patch-level. In this work, we develop a vision-language model based on the BLIP-2 framework using WSIs paired with curated text from pathology reports. This enables applications utilizing a shared image-text embedding space, such as text or image retrieval for finding cases of interest, as well as integration of the WSI encoder with a frozen large language model (LLM) for WSI-based generative text capabilities such as report generation or AI-in-the-loop interactions. We utilize a de-identified dataset of over 350,000 WSIs and diagnostic text pairs, spanning a wide range of diagnoses, procedure types, and tissue types. We present pathologist evaluation of text generation and text retrieval using WSI embeddings, as well as results for WSI classification and workflow prioritization (slide-level triaging). Model-generated text for WSIs was rated by pathologists as accurate, without clinically significant error or omission, for 78% of WSIs on average. This work demonstrates exciting potential capabilities for language-aligned WSI embeddings.

For the early identification, diagnosis, and treatment of mental health illnesses, the integration of deep learning (DL) and machine learning (ML) has started playing a significant role. By evaluating complex data from imaging, genetics, and behavioral assessments, these technologies have the potential to significantly improve clinical outcomes. However, they also present unique challenges related to data integration and ethical issues. This survey reviews the development of ML and DL methods for the early diagnosis and treatment of mental health issues. It examines a range of applications, with a particular emphasis on behavioral assessments, genetic and biomarker analysis, and medical imaging for diagnosing diseases like depression, bipolar disorder, and schizophrenia. Predictive modeling for illness progression is further discussed, focusing on the role of risk prediction models and longitudinal studies. Key findings highlight how ML and DL can improve diagnostic accuracy and treatment outcomes while addressing methodological inconsistencies, data integration challenges, and ethical concerns. The study emphasizes the importance of building real-time monitoring systems for individualized treatment, enhancing data fusion techniques, and fostering interdisciplinary collaboration. Future research should focus on overcoming these obstacles to ensure the valuable and ethical application of ML and DL in mental health services.

Automatic medical report generation (MRG) is of great research value as it has the potential to relieve radiologists from the heavy burden of report writing. Despite recent advancements, accurate MRG remains challenging due to the need for precise clinical understanding and the identification of clinical findings. Moreover, the imbalanced distribution of diseases makes the challenge even more pronounced, as rare diseases are underrepresented in training data, making their diagnostic performance unreliable. To address these challenges, we propose diagnosis-driven prompts for medical report generation (PromptMRG), a novel framework that aims to improve the diagnostic accuracy of MRG with the guidance of diagnosis-aware prompts. Specifically, PromptMRG is based on encoder-decoder architecture with an extra disease classification branch. When generating reports, the diagnostic results from the classification branch are converted into token prompts to explicitly guide the generation process. To further improve the diagnostic accuracy, we design cross-modal feature enhancement, which retrieves similar reports from the database to assist the diagnosis of a query image by leveraging the knowledge from a pre-trained CLIP. Moreover, the disease imbalanced issue is addressed by applying an adaptive logit-adjusted loss to the classification branch based on the individual learning status of each disease, which overcomes the barrier of text decoder's inability to manipulate disease distributions. Experiments on two MRG benchmarks show the effectiveness of the proposed method, where it obtains state-of-the-art clinical efficacy performance on both datasets.

The meaningful use of electronic health records (EHR) continues to progress in the digital era with clinical decision support systems augmented by artificial intelligence. A priority in improving provider experience is to overcome information overload and reduce the cognitive burden so fewer medical errors and cognitive biases are introduced during patient care. One major type of medical error is diagnostic error due to systematic or predictable errors in judgment that rely on heuristics. The potential for clinical natural language processing (cNLP) to model diagnostic reasoning in humans with forward reasoning from data to diagnosis and potentially reduce the cognitive burden and medical error has not been investigated. Existing tasks to advance the science in cNLP have largely focused on information extraction and named entity recognition through classification tasks. We introduce a novel suite of tasks coined as Diagnostic Reasoning Benchmarks, DR.BENCH, as a new benchmark for developing and evaluating cNLP models with clinical diagnostic reasoning ability. The suite includes six tasks from ten publicly available datasets addressing clinical text understanding, medical knowledge reasoning, and diagnosis generation. DR.BENCH is the first clinical suite of tasks designed to be a natural language generation framework to evaluate pre-trained language models. Experiments with state-of-the-art pre-trained generative language models using large general domain models and models that were continually trained on a medical corpus demonstrate opportunities for improvement when evaluated in DR. BENCH. We share DR. BENCH as a publicly available GitLab repository with a systematic approach to load and evaluate models for the cNLP community.

Finding relevant literature underpins the practice of evidence-based medicine. From 2014 to 2016, TREC conducted a clinical decision support track, wherein participants were tasked with finding articles relevant to clinical questions posed by physicians. In total, 87 teams have participated over the past three years, generating 395 runs. During this period, each team has trialled a variety of methods. While there was significant overlap in the methods employed by different teams, the results were varied. Due to the diversity of the platforms used, the results arising from the different techniques are not directly comparable, reducing the ability to build on previous work. By using a stable platform, we have been able to compare different document and query processing techniques, allowing us to experiment with different search parameters. We have used our system to reproduce leading teams runs, and compare the results obtained. By benchmarking our indexing and search techniques, we can statistically test a variety of hypotheses, paving the way for further research.

Background: AI-based classification models are essential for improving lung cancer diagnosis. However, the relative performance of lesion-level versus chest-region models in internal and external datasets remains unclear. Purpose: This study evaluates the performance of lesion-level and chest-region models for lung cancer classification, comparing their effectiveness across internal Duke Lung Nodule Dataset 2024 (DLND24) and external (LUNA16, NLST) datasets, with a focus on subgroup analyses by demographics, histology, and imaging characteristics. Materials and Methods: Two AI models were trained: one using lesion-centric patches (64,64,64) and the other using chest-region patches (512,512,8). Internal validation was conducted on DLND24, while external validation utilized LUNA16 and NLST datasets. The models performances were assessed using AUC-ROC, with subgroup analyses for demographic, clinical, and imaging factors. Statistical comparisons were performed using DeLongs test. Gradient-based visualizations and probability distribution were further used for analysis. Results: The lesion-level model consistently outperformed the chest-region model across datasets. In internal validation, the lesion-level model achieved an AUC of 0.71(CI: 0.61-0.81), compared to 0.68(0.57-0.77) for the chest-region model. External validation showed similar trends, with AUCs of 0.90(0.87-0.92) and 0.81(0.79-0.82) on LUNA16 and NLST, respectively. Subgroup analyses revealed significant advantages for lesion-level models in certain histological subtypes (adenocarcinoma) and imaging conditions (CT manufacturers). Conclusion: Lesion-level models demonstrate superior classification performance, especially for external datasets and challenging subgroups, suggesting their clinical utility for precision lung cancer diagnostics.

Chromosome analysis is vital for diagnosing genetic disorders and guiding cancer therapy decisions through the identification of somatic clonal aberrations. However, developing an AI model are hindered by the overwhelming complexity and diversity of chromosomal abnormalities, requiring extensive annotation efforts, while automated methods remain task-specific and lack generalizability due to the scarcity of comprehensive datasets spanning diverse resource conditions. Here, we introduce CHROMA, a foundation model for cytogenomics, designed to overcome these challenges by learning generalizable representations of chromosomal abnormalities. Pre-trained on over 84,000 specimens (~4 million chromosomal images) via self-supervised learning, CHROMA outperforms other methods across all types of abnormalities, even when trained on fewer labelled data and more imbalanced datasets. By facilitating comprehensive mapping of instability and clonal leisons across various aberration types, CHROMA offers a scalable and generalizable solution for reliable and automated clinical analysis, reducing the annotation workload for experts and advancing precision oncology through the early detection of rare genomic abnormalities, enabling broad clinical AI applications and making advanced genomic analysis more accessible.

Pathological diagnosis remains the definitive standard for identifying tumors. The rise of multimodal large models has simplified the process of integrating image analysis with textual descriptions. Despite this advancement, the substantial costs associated with training and deploying these complex multimodal models, together with a scarcity of high-quality training datasets, create a significant divide between cutting-edge technology and its application in the clinical setting. We had meticulously compiled a dataset of approximately 45,000 cases, covering over 6 different tasks, including the classification of organ tissues, generating pathology report descriptions, and addressing pathology-related questions and answers. We have fine-tuned multimodal large models, specifically LLaVA, Qwen-VL, InternLM, with this dataset to enhance instruction-based performance. We conducted a qualitative assessment of the capabilities of the base model and the fine-tuned model in performing image captioning and classification tasks on the specific dataset. The evaluation results demonstrate that the fine-tuned model exhibits proficiency in addressing typical pathological questions. We hope that by making both our models and datasets publicly available, they can be valuable to the medical and research communities.

Surface analysis of the cortex is ubiquitous in human neuroimaging with MRI, e.g., for cortical registration, parcellation, or thickness estimation. The convoluted cortical geometry requires isotropic scans (e.g., 1mm MPRAGEs) and good gray-white matter contrast for 3D reconstruction. This precludes the analysis of most brain MRI scans acquired for clinical purposes. Analyzing such scans would enable neuroimaging studies with sample sizes that cannot be achieved with current research datasets, particularly for underrepresented populations and rare diseases. Here we present the first method for cortical reconstruction, registration, parcellation, and thickness estimation for clinical brain MRI scans of any resolution and pulse sequence. The methods has a learning component and a classical optimization module. The former uses domain randomization to train a CNN that predicts an implicit representation of the white matter and pial surfaces (a signed distance function) at 1mm isotropic resolution, independently of the pulse sequence and resolution of the input. The latter uses geometry processing to place the surfaces while accurately satisfying topological and geometric constraints, thus enabling subsequent parcellation and thickness estimation with existing methods. We present results on 5mm axial FLAIR scans from ADNI and on a highly heterogeneous clinical dataset with 5,000 scans. Code and data are publicly available at https://surfer.nmr.mgh.harvard.edu/fswiki/recon-all-clinical

Following the global COVID-19 pandemic, the number of scientific papers studying the virus has grown massively, leading to increased interest in automated literate review. We present a clinical text mining system that improves on previous efforts in three ways. First, it can recognize over 100 different entity types including social determinants of health, anatomy, risk factors, and adverse events in addition to other commonly used clinical and biomedical entities. Second, the text processing pipeline includes assertion status detection, to distinguish between clinical facts that are present, absent, conditional, or about someone other than the patient. Third, the deep learning models used are more accurate than previously available, leveraging an integrated pipeline of state-of-the-art pretrained named entity recognition models, and improving on the previous best performing benchmarks for assertion status detection. We illustrate extracting trends and insights, e.g. most frequent disorders and symptoms, and most common vital signs and EKG findings, from the COVID-19 Open Research Dataset (CORD-19). The system is built using the Spark NLP library which natively supports scaling to use distributed clusters, leveraging GPUs, configurable and reusable NLP pipelines, healthcare specific embeddings, and the ability to train models to support new entity types or human languages with no code changes.

Recently, Computer-Aided Diagnosis (CAD) systems have emerged as indispensable tools in clinical diagnostic workflows, significantly alleviating the burden on radiologists. Nevertheless, despite their integration into clinical settings, CAD systems encounter limitations. Specifically, while CAD systems can achieve high performance in the detection of lung nodules, they face challenges in accurately predicting multiple cancer types. This limitation can be attributed to the scarcity of publicly available datasets annotated with expert-level cancer type information. This research aims to bridge this gap by providing publicly accessible datasets and reliable tools for medical diagnosis, facilitating a finer categorization of different types of lung diseases so as to offer precise treatment recommendations. To achieve this objective, we curated a diverse dataset of lung Computed Tomography (CT) images, comprising 330 annotated nodules (nodules are labeled as bounding boxes) from 95 distinct patients. The quality of the dataset was evaluated using a variety of classical classification and detection models, and these promising results demonstrate that the dataset has a feasible application and further facilitate intelligent auxiliary diagnosis.

Current vision-language models (VLMs) in medicine are primarily designed for categorical question answering (e.g., "Is this normal or abnormal?") or qualitative descriptive tasks. However, clinical decision-making often relies on quantitative assessments, such as measuring the size of a tumor or the angle of a joint, from which physicians draw their own diagnostic conclusions. This quantitative reasoning capability remains underexplored and poorly supported in existing VLMs. In this work, we introduce MedVision, a large-scale dataset and benchmark specifically designed to evaluate and improve VLMs on quantitative medical image analysis. MedVision spans 22 public datasets covering diverse anatomies and modalities, with 30.8 million image-annotation pairs. We focus on three representative quantitative tasks: (1) detection of anatomical structures and abnormalities, (2) tumor/lesion (T/L) size estimation, and (3) angle/distance (A/D) measurement. Our benchmarks show that current off-the-shelf VLMs perform poorly on these tasks. However, with supervised fine-tuning on MedVision, we significantly enhance their performance across detection, T/L estimation, and A/D measurement, demonstrating reduced error rates and improved precision. This work provides a foundation for developing VLMs with robust quantitative reasoning capabilities in medical imaging. Code and data are available at https://medvision-vlm.github.io.

Breast ultrasound (BUS) is a critical diagnostic tool in the field of breast imaging, aiding in the early detection and characterization of breast abnormalities. Interpreting breast ultrasound images commonly involves creating comprehensive medical reports, containing vital information to promptly assess the patient's condition. However, the ultrasound imaging system necessitates capturing multiple images of various parts to compile a single report, presenting a time-consuming challenge. To address this problem, we propose the integration of multiple image analysis tools through a LangChain using Large Language Models (LLM), into the breast reporting process. Through a combination of designated tools and text generation through LangChain, our method can accurately extract relevant features from ultrasound images, interpret them in a clinical context, and produce comprehensive and standardized reports. This approach not only reduces the burden on radiologists and healthcare professionals but also enhances the consistency and quality of reports. The extensive experiments shows that each tools involved in the proposed method can offer qualitatively and quantitatively significant results. Furthermore, clinical evaluation on the generated reports demonstrates that the proposed method can make report in clinically meaningful way.

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.

Clinical machine learning research and AI driven clinical decision support models rely on clinically accurate labels. Manually extracting these labels with the help of clinical specialists is often time-consuming and expensive. This study tests the feasibility of automatic span- and document-level diagnosis extraction from unstructured Dutch echocardiogram reports. We included 115,692 unstructured echocardiogram reports from the UMCU a large university hospital in the Netherlands. A randomly selected subset was manually annotated for the occurrence and severity of eleven commonly described cardiac characteristics. We developed and tested several automatic labelling techniques at both span and document levels, using weighted and macro F1-score, precision, and recall for performance evaluation. We compared the performance of span labelling against document labelling methods, which included both direct document classifiers and indirect document classifiers that rely on span classification results. The SpanCategorizer and MedRoBERTa.nl models outperformed all other span and document classifiers, respectively. The weighted F1-score varied between characteristics, ranging from 0.60 to 0.93 in SpanCategorizer and 0.96 to 0.98 in MedRoBERTa.nl. Direct document classification was superior to indirect document classification using span classifiers. SetFit achieved competitive document classification performance using only 10\% of the training data. Utilizing a reduced label set yielded near-perfect document classification results. We recommend using our published SpanCategorizer and MedRoBERTa.nl models for span- and document-level diagnosis extraction from Dutch echocardiography reports. For settings with limited training data, SetFit may be a promising alternative for document classification.

We describe HypotheSAEs, a general method to hypothesize interpretable relationships between text data (e.g., headlines) and a target variable (e.g., clicks). HypotheSAEs has three steps: (1) train a sparse autoencoder on text embeddings to produce interpretable features describing the data distribution, (2) select features that predict the target variable, and (3) generate a natural language interpretation of each feature (e.g., "mentions being surprised or shocked") using an LLM. Each interpretation serves as a hypothesis about what predicts the target variable. Compared to baselines, our method better identifies reference hypotheses on synthetic datasets (at least +0.06 in F1) and produces more predictive hypotheses on real datasets (~twice as many significant findings), despite requiring 1-2 orders of magnitude less compute than recent LLM-based methods. HypotheSAEs also produces novel discoveries on two well-studied tasks: explaining partisan differences in Congressional speeches and identifying drivers of engagement with online headlines.

Vietnamese medical research has become an increasingly vital domain, particularly with the rise of intelligent technologies aimed at reducing time and resource burdens in clinical diagnosis. Recent advances in vision-language models (VLMs), such as Gemini and GPT-4V, have sparked a growing interest in applying AI to healthcare. However, most existing VLMs lack exposure to Vietnamese medical data, limiting their ability to generate accurate and contextually appropriate diagnostic outputs for Vietnamese patients. To address this challenge, we introduce ViX-Ray, a novel dataset comprising 5,400 Vietnamese chest X-ray images annotated with expert-written findings and impressions from physicians at a major Vietnamese hospital. We analyze linguistic patterns within the dataset, including the frequency of mentioned body parts and diagnoses, to identify domain-specific linguistic characteristics of Vietnamese radiology reports. Furthermore, we fine-tune five state-of-the-art open-source VLMs on ViX-Ray and compare their performance to leading proprietary models, GPT-4V and Gemini. Our results show that while several models generate outputs partially aligned with clinical ground truths, they often suffer from low precision and excessive hallucination, especially in impression generation. These findings not only demonstrate the complexity and challenge of our dataset but also establish ViX-Ray as a valuable benchmark for evaluating and advancing vision-language models in the Vietnamese clinical domain.

Interpretability research on large language models (LLMs) has yielded important insights into model behaviour, yet recurring pitfalls persist: findings that do not generalise, and causal interpretations that outrun the evidence. Our position is that causal inference specifies what constitutes a valid mapping from model activations to invariant high-level structures, the data or assumptions needed to achieve it, and the inferences it can support. Specifically, Pearl's causal hierarchy clarifies what an interpretability study can justify. Observations establish associations between model behaviour and internal components. Interventions (e.g., ablations or activation patching) support claims how these edits affect a behavioural metric (e.g., average change in token probabilities) over a set of prompts. However, counterfactual claims -- i.e., asking what the model output would have been for the same prompt under an unobserved intervention -- remain largely unverifiable without controlled supervision. We show how causal representation learning (CRL) operationalises this hierarchy, specifying which variables are recoverable from activations and under what assumptions. Together, these motivate a diagnostic framework that helps practitioners select methods and evaluations matching claims to evidence such that findings generalise.

The SYNTAX score has become a widely used measure of coronary disease severity , crucial in selecting the optimal mode of revascularization. This paper introduces a new medical regression and classification problem - automatically estimating SYNTAX score from coronary angiography. Our study presents a comprehensive dataset of 1,844 patients, featuring a balanced distribution of individuals with zero and non-zero scores. This dataset includes a first-of-its-kind, complete coronary angiography samples captured through a multi-view X-ray video, allowing one to observe coronary arteries from multiple perspectives. Furthermore, we present a novel, fully automatic end-to-end method for estimating the SYNTAX. For such a difficult task, we have achieved a solid coefficient of determination R2 of 0.51 in score predictions.

Coronary artery disease (CAD) remains the leading cause of death globally and invasive coronary angiography (ICA) is considered the gold standard of anatomical imaging evaluation when CAD is suspected. However, risk evaluation based on ICA has several limitations, such as visual assessment of stenosis severity, which has significant interobserver variability. This motivates to development of a lesion classification system that can support specialists in their clinical procedures. Although deep learning classification methods are well-developed in other areas of medical imaging, ICA image classification is still at an early stage. One of the most important reasons is the lack of available and high-quality open-access datasets. In this paper, we reported a new annotated ICA images dataset, CADICA, to provide the research community with a comprehensive and rigorous dataset of coronary angiography consisting of a set of acquired patient videos and associated disease-related metadata. This dataset can be used by clinicians to train their skills in angiographic assessment of CAD severity and by computer scientists to create computer-aided diagnostic systems to help in such assessment. In addition, baseline classification methods are proposed and analyzed, validating the functionality of CADICA and giving the scientific community a starting point to improve CAD detection.

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.

The World Health Organization added Disease X to their shortlist of blueprint priority diseases to represent a hypothetical, unknown pathogen that could cause a future epidemic. During different virus outbreaks of the past, such as COVID-19, Influenza, Lyme Disease, and Zika virus, researchers from various disciplines utilized Google Trends to mine multimodal components of web behavior to study, investigate, and analyze the global awareness, preparedness, and response associated with these respective virus outbreaks. As the world prepares for Disease X, a dataset on web behavior related to Disease X would be crucial to contribute towards the timely advancement of research in this field. Furthermore, none of the prior works in this field have focused on the development of a dataset to compile relevant web behavior data, which would help to prepare for Disease X. To address these research challenges, this work presents a dataset of web behavior related to Disease X, which emerged from different geographic regions of the world, between February 2018 and August 2023. Specifically, this dataset presents the search interests related to Disease X from 94 geographic regions. The dataset was developed by collecting data using Google Trends. The relevant search interests for all these regions for each month in this time range are available in this dataset. This paper also discusses the compliance of this dataset with the FAIR principles of scientific data management. Finally, an analysis of this dataset is presented to uphold the applicability, relevance, and usefulness of this dataset for the investigation of different research questions in the interrelated fields of Big Data, Data Mining, Healthcare, Epidemiology, and Data Analysis with a specific focus on Disease X.

Chest X-ray plays a central role in thoracic diagnosis, and its interpretation inherently requires multi-step, evidence-grounded reasoning. However, large vision-language models (LVLMs) often generate plausible responses that are not faithfully grounded in diagnostic evidence and provide limited visual evidence for verification, while also requiring costly retraining to support new diagnostic tasks, limiting their reliability and adaptability in clinical settings. To address these limitations, we present CXReasonAgent, a diagnostic agent that integrates a large language model (LLM) with clinically grounded diagnostic tools to perform evidence-grounded diagnostic reasoning using image-derived diagnostic and visual evidence. To evaluate these capabilities, we introduce CXReasonDial, a multi-turn dialogue benchmark with 1,946 dialogues across 12 diagnostic tasks, and show that CXReasonAgent produces faithfully grounded responses, enabling more reliable and verifiable diagnostic reasoning than LVLMs. These findings highlight the importance of integrating clinically grounded diagnostic tools, particularly in safety-critical clinical settings.

Rare diseases collectively affect over 300 million individuals worldwide, yet timely and accurate diagnosis remains a pervasive challenge. This is largely due to their clinical heterogeneity, low individual prevalence, and the limited familiarity most clinicians have with rare conditions. Here, we introduce DeepRare, the first rare disease diagnosis agentic system powered by a large language model (LLM), capable of processing heterogeneous clinical inputs. The system generates ranked diagnostic hypotheses for rare diseases, each accompanied by a transparent chain of reasoning that links intermediate analytic steps to verifiable medical evidence. DeepRare comprises three key components: a central host with a long-term memory module; specialized agent servers responsible for domain-specific analytical tasks integrating over 40 specialized tools and web-scale, up-to-date medical knowledge sources, ensuring access to the most current clinical information. This modular and scalable design enables complex diagnostic reasoning while maintaining traceability and adaptability. We evaluate DeepRare on eight datasets. The system demonstrates exceptional diagnostic performance among 2,919 diseases, achieving 100% accuracy for 1013 diseases. In HPO-based evaluations, DeepRare significantly outperforms other 15 methods, like traditional bioinformatics diagnostic tools, LLMs, and other agentic systems, achieving an average Recall@1 score of 57.18% and surpassing the second-best method (Reasoning LLM) by a substantial margin of 23.79 percentage points. For multi-modal input scenarios, DeepRare achieves 70.60% at Recall@1 compared to Exomiser's 53.20% in 109 cases. Manual verification of reasoning chains by clinical experts achieves 95.40% agreements. Furthermore, the DeepRare system has been implemented as a user-friendly web application http://raredx.cn/doctor.

In the last decade, several organizations have produced documents intended to standardize, in the normative sense, and promote guidance to our recent and rapid AI development. However, the full spectrum of ideas presented in these documents has not yet been analyzed, except for a few meta-analyses and critical reviews of the field. In this work, we seek to expand on the work done by past researchers and create a tool for better data visualization of the contents and nature of these documents, to understand whether there is consensus or similarity between the principles espoused by various institutions, which may inspire debates on future regulations. We also provide some preliminary thoughts and questions that could guide the continuity of the research through a critical analysis of the results acquired by our methodology into a sample size of 200 documents.

Rationale: Computer aided detection (CAD) algorithms for Pulmonary Embolism (PE) algorithms have been shown to increase radiologists' sensitivity with a small increase in specificity. However, CAD for PE has not been adopted into clinical practice, likely because of the high number of false positives current CAD software produces. Objective: To generate a database of annotated computed tomography pulmonary angiographies, use it to compare the sensitivity and false positive rate of current algorithms and to develop new methods that improve such metrics. Methods: 91 Computed tomography pulmonary angiography scans were annotated by at least one radiologist by segmenting all pulmonary emboli visible on the study. 20 annotated CTPAs were open to the public in the form of a medical image analysis challenge. 20 more were kept for evaluation purposes. 51 were made available post-challenge. 8 submissions, 6 of them novel, were evaluated on the 20 evaluation CTPAs. Performance was measured as per embolus sensitivity vs. false positives per scan curve. Results: The best algorithms achieved a per-embolus sensitivity of 75% at 2 false positives per scan (fps) or of 70% at 1 fps, outperforming the state of the art. Deep learning approaches outperformed traditional machine learning ones, and their performance improved with the number of training cases. Significance: Through this work and challenge we have improved the state-of-the art of computer aided detection algorithms for pulmonary embolism. An open database and an evaluation benchmark for such algorithms have been generated, easing the development of further improvements. Implications on clinical practice will need further research.

As a lightweight and non-invasive imaging technique, lung ultrasound (LUS) has gained importance for assessing lung pathologies. The use of Artificial intelligence (AI) in medical decision support systems is promising due to the time- and expertise-intensive interpretation, however, due to the poor quality of existing data used for training AI models, their usability for real-world applications remains unclear. In a prospective study, we analyze data from 63 COVID-19 suspects (33 positive) collected at Maastricht University Medical Centre. Ultrasound recordings at six body locations were acquired following the BLUE protocol and manually labeled for severity of lung involvement. Several AI models were applied and trained for detection and severity of pulmonary infection. The severity of the lung infection, as assigned by human annotators based on the LUS videos, is not significantly different between COVID-19 positive and negative patients (p = 0.89). Nevertheless, the predictions of image-based AI models identify a COVID-19 infection with 65% accuracy when applied zero-shot (i.e., trained on other datasets), and up to 79% with targeted training, whereas the accuracy based on human annotations is at most 65%. Multi-modal models combining images and CBC improve significantly over image-only models. Although our analysis generally supports the value of AI in LUS assessment, the evaluated models fall short of the performance expected from previous work. We find this is due to 1) the heterogeneity of LUS datasets, limiting the generalization ability to new data, 2) the frame-based processing of AI models ignoring video-level information, and 3) lack of work on multi-modal models that can extract the most relevant information from video-, image- and variable-based inputs. To aid future research, we publish the dataset at: https://github.com/NinaWie/COVID-BLUES.

Background: Natural Language Processing (NLP) is widely used to extract clinical insights from Electronic Health Records (EHRs). However, the lack of annotated data, automated tools, and other challenges hinder the full utilisation of NLP for EHRs. Various Machine Learning (ML), Deep Learning (DL) and NLP techniques are studied and compared to understand the limitations and opportunities in this space comprehensively. Methodology: After screening 261 articles from 11 databases, we included 127 papers for full-text review covering seven categories of articles: 1) medical note classification, 2) clinical entity recognition, 3) text summarisation, 4) deep learning (DL) and transfer learning architecture, 5) information extraction, 6) Medical language translation and 7) other NLP applications. This study follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Result and Discussion: EHR was the most commonly used data type among the selected articles, and the datasets were primarily unstructured. Various ML and DL methods were used, with prediction or classification being the most common application of ML or DL. The most common use cases were: the International Classification of Diseases, Ninth Revision (ICD-9) classification, clinical note analysis, and named entity recognition (NER) for clinical descriptions and research on psychiatric disorders. Conclusion: We find that the adopted ML models were not adequately assessed. In addition, the data imbalance problem is quite important, yet we must find techniques to address this underlining problem. Future studies should address key limitations in studies, primarily identifying Lupus Nephritis, Suicide Attempts, perinatal self-harmed and ICD-9 classification.

Knowledge Graph (KG) plays a crucial role in Medical Report Generation (MRG) because it reveals the relations among diseases and thus can be utilized to guide the generation process. However, constructing a comprehensive KG is labor-intensive and its applications on the MRG process are under-explored. In this study, we establish a complete KG on chest X-ray imaging that includes 137 types of diseases and abnormalities. Based on this KG, we find that the current MRG data sets exhibit a long-tailed problem in disease distribution. To mitigate this problem, we introduce a novel augmentation strategy that enhances the representation of disease types in the tail-end of the distribution. We further design a two-stage MRG approach, where a classifier is first trained to detect whether the input images exhibit any abnormalities. The classified images are then independently fed into two transformer-based generators, namely, ``disease-specific generator" and ``disease-free generator" to generate the corresponding reports. To enhance the clinical evaluation of whether the generated reports correctly describe the diseases appearing in the input image, we propose diverse sensitivity (DS), a new metric that checks whether generated diseases match ground truth and measures the diversity of all generated diseases. Results show that the proposed two-stage generation framework and augmentation strategies improve DS by a considerable margin, indicating a notable reduction in the long-tailed problem associated with under-represented diseases.

Lung cancer is the deadliest type of cancer worldwide and late detection is the major factor for the low survival rate of patients. Low dose computed tomography has been suggested as a potential screening tool but manual screening is costly, time-consuming and prone to variability. This has fueled the development of automatic methods for the detection, segmentation and characterisation of pulmonary nodules but its application to clinical routine is challenging. In this study, a new database for the development and testing of pulmonary nodule computer-aided strategies is presented which intends to complement current databases by giving additional focus to radiologist variability and local clinical reality. State-of-the-art nodule detection, segmentation and characterization methods are tested and compared to manual annotations as well as collaborative strategies combining multiple radiologists and radiologists and computer-aided systems. It is shown that state-of-the-art methodologies can determine a patient's follow-up recommendation as accurately as a radiologist, though the nodule detection method used shows decreased performance in this database.