Daily Papers

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.

Large language models have demonstrated remarkable proficiency in long and complex reasoning tasks. However, they frequently exhibit a problematic reliance on familiar reasoning patterns, a phenomenon we term reasoning rigidity. Despite explicit instructions from users, these models often override clearly stated conditions and default to habitual reasoning trajectories, leading to incorrect conclusions. This behavior presents significant challenges, particularly in domains such as mathematics and logic puzzle, where precise adherence to specified constraints is critical. To systematically investigate reasoning rigidity, a behavior largely unexplored in prior work, we introduce a expert-curated diagnostic set, . Our dataset includes specially modified variants of existing mathematical benchmarks, namely AIME and MATH500, as well as well-known puzzles deliberately redesigned to require deviation from familiar reasoning strategies. Using this dataset, we identify recurring contamination patterns that occur when models default to ingrained reasoning. Specifically, we categorize this contamination into three distinctive modes: (i) Interpretation Overload, (ii) Input Distrust, and (iii) Partial Instruction Attention, each causing models to ignore or distort provided instructions. We publicly release our diagnostic set to facilitate future research on mitigating reasoning rigidity in language models.

Recent advances in large vision-language models have led to impressive performance in visual question answering and multimodal reasoning. However, it remains unclear whether these models genuinely perform grounded visual reasoning or rely on superficial patterns and dataset biases. In this work, we introduce MagiC, a comprehensive benchmark designed to evaluate grounded multimodal cognition, assessing not only answer accuracy but also the quality of step-by-step reasoning and its alignment with relevant visual evidence. Our benchmark includes approximately 5,500 weakly supervised QA examples generated from strong model outputs and 900 human-curated examples with fine-grained annotations, including answers, rationales, and bounding box groundings. We evaluate 15 vision-language models ranging from 7B to 70B parameters across four dimensions: final answer correctness, reasoning validity, grounding fidelity, and self-correction ability. MagiC further includes diagnostic settings to probe model robustness under adversarial visual cues and assess their capacity for introspective error correction. We introduce new metrics such as MagiScore and StepSense, and provide comprehensive analyses that reveal key limitations and opportunities in current approaches to grounded visual reasoning.

Omni-modal large language models (OLMs) redefine human-machine interaction by natively integrating audio, vision, and text. However, existing OLM benchmarks remain anchored to static, accuracy-centric tasks, leaving a critical gap in assessing social interactivity, the fundamental capacity to navigate dynamic cues in natural dialogues. To this end, we propose SocialOmni, a comprehensive benchmark that operationalizes the evaluation of this conversational interactivity across three core dimensions: (i) speaker separation and identification (who is speaking), (ii) interruption timing control (when to interject), and (iii) natural interruption generation (how to phrase the interruption). SocialOmni features 2,000 perception samples and a quality-controlled diagnostic set of 209 interaction-generation instances with strict temporal and contextual constraints, complemented by controlled audio-visual inconsistency scenarios to test model robustness. We benchmarked 12 leading OLMs, which uncovers significant variance in their social-interaction capabilities across models. Furthermore, our analysis reveals a pronounced decoupling between a model's perceptual accuracy and its ability to generate contextually appropriate interruptions, indicating that understanding-centric metrics alone are insufficient to characterize conversational social competence. More encouragingly, these diagnostics from SocialOmni yield actionable signals for bridging the perception-interaction divide in future OLMs.

In this work, we introduce MedAgentSim, an open-source simulated clinical environment with doctor, patient, and measurement agents designed to evaluate and enhance LLM performance in dynamic diagnostic settings. Unlike prior approaches, our framework requires doctor agents to actively engage with patients through multi-turn conversations, requesting relevant medical examinations (e.g., temperature, blood pressure, ECG) and imaging results (e.g., MRI, X-ray) from a measurement agent to mimic the real-world diagnostic process. Additionally, we incorporate self improvement mechanisms that allow models to iteratively refine their diagnostic strategies. We enhance LLM performance in our simulated setting by integrating multi-agent discussions, chain-of-thought reasoning, and experience-based knowledge retrieval, facilitating progressive learning as doctor agents interact with more patients. We also introduce an evaluation benchmark for assessing the LLM's ability to engage in dynamic, context-aware diagnostic interactions. While MedAgentSim is fully automated, it also supports a user-controlled mode, enabling human interaction with either the doctor or patient agent. Comprehensive evaluations in various simulated diagnostic scenarios demonstrate the effectiveness of our approach. Our code, simulation tool, and benchmark are available at https://medagentsim.netlify.app/.

Although Large Audio-Language Models (LALMs) deliver state-of-the-art (SOTA) performance, they frequently suffer from hallucinations, e.g. generating text not grounded in the audio input. We analyze these grounding failures and identify a distinct taxonomy: Event Omission, False Event Identity, Temporal Relation Error, and Quantitative Temporal Error. To address this, we introduce the AHA (Audio Hallucination Alignment) framework. By leveraging counterfactual hard negative mining, our pipeline constructs a high-quality preference dataset that forces models to distinguish strict acoustic evidence from linguistically plausible fabrications. Additionally, we establish AHA-Eval, a diagnostic benchmark designed to rigorously test these fine-grained temporal reasoning capabilities. We apply this data to align Qwen2.5-Omni. The resulting model, Qwen-Audio-AHA, achieves a 13.7% improvement on AHA-Eval. Crucially, this benefit generalizes beyond our diagnostic set. Our model shows substantial gains on public benchmarks, including 1.3% on MMAU-Test and 1.6% on MMAR, outperforming latest SOTA methods.

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

As data-science agents shift from co-pilots to auto-pilots, silent misframing becomes a critical failure mode. Agents quietly commit to plausible but unintended task framings, producing clean, executable artifacts that hide their incorrect assessment of the task. Existing benchmarks score whether the pipeline runs, ignoring whether the agent recognized the task was underspecified. We introduce Ambig-DS, two diagnostic suites: one for prediction-target ambiguity (Ambig-DS-Target, 51 tasks built on DSBench, a tabular modeling benchmark) and one for evaluation-objective ambiguity (Ambig-DS-Objective, 61 tasks built on MLE-bench, a Kaggle-style ML competition benchmark), constructed so that scoring uses each source benchmark's original evaluator. For every task we pair the original, fully specified version with an ambiguous variant produced by controlled edits; a human-and-LLM verification pipeline confirms each variant admits multiple plausible interpretations with decision-relevant consequences. The suites are analyzed independently and ambiguity lowers performance in both. Across five agents spanning efficient to frontier-class models, we find in our controlled diagnostic setting: (i) failures are silent commitments: wrong-target submissions on Target, wrong-metric or non-committal baseline submissions on Objective, rather than execution errors; (ii) allowing the agent to ask one clarifying question recovers much of the loss under idealized conditions, suggesting missing framing information drives a substantial part of the observed degradation; but (iii) agents cannot reliably tell when to use it: permissive prompts induce over-asking on clear tasks, while conservative prompts induce silent defaulting on ambiguous ones. Recognizing target and objective underspecification, not pipeline execution, is the bottleneck missing from standard DS-agent evaluations.

Large language models (LLMs) now perform strongly on many public math suites, yet frontier separation within mathematics increasingly suffers from ceiling effects. We present two complementary benchmarks: SKYLENAGE-ReasoningMATH, a 100-item, structure-aware diagnostic set with per-item metadata on length, numeric density, and symbolic complexity; and SKYLENAGE-MATH, a 150-item contest-style suite spanning four stages from high school to doctoral under a seven-subject taxonomy. We evaluate fifteen contemporary LLM variants under a single setup and analyze subject x model and grade x model performance. On the contest suite, the strongest model reaches 44% while the runner-up reaches 37%; accuracy declines from high school to doctoral, and top systems exhibit a doctoral-to-high-school retention near 79%. On the reasoning set, the best model attains 81% overall, and hardest-slice results reveal clear robustness gaps between leaders and the mid-tier. In summary, we release SKYLENAGE-ReasoningMATH and report aggregate results for SKYLENAGE-MATH; together, SKYLENAGE provides a hard, reasoning-centered and broadly covering math benchmark with calibrated difficulty and rich metadata, serving as a reference benchmark for future evaluations of mathematical reasoning.

Real-time recurrent learning (RTRL) for sequence-processing recurrent neural networks (RNNs) offers certain conceptual advantages over backpropagation through time (BPTT). RTRL requires neither caching past activations nor truncating context, and enables online learning. However, RTRL's time and space complexity make it impractical. To overcome this problem, most recent work on RTRL focuses on approximation theories, while experiments are often limited to diagnostic settings. Here we explore the practical promise of RTRL in more realistic settings. We study actor-critic methods that combine RTRL and policy gradients, and test them in several subsets of DMLab-30, ProcGen, and Atari-2600 environments. On DMLab memory tasks, our system trained on fewer than 1.2 B environmental frames is competitive with or outperforms well-known IMPALA and R2D2 baselines trained on 10 B frames. To scale to such challenging tasks, we focus on certain well-known neural architectures with element-wise recurrence, allowing for tractable RTRL without approximation. Importantly, we also discuss rarely addressed limitations of RTRL in real-world applications, such as its complexity in the multi-layer case.

In this work, we dive deep into one of the popular knowledge-grounded dialogue benchmarks that focus on faithfulness, FaithDial. We show that a significant portion of the FaithDial data contains annotation artifacts, which may bias models towards completely ignoring the conversation history. We therefore introduce CHARP, a diagnostic test set, designed for an improved evaluation of hallucinations in conversational model. CHARP not only measures hallucination but also the compliance of the models to the conversation task. Our extensive analysis reveals that models primarily exhibit poor performance on CHARP due to their inability to effectively attend to and reason over the conversation history. Furthermore, the evaluation methods of FaithDial fail to capture these shortcomings, neglecting the conversational history. Our findings indicate that there is substantial room for contribution in both dataset creation and hallucination evaluation for knowledge-grounded dialogue, and that CHARP can serve as a tool for monitoring the progress in this particular research area. CHARP is publicly available at https://huggingface.co/datasets/huawei-noah/CHARP

In this paper, we introduce an advanced Russian general language understanding evaluation benchmark -- RussianGLUE. Recent advances in the field of universal language models and transformers require the development of a methodology for their broad diagnostics and testing for general intellectual skills - detection of natural language inference, commonsense reasoning, ability to perform simple logical operations regardless of text subject or lexicon. For the first time, a benchmark of nine tasks, collected and organized analogically to the SuperGLUE methodology, was developed from scratch for the Russian language. We provide baselines, human level evaluation, an open-source framework for evaluating models (https://github.com/RussianNLP/RussianSuperGLUE), and an overall leaderboard of transformer models for the Russian language. Besides, we present the first results of comparing multilingual models in the adapted diagnostic test set and offer the first steps to further expanding or assessing state-of-the-art models independently of language.

We present EBench, a simulation benchmark that diagnoses generalist mobile manipulation policies beyond a single success-rate scalar. EBench comprises 26 diverse and challenging manipulation tasks annotated along 5 capability dimensions and 4 generalization dimensions. We evaluate state-of-the-art generalist manipulation models including π_0, π_{0.5}, XVLA, and InternVLA-A1, and reveal that models with near success rates exhibit strikingly different capability profiles: π_{0.5} achieves the highest test success rate and the best train--test retention, whereas InternVLA-A1 dominates mobile manipulation but collapses on dexterous tasks, and XVLA exhibits strengths on a disjoint set of atomic skills compared to other policies. Beyond capability profiling, EBench analyzes the generalization ability from 4 representative perspectives, identifying the impact of different distribution shift factors. The results reveal strengths and weaknesses of models behind an overall score. We hope this benchmark offers a broad set of diagnostic signals to guide iteration on generalist manipulation models.

Personalized presentation generation requires more than conditioning on a current prompt or template: agents must preserve stable user preferences across tasks, retain newly introduced preferences and constraints during multi-turn revision, and carry out local edits reliably. We propose MemSlides, a hierarchical memory framework for personalized presentation agents that separates long-term memory from working memory and further divides long-term memory into user profile memory and tool memory. User profile memory stores intent-conditioned profiles for round-0 personalization, working memory carries active preferences and session constraints across revision rounds, and tool memory stores reusable execution experience for reliable localized editing. MemSlides pairs this memory design with scoped slide-local revision, so targeted updates act on the smallest affected region instead of repeatedly regenerating the full deck. In controlled experiments, user profile memory improves persona-alignment judgments on a multi-persona, multi-intent profile bank, tool-memory injection improves closed-loop modify behavior in diagnostic matched-pair settings, and qualitative cases illustrate working memory's ability to carryover preferences. Taken together, these results suggest that effective personalization in presentation authoring depends on separating persistent user profiles, session-level working memory, and reusable execution experience across generation and localized revision.

Large language models (LLMs) show promise for clinical reasoning and decision support, but evaluation in realistic, electronic health record-congruent settings remains limited. Existing benchmarks often rely on static datasets or unstructured inputs that do not reflect the structured, interoperable data formats used in clinical systems. We introduce a pipeline for generating clinically realistic HL7 FHIR R4 bundles from unstructured text, enabling controllable evaluation of clinical decision support systems. The pipeline combines staged LLM generation with terminology-grounded validation and repair to reduce hallucinated codes and enforce structural and semantic consistency. Applying this approach to MedCaseReasoning, we construct MedCase-Structured, a synthetic dataset aligned with clinician-authored diagnostic cases, achieving valid FHIR generation for 82.5% of cases. Evaluation on MedCase-Structured reveals consistently lower diagnostic accuracy for LLMs on structured FHIR inputs than with plain text, highlighting the importance of deployment-aligned benchmarking.

Coronary angiography (CAG) is the gold-standard imaging modality for evaluating coronary artery disease, but its interpretation and subsequent treatment planning rely heavily on expert cardiologists. To enable AI-based decision support, we introduce a two-stage, physician-curated pipeline and a bilingual (Japanese/English) CAG image-report dataset. First, we sample 14,686 frames from 539 exams and annotate them for key-frame detection and left/right laterality; a ConvNeXt-Base CNN trained on this data achieves 0.96 F1 on laterality classification, even on low-contrast frames. Second, we apply the CNN to 243 independent exams, extract 1,114 key frames, and pair each with its pre-procedure report and expert-validated diagnostic and treatment summary, yielding a parallel corpus. We then fine-tune three open-source VLMs (PaliGemma2, Gemma3, and ConceptCLIP-enhanced Gemma3) via LoRA and evaluate them using VLScore and cardiologist review. Although PaliGemma2 w/LoRA attains the highest VLScore, Gemma3 w/LoRA achieves the top clinician rating (mean 7.20/10); we designate this best-performing model as CAG-VLM. These results demonstrate that specialized, fine-tuned VLMs can effectively assist cardiologists in generating clinical reports and treatment recommendations from CAG images.

Given the clinical notes written in electronic health records (EHRs), it is challenging to predict the diagnostic codes which is formulated as a multi-label classification task. The large set of labels, the hierarchical dependency, and the imbalanced data make this prediction task extremely hard. Most existing work built a binary prediction for each label independently, ignoring the dependencies between labels. To address this problem, we propose a two-stage framework to improve automatic ICD coding by capturing the label correlation. Specifically, we train a label set distribution estimator to rescore the probability of each label set candidate generated by a base predictor. This paper is the first attempt at learning the label set distribution as a reranking module for medical code prediction. In the experiments, our proposed framework is able to improve upon best-performing predictors on the benchmark MIMIC datasets. The source code of this project is available at https://github.com/MiuLab/ICD-Correlation.

Some security-development settings require local models that map an objective to an ordered, checkable plan. We present a low-rank decomposition adapter and release a case-disjoint corpus with 24 authored decompositions and 83 derived next-step examples across 24 satellite-security cases. To prevent reference-plan leakage, prompts contain one objective and eight shuffled SPARTA candidates. The evaluation candidate sets are constructed with oracle inclusion of every reference technique, so this study measures selection from a controlled set, not retrieval. On six fixed cases and five decoding seeds, mean scores vary across adapters and prompted Qwen2.5 baselines; a separate greedy check over three adapter training seeds shows non-negligible training variance. A 24-fold greedy leave-one-case-out control at the two compact sizes likewise shows tradeoffs: at 1.5B, adapter precision is 0.583 against 0.480 for two-shot prompting, while recall is 0.586 against 0.660. Case-resampling intervals for adapter precision relative to the strongest prompted baseline cross zero at 1.5B and 7B. The adapter is also substantially more format-compliant, which prevents attributing all score differences to selection. Autoregressive next-step accuracy is 0.08, 0.06, and 0.29 at 0.5B, 1.5B, and 7B. We therefore offer the formulation, leakage-controlled dataset, reproducibility package, and descriptive analysis as a proof of concept, not evidence of a reliable stand-alone decomposition system or a general adapter advantage. A separate diagnostic tests contract reuse.

Neural text-to-SQL models have achieved remarkable performance in translating natural language questions into SQL queries. However, recent studies reveal that text-to-SQL models are vulnerable to task-specific perturbations. Previous curated robustness test sets usually focus on individual phenomena. In this paper, we propose a comprehensive robustness benchmark based on Spider, a cross-domain text-to-SQL benchmark, to diagnose the model robustness. We design 17 perturbations on databases, natural language questions, and SQL queries to measure the robustness from different angles. In order to collect more diversified natural question perturbations, we utilize large pretrained language models (PLMs) to simulate human behaviors in creating natural questions. We conduct a diagnostic study of the state-of-the-art models on the robustness set. Experimental results reveal that even the most robust model suffers from a 14.0% performance drop overall and a 50.7% performance drop on the most challenging perturbation. We also present a breakdown analysis regarding text-to-SQL model designs and provide insights for improving model robustness.

Robust benchmarks are crucial for evaluating Multimodal Large Language Models (MLLMs). Yet we find that models can ace many multimodal benchmarks without strong visual understanding, instead exploiting biases, linguistic priors, and superficial patterns. This is especially problematic for vision-centric benchmarks that are meant to require visual inputs. We adopt a diagnostic principle for benchmark design: if a benchmark can be gamed, it will be. Designers should therefore try to ``game'' their own benchmarks first, using diagnostic and debiasing procedures to systematically identify and mitigate non-visual biases. Effective diagnosis requires directly ``training on the test set'' -- probing the released test set for its intrinsic, exploitable patterns. We operationalize this standard with two components. First, we diagnose benchmark susceptibility using a ``Test-set Stress-Test'' (TsT) methodology. Our primary diagnostic tool involves fine-tuning a powerful Large Language Model via k-fold cross-validation on exclusively the non-visual, textual inputs of the test set to reveal shortcut performance and assign each sample a bias score s(x). We complement this with a lightweight Random Forest-based diagnostic operating on hand-crafted features for fast, interpretable auditing. Second, we debias benchmarks by filtering high-bias samples using an ``Iterative Bias Pruning'' (IBP) procedure. Applying this framework to four benchmarks -- VSI-Bench, CV-Bench, MMMU, and VideoMME -- we uncover pervasive non-visual biases. As a case study, we apply our full framework to create VSI-Bench-Debiased, demonstrating reduced non-visual solvability and a wider vision-blind performance gap than the original.

Vision-Language Models (VLMs) frequently "hallucinate" - generate plausible yet factually incorrect statements - posing a critical barrier to their trustworthy deployment. In this work, we propose a new paradigm for diagnosing hallucinations, recasting them from static output errors into dynamic pathologies of a model's computational cognition. Our framework is grounded in a normative principle of computational rationality, allowing us to model a VLM's generation as a dynamic cognitive trajectory. We design a suite of information-theoretic probes that project this trajectory onto an interpretable, low-dimensional Cognitive State Space. Our central discovery is a governing principle we term the geometric-information duality: a cognitive trajectory's geometric abnormality within this space is fundamentally equivalent to its high information-theoretic surprisal. Hallucination detection is counts as a geometric anomaly detection problem. Evaluated across diverse settings - from rigorous binary QA (POPE) and comprehensive reasoning (MME) to unconstrained open-ended captioning (MS-COCO) - our framework achieves state-of-the-art performance. Crucially, it operates with high efficiency under weak supervision and remains highly robust even when calibration data is heavily contaminated. This approach enables a causal attribution of failures, mapping observable errors to distinct pathological states: perceptual instability (measured by Perceptual Entropy), logical-causal failure (measured by Inferential Conflict), and decisional ambiguity (measured by Decision Entropy). Ultimately, this opens a path toward building AI systems whose reasoning is transparent, auditable, and diagnosable by design.

Large language model-based web agents have demonstrated strong performance on realistic web interaction tasks. However, existing evaluations are predominantly conducted under relatively stable and well-behaved interaction conditions, which may overestimate agent robustness. High task success in such idealized settings does not necessarily reflect performance under realistic web interaction. To address this limitation, we introduce a diagnostic stress-testing benchmark for web agents. We first construct realistic and controllable web environments that provide clean and stable interaction workflows as reference baselines. We then introduce structured and controlled perturbations that emulate interaction variability, including shifting layouts, altered interaction semantics, and execution disruptions. By comparing agent behavior between clean and perturbed settings, our framework enables systematic diagnosis of robustness under what-if interaction scenarios. Through extensive evaluation of state-of-the-art multimodal web agents, we show that stress-based evaluation exposes failure modes and substantial robustness gaps that remain hidden under clean benchmark conditions.

We introduce EgoSchema, a very long-form video question-answering dataset, and benchmark to evaluate long video understanding capabilities of modern vision and language systems. Derived from Ego4D, EgoSchema consists of over 5000 human curated multiple choice question answer pairs, spanning over 250 hours of real video data, covering a very broad range of natural human activity and behavior. For each question, EgoSchema requires the correct answer to be selected between five given options based on a three-minute-long video clip. While some prior works have proposed video datasets with long clip lengths, we posit that merely the length of the video clip does not truly capture the temporal difficulty of the video task that is being considered. To remedy this, we introduce temporal certificate sets, a general notion for capturing the intrinsic temporal understanding length associated with a broad range of video understanding tasks & datasets. Based on this metric, we find EgoSchema to have intrinsic temporal lengths over 5.7x longer than the second closest dataset and 10x to 100x longer than any other video understanding dataset. Further, our evaluation of several current state-of-the-art video and language models shows them to be severely lacking in long-term video understanding capabilities. Even models with several billions of parameters achieve QA accuracy less than 33% (random is 20%) on the EgoSchema multi-choice question answering task, while humans achieve about 76% accuracy. We posit that {}, with its long intrinsic temporal structures and diverse complexity, would serve as a valuable evaluation probe for developing effective long-term video understanding systems in the future. Data and Zero-shot model evaluation code are open-sourced for both public and commercial use under the Ego4D license at http://egoschema.github.io

Vision-Language-Action (VLA) models achieve strong performance in robotic manipulation by leveraging pre-trained vision-language backbones. However, in downstream robotic settings, they are typically fine-tuned with limited data, leading to overfitting to specific instruction formulations and leaving robustness to paraphrased instructions underexplored. To study this gap, we introduce LIBERO-Para, a controlled benchmark that independently varies action expressions and object references for fine-grained analysis of linguistic generalization. Across seven VLA configurations (0.6B-7.5B), we observe consistent performance degradation of 22-52 pp under paraphrasing. This degradation is primarily driven by object-level lexical variation: even simple synonym substitutions cause large drops, indicating reliance on surface-level matching rather than semantic grounding. Moreover, 80-96% of failures arise from planning-level trajectory divergence rather than execution errors, showing that paraphrasing disrupts task identification. Binary success rate treats all paraphrases equally, obscuring whether models perform consistently across difficulty levels or rely on easier cases. To address this, we propose PRIDE, a metric that quantifies paraphrase difficulty using semantic and syntactic factors. Our benchmark and corresponding code are available at: https://github.com/cau-hai-lab/LIBERO-Para

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.

The rapid progress of multimodal large language models (MLLMs) has led to increasing interest in agent-based systems. While most prior work in medical imaging concentrates on automating routine clinical workflows, we study an underexplored yet clinically significant setting: distinguishing visually hard-to-separate diseases in a zero-shot setting. We benchmark representative agents on two imaging-only proxy diagnostic tasks, (1) melanoma vs. atypical nevus and (2) pulmonary edema vs. pneumonia, where visual features are highly confounded despite substantial differences in clinical management. We introduce a multi-agent framework based on contrastive adjudication. Experimental results show improved diagnostic performance (an 11-percentage-point gain in accuracy on dermoscopy data) and reduced unsupported claims on qualitative samples, although overall performance remains insufficient for clinical deployment. We acknowledge the inherent uncertainty in human annotations and the absence of clinical context, which further limit the translation to real-world settings. Within this controlled setting, this pilot study provides preliminary insights into zero-shot agent performance in visually confounded scenarios.

Blueshifted absorption is the classic spectroscopic signature of an accretion disc wind in X-ray binaries and cataclysmic variables (CVs). However, outflows can also create pure emission lines, especially at optical wavelengths. Therefore, developing other outflow diagnostics for these types of lines is worthwhile. With this in mind, we construct a systematic grid of 3645 synthetic wind-formed H-alpha line profiles for CVs with the radiative transfer code SIROCCO. Our grid yields a variety of line shapes: symmetric, asymmetric, single- to quadruple-peaked, and even P-Cygni profiles. About 20% of these lines -- our `Gold' sample -- have strengths and widths consistent with observations. We use this grid to test a recently proposed method for identifying wind-formed emission lines based on deviations in the wing profile shape: the `excess equivalent width diagnostic diagram'. We find that our `Gold' sample can preferentially populate the suggested `wind regions' of this diagram. However, the method is highly sensitive to the adopted definition of the line profile `wing'. Hence, we propose a refined definition based on the full-width at half maximum to improve the interpretability of the diagnostic diagram. Furthermore, we define an approximate scaling relation for the strengths of wind-formed CV emission lines in terms of the outflow parameters. This relation provides a fast way to assess whether -- and what kind of -- outflow can produce an observed emission line. All our wind-based models are open-source and we provide an easy-to-use web-based tool to browse our full set of H-alpha spectral profiles.

At the heart of medicine lies the physician-patient dialogue, where skillful history-taking paves the way for accurate diagnosis, effective management, and enduring trust. Artificial Intelligence (AI) systems capable of diagnostic dialogue could increase accessibility, consistency, and quality of care. However, approximating clinicians' expertise is an outstanding grand challenge. Here, we introduce AMIE (Articulate Medical Intelligence Explorer), a Large Language Model (LLM) based AI system optimized for diagnostic dialogue. AMIE uses a novel self-play based simulated environment with automated feedback mechanisms for scaling learning across diverse disease conditions, specialties, and contexts. We designed a framework for evaluating clinically-meaningful axes of performance including history-taking, diagnostic accuracy, management reasoning, communication skills, and empathy. We compared AMIE's performance to that of primary care physicians (PCPs) in a randomized, double-blind crossover study of text-based consultations with validated patient actors in the style of an Objective Structured Clinical Examination (OSCE). The study included 149 case scenarios from clinical providers in Canada, the UK, and India, 20 PCPs for comparison with AMIE, and evaluations by specialist physicians and patient actors. AMIE demonstrated greater diagnostic accuracy and superior performance on 28 of 32 axes according to specialist physicians and 24 of 26 axes according to patient actors. Our research has several limitations and should be interpreted with appropriate caution. Clinicians were limited to unfamiliar synchronous text-chat which permits large-scale LLM-patient interactions but is not representative of usual clinical practice. While further research is required before AMIE could be translated to real-world settings, the results represent a milestone towards conversational diagnostic AI.

Acute poly-substance intoxication requires rapid, life-saving decisions under substantial uncertainty, as clinicians must rely on incomplete ingestion details and nonspecific symptoms. Effective diagnostic reasoning in this chaotic environment requires fusing unstructured, non-medical narratives (e.g. paramedic scene descriptions and unreliable patient self-reports or known histories), with structured medical data like vital signs. While Large Language Models (LLMs) show potential for processing such heterogeneous inputs, they struggle in this setting, often underperforming simple baselines that rely solely on patient histories. To address this, we present DeToxR (Decision-support for Toxicology with Reasoning), the first adaptation of Reinforcement Learning (RL) to emergency toxicology. We design a robust data-fusion engine for multi-label prediction across 14 substance classes based on an LLM finetuned with Group Relative Policy Optimization (GRPO). We optimize the model's reasoning directly using a clinical performance reward. By formulating a multi-label agreement metric as the reward signal, the model is explicitly penalized for missing co-ingested substances and hallucinating absent poisons. Our model significantly outperforms its unadapted base LLM counterpart and supervised baselines. Furthermore, in a clinical validation study, the model indicates a clinical advantage by outperforming an expert toxicologist in identifying the correct poisons (Micro-F1: 0.644 vs. 0.473). These results demonstrate the potential of RL-aligned LLMs to synthesize unstructured pre-clinical narratives and structured medical data for decision support in high-stakes environments.

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.

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.

State-of-the-art visual grounding models can achieve high detection accuracy, but they are not designed to distinguish between all objects versus only certain objects of interest. In natural language, in order to specify a particular object or set of objects of interest, humans use determiners such as "my", "either" and "those". Determiners, as an important word class, are a type of schema in natural language about the reference or quantity of the noun. Existing grounded referencing datasets place much less emphasis on determiners, compared to other word classes such as nouns, verbs and adjectives. This makes it difficult to develop models that understand the full variety and complexity of object referencing. Thus, we have developed and released the DetermiNet dataset , which comprises 250,000 synthetically generated images and captions based on 25 determiners. The task is to predict bounding boxes to identify objects of interest, constrained by the semantics of the given determiner. We find that current state-of-the-art visual grounding models do not perform well on the dataset, highlighting the limitations of existing models on reference and quantification tasks.

We introduce MentalBench, a benchmark for evaluating psychiatric diagnostic decision-making in large language models (LLMs). Existing mental health benchmarks largely rely on social media data, limiting their ability to assess DSM-grounded diagnostic judgments. At the core of MentalBench is MentalKG, a psychiatrist-built and validated knowledge graph encoding DSM-5 diagnostic criteria and differential diagnostic rules for 23 psychiatric disorders. Using MentalKG as a golden-standard logical backbone, we generate 24,750 synthetic clinical cases that systematically vary in information completeness and diagnostic complexity, enabling low-noise and interpretable evaluation. Our experiments show that while state-of-the-art LLMs perform well on structured queries probing DSM-5 knowledge, they struggle to calibrate confidence in diagnostic decision-making when distinguishing between clinically overlapping disorders. These findings reveal evaluation gaps not captured by existing benchmarks.

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.

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.

Benchmarks within the OpenClaw ecosystem have thus far evaluated exclusively assistant-level tasks, leaving the academic-level capabilities of OpenClaw largely unexamined. We introduce AcademiClaw, a bilingual benchmark of 80 complex, long-horizon tasks sourced directly from university students' real academic workflows -- homework, research projects, competitions, and personal projects -- that they found current AI agents unable to solve effectively. Curated from 230 student-submitted candidates through rigorous expert review, the final task set spans 25+ professional domains, ranging from olympiad-level mathematics and linguistics problems to GPU-intensive reinforcement learning and full-stack system debugging, with 16 tasks requiring CUDA GPU execution. Each task executes in an isolated Docker sandbox and is scored on task completion by multi-dimensional rubrics combining six complementary techniques, with an independent five-category safety audit providing additional behavioral analysis. Experiments on six frontier models show that even the best achieves only a 55\% pass rate. Further analysis uncovers sharp capability boundaries across task domains, divergent behavioral strategies among models, and a disconnect between token consumption and output quality, providing fine-grained diagnostic signals beyond what aggregate metrics reveal. We hope that AcademiClaw and its open-sourced data and code can serve as a useful resource for the OpenClaw community, driving progress toward agents that are more capable and versatile across the full breadth of real-world academic demands. All data and code are available at https://github.com/GAIR-NLP/AcademiClaw.

Alignment tuning is meant to make harmful-request refusal robust, yet this safety behavior can be erased by a small set of benign fine-tuning examples. This is a deployment risk for open-weight models because a checkpoint can pass refusal tests at release time and later lose refusal under low-cost downstream fine-tuning. Prior work has established these refusal failures, but existing studies do not show how to detect this fragility in the aligned model itself before an attack or fine-tuning intervention is run. We introduce Skin-Deep, a geometric diagnostic that detects alignment fragility directly from the aligned model's hidden-state activations before such an intervention is run and compresses the layer-wise safety geometry into a single scalar, the Geometric Fragility Score (GFS). Applied to twenty-one instruction-tuned models spanning six alignment recipes and 3B--32B parameters, Skin-Deep reveals a recurring low-rank safety subspace across model families. Direction ablations show that removing directions in this subspace weakens harmful-request refusal, providing causal evidence that the recovered geometry underlies refusal behavior. Crucially, GFS identifies, before any fine-tuning, the initially safe model that retains the most refusal after small-scale LoRA fine-tuning. These results establish GFS as a practical pre-deployment diagnostic for flagging fragile refusal behavior without running an attack.

Dynamic graph learning methods have recently emerged as powerful tools for modelling relational data evolving through time. However, despite extensive benchmarking efforts, it remains unclear whether current Temporal Graph Neural Networks (TGNNs) effectively capture core temporal patterns such as periodicity, cause-and-effect, and long-range dependencies. In this work, we introduce the Temporal Graph Reasoning Benchmark (T-GRAB), a comprehensive set of synthetic tasks designed to systematically probe the capabilities of TGNNs to reason across time. T-GRAB provides controlled, interpretable tasks that isolate key temporal skills: counting/memorizing periodic repetitions, inferring delayed causal effects, and capturing long-range dependencies over both spatial and temporal dimensions. We evaluate 11 temporal graph learning methods on these tasks, revealing fundamental shortcomings in their ability to generalize temporal patterns. Our findings offer actionable insights into the limitations of current models, highlight challenges hidden by traditional real-world benchmarks, and motivate the development of architectures with stronger temporal reasoning abilities. The code for T-GRAB can be found at: https://github.com/alirezadizaji/T-GRAB.

Accurate diagnostic coding of medical notes is crucial for enhancing patient care, medical research, and error-free billing in healthcare organizations. Manual coding is a time-consuming task for providers, and diagnostic codes often exhibit low sensitivity and specificity, whereas the free text in medical notes can be a more precise description of a patients status. Thus, accurate automated diagnostic coding of medical notes has become critical for a learning healthcare system. Recent developments in long-document transformer architectures have enabled attention-based deep-learning models to adjudicate medical notes. In addition, contrastive loss functions have been used to jointly pre-train large language and image models with noisy labels. To further improve the automated adjudication of medical notes, we developed an approach based on i) models for ICD-10 diagnostic code sequences using a large real-world data set, ii) large language models for medical notes, and iii) contrastive pre-training to build an integrated model of both ICD-10 diagnostic codes and corresponding medical text. We demonstrate that a contrastive approach for pre-training improves performance over prior state-of-the-art models for the MIMIC-III-50, MIMIC-III-rare50, and MIMIC-III-full diagnostic coding tasks.

Recent advances in semi-supervised semantic segmentation have been heavily reliant on pseudo labeling to compensate for limited labeled data, disregarding the valuable relational knowledge among semantic concepts. To bridge this gap, we devise LogicDiag, a brand new neural-logic semi-supervised learning framework. Our key insight is that conflicts within pseudo labels, identified through symbolic knowledge, can serve as strong yet commonly ignored learning signals. LogicDiag resolves such conflicts via reasoning with logic-induced diagnoses, enabling the recovery of (potentially) erroneous pseudo labels, ultimately alleviating the notorious error accumulation problem. We showcase the practical application of LogicDiag in the data-hungry segmentation scenario, where we formalize the structured abstraction of semantic concepts as a set of logic rules. Extensive experiments on three standard semi-supervised semantic segmentation benchmarks demonstrate the effectiveness and generality of LogicDiag. Moreover, LogicDiag highlights the promising opportunities arising from the systematic integration of symbolic reasoning into the prevalent statistical, neural learning approaches.

Bias in Large Language Models (LLMs) significantly undermines their reliability and fairness. We focus on a common form of bias: when two reference concepts in the model's concept space, such as sentiment polarities (e.g., "positive" and "negative"), are asymmetrically correlated with a third, target concept, such as a reviewing aspect, the model exhibits unintended bias. For instance, the understanding of "food" should not skew toward any particular sentiment. Existing bias evaluation methods assess behavioral differences of LLMs by constructing labeled data for different social groups and measuring model responses across them, a process that requires substantial human effort and captures only a limited set of social concepts. To overcome these limitations, we propose BiasLens, a test-set-free bias analysis framework based on the structure of the model's vector space. BiasLens combines Concept Activation Vectors (CAVs) with Sparse Autoencoders (SAEs) to extract interpretable concept representations, and quantifies bias by measuring the variation in representational similarity between the target concept and each of the reference concepts. Even without labeled data, BiasLens shows strong agreement with traditional bias evaluation metrics (Spearman correlation r > 0.85). Moreover, BiasLens reveals forms of bias that are difficult to detect using existing methods. For example, in simulated clinical scenarios, a patient's insurance status can cause the LLM to produce biased diagnostic assessments. Overall, BiasLens offers a scalable, interpretable, and efficient paradigm for bias discovery, paving the way for improving fairness and transparency in LLMs.

Code agents increasingly help developers work with unfamiliar repositories, but every such task depends on a costly prerequisite: bootstrapping the repository into a usable development state. This process requires substantial trial-and-error exploration, yet the resulting knowledge--resolved dependencies, repair strategies--stays trapped in a single conversation, unavailable to future agents. We therefore formulate repository bootstrapping as a reusable startup knowledge problem and introduce BootstrapAgent, a multi-agent framework that distills the heuristics discovered during bootstrap exploration into a persistent, verifiable, agent-consumable .bootstrap contract. Through evidence extraction, structured planning, deterministic Docker-based verification, and trace-driven repair, BootstrapAgent generates a contract covering environment setup, diagnostic checks, minimal verification, and accumulated repair knowledge. We further propose warm repair with clean replay to accelerate iterative debugging without sacrificing cold-start reproducibility, and a delta repair with sanity check to prevent reward hacking. Experiments on three benchmarks show that BootstrapAgent achieves a 92.9% success rate, outperforming the baseline by over 10% while reducing downstream agent token usage by 25.9% and build time by 22.3%. Our code is available at https://github.com/Vossera/BootstrapAgent.

Planning is central to LLM agents: before acting, an agent must decompose goals, select tools, reason over constraints, and decide when a task is infeasible. Yet existing agent evaluations often report only end-to-end success, making it difficult to determine whether failures stem from planning or execution. We introduce Agent Planning Benchmark (APB), a planning-specific diagnostic benchmark with 4,209 multimodal cases across 22 domains and five settings, covering holistic planning, feedback-conditioned step-wise planning, and robustness under extraneous tools, broken tools, and unsolvable tasks. Across 12 MLLMs, APB reveals systematic weaknesses in long-horizon planning, tool-noise robustness, calibrated refusal, and inference-time refinement. We further validate APB on 200 ToolSandbox tasks and 200 τ^2-bench tasks, where APB-guided refinement consistently improves plan correctness, plan grade, and downstream execution metrics across three representative models. APB thus serves as an upstream diagnostic complement to execution benchmarks. The APB benchmark and code are available in https://github.com/Mikivishy/AgentPlanningBenchmark{this URL}.

Electrocardiography plays a central role in cardiovascular diagnostics, yet existing automated approaches often struggle to generalize across clinical tasks and offer limited support for open-ended reasoning. We present DiagECG, a novel framework that integrates time-series and language modeling by enabling large language models to process 12-lead ECG signals for clinical text generation tasks. Our approach discretizes continuous ECG embeddings into symbolic tokens using a lead-independent encoder and quantization module. These tokens are then used to extend the vocabulary of LLM, allowing the model to handle both ECG and natural language inputs in a unified manner. To bridge the modality gap, we pretrain the model on an autoregressive ECG forecasting task, enabling the LLM to model temporal dynamics using its native language modeling capabilities. Finally, we perform instruction tuning on both ECG question answering and diagnostic report generation. Without modifying the core model, DiagECG achieves strong performance across tasks while maintaining generalization to out-of-distribution settings. Extensive experiments demonstrate the effectiveness of each component and highlight the potential of integrating symbolic ECG representations into LLMs for medical reasoning.

Although large multimodal models (LMMs) have demonstrated remarkable capabilities in visual scene interpretation and reasoning, their capacity for complex and precise 3-dimensional spatial reasoning remains uncertain. Existing benchmarks focus predominantly on 2D spatial understanding and lack a framework to comprehensively evaluate 6D spatial reasoning across varying complexities. To address this limitation, we present PulseCheck457, a scalable and unbiased synthetic dataset designed with 4 key capability for spatial reasoning: multi-object recognition, 2D location, 3D location, and 3D orientation. We develop a cascading evaluation structure, constructing 7 question types across 5 difficulty levels that range from basic single object recognition to our new proposed complex 6D spatial reasoning tasks. We evaluated various large multimodal models (LMMs) on PulseCheck457, observing a general decline in performance as task complexity increases, particularly in 3D reasoning and 6D spatial tasks. To quantify these challenges, we introduce the Relative Performance Dropping Rate (RPDR), highlighting key weaknesses in 3D reasoning capabilities. Leveraging the unbiased attribute design of our dataset, we also uncover prediction biases across different attributes, with similar patterns observed in real-world image settings.

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.

Retrieval-augmented generation (RAG) under a fixed reader-context budget forces a selection problem: of the evidence retrieved, only a fraction can be shown to the reader. We argue that document recall -- the standard retrieval metric -- is the wrong quantity to optimize in this regime, and we make two contributions. First, as a general contribution, we introduce answer-in-context, a diagnostic that measures whether a gold answer survives as a contiguous span in the packed reader context (not the retrieved set). It predicts answer F1 better than recall (r=0.39-0.55 vs. about 0.31), separates answer quality roughly five-fold (0.60 vs. 0.12 on HotpotQA), and carries information beyond retrieval: it adds Delta R squared=0.17 over recall and shows a 4.6x EM gap even among questions where all gold was retrieved. We also confirm it interventionally: on 2WikiMultiHopQA a packing change that raises coverage but not answer-in-context yields no accuracy gain. Second, as a conditional contribution, we cast reader-context construction as budgeted monotone submodular maximization and build a packer that jointly optimizes relevance, query coverage, representativeness, and diversity. On HotpotQA with a 160-token budget and a 3B reader it beats a strong focused heuristic, MMR, and naive packing -- by up to +5.1 F1 at equal-or-lower token cost, across three seeds. Crucially, we map the scope of this win honestly: it requires the conjunction of (i) multi-hop complementary structure, (ii) retrieval that surfaces the evidence, (iii) a binding but not extreme budget, and (iv) a reader weak enough that evidence density, not reading capacity, is the bottleneck. A quantization-controlled reader-scale ladder (3B to 7B to 14B) shows the edge over the heuristic is absorbed by 7B and significantly reverses by 14B, while the diagnostic explains every boundary with a single variable.

Vision-Language Models (VLMs) show promise in medical image analysis, yet their capacity for structured reasoning in complex domains like dermatology is often limited by data scarcity and the high computational cost of advanced training techniques. To address these challenges, we introduce DermIQ-VLM, a VLM developed through a multi-stage, resource-efficient methodology designed to emulate a dermatologist's diagnostic process. Our primary contribution is a modified version of Grouped Relative Policy Optimization (GRPO), called GRPO++, which stabilizes the powerful but data-intensive GRPO framework. Our proposed training pipeline first employs GRPO++ for reasoning-oriented disease recognition, followed by supervised fine-tuning for conversational ability. To mitigate factual errors introduced during this step, we then align the model using Direct Preference Optimization (DPO), leveraging a Knowledge Graph-based system as a scalable proxy for expert preference. A preliminary evaluation on a curated dermatological dataset demonstrates that our proposed methodology yields notable performance gains over standard fine-tuning approaches. These findings validate the potential of our pipeline as a feasible pathway for developing specialized, reliable VLMs in resource-constrained environments.

Retrieval-Augmented Generation (RAG) extends large language models (LLMs) beyond parametric knowledge, yet it is unclear when iterative retrieval-reasoning loops meaningfully outperform static RAG, particularly in scientific domains with multi-hop reasoning, sparse domain knowledge, and heterogeneous evidence. We provide the first controlled, mechanism-level diagnostic study of whether synchronized iterative retrieval and reasoning can surpass an idealized static upper bound (Gold Context) RAG. We benchmark eleven state-of-the-art LLMs under three regimes: (i) No Context, measuring reliance on parametric memory; (ii) Gold Context, where all oracle evidence is supplied at once; and (iii) Iterative RAG, a training-free controller that alternates retrieval, hypothesis refinement, and evidence-aware stopping. Using the chemistry-focused ChemKGMultiHopQA dataset, we isolate questions requiring genuine retrieval and analyze behavior with diagnostics spanning retrieval coverage gaps, anchor-carry drop, query quality, composition fidelity, and control calibration. Across models, Iterative RAG consistently outperforms Gold Context, with gains up to 25.6 percentage points, especially for non-reasoning fine-tuned models. Staged retrieval reduces late-hop failures, mitigates context overload, and enables dynamic correction of early hypothesis drift, but remaining failure modes include incomplete hop coverage, distractor latch trajectories, early stopping miscalibration, and high composition failure rates even with perfect retrieval. Overall, staged retrieval is often more influential than the mere presence of ideal evidence; we provide practical guidance for deploying and diagnosing RAG systems in specialized scientific settings and a foundation for more reliable, controllable iterative retrieval-reasoning frameworks.

Medical Visual Question Answering (Med-VQA) holds significant potential for clinical decision support, yet existing efforts primarily focus on 2D imaging with limited task diversity. This paper presents 3D-RAD, a large-scale dataset designed to advance 3D Med-VQA using radiology CT scans. The 3D-RAD dataset encompasses six diverse VQA tasks: anomaly detection, image observation, medical computation, existence detection, static temporal diagnosis, and longitudinal temporal diagnosis. It supports both open- and closed-ended questions while introducing complex reasoning challenges, including computational tasks and multi-stage temporal analysis, to enable comprehensive benchmarking. Extensive evaluations demonstrate that existing vision-language models (VLMs), especially medical VLMs exhibit limited generalization, particularly in multi-temporal tasks, underscoring the challenges of real-world 3D diagnostic reasoning. To drive future advancements, we release a high-quality training set 3D-RAD-T of 136,195 expert-aligned samples, showing that fine-tuning on this dataset could significantly enhance model performance. Our dataset and code, aiming to catalyze multimodal medical AI research and establish a robust foundation for 3D medical visual understanding, are publicly available at https://github.com/Tang-xiaoxiao/3D-RAD.

Understanding uncertainty in chain-of-thought reasoning is critical for reliable deployment of large language models. In this work, we propose a simple yet effective diagnostic approach based on trajectory shape rather than scalar magnitude. We show that this signal is practical, interpretable, and inexpensive to obtain in black-box settings, while remaining robust across models and datasets. Through extensive ablations and cross-domain replications, we demonstrate its utility for selective prediction and triage. Our findings offer a generalizable insight into uncertainty dynamics in reasoning tasks, with particular focus on numeric and discrete-answer settings.

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.

Deep learning-based electrocardiogram (ECG) classification has shown impressive performance but clinical adoption has been slowed by the lack of transparent and faithful explanations. Post hoc methods such as saliency maps may fail to reflect a model's true decision process. Prototype-based reasoning offers a more transparent alternative by grounding decisions in similarity to learned representations of real ECG segments, enabling faithful, case-based explanations. We introduce ProtoECGNet, a prototype-based deep learning model for interpretable, multi-label ECG classification. ProtoECGNet employs a structured, multi-branch architecture that reflects clinical interpretation workflows: it integrates a 1D CNN with global prototypes for rhythm classification, a 2D CNN with time-localized prototypes for morphology-based reasoning, and a 2D CNN with global prototypes for diffuse abnormalities. Each branch is trained with a prototype loss designed for multi-label learning, combining clustering, separation, diversity, and a novel contrastive loss that encourages appropriate separation between prototypes of unrelated classes while allowing clustering for frequently co-occurring diagnoses. We evaluate ProtoECGNet on all 71 diagnostic labels from the PTB-XL dataset, demonstrating competitive performance relative to state-of-the-art black-box models while providing structured, case-based explanations. To assess prototype quality, we conduct a structured clinician review of the final model's projected prototypes, finding that they are rated as representative and clear. ProtoECGNet shows that prototype learning can be effectively scaled to complex, multi-label time-series classification, offering a practical path toward transparent and trustworthy deep learning models for clinical decision support.

Bankart lesions, or anterior-inferior glenoid labral tears, are diagnostically challenging on standard MRIs due to their subtle imaging features-often necessitating invasive MRI arthrograms (MRAs). This study develops deep learning (DL) models to detect Bankart lesions on both standard MRIs and MRAs, aiming to improve diagnostic accuracy and reduce reliance on MRAs. We curated a dataset of 586 shoulder MRIs (335 standard, 251 MRAs) from 558 patients who underwent arthroscopy. Ground truth labels were derived from intraoperative findings, the gold standard for Bankart lesion diagnosis. Separate DL models for MRAs and standard MRIs were trained using the Swin Transformer architecture, pre-trained on a public knee MRI dataset. Predictions from sagittal, axial, and coronal views were ensembled to optimize performance. The models were evaluated on a 20% hold-out test set (117 MRIs: 46 MRAs, 71 standard MRIs). Bankart lesions were identified in 31.9% of MRAs and 8.6% of standard MRIs. The models achieved AUCs of 0.87 (86% accuracy, 83% sensitivity, 86% specificity) and 0.90 (85% accuracy, 82% sensitivity, 86% specificity) on standard MRIs and MRAs, respectively. These results match or surpass radiologist performance on our dataset and reported literature metrics. Notably, our model's performance on non-invasive standard MRIs matched or surpassed the radiologists interpreting MRAs. This study demonstrates the feasibility of using DL to address the diagnostic challenges posed by subtle pathologies like Bankart lesions. Our models demonstrate potential to improve diagnostic confidence, reduce reliance on invasive imaging, and enhance accessibility to care.

Prototype-based neural networks offer interpretable predictions by comparing inputs to learned, representative signal patterns anchored in training data. While such models have shown promise in the classification of physiological data, it remains unclear whether their prototypes capture an underlying structure that aligns with broader clinical phenotypes. We use a prototype-based deep learning model trained for multi-label ECG classification using the PTB-XL dataset. Then without modification we performed inference on the MIMIC-IV clinical database. We assess whether individual prototypes, trained solely for classification, are associated with hospital discharge diagnoses in the form of phecodes in this external population. Individual prototypes demonstrate significantly stronger and more specific associations with clinical outcomes compared to the classifier's class predictions, NLP-extracted concepts, or broader prototype classes across all phecode categories. Prototype classes with mixed significance patterns exhibit significantly greater intra-class distances (p < 0.0001), indicating the model learned to differentiate clinically meaningful variations within diagnostic categories. The prototypes achieve strong predictive performance across diverse conditions, with AUCs ranging from 0.89 for atrial fibrillation to 0.91 for heart failure, while also showing substantial signal for non-cardiac conditions such as sepsis and renal disease. These findings suggest that prototype-based models can support interpretable digital phenotyping from physiologic time-series data, providing transferable intermediate phenotypes that capture clinically meaningful physiologic signatures beyond their original training objectives.

Deep learning has shown strong performance in musculoskeletal imaging, but prior work has largely targeted conditions where diagnosis is relatively straightforward. More challenging problems remain underexplored, such as detecting Bankart lesions (anterior-inferior glenoid labral tears) on standard MRIs. These lesions are difficult to diagnose due to subtle imaging features, often necessitating invasive MRI arthrograms (MRAs). We introduce ScopeMRI, the first publicly available, expert-annotated dataset for shoulder pathologies, and present a deep learning framework for Bankart lesion detection on both standard MRIs and MRAs. ScopeMRI contains shoulder MRIs from patients who underwent arthroscopy, providing ground-truth labels from intraoperative findings, the diagnostic gold standard. Separate models were trained for MRIs and MRAs using CNN- and transformer-based architectures, with predictions ensembled across multiple imaging planes. Our models achieved radiologist-level performance, with accuracy on standard MRIs surpassing radiologists interpreting MRAs. External validation on independent hospital data demonstrated initial generalizability across imaging protocols. By releasing ScopeMRI and a modular codebase for training and evaluation, we aim to accelerate research in musculoskeletal imaging and foster development of datasets and models that address clinically challenging diagnostic tasks.

Large neural models are increasingly deployed in high-stakes settings, raising concerns about whether their behavior reliably aligns with human values. Interpretability provides a route to internal transparency by revealing the computations that drive outputs. We argue that interpretability especially mechanistic approaches should be treated as a design principle for alignment, not an auxiliary diagnostic tool. Post-hoc methods such as LIME or SHAP offer intuitive but correlational explanations, while mechanistic techniques like circuit tracing or activation patching yield causal insight into internal failures, including deceptive or misaligned reasoning that behavioral methods like RLHF, red teaming, or Constitutional AI may overlook. Despite these advantages, interpretability faces challenges of scalability, epistemic uncertainty, and mismatches between learned representations and human concepts. Our position is that progress on safe and trustworthy AI will depend on making interpretability a first-class objective of AI research and development, ensuring that systems are not only effective but also auditable, transparent, and aligned with human intent.

Echocardiography records ultrasound videos of the heart, enabling clinicians to assess cardiac function. Recent advances in large-scale vision-language models (VLMs) have spurred interest in automating echocardiographic interpretation. However, most existing medical VLMs rely on single-frame (image) inputs, which can reduce diagnostic accuracy for conditions identifiable only through cardiac motion. In addition, echocardiographic videos are captured from multiple views, each varying in suitability for detecting specific conditions. Leveraging multiple views may therefore improve diagnostic performance. We developed a video-language model that processes full video sequences from five standard views, trained on 60,747 echocardiographic video-report pairs. We evaluated the gains in retrieval performance from video input and multi-view support, including the contributions of various pretrained models.

Pre-trained Transformers often exhibit over-confidence in source patterns and difficulty in forming new target-domain patterns during fine-tuning. We formalize the mechanism of output saturation leading to gradient suppression through standard cross-entropy and softmax analysis, showing that gradient suppression at inflection layers confines adaptation to high-level recombination of existing features while preventing low-level reconstruction. We introduce a set of layer-wise diagnostic metrics -- attention entropy (saturation proxy), activation gradient norm, parameter gradient norm, and Delta-CKA under a shared PCA basis -- to identify inflection layers characterized by both low attention entropy and steep gradient decay. Building on these findings, we propose a diagnose-first, inject-light fine-tuning strategy: selectively inserting LoRA adapters at inflection layers to restore suppressed backward signals with minimal parameter overhead. Experiments on BERT-base transfer from SST-2 to Rotten Tomatoes under under-trained and over-trained source regimes reveal that over-trained initialization benefits from inflection-layer LoRA injection, while under-trained initialization suffers performance degradation. When base features are strong, unblocking inflection layers facilitates high-level compositional adaptation; when base features are weak, full-pathway unblocking is required for low-level reconstruction, as supported by joint analysis of layer-wise activation gradients and Delta-CKA dynamics.

Osteoporotic vertebral compression fractures (VCFs) are prevalent in the elderly population, typically assessed on computed tomography (CT) scans by evaluating vertebral height loss. This assessment helps determine the fracture's impact on spinal stability and the need for surgical intervention. However, clinical data indicate that many VCFs exhibit irregular compression, complicating accurate diagnosis. While deep learning methods have shown promise in aiding VCFs screening, they often lack interpretability and sufficient sensitivity, limiting their clinical applicability. To address these challenges, we introduce a novel vertebra synthesis-height loss quantification-VCFs grading framework. Our proposed model, HealthiVert-GAN, utilizes a coarse-to-fine synthesis network designed to generate pseudo-healthy vertebral images that simulate the pre-fracture state of fractured vertebrae. This model integrates three auxiliary modules that leverage the morphology and height information of adjacent healthy vertebrae to ensure anatomical consistency. Additionally, we introduce the Relative Height Loss of Vertebrae (RHLV) as a quantification metric, which divides each vertebra into three sections to measure height loss between pre-fracture and post-fracture states, followed by fracture severity classification using a Support Vector Machine (SVM). Our approach achieves state-of-the-art classification performance on both the Verse2019 dataset and our private dataset, and it provides cross-sectional distribution maps of vertebral height loss. This practical tool enhances diagnostic sensitivity in clinical settings and assisting in surgical decision-making. Our code is available: https://github.com/zhibaishouheilab/HealthiVert-GAN.

Despite the advancements and impressive performance of Multimodal Large Language Models (MLLMs) on benchmarks, their effectiveness in real-world, long-context, and multi-image tasks is unclear due to the benchmarks' limited scope. Existing benchmarks often focus on single-image and short-text samples, and when assessing multi-image tasks, they either limit the image count or focus on specific task (e.g time-series captioning), potentially obscuring the performance challenges of MLLMs. To address these limitations, we introduce MileBench, a pioneering benchmark designed to test the MultImodal Long-contExt capabilities of MLLMs. This benchmark comprises not only multimodal long contexts, but also multiple tasks requiring both comprehension and generation. We establish two distinct evaluation sets, diagnostic and realistic, to systematically assess MLLMs' long-context adaptation capacity and their ability to complete tasks in long-context scenarios. Our experimental results, obtained from testing 20 models, revealed that while the closed-source GPT-4(Vision) and Gemini 1.5 outperform others, most open-source MLLMs struggle in long-context situations. Interestingly, the performance gap tends to widen with an increase in the number of images. We strongly encourage an intensification of research efforts towards enhancing MLLMs' long-context capabilities, especially in scenarios involving multiple images.

Large language models (LLMs) are increasingly being used for complex research tasks such as literature review, idea generation, and scientific paper analysis, yet their ability to truly understand and process the intricate relationships within complex research papers, such as the logical links between claims and supporting evidence remains largely unexplored. In this study, we present CLAIM-BENCH, a comprehensive benchmark for evaluating LLMs' capabilities in scientific claim-evidence extraction and validation, a task that reflects deeper comprehension of scientific argumentation. We systematically compare three approaches which are inspired by divide and conquer approaches, across six diverse LLMs, highlighting model-specific strengths and weaknesses in scientific comprehension. Through evaluation involving over 300 claim-evidence pairs across multiple research domains, we reveal significant limitations in LLMs' ability to process complex scientific content. Our results demonstrate that closed-source models like GPT-4 and Claude consistently outperform open-source counterparts in precision and recall across claim-evidence identification tasks. Furthermore, strategically designed three-pass and one-by-one prompting approaches significantly improve LLMs' abilities to accurately link dispersed evidence with claims, although this comes at increased computational cost. CLAIM-BENCH sets a new standard for evaluating scientific comprehension in LLMs, offering both a diagnostic tool and a path forward for building systems capable of deeper, more reliable reasoning across full-length papers.

This study introduces an evaluation benchmark for middle school algebra to be used in artificial intelligence(AI) based educational platforms. The goal is to support the design of AI systems that can enhance learner conceptual understanding of algebra by taking into account their current level of algebra comprehension. The data set comprises 55 misconceptions about algebra, common errors, and 220 diagnostic examples identified in previous peer-reviewed studies. We provide an example application using a large language model, observing a range of precision and recall scores depending on the topic and experimental setup that reaches 83.9% when including educator feedback and restricting it by topic. We found that topics such as ratios and proportions prove as difficult for LLMs as they are for students. We included a human assessment of LLMs results and feedback from five middle school math educators on the clarity and occurrence of misconceptions in the dataset and the potential use of AI in conjunction with the dataset. Most educators (80% or more) indicated that they encounter these misconceptions among their students, suggesting the relevance of the data set to teaching middle school algebra. Despite varying familiarity with AI tools, four out of five educators expressed interest in using the data set with AI to diagnose student misconceptions or train teachers. The results emphasize the importance of topic-constrained testing, the need for multimodal approaches, and the relevance of human expertise to gain practical insights when using AI for human learning.

While powerful in image-conditioned generation, multimodal large language models (MLLMs) can display uneven performance across demographic groups, highlighting fairness risks. In safety-critical clinical settings, such disparities risk producing unequal diagnostic narratives and eroding trust in AI-assisted decision-making. While fairness has been studied extensively in vision-only and language-only models, its impact on MLLMs remains largely underexplored. To address these biases, we introduce FairLLaVA, a parameter-efficient fine-tuning method that mitigates group disparities in visual instruction tuning without compromising overall performance. By minimizing the mutual information between target attributes, FairLLaVA regularizes the model's representations to be demographic-invariant. The method can be incorporated as a lightweight plug-in, maintaining efficiency with low-rank adapter fine-tuning, and provides an architecture-agnostic approach to fair visual instruction following. Extensive experiments on large-scale chest radiology report generation and dermoscopy visual question answering benchmarks show that FairLLaVA consistently reduces inter-group disparities while improving both equity-scaled clinical performance and natural language generation quality across diverse medical imaging modalities. Code can be accessed at https://github.com/bhosalems/FairLLaVA.

Recent Multimodal Large Language Models (MLLMs) achieve promising performance on visual and audio benchmarks independently. However, the ability of these models to process cross-modal information synchronously remains largely unexplored. We introduce Daily-Omni, a multiple-choice Audio-Visual QA benchmark featuring 684 real-world videos and 1,197 questions spanning 6 task families that explicitly require cross-modal temporal reasoning. To support scalable benchmark construction, we develop a semi-automatic pipeline for annotation, cross-modal consistency refinement, temporal alignment elicitation, and text-only leakage filtering, followed by human verification. We further provide a diagnostic evaluation suite and extensively evaluate 24 foundation models under 37 model--modality settings (Audio+Video / Audio-only / Video-only / Text-only). Finally, we include a training-free modular diagnostic baseline that composes off-the-shelf unimodal models to serve as a diagnostic baseline and to illustrate how explicit temporal alignment signals affect performance. Results indicate that many end-to-end MLLMs still struggle on alignment-critical questions, suggesting that robust cross-modal temporal alignment remains an important open challenge.

Despite the rapid advancements in Multimodal Large Language Models (MLLMs), a critical question regarding their visual grounding mechanism remains unanswered: do these models genuinely ``read'' text embedded in images, or do they merely rely on parametric shortcuts in the text prompt? In this work, we diagnose this issue by introducing the Visualized-Question (VQ) setting, where text queries are rendered directly onto images to structurally mandate visual engagement. Our diagnostic experiments on Qwen2.5-VL reveal a startling capability-utilization gap: despite possessing strong OCR capabilities, models suffer a performance degradation of up to 12.7% in the VQ setting, exposing a deep-seated ``modality laziness.'' To bridge this gap, we propose SimpleOCR, a plug-and-play training strategy that imposes a structural constraint on the learning process. By transforming training samples into the VQ format with randomized styles, SimpleOCR effectively invalidates text-based shortcuts, compelling the model to activate and optimize its visual text extraction pathways. Empirically, SimpleOCR yields robust gains without architectural modifications. On four representative OOD benchmarks, it surpasses the base model by 5.4% and GRPO based on original images by 2.7%, while exhibiting extreme data efficiency, achieving superior performance with 30x fewer samples (8.5K) than recent RL-based methods. Furthermore, its plug-and-play nature allows seamless integration with advanced RL strategies like NoisyRollout to yield complementary improvements. Code is available at https://github.com/aiming-lab/SimpleOCR.

As humans increasingly rely on multiround conversational AI for high stakes decisions, principled frameworks are needed to ensure such interactions reliably improve decision quality. We adopt a human centric view governed by two principles: counterfactual harm, ensuring the AI does not undermine human strengths, and complementarity, ensuring it adds value where the human is prone to err. We formalize these concepts via user defined rules, allowing users to specify exactly what harm and complementarity mean for their specific task. We then introduce an online, distribution free algorithm with finite sample guarantees that enforces the user-specified constraints over the collaboration dynamics. We evaluate our framework across two interactive settings: LLM simulated collaboration on a medical diagnostic task and a human crowdsourcing study on a pictorial reasoning task. We show that our online procedure maintains prescribed counterfactual harm and complementarity violation rates even under nonstationary interaction dynamics. Moreover, tightening or loosening these constraints produces predictable shifts in downstream human accuracy, confirming that the two principles serve as practical levers for steering multi-round collaboration toward better decision quality without the need to model or constrain human behavior.

Large language models (LLMs) have become increasingly capable of following instructions and complex reasoning, making prompting a flexible interface for adapting models without parameter updates. Yet prompt design remains labor-intensive and highly sensitive to formatting, phrasing, and instruction order, motivating automated prompt optimization methods that reduce manual effort while preserving inference-time flexibility. However, existing methods often search over prompt candidates or use fixed critique-refine pipelines driven by individual examples or small batches, limiting their ability to capture systematic error patterns and make targeted edits grounded in failure history. We propose Reflective Prompt Tuning (RPT), a framework that uses LLM function calling to simulate the iterative workflow of human prompt engineers. An LLM optimizer calls a diagnostic function that evaluates the target model over an entire optimization set, summarizes recurring failure modes, and returns a structured diagnostic report. The optimizer uses this report, together with an accumulated memory of prior reports, to revise the prompt for the next iteration. RPT further supports confidence-aware optimization by using calibration signals in diagnostic feedback and final prompt selection. Across three reasoning tasks, RPT improves over initial prompts by up to 12.9 points, remains competitive with state of the art, and improves confidence calibration. Our analyses show that RPT is especially effective on multi-hop and mathematical reasoning, producing targeted prompt revisions that align with diagnosed failure patterns and lead to gains in task performance and calibration.

Urdu fake news detection remains under-resourced despite Urdu being spoken by over 231 million people worldwide. While prior work has demonstrated strong in-domain performance on individual Urdu datasets, cross-dataset generalisation has received little systematic attention. This paper presents the first cross-dataset generalisation study for Urdu fake news detection, using two publicly available balanced datasets: the Ax-to-Grind Urdu corpus (10,083 articles, 15 domains) and the Notri-Fact Urdu dataset (13,388 articles). We fine-tune xlm-roberta-base under four experimental conditions, in-domain on each dataset and two zero-shot cross-domain transfer directions, comparing against TF-IDF baselines using Logistic Regression and Support Vector Machines. Our experiments reveal a striking asymmetry: Notri-Fact to Ax-to-Grind transfer achieves a macro F1 of 0.771, while the reverse collapses to F1 of 0.005, with the model predicting fake for 99.7% of test articles. We demonstrate that this collapse stems from a systematic length confound in Ax-to-Grind, where fake articles average 117 words versus 35 for real articles, a 3.4x asymmetry inducing shortcut learning. A length ablation capping articles at 50 words yields only a 0.0067 F1 drop, confirming the confound inflates but does not solely drive in-domain performance. We provide a reusable diagnostic methodology that combines bidirectional transfer analysis and prediction-collapse inspection to identify confound-driven behavior in multilingual fake news detection settings.

Leaf-lesion segmentation is topology-sensitive: small merges, splits, or false holes can be biologically meaningful descriptors of biochemical pathways, yet they are weakly penalized by standard pixel-wise losses in Euclidean latents. I explore HyperTopo-Adapters, a lightweight, parameter-efficient head trained on top of a frozen vision encoder, which embeds features on a product manifold -- hyperbolic + Euclidean + spherical (H + E + S) -- to encourage hierarchical separation (H), local linear detail (E), and global closure (S). A topology prior complements Dice/BCE in two forms: (i) persistent-homology (PH) distance for evaluation and selection, and (ii) a differentiable surrogate that combines a soft Euler-characteristic match with total variation regularization for stable training. I introduce warm-ups for both the hyperbolic contrastive term and the topology prior, per-sample evaluation of structure-aware metrics (Boundary-F1, Betti errors, PD distance), and a min-PD within top-K Dice rule for checkpoint selection. On a Kaggle leaf-lesion dataset (N=2,940), early results show consistent gains in boundary and topology metrics (reducing Delta beta_1 hole error by 9%) while Dice/IoU remain competitive. The study is diagnostic by design: I report controlled ablations (curvature learning, latent dimensions, contrastive temperature, surrogate settings), and ongoing tests varying encoder strength (ResNet-50, DeepLabV3, DINOv2/v3), input resolution, PH weight, and partial unfreezing of late blocks. The contribution is an open, reproducible train/eval suite (available at https://github.com/ChimdiWalter/HyperTopo-Adapters) that isolates geometric/topological priors and surfaces failure modes to guide stronger, topology-preserving architectures.

Ultrasound is crucial in modern medicine but faces challenges like operator dependence, image noise, and real-time scanning, hindering AI integration. While large multimodal models excel in other medical imaging areas, they struggle with ultrasound's complexities. To address this, we introduce Dolphin v1.0 (V1) and its reasoning-augmented version, Dolphin R1-the first large-scale multimodal ultrasound foundation models unifying diverse clinical tasks in a single vision-language framework.To tackle ultrasound variability and noise, we curated a 2-million-scale multimodal dataset, combining textbook knowledge, public data, synthetic samples, and general corpora. This ensures robust perception, generalization, and clinical adaptability.The Dolphin series employs a three-stage training strategy: domain-specialized pretraining, instruction-driven alignment, and reinforcement-based refinement. Dolphin v1.0 delivers reliable performance in classification, detection, regression, and report generation. Dolphin R1 enhances diagnostic inference, reasoning transparency, and interpretability through reinforcement learning with ultrasound-specific rewards.Evaluated on U2-Bench across eight ultrasound tasks, Dolphin R1 achieves a U2-score of 0.5835-over twice the second-best model (0.2968) setting a new state of the art. Dolphin v1.0 also performs competitively, validating the unified framework. Comparisons show reasoning-enhanced training significantly improves diagnostic accuracy, consistency, and interpretability, highlighting its importance for high-stakes medical AI.

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.

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.

Large Vision-Language Models (LVLMs) are increasingly being explored for applications in telemedicine, yet their ability to engage with diverse patient behaviors remains underexplored. We introduce 3MDBench (Medical Multimodal Multi-agent Dialogue Benchmark), an open-source evaluation framework designed to assess LLM-driven medical consultations. Unlike existing benchmarks, 3MDBench simulates real-world patient variability by incorporating four temperament-driven Patient Agents and an Assessor Agent that evaluates diagnostic accuracy and dialogue quality. The benchmark integrates textual and image-based patient data across 34 common diagnoses, mirroring real-world telemedicine interactions. Under different diagnostic strategies, we evaluate state-of-the-art LVLMs. Our findings demonstrate that incorporating dialogue improves the F1 score from 50.4 to 54.2 compared to non-dialogue settings, underscoring the value of context-driven, information-seeking questioning. Additionally, we demonstrate that multimodal inputs enhance diagnostic efficiency. Image-supported models outperform text-only counterparts by raising the diagnostic F1 score from 52.8 to 54.2 in a similar dialogue setting. Finally, we suggest an approach that improves the diagnostic F1-score to 70.3 by training the CNN model on the diagnosis prediction task and incorporating its top-3 predictions into the LVLM context. 3MDBench provides a reproducible and extendable evaluation framework for AI-driven medical assistants. It offers insights into how patient temperament, dialogue strategies, and multimodal reasoning influence diagnosis quality. By addressing real-world complexities in telemedicine, our benchmark paves the way for more empathetic, reliable, and context-aware AI-driven healthcare solutions. The source code of our benchmark is publicly available: https://github.com/univanxx/3mdbench

Oral cancer is highly common across the globe and is mostly diagnosed during the later stages due to the close visual similarity to benign, precancerous, and malignant lesions in the oral cavity. Implementing computer aided diagnosis systems early on has the potential to greatly improve clinical outcomes. This research intends to use deep learning to build a multiclass classifier for sixteen different oral lesions. To overcome the challenges of limited and imbalanced datasets, the proposed technique combines stratified data splitting and advanced data augmentation and oversampling to perform the classification. The experimental results, which achieved 83.33 percent accuracy, 89.12 percent precision, and 77.31 percent recall, demonstrate the superiority of the suggested model over state of the art methods now in use. The suggested model effectively conveys the effectiveness of oversampling and augmentation strategies in situations where the minority class classification performance is noteworthy. As a first step toward trustworthy computer aided diagnostic systems for the early detection of oral cancer in clinical settings, the suggested framework shows promise.

Recent advances in reasoning with large language models (LLMs)has shown remarkable reasoning capabilities in domains such as mathematics and coding, yet their application to clinical diagnosis remains underexplored. Here, we introduce ClinicalGPT-R1, a reasoning enhanced generalist large language model for disease diagnosis. Trained on a dataset of 20,000 real-world clinical records, ClinicalGPT-R1 leverages diverse training strategies to enhance diagnostic reasoning. To benchmark performance, we curated MedBench-Hard, a challenging dataset spanning seven major medical specialties and representative diseases. Experimental results demonstrate that ClinicalGPT-R1 outperforms GPT-4o in Chinese diagnostic tasks and achieves comparable performance to GPT-4 in English settings. This comparative study effectively validates the superior performance of ClinicalGPT-R1 in disease diagnosis tasks. Resources are available at https://github.com/medfound/medfound.

Compressed Sensing MRI reconstructs images of the body's internal anatomy from undersampled measurements, thereby reducing scan time. Recently, deep learning has shown great potential for reconstructing high-fidelity images from highly undersampled measurements. However, one needs to train multiple models for different undersampling patterns and desired output image resolutions, since most networks operate on a fixed discretization. Such approaches are highly impractical in clinical settings, where undersampling patterns and image resolutions are frequently changed to accommodate different real-time imaging and diagnostic requirements. We propose a unified MRI reconstruction model robust to various measurement undersampling patterns and image resolutions. Our approach uses neural operators, a discretization-agnostic architecture applied in both image and measurement spaces, to capture local and global features. Empirically, our model improves SSIM by 11% and PSNR by 4 dB over a state-of-the-art CNN (End-to-End VarNet), with 600times faster inference than diffusion methods. The resolution-agnostic design also enables zero-shot super-resolution and extended field-of-view reconstruction, offering a versatile and efficient solution for clinical MR imaging. Our unified model offers a versatile solution for MRI, adapting seamlessly to various measurement undersampling and imaging resolutions, making it highly effective for flexible and reliable clinical imaging. Our code is available at https://armeet.ca/nomri.

Chest X-ray imaging is crucial for diagnosing pulmonary and cardiac diseases, yet its interpretation demands extensive clinical experience and suffers from inter-observer variability. While deep learning models offer high diagnostic accuracy, their black-box nature hinders clinical adoption in high-stakes medical settings. To address this, we propose X-Ray-CoT (Chest X-Ray Chain-of-Thought), a novel framework leveraging Vision-Language Large Models (LVLMs) for intelligent chest X-ray diagnosis and interpretable report generation. X-Ray-CoT simulates human radiologists' "chain-of-thought" by first extracting multi-modal features and visual concepts, then employing an LLM-based component with a structured Chain-of-Thought prompting strategy to reason and produce detailed natural language diagnostic reports. Evaluated on the CORDA dataset, X-Ray-CoT achieves competitive quantitative performance, with a Balanced Accuracy of 80.52% and F1 score of 78.65% for disease diagnosis, slightly surpassing existing black-box models. Crucially, it uniquely generates high-quality, explainable reports, as validated by preliminary human evaluations. Our ablation studies confirm the integral role of each proposed component, highlighting the necessity of multi-modal fusion and CoT reasoning for robust and transparent medical AI. This work represents a significant step towards trustworthy and clinically actionable AI systems in medical imaging.

Given a question, a language model (LM) implicitly encodes a distribution over possible answers. In practice, post-training procedures for LMs often collapse this distribution onto a single dominant mode. While this is generally not a problem for benchmark-style evaluations that assume one correct answer, many real-world tasks inherently involve multiple valid answers or irreducible uncertainty. Examples include medical diagnosis, ambiguous question answering, and settings with incomplete information. In these cases, we would like LMs to generate multiple plausible hypotheses, ideally with confidence estimates for each one, and without computationally intensive repeated sampling to generate non-modal answers. This paper describes a multi-answer reinforcement learning approach for training LMs to perform distributional reasoning over multiple answers during inference. We modify the RL objective to enable models to explicitly generate multiple candidate answers in a single forward pass, internalizing aspects of inference-time search into the model's generative process. Across question-answering, medical diagnostic, and coding benchmarks, we observe improved diversity, coverage, and set-level calibration scores compared to single answer trained baselines. Models trained with our approach require fewer tokens to generate multiple answers than competing approaches. On coding tasks, they are also substantially more accurate. These results position multi-answer RL as a principled and compute-efficient alternative to inference-time scaling procedures such as best-of-k. Code and more information can be found at https://multi-answer-rl.github.io/.

This study investigates the integration of diverse patient data sources into multimodal language models for automated chest X-ray (CXR) report generation. Traditionally, CXR report generation relies solely on CXR images and limited radiology data, overlooking valuable information from patient health records, particularly from emergency departments. Utilising the MIMIC-CXR and MIMIC-IV-ED datasets, we incorporate detailed patient information such as aperiodic vital signs, medications, and clinical history to enhance diagnostic accuracy. We introduce a novel approach to transform these heterogeneous data sources into embeddings that prompt a multimodal language model, significantly enhancing the diagnostic accuracy of generated radiology reports. Our comprehensive evaluation demonstrates the benefits of using a broader set of patient data, underscoring the potential for enhanced diagnostic capabilities and better patient outcomes through the integration of multimodal data in CXR report generation.

Musculoskeletal disorders represent a significant global health burden and are a leading cause of disability worldwide. While MRI is essential for accurate diagnosis, its interpretation remains exceptionally challenging. Radiologists must identify multiple potential abnormalities within complex anatomical structures across different imaging planes, a process that requires significant expertise and is prone to variability. We developed OrthoDiffusion, a unified diffusion-based foundation model designed for multi-task musculoskeletal MRI interpretation. The framework utilizes three orientation-specific 3D diffusion models, pre-trained in a self-supervised manner on 15,948 unlabeled knee MRI scans, to learn robust anatomical features from sagittal, coronal, and axial views. These view-specific representations are integrated to support diverse clinical tasks, including anatomical segmentation and multi-label diagnosis. Our evaluation demonstrates that OrthoDiffusion achieves excellent performance in the segmentation of 11 knee structures and the detection of 8 knee abnormalities. The model exhibited remarkable robustness across different clinical centers and MRI field strengths, consistently outperforming traditional supervised models. Notably, in settings where labeled data was scarce, OrthoDiffusion maintained high diagnostic precision using only 10\% of training labels. Furthermore, the anatomical representations learned from knee imaging proved highly transferable to other joints, achieving strong diagnostic performance across 11 diseases of the ankle and shoulder. These findings suggest that diffusion-based foundation models can serve as a unified platform for multi-disease diagnosis and anatomical segmentation, potentially improving the efficiency and accuracy of musculoskeletal MRI interpretation in real-world clinical workflows.

Medical vision-and-language models (MVLMs) have attracted substantial interest due to their capability to offer a natural language interface for interpreting complex medical data. Their applications are versatile and have the potential to improve diagnostic accuracy and decision-making for individual patients while also contributing to enhanced public health monitoring, disease surveillance, and policy-making through more efficient analysis of large data sets. MVLMS integrate natural language processing with medical images to enable a more comprehensive and contextual understanding of medical images alongside their corresponding textual information. Unlike general vision-and-language models trained on diverse, non-specialized datasets, MVLMs are purpose-built for the medical domain, automatically extracting and interpreting critical information from medical images and textual reports to support clinical decision-making. Popular clinical applications of MVLMs include automated medical report generation, medical visual question answering, medical multimodal segmentation, diagnosis and prognosis and medical image-text retrieval. Here, we provide a comprehensive overview of MVLMs and the various medical tasks to which they have been applied. We conduct a detailed analysis of various vision-and-language model architectures, focusing on their distinct strategies for cross-modal integration/exploitation of medical visual and textual features. We also examine the datasets used for these tasks and compare the performance of different models based on standardized evaluation metrics. Furthermore, we highlight potential challenges and summarize future research trends and directions. The full collection of papers and codes is available at: https://github.com/YtongXie/Medical-Vision-and-Language-Tasks-and-Methodologies-A-Survey.

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.

Empirical scaling laws prescribe how to allocate parameters, data, and compute, while maximal-update parameterization (muP) enables learning-rate transfer across widths by equalizing early-time update magnitudes. However, in modern scale-invariant architectures, training quickly enters an optimizer-governed steady state where normalization layers create backward scale sensitivity and the effective learning rate becomes width dependent, degrading muP transfer. We address this by introducing a weight-decay scaling rule for AdamW that preserves sublayer gain across widths. Empirically, the singular-value spectrum of each matrix parameter scales in norm as eta/lambda with an approximately invariant shape; under width scaling d, we observe that the top singular value scales approximately as eta/lambdacdot d^{0.75}. Combining this observation with the muP learning-rate rule eta_2propto d^{-1} for matrix-like parameters implies an empirical weight-decay scaling rule lambda_2propto d that approximately keeps sublayer gains width invariant. Together with vector-like parameters trained at eta_1=Theta_d(1) and lambda_1=0, this yields zero-shot transfer of both learning rate and weight decay from proxy to target widths, removing per-width sweeps. We validate the rule on LLaMA-style Transformers and in a minimal synthetic setting, and we provide a simple diagnostic, matching top singular values, to check sublayer-gain invariance. Our results extend muP beyond the near-init regime by explicitly controlling steady-state scales set by the optimizer, offering a practical recipe for width-robust hyperparameter transfer under AdamW.

This paper explores the advancements and applications of large-scale models in the medical field, with a particular focus on Medical Large Models (MedLMs). These models, encompassing Large Language Models (LLMs), Vision Models, 3D Large Models, and Multimodal Models, are revolutionizing healthcare by enhancing disease prediction, diagnostic assistance, personalized treatment planning, and drug discovery. The integration of graph neural networks in medical knowledge graphs and drug discovery highlights the potential of Large Graph Models (LGMs) in understanding complex biomedical relationships. The study also emphasizes the transformative role of Vision-Language Models (VLMs) and 3D Large Models in medical image analysis, anatomical modeling, and prosthetic design. Despite the challenges, these technologies are setting new benchmarks in medical innovation, improving diagnostic accuracy, and paving the way for personalized healthcare solutions. This paper aims to provide a comprehensive overview of the current state and future directions of large models in medicine, underscoring their significance in advancing global health.

Existing research on Domain Robustness (DR) suffers from disparate setups, lack of evaluation task variety, and reliance on challenge sets. In this paper, we pose a fundamental question: What is the state of affairs of the DR challenge in the era of Large Language Models (LLMs)? To this end, we construct a DR benchmark comprising diverse NLP tasks, including sentence and token-level classification, QA, and generation, each task consists of several domains. We explore the DR challenge of fine-tuned and few-shot learning models in natural domain shift settings and devise two diagnostic metrics of Out-of-Distribution (OOD) performance degradation: The commonly used Source Drop (SD) and the overlooked Target Drop (TD). Our findings reveal important insights: First, despite their capabilities, zero-to-few shot LLMs and fine-tuning approaches still fail to meet satisfactory performance in the OOD context; Second, TD approximates better than SD the average OOD degradation; Third, in a significant proportion of domain shifts, either SD or TD is positive, but not both, and therefore disregarding one can lead to incorrect DR conclusions.

Parkinson's disease (PD) is a neurological disorder impacting a person's speech. Among automatic PD assessment methods, deep learning models have gained particular interest. Recently, the community has explored cross-pathology and cross-language models which can improve diagnostic accuracy even further. However, strict patient data privacy regulations largely prevent institutions from sharing patient speech data with each other. In this paper, we employ federated learning (FL) for PD detection using speech signals from 3 real-world language corpora of German, Spanish, and Czech, each from a separate institution. Our results indicate that the FL model outperforms all the local models in terms of diagnostic accuracy, while not performing very differently from the model based on centrally combined training sets, with the advantage of not requiring any data sharing among collaborators. This will simplify inter-institutional collaborations, resulting in enhancement of patient outcomes.

World models are increasingly regarded as a decisive step toward artificial general intelligence, yet modeling the physical world demands more than rendering convincing frames on demand: it requires an internal world state that keeps evolving over time, decoupled from observation, so that objects endure and events run to their conclusions whether or not a camera is watching, much as the moon holds to its orbit when no one is looking. This requirement is a blind spot of existing benchmarks, which reward surface properties such as fidelity, motion, and camera controllability while never asking whether a generated world keeps evolving once it is unobserved. We introduce WRBench, the first systematic diagnostic benchmark that treats camera motion as an intervention on observability and resolves evaluation into a human-calibrated chain that asks whether the camera executes the requested interaction, whether the scene stays continuous and identifiable while in view, and whether a returning target remains consistent with the event that was set in motion. Across 9{,}600 videos from 23 models spanning four control paradigms, one finding proves stubborn: current systems maintain the observed world as a tracking shot, resuming a returning target in the state at which it was abandoned rather than advancing the event while it went unseen. Because this failure recurs across control paradigms, model families, and increments of scale, robust world-state evolution does not follow from cleaner imagery, tighter control, richer geometric priors, or sheer parameter count We therefore argue that the stability of the physical state kernel and the consistency of worldlines under viewpoint intervention should become first-class objectives of world-model design, so that a world model captures how the world will unfold rather than how the next frame appears.

Linguistic expressions of emotions such as depression, anxiety, and trauma-related states are pervasive in clinical notes, counseling dialogues, and online mental health communities, and accurate recognition of these emotions is essential for clinical triage, risk assessment, and timely intervention. Although large language models (LLMs) have demonstrated strong generalization ability in emotion analysis tasks, their diagnostic reliability in high-stakes, context-intensive medical settings remains highly sensitive to prompt design. Moreover, existing methods face two key challenges: emotional comorbidity, in which multiple intertwined emotional states complicate prediction, and inefficient exploration of clinically relevant cues. To address these challenges, we propose APOLO (Automated Prompt Optimization for Linguistic Emotion Diagnosis), a framework that systematically explores a broader and finer-grained prompt space to improve diagnostic efficiency and robustness. APOLO formulates instruction refinement as a Partially Observable Markov Decision Process and adopts a multi-agent collaboration mechanism involving Planner, Teacher, Critic, Student, and Target roles. Within this closed-loop framework, the Planner defines an optimization trajectory, while the Teacher-Critic-Student agents iteratively refine prompts to enhance reasoning stability and effectiveness, and the Target agent determines whether to continue optimization based on performance evaluation. Experimental results show that APOLO consistently improves diagnostic accuracy and robustness across domain-specific and stratified benchmarks, demonstrating a scalable and generalizable paradigm for trustworthy LLM applications in mental healthcare.

The rapid progress of text-to-image (T2I) models has unlocked unprecedented creative potential, yet their ability to faithfully render complex prompts involving multiple objects, attributes, and spatial relationships remains a significant bottleneck. Progress is hampered by a lack of adequate evaluation methods; current benchmarks are often restricted to closed-set vocabularies, lack fine-grained diagnostic capabilities, and fail to provide the interpretable feedback necessary to diagnose and remedy specific compositional failures. We solve these challenges by introducing SANEval (Spatial, Attribute, and Numeracy Evaluation), a comprehensive benchmark that establishes a scalable new pipeline for open-vocabulary compositional evaluation. SANEval combines a large language model (LLM) for deep prompt understanding with an LLM-enhanced, open-vocabulary object detector to robustly evaluate compositional adherence, unconstrained by a fixed vocabulary. Through extensive experiments on six state-of-the-art T2I models, we demonstrate that SANEval's automated evaluations provide a more faithful proxy for human assessment; our metric achieves a Spearman's rank correlation with statistically different results than those of existing benchmarks across tasks of attribute binding, spatial relations, and numeracy. To facilitate future research in compositional T2I generation and evaluation, we will release the SANEval dataset and our open-source evaluation pipeline.

We present SpinBench, a cognitively grounded diagnostic benchmark for evaluating spatial reasoning in vision language models (VLMs). SpinBench is designed around the core challenge of spatial reasoning: perspective taking, the ability to reason about how scenes and object relations change under viewpoint transformation. Since perspective taking requires multiple cognitive capabilities, such as recognizing objects across views, relative positions grounding, and mentally simulating transformations, SpinBench introduces a set of fine-grained diagnostic categories. Our categories target translation, rotation, object relative pose, and viewpoint change, and are progressively structured so that single-object simpler tasks scaffold toward the most demanding multi-object perspective-taking setting. We evaluate 37 state-of-the-art VLMs, both proprietary and open source. Results reveal systematic weaknesses: strong egocentric bias, poor rotational understanding, and inconsistencies under symmetrical and syntactic reformulations. Scaling analysis shows both smooth improvements and emergent capabilities. While human subjects achieve high accuracy (91.2\%), task difficulty as measured by human response time shows strong correlation with VLM accuracy, indicating that SpinBench captures spatial reasoning challenges shared across humans and VLMs. We believe SpinBench provides critical insights into spatial reasoning in VLMs and highlights key gaps in their ability to reason about physical space. Our website can be found at https://spinbench25.github.io/.

We introduce SeePhys Pro, a fine-grained modality transfer benchmark that studies whether models preserve the same reasoning capability when critical information is progressively transferred from text to image. Unlike standard vision-essential benchmarks that evaluate a single input form, SeePhys Pro features four semantically aligned variants for each problem with progressively increasing visual elements. Our evaluation shows that current frontier models are far from representation-invariant reasoners: performance degrades on average as information moves from language to diagrams, with visual variable grounding as the most critical bottleneck. Motivated by this inference-time fragility, we further develop large training corpora for multimodal RLVR and use blind training as a diagnostic control, finding that RL with all training images masked can still improve performance on unmasked validation sets. To analyze this effect, text-deletion, image-mask-rate, and format-saturation controls suggest that such gains can arise from residual textual and distributional cues rather than valid visual evidence. Our results highlight the need to evaluate multimodal reasoning not only by final-answer accuracy, but also by robustness under modality transfer and by diagnostics that test whether improvements rely on task-critical visual evidence.

Neurophysiological recordings such as electroencephalography (EEG) offer accessible and minimally invasive means of estimating physiological activity for applications in healthcare, diagnostic screening, and even immersive entertainment. However, these recordings yield high-dimensional, noisy time-series data that typically require extensive pre-processing and handcrafted feature extraction to reveal meaningful information. Recently, there has been a surge of interest in applying representation learning techniques from large pre-trained (foundation) models to effectively decode and interpret biosignals. We discuss the challenges posed for incorporating such methods and introduce BioCodec, an alternative representation learning framework inspired by neural codecs to capture low-level signal characteristics in the form of discrete tokens. Pre-trained on thousands of EEG hours, BioCodec shows efficacy across multiple downstream tasks, ranging from clinical diagnostic tasks and sleep physiology to decoding speech and motor imagery, particularly in low-resource settings. Additionally, we provide a qualitative analysis of codebook usage and estimate the spatial coherence of codebook embeddings from EEG connectivity. Notably, we also document the suitability of our method to other biosignal data, i.e., electromyographic (EMG) signals. Overall, the proposed approach provides a versatile solution for biosignal tokenization that performs competitively with state-of-the-art models. The source code and model checkpoints are shared.

In the fields of affective computing (AC) and brain-machine interface (BMI), the analysis of physiological and behavioral signals to discern individual emotional states has emerged as a critical research frontier. While deep learning-based approaches have made notable strides in EEG emotion recognition, particularly in feature extraction and pattern recognition, significant challenges persist in achieving end-to-end emotion computation, including real-time processing, individual adaptation, and seamless user interaction. This paper presents the EEG Emotion Copilot, a system optimizing a lightweight large language model (LLM) with 0.5B parameters operating in a local setting, which first recognizes emotional states directly from EEG signals, subsequently generates personalized diagnostic and treatment suggestions, and finally supports the automation of assisted electronic medical records. Specifically, we demonstrate the critical techniques in the novel data structure of prompt, model pruning and fine-tuning training, and deployment strategies aiming at improving real-time performance and computational efficiency. Extensive experiments show that our optimized lightweight LLM-based copilot achieves an enhanced intuitive interface for participant interaction, superior accuracy of emotion recognition and assisted electronic medical records generation, in comparison to such models with similar scale parameters or large-scale parameters such as 1.5B, 1.8B, 3B and 7B. In summary, through these efforts, the proposed copilot is expected to advance the application of AC in the medical domain, offering innovative solution to mental health monitoring. The codes will be released at https://github.com/NZWANG/EEG_Emotion_Copilot.

Evaluations should do more than measure a models current performance. They should tell us what to fix for the next model iteration and provide a way to generate targeted post training data. Most evaluation pipelines identify weak examples, topics, or categories, but they leave the underlying capability failure implicit: they say where a model fails, not why. We introduce CRAFT, a method that converts any rubric based evaluation dataset into a model specific diagnosis of weak capabilities. CRAFT treats each grading criterion as a capability probe: it extracts a capability description from every prompt rubric pair, clusters these descriptions into a hierarchical capability tree, scores the target model at every node, and selects low performing nodes dynamically across tree levels, at the granularity where each failure is clearest. The selected weak capabilities then direct the generation of targeted supervised finetuning data. Holding the data generation, finetuning, and evaluation setup fixed, we compare CRAFT against prompt level EvalTree clustering and untargeted random generation on four open source models, two professional domains (finance and legal), and 13 held out benchmarks disjoint from the diagnostic data. CRAFT achieves the strongest finance domain average for all four models under repeated temperature decoding; on legal domain, it is strongest for three of four models and remains within the decoding variance bands of the best baseline on the fourth. Diagnosing weaknesses at the level of rubric criteria, rather than prompts or categories, thus yields both a sharper picture of what a model cannot do and measurably better models after finetuning on that diagnosis.

A global shortage of trained sonographers limits prenatal ultrasound screening in low- and middle-income countries, where over half of pregnant women receive no skilled sonography. Current deep learning approaches address detection, segmentation, or classification in isolation, each demanding a separate model and expert-specified labels at inference. We present FADA, a unified vision-language model built on Qwen3.5-VL that performs clinical interpretation, classification, detection, and segmentation through a single interpretation-first pipeline without external labels. FADA distills knowledge from four domain-specific foundation models (FetalCLIP, UltraSAM, USF-MAE, UltraFedFM) via offline pre-computed feature caching. Selective distillation, which applies feature alignment only to annotation tasks while interpretation relies on standard fine-tuning, consistently outperforms full distillation across most evaluation axes. The recommended variant, FADA-SKD, achieves 0.8820 mean Dice for segmentation, 0.7671 mAP@0.50 for detection, and 100% structured interpretation compliance. Expert sonographer validation across 237 images confirms clinically acceptable outputs in both autonomous and human-in-the-loop modes, with 73.5% of interpretations scoring perfectly under clinician guidance. The system is trainable on a single consumer GPU and deployable without cloud connectivity. We validate edge deployment by running the compressed 0.8B model on a commodity smartphone (Qualcomm Snapdragon 7 Gen 1, 12 GB RAM) using llama.cpp with GGUF quantization, completing the full 5-phase pipeline in approximately 60 seconds entirely offline. This establishes a practical pathway for integrating AI-assisted fetal assessment with portable ultrasound devices, directly addressing diagnostic access gaps in resource-constrained settings. Code, models, and data are available at https://github.com/mahmoodphd/FADA.

Thyroid nodule classification using ultrasound imaging is essential for early diagnosis and clinical decision-making; however, despite promising performance on in-distribution data, existing deep learning methods often exhibit limited robustness and generalisation when deployed across different ultrasound devices or clinical environments. This limitation is mainly attributed to the pronounced heterogeneity of thyroid ultrasound images, which can lead models to capture spurious correlations rather than reliable diagnostic cues. To address this challenge, we propose PEMV-thyroid, a Prototype-Enhanced Multi-View learning framework that accounts for data heterogeneity by learning complementary representations from multiple feature perspectives and refining decision boundaries through a prototype-based correction mechanism with mixed prototype information. By integrating multi-view representations with prototype-level guidance, the proposed approach enables more stable representation learning under heterogeneous imaging conditions. Extensive experiments on multiple thyroid ultrasound datasets demonstrate that PEMV-thyroid consistently outperforms state-of-the-art methods, particularly in cross-device and cross-domain evaluation scenarios, leading to improved diagnostic accuracy and generalisation performance in real-world clinical settings. The source code is available at https://github.com/chenyangmeii/Prototype-Enhanced-Multi-View-Learning.

While Large Language Models (LLMs) achieve expert-level performance on standard medical benchmarks through single-hop factual recall, they severely struggle with the complex, multi-hop diagnostic reasoning required in real-world clinical settings. A primary obstacle is "shortcut learning", where models exploit highly connected, generic hub nodes (e.g., "inflammation") in knowledge graphs to bypass authentic micro-pathological cascades. To address this, we introduce ShatterMed-QA, a bilingual benchmark of 10,558 multi-hop clinical questions designed to rigorously evaluate deep diagnostic reasoning. Our framework constructs a topology-regularized medical Knowledge Graph using a novel k-Shattering algorithm, which physically prunes generic hubs to explicitly sever logical shortcuts. We synthesize the evaluation vignettes by applying implicit bridge entity masking and topology-driven hard negative sampling, forcing models to navigate biologically plausible distractors without relying on superficial elimination. Comprehensive evaluations of 21 LLMs reveal massive performance degradation on our multi-hop tasks, particularly among domain-specific models. Crucially, restoring the masked evidence via Retrieval-Augmented Generation (RAG) triggers near-universal performance recovery, validating ShatterMed-QA's structural fidelity and proving its efficacy in diagnosing the fundamental reasoning deficits of current medical AI. Explore the dataset, interactive examples, and full leaderboards at our project website: https://shattermed-qa-web.vercel.app/

Intraoperative pathology is pivotal to precision surgery, yet its clinical impact is constrained by diagnostic complexity and the limited availability of high-quality frozen-section data. While computational pathology has made significant strides, the lack of large-scale, prospective validation has impeded its routine adoption in surgical workflows. Here, we introduce CRISP, a clinical-grade foundation model developed on over 100,000 frozen sections from eight medical centers, specifically designed to provide Clinical-grade Robust Intraoperative Support for Pathology (CRISP). CRISP was comprehensively evaluated on more than 15,000 intraoperative slides across nearly 100 retrospective diagnostic tasks, including benign-malignant discrimination, key intraoperative decision-making, and pan-cancer detection, etc. The model demonstrated robust generalization across diverse institutions, tumor types, and anatomical sites-including previously unseen sites and rare cancers. In a prospective cohort of over 2,000 patients, CRISP sustained high diagnostic accuracy under real-world conditions, directly informing surgical decisions in 92.6% of cases. Human-AI collaboration further reduced diagnostic workload by 35%, avoided 105 ancillary tests and enhanced detection of micrometastases with 87.5% accuracy. Together, these findings position CRISP as a clinical-grade paradigm for AI-driven intraoperative pathology, bridging computational advances with surgical precision and accelerating the translation of artificial intelligence into routine clinical practice.

Echocardiography is a vital non-invasive modality for cardiac assessment, with left ventricular ejection fraction (LVEF) serving as a key indicator of heart function. Existing LVEF estimation methods depend on large-scale annotated video datasets, which are costly and limit adaptability across various clinical settings. Recent vision-language models for echocardiography, such as EchoCLIP, apply image-to-text pretraining but fail to capture crucial temporal dynamics and localized cardiac structures essential for accurate diagnosis. To address these challenges, we propose CardiacCLIP, a video-based framework that enhances LVEF prediction through attention-based frame aggregation and multi-resolution input scaling. Specifically, we introduce MFL (Multi Frame Learning), a novel attention-based mechanism for selectively fusing informative frames, and EchoZoom, a multi-scale feature extraction strategy that refines spatial representations of cardiac structures. As a novel adaptation of CLIP models for few-shot echocardiogram video analysis, our approach significantly improves diagnostic accuracy, reducing MAE by 2.07 on the EchoNet-Dynamic dataset under 1-shot setting. The code is available at https://github.com/xmed-lab/CardiacCLIP.

Interactive medical questioning is essential in real-world clinical consultations, where physicians must actively gather information from patients. While medical Large Language Models (LLMs) have shown impressive capabilities in static medical question answering, they predominantly operate under a reactive paradigm: generating answers directly without seeking additional information, which risks incorrect diagnoses in such interactive settings. To address this limitation, we propose ProMed, a reinforcement learning (RL) framework that transitions medical LLMs toward a proactive paradigm, equipping them with the ability to ask clinically valuable questions before decision-making. At the core of ProMed is the Shapley Information Gain (SIG) reward, which quantifies the clinical utility of each question by combining the amount of newly acquired information with its contextual importance, estimated via Shapley values. We integrate SIG into a two-stage training pipeline: (1) SIG-Guided Model Initialization uses Monte Carlo Tree Search (MCTS) to construct high-reward interaction trajectories to supervise the model, and (2) SIG-Augmented Policy Optimization, which integrates SIG and enhances RL with a novel SIG-guided Reward Distribution Mechanism that assigns higher rewards to informative questions for targeted optimization. Extensive experiments on two newly curated partial-information medical benchmarks demonstrate that ProMed significantly outperforms state-of-the-art methods by an average of 6.29% and delivers a 54.45% gain over the reactive paradigm, while also generalizing robustly to out-of-domain cases.

The integration of artificial intelligence (AI) with radiology marks a transformative era in medicine. Vision foundation models have been adopted to enhance radiologic imaging analysis. However, the distinct complexities of radiologic 2D and 3D radiologic data pose unique challenges that existing models, pre-trained on general non-medical images, fail to address adequately. To bridge this gap and capitalize on the diagnostic precision required in radiologic imaging, we introduce Radiologic Contrastive Language-Image Pre-training (RadCLIP): a cross-modal vision-language foundational model that harnesses Vision Language Pre-training (VLP) framework to improve radiologic image analysis. Building upon Contrastive Language-Image Pre-training (CLIP), RadCLIP incorporates a slice pooling mechanism tailored for volumetric image analysis and is pre-trained using a large and diverse dataset of radiologic image-text pairs. The RadCLIP was pre-trained to effectively align radiologic images with their corresponding text annotations, creating a robust vision backbone for radiologic images. Extensive experiments demonstrate RadCLIP's superior performance in both uni-modal radiologic image classification and cross-modal image-text matching, highlighting its significant promise for improving diagnostic accuracy and efficiency in clinical settings. Our Key contributions include curating a large dataset with diverse radiologic 2D/3D radiologic image-text pairs, a slice pooling adapter using an attention mechanism for integrating 2D images, and comprehensive evaluations of RadCLIP on various radiologic downstream tasks.

Automatically summarizing patients' main problems from daily progress notes using natural language processing methods helps to battle against information and cognitive overload in hospital settings and potentially assists providers with computerized diagnostic decision support. Problem list summarization requires a model to understand, abstract, and generate clinical documentation. In this work, we propose a new NLP task that aims to generate a list of problems in a patient's daily care plan using input from the provider's progress notes during hospitalization. We investigate the performance of T5 and BART, two state-of-the-art seq2seq transformer architectures, in solving this problem. We provide a corpus built on top of progress notes from publicly available electronic health record progress notes in the Medical Information Mart for Intensive Care (MIMIC)-III. T5 and BART are trained on general domain text, and we experiment with a data augmentation method and a domain adaptation pre-training method to increase exposure to medical vocabulary and knowledge. Evaluation methods include ROUGE, BERTScore, cosine similarity on sentence embedding, and F-score on medical concepts. Results show that T5 with domain adaptive pre-training achieves significant performance gains compared to a rule-based system and general domain pre-trained language models, indicating a promising direction for tackling the problem summarization task.

Biomedical image analysis spans diverse modalities and tasks, yet real-world deployment is hindered by severe distribution shifts across scanners, protocols, and patient populations. High-performing models consequently require repeated domain-specific fine-tuning, which is a costly cycle that becomes impractical when labels are scarce or privacy constraints limit data sharing. We propose OPERA (Offline Policy-guided Expert Routing and Adaptation), a multi-agent ensemble framework that addresses this deployment bottleneck by treating expert weight assignment as an offline policy learning problem: a routing policy is learned from a small validation set without gradient updates to any expert agent, then deployed with test-time adaptation to handle distribution shift. OPERA coordinates heterogeneous specialist agents through complementary mechanisms. The expert profiling module learns selection policies offline, enabling informed allocation of expertise. Each agent undergoes confidence calibration through temperature adjustment, ensuring more reliable probabilistic outputs. OPERA also incorporates distribution aware adaptation, where class weights are dynamically adjusted at the batch level using statistics derived from unlabeled test data. Instance level routing assigns each sample to the most suitable expert by leveraging inter model agreement and predictive entropy. We evaluate OPERA on 9 datasets covering fundus photography, chest X-ray, CT, MRI, and multimodal diagnostic benchmarks, comparing against 30+ baselines across classification, segmentation, and multimodal settings. OPERA consistently improves performance and calibration quality, demonstrating that offline policy-guided expert agents coordination is a practical path to deployable biomedical AI without retraining. Code is on https://github.com/HUANGLIZI/OPERA{GitHub}.

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.

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.

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).

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.

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.

Given the dominance of dense retrievers that do not generalize well beyond their training dataset distributions, domain-specific test sets are essential in evaluating retrieval. There are few test datasets for retrieval systems intended for use by healthcare providers in a point-of-care setting. To fill this gap we have collaborated with medical professionals to create CURE, an ad-hoc retrieval test dataset for passage ranking with 2000 queries spanning 10 medical domains with a monolingual (English) and two cross-lingual (French/Spanish -> English) conditions. In this paper, we describe how CURE was constructed and provide baseline results to showcase its effectiveness as an evaluation tool. CURE is published with a Creative Commons Attribution Non Commercial 4.0 license and can be accessed on Hugging Face.

Most of the existing chest X-ray datasets include labels from a list of findings without specifying their locations on the radiographs. This limits the development of machine learning algorithms for the detection and localization of chest abnormalities. In this work, we describe a dataset of more than 100,000 chest X-ray scans that were retrospectively collected from two major hospitals in Vietnam. Out of this raw data, we release 18,000 images that were manually annotated by a total of 17 experienced radiologists with 22 local labels of rectangles surrounding abnormalities and 6 global labels of suspected diseases. The released dataset is divided into a training set of 15,000 and a test set of 3,000. Each scan in the training set was independently labeled by 3 radiologists, while each scan in the test set was labeled by the consensus of 5 radiologists. We designed and built a labeling platform for DICOM images to facilitate these annotation procedures. All images are made publicly available (https://www.physionet.org/content/vindr-cxr/1.0.0/) in DICOM format along with the labels of both the training set and the test set.

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.

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

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.

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.

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.

The rapid advancement of large-scale vision-language models has showcased remarkable capabilities across various tasks. However, the lack of extensive and high-quality image-text data in medicine has greatly hindered the development of large-scale medical vision-language models. In this work, we present a diagnosis-guided bootstrapping strategy that exploits both image and label information to construct vision-language datasets. Based on the constructed dataset, we developed MedDr, a generalist foundation model for healthcare capable of handling diverse medical data modalities, including radiology, pathology, dermatology, retinography, and endoscopy. Moreover, during inference, we propose a simple but effective retrieval-augmented medical diagnosis strategy, which enhances the model's generalization ability. Extensive experiments on visual question answering, medical report generation, and medical image diagnosis demonstrate the superiority of our method.

Seeking health-related advice on the internet has become a common practice in the digital era. Determining the trustworthiness of medical claims found online and finding appropriate evidence for this information is increasingly challenging. Fact-checking has emerged as an approach to assess the veracity of factual claims using evidence from credible knowledge sources. To help advance the automation of this task, in this paper, we introduce a novel dataset of 750 health-related claims, labeled for veracity by medical experts and backed with evidence from appropriate clinical studies. We provide an analysis of the dataset, highlighting its characteristics and challenges. The dataset can be used for Machine Learning tasks related to automated fact-checking such as evidence retrieval, veracity prediction, and explanation generation. For this purpose, we provide baseline models based on different approaches, examine their performance, and discuss the findings.

Artificial intelligence (AI) systems built on incomplete or biased data will often exhibit problematic outcomes. Current methods of data analysis, particularly before model development, are costly and not standardized. The Dataset Nutrition Label (the Label) is a diagnostic framework that lowers the barrier to standardized data analysis by providing a distilled yet comprehensive overview of dataset "ingredients" before AI model development. Building a Label that can be applied across domains and data types requires that the framework itself be flexible and adaptable; as such, the Label is comprised of diverse qualitative and quantitative modules generated through multiple statistical and probabilistic modelling backends, but displayed in a standardized format. To demonstrate and advance this concept, we generated and published an open source prototype with seven sample modules on the ProPublica Dollars for Docs dataset. The benefits of the Label are manyfold. For data specialists, the Label will drive more robust data analysis practices, provide an efficient way to select the best dataset for their purposes, and increase the overall quality of AI models as a result of more robust training datasets and the ability to check for issues at the time of model development. For those building and publishing datasets, the Label creates an expectation of explanation, which will drive better data collection practices. We also explore the limitations of the Label, including the challenges of generalizing across diverse datasets, and the risk of using "ground truth" data as a comparison dataset. We discuss ways to move forward given the limitations identified. Lastly, we lay out future directions for the Dataset Nutrition Label project, including research and public policy agendas to further advance consideration of the concept.

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/.