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Aug 25

Expediting and Elevating Large Language Model Reasoning via Hidden Chain-of-Thought Decoding

Large language models (LLMs) have demonstrated remarkable capabilities in tasks requiring reasoning and multi-step problem-solving through the use of chain-of-thought (CoT) prompting. However, generating the full CoT process results in significantly longer output sequences, leading to increased computational costs and latency during inference. To address this challenge, we propose a novel approach to compress the CoT process through semantic alignment, enabling more efficient decoding while preserving the benefits of CoT reasoning. Our method introduces an auxiliary CoT model that learns to generate and compress the full thought process into a compact special token representation semantically aligned with the original CoT output. This compressed representation is then integrated into the input of the Hidden Chain-of-Thought (HCoT) model. The training process follows a two-stage procedure: First, the CoT model is optimized to generate the compressed token representations aligned with the ground-truth CoT outputs using a contrastive loss. Subsequently, with the CoT model parameters frozen, the HCoT model is fine-tuned to generate accurate subsequent predictions conditioned on the prefix instruction and the compressed CoT representations from the CoT model. Extensive experiments across three challenging domains - mathematical reasoning, agent invocation, and question answering - demonstrate that our semantic compression approach achieves competitive or improved performance compared to the full CoT baseline, while providing significant speedups of at least 1.5x in decoding time. Moreover, incorporating contrastive learning objectives further enhances the quality of the compressed representations, leading to better CoT prompting and improved task accuracy. Our work paves the way for more efficient exploitation of multi-step reasoning capabilities in LLMs across a wide range of applications.

  • 5 authors
·
Sep 13, 2024 2

Parameter-Selective Continual Test-Time Adaptation

Continual Test-Time Adaptation (CTTA) aims to adapt a pretrained model to ever-changing environments during the test time under continuous domain shifts. Most existing CTTA approaches are based on the Mean Teacher (MT) structure, which contains a student and a teacher model, where the student is updated using the pseudo-labels from the teacher model, and the teacher is then updated by exponential moving average strategy. However, these methods update the MT model indiscriminately on all parameters of the model. That is, some critical parameters involving sharing knowledge across different domains may be erased, intensifying error accumulation and catastrophic forgetting. In this paper, we introduce Parameter-Selective Mean Teacher (PSMT) method, which is capable of effectively updating the critical parameters within the MT network under domain shifts. First, we introduce a selective distillation mechanism in the student model, which utilizes past knowledge to regularize novel knowledge, thereby mitigating the impact of error accumulation. Second, to avoid catastrophic forgetting, in the teacher model, we create a mask through Fisher information to selectively update parameters via exponential moving average, with preservation measures applied to crucial parameters. Extensive experimental results verify that PSMT outperforms state-of-the-art methods across multiple benchmark datasets. Our code is available at https://github.com/JiaxuTian/PSMT.

  • 2 authors
·
Jul 2, 2024

A Hybrid Framework for Real-Time Data Drift and Anomaly Identification Using Hierarchical Temporal Memory and Statistical Tests

Data Drift is the phenomenon where the generating model behind the data changes over time. Due to data drift, any model built on the past training data becomes less relevant and inaccurate over time. Thus, detecting and controlling for data drift is critical in machine learning models. Hierarchical Temporal Memory (HTM) is a machine learning model developed by Jeff Hawkins, inspired by how the human brain processes information. It is a biologically inspired model of memory that is similar in structure to the neocortex, and whose performance is claimed to be comparable to state of the art models in detecting anomalies in time series data. Another unique benefit of HTMs is its independence from training and testing cycle; all the learning takes place online with streaming data and no separate training and testing cycle is required. In sequential learning paradigm, Sequential Probability Ratio Test (SPRT) offers some unique benefit for online learning and inference. This paper proposes a novel hybrid framework combining HTM and SPRT for real-time data drift detection and anomaly identification. Unlike existing data drift methods, our approach eliminates frequent retraining and ensures low false positive rates. HTMs currently work with one dimensional or univariate data. In a second study, we also propose an application of HTM in multidimensional supervised scenario for anomaly detection by combining the outputs of multiple HTM columns, one for each dimension of the data, through a neural network. Experimental evaluations demonstrate that the proposed method outperforms conventional drift detection techniques like the Kolmogorov-Smirnov (KS) test, Wasserstein distance, and Population Stability Index (PSI) in terms of accuracy, adaptability, and computational efficiency. Our experiments also provide insights into optimizing hyperparameters for real-time deployment in domains such as Telecom.

  • 3 authors
·
Apr 24, 2025

HY-MT1.5 Technical Report

In this report, we introduce our latest translation models, HY-MT1.5-1.8B and HY-MT1.5-7B, a new family of machine translation models developed through a holistic training framework tailored for high-performance translation. Our methodology orchestrates a multi-stage pipeline that integrates general and MT-oriented pre-training, supervised fine-tuning, on-policy distillation, and reinforcement learning. HY-MT1.5-1.8B, the 1.8B-parameter model demonstrates remarkable parameter efficiency, comprehensively outperforming significantly larger open-source baselines (e.g., Tower-Plus-72B, Qwen3-32B) and mainstream commercial APIs (e.g., Microsoft Translator, Doubao Translator) in standard Chinese-foreign and English-foreign tasks. It achieves approximately 90% of the performance of ultra-large proprietary models such as Gemini-3.0-Pro, while marginally trailing Gemini-3.0-Pro on WMT25 and Mandarin-minority language benchmarks, it maintains a substantial lead over other competing models. Furthermore, HY-MT1.5-7B establishes a new state-of-the-art for its size class, achieving 95% of Gemini-3.0-Pro's performance on Flores-200 and surpassing it on the challenging WMT25 and Mandarin-minority language test sets. Beyond standard translation, the HY-MT1.5 series supports advanced constraints, including terminology intervention, context-aware translation, and format preservation. Extensive empirical evaluations confirm that both models offer highly competitive, robust solutions for general and specialized translation tasks within their respective parameter scales.

  • 5 authors
·
Dec 30, 2025

Secrets of RLHF in Large Language Models Part I: PPO

Large language models (LLMs) have formulated a blueprint for the advancement of artificial general intelligence. Its primary objective is to function as a human-centric (helpful, honest, and harmless) assistant. Alignment with humans assumes paramount significance, and reinforcement learning with human feedback (RLHF) emerges as the pivotal technological paradigm underpinning this pursuit. Current technical routes usually include reward models to measure human preferences, Proximal Policy Optimization (PPO) to optimize policy model outputs, and process supervision to improve step-by-step reasoning capabilities. However, due to the challenges of reward design, environment interaction, and agent training, coupled with huge trial and error cost of large language models, there is a significant barrier for AI researchers to motivate the development of technical alignment and safe landing of LLMs. The stable training of RLHF has still been a puzzle. In the first report, we dissect the framework of RLHF, re-evaluate the inner workings of PPO, and explore how the parts comprising PPO algorithms impact policy agent training. We identify policy constraints being the key factor for the effective implementation of the PPO algorithm. Therefore, we explore the PPO-max, an advanced version of PPO algorithm, to efficiently improve the training stability of the policy model. Based on our main results, we perform a comprehensive analysis of RLHF abilities compared with SFT models and ChatGPT. The absence of open-source implementations has posed significant challenges to the investigation of LLMs alignment. Therefore, we are eager to release technical reports, reward models and PPO codes

  • 27 authors
·
Jul 10, 2023 1

Hierarchical Text Classification Using Black Box Large Language Models

Hierarchical Text Classification (HTC) aims to assign texts to structured label hierarchies; however, it faces challenges due to data scarcity and model complexity. This study explores the feasibility of using black box Large Language Models (LLMs) accessed via APIs for HTC, as an alternative to traditional machine learning methods that require extensive labeled data and computational resources. We evaluate three prompting strategies -- Direct Leaf Label Prediction (DL), Direct Hierarchical Label Prediction (DH), and Top-down Multi-step Hierarchical Label Prediction (TMH) -- in both zero-shot and few-shot settings, comparing the accuracy and cost-effectiveness of these strategies. Experiments on two datasets show that a few-shot setting consistently improves classification accuracy compared to a zero-shot setting. While a traditional machine learning model achieves high accuracy on a dataset with a shallow hierarchy, LLMs, especially DH strategy, tend to outperform the machine learning model on a dataset with a deeper hierarchy. API costs increase significantly due to the higher input tokens required for deeper label hierarchies on DH strategy. These results emphasize the trade-off between accuracy improvement and the computational cost of prompt strategy. These findings highlight the potential of black box LLMs for HTC while underscoring the need to carefully select a prompt strategy to balance performance and cost.

  • 2 authors
·
Aug 6, 2025

The Perfect Blend: Redefining RLHF with Mixture of Judges

Reinforcement learning from human feedback (RLHF) has become the leading approach for fine-tuning large language models (LLM). However, RLHF has limitations in multi-task learning (MTL) due to challenges of reward hacking and extreme multi-objective optimization (i.e., trade-off of multiple and/or sometimes conflicting objectives). Applying RLHF for MTL currently requires careful tuning of the weights for reward model and data combinations. This is often done via human intuition and does not generalize. In this work, we introduce a novel post-training paradigm which we called Constrained Generative Policy Optimization (CGPO). The core of CGPO is Mixture of Judges (MoJ) with cost-efficient constrained policy optimization with stratification, which can identify the perfect blend in RLHF in a principled manner. It shows strong empirical results with theoretical guarantees, does not require extensive hyper-parameter tuning, and is plug-and-play in common post-training pipelines. Together, this can detect and mitigate reward hacking behaviors while reaching a pareto-optimal point across an extremely large number of objectives. Our empirical evaluations demonstrate that CGPO significantly outperforms standard RLHF algorithms like PPO and DPO across various tasks including general chat, STEM questions, instruction following, and coding. Specifically, CGPO shows improvements of 7.4% in AlpacaEval-2 (general chat), 12.5% in Arena-Hard (STEM & reasoning), and consistent gains in other domains like math and coding. Notably, PPO, while commonly used, is prone to severe reward hacking in popular coding benchmarks, which CGPO successfully addresses. This breakthrough in RLHF not only tackles reward hacking and extreme multi-objective optimization challenges but also advances the state-of-the-art in aligning general-purpose LLMs for diverse applications.

  • 20 authors
·
Sep 30, 2024

Hierarchical Multi-Interest Co-Network For Coarse-Grained Ranking

In this era of information explosion, a personalized recommendation system is convenient for users to get information they are interested in. To deal with billions of users and items, large-scale online recommendation services usually consist of three stages: candidate generation, coarse-grained ranking, and fine-grained ranking. The success of each stage depends on whether the model accurately captures the interests of users, which are usually hidden in users' behavior data. Previous research shows that users' interests are diverse, and one vector is not sufficient to capture users' different preferences. Therefore, many methods use multiple vectors to encode users' interests. However, there are two unsolved problems: (1) The similarity of different vectors in existing methods is too high, with too much redundant information. Consequently, the interests of users are not fully represented. (2) Existing methods model the long-term and short-term behaviors together, ignoring the differences between them. This paper proposes a Hierarchical Multi-Interest Co-Network (HCN) to capture users' diverse interests in the coarse-grained ranking stage. Specifically, we design a hierarchical multi-interest extraction layer to update users' diverse interest centers iteratively. The multiple embedded vectors obtained in this way contain more information and represent the interests of users better in various aspects. Furthermore, we develop a Co-Interest Network to integrate users' long-term and short-term interests. Experiments on several real-world datasets and one large-scale industrial dataset show that HCN effectively outperforms the state-of-the-art methods. We deploy HCN into a large-scale real world E-commerce system and achieve extra 2.5\% improvements on GMV (Gross Merchandise Value).

  • 7 authors
·
Oct 19, 2022

MedAgentBench: A Realistic Virtual EHR Environment to Benchmark Medical LLM Agents

Recent large language models (LLMs) have demonstrated significant advancements, particularly in their ability to serve as agents thereby surpassing their traditional role as chatbots. These agents can leverage their planning and tool utilization capabilities to address tasks specified at a high level. However, a standardized dataset to benchmark the agent capabilities of LLMs in medical applications is currently lacking, making the evaluation of LLMs on complex tasks in interactive healthcare environments challenging. To address this gap, we introduce MedAgentBench, a broad evaluation suite designed to assess the agent capabilities of large language models within medical records contexts. MedAgentBench encompasses 300 patient-specific clinically-derived tasks from 10 categories written by human physicians, realistic profiles of 100 patients with over 700,000 data elements, a FHIR-compliant interactive environment, and an accompanying codebase. The environment uses the standard APIs and communication infrastructure used in modern EMR systems, so it can be easily migrated into live EMR systems. MedAgentBench presents an unsaturated agent-oriented benchmark that current state-of-the-art LLMs exhibit some ability to succeed at. The best model (Claude 3.5 Sonnet v2) achieves a success rate of 69.67%. However, there is still substantial space for improvement which gives the community a next direction to optimize. Furthermore, there is significant variation in performance across task categories. MedAgentBench establishes this and is publicly available at https://github.com/stanfordmlgroup/MedAgentBench , offering a valuable framework for model developers to track progress and drive continuous improvements in the agent capabilities of large language models within the medical domain.

  • 7 authors
·
Jan 24, 2025

Iterative Nash Policy Optimization: Aligning LLMs with General Preferences via No-Regret Learning

Reinforcement Learning with Human Feedback (RLHF) has achieved great success in aligning large language models (LLMs) with human preferences. Prevalent RLHF approaches are reward-based, following the Bradley-Terry (BT) model assumption, which may not fully capture the complexity of human preferences. In this paper, we explore RLHF under a general preference framework and approach it from a game-theoretic perspective. Specifically, we formulate the problem as a two-player game and propose a novel algorithm, iterative Nash policy optimization (INPO). The key idea is to let the policy play against itself via no-regret learning, thereby approximating the Nash policy. Unlike previous methods, INPO bypasses the need for estimating the expected win rate for individual responses, which typically incurs high computational or annotation costs. Instead, we introduce a new loss objective that is directly minimized over a preference dataset. We provide theoretical analysis for our approach and demonstrate its effectiveness through experiments on various representative benchmarks. With an LLaMA-3-8B-based SFT model, INPO achieves a 41.5% length-controlled win rate on AlpacaEval 2.0 and a 38.3% win rate on Arena-Hard, showing substantial improvement over the state-of-the-art iterative algorithm [Dong et al., 2024] under the BT model assumption. Additionally, our ablation study highlights the benefits of incorporating KL regularization for response length control.

  • 9 authors
·
Jun 30, 2024 1

RLHF Workflow: From Reward Modeling to Online RLHF

We present the workflow of Online Iterative Reinforcement Learning from Human Feedback (RLHF) in this technical report, which is widely reported to outperform its offline counterpart by a large margin in the recent large language model (LLM) literature. However, existing open-source RLHF projects are still largely confined to the offline learning setting. In this technical report, we aim to fill in this gap and provide a detailed recipe that is easy to reproduce for online iterative RLHF. In particular, since online human feedback is usually infeasible for open-source communities with limited resources, we start by constructing preference models using a diverse set of open-source datasets and use the constructed proxy preference model to approximate human feedback. Then, we discuss the theoretical insights and algorithmic principles behind online iterative RLHF, followed by a detailed practical implementation. Our trained LLM, SFR-Iterative-DPO-LLaMA-3-8B-R, achieves impressive performance on LLM chatbot benchmarks, including AlpacaEval-2, Arena-Hard, and MT-Bench, as well as other academic benchmarks such as HumanEval and TruthfulQA. We have shown that supervised fine-tuning (SFT) and iterative RLHF can obtain state-of-the-art performance with fully open-source datasets. Further, we have made our models, curated datasets, and comprehensive step-by-step code guidebooks publicly available. Please refer to https://github.com/RLHFlow/RLHF-Reward-Modeling and https://github.com/RLHFlow/Online-RLHF for more detailed information.

  • 10 authors
·
May 13, 2024 5

MeNTi: Bridging Medical Calculator and LLM Agent with Nested Tool Calling

Integrating tools into Large Language Models (LLMs) has facilitated the widespread application. Despite this, in specialized downstream task contexts, reliance solely on tools is insufficient to fully address the complexities of the real world. This particularly restricts the effective deployment of LLMs in fields such as medicine. In this paper, we focus on the downstream tasks of medical calculators, which use standardized tests to assess an individual's health status. We introduce MeNTi, a universal agent architecture for LLMs. MeNTi integrates a specialized medical toolkit and employs meta-tool and nested calling mechanisms to enhance LLM tool utilization. Specifically, it achieves flexible tool selection and nested tool calling to address practical issues faced in intricate medical scenarios, including calculator selection, slot filling, and unit conversion. To assess the capabilities of LLMs for quantitative assessment throughout the clinical process of calculator scenarios, we introduce CalcQA. This benchmark requires LLMs to use medical calculators to perform calculations and assess patient health status. CalcQA is constructed by professional physicians and includes 100 case-calculator pairs, complemented by a toolkit of 281 medical tools. The experimental results demonstrate significant performance improvements with our framework. This research paves new directions for applying LLMs in demanding scenarios of medicine.

  • 6 authors
·
Oct 17, 2024

TxAgent: An AI Agent for Therapeutic Reasoning Across a Universe of Tools

Precision therapeutics require multimodal adaptive models that generate personalized treatment recommendations. We introduce TxAgent, an AI agent that leverages multi-step reasoning and real-time biomedical knowledge retrieval across a toolbox of 211 tools to analyze drug interactions, contraindications, and patient-specific treatment strategies. TxAgent evaluates how drugs interact at molecular, pharmacokinetic, and clinical levels, identifies contraindications based on patient comorbidities and concurrent medications, and tailors treatment strategies to individual patient characteristics. It retrieves and synthesizes evidence from multiple biomedical sources, assesses interactions between drugs and patient conditions, and refines treatment recommendations through iterative reasoning. It selects tools based on task objectives and executes structured function calls to solve therapeutic tasks that require clinical reasoning and cross-source validation. The ToolUniverse consolidates 211 tools from trusted sources, including all US FDA-approved drugs since 1939 and validated clinical insights from Open Targets. TxAgent outperforms leading LLMs, tool-use models, and reasoning agents across five new benchmarks: DrugPC, BrandPC, GenericPC, TreatmentPC, and DescriptionPC, covering 3,168 drug reasoning tasks and 456 personalized treatment scenarios. It achieves 92.1% accuracy in open-ended drug reasoning tasks, surpassing GPT-4o and outperforming DeepSeek-R1 (671B) in structured multi-step reasoning. TxAgent generalizes across drug name variants and descriptions. By integrating multi-step inference, real-time knowledge grounding, and tool-assisted decision-making, TxAgent ensures that treatment recommendations align with established clinical guidelines and real-world evidence, reducing the risk of adverse events and improving therapeutic decision-making.

  • 8 authors
·
Mar 13, 2025 3

Introducing Three New Benchmark Datasets for Hierarchical Text Classification

Hierarchical Text Classification (HTC) is a natural language processing task with the objective to classify text documents into a set of classes from a structured class hierarchy. Many HTC approaches have been proposed which attempt to leverage the class hierarchy information in various ways to improve classification performance. Machine learning-based classification approaches require large amounts of training data and are most-commonly compared through three established benchmark datasets, which include the Web Of Science (WOS), Reuters Corpus Volume 1 Version 2 (RCV1-V2) and New York Times (NYT) datasets. However, apart from the RCV1-V2 dataset which is well-documented, these datasets are not accompanied with detailed description methodologies. In this paper, we introduce three new HTC benchmark datasets in the domain of research publications which comprise the titles and abstracts of papers from the Web of Science publication database. We first create two baseline datasets which use existing journal-and citation-based classification schemas. Due to the respective shortcomings of these two existing schemas, we propose an approach which combines their classifications to improve the reliability and robustness of the dataset. We evaluate the three created datasets with a clustering-based analysis and show that our proposed approach results in a higher quality dataset where documents that belong to the same class are semantically more similar compared to the other datasets. Finally, we provide the classification performance of four state-of-the-art HTC approaches on these three new datasets to provide baselines for future studies on machine learning-based techniques for scientific publication classification.

  • 3 authors
·
Nov 28, 2024

HuatuoGPT, towards Taming Language Model to Be a Doctor

In this paper, we present HuatuoGPT, a large language model (LLM) for medical consultation. The core recipe of HuatuoGPT is to leverage both distilled data from ChatGPT and real-world data from doctors in the supervised fine-tuned stage. The responses of ChatGPT are usually detailed, well-presented and informative while it cannot perform like a doctor in many aspects, e.g. for integrative diagnosis. We argue that real-world data from doctors would be complementary to distilled data in the sense the former could tame a distilled language model to perform like doctors. To better leverage the strengths of both data, we train a reward model to align the language model with the merits that both data bring, following an RLAIF (reinforced learning from AI feedback) fashion. To evaluate and benchmark the models, we propose a comprehensive evaluation scheme (including automatic and manual metrics). Experimental results demonstrate that HuatuoGPT achieves state-of-the-art results in performing medical consultation among open-source LLMs in GPT-4 evaluation, human evaluation, and medical benchmark datasets. It is worth noting that by using additional real-world data and RLAIF, the distilled language model (i.e., HuatuoGPT) outperforms its teacher model ChatGPT in most cases. Our code, data, and models are publicly available at https://github.com/FreedomIntelligence/HuatuoGPT. The online demo is available at https://www.HuatuoGPT.cn/.

  • 13 authors
·
May 24, 2023

Accelerometry-Derived Digital Biomarkers for Cardiometabolic Risk: A Population-Representative Tabular Benchmark with Uncertainty Quantification

Structured tabular data dominates clinical medicine, yet existing benchmarks fail to reflect real-world properties like complex survey sampling, demographic oversampling, and subgroup fairness. We introduce the NHANES Accelerometry Cardiometabolic Benchmark, derived from NHANES 2003-2006, comprising 1,381 adults with hip-worn accelerometry, fasting laboratory biomarkers, dietary intake, and anthropometrics. We evaluate three tabular learning methods -- ridge regression, XGBoost, and the foundation model TabPFN v2 -- to predict glycated haemoglobin (HbA1c), fasting triglycerides, and C-reactive protein (CRP) from activity phenotypes and lifestyle covariates. TabPFN v2 achieves the best overall performance (HbA1c R^2=0.156, CRP R^2=0.383), while triglycerides remain largely unpredictable (R^2 < 0.05), consistent with known genetic dominance. We apply split conformal prediction to generate distribution-free 90% prediction intervals and evaluate demographic coverage equity across sex and race/ethnicity subgroups. Marginal coverage aligns with the 90% target for CRP and HbA1c but falls below for triglycerides. At the subgroup level, we observe localized undercoverage (e.g., HbA1c for Mexican American participants), illustrating the gap between marginal guarantees and the conditional coverage required for clinical fairness. Code and data are at https://github.com/felizzi/nhanes-accel-cardiometabolic-benchmark.

  • 1 authors
·
Jun 28

Reinforcement Learning from Human Feedback with High-Confidence Safety Constraints

Existing approaches to language model alignment often treat safety as a tradeoff against helpfulness, which can lead to unacceptable responses in sensitive domains. To ensure reliable performance in such settings, we propose High-Confidence Safe Reinforcement Learning from Human Feedback (HC-RLHF), a method that provides high-confidence safety guarantees while maximizing helpfulness. Similar to previous methods, HC-RLHF explicitly decouples human preferences into helpfulness and harmlessness (safety), which are learned by training a reward model and a cost model, respectively. It then employs a two-step process to find safe solutions. In the first step, it optimizes the reward function under an intentionally pessimistic version of the cost constraint. In the second step, the trained model undergoes a safety test to verify whether its performance stays within an upper-confidence bound of the actual cost constraint. We provide a theoretical analysis of HC-RLHF, including proof that it will not return an unsafe solution with a probability greater than a user-specified threshold. For our empirical analysis, we apply HC-RLHF to align three different language models (Qwen2-1.5B, Qwen2.5-3B, and LLaMa3.2-3B) with human preferences. Our results demonstrate that HC-RLHF produces safe models with high probability and can improve harmlessness and helpfulness compared to previous methods.

  • 6 authors
·
Jun 9, 2025

CHIME: LLM-Assisted Hierarchical Organization of Scientific Studies for Literature Review Support

Literature review requires researchers to synthesize a large amount of information and is increasingly challenging as the scientific literature expands. In this work, we investigate the potential of LLMs for producing hierarchical organizations of scientific studies to assist researchers with literature review. We define hierarchical organizations as tree structures where nodes refer to topical categories and every node is linked to the studies assigned to that category. Our naive LLM-based pipeline for hierarchy generation from a set of studies produces promising yet imperfect hierarchies, motivating us to collect CHIME, an expert-curated dataset for this task focused on biomedicine. Given the challenging and time-consuming nature of building hierarchies from scratch, we use a human-in-the-loop process in which experts correct errors (both links between categories and study assignment) in LLM-generated hierarchies. CHIME contains 2,174 LLM-generated hierarchies covering 472 topics, and expert-corrected hierarchies for a subset of 100 topics. Expert corrections allow us to quantify LLM performance, and we find that while they are quite good at generating and organizing categories, their assignment of studies to categories could be improved. We attempt to train a corrector model with human feedback which improves study assignment by 12.6 F1 points. We release our dataset and models to encourage research on developing better assistive tools for literature review.

  • 8 authors
·
Jul 22, 2024

EHRMamba: Towards Generalizable and Scalable Foundation Models for Electronic Health Records

Transformers have significantly advanced the modeling of Electronic Health Records (EHR), yet their deployment in real-world healthcare is limited by several key challenges. Firstly, the quadratic computational cost and insufficient context length of these models pose significant obstacles for hospitals in processing the extensive medical histories typical in EHR data. Additionally, existing models employ separate finetuning for each clinical task, complicating maintenance in healthcare environments. Moreover, these models focus exclusively on either clinical prediction or EHR forecasting, lacking the flexibility to perform well across both. To overcome these limitations, we introduce EHRMamba, a robust foundation model built on the Mamba architecture. EHRMamba can process sequences up to four times longer than previous models due to its linear computational cost. We also introduce a novel approach to Multitask Prompted Finetuning (MTF) for EHR data, which enables EHRMamba to simultaneously learn multiple clinical tasks in a single finetuning phase, significantly enhancing deployment and cross-task generalization. Furthermore, our model leverages the HL7 FHIR data standard to simplify integration into existing hospital systems. Alongside EHRMamba, we open-source Odyssey, a toolkit designed to support the development and deployment of EHR foundation models, with an emphasis on data standardization and interpretability. Our evaluations on the MIMIC-IV dataset demonstrate that EHRMamba advances state-of-the-art performance across 6 major clinical tasks and excels in EHR forecasting, marking a significant leap forward in the field.

  • 4 authors
·
May 23, 2024

PsyDraw: A Multi-Agent Multimodal System for Mental Health Screening in Left-Behind Children

Left-behind children (LBCs), numbering over 66 million in China, face severe mental health challenges due to parental migration for work. Early screening and identification of at-risk LBCs is crucial, yet challenging due to the severe shortage of mental health professionals, especially in rural areas. While the House-Tree-Person (HTP) test shows higher child participation rates, its requirement for expert interpretation limits its application in resource-scarce regions. To address this challenge, we propose PsyDraw, a multi-agent system based on Multimodal Large Language Models that assists mental health professionals in analyzing HTP drawings. The system employs specialized agents for feature extraction and psychological interpretation, operating in two stages: comprehensive feature analysis and professional report generation. Evaluation of HTP drawings from 290 primary school students reveals that 71.03% of the analyzes achieved High Consistency with professional evaluations, 26.21% Moderate Consistency and only 2.41% Low Consistency. The system identified 31.03% of cases requiring professional attention, demonstrating its effectiveness as a preliminary screening tool. Currently deployed in pilot schools, \method shows promise in supporting mental health professionals, particularly in resource-limited areas, while maintaining high professional standards in psychological assessment.

  • 8 authors
·
Dec 19, 2024

The Alignment Ceiling: Objective Mismatch in Reinforcement Learning from Human Feedback

Reinforcement learning from human feedback (RLHF) has emerged as a powerful technique to make large language models (LLMs) more capable in complex settings. RLHF proceeds as collecting human preference data, training a reward model on said data, and optimizing a base ML model with respect to said reward for extrinsic evaluation metrics (e.g. MMLU, GSM8k). RLHF relies on many assumptions about how the various pieces fit together, such as a reward model capturing human preferences and an RL optimizer extracting the right signal from a reward model. As the RLHF process involves many distinct design decisions, it is easy to assume that multiple processes are correlated and therefore numerically linked. This apparent correlation is often not true, where reward models are easily overoptimized or RL optimizers can reduce performance on tasks not modeled in the data. Notable manifestations of models trained with imperfect RLHF systems are those that are prone to refusing basic requests for safety reasons or appearing lazy in generations. As chat model evaluation becomes increasingly nuanced, the reliance on a perceived link between reward model training, RL scores, and downstream performance drives these issues, which we describe as an objective mismatch. In this paper, we illustrate the causes of this issue, reviewing relevant literature from model-based reinforcement learning, and argue for solutions. By solving objective mismatch in RLHF, the ML models of the future will be more precisely aligned to user instructions for both safety and helpfulness.

  • 2 authors
·
Oct 31, 2023

Toward World Modeling of Physiological Signals with Chaos-Theoretic Balancing and Latent Dynamics

Physiological time series signals reflect complex, multi-scale dynamical processes of the human body. Existing modeling studies focus on static tasks such as classification, event forecasting, or short-horizon next step prediction, while long-horizon signal-level forecasting and predictive nature of physiological signals remain underexplored. We introduce NormWear-2, a world model that encodes both multivariate physiological signals and clinical intervention variables into a shared latent space and models their joint temporal evolution as a dynamical system. Our approach combines inference from prior pre-trained knowledge (intuition) with instant non-parametric latent state transition adaptation (insight), enabling coherent forecasting across multiple temporal scales, conditioned on heterogeneous clinical interventions. During the pretraining phase, we find that chaos-theoretic balancing of dynamical regime diversity yields more robust representations, with a smaller balanced corpus outperforming one twice its size and capturing bifurcation regimes. We evaluate the world model performance across diverse real-world physiological datasets spanning heterogeneous temporal resolutions and intervention regimes, covering daily life, point-of-care, and clinical settings, including fitness planning, hemodialysis, diabetes management, and surgical monitoring. These evaluation datasets comprise records from 8,026 subjects, spanning study durations from 3.2 hours for high-resolution signal data to 2.3 years for longitudinal clinical biomarker tracking. NormWear-2 achieves the best overall forecasting performance across time, frequency, and latent representation domains, with significant improvements over state-of-the-art time series foundation models, while maintaining competitive downstream representation quality, providing a step toward general-purpose world models for physiological signals.

  • 11 authors
·
May 13

Health Text Simplification: An Annotated Corpus for Digestive Cancer Education and Novel Strategies for Reinforcement Learning

Objective: The reading level of health educational materials significantly influences the understandability and accessibility of the information, particularly for minoritized populations. Many patient educational resources surpass the reading level and complexity of widely accepted standards. There is a critical need for high-performing text simplification models in health information to enhance dissemination and literacy. This need is particularly acute in cancer education, where effective prevention and screening education can substantially reduce morbidity and mortality. Methods: We introduce Simplified Digestive Cancer (SimpleDC), a parallel corpus of cancer education materials tailored for health text simplification research, comprising educational content from the American Cancer Society, Centers for Disease Control and Prevention, and National Cancer Institute. Utilizing SimpleDC alongside the existing Med-EASi corpus, we explore Large Language Model (LLM)-based simplification methods, including fine-tuning, reinforcement learning (RL), reinforcement learning with human feedback (RLHF), domain adaptation, and prompt-based approaches. Our experimentation encompasses Llama 2 and GPT-4. A novel RLHF reward function is introduced, featuring a lightweight model adept at distinguishing between original and simplified texts, thereby enhancing the model's effectiveness with unlabeled data. Results: Fine-tuned Llama 2 models demonstrated high performance across various metrics. Our innovative RLHF reward function surpassed existing RL text simplification reward functions in effectiveness. The results underscore that RL/RLHF can augment fine-tuning, facilitating model training on unlabeled text and improving performance.

  • 6 authors
·
Jan 26, 2024

SuperHF: Supervised Iterative Learning from Human Feedback

While large language models demonstrate remarkable capabilities, they often present challenges in terms of safety, alignment with human values, and stability during training. Here, we focus on two prevalent methods used to align these models, Supervised Fine-Tuning (SFT) and Reinforcement Learning from Human Feedback (RLHF). SFT is simple and robust, powering a host of open-source models, while RLHF is a more sophisticated method used in top-tier models like ChatGPT but also suffers from instability and susceptibility to reward hacking. We propose a novel approach, Supervised Iterative Learning from Human Feedback (SuperHF), which seeks to leverage the strengths of both methods. Our hypothesis is two-fold: that the reward model used in RLHF is critical for efficient data use and model generalization and that the use of Proximal Policy Optimization (PPO) in RLHF may not be necessary and could contribute to instability issues. SuperHF replaces PPO with a simple supervised loss and a Kullback-Leibler (KL) divergence prior. It creates its own training data by repeatedly sampling a batch of model outputs and filtering them through the reward model in an online learning regime. We then break down the reward optimization problem into three components: robustly optimizing the training rewards themselves, preventing reward hacking-exploitation of the reward model that degrades model performance-as measured by a novel METEOR similarity metric, and maintaining good performance on downstream evaluations. Our experimental results show SuperHF exceeds PPO-based RLHF on the training objective, easily and favorably trades off high reward with low reward hacking, improves downstream calibration, and performs the same on our GPT-4 based qualitative evaluation scheme all the while being significantly simpler to implement, highlighting SuperHF's potential as a competitive language model alignment technique.

  • 7 authors
·
Oct 25, 2023

TxGemma: Efficient and Agentic LLMs for Therapeutics

Therapeutic development is a costly and high-risk endeavor that is often plagued by high failure rates. To address this, we introduce TxGemma, a suite of efficient, generalist large language models (LLMs) capable of therapeutic property prediction as well as interactive reasoning and explainability. Unlike task-specific models, TxGemma synthesizes information from diverse sources, enabling broad application across the therapeutic development pipeline. The suite includes 2B, 9B, and 27B parameter models, fine-tuned from Gemma-2 on a comprehensive dataset of small molecules, proteins, nucleic acids, diseases, and cell lines. Across 66 therapeutic development tasks, TxGemma achieved superior or comparable performance to the state-of-the-art generalist model on 64 (superior on 45), and against state-of-the-art specialist models on 50 (superior on 26). Fine-tuning TxGemma models on therapeutic downstream tasks, such as clinical trial adverse event prediction, requires less training data than fine-tuning base LLMs, making TxGemma suitable for data-limited applications. Beyond these predictive capabilities, TxGemma features conversational models that bridge the gap between general LLMs and specialized property predictors. These allow scientists to interact in natural language, provide mechanistic reasoning for predictions based on molecular structure, and engage in scientific discussions. Building on this, we further introduce Agentic-Tx, a generalist therapeutic agentic system powered by Gemini 2.5 that reasons, acts, manages diverse workflows, and acquires external domain knowledge. Agentic-Tx surpasses prior leading models on the Humanity's Last Exam benchmark (Chemistry & Biology) with 52.3% relative improvement over o3-mini (high) and 26.7% over o3-mini (high) on GPQA (Chemistry) and excels with improvements of 6.3% (ChemBench-Preference) and 2.4% (ChemBench-Mini) over o3-mini (high).

  • 9 authors
·
Apr 8, 2025

simpleKT: A Simple But Tough-to-Beat Baseline for Knowledge Tracing

Knowledge tracing (KT) is the problem of predicting students' future performance based on their historical interactions with intelligent tutoring systems. Recently, many works present lots of special methods for applying deep neural networks to KT from different perspectives like model architecture, adversarial augmentation and etc., which make the overall algorithm and system become more and more complex. Furthermore, due to the lack of standardized evaluation protocol liu2022pykt, there is no widely agreed KT baselines and published experimental comparisons become inconsistent and self-contradictory, i.e., the reported AUC scores of DKT on ASSISTments2009 range from 0.721 to 0.821 minn2018deep,yeung2018addressing. Therefore, in this paper, we provide a strong but simple baseline method to deal with the KT task named simpleKT. Inspired by the Rasch model in psychometrics, we explicitly model question-specific variations to capture the individual differences among questions covering the same set of knowledge components that are a generalization of terms of concepts or skills needed for learners to accomplish steps in a task or a problem. Furthermore, instead of using sophisticated representations to capture student forgetting behaviors, we use the ordinary dot-product attention function to extract the time-aware information embedded in the student learning interactions. Extensive experiments show that such a simple baseline is able to always rank top 3 in terms of AUC scores and achieve 57 wins, 3 ties and 16 loss against 12 DLKT baseline methods on 7 public datasets of different domains. We believe this work serves as a strong baseline for future KT research. Code is available at https://github.com/pykt-team/pykt-toolkitWe merged our model to the \textsc{pyKT benchmark at https://pykt.org/.}.

  • 5 authors
·
Feb 22, 2023

MacroHFT: Memory Augmented Context-aware Reinforcement Learning On High Frequency Trading

High-frequency trading (HFT) that executes algorithmic trading in short time scales, has recently occupied the majority of cryptocurrency market. Besides traditional quantitative trading methods, reinforcement learning (RL) has become another appealing approach for HFT due to its terrific ability of handling high-dimensional financial data and solving sophisticated sequential decision-making problems, e.g., hierarchical reinforcement learning (HRL) has shown its promising performance on second-level HFT by training a router to select only one sub-agent from the agent pool to execute the current transaction. However, existing RL methods for HFT still have some defects: 1) standard RL-based trading agents suffer from the overfitting issue, preventing them from making effective policy adjustments based on financial context; 2) due to the rapid changes in market conditions, investment decisions made by an individual agent are usually one-sided and highly biased, which might lead to significant loss in extreme markets. To tackle these problems, we propose a novel Memory Augmented Context-aware Reinforcement learning method On HFT, a.k.a. MacroHFT, which consists of two training phases: 1) we first train multiple types of sub-agents with the market data decomposed according to various financial indicators, specifically market trend and volatility, where each agent owns a conditional adapter to adjust its trading policy according to market conditions; 2) then we train a hyper-agent to mix the decisions from these sub-agents and output a consistently profitable meta-policy to handle rapid market fluctuations, equipped with a memory mechanism to enhance the capability of decision-making. Extensive experiments on various cryptocurrency markets demonstrate that MacroHFT can achieve state-of-the-art performance on minute-level trading tasks.

  • 6 authors
·
Jun 20, 2024

Hierarchical Verbalizer for Few-Shot Hierarchical Text Classification

Due to the complex label hierarchy and intensive labeling cost in practice, the hierarchical text classification (HTC) suffers a poor performance especially when low-resource or few-shot settings are considered. Recently, there is a growing trend of applying prompts on pre-trained language models (PLMs), which has exhibited effectiveness in the few-shot flat text classification tasks. However, limited work has studied the paradigm of prompt-based learning in the HTC problem when the training data is extremely scarce. In this work, we define a path-based few-shot setting and establish a strict path-based evaluation metric to further explore few-shot HTC tasks. To address the issue, we propose the hierarchical verbalizer ("HierVerb"), a multi-verbalizer framework treating HTC as a single- or multi-label classification problem at multiple layers and learning vectors as verbalizers constrained by hierarchical structure and hierarchical contrastive learning. In this manner, HierVerb fuses label hierarchy knowledge into verbalizers and remarkably outperforms those who inject hierarchy through graph encoders, maximizing the benefits of PLMs. Extensive experiments on three popular HTC datasets under the few-shot settings demonstrate that prompt with HierVerb significantly boosts the HTC performance, meanwhile indicating an elegant way to bridge the gap between the large pre-trained model and downstream hierarchical classification tasks. Our code and few-shot dataset are publicly available at https://github.com/1KE-JI/HierVerb.

  • 4 authors
·
May 26, 2023

TransactionGPT

We present TransactionGPT (TGPT), a foundation model for consumer transaction data within one of world's largest payment networks. TGPT is designed to understand and generate transaction trajectories while simultaneously supporting a variety of downstream prediction and classification tasks. We introduce a novel 3D-Transformer architecture specifically tailored for capturing the complex dynamics in payment transaction data. This architecture incorporates design innovations that enhance modality fusion and computational efficiency, while seamlessly enabling joint optimization with downstream objectives. Trained on billion-scale real-world transactions, TGPT significantly improves downstream classification performance against a competitive production model and exhibits advantages over baselines in generating future transactions. We conduct extensive empirical evaluations utilizing a diverse collection of company transaction datasets spanning multiple downstream tasks, thereby enabling a thorough assessment of TGPT's effectiveness and efficiency in comparison to established methodologies. Furthermore, we examine the incorporation of LLM-derived embeddings within TGPT and benchmark its performance against fine-tuned LLMs, demonstrating that TGPT achieves superior predictive accuracy as well as faster training and inference. We anticipate that the architectural innovations and practical guidelines from this work will advance foundation models for transaction-like data and catalyze future research in this emerging field.

  • 27 authors
·
Nov 11, 2025

Parallel Bayesian Optimization of Agent-based Transportation Simulation

MATSim (Multi-Agent Transport Simulation Toolkit) is an open source large-scale agent-based transportation planning project applied to various areas like road transport, public transport, freight transport, regional evacuation, etc. BEAM (Behavior, Energy, Autonomy, and Mobility) framework extends MATSim to enable powerful and scalable analysis of urban transportation systems. The agents from the BEAM simulation exhibit 'mode choice' behavior based on multinomial logit model. In our study, we consider eight mode choices viz. bike, car, walk, ride hail, driving to transit, walking to transit, ride hail to transit, and ride hail pooling. The 'alternative specific constants' for each mode choice are critical hyperparameters in a configuration file related to a particular scenario under experimentation. We use the 'Urbansim-10k' BEAM scenario (with 10,000 population size) for all our experiments. Since these hyperparameters affect the simulation in complex ways, manual calibration methods are time consuming. We present a parallel Bayesian optimization method with early stopping rule to achieve fast convergence for the given multi-in-multi-out problem to its optimal configurations. Our model is based on an open source HpBandSter package. This approach combines hierarchy of several 1D Kernel Density Estimators (KDE) with a cheap evaluator (Hyperband, a single multidimensional KDE). Our model has also incorporated extrapolation based early stopping rule. With our model, we could achieve a 25% L1 norm for a large-scale BEAM simulation in fully autonomous manner. To the best of our knowledge, our work is the first of its kind applied to large-scale multi-agent transportation simulations. This work can be useful for surrogate modeling of scenarios with very large populations.

Large Language Models to Identify Social Determinants of Health in Electronic Health Records

Social determinants of health (SDoH) have an important impact on patient outcomes but are incompletely collected from the electronic health records (EHR). This study researched the ability of large language models to extract SDoH from free text in EHRs, where they are most commonly documented, and explored the role of synthetic clinical text for improving the extraction of these scarcely documented, yet extremely valuable, clinical data. 800 patient notes were annotated for SDoH categories, and several transformer-based models were evaluated. The study also experimented with synthetic data generation and assessed for algorithmic bias. Our best-performing models were fine-tuned Flan-T5 XL (macro-F1 0.71) for any SDoH, and Flan-T5 XXL (macro-F1 0.70). The benefit of augmenting fine-tuning with synthetic data varied across model architecture and size, with smaller Flan-T5 models (base and large) showing the greatest improvements in performance (delta F1 +0.12 to +0.23). Model performance was similar on the in-hospital system dataset but worse on the MIMIC-III dataset. Our best-performing fine-tuned models outperformed zero- and few-shot performance of ChatGPT-family models for both tasks. These fine-tuned models were less likely than ChatGPT to change their prediction when race/ethnicity and gender descriptors were added to the text, suggesting less algorithmic bias (p<0.05). At the patient-level, our models identified 93.8% of patients with adverse SDoH, while ICD-10 codes captured 2.0%. Our method can effectively extracted SDoH information from clinic notes, performing better compare to GPT zero- and few-shot settings. These models could enhance real-world evidence on SDoH and aid in identifying patients needing social support.

  • 14 authors
·
Aug 11, 2023

MedS^3: Towards Medical Small Language Models with Self-Evolved Slow Thinking

Medical language models (MLMs) have become pivotal in advancing medical natural language processing. However, prior models that rely on pre-training or supervised fine-tuning often exhibit low data efficiency and limited practicality in real-world clinical applications. While OpenAIs O1 highlights test-time scaling in mathematics, attempts to replicate this approach in medicine typically distill responses from GPT-series models to open-source models, focusing primarily on multiple-choice tasks. This strategy, though straightforward, neglects critical concerns like data privacy and realistic deployment in clinical settings. In this work, we present a deployable, small-scale medical language model, \mone, designed for long-chain reasoning in clinical tasks using a self-evolution paradigm. Starting with a seed dataset of around 8,000 instances spanning five domains and 16 datasets, we prompt a base policy model to perform Monte Carlo Tree Search (MCTS) to construct verifiable reasoning chains. Each reasoning step is assigned an evolution rollout value, allowing verified trajectories to train the policy model and the reward model. During inference, the policy model generates multiple responses, and the reward model selects the one with the highest reward score. Experiments on eleven evaluation datasets demonstrate that \mone outperforms prior open-source models by 2 points, with the addition of the reward model further boosting performance (sim13 points), surpassing GPT-4o-mini. Code and data are available at https://github.com/pixas/MedSSS.

  • 6 authors
·
Jan 21, 2025

Liver Segmentation using Turbolift Learning for CT and Cone-beam C-arm Perfusion Imaging

Model-based reconstruction employing the time separation technique (TST) was found to improve dynamic perfusion imaging of the liver using C-arm cone-beam computed tomography (CBCT). To apply TST using prior knowledge extracted from CT perfusion data, the liver should be accurately segmented from the CT scans. Reconstructions of primary and model-based CBCT data need to be segmented for proper visualisation and interpretation of perfusion maps. This research proposes Turbolift learning, which trains a modified version of the multi-scale Attention UNet on different liver segmentation tasks serially, following the order of the trainings CT, CBCT, CBCT TST - making the previous trainings act as pre-training stages for the subsequent ones - addressing the problem of limited number of datasets for training. For the final task of liver segmentation from CBCT TST, the proposed method achieved an overall Dice scores of 0.874pm0.031 and 0.905pm0.007 in 6-fold and 4-fold cross-validation experiments, respectively - securing statistically significant improvements over the model, which was trained only for that task. Experiments revealed that Turbolift not only improves the overall performance of the model but also makes it robust against artefacts originating from the embolisation materials and truncation artefacts. Additionally, in-depth analyses confirmed the order of the segmentation tasks. This paper shows the potential of segmenting the liver from CT, CBCT, and CBCT TST, learning from the available limited training data, which can possibly be used in the future for the visualisation and evaluation of the perfusion maps for the treatment evaluation of liver diseases.

  • 12 authors
·
Jul 20, 2022

Classification of Non-native Handwritten Characters Using Convolutional Neural Network

The use of convolutional neural networks (CNNs) has accelerated the progress of handwritten character classification/recognition. Handwritten character recognition (HCR) has found applications in various domains, such as traffic signal detection, language translation, and document information extraction. However, the widespread use of existing HCR technology is yet to be seen as it does not provide reliable character recognition with outstanding accuracy. One of the reasons for unreliable HCR is that existing HCR methods do not take the handwriting styles of non-native writers into account. Hence, further improvement is needed to ensure the reliability and extensive deployment of character recognition technologies for critical tasks. In this work, the classification of English characters written by non-native users is performed by proposing a custom-tailored CNN model. We train this CNN with a new dataset called the handwritten isolated English character (HIEC) dataset. This dataset consists of 16,496 images collected from 260 persons. This paper also includes an ablation study of our CNN by adjusting hyperparameters to identify the best model for the HIEC dataset. The proposed model with five convolutional layers and one hidden layer outperforms state-of-the-art models in terms of character recognition accuracy and achieves an accuracy of 97.04%. Compared with the second-best model, the relative improvement of our model in terms of classification accuracy is 4.38%.

  • 4 authors
·
Jun 6, 2024

Temporal-spatial Correlation Attention Network for Clinical Data Analysis in Intensive Care Unit

In recent years, medical information technology has made it possible for electronic health record (EHR) to store fairly complete clinical data. This has brought health care into the era of "big data". However, medical data are often sparse and strongly correlated, which means that medical problems cannot be solved effectively. With the rapid development of deep learning in recent years, it has provided opportunities for the use of big data in healthcare. In this paper, we propose a temporal-saptial correlation attention network (TSCAN) to handle some clinical characteristic prediction problems, such as predicting death, predicting length of stay, detecting physiologic decline, and classifying phenotypes. Based on the design of the attention mechanism model, our approach can effectively remove irrelevant items in clinical data and irrelevant nodes in time according to different tasks, so as to obtain more accurate prediction results. Our method can also find key clinical indicators of important outcomes that can be used to improve treatment options. Our experiments use information from the Medical Information Mart for Intensive Care (MIMIC-IV) database, which is open to the public. Finally, we have achieved significant performance benefits of 2.0\% (metric) compared to other SOTA prediction methods. We achieved a staggering 90.7\% on mortality rate, 45.1\% on length of stay. The source code can be find: https://github.com/yuyuheintju/TSCAN.

  • 6 authors
·
Jun 2, 2023

Lessons Learned from Mining the Hugging Face Repository

The rapidly evolving fields of Machine Learning (ML) and Artificial Intelligence have witnessed the emergence of platforms like Hugging Face (HF) as central hubs for model development and sharing. This experience report synthesizes insights from two comprehensive studies conducted on HF, focusing on carbon emissions and the evolutionary and maintenance aspects of ML models. Our objective is to provide a practical guide for future researchers embarking on mining software repository studies within the HF ecosystem to enhance the quality of these studies. We delve into the intricacies of the replication package used in our studies, highlighting the pivotal tools and methodologies that facilitated our analysis. Furthermore, we propose a nuanced stratified sampling strategy tailored for the diverse HF Hub dataset, ensuring a representative and comprehensive analytical approach. The report also introduces preliminary guidelines, transitioning from repository mining to cohort studies, to establish causality in repository mining studies, particularly within the ML model of HF context. This transition is inspired by existing frameworks and is adapted to suit the unique characteristics of the HF model ecosystem. Our report serves as a guiding framework for researchers, contributing to the responsible and sustainable advancement of ML, and fostering a deeper understanding of the broader implications of ML models.

  • 3 authors
·
Feb 11, 2024

A Survey on Medical Large Language Models: Technology, Application, Trustworthiness, and Future Directions

With the advent of Large Language Models (LLMs), medical artificial intelligence (AI) has experienced substantial technological progress and paradigm shifts, highlighting the potential of LLMs to streamline healthcare delivery and improve patient outcomes. Considering this rapid technical progress, in this survey, we trace the recent advances of Medical Large Language Models (Med-LLMs), including the background, key findings, and mainstream techniques, especially for the evolution from general-purpose models to medical-specialized applications. Firstly, we delve into the foundational technology of Med-LLMs, indicating how general models can be progressively adapted and refined for the complicated medical tasks. Secondly, the wide-ranging applications of Med-LLMs are investigated across various healthcare domains, as well as an up-to-date review of existing Med-LLMs. The transformative impact of these models on daily medical practice is evident through their ability to assist clinicians, educators, and patients. Recognizing the importance of responsible innovation, we discuss the challenges associated with ensuring fairness, accountability, privacy, and robustness. Ethical considerations, rigorous evaluation methodologies, and the establishment of regulatory frameworks are crucial for building trustworthiness in the real-world system. We emphasize the need for ongoing scrutiny and development to maintain high standards of safety and reliability. Finally, we anticipate possible future trajectories for Med-LLMs, identifying key avenues for prudent expansion. By consolidating these insights, our review aims to provide professionals and researchers with a thorough understanding of the strengths and limitations of Med-LLMs, fostering a balanced and ethical approach to their integration into the healthcare ecosystem.

  • 9 authors
·
Jun 5, 2024

Generative Pretrained Hierarchical Transformer for Time Series Forecasting

Recent efforts have been dedicated to enhancing time series forecasting accuracy by introducing advanced network architectures and self-supervised pretraining strategies. Nevertheless, existing approaches still exhibit two critical drawbacks. Firstly, these methods often rely on a single dataset for training, limiting the model's generalizability due to the restricted scale of the training data. Secondly, the one-step generation schema is widely followed, which necessitates a customized forecasting head and overlooks the temporal dependencies in the output series, and also leads to increased training costs under different horizon length settings. To address these issues, we propose a novel generative pretrained hierarchical transformer architecture for forecasting, named GPHT. There are two aspects of key designs in GPHT. On the one hand, we advocate for constructing a mixed dataset for pretraining our model, comprising various datasets from diverse data scenarios. This approach significantly expands the scale of training data, allowing our model to uncover commonalities in time series data and facilitating improved transfer to specific datasets. On the other hand, GPHT employs an auto-regressive forecasting approach under the channel-independent assumption, effectively modeling temporal dependencies in the output series. Importantly, no customized forecasting head is required, enabling a single model to forecast at arbitrary horizon settings. We conduct sufficient experiments on eight datasets with mainstream self-supervised pretraining models and supervised models. The results demonstrated that GPHT surpasses the baseline models across various fine-tuning and zero/few-shot learning settings in the traditional long-term forecasting task, providing support for verifying the feasibility of pretrained time series large models.

  • 5 authors
·
Feb 26, 2024

Medical World Model: Generative Simulation of Tumor Evolution for Treatment Planning

Providing effective treatment and making informed clinical decisions are essential goals of modern medicine and clinical care. We are interested in simulating disease dynamics for clinical decision-making, leveraging recent advances in large generative models. To this end, we introduce the Medical World Model (MeWM), the first world model in medicine that visually predicts future disease states based on clinical decisions. MeWM comprises (i) vision-language models to serve as policy models, and (ii) tumor generative models as dynamics models. The policy model generates action plans, such as clinical treatments, while the dynamics model simulates tumor progression or regression under given treatment conditions. Building on this, we propose the inverse dynamics model that applies survival analysis to the simulated post-treatment tumor, enabling the evaluation of treatment efficacy and the selection of the optimal clinical action plan. As a result, the proposed MeWM simulates disease dynamics by synthesizing post-treatment tumors, with state-of-the-art specificity in Turing tests evaluated by radiologists. Simultaneously, its inverse dynamics model outperforms medical-specialized GPTs in optimizing individualized treatment protocols across all metrics. Notably, MeWM improves clinical decision-making for interventional physicians, boosting F1-score in selecting the optimal TACE protocol by 13%, paving the way for future integration of medical world models as the second readers.

  • 11 authors
·
Jun 2, 2025 2

Towards a Unified View of Large Language Model Post-Training

Two major sources of training data exist for post-training modern language models: online (model-generated rollouts) data, and offline (human or other-model demonstrations) data. These two types of data are typically used by approaches like Reinforcement Learning (RL) and Supervised Fine-Tuning (SFT), respectively. In this paper, we show that these approaches are not in contradiction, but are instances of a single optimization process. We derive a Unified Policy Gradient Estimator, and present the calculations of a wide spectrum of post-training approaches as the gradient of a common objective under different data distribution assumptions and various bias-variance tradeoffs. The gradient estimator is constructed with four interchangeable parts: stabilization mask, reference policy denominator, advantage estimate, and likelihood gradient. Motivated by our theoretical findings, we propose Hybrid Post-Training (HPT), an algorithm that dynamically selects different training signals. HPT is designed to yield both effective exploitation of demonstration and stable exploration without sacrificing learned reasoning patterns. We provide extensive experiments and ablation studies to verify the effectiveness of our unified theoretical framework and HPT. Across six mathematical reasoning benchmarks and two out-of-distribution suites, HPT consistently surpasses strong baselines across models of varying scales and families.

  • 12 authors
·
Sep 4, 2025 7

Multi-Treatment Multi-Task Uplift Modeling for Enhancing User Growth

As a key component in boosting online user growth, uplift modeling aims to measure individual user responses (e.g., whether to play the game) to various treatments, such as gaming bonuses, thereby enhancing business outcomes. However, previous research typically considers a single-task, single-treatment setting, where only one treatment exists and the overall treatment effect is measured by a single type of user response. In this paper, we propose a Multi-Treatment Multi-Task (MTMT) uplift network to estimate treatment effects in a multi-task scenario. We identify the multi-treatment problem as a causal inference problem with a tiered response, comprising a base effect (from offering a treatment) and an incremental effect (from offering a specific type of treatment), where the base effect can be numerically much larger than the incremental effect. Specifically, MTMT separately encodes user features and treatments. The user feature encoder uses a multi-gate mixture of experts (MMOE) network to encode relevant user features, explicitly learning inter-task relations. The resultant embeddings are used to measure natural responses per task. Furthermore, we introduce a treatment-user feature interaction module to model correlations between each treatment and user feature. Consequently, we separately measure the base and incremental treatment effect for each task based on the produced treatment-aware representations. Experimental results based on an offline public dataset and an online proprietary dataset demonstrate the effectiveness of MTMT in single/multi-treatment and single/multi-task settings. Additionally, MTMT has been deployed in our gaming platform to improve user experience.

  • 5 authors
·
Aug 22, 2024

Demystifying Large Language Models for Medicine: A Primer

Large language models (LLMs) represent a transformative class of AI tools capable of revolutionizing various aspects of healthcare by generating human-like responses across diverse contexts and adapting to novel tasks following human instructions. Their potential application spans a broad range of medical tasks, such as clinical documentation, matching patients to clinical trials, and answering medical questions. In this primer paper, we propose an actionable guideline to help healthcare professionals more efficiently utilize LLMs in their work, along with a set of best practices. This approach consists of several main phases, including formulating the task, choosing LLMs, prompt engineering, fine-tuning, and deployment. We start with the discussion of critical considerations in identifying healthcare tasks that align with the core capabilities of LLMs and selecting models based on the selected task and data, performance requirements, and model interface. We then review the strategies, such as prompt engineering and fine-tuning, to adapt standard LLMs to specialized medical tasks. Deployment considerations, including regulatory compliance, ethical guidelines, and continuous monitoring for fairness and bias, are also discussed. By providing a structured step-by-step methodology, this tutorial aims to equip healthcare professionals with the tools necessary to effectively integrate LLMs into clinical practice, ensuring that these powerful technologies are applied in a safe, reliable, and impactful manner.

  • 23 authors
·
Oct 24, 2024

Nash Learning from Human Feedback

Reinforcement learning from human feedback (RLHF) has emerged as the main paradigm for aligning large language models (LLMs) with human preferences. Typically, RLHF involves the initial step of learning a reward model from human feedback, often expressed as preferences between pairs of text generations produced by a pre-trained LLM. Subsequently, the LLM's policy is fine-tuned by optimizing it to maximize the reward model through a reinforcement learning algorithm. However, an inherent limitation of current reward models is their inability to fully represent the richness of human preferences and their dependency on the sampling distribution. In this study, we introduce an alternative pipeline for the fine-tuning of LLMs using pairwise human feedback. Our approach entails the initial learning of a preference model, which is conditioned on two inputs given a prompt, followed by the pursuit of a policy that consistently generates responses preferred over those generated by any competing policy, thus defining the Nash equilibrium of this preference model. We term this approach Nash learning from human feedback (NLHF). In the context of a tabular policy representation, we present a novel algorithmic solution, Nash-MD, founded on the principles of mirror descent. This algorithm produces a sequence of policies, with the last iteration converging to the regularized Nash equilibrium. Additionally, we explore parametric representations of policies and introduce gradient descent algorithms for deep-learning architectures. To demonstrate the effectiveness of our approach, we present experimental results involving the fine-tuning of a LLM for a text summarization task. We believe NLHF offers a compelling avenue for preference learning and policy optimization with the potential of advancing the field of aligning LLMs with human preferences.

  • 17 authors
·
Dec 1, 2023 2

xHC: Expanded Hyper-Connections

Hyper-Connections (HC) expand the residual stream of Transformers into N parallel streams, providing a form of memory scaling beyond model width and depth. Manifold-Constrained HC (mHC) stabilizes this formulation at scale. The large gains from N{=}1 to N{=}4 suggest residual-stream expansion as a promising scaling axis. However, existing HC-family methods typically stop at N{=}4. Our experiments reveal why: scaling mHC beyond this point yields diminishing performance gains and rapidly increasing training cost. We attribute this limitation to two bottlenecks: insufficient write-back information for an expanding number of streams and residual-mixing generation whose cost scales cubically with N. To address both bottlenecks, we propose xHC (Expanded Hyper-Connections), the first HC-family method to achieve meaningful expansion beyond N{=}4. xHC combines temporal feature augmentation for richer write-back with a sparse residual-stream architecture that updates only k=4 of the N=16 streams while retaining dense access to the full residual state. Across 18B and 28B MoE models, xHC delivers strong and consistent downstream improvements. On an 18B MoE model, xHC improves the average downstream score by 4.0 points over mHC, while adding only modest training FLOPs over the vanilla baseline. Scaling-law experiments show that the vanilla and mHC require 1.50times and 1.19times the compute of xHC, respectively, to reach the same loss. Practical large-N training also requires controlling memory traffic from the expanded residual state. We therefore introduce xHC-Flash, which reduces the per-sublayer memory traffic from 73.5C to 40C, comparable to the 34C required by mHC at N{=}4, while retaining the gains of full xHC. Together, xHC and xHC-Flash make large-N residual-stream expansion effective and practical for LLM pre-training.

dots-studio dots studio
·
Jul 15 3

EHRSHOT: An EHR Benchmark for Few-Shot Evaluation of Foundation Models

While the general machine learning (ML) community has benefited from public datasets, tasks, and models, the progress of ML in healthcare has been hampered by a lack of such shared assets. The success of foundation models creates new challenges for healthcare ML by requiring access to shared pretrained models to validate performance benefits. We help address these challenges through three contributions. First, we publish a new dataset, EHRSHOT, which contains deidentified structured data from the electronic health records (EHRs) of 6,739 patients from Stanford Medicine. Unlike MIMIC-III/IV and other popular EHR datasets, EHRSHOT is longitudinal and not restricted to ICU/ED patients. Second, we publish the weights of CLMBR-T-base, a 141M parameter clinical foundation model pretrained on the structured EHR data of 2.57M patients. We are one of the first to fully release such a model for coded EHR data; in contrast, most prior models released for clinical data (e.g. GatorTron, ClinicalBERT) only work with unstructured text and cannot process the rich, structured data within an EHR. We provide an end-to-end pipeline for the community to validate and build upon its performance. Third, we define 15 few-shot clinical prediction tasks, enabling evaluation of foundation models on benefits such as sample efficiency and task adaptation. Our model and dataset are available via a research data use agreement from the Stanford AIMI Center. Code to reproduce our results are available at our Github repo: https://github.com/som-shahlab/ehrshot-benchmark

  • 5 authors
·
Jul 5, 2023

Reward Model Ensembles Help Mitigate Overoptimization

Reinforcement learning from human feedback (RLHF) is a standard approach for fine-tuning large language models to follow instructions. As part of this process, learned reward models are used to approximately model human preferences. However, as imperfect representations of the "true" reward, these learned reward models are susceptible to overoptimization. Gao et al. (2023) studied this phenomenon in a synthetic human feedback setup with a significantly larger "gold" reward model acting as the true reward (instead of humans) and showed that overoptimization remains a persistent problem regardless of the size of the proxy reward model and training data used. Using a similar setup, we conduct a systematic study to evaluate the efficacy of using ensemble-based conservative optimization objectives, specifically worst-case optimization (WCO) and uncertainty-weighted optimization (UWO), for mitigating reward model overoptimization when using two optimization methods: (a) best-of-n sampling (BoN) (b) proximal policy optimization (PPO). We additionally extend the setup of Gao et al. (2023) to include 25% label noise to better mirror real-world conditions. Both with and without label noise, we find that conservative optimization practically eliminates overoptimization and improves performance by up to 70% for BoN sampling. For PPO, ensemble-based conservative optimization always reduces overoptimization and outperforms single reward model optimization. Moreover, combining it with a small KL penalty successfully prevents overoptimization at no performance cost. Overall, our results demonstrate that ensemble-based conservative optimization can effectively counter overoptimization.

  • 4 authors
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Oct 4, 2023

Continuous online sequence learning with an unsupervised neural network model

The ability to recognize and predict temporal sequences of sensory inputs is vital for survival in natural environments. Based on many known properties of cortical neurons, hierarchical temporal memory (HTM) sequence memory is recently proposed as a theoretical framework for sequence learning in the cortex. In this paper, we analyze properties of HTM sequence memory and apply it to sequence learning and prediction problems with streaming data. We show the model is able to continuously learn a large number of variable-order temporal sequences using an unsupervised Hebbian-like learning rule. The sparse temporal codes formed by the model can robustly handle branching temporal sequences by maintaining multiple predictions until there is sufficient disambiguating evidence. We compare the HTM sequence memory with other sequence learning algorithms, including statistical methods: autoregressive integrated moving average (ARIMA), feedforward neural networks: online sequential extreme learning machine (ELM), and recurrent neural networks: long short-term memory (LSTM) and echo-state networks (ESN), on sequence prediction problems with both artificial and real-world data. The HTM model achieves comparable accuracy to other state-of-the-art algorithms. The model also exhibits properties that are critical for sequence learning, including continuous online learning, the ability to handle multiple predictions and branching sequences with high order statistics, robustness to sensor noise and fault tolerance, and good performance without task-specific hyper- parameters tuning. Therefore the HTM sequence memory not only advances our understanding of how the brain may solve the sequence learning problem, but is also applicable to a wide range of real-world problems such as discrete and continuous sequence prediction, anomaly detection, and sequence classification.

  • 3 authors
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Dec 16, 2015

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
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Jun 1

HyperWalker: Dynamic Hypergraph-Based Deep Diagnosis for Multi-Hop Clinical Modeling across EHR and X-Ray in Medical VLMs

Automated clinical diagnosis remains a core challenge in medical AI, which usually requires models to integrate multi-modal data and reason across complex, case-specific contexts. Although recent methods have advanced medical report generation (MRG) and visual question answering (VQA) with medical vision-language models (VLMs), these methods, however, predominantly operate under a sample-isolated inference paradigm, as such processing cases independently without access to longitudinal electronic health records (EHRs) or structurally related patient examples. This paradigm limits reasoning to image-derived information alone, which ignores external complementary medical evidence for potentially more accurate diagnosis. To overcome this limitation, we propose HyperWalker, a Deep Diagnosis framework that reformulates clinical reasoning via dynamic hypergraphs and test-time training. First, we construct a dynamic hypergraph, termed iBrochure, to model the structural heterogeneity of EHR data and implicit high-order associations among multimodal clinical information. Within this hypergraph, a reinforcement learning agent, Walker, navigates to and identifies optimal diagnostic paths. To ensure comprehensive coverage of diverse clinical characteristics in test samples, we incorporate a linger mechanism, a multi-hop orthogonal retrieval strategy that iteratively selects clinically complementary neighborhood cases reflecting distinct clinical attributes. Experiments on MRG with MIMIC and medical VQA on EHRXQA demonstrate that HyperWalker achieves state-of-the-art performance. Code is available at: https://github.com/Bean-Young/HyperWalker

  • 5 authors
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Jan 19

The ELEVATE-AI LLMs Framework: An Evaluation Framework for Use of Large Language Models in HEOR: an ISPOR Working Group Report

Introduction. Generative Artificial Intelligence, particularly large language models (LLMs), offers transformative potential for Health Economics and Outcomes Research (HEOR). However, evaluating the quality, transparency, and rigor of LLM-assisted research lacks standardized guidance. This article introduces the ELEVATE AI LLMs framework and checklist, designed to support researchers and reviewers in assessing LLM use in HEOR. Methods. The ELEVATE AI LLMs framework was developed through a targeted review of existing guidelines and evaluation frameworks. The framework comprises ten evaluation domains, including model characteristics, accuracy, comprehensiveness, and fairness. The accompanying checklist operationalizes the framework. To validate the framework, we applied it to two published studies, demonstrating its usability across different HEOR tasks. Results. The ELEVATE AI LLMs framework provides a comprehensive structure for evaluating LLM-assisted research, while the checklist facilitates practical application. Validation of the framework and checklist on studies of systematic literature reviews and health economic modeling highlighted their ability to identify strengths and gaps in reporting. Limitations. While the ELEVATE AI LLMs framework provides robust guidance, its broader generalizability and applicability to diverse HEOR tasks require further empirical testing. Additionally, several metrics adapted from computer science need further validation in HEOR contexts. Conclusion. The ELEVATE AI LLMs framework and checklist fill a critical gap in HEOR by offering structured guidance for evaluating LLM-assisted research. By promoting transparency, accuracy, and reproducibility, they aim to standardize and improve the integration of LLMs into HEOR, ensuring their outputs meet the field's rigorous standards.

  • 8 authors
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Dec 23, 2024

CMT: Mid-Training for Efficient Learning of Consistency, Mean Flow, and Flow Map Models

Flow map models such as Consistency Models (CM) and Mean Flow (MF) enable few-step generation by learning the long jump of the ODE solution of diffusion models, yet training remains unstable, sensitive to hyperparameters, and costly. Initializing from a pre-trained diffusion model helps, but still requires converting infinitesimal steps into a long-jump map, leaving instability unresolved. We introduce mid-training, the first concept and practical method that inserts a lightweight intermediate stage between the (diffusion) pre-training and the final flow map training (i.e., post-training) for vision generation. Concretely, Consistency Mid-Training (CMT) is a compact and principled stage that trains a model to map points along a solver trajectory from a pre-trained model, starting from a prior sample, directly to the solver-generated clean sample. It yields a trajectory-consistent and stable initialization. This initializer outperforms random and diffusion-based baselines and enables fast, robust convergence without heuristics. Initializing post-training with CMT weights further simplifies flow map learning. Empirically, CMT achieves state of the art two step FIDs: 1.97 on CIFAR-10, 1.32 on ImageNet 64x64, and 1.84 on ImageNet 512x512, while using up to 98% less training data and GPU time, compared to CMs. On ImageNet 256x256, CMT reaches 1-step FID 3.34 while cutting total training time by about 50% compared to MF from scratch (FID 3.43). This establishes CMT as a principled, efficient, and general framework for training flow map models.

  • 4 authors
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Sep 29, 2025

Training-Free Adaptation of Diffusion Models via Doob's h-Transform

Adaptation methods have been a workhorse for unlocking the transformative power of pre-trained diffusion models in diverse applications. Existing approaches often abstract adaptation objectives as a reward function and steer diffusion models to generate high-reward samples. However, these approaches can incur high computational overhead due to additional training, or rely on stringent assumptions on the reward such as differentiability. Moreover, despite their empirical success, theoretical justification and guarantees are seldom established. In this paper, we propose DOIT (Doob-Oriented Inference-time Transformation), a training-free and computationally efficient adaptation method that applies to generic, non-differentiable rewards. The key framework underlying our method is a measure transport formulation that seeks to transport the pre-trained generative distribution to a high-reward target distribution. We leverage Doob's h-transform to realize this transport, which induces a dynamic correction to the diffusion sampling process and enables efficient simulation-based computation without modifying the pre-trained model. Theoretically, we establish a high probability convergence guarantee to the target high-reward distribution via characterizing the approximation error in the dynamic Doob's correction. Empirically, on D4RL offline RL benchmarks, our method consistently outperforms state-of-the-art baselines while preserving sampling efficiency.

  • 5 authors
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Feb 18

Visual Document Understanding and Question Answering: A Multi-Agent Collaboration Framework with Test-Time Scaling

Existing vision-language models (VLMs), whether generalists or specialists, remain constrained by their parameter scale, lack robust self-correction capabilities, and underperform in tasks involving long visual contexts and complex reasoning, resulting in suboptimal performance on document-based tasks. To address this, we propose MACT, a Multi-Agent Collaboration framework with Test-Time scaling, tailored for visual document understanding and visual question answering (VQA). It comprises four distinct small-scale agents, i.e., planning, execution, judgment, and answer agents, with clearly defined roles and effective collaboration. Notably, the judgment agent exclusively verifies correctness and redirects to prior agents for revisions, outperforming conventional correction strategies. To further expand the capability boundaries of the framework, we propose mixed reward modeling that balances agent-specific abilities and global collaboration, as well as agent-wise hybrid test-time scaling, which customizes different scaling strategies for each agent based on their functions. Evaluated on benchmarks spanning both document-based and non-document-based settings, our MACT shows superior performance with a smaller parameter scale without sacrificing the ability of general and mathematical tasks. Especially, it stands out in benchmarks involving long visual contexts and complicated reasoning. The three variants of MACT consistently hold the top three positions in average scores, leading in 13 of the 15 benchmarks. Code will be available at: https://github.com/YU-deep/MACT.git.

  • 9 authors
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Aug 5, 2025 2

Evaluating Large Language Models in Dynamic Clinical Decision-Making with Standardized Patient Cases

Large language models (LLMs) are increasingly proposed as clinical agents, yet static, single-turn benchmarks cannot capture how a model dynamically delivers care across an encounter: gathering information, planning treatment, and adapting longitudinal management across successive patient states. Medical education has long addressed an analogous challenge through standardized patients (SPs): trained actors who consistently portray clinical cases, enabling realistic practice and objective, scripted assessment. Here we introduce MedSP1000, an SP-derived interactive benchmark for clinical-agent evaluation, including 1,638 SP cases with 24,602 trajectory-level peer-reviewed rubrics. MedSP1000 converts peer-reviewed SP teaching cases into executable scenarios with defined SP case scripts, clinical environment contexts, and human-validated structured rubric. In each simulation evaluation run, a clinical agent interacts in closed loop with a patient agent and an environment controller, and its behaviour is scored throughout the encounter against expert criteria specified in the original materials. Applying MedSP1000 to a range of general-purpose and medically specialized LLMs, we find that performance on static benchmarks does not reliably translate to such educational scenarios. The best-performing model, GPT-5.5, completes only 60.4% of expert-defined rubric items, whereas the strongest medically specialized model reaches 40.0%; increasing test-time compute produces no measurable gain. These results suggest that current LLMs, including agentic systems tuned for medicine, are not yet reliable enough to be safely integrated into actual clinical practice. More broadly, MedSP1000 shows how process-level, SP-style evaluation can reveal clinically relevant failure modes that single-turn benchmarks miss.

  • 6 authors
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Jun 2 1

CT-ΔBench: A Benchmark for Longitudinal 3D Medical Imaging Difference Reporting with Vision-Language Models

In medical imaging, the clinical value of Computed Tomography (CT) lies not only in depicting current disease status, but crucially in enabling longitudinal comparison of serial scans to determine disease evolution, a process that underpins response assessment, recurrence detection, and ongoing patient management. Yet, despite this central role of temporal comparison in clinical decision-making, existing medical foundation models remain largely confined to single-study understanding, leaving temporally grounded cross-examination insufficiently addressed. To address this gap, we study longitudinal imaging difference reporting, a task in which a model takes two temporally separated scans from the same patient and generates a clinically meaningful report describing interval changes between them. We introduce CT-ΔBench, a dedicated benchmark for this task with patient-level splitting to prevent information leakage. To better evaluate this task beyond surface-level text similarity, we further develop change-aware metrics specifically designed to capture clinically meaningful longitudinal changes, and conduct an independent physician validation to assess the reliability of the synthesized references and event extraction pipeline. We also compare direct paired-CT reasoning with an indirect two-stage pipeline that first generates single-timepoint reports and then performs textual differencing. Finally, we propose DeltaMed, a baseline model for direct paired-CT difference reporting, and train it on the benchmark training set. Together, these contributions lay the groundwork for temporally aware medical foundation models that better reflect real-world longitudinal clinical reasoning.

  • 4 authors
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Aug 11

A Unified Pairwise Framework for RLHF: Bridging Generative Reward Modeling and Policy Optimization

Reinforcement Learning from Human Feedback (RLHF) has emerged as a important paradigm for aligning large language models (LLMs) with human preferences during post-training. This framework typically involves two stages: first, training a reward model on human preference data, followed by optimizing the language model using reinforcement learning algorithms. However, current RLHF approaches may constrained by two limitations. First, existing RLHF frameworks often rely on Bradley-Terry models to assign scalar rewards based on pairwise comparisons of individual responses. However, this approach imposes significant challenges on reward model (RM), as the inherent variability in prompt-response pairs across different contexts demands robust calibration capabilities from the RM. Second, reward models are typically initialized from generative foundation models, such as pre-trained or supervised fine-tuned models, despite the fact that reward models perform discriminative tasks, creating a mismatch. This paper introduces Pairwise-RL, a RLHF framework that addresses these challenges through a combination of generative reward modeling and a pairwise proximal policy optimization (PPO) algorithm. Pairwise-RL unifies reward model training and its application during reinforcement learning within a consistent pairwise paradigm, leveraging generative modeling techniques to enhance reward model performance and score calibration. Experimental evaluations demonstrate that Pairwise-RL outperforms traditional RLHF frameworks across both internal evaluation datasets and standard public benchmarks, underscoring its effectiveness in improving alignment and model behavior.

  • 6 authors
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Apr 7, 2025

Generalist Foundation Models Are Not Clinical Enough for Hospital Operations

Hospitals and healthcare systems rely on operational decisions that determine patient flow, cost, and quality of care. Despite strong performance on medical knowledge and conversational benchmarks, foundation models trained on general text may lack the specialized knowledge required for these operational decisions. We introduce Lang1, a family of models (100M-7B parameters) pretrained on a specialized corpus blending 80B clinical tokens from NYU Langone Health's EHRs and 627B tokens from the internet. To rigorously evaluate Lang1 in real-world settings, we developed the REalistic Medical Evaluation (ReMedE), a benchmark derived from 668,331 EHR notes that evaluates five critical tasks: 30-day readmission prediction, 30-day mortality prediction, length of stay, comorbidity coding, and predicting insurance claims denial. In zero-shot settings, both general-purpose and specialized models underperform on four of five tasks (36.6%-71.7% AUROC), with mortality prediction being an exception. After finetuning, Lang1-1B outperforms finetuned generalist models up to 70x larger and zero-shot models up to 671x larger, improving AUROC by 3.64%-6.75% and 1.66%-23.66% respectively. We also observed cross-task scaling with joint finetuning on multiple tasks leading to improvement on other tasks. Lang1-1B effectively transfers to out-of-distribution settings, including other clinical tasks and an external health system. Our findings suggest that predictive capabilities for hospital operations require explicit supervised finetuning, and that this finetuning process is made more efficient by in-domain pretraining on EHR. Our findings support the emerging view that specialized LLMs can compete with generalist models in specialized tasks, and show that effective healthcare systems AI requires the combination of in-domain pretraining, supervised finetuning, and real-world evaluation beyond proxy benchmarks.

newyorkuniversity New York University
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Nov 17, 2025 3

Evaluating Robustness of Reward Models for Mathematical Reasoning

Reward models are key in reinforcement learning from human feedback (RLHF) systems, aligning the model behavior with human preferences. Particularly in the math domain, there have been plenty of studies using reward models to align policies for improving reasoning capabilities. Recently, as the importance of reward models has been emphasized, RewardBench is proposed to understand their behavior. However, we figure out that the math subset of RewardBench has different representations between chosen and rejected completions, and relies on a single comparison, which may lead to unreliable results as it only see an isolated case. Therefore, it fails to accurately present the robustness of reward models, leading to a misunderstanding of its performance and potentially resulting in reward hacking. In this work, we introduce a new design for reliable evaluation of reward models, and to validate this, we construct RewardMATH, a benchmark that effectively represents the robustness of reward models in mathematical reasoning tasks. We demonstrate that the scores on RewardMATH strongly correlate with the results of optimized policy and effectively estimate reward overoptimization, whereas the existing benchmark shows almost no correlation. The results underscore the potential of our design to enhance the reliability of evaluation, and represent the robustness of reward model. We make our code and data publicly available.

  • 7 authors
·
Oct 2, 2024

Epicasting: An Ensemble Wavelet Neural Network (EWNet) for Forecasting Epidemics

Infectious diseases remain among the top contributors to human illness and death worldwide, among which many diseases produce epidemic waves of infection. The unavailability of specific drugs and ready-to-use vaccines to prevent most of these epidemics makes the situation worse. These force public health officials and policymakers to rely on early warning systems generated by reliable and accurate forecasts of epidemics. Accurate forecasts of epidemics can assist stakeholders in tailoring countermeasures, such as vaccination campaigns, staff scheduling, and resource allocation, to the situation at hand, which could translate to reductions in the impact of a disease. Unfortunately, most of these past epidemics exhibit nonlinear and non-stationary characteristics due to their spreading fluctuations based on seasonal-dependent variability and the nature of these epidemics. We analyse a wide variety of epidemic time series datasets using a maximal overlap discrete wavelet transform (MODWT) based autoregressive neural network and call it EWNet model. MODWT techniques effectively characterize non-stationary behavior and seasonal dependencies in the epidemic time series and improve the nonlinear forecasting scheme of the autoregressive neural network in the proposed ensemble wavelet network framework. From a nonlinear time series viewpoint, we explore the asymptotic stationarity of the proposed EWNet model to show the asymptotic behavior of the associated Markov Chain. We also theoretically investigate the effect of learning stability and the choice of hidden neurons in the proposal. From a practical perspective, we compare our proposed EWNet framework with several statistical, machine learning, and deep learning models. Experimental results show that the proposed EWNet is highly competitive compared to the state-of-the-art epidemic forecasting methods.

  • 4 authors
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Jun 21, 2022

Reinforcement Learning with Human Feedback: Learning Dynamic Choices via Pessimism

In this paper, we study offline Reinforcement Learning with Human Feedback (RLHF) where we aim to learn the human's underlying reward and the MDP's optimal policy from a set of trajectories induced by human choices. RLHF is challenging for multiple reasons: large state space but limited human feedback, the bounded rationality of human decisions, and the off-policy distribution shift. In this paper, we focus on the Dynamic Discrete Choice (DDC) model for modeling and understanding human choices. DCC, rooted in econometrics and decision theory, is widely used to model a human decision-making process with forward-looking and bounded rationality. We propose a Dynamic-Choice-Pessimistic-Policy-Optimization (DCPPO) method. \ The method involves a three-stage process: The first step is to estimate the human behavior policy and the state-action value function via maximum likelihood estimation (MLE); the second step recovers the human reward function via minimizing Bellman mean squared error using the learned value functions; the third step is to plug in the learned reward and invoke pessimistic value iteration for finding a near-optimal policy. With only single-policy coverage (i.e., optimal policy) of the dataset, we prove that the suboptimality of DCPPO almost matches the classical pessimistic offline RL algorithm in terms of suboptimality's dependency on distribution shift and dimension. To the best of our knowledge, this paper presents the first theoretical guarantees for off-policy offline RLHF with dynamic discrete choice model.

  • 3 authors
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May 28, 2023

Motion simulation of radio-labeled cells in whole-body positron emission tomography

Cell tracking is a subject of active research gathering great interest in medicine and biology. Positron emission tomography (PET) is well suited for tracking radio-labeled cells in vivo due to its exceptional sensitivity and whole-body capability. For validation, ground-truth data are desirable that realistically mimic the flow of cells in a clinical situation. This study develops a workflow (CeFloPS) for simulating moving radio-labeled cells in a human phantom. From the XCAT phantom, the blood vessels are reduced to nodal networks along which cells can move and distribute to organs and tissues. The movement is directed by the blood flow, which is calculated in each node using the Hagen-Pooiseuille equation and Kirchhoff's laws assuming laminar flow. Organs are voxelized and movement of cells from artery entry to vein exit is generated via a biased 3D random walk. The probabilities of cells moving or remaining in tissues are derived from rate constants of tracer kinetic-based compartment modeling. PET listmode data is generated using the Monte-Carlo simulation framework GATE based on the definition of a large-body PET scanner with cell paths as moving radioactive sources and the XCAT phantom providing attenuation data. From the flow simulation of 100,000 cells, 100 sample cells were further processed by GATE and listmode data was reconstructed into images for comparison. As demonstrated by comparisons of simulated and reconstructed cell distributions, CeFloPS is capable of simulating cell behavior in whole-body PET. It achieves this simulation in a way that is anatomically and physiologically reasonable, thereby providing valuable data for the development and validation of cell tracking algorithms.

  • 5 authors
·
Jul 10, 2024

Tx-LLM: A Large Language Model for Therapeutics

Developing therapeutics is a lengthy and expensive process that requires the satisfaction of many different criteria, and AI models capable of expediting the process would be invaluable. However, the majority of current AI approaches address only a narrowly defined set of tasks, often circumscribed within a particular domain. To bridge this gap, we introduce Tx-LLM, a generalist large language model (LLM) fine-tuned from PaLM-2 which encodes knowledge about diverse therapeutic modalities. Tx-LLM is trained using a collection of 709 datasets that target 66 tasks spanning various stages of the drug discovery pipeline. Using a single set of weights, Tx-LLM simultaneously processes a wide variety of chemical or biological entities(small molecules, proteins, nucleic acids, cell lines, diseases) interleaved with free-text, allowing it to predict a broad range of associated properties, achieving competitive with state-of-the-art (SOTA) performance on 43 out of 66 tasks and exceeding SOTA on 22. Among these, Tx-LLM is particularly powerful and exceeds best-in-class performance on average for tasks combining molecular SMILES representations with text such as cell line names or disease names, likely due to context learned during pretraining. We observe evidence of positive transfer between tasks with diverse drug types (e.g.,tasks involving small molecules and tasks involving proteins), and we study the impact of model size, domain finetuning, and prompting strategies on performance. We believe Tx-LLM represents an important step towards LLMs encoding biochemical knowledge and could have a future role as an end-to-end tool across the drug discovery development pipeline.

  • 10 authors
·
Jun 10, 2024

HPNet: Dynamic Trajectory Forecasting with Historical Prediction Attention

Predicting the trajectories of road agents is essential for autonomous driving systems. The recent mainstream methods follow a static paradigm, which predicts the future trajectory by using a fixed duration of historical frames. These methods make the predictions independently even at adjacent time steps, which leads to potential instability and temporal inconsistency. As successive time steps have largely overlapping historical frames, their forecasting should have intrinsic correlation, such as overlapping predicted trajectories should be consistent, or be different but share the same motion goal depending on the road situation. Motivated by this, in this work, we introduce HPNet, a novel dynamic trajectory forecasting method. Aiming for stable and accurate trajectory forecasting, our method leverages not only historical frames including maps and agent states, but also historical predictions. Specifically, we newly design a Historical Prediction Attention module to automatically encode the dynamic relationship between successive predictions. Besides, it also extends the attention range beyond the currently visible window benefitting from the use of historical predictions. The proposed Historical Prediction Attention together with the Agent Attention and Mode Attention is further formulated as the Triple Factorized Attention module, serving as the core design of HPNet.Experiments on the Argoverse and INTERACTION datasets show that HPNet achieves state-of-the-art performance, and generates accurate and stable future trajectories. Our code are available at https://github.com/XiaolongTang23/HPNet.

  • 6 authors
·
Apr 9, 2024