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Aug 4

An Integrated AI-Enabled System Using One Class Twin Cross Learning (OCT-X) for Early Gastric Cancer Detection

Early detection of gastric cancer, a leading cause of cancer-related mortality worldwide, remains hampered by the limitations of current diagnostic technologies, leading to high rates of misdiagnosis and missed diagnoses. To address these challenges, we propose an integrated system that synergizes advanced hardware and software technologies to balance speed-accuracy. Our study introduces the One Class Twin Cross Learning (OCT-X) algorithm. Leveraging a novel fast double-threshold grid search strategy (FDT-GS) and a patch-based deep fully convolutional network, OCT-X maximizes diagnostic accuracy through real-time data processing and seamless lesion surveillance. The hardware component includes an all-in-one point-of-care testing (POCT) device with high-resolution imaging sensors, real-time data processing, and wireless connectivity, facilitated by the NI CompactDAQ and LabVIEW software. Our integrated system achieved an unprecedented diagnostic accuracy of 99.70%, significantly outperforming existing models by up to 4.47%, and demonstrated a 10% improvement in multirate adaptability. These findings underscore the potential of OCT-X as well as the integrated system in clinical diagnostics, offering a path toward more accurate, efficient, and less invasive early gastric cancer detection. Future research will explore broader applications, further advancing oncological diagnostics. Code is available at https://github.com/liu37972/Multirate-Location-on-OCT-X-Learning.git.

  • 12 authors
·
Mar 31, 2025

Automatic Differential Diagnosis using Transformer-Based Multi-Label Sequence Classification

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.

  • 3 authors
·
Aug 28, 2024 1

Polyp-Gen: Realistic and Diverse Polyp Image Generation for Endoscopic Dataset Expansion

Automated diagnostic systems (ADS) have shown significant potential in the early detection of polyps during endoscopic examinations, thereby reducing the incidence of colorectal cancer. However, due to high annotation costs and strict privacy concerns, acquiring high-quality endoscopic images poses a considerable challenge in the development of ADS. Despite recent advancements in generating synthetic images for dataset expansion, existing endoscopic image generation algorithms failed to accurately generate the details of polyp boundary regions and typically required medical priors to specify plausible locations and shapes of polyps, which limited the realism and diversity of the generated images. To address these limitations, we present Polyp-Gen, the first full-automatic diffusion-based endoscopic image generation framework. Specifically, we devise a spatial-aware diffusion training scheme with a lesion-guided loss to enhance the structural context of polyp boundary regions. Moreover, to capture medical priors for the localization of potential polyp areas, we introduce a hierarchical retrieval-based sampling strategy to match similar fine-grained spatial features. In this way, our Polyp-Gen can generate realistic and diverse endoscopic images for building reliable ADS. Extensive experiments demonstrate the state-of-the-art generation quality, and the synthetic images can improve the downstream polyp detection task. Additionally, our Polyp-Gen has shown remarkable zero-shot generalizability on other datasets. The source code is available at https://github.com/CUHK-AIM-Group/Polyp-Gen.

  • 7 authors
·
Jan 27, 2025

Multi-Spectroscopic Method to Quantify Rapid Decomposition of an Organophosphate Simulant Using Reactive Materials as a Function of Metal Powder Chemistry and Temperature

The development of advanced diagnostic systems to measure and optimize emerging energetic material performance is critical for the defeat of Chemical Warfare Agents (CWA). This study presents an integrated multi-spectroscopic approach to monitor the interaction between a CWA simulant, Diisopropyl Methyl Phosphonate (DIMP), and combusting composite metal particles. A custom benchtop Polygonal Rotating Mirror Infrared Spectrometer (PRiMIRS), equipped with a customizable experimental chamber, is employed to observe DIMP decomposition. Tunable Diode Laser Absorption Spectroscopy (TDLAS) is used to measure path-averaged gas temperature profiles during combustion. In the experiment, the chamber is preheated to evaporate liquid DIMP. Various composite metal powders (Al-8Mg):3Zr, (Al-8Mg):Zr, 2(Al-8Mg):Zr, and 4(Al-8Mg):Zr are placed on a stainless steel mount and ignited using 3Al-2Ni sputter-deposited nanolayered foils. The combusting metal particles mix with the DIMP vapor, initiating chemical and thermal interactions. PRiMIRS captures DIMP spectral evolution, while TDLAS simultaneously monitors gas temperature. A spectral defeat parameter was developed to enable quantitative real-time assessment of the DIMP destruction. It uses infrared light absorption by both from DIMP and its immediate decomposition products Isopropyl Methyl Phosphonate (IMP) and Isopropyl Alcohol (IPA). Fourier Transform Infrared Spectroscopy (FTIR) serves as a secondary verification tool quantifying the decomposition products over extended timeframes, and Transmission Electron Microscopy (TEM) confirms the expected metal oxide dispersion within the reaction space. This study reports variability in DIMP defeat as a function of metal powder stoichiometry, metal powder loading, and path-averaged gas temperature profiles, offering critical insights into optimizing reactive materials for effective CWA neutralization.

  • 6 authors
·
Sep 4, 2025

AOI: Turning Failed Trajectories into Training Signals for Autonomous Cloud Diagnosis

Large language model (LLM) agents offer a promising data-driven approach to automating Site Reliability Engineering (SRE), yet their enterprise deployment is constrained by three challenges: restricted access to proprietary data, unsafe action execution under permission-governed environments, and the inability of closed systems to improve from failures. We present AOI (Autonomous Operations Intelligence), a trainable multi-agent framework formulating automated operations as a structured trajectory learning problem under security constraints. Our approach integrates three key components. First, a trainable diagnostic system applies Group Relative Policy Optimization (GRPO) to distill expert-level knowledge into locally deployed open-source models, enabling preference-based learning without exposing sensitive data. Second, a read-write separated execution architecture decomposes operational trajectories into observation, reasoning, and action phases, allowing safe learning while preventing unauthorized state mutation. Third, a Failure Trajectory Closed-Loop Evolver mines unsuccessful trajectories and converts them into corrective supervision signals, enabling continual data augmentation. Evaluated on the AIOpsLab benchmark, our contributions yield cumulative gains. (1) The AOI runtime alone achieves 66.3% best@5 success on all 86 tasks, outperforming the prior state-of-the-art (41.9%) by 24.4 points. (2) Adding Observer GRPO training, a locally deployed 14B model reaches 42.9% avg@1 on 63 held-out tasks with unseen fault types, surpassing Claude Sonnet 4.5. (3) The Evolver converts 37 failed trajectories into diagnostic guidance, improving end-to-end avg@5 by 4.8 points while reducing variance by 35%.

  • 14 authors
·
Mar 16

Retinal Fundus Multi-Disease Image Classification using Hybrid CNN-Transformer-Ensemble Architectures

Our research is motivated by the urgent global issue of a large population affected by retinal diseases, which are evenly distributed but underserved by specialized medical expertise, particularly in non-urban areas. Our primary objective is to bridge this healthcare gap by developing a comprehensive diagnostic system capable of accurately predicting retinal diseases solely from fundus images. However, we faced significant challenges due to limited, diverse datasets and imbalanced class distributions. To overcome these issues, we have devised innovative strategies. Our research introduces novel approaches, utilizing hybrid models combining deeper Convolutional Neural Networks (CNNs), Transformer encoders, and ensemble architectures sequentially and in parallel to classify retinal fundus images into 20 disease labels. Our overarching goal is to assess these advanced models' potential in practical applications, with a strong focus on enhancing retinal disease diagnosis accuracy across a broader spectrum of conditions. Importantly, our efforts have surpassed baseline model results, with the C-Tran ensemble model emerging as the leader, achieving a remarkable model score of 0.9166, surpassing the baseline score of 0.9. Additionally, experiments with the IEViT model showcased equally promising outcomes with improved computational efficiency. We've also demonstrated the effectiveness of dynamic patch extraction and the integration of domain knowledge in computer vision tasks. In summary, our research strives to contribute significantly to retinal disease diagnosis, addressing the critical need for accessible healthcare solutions in underserved regions while aiming for comprehensive and accurate disease prediction.

  • 3 authors
·
Mar 27, 2025

A Review of Deep Learning Approaches for Non-Invasive Cognitive Impairment Detection

This review paper explores recent advances in deep learning approaches for non-invasive cognitive impairment detection. We examine various non-invasive indicators of cognitive decline, including speech and language, facial, and motoric mobility. The paper provides an overview of relevant datasets, feature-extracting techniques, and deep-learning architectures applied to this domain. We have analyzed the performance of different methods across modalities and observed that speech and language-based methods generally achieved the highest detection performance. Studies combining acoustic and linguistic features tended to outperform those using a single modality. Facial analysis methods showed promise for visual modalities but were less extensively studied. Most papers focused on binary classification (impaired vs. non-impaired), with fewer addressing multi-class or regression tasks. Transfer learning and pre-trained language models emerged as popular and effective techniques, especially for linguistic analysis. Despite significant progress, several challenges remain, including data standardization and accessibility, model explainability, longitudinal analysis limitations, and clinical adaptation. Lastly, we propose future research directions, such as investigating language-agnostic speech analysis methods, developing multi-modal diagnostic systems, and addressing ethical considerations in AI-assisted healthcare. By synthesizing current trends and identifying key obstacles, this review aims to guide further development of deep learning-based cognitive impairment detection systems to improve early diagnosis and ultimately patient outcomes.

  • 6 authors
·
Oct 25, 2024

Electrocardiogram-Language Model for Few-Shot Question Answering with Meta Learning

Electrocardiogram (ECG) interpretation requires specialized expertise, often involving synthesizing insights from ECG signals with complex clinical queries posed in natural language. The scarcity of labeled ECG data coupled with the diverse nature of clinical inquiries presents a significant challenge for developing robust and adaptable ECG diagnostic systems. This work introduces a novel multimodal meta-learning method for few-shot ECG question answering, addressing the challenge of limited labeled data while leveraging the rich knowledge encoded within large language models (LLMs). Our LLM-agnostic approach integrates a pre-trained ECG encoder with a frozen LLM (e.g., LLaMA and Gemma) via a trainable fusion module, enabling the language model to reason about ECG data and generate clinically meaningful answers. Extensive experiments demonstrate superior generalization to unseen diagnostic tasks compared to supervised baselines, achieving notable performance even with limited ECG leads. For instance, in a 5-way 5-shot setting, our method using LLaMA-3.1-8B achieves accuracy of 84.6%, 77.3%, and 69.6% on single verify, choose and query question types, respectively. These results highlight the potential of our method to enhance clinical ECG interpretation by combining signal processing with the nuanced language understanding capabilities of LLMs, particularly in data-constrained scenarios.

  • 5 authors
·
Oct 18, 2024

CADICA: a new dataset for coronary artery disease detection by using invasive coronary angiography

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

  • 7 authors
·
Feb 1, 2024

Representation learning for improved interpretability and classification accuracy of clinical factors from EEG

Despite extensive standardization, diagnostic interviews for mental health disorders encompass substantial subjective judgment. Previous studies have demonstrated that EEG-based neural measures can function as reliable objective correlates of depression, or even predictors of depression and its course. However, their clinical utility has not been fully realized because of 1) the lack of automated ways to deal with the inherent noise associated with EEG data at scale, and 2) the lack of knowledge of which aspects of the EEG signal may be markers of a clinical disorder. Here we adapt an unsupervised pipeline from the recent deep representation learning literature to address these problems by 1) learning a disentangled representation using beta-VAE to denoise the signal, and 2) extracting interpretable features associated with a sparse set of clinical labels using a Symbol-Concept Association Network (SCAN). We demonstrate that our method is able to outperform the canonical hand-engineered baseline classification method on a number of factors, including participant age and depression diagnosis. Furthermore, our method recovers a representation that can be used to automatically extract denoised Event Related Potentials (ERPs) from novel, single EEG trajectories, and supports fast supervised re-mapping to various clinical labels, allowing clinicians to re-use a single EEG representation regardless of updates to the standardized diagnostic system. Finally, single factors of the learned disentangled representations often correspond to meaningful markers of clinical factors, as automatically detected by SCAN, allowing for human interpretability and post-hoc expert analysis of the recommendations made by the model.

  • 9 authors
·
Oct 28, 2020

Adaptive Depth in Looped Transformers: Diagnosing Learned Halting Gates and Trajectory Readouts

Looped Transformers increase test-time computation by repeatedly applying a shared recurrent block. Learned halting objectives in looped Transformers typically use a single exit distribution both as the inference-time stopping rule and as the training-time weighting of per-depth losses. This entangles exit selection with trajectory formation: the gate not only chooses which recurrent state to use, but also determines how strongly each intermediate state is supervised. Consequently, poor adaptive-compute performance can arise from the readout, the induced trajectory, or their interaction. We study adaptive depth in looped Transformers through this trajectory--readout lens, across controlled synthetic tasks (modular arithmetic and binary parity) and large-scale Ouro-1.4B and 2.6B checkpoints. We find that fixed-prior depth supervision, which shapes the trajectory without an input-dependent halting policy, produces difficulty-aware trajectories whose intermediate states expose useful stopping signals, and that simple post-hoc confidence readouts often match or outperform learned linear and MLP gates. Fitting gates on frozen trajectories localizes the failure: it appears to stem mainly from the trajectory induced by joint gate training rather than from limited gate expressivity. The same pattern is present in Ouro evaluations, where pretrained ponder gates are competitive but not uniformly Pareto-optimal, and measured latency confirms that the resulting reductions in average exit depth translate into practical inference-time savings. Our systematic diagnostic evaluation reframes adaptive depth in looped Transformers as a joint problem of trajectory formation and exit readout, rather than gate learning alone, highlighting a distinction that prior learned-halting work has often left implicit.

  • 3 authors
·
Jul 7

Exploring Large Language Models for Specialist-level Oncology Care

Large language models (LLMs) have shown remarkable progress in encoding clinical knowledge and responding to complex medical queries with appropriate clinical reasoning. However, their applicability in subspecialist or complex medical settings remains underexplored. In this work, we probe the performance of AMIE, a research conversational diagnostic AI system, in the subspecialist domain of breast oncology care without specific fine-tuning to this challenging domain. To perform this evaluation, we curated a set of 50 synthetic breast cancer vignettes representing a range of treatment-naive and treatment-refractory cases and mirroring the key information available to a multidisciplinary tumor board for decision-making (openly released with this work). We developed a detailed clinical rubric for evaluating management plans, including axes such as the quality of case summarization, safety of the proposed care plan, and recommendations for chemotherapy, radiotherapy, surgery and hormonal therapy. To improve performance, we enhanced AMIE with the inference-time ability to perform web search retrieval to gather relevant and up-to-date clinical knowledge and refine its responses with a multi-stage self-critique pipeline. We compare response quality of AMIE with internal medicine trainees, oncology fellows, and general oncology attendings under both automated and specialist clinician evaluations. In our evaluations, AMIE outperformed trainees and fellows demonstrating the potential of the system in this challenging and important domain. We further demonstrate through qualitative examples, how systems such as AMIE might facilitate conversational interactions to assist clinicians in their decision making. However, AMIE's performance was overall inferior to attending oncologists suggesting that further research is needed prior to consideration of prospective uses.

  • 21 authors
·
Nov 5, 2024

Current World Models Lack a Persistent State Core

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.

Learning Sub-Sampling and Signal Recovery with Applications in Ultrasound Imaging

Limitations on bandwidth and power consumption impose strict bounds on data rates of diagnostic imaging systems. Consequently, the design of suitable (i.e. task- and data-aware) compression and reconstruction techniques has attracted considerable attention in recent years. Compressed sensing emerged as a popular framework for sparse signal reconstruction from a small set of compressed measurements. However, typical compressed sensing designs measure a (non)linearly weighted combination of all input signal elements, which poses practical challenges. These designs are also not necessarily task-optimal. In addition, real-time recovery is hampered by the iterative and time-consuming nature of sparse recovery algorithms. Recently, deep learning methods have shown promise for fast recovery from compressed measurements, but the design of adequate and practical sensing strategies remains a challenge. Here, we propose a deep learning solution termed Deep Probabilistic Sub-sampling (DPS), that learns a task-driven sub-sampling pattern, while jointly training a subsequent task model. Once learned, the task-based sub-sampling patterns are fixed and straightforwardly implementable, e.g. by non-uniform analog-to-digital conversion, sparse array design, or slow-time ultrasound pulsing schemes. The effectiveness of our framework is demonstrated in-silico for sparse signal recovery from partial Fourier measurements, and in-vivo for both anatomical image and tissue-motion (Doppler) reconstruction from sub-sampled medical ultrasound imaging data.

  • 5 authors
·
Aug 15, 2019

MedFrameQA: A Multi-Image Medical VQA Benchmark for Clinical Reasoning

Existing medical VQA benchmarks mostly focus on single-image analysis, yet clinicians almost always compare a series of images before reaching a diagnosis. To better approximate this workflow, we introduce MedFrameQA -- the first benchmark that explicitly evaluates multi-image reasoning in medical VQA. To build MedFrameQA both at scale and in high-quality, we develop 1) an automated pipeline that extracts temporally coherent frames from medical videos and constructs VQA items whose content evolves logically across images, and 2) a multiple-stage filtering strategy, including model-based and manual review, to preserve data clarity, difficulty, and medical relevance. The resulting dataset comprises 2,851 VQA pairs (gathered from 9,237 high-quality frames in 3,420 videos), covering nine human body systems and 43 organs; every question is accompanied by two to five images. We comprehensively benchmark ten advanced Multimodal LLMs -- both proprietary and open source, with and without explicit reasoning modules -- on MedFrameQA. The evaluation challengingly reveals that all models perform poorly, with most accuracies below 50%, and accuracy fluctuates as the number of images per question increases. Error analysis further shows that models frequently ignore salient findings, mis-aggregate evidence across images, and propagate early mistakes through their reasoning chains; results also vary substantially across body systems, organs, and modalities. We hope this work can catalyze research on clinically grounded, multi-image reasoning and accelerate progress toward more capable diagnostic AI systems.

  • 5 authors
·
May 22, 2025

SilVar-Med: A Speech-Driven Visual Language Model for Explainable Abnormality Detection in Medical Imaging

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

  • 6 authors
·
Apr 14, 2025 2

Benchmarking Sensor Robustness in Plasma Diagnostic Models: A Systematic Evaluation on TokaMark

Plasma diagnostic models for tokamak fusion devices are almost universally evaluated on clean, complete sensor data. In practice, fusion diagnostics fail regularly: acquisition systems start late, individual sensors die, and signal dropouts cluster precisely when a plasma disruption is approaching. We present the first systematic robustness benchmark for plasma diagnostic ML using the TokaMark dataset of 11,573 MAST shots, evaluating XGBoost, LSTM, Transformer, and the TokaMark CNN baseline across six physically-grounded failure scenarios and three imputation strategies. We introduce the Robustness Score (RS) for standardized cross-architecture comparison. Our central finding is that disruption-proximate sensor failure (corruption injected in the final window timesteps) collapses sequence model performance (LSTM +212% NRMSE) while a statistical feature model remains comparatively stable (XGBoost +37%). Forward-fill imputation eliminates nearly all degradation from random dropout for sequence models (LSTM +57% to ~0%), but offers little help when the end of the window is corrupted. Shot-level alarm evaluation using ground-truth disruption timestamps reveals that LSTM alarm detection collapses to TPR=0.00 under proximate sensor failure, while mean-fill imputation recovers it to TPR=1.00, a reversal of the pattern observed in NRMSE. Plasma current emerges as the single most critical diagnostic across all architectures (+73% to +140% upon removal). Code, data, and trained checkpoints are available at https://github.com/Neerav-Gupta/tokamark-robustness.

  • 1 authors
·
Jul 4 2

PermaFrost-Attack: Stealth Pretraining Seeding(SPS) for planting Logic Landmines During LLM Training

Aligned large language models (LLMs) remain vulnerable to adversarial manipulation, and their reliance on web-scale pretraining creates a subtle but consequential attack surface. We study Stealth Pretraining Seeding (SPS), a threat model in which adversaries distribute small amounts of poisoned content across stealth websites, increasing the likelihood that such material is absorbed into future training corpora derived from sources such as Common Crawl. Because each individual payload is tiny, diffuse, and superficially benign, the attack is difficult to detect during dataset construction or filtering. The result is a latent form of poisoning that remains largely invisible under standard evaluation, yet can later be activated by a precise trigger such as <00TRIGGER00>. We call this attack PermaFrost, reflecting its latent and reactivatable nature. We study it through PermaFrost-Attack, a controlled framework for latent conceptual poisoning, together with three geometric diagnostics: Thermodynamic Length, Spectral Curvature, and the Infection Traceback Graph. Across multiple model families and scales, we show that this controlled SPS proxy can induce persistent unsafe behavior that often remains hidden under standard evaluation. Our results identify SPS as a practical and underappreciated threat to future foundation models. This paper introduces a novel geometric diagnostic lens for systematically examining latent model behavior, providing a principled foundation for detecting, characterizing, and understanding vulnerabilities that may remain invisible under standard evaluation.

  • 7 authors
·
Apr 27

On the Entropy in Last-Mile Logistics

Last-mile logistics (LML) is characterized by high fragmentation, yet existing research treats this as an exogenous constraint rather than a quantifiable and optimizable system property. This paper introduces a framework for measuring LML complexity using structural entropy, derived from Boltzmann's statistical mechanics. Unlike traditional KPIs such as distance or cost, structural entropy quantifies the cardinality of the configuration space, providing a diagnostic of inherent system disorder. We establish a formal duality with Shannon entropy, linking absolute complexity burden to distributional balance. We apply our entropy framework to 6,112 Amazon last-mile routes across five U.S. cities. Current operations exhibit persistently high normalized entropy, indicating near-maximal fragmentation. A stable non-linear scaling relationship between entropy and route distance validates the metric as a predictive indicator of operational difficulty. To evaluate spatial consolidation, we develop a system-wide entropy measure accounting for all movements by both carriers and customers. We establish a theoretical conservation principle: under idealized conditions, spatial consolidation merely redistributes entropy from carrier to customer. Both idealizing conditions are violated in practice, thereby increasing total system entropy. Our system-wide measure reveals that spatial consolidation reduces carrier entropy by up to 40% under aggressive adoption but increases total system entropy by activating customer collection trips, though trip chaining can diminish this effect. Temporal consolidation, by contrast, genuinely reduces entropy by decreasing delivery events without creating new movements. By formalizing fragmentation as a measurable structural property, this research provides a new lens for network design, consolidation policy, and evaluation last-mile system performance.

  • 2 authors
·
Feb 25

ViCrit: A Verifiable Reinforcement Learning Proxy Task for Visual Perception in VLMs

Reinforcement learning (RL) has shown great effectiveness for fine-tuning large language models (LLMs) using tasks that are challenging yet easily verifiable, such as math reasoning or code generation. However, extending this success to visual perception in vision-language models (VLMs) has been impeded by the scarcity of vision-centric tasks that are simultaneously challenging and unambiguously verifiable. To this end, we introduce ViCrit (Visual Caption Hallucination Critic), an RL proxy task that trains VLMs to localize a subtle, synthetic visual hallucination injected into paragraphs of human-written image captions. Starting from a 200-word captions, we inject a single, subtle visual description error-altering a few words on objects, attributes, counts, or spatial relations-and task the model to pinpoint the corrupted span given the image and the modified caption. This formulation preserves the full perceptual difficulty while providing a binary, exact-match reward that is easy to compute and unambiguous. Models trained with the ViCrit Task exhibit substantial gains across a variety of VL benchmarks. Crucially, the improvements transfer beyond natural-image training data to abstract image reasoning and visual math, showing promises of learning to perceive rather than barely memorizing seen objects. To facilitate evaluation, we further introduce ViCrit-Bench, a category-balanced diagnostic benchmark that systematically probes perception errors across diverse image domains and error types. Together, our results demonstrate that fine-grained hallucination criticism is an effective and generalizable objective for enhancing visual perception in VLMs.

  • 13 authors
·
Jun 11, 2025 2

When Agents Fail to Act: A Diagnostic Framework for Tool Invocation Reliability in Multi-Agent LLM Systems

Multi-agent systems powered by large language models (LLMs) are transforming enterprise automation, yet systematic evaluation methodologies for assessing tool-use reliability remain underdeveloped. We introduce a comprehensive diagnostic framework that leverages big data analytics to evaluate procedural reliability in intelligent agent systems, addressing critical needs for SME-centric deployment in privacy-sensitive environments. Our approach features a 12-category error taxonomy capturing failure modes across tool initialization, parameter handling, execution, and result interpretation. Through systematic evaluation of 1,980 deterministic test instances spanning both open-weight models (Qwen2.5 series, Functionary) and proprietary alternatives (GPT-4, Claude 3.5/3.7) across diverse edge hardware configurations, we identify actionable reliability thresholds for production deployment. Our analysis reveals that procedural reliability, particularly tool initialization failures, constitutes the primary bottleneck for smaller models, while qwen2.5:32b achieves flawless performance matching GPT-4.1. The framework demonstrates that mid-sized models (qwen2.5:14b) offer practical accuracy-efficiency trade-offs on commodity hardware (96.6\% success rate, 7.3 s latency), enabling cost-effective intelligent agent deployment for resource-constrained organizations. This work establishes foundational infrastructure for systematic reliability evaluation of tool-augmented multi-agent AI systems.

  • 3 authors
·
Jan 21

End-to-End Agentic RAG System Training for Traceable Diagnostic Reasoning

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.

  • 10 authors
·
Aug 21, 2025 2

A Diagnostic Kit for Optical Emission Lines Shaped by Accretion Disc Winds

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.

  • 5 authors
·
Sep 2, 2025

An Agentic System for Rare Disease Diagnosis with Traceable Reasoning

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

  • 12 authors
·
Jun 25, 2025 1

Towards Conversational Diagnostic AI

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.

  • 25 authors
·
Jan 10, 2024

BRAINS: A Retrieval-Augmented System for Alzheimer's Detection and Monitoring

As the global burden of Alzheimer's disease (AD) continues to grow, early and accurate detection has become increasingly critical, especially in regions with limited access to advanced diagnostic tools. We propose BRAINS (Biomedical Retrieval-Augmented Intelligence for Neurodegeneration Screening) to address this challenge. This novel system harnesses the powerful reasoning capabilities of Large Language Models (LLMs) for Alzheimer's detection and monitoring. BRAINS features a dual-module architecture: a cognitive diagnostic module and a case-retrieval module. The Diagnostic Module utilizes LLMs fine-tuned on cognitive and neuroimaging datasets -- including MMSE, CDR scores, and brain volume metrics -- to perform structured assessments of Alzheimer's risk. Meanwhile, the Case Retrieval Module encodes patient profiles into latent representations and retrieves similar cases from a curated knowledge base. These auxiliary cases are fused with the input profile via a Case Fusion Layer to enhance contextual understanding. The combined representation is then processed with clinical prompts for inference. Evaluations on real-world datasets demonstrate BRAINS effectiveness in classifying disease severity and identifying early signs of cognitive decline. This system not only shows strong potential as an assistive tool for scalable, explainable, and early-stage Alzheimer's disease detection, but also offers hope for future applications in the field.

eliteresearch ELITE Research Lab
·
Nov 4, 2025 1

OpenExempt: A Diagnostic Benchmark for Legal Reasoning and a Framework for Creating Custom Benchmarks on Demand

Reasoning benchmarks have played a crucial role in the progress of language models. Yet rigorous evaluation remains a significant challenge as static question-answer pairs provide only a snapshot of performance, compressing complex behavior into a single accuracy metric. This limitation is especially true in complex, rule-bound domains such as law, where existing benchmarks are costly to build and ill suited for isolating specific failure modes. To address this, we introduce OpenExempt, a framework and benchmark for diagnostic evaluation of legal reasoning. The OpenExempt Framework uses expert-crafted symbolic representations of U.S. Bankruptcy Code statutes to dynamically generate a large space of natural language reasoning tasks and their machine-computable solutions on demand. This gives users fine-grained control over task complexity and scope, allowing individual reasoning skills to be probed in isolation. Using this system, we construct the OpenExempt Benchmark, a diagnostic benchmark for legal reasoning with 9,765 samples across nine evaluation suites designed to carefully probe model capabilities. Experiments on 13 diverse language models reveal sharp performance cliffs that emerge only under longer reasoning paths and in the presence of obfuscating statements. We release the framework and benchmark publicly to support research aimed at understanding and improving the next generation of reasoning systems.

  • 5 authors
·
Jan 19

Health system learning achieves generalist neuroimaging models

Frontier artificial intelligence (AI) models, such as OpenAI's GPT-5 and Meta's DINOv3, have advanced rapidly through training on internet-scale public data, yet such systems lack access to private clinical data. Neuroimaging, in particular, is underrepresented in the public domain due to identifiable facial features within MRI and CT scans, fundamentally restricting model performance in clinical medicine. Here, we show that frontier models underperform on neuroimaging tasks and that learning directly from uncurated data generated during routine clinical care at health systems, a paradigm we call health system learning, yields high-performance, generalist neuroimaging models. We introduce NeuroVFM, a visual foundation model trained on 5.24 million clinical MRI and CT volumes using a scalable volumetric joint-embedding predictive architecture. NeuroVFM learns comprehensive representations of brain anatomy and pathology, achieving state-of-the-art performance across multiple clinical tasks, including radiologic diagnosis and report generation. The model exhibits emergent neuroanatomic understanding and interpretable visual grounding of diagnostic findings. When paired with open-source language models through lightweight visual instruction tuning, NeuroVFM generates radiology reports that surpass frontier models in accuracy, clinical triage, and expert preference. Through clinically grounded visual understanding, NeuroVFM reduces hallucinated findings and critical errors, offering safer clinical decision support. These results establish health system learning as a paradigm for building generalist medical AI and provide a scalable framework for clinical foundation models.

LungNoduleAgent: A Collaborative Multi-Agent System for Precision Diagnosis of Lung Nodules

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

  • 10 authors
·
Nov 25, 2025

Omni-Persona: Systematic Benchmarking and Improving Omnimodal Personalization

While multimodal large language models have advanced across text, image, and audio, personalization research has remained primarily vision-language, with unified omnimodal benchmarking that jointly covers text, image, and audio still limited, and lacking the methodological rigor to account for absent-persona scenarios or systematic grounding studies. We introduce Omni-Persona, the first comprehensive benchmark for omnimodal personalization. We formalize the task as cross-modal routing over the Persona Modality Graph, encompassing 4 task groups and 18 fine-grained tasks across {sim}750 items. To rigorously diagnose grounding behavior, we propose Calibrated Accuracy (mathrm{Cal)}, which jointly rewards correct grounding and appropriate abstention, incorporating absent-persona queries within a unified evaluation framework. On our dedicated experiments, three diagnostic findings emerge: (i) open-source models show a consistent audio-vs-visual grounding gap that RLVR partially narrows via dense rule-based supervision; (ii) answerable recall and parameter scale are incomplete diagnostics, since strong recall can coexist with absent-persona hallucination and larger models do not always achieve higher Cal, exposing calibration as a separate evaluation axis; and (iii) SFT is bounded by the difficulty of constructing annotated ground-truth supervision at scale, while RLVR generalizes more consistently through outcome-level verifiable feedback yet drifts toward conservative behavior and lower generation quality under our reward design. Omni-Persona thus serves as a diagnostic framework that surfaces the pitfalls of omnimodal personalization, guiding future post-training and reward design.

BESPOKE: Benchmark for Search-Augmented Large Language Model Personalization via Diagnostic Feedback

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

  • 4 authors
·
Sep 25, 2025 2

MedVista3D: Vision-Language Modeling for Reducing Diagnostic Errors in 3D CT Disease Detection, Understanding and Reporting

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

  • 6 authors
·
Sep 3, 2025 2

Why Supervised Fine-Tuning Fails to Learn: A Systematic Study of Incomplete Learning in Large Language Models

Supervised Fine-Tuning (SFT) is the standard approach for adapting large language models (LLMs) to downstream tasks. However, we observe a persistent failure mode: even after convergence, models often fail to correctly reproduce a subset of their own supervised training data. We refer to this behavior as the Incomplete Learning Phenomenon(ILP). This paper presents the first systematic study of ILP in LLM fine-tuning. We formalize ILP as post-training failure to internalize supervised instances and demonstrate its prevalence across multiple model families, domains, and datasets. Through controlled analyses, we identify five recurrent sources of incomplete learning: (1) missing prerequisite knowledge in the pre-trained model, (2) conflicts between SFT supervision and pre-training knowledge, (3) internal inconsistencies within SFT data, (4) left-side forgetting during sequential fine-tuning, and (5) insufficient optimization for rare or complex patterns. We introduce a diagnostic-first framework that maps unlearned samples to these causes using observable training and inference signals, and study several targeted mitigation strategies as causal interventions. Experiments on Qwen, LLaMA, and OLMo2 show that incomplete learning is widespread and heterogeneous, and that improvements in aggregate metrics can mask persistent unlearned subsets. The findings highlight the need for fine-grained diagnosis of what supervised fine-tuning fails to learn, and why.

Tencent-Hunyuan Tencent Hunyuan
·
Apr 23

V-LoL: A Diagnostic Dataset for Visual Logical Learning

Despite the successes of recent developments in visual AI, different shortcomings still exist; from missing exact logical reasoning, to abstract generalization abilities, to understanding complex and noisy scenes. Unfortunately, existing benchmarks, were not designed to capture more than a few of these aspects. Whereas deep learning datasets focus on visually complex data but simple visual reasoning tasks, inductive logic datasets involve complex logical learning tasks, however, lack the visual component. To address this, we propose the visual logical learning dataset, V-LoL, that seamlessly combines visual and logical challenges. Notably, we introduce the first instantiation of V-LoL, V-LoL-Trains, -- a visual rendition of a classic benchmark in symbolic AI, the Michalski train problem. By incorporating intricate visual scenes and flexible logical reasoning tasks within a versatile framework, V-LoL-Trains provides a platform for investigating a wide range of visual logical learning challenges. We evaluate a variety of AI systems including traditional symbolic AI, neural AI, as well as neuro-symbolic AI. Our evaluations demonstrate that even state-of-the-art AI faces difficulties in dealing with visual logical learning challenges, highlighting unique advantages and limitations specific to each methodology. Overall, V-LoL opens up new avenues for understanding and enhancing current abilities in visual logical learning for AI systems.

  • 5 authors
·
Jun 13, 2023

Automatic Failure Attribution and Critical Step Prediction Method for Multi-Agent Systems Based on Causal Inference

Multi-agent systems (MAS) are critical for automating complex tasks, yet their practical deployment is severely hampered by the challenge of failure attribution. Current diagnostic tools, which rely on statistical correlations, are fundamentally inadequate; on challenging benchmarks like Who\&When, state-of-the-art methods achieve less than 15\% accuracy in locating the root-cause step of a failure. To address this critical gap, we introduce the first failure attribution framework for MAS grounded in multi-granularity causal inference. Our approach makes two key technical contributions: (1) a performance causal inversion principle, which correctly models performance dependencies by reversing the data flow in execution logs, combined with Shapley values to accurately assign agent-level blame; (2) a novel causal discovery algorithm, CDC-MAS, that robustly identifies critical failure steps by tackling the non-stationary nature of MAS interaction data. The framework's attribution results directly fuel an automated optimization loop, generating targeted suggestions whose efficacy is validated via counterfactual simulations. Evaluations on the Who\&When and TRAIL benchmarks demonstrate a significant leap in performance. Our method achieves up to 36.2\% step-level accuracy. Crucially, the generated optimizations boost overall task success rates by an average of 22.4\%. This work provides a principled and effective solution for debugging complex agent interactions, paving the way for more reliable and interpretable multi-agent systems.

  • 7 authors
·
Sep 10, 2025

Integrating Clinical Knowledge Graphs and Gradient-Based Neural Systems for Enhanced Melanoma Diagnosis via the 7-Point Checklist

The 7-point checklist (7PCL) is a widely used diagnostic tool in dermoscopy for identifying malignant melanoma by assigning point values to seven specific attributes. However, the traditional 7PCL is limited to distinguishing between malignant melanoma and melanocytic Nevi, and falls short in scenarios where multiple skin diseases with appearances similar to melanoma coexist. To address this limitation, we propose a novel diagnostic framework that integrates a clinical knowledge-based topological graph (CKTG) with a gradient diagnostic strategy featuring a data-driven weighting system (GD-DDW). The CKTG captures both the internal and external relationships among the 7PCL attributes, while the GD-DDW emulates dermatologists' diagnostic processes, prioritizing visual observation before making predictions. Additionally, we introduce a multimodal feature extraction approach leveraging a dual-attention mechanism to enhance feature extraction through cross-modal interaction and unimodal collaboration. This method incorporates meta-information to uncover interactions between clinical data and image features, ensuring more accurate and robust predictions. Our approach, evaluated on the EDRA dataset, achieved an average AUC of 88.6%, demonstrating superior performance in melanoma detection and feature prediction. This integrated system provides data-driven benchmarks for clinicians, significantly enhancing the precision of melanoma diagnosis.

  • 7 authors
·
Jul 23, 2024

DR.BENCH: Diagnostic Reasoning Benchmark for Clinical Natural Language Processing

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

  • 7 authors
·
Sep 29, 2022

A deep learning system for differential diagnosis of skin diseases

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

  • 22 authors
·
Sep 11, 2019

Causal Judge Evaluation: Calibrated Surrogate Metrics for LLM Systems

LLM-as-judge evaluation has become the de facto standard for scaling model assessment, but the practice is statistically unsound: uncalibrated scores can invert preferences, naive confidence intervals on uncalibrated scores achieve near-0% coverage, and importance-weighted estimators collapse under limited overlap despite high effective sample size (ESS). We introduce Causal Judge Evaluation (CJE), a framework that fixes all three failures. On n=4,961 Chatbot Arena prompts (after filtering from 5k), CJE achieves 99% pairwise ranking accuracy at full sample size (94% averaged across configurations), matching oracle quality, at 14x lower cost (for ranking 5 policies) by calibrating a 16x cheaper judge on just 5% oracle labels (~250 labels). CJE combines three components: (i) AutoCal-R, reward calibration via mean-preserving isotonic regression; (ii) SIMCal-W, weight stabilization via stacking of S-monotone candidates; and (iii) Oracle-Uncertainty Aware (OUA) inference that propagates calibration uncertainty into confidence intervals. We formalize the Coverage-Limited Efficiency (CLE) diagnostic, which explains why IPS-style estimators fail even when ESS exceeds 90%: the logger rarely visits regions where target policies concentrate. Key findings: SNIPS inverts rankings even with reward calibration (38% pairwise, negative Kendall's tau) due to weight instability; calibrated IPS remains near-random (47%) despite weight stabilization, consistent with CLE; OUA improves coverage from near-0% to ~86% (Direct) and ~96% (stacked-DR), where naive intervals severely under-cover.

  • 1 authors
·
Dec 11, 2025 2

WeGenBench: A Multidimensional Diagnostic Benchmark towards Text-to-Image Model Optimization

Recent text-to-image generation models have demonstrated remarkable capabilities in synthesizing highly realistic images from text inputs alone. Although existing benchmarks can evaluate the generation capabilities of various models to some extent, they struggle to comprehensively and accurately measure performance across multiple dimensions, often failing to reveal the inherent deficiencies of models in specific categories. To address these limitations, we propose WeGenBench, a novel benchmark designed for the comprehensive, multi-perspective evaluation of text-to-image generation capabilities. Our benchmark comprises a total of 4,000 test prompts across two primary categories, meticulously balanced between Chinese and English to evaluate bilingual and cross-cultural generation capabilities. Beyond macroscopic scene classification, we annotate each prompt with multi-dimensional tags tailored to the distinct content and challenges of each language, thereby refining the generation tasks into more specific sub-categories. Through a cross-dimensional evaluation mechanism leveraging both scene classifications and multi-dimensional tags, WeGenBench can precisely pinpoint model shortcomings in specific generation categories. Furthermore, to measure generation quality more accurately, we design and validate several novel evaluation metrics by integrating Vision-Language Models (VLMs), which assess model performance on domain-specific tasks from three core aspects. Crucially, our approach yields both the assessment outcomes and the detailed reasoning trajectories, facilitating a rigorous verification of the accuracy and soundness of the evaluation results. Finally, we conduct systematic benchmarking on current state-of-the-art methods and provide an in-depth analysis of the limitations present in existing models.

  • 9 authors
·
Jun 17

Gender-Dependent Diagnostic Substitution in LLM Medical Triage: Same Symptoms, Unequal Urgency

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

  • 1 authors
·
Jun 1

CT-FineBench: A Diagnostic Fidelity Benchmark for Fine-Grained Evaluation of CT Report Generation

The evaluation of generated reports remains a critical challenge in Computed Tomography (CT) report generation, due to the large volume of text, the diversity and complexity of findings, and the presence of fine-grained, disease-oriented attributes. Conventional evaluation metrics offer only coarse measures of lexical overlap or entity matching and fail to reflect the granular diagnostic accuracy required for clinical use. To address this gap, we propose CT-FineBench, a benchmark built from CT-RATE and Merlin to evaluate the fine-grained factual consistency of CT reports, constructed from CT-RATE and Merlin. Our benchmark is constructed through a meticulous, Question-Answering (QA) based process: first, we identify and structure key, finding-specific clinical attributes (like location, size, margin). Second, we systematically transform these attributes into a QA dataset, where questions probe for specific clinical details grounded in gold-standard reports. The evaluation protocol for CT-FineBench involves using this QA dataset to query a machine-generated report and scoring the correctness of the answers. This allows for a comprehensive, interpretable, and clinically-relevant assessment, moving beyond superficial lexical overlap to pinpoint specific clinical errors. Experiments show that CT-FineBench correlates better with expert clinical assessment and is substantially more sensitive to fine-grained factual errors than prior metrics.

  • 7 authors
·
Apr 26

DoctorAgent-RL: A Multi-Agent Collaborative Reinforcement Learning System for Multi-Turn Clinical Dialogue

Large language models (LLMs) have demonstrated excellent capabilities in the field of biomedical question answering, but their application in real-world clinical consultations still faces core challenges. Existing systems rely on a one-way information transmission mode where patients must fully describe their symptoms in a single round, leading to nonspecific diagnostic recommendations when complaints are vague. Traditional multi-turn dialogue methods based on supervised learning are constrained by static data-driven paradigms, lacking generalizability and struggling to intelligently extract key clinical information. To address these limitations, we propose DoctorAgent-RL, a reinforcement learning (RL)-based multi-agent collaborative framework that models medical consultations as a dynamic decision-making process under uncertainty. The doctor agent continuously optimizes its questioning strategy within the RL framework through multi-turn interactions with the patient agent, dynamically adjusting its information-gathering path based on comprehensive rewards from the Consultation Evaluator. This RL fine-tuning mechanism enables LLMs to autonomously develop interaction strategies aligned with clinical reasoning logic, rather than superficially imitating patterns in existing dialogue data. Notably, we constructed MTMedDialog, the first English multi-turn medical consultation dataset capable of simulating patient interactions. Experiments demonstrate that DoctorAgent-RL outperforms existing models in both multi-turn reasoning capability and final diagnostic performance, demonstrating practical value in assisting clinical consultations. https://github.com/JarvisUSTC/DoctorAgent-RL

  • 4 authors
·
May 26, 2025 2

Diagnostic Impact of Cine Clips for Thyroid Nodule Assessment on Ultrasound

Background: Thyroid ultrasound is commonly performed using a combination of static images and cine clips (video recordings). However, the exact utility and impact of cine images remains unknown. This study aimed to evaluate the impact of cine imaging on accuracy and consistency of thyroid nodule assessment, using the American College of Radiology Thyroid Reporting and Data System (ACR TI-RADS). Methods: 50 benign and 50 malignant thyroid nodules with cytopathology results were included. A reader study with 4 specialty-trained radiologists was then conducted over 3 rounds, assessing only static images in the first two rounds and both static and cine images in the third round. TI-RADS scores and the consequent management recommendations were then evaluated by comparing them to the malignancy status of the nodules. Results: Mean sensitivity for malignancy detection was 0.65 for static images and 0.67 with both static and cine images (p>0.5). Specificity was 0.20 for static images and 0.22 with both static and cine images (p>0.5). Management recommendations were similar with and without cine images. Intrareader agreement on feature assignments remained consistent across all rounds, though TI-RADS point totals were slightly higher with cine images. Conclusion: The inclusion of cine imaging for thyroid nodule assessment on ultrasound did not significantly change diagnostic performance. Current practice guidelines, which do not mandate cine imaging, are sufficient for accurate diagnosis.

  • 7 authors
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Jan 31

MMed-RAG: Versatile Multimodal RAG System for Medical Vision Language Models

Artificial Intelligence (AI) has demonstrated significant potential in healthcare, particularly in disease diagnosis and treatment planning. Recent progress in Medical Large Vision-Language Models (Med-LVLMs) has opened up new possibilities for interactive diagnostic tools. However, these models often suffer from factual hallucination, which can lead to incorrect diagnoses. Fine-tuning and retrieval-augmented generation (RAG) have emerged as methods to address these issues. However, the amount of high-quality data and distribution shifts between training data and deployment data limit the application of fine-tuning methods. Although RAG is lightweight and effective, existing RAG-based approaches are not sufficiently general to different medical domains and can potentially cause misalignment issues, both between modalities and between the model and the ground truth. In this paper, we propose a versatile multimodal RAG system, MMed-RAG, designed to enhance the factuality of Med-LVLMs. Our approach introduces a domain-aware retrieval mechanism, an adaptive retrieved contexts selection method, and a provable RAG-based preference fine-tuning strategy. These innovations make the RAG process sufficiently general and reliable, significantly improving alignment when introducing retrieved contexts. Experimental results across five medical datasets (involving radiology, ophthalmology, pathology) on medical VQA and report generation demonstrate that MMed-RAG can achieve an average improvement of 43.8% in the factual accuracy of Med-LVLMs. Our data and code are available in https://github.com/richard-peng-xia/MMed-RAG.

  • 9 authors
·
Oct 16, 2024 3

Electroencephalography and Electromyography as a Non-Invasive Biomarker of Neural Regeneration: A Review of Central and Peripheral Nervous System Injury and Regeneration

Regeneration of the nervous system after injury remains an important therapeutic objective, especially in the central nervous system (CNS), in which regeneration is restricted by both neuronal limitations as well as adverse extracellular environments. Conversely, the peripheral nervous system (PNS) displays enhanced regenerative capability in the presence of supportive Schwann cells (SC) and pro-growth stimuli. While the structure and molecular mechanisms are thoroughly understood, functional biomarkers that can non-invasively monitor regeneration in real time are limited. In this review, we discuss the promise of electroencephalography (EEG) as well as electromyography (EMG) as real-time, non-invasive biomarkers to monitor damage to nerves and regeneration in both CNS and PNS contexts. First, we contrast biological and electrophysiological indicators of CNS/PNS injury, showing how EEG signs, including oscillatory power, connectivity, and evoked potential changes, reflect dysfunction due to injury as well as neuroplastic reorganization. Also, EMG provides direct insight into muscle activation and peripheral output, providing useful EEG complementation in neuromuscular pathway integrity and reactivation. In CNS injuries (e.g., stroke, spinal cord injury (SCI)), EEG typically shows global slowing, disrupted interhemispheric coherence, and partial recovery of higher frequencies. For PNS injuries, EEG can capture cortical remapping and return of somatosensory evoked responses with re-establishment of the peripheries' connectivity. EMG, in turn, enables monitoring of reinnervation and restoration of functional motor output. This review presents a dual-system perspective, positioning EEG and EMG not only as diagnostic tools but also as functional biomarkers of neural regeneration, thereby bridging electrophysiology, plasticity, and clinical recovery.

  • 4 authors
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May 2

TRUST: An LLM-Based Dialogue System for Trauma Understanding and Structured Assessments

Objectives: While Large Language Models (LLMs) have been widely used to assist clinicians and support patients, no existing work has explored dialogue systems for standard diagnostic interviews and assessments. This study aims to bridge the gap in mental healthcare accessibility by developing an LLM-powered dialogue system that replicates clinician behavior. Materials and Methods: We introduce TRUST, a framework of cooperative LLM modules capable of conducting formal diagnostic interviews and assessments for Post-Traumatic Stress Disorder (PTSD). To guide the generation of appropriate clinical responses, we propose a Dialogue Acts schema specifically designed for clinical interviews. Additionally, we develop a patient simulation approach based on real-life interview transcripts to replace time-consuming and costly manual testing by clinicians. Results: A comprehensive set of evaluation metrics is designed to assess the dialogue system from both the agent and patient simulation perspectives. Expert evaluations by conversation and clinical specialists show that TRUST performs comparably to real-life clinical interviews. Discussion: Our system performs at the level of average clinicians, with room for future enhancements in communication styles and response appropriateness. Conclusions: Our TRUST framework shows its potential to facilitate mental healthcare availability.

  • 4 authors
·
Apr 30, 2025

Clinical Decision Support System for Unani Medicine Practitioners

Like other fields of Traditional Medicines, Unani Medicines have been found as an effective medical practice for ages. It is still widely used in the subcontinent, particularly in Pakistan and India. However, Unani Medicines Practitioners are lacking modern IT applications in their everyday clinical practices. An Online Clinical Decision Support System may address this challenge to assist apprentice Unani Medicines practitioners in their diagnostic processes. The proposed system provides a web-based interface to enter the patient's symptoms, which are then automatically analyzed by our system to generate a list of probable diseases. The system allows practitioners to choose the most likely disease and inform patients about the associated treatment options remotely. The system consists of three modules: an Online Clinical Decision Support System, an Artificial Intelligence Inference Engine, and a comprehensive Unani Medicines Database. The system employs advanced AI techniques such as Decision Trees, Deep Learning, and Natural Language Processing. For system development, the project team used a technology stack that includes React, FastAPI, and MySQL. Data and functionality of the application is exposed using APIs for integration and extension with similar domain applications. The novelty of the project is that it addresses the challenge of diagnosing diseases accurately and efficiently in the context of Unani Medicines principles. By leveraging the power of technology, the proposed Clinical Decision Support System has the potential to ease access to healthcare services and information, reduce cost, boost practitioner and patient satisfaction, improve speed and accuracy of the diagnostic process, and provide effective treatments remotely. The application will be useful for Unani Medicines Practitioners, Patients, Government Drug Regulators, Software Developers, and Medical Researchers.

  • 5 authors
·
Oct 24, 2023

Anatomy of a Lie: A Multi-Stage Diagnostic Framework for Tracing Hallucinations in Vision-Language Models

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.

A Retrospective Systematic Study on Hierarchical Sparse Query Transformer-assisted Ultrasound Screening for Early Hepatocellular Carcinoma

Hepatocellular carcinoma (HCC), ranking as the third leading cause of cancer-related mortality worldwide, demands urgent improvements in early detection to enhance patient survival. While ultrasound remains the preferred screening modality due to its cost-effectiveness and real-time capabilities, its sensitivity (59%-78%) heavily relies on radiologists' expertise, leading to inconsistent diagnostic outcomes and operational inefficiencies. Recent advancements in AI technology offer promising solutions to bridge this gap. This study introduces the Hierarchical Sparse Query Transformer (HSQformer), a novel hybrid architecture that synergizes CNNs' local feature extraction with Vision Transformers' global contextual awareness through latent space representation and sparse learning. By dynamically activating task-specific experts via a Mixture-of-Experts (MoE) framework, HSQformer achieves hierarchical feature integration without structural redundancy. Evaluated across three clinical scenarios: single-center, multi-center, and high-risk patient cohorts, HSQformer outperforms state-of-the-art models (e.g., 95.38% AUC in multi-center testing) and matches senior radiologists' diagnostic accuracy while significantly surpassing junior counterparts. These results highlight the potential of AI-assisted tools to standardize HCC screening, reduce dependency on human expertise, and improve early diagnosis rates. The full code is available at https://github.com/Asunatan/HSQformer.

  • 11 authors
·
Feb 5, 2025

Evaluating AI systems under uncertain ground truth: a case study in dermatology

For safety, medical AI systems undergo thorough evaluations before deployment, validating their predictions against a ground truth which is assumed to be fixed and certain. However, this ground truth is often curated in the form of differential diagnoses. While a single differential diagnosis reflects the uncertainty in one expert assessment, multiple experts introduce another layer of uncertainty through disagreement. Both forms of uncertainty are ignored in standard evaluation which aggregates these differential diagnoses to a single label. In this paper, we show that ignoring uncertainty leads to overly optimistic estimates of model performance, therefore underestimating risk associated with particular diagnostic decisions. To this end, we propose a statistical aggregation approach, where we infer a distribution on probabilities of underlying medical condition candidates themselves, based on observed annotations. This formulation naturally accounts for the potential disagreements between different experts, as well as uncertainty stemming from individual differential diagnoses, capturing the entire ground truth uncertainty. Our approach boils down to generating multiple samples of medical condition probabilities, then evaluating and averaging performance metrics based on these sampled probabilities. In skin condition classification, we find that a large portion of the dataset exhibits significant ground truth uncertainty and standard evaluation severely over-estimates performance without providing uncertainty estimates. In contrast, our framework provides uncertainty estimates on common metrics of interest such as top-k accuracy and average overlap, showing that performance can change multiple percentage points. We conclude that, while assuming a crisp ground truth can be acceptable for many AI applications, a more nuanced evaluation protocol should be utilized in medical diagnosis.

  • 20 authors
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Jul 5, 2023

TrioXpert: An Automated Incident Management Framework for Microservice System

Automated incident management plays a pivotal role in large-scale microservice systems. However, many existing methods rely solely on single-modal data (e.g., metrics, logs, and traces) and struggle to simultaneously address multiple downstream tasks, including anomaly detection (AD), failure triage (FT), and root cause localization (RCL). Moreover, the lack of clear reasoning evidence in current techniques often leads to insufficient interpretability. To address these limitations, we propose TrioXpert, an end-to-end incident management framework capable of fully leveraging multimodal data. TrioXpert designs three independent data processing pipelines based on the inherent characteristics of different modalities, comprehensively characterizing the operational status of microservice systems from both numerical and textual dimensions. It employs a collaborative reasoning mechanism using large language models (LLMs) to simultaneously handle multiple tasks while providing clear reasoning evidence to ensure strong interpretability. We conducted extensive evaluations on two microservice system datasets, and the experimental results demonstrate that TrioXpert achieves outstanding performance in AD (improving by 4.7% to 57.7%), FT (improving by 2.1% to 40.6%), and RCL (improving by 1.6% to 163.1%) tasks. TrioXpert has also been deployed in Lenovo's production environment, demonstrating substantial gains in diagnostic efficiency and accuracy.

  • 8 authors
·
Jun 11, 2025

WorldBench: Disambiguating Physics for Diagnostic Evaluation of World Models

Recent advances in generative foundational models, often termed "world models," have propelled interest in applying them to critical tasks like robotic planning and autonomous system training. For reliable deployment, these models must exhibit high physical fidelity, accurately simulating real-world dynamics. Existing physics-based video benchmarks, however, suffer from entanglement, where a single test simultaneously evaluates multiple physical laws and concepts, fundamentally limiting their diagnostic capability. We introduce WorldBench, a novel video-based benchmark specifically designed for concept-specific, disentangled evaluation, allowing us to rigorously isolate and assess understanding of a single physical concept or law at a time. To make WorldBench comprehensive, we design benchmarks at two different levels: 1) an evaluation of intuitive physical understanding with concepts such as object permanence or scale/perspective, and 2) an evaluation of low-level physical constants and material properties such as friction coefficients or fluid viscosity. When SOTA video-based world models are evaluated on WorldBench, we find specific patterns of failure in particular physics concepts, with all tested models lacking the physical consistency required to generate reliable real-world interactions. Through its concept-specific evaluation, WorldBench offers a more nuanced and scalable framework for rigorously evaluating the physical reasoning capabilities of video generation and world models, paving the way for more robust and generalizable world-model-driven learning.

  • 10 authors
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Jan 29 2

Optimal Turkish Subword Strategies at Scale: Systematic Evaluation of Data, Vocabulary, Morphology Interplay

Tokenization is a pivotal design choice for neural language modeling in morphologically rich languages (MRLs) such as Turkish, where productive agglutination challenges both vocabulary efficiency and morphological fidelity. Prior studies have explored tokenizer families and vocabulary sizes but typically (i) vary vocabulary without systematically controlling the tokenizer's training corpus, (ii) provide limited intrinsic diagnostics, and (iii) evaluate a narrow slice of downstream tasks. We present the first comprehensive, principled study of Turkish subword tokenization; a "subwords manifest", that jointly varies vocabulary size and tokenizer training corpus size (data and vocabulary coupling), compares multiple tokenizer families under matched parameter budgets (WordPiece, morphology level, and character baselines), and evaluates across semantic (NLI, STS, sentiment analysis, NER), syntactic (POS, dependency parsing), and morphology-sensitive probes. To explain why tokenizers succeed or fail, we introduce a morphology-aware diagnostic toolkit that goes beyond coarse aggregates to boundary-level micro/macro F1, decoupled lemma atomicity vs. surface boundary hits, over/under-segmentation indices, character/word edit distances (CER/WER), continuation rates, and affix-type coverage and token-level atomicity. Our contributions are fourfold: (i) a systematic investigation of the vocabulary-corpus-success triad; (ii) a unified, morphology-aware evaluation framework linking intrinsic diagnostics to extrinsic outcomes; (iii) controlled comparisons identifying when character-level and morphology-level tokenization pay off; and (iv) an open-source release of evaluation code, tokenizer pipelines, and models. As the first work of its kind, this "subwords manifest" delivers actionable guidance for building effective tokenizers in MRLs and establishes a reproducible foundation for future research.

Beyond Empathy: Integrating Diagnostic and Therapeutic Reasoning with Large Language Models for Mental Health Counseling

Large language models (LLMs) hold significant potential for mental health support, capable of generating empathetic responses and simulating therapeutic conversations. However, existing LLM-based approaches often lack the clinical grounding necessary for real-world psychological counseling, particularly in explicit diagnostic reasoning aligned with standards like the DSM/ICD and incorporating diverse therapeutic modalities beyond basic empathy or single strategies. To address these critical limitations, we propose PsyLLM, the first large language model designed to systematically integrate both diagnostic and therapeutic reasoning for mental health counseling. To develop the PsyLLM, we propose a novel automated data synthesis pipeline. This pipeline processes real-world mental health posts, generates multi-turn dialogue structures, and leverages LLMs guided by international diagnostic standards (e.g., DSM/ICD) and multiple therapeutic frameworks (e.g., CBT, ACT, psychodynamic) to simulate detailed clinical reasoning processes. Rigorous multi-dimensional filtering ensures the generation of high-quality, clinically aligned dialogue data. In addition, we introduce a new benchmark and evaluation protocol, assessing counseling quality across four key dimensions: comprehensiveness, professionalism, authenticity, and safety. Our experiments demonstrate that PsyLLM significantly outperforms state-of-the-art baseline models on this benchmark.

  • 8 authors
·
May 21, 2025

DiagnosisArena: Benchmarking Diagnostic Reasoning for Large Language Models

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.

  • 8 authors
·
May 20, 2025

EEG-FM-Bench: A Comprehensive Benchmark for the Systematic Evaluation of EEG Foundation Models

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

  • 5 authors
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Feb 12

EgoSchema: A Diagnostic Benchmark for Very Long-form Video Language Understanding

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

  • 3 authors
·
Aug 17, 2023

FileGram: Grounding Agent Personalization in File-System Behavioral Traces

Coworking AI agents operating within local file systems are rapidly emerging as a paradigm in human-AI interaction; however, effective personalization remains limited by severe data constraints, as strict privacy barriers and the difficulty of jointly collecting multimodal real-world traces prevent scalable training and evaluation, and existing methods remain interaction-centric while overlooking dense behavioral traces in file-system operations; to address this gap, we propose FileGram, a comprehensive framework that grounds agent memory and personalization in file-system behavioral traces, comprising three core components: (1) FileGramEngine, a scalable persona-driven data engine that simulates realistic workflows and generates fine-grained multimodal action sequences at scale; (2) FileGramBench, a diagnostic benchmark grounded in file-system behavioral traces for evaluating memory systems on profile reconstruction, trace disentanglement, persona drift detection, and multimodal grounding; and (3) FileGramOS, a bottom-up memory architecture that builds user profiles directly from atomic actions and content deltas rather than dialogue summaries, encoding these traces into procedural, semantic, and episodic channels with query-time abstraction; extensive experiments show that FileGramBench remains challenging for state-of-the-art memory systems and that FileGramEngine and FileGramOS are effective, and by open-sourcing the framework, we hope to support future research on personalized memory-centric file-system agents.

  • 9 authors
·
Apr 5 1

Your Agents Are Aging Too: Agent Lifespan Engineering for Deployed Systems

Long-lived AI agents are increasingly deployed as persistent operational systems, yet they are still evaluated like freshly initialized models. Day-one benchmarks miss a basic systems question: how long does an agent remain reliable after deployment? Even when model weights are frozen, an agent's effective state keeps changing as it compresses interaction history, retrieves from a growing memory store, revises facts after updates, and undergoes routine maintenance. Reliability therefore becomes a lifespan property of the full agent harness, not only a snapshot property of the base model. We introduce AgingBench, a longitudinal reliability benchmark for agent lifespan engineering: measuring not only whether deployed agents degrade, but what form the degradation takes and where repair should target. AgingBench organizes agent aging into four mechanisms: compression aging, interference aging, revision aging, and maintenance aging. To diagnose these failures, AgingBench uses temporal dependency graphs and paired counterfactual probes that produce diagnostic profiles for the write, retrieval, and utilization stages of the memory pipeline. Across 7 scenarios, 14 models, multiple memory policies, and both runner-controlled and autonomous agents, over ~400 runs spanning 8 - 200 sessions show that agent aging is not one-dimensional: behavioral tests can remain clean while factual precision decays; derived-state tracking can collapse sharply within a single model; and the same wrong answer can require different repairs depending on what the diagnostic profile points to. These results suggest that reliable agent deployment requires lifespan evaluation, mechanism-level diagnosis, and stage-targeted repair, not only stronger day-one models.

  • 8 authors
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May 24 2

When Iterative RAG Beats Ideal Evidence: A Diagnostic Study in Scientific Multi-hop Question Answering

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.

  • 5 authors
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Jan 27

MedMASLab: A Unified Orchestration Framework for Benchmarking Multimodal Medical Multi-Agent Systems

While Multi-Agent Systems (MAS) show potential for complex clinical decision support, the field remains hindered by architectural fragmentation and the lack of standardized multimodal integration. Current medical MAS research suffers from non-uniform data ingestion pipelines, inconsistent visual-reasoning evaluation, and a lack of cross-specialty benchmarking. To address these challenges, we present MedMASLab, a unified framework and benchmarking platform for multimodal medical multi-agent systems. MedMASLab introduces: (1) A standardized multimodal agent communication protocol that enables seamless integration of 11 heterogeneous MAS architectures across 24 medical modalities. (2) An automated clinical reasoning evaluator, a zero-shot semantic evaluation paradigm that overcomes the limitations of lexical string-matching by leveraging large vision-language models to verify diagnostic logic and visual grounding. (3) The most extensive benchmark to date, spanning 11 organ systems and 473 diseases, standardizing data from 11 clinical benchmarks. Our systematic evaluation reveals a critical domain-specific performance gap: while MAS improves reasoning depth, current architectures exhibit significant fragility when transitioning between specialized medical sub-domains. We provide a rigorous ablation of interaction mechanisms and cost-performance trade-offs, establishing a new technical baseline for future autonomous clinical systems. The source code and data is publicly available at: https://github.com/NUS-Project/MedMASLab/

  • 9 authors
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Mar 10

OCTCube-M: A 3D multimodal optical coherence tomography foundation model for retinal and systemic diseases with cross-cohort and cross-device validation

We present OCTCube-M, a 3D OCT-based multi-modal foundation model for jointly analyzing OCT and en face images. OCTCube-M first developed OCTCube, a 3D foundation model pre-trained on 26,685 3D OCT volumes encompassing 1.62 million 2D OCT images. It then exploits a novel multi-modal contrastive learning framework COEP to integrate other retinal imaging modalities, such as fundus autofluorescence and infrared retinal imaging, into OCTCube, efficiently extending it into multi-modal foundation models. OCTCube achieves best performance on predicting 8 retinal diseases, demonstrating strong generalizability on cross-cohort, cross-device and cross-modality prediction. OCTCube can also predict cross-organ nodule malignancy (CT) and low cardiac ejection fraction as well as systemic diseases, such as diabetes and hypertension, revealing its wide applicability beyond retinal diseases. We further develop OCTCube-IR using COEP with 26,685 OCT and IR image pairs. OCTCube-IR can accurately retrieve between OCT and IR images, allowing joint analysis between 3D and 2D retinal imaging modalities. Finally, we trained a tri-modal foundation model OCTCube-EF from 4 million 2D OCT images and 400K en face retinal images. OCTCube-EF attains the best performance on predicting the growth rate of geographic atrophy (GA) across datasets collected from 6 multi-center global trials conducted in 23 countries. This improvement is statistically equivalent to running a clinical trial with more than double the size of the original study. Our analysis based on another retrospective case study reveals OCTCube-EF's ability to avoid false positive Phase-III results according to its accurate treatment effect estimation on the Phase-II results. In sum, OCTCube-M is a 3D multi-modal foundation model framework that integrates OCT and other retinal imaging modalities revealing substantial diagnostic and prognostic benefits.

  • 12 authors
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Aug 20, 2024

Nuclear Quadrupole Hyperfine Structure in HC14N/H14NC and DC15N/D15NC Isomerization: A Diagnostic Tool for Characterizing Vibrational Localization

Large-amplitude molecular motions which occur during isomerization can cause significant changes in electronic structure. These variations in electronic properties can be used to identify vibrationally-excited eigenstates which are localized along the potential energy surface. This work demonstrates that nuclear quadrupole hyperfine interactions can be used as a diagnostic marker of progress along the isomerization path in both the HC14N/H14NC and DC15N/D15NC chemical systems. Ab initio calculations at the CCSD(T)/cc-pCVQZ level indicate that the hyperfine interaction is extremely sensitive to the chemical bonding of the quadrupolar 14N nucleus and can therefore be used to determine in which potential well the vibrational wavefunction is localized. A natural bonding orbital analysis along the isomerization path further demonstrates that hyperfine interactions arise from the asphericity of the electron density at the quadrupolar nucleus. Using the CCSD(T) potential surface, the quadrupole coupling constants of highly-excited vibrational states are computed from a one-dimensional internal coordinate path Hamiltonian. The excellent agreement between ab initio calculations and recent measurements demonstrates that nuclear quadrupole hyperfine structure can be used as a diagnostic tool for characterizing localized HCN and HNC vibrational states.

  • 1 authors
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Dec 20, 2010