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Jul 31

Reasoning or Rhetoric? An Empirical Analysis of Moral Reasoning Explanations in Large Language Models

Do large language models reason morally, or do they merely sound like they do? We investigate whether LLM responses to moral dilemmas exhibit genuine developmental progression through Kohlberg's stages of moral development, or whether alignment training instead produces reasoning-like outputs that superficially resemble mature moral judgment without the underlying developmental trajectory. Using an LLM-as-judge scoring pipeline validated across three judge models, we classify more than 600 responses from 13 LLMs spanning a range of architectures, parameter scales, and training regimes across six classical moral dilemmas, and conduct ten complementary analyses to characterize the nature and internal coherence of the resulting patterns. Our results reveal a striking inversion: responses overwhelmingly correspond to post-conventional reasoning (Stages 5-6) regardless of model size, architecture, or prompting strategy, the effective inverse of human developmental norms, where Stage 4 dominates. Most strikingly, a subset of models exhibit moral decoupling: systematic inconsistency between stated moral justification and action choice, a form of logical incoherence that persists across scale and prompting strategy and represents a direct reasoning consistency failure independent of rhetorical sophistication. Model scale carries a statistically significant but practically small effect; training type has no significant independent main effect; and models exhibit near-robotic cross-dilemma consistency producing logically indistinguishable responses across semantically distinct moral problems. We posit that these patterns constitute evidence for moral ventriloquism: the acquisition, through alignment training, of the rhetorical conventions of mature moral reasoning without the underlying developmental trajectory those conventions are meant to represent.

  • 4 authors
·
Mar 23 2

The MAMA-MIA Challenge: Advancing Generalizability and Fairness in Breast MRI Tumor Segmentation and Treatment Response Prediction

Breast cancer is the most frequently diagnosed malignancy among women worldwide and a leading cause of cancer-related mortality. Dynamic contrast-enhanced magnetic resonance imaging plays a central role in tumor characterization and treatment monitoring, particularly in patients receiving neoadjuvant chemotherapy. However, existing artificial intelligence models for breast magnetic resonance imaging are typically developed and evaluated using heterogeneous datasets, study populations, and assessment protocols, making direct comparison difficult and limiting understanding of model robustness across institutions and clinically relevant patient subgroups. The MAMA-MIA Challenge was designed to address these challenges by providing a standardized benchmark for the joint evaluation of primary tumor segmentation and prediction of pathologic complete response using pre-treatment magnetic resonance imaging only. The training cohort comprised 1,506 patients from multiple institutions in the United States, while evaluation was conducted on an external test set of 574 patients from three independent European centers to assess cross-continental and cross-institutional generalization. A unified scoring framework combined predictive performance with subgroup consistency across age, menopausal status, and breast density. Twenty-six international teams participated in the final evaluation phase. Results demonstrate substantial performance variability under a common external evaluation framework and reveal trade-offs between overall accuracy and subgroup fairness. The challenge provides standardized datasets, evaluation protocols, and public resources to promote the development of robust and equitable artificial intelligence systems for breast cancer imaging.

  • 46 authors
·
Jun 18

medigan: a Python library of pretrained generative models for medical image synthesis

Synthetic data generated by generative models can enhance the performance and capabilities of data-hungry deep learning models in medical imaging. However, there is (1) limited availability of (synthetic) datasets and (2) generative models are complex to train, which hinders their adoption in research and clinical applications. To reduce this entry barrier, we propose medigan, a one-stop shop for pretrained generative models implemented as an open-source framework-agnostic Python library. medigan allows researchers and developers to create, increase, and domain-adapt their training data in just a few lines of code. Guided by design decisions based on gathered end-user requirements, we implement medigan based on modular components for generative model (i) execution, (ii) visualisation, (iii) search & ranking, and (iv) contribution. The library's scalability and design is demonstrated by its growing number of integrated and readily-usable pretrained generative models consisting of 21 models utilising 9 different Generative Adversarial Network architectures trained on 11 datasets from 4 domains, namely, mammography, endoscopy, x-ray, and MRI. Furthermore, 3 applications of medigan are analysed in this work, which include (a) enabling community-wide sharing of restricted data, (b) investigating generative model evaluation metrics, and (c) improving clinical downstream tasks. In (b), extending on common medical image synthesis assessment and reporting standards, we show Fréchet Inception Distance variability based on image normalisation and radiology-specific feature extraction.

  • 12 authors
·
Sep 28, 2022