Daily Papers

Dense retrieval (DR) converts queries and documents into dense embeddings and measures the similarity between queries and documents in vector space. One of the challenges in DR is the lack of domain-specific training data. While DR models can learn from large-scale public datasets like MS MARCO through transfer learning, evidence shows that not all DR models and domains can benefit from transfer learning equally. Recently, some researchers have resorted to large language models (LLMs) to improve the zero-shot and few-shot DR models. However, the hard prompts or human-written prompts utilized in these works cannot guarantee the good quality of generated weak queries. To tackle this, we propose soft prompt tuning for augmenting DR (SPTAR): For each task, we leverage soft prompt-tuning to optimize a task-specific soft prompt on limited ground truth data and then prompt the LLMs to tag unlabeled documents with weak queries, yielding enough weak document-query pairs to train task-specific dense retrievers. We design a filter to select high-quality example document-query pairs in the prompt to further improve the quality of weak tagged queries. To the best of our knowledge, there is no prior work utilizing soft prompt tuning to augment DR models. The experiments demonstrate that SPTAR outperforms the unsupervised baselines BM25 and the recently proposed LLMs-based augmentation method for DR.

In the information retrieval (IR) area, dense retrieval (DR) models use deep learning techniques to encode queries and passages into embedding space to compute their semantic relations. It is important for DR models to balance both efficiency and effectiveness. Pre-trained language models (PLMs), especially Transformer-based PLMs, have been proven to be effective encoders of DR models. However, the self-attention component in Transformer-based PLM results in a computational complexity that grows quadratically with sequence length, and thus exhibits a slow inference speed for long-text retrieval. Some recently proposed non-Transformer PLMs, especially the Mamba architecture PLMs, have demonstrated not only comparable effectiveness to Transformer-based PLMs on generative language tasks but also better efficiency due to linear time scaling in sequence length. This paper implements the Mamba Retriever to explore whether Mamba can serve as an effective and efficient encoder of DR model for IR tasks. We fine-tune the Mamba Retriever on the classic short-text MS MARCO passage ranking dataset and the long-text LoCoV0 dataset. Experimental results show that (1) on the MS MARCO passage ranking dataset and BEIR, the Mamba Retriever achieves comparable or better effectiveness compared to Transformer-based retrieval models, and the effectiveness grows with the size of the Mamba model; (2) on the long-text LoCoV0 dataset, the Mamba Retriever can extend to longer text length than its pre-trained length after fine-tuning on retrieval task, and it has comparable or better effectiveness compared to other long-text retrieval models; (3) the Mamba Retriever has superior inference speed for long-text retrieval. In conclusion, Mamba Retriever is both effective and efficient, making it a practical model, especially for long-text retrieval.

Recently, Information Retrieval community has witnessed fast-paced advances in Dense Retrieval (DR), which performs first-stage retrieval with embedding-based search. Despite the impressive ranking performance, previous studies usually adopt brute-force search to acquire candidates, which is prohibitive in practical Web search scenarios due to its tremendous memory usage and time cost. To overcome these problems, vector compression methods have been adopted in many practical embedding-based retrieval applications. One of the most popular methods is Product Quantization (PQ). However, although existing vector compression methods including PQ can help improve the efficiency of DR, they incur severely decayed retrieval performance due to the separation between encoding and compression. To tackle this problem, we present JPQ, which stands for Joint optimization of query encoding and Product Quantization. It trains the query encoder and PQ index jointly in an end-to-end manner based on three optimization strategies, namely ranking-oriented loss, PQ centroid optimization, and end-to-end negative sampling. We evaluate JPQ on two publicly available retrieval benchmarks. Experimental results show that JPQ significantly outperforms popular vector compression methods. Compared with previous DR models that use brute-force search, JPQ almost matches the best retrieval performance with 30x compression on index size. The compressed index further brings 10x speedup on CPU and 2x speedup on GPU in query latency.

Ranking has always been one of the top concerns in information retrieval researches. For decades, the lexical matching signal has dominated the ad-hoc retrieval process, but solely using this signal in retrieval may cause the vocabulary mismatch problem. In recent years, with the development of representation learning techniques, many researchers turn to Dense Retrieval (DR) models for better ranking performance. Although several existing DR models have already obtained promising results, their performance improvement heavily relies on the sampling of training examples. Many effective sampling strategies are not efficient enough for practical usage, and for most of them, there still lacks theoretical analysis in how and why performance improvement happens. To shed light on these research questions, we theoretically investigate different training strategies for DR models and try to explain why hard negative sampling performs better than random sampling. Through the analysis, we also find that there are many potential risks in static hard negative sampling, which is employed by many existing training methods. Therefore, we propose two training strategies named a Stable Training Algorithm for dense Retrieval (STAR) and a query-side training Algorithm for Directly Optimizing Ranking pErformance (ADORE), respectively. STAR improves the stability of DR training process by introducing random negatives. ADORE replaces the widely-adopted static hard negative sampling method with a dynamic one to directly optimize the ranking performance. Experimental results on two publicly available retrieval benchmark datasets show that either strategy gains significant improvements over existing competitive baselines and a combination of them leads to the best performance.

Dense Retrieval (DR) has achieved state-of-the-art first-stage ranking effectiveness. However, the efficiency of most existing DR models is limited by the large memory cost of storing dense vectors and the time-consuming nearest neighbor search (NNS) in vector space. Therefore, we present RepCONC, a novel retrieval model that learns discrete Representations via CONstrained Clustering. RepCONC jointly trains dual-encoders and the Product Quantization (PQ) method to learn discrete document representations and enables fast approximate NNS with compact indexes. It models quantization as a constrained clustering process, which requires the document embeddings to be uniformly clustered around the quantization centroids and supports end-to-end optimization of the quantization method and dual-encoders. We theoretically demonstrate the importance of the uniform clustering constraint in RepCONC and derive an efficient approximate solution for constrained clustering by reducing it to an instance of the optimal transport problem. Besides constrained clustering, RepCONC further adopts a vector-based inverted file system (IVF) to support highly efficient vector search on CPUs. Extensive experiments on two popular ad-hoc retrieval benchmarks show that RepCONC achieves better ranking effectiveness than competitive vector quantization baselines under different compression ratio settings. It also substantially outperforms a wide range of existing retrieval models in terms of retrieval effectiveness, memory efficiency, and time efficiency.

A vital step towards the widespread adoption of neural retrieval models is their resource efficiency throughout the training, indexing and query workflows. The neural IR community made great advancements in training effective dual-encoder dense retrieval (DR) models recently. A dense text retrieval model uses a single vector representation per query and passage to score a match, which enables low-latency first stage retrieval with a nearest neighbor search. Increasingly common, training approaches require enormous compute power, as they either conduct negative passage sampling out of a continuously updating refreshing index or require very large batch sizes for in-batch negative sampling. Instead of relying on more compute capability, we introduce an efficient topic-aware query and balanced margin sampling technique, called TAS-Balanced. We cluster queries once before training and sample queries out of a cluster per batch. We train our lightweight 6-layer DR model with a novel dual-teacher supervision that combines pairwise and in-batch negative teachers. Our method is trainable on a single consumer-grade GPU in under 48 hours (as opposed to a common configuration of 8x V100s). We show that our TAS-Balanced training method achieves state-of-the-art low-latency (64ms per query) results on two TREC Deep Learning Track query sets. Evaluated on NDCG@10, we outperform BM25 by 44%, a plainly trained DR by 19%, docT5query by 11%, and the previous best DR model by 5%. Additionally, TAS-Balanced produces the first dense retriever that outperforms every other method on recall at any cutoff on TREC-DL and allows more resource intensive re-ranking models to operate on fewer passages to improve results further.

Dense retrieval (DR) has shown promising results in information retrieval. In essence, DR requires high-quality text representations to support effective search in the representation space. Recent studies have shown that pre-trained autoencoder-based language models with a weak decoder can provide high-quality text representations, boosting the effectiveness and few-shot ability of DR models. However, even a weak autoregressive decoder has the bypass effect on the encoder. More importantly, the discriminative ability of learned representations may be limited since each token is treated equally important in decoding the input texts. To address the above problems, in this paper, we propose a contrastive pre-training approach to learn a discriminative autoencoder with a lightweight multi-layer perception (MLP) decoder. The basic idea is to generate word distributions of input text in a non-autoregressive fashion and pull the word distributions of two masked versions of one text close while pushing away from others. We theoretically show that our contrastive strategy can suppress the common words and highlight the representative words in decoding, leading to discriminative representations. Empirical results show that our method can significantly outperform the state-of-the-art autoencoder-based language models and other pre-trained models for dense retrieval.

Large Language Model-based Dense Retrieval (LLM-DR) optimizes over numerous heterogeneous fine-tuning collections from different domains. However, the discussion about its training data distribution is still minimal. Previous studies rely on empirically assigned dataset choices or sampling ratios, which inevitably leads to sub-optimal retrieval performances. In this paper, we propose a new task-level Distributionally Robust Optimization (tDRO) algorithm for LLM-DR fine-tuning, targeted at improving the universal domain generalization ability by end-to-end reweighting the data distribution of each task. The tDRO parameterizes the domain weights and updates them with scaled domain gradients. The optimized weights are then transferred to the LLM-DR fine-tuning to train more robust retrievers. Experiments show optimal improvements in large-scale retrieval benchmarks and reduce up to 30% dataset usage after applying our optimization algorithm with a series of different-sized LLM-DR models.

Diabetic retinopathy (DR) is a leading cause of vision loss in working-age adults. While screening reduces the risk of blindness, traditional imaging is often costly and inaccessible. Artificial intelligence (AI) algorithms present a scalable diagnostic solution, but concerns regarding fairness and generalization persist. This work evaluates the fairness and performance of image-trained models in DR prediction, as well as the impact of disentanglement as a bias mitigation technique, using the diverse mBRSET fundus dataset. Three models, ConvNeXt V2, DINOv2, and Swin V2, were trained on macula images to predict DR and sensitive attributes (SAs) (e.g., age and gender/sex). Fairness was assessed between subgroups of SAs, and disentanglement was applied to reduce bias. All models achieved high DR prediction performance in diagnosing (up to 94% AUROC) and could reasonably predict age and gender/sex (91% and 77% AUROC, respectively). Fairness assessment suggests disparities, such as a 10% AUROC gap between age groups in DINOv2. Disentangling SAs from DR prediction had varying results, depending on the model selected. Disentanglement improved DINOv2 performance (2% AUROC gain), but led to performance drops in ConvNeXt V2 and Swin V2 (7% and 3%, respectively). These findings highlight the complexity of disentangling fine-grained features in fundus imaging and emphasize the importance of fairness in medical imaging AI to ensure equitable and reliable healthcare solutions.

Equipping large language models (LLMs) with complex, interleaved reasoning and tool-use capabilities has become a key focus in agentic AI research, especially with recent advances in reasoning-oriented (``thinking'') models. Such capabilities are key to unlocking a number of important applications. One such application is Deep Research (DR), which requires extensive search and reasoning over many sources. Our work in this paper focuses on the development of native Autonomous Single-Agent models for DR featuring minimal web crawling and Python tool integration. Unlike multi-agent systems, where agents take up pre-defined roles and are told what to do at each step in a static workflow, an autonomous single-agent determines its next action dynamically based on context, without manual directive. While prior work has proposed training recipes for base or instruction-tuned LLMs, we focus on continual reinforcement learning (RL) of reasoning-optimized models to further enhance agentic skills while preserving reasoning ability. Towards this end, we propose a simple RL recipe with entirely synthetic data, which we apply to various open-source LLMs. Our best variant SFR-DR-20B achieves up to 28.7% on Humanity's Last Exam benchmark. In addition, we conduct key analysis experiments to provide more insights into our methodologies.

Language models for program synthesis are usually trained and evaluated on programming competition datasets (MBPP, APPS). However, these datasets are limited in size and quality, while these language models are extremely data hungry. Additionally, the language models have a misaligned program synthesis process compared to humans. While humans iteratively develop code with the help of a compiler, most program synthesis models currently produce code in one go. To solve these issues, we introduce a bootstrapping algorithm for program synthesis, that supports teaching models how to repair. We show that bootstrapping consistently outperforms regular fine-tuning. Compared to other work, our bootstrapped model performs on par with fine-tuned models that are 68\% larger. Notably, bootstrapping with repairing also improves non-repairing performance compared to regular bootstrapping during inference. However, on our models, repairing during inference is likely inferior to simply sampling the same number of solutions. Furthermore, we find that there are issues with the example test cases in the training portion of the APPS dataset that are valuable to the community, as many repairing and reinforcement learning methods rely on them.

Large Language Models (LLMs) have made significant strides in natural language processing but face challenges in terms of computational expense and inefficiency as they grow in size, especially in domain-specific tasks. Small Language Models (SLMs), on the other hand, often struggle in these tasks due to limited capacity and training data. In this paper, we introduce Dr. LLaMA, a method for improving SLMs through generative data augmentation using LLMs, focusing on medical question-answering tasks and the PubMedQA dataset. Our findings indicate that LLMs effectively refine and diversify existing question-answer pairs, resulting in improved performance of a much smaller model on domain-specific QA datasets after fine-tuning. This study highlights the challenges of using LLMs for domain-specific question answering and suggests potential research directions to address these limitations, ultimately aiming to create more efficient and capable models for specialized applications. We have also made our code available for interested researchers

The visual models pretrained on large-scale benchmarks encode general knowledge and prove effective in building more powerful representations for downstream tasks. Most existing approaches follow the fine-tuning paradigm, either by initializing or regularizing the downstream model based on the pretrained one. The former fails to retain the knowledge in the successive fine-tuning phase, thereby prone to be over-fitting, and the latter imposes strong constraints to the weights or feature maps of the downstream model without considering semantic drift, often incurring insufficient optimization. To deal with these issues, we propose a novel fine-tuning framework, namely distribution regularization with semantic calibration (DR-Tune). It employs distribution regularization by enforcing the downstream task head to decrease its classification error on the pretrained feature distribution, which prevents it from over-fitting while enabling sufficient training of downstream encoders. Furthermore, to alleviate the interference by semantic drift, we develop the semantic calibration (SC) module to align the global shape and class centers of the pretrained and downstream feature distributions. Extensive experiments on widely used image classification datasets show that DR-Tune consistently improves the performance when combing with various backbones under different pretraining strategies. Code is available at: https://github.com/weeknan/DR-Tune.

Deep research models perform multi-step research to produce long-form, well-attributed answers. However, most open deep research models are trained on easily verifiable short-form QA tasks via reinforcement learning with verifiable rewards (RLVR), which does not extend to realistic long-form tasks. We address this with Reinforcement Learning with Evolving Rubrics (RLER), in which we construct and maintain rubrics that co-evolve with the policy model during training; this allows the rubrics to incorporate information that the model has newly explored and to provide discriminative, on-policy feedback. Using RLER, we develop Deep Research Tulu (DR Tulu-8B), the first open model that is directly trained for open-ended, long-form deep research. Across four long-form deep research benchmarks in science, healthcare and general domains, DR Tulu substantially outperforms existing open deep research models, and matches or exceeds proprietary deep research systems, while being significantly smaller and cheaper per query. To facilitate future research, we release all data, models, and code, including our new MCP-based agent infrastructure for deep research systems.

Vision-Language Models (VLM) can support clinicians by analyzing medical images and engaging in natural language interactions to assist in diagnostic and treatment tasks. However, VLMs often exhibit "hallucinogenic" behavior, generating textual outputs not grounded in contextual multimodal information. This challenge is particularly pronounced in the medical domain, where we do not only require VLM outputs to be accurate in single interactions but also to be consistent with clinical reasoning and diagnostic pathways throughout multi-turn conversations. For this purpose, we propose a new alignment algorithm that uses symbolic representations of clinical reasoning to ground VLMs in medical knowledge. These representations are utilized to (i) generate GPT-4-guided visual instruction tuning data at scale, simulating clinician-VLM conversations with demonstrations of clinical reasoning, and (ii) create an automatic reward function that evaluates the clinical validity of VLM generations throughout clinician-VLM interactions. Our algorithm eliminates the need for human involvement in training data generation or reward model construction, reducing costs compared to standard reinforcement learning with human feedback (RLHF). We apply our alignment algorithm to develop Dr-LLaVA, a conversational VLM finetuned for analyzing bone marrow pathology slides, demonstrating strong performance in multi-turn medical conversations.

This study addresses the challenge of noise in training datasets for Direct Preference Optimization (DPO), a method for aligning Large Language Models (LLMs) with human preferences. We categorize noise into pointwise noise, which includes low-quality data points, and pairwise noise, which encompasses erroneous data pair associations that affect preference rankings. Utilizing Distributionally Robust Optimization (DRO), we enhance DPO's resilience to these types of noise. Our theoretical insights reveal that DPO inherently embeds DRO principles, conferring robustness to pointwise noise, with the regularization coefficient beta playing a critical role in its noise resistance. Extending this framework, we introduce Distributionally Robustifying DPO (Dr. DPO), which integrates pairwise robustness by optimizing against worst-case pairwise scenarios. The novel hyperparameter beta' in Dr. DPO allows for fine-tuned control over data pair reliability, providing a strategic balance between exploration and exploitation in noisy training environments. Empirical evaluations demonstrate that Dr. DPO substantially improves the quality of generated text and response accuracy in preference datasets, showcasing enhanced performance in both noisy and noise-free settings. The code is available at https://github.com/junkangwu/Dr_DPO.

Vision Foundation Models (VFMs) excel in generalization due to large-scale pretraining, but fine-tuning them for Domain Generalized Semantic Segmentation (DGSS) while maintaining this ability remains challenging. Existing approaches either selectively fine-tune parameters or freeze the VFMs and update only the adapters, both of which may underutilize the VFMs' full potential in DGSS tasks. We observe that domain-sensitive parameters in VFMs, arising from task and distribution differences, can hinder generalization. To address this, we propose FisherTune, a robust fine-tuning method guided by the Domain-Related Fisher Information Matrix (DR-FIM). DR-FIM measures parameter sensitivity across tasks and domains, enabling selective updates that preserve generalization and enhance DGSS adaptability. FisherTune incorporates variational inference to stabilize DR-FIM estimation, treating parameters as Gaussian-distributed variables and leveraging pre-trained priors. Extensive experiments show that FisherTune achieves superior cross-domain segmentation while maintaining generalization, outperforming selective-parameter and adapter-based methods.

Large Language Models (LLMs) have recently achieved remarkable progress by leveraging Reinforcement Learning and extended Chain-of-Thought (CoT) techniques. However, the challenge of performing efficient language reasoning--especially during inference with extremely long outputs--has drawn increasing attention from the research community. In this work, we propose a dynamic ratio-based training pipeline that does not rely on sophisticated data annotations or interpolation between multiple models. We continuously balance the weights between the model's System-1 and System-2 data to eliminate redundant reasoning processes while preserving the model's reasoning capability. We validate our approach across models on DeepSeek-R1-Distill-7B and DeepSeek-R1-Distill-14B and on a diverse set of benchmarks with varying difficulty levels. Our method significantly reduces the number of output tokens by nearly 40% while maintaining the accuracy of the reasoning. Our code and data will be available soon.

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

We present a new zero-shot dense retrieval (ZeroDR) method, COCO-DR, to improve the generalization ability of dense retrieval by combating the distribution shifts between source training tasks and target scenarios. To mitigate the impact of document differences, COCO-DR continues pretraining the language model on the target corpora to adapt the model to target distributions via COtinuous COtrastive learning. To prepare for unseen target queries, COCO-DR leverages implicit Distributionally Robust Optimization (iDRO) to reweight samples from different source query clusters for improving model robustness over rare queries during fine-tuning. COCO-DR achieves superior average performance on BEIR, the zero-shot retrieval benchmark. At BERT Base scale, COCO-DR Base outperforms other ZeroDR models with 60x larger size. At BERT Large scale, COCO-DR Large outperforms the giant GPT-3 embedding model which has 500x more parameters. Our analysis show the correlation between COCO-DR's effectiveness in combating distribution shifts and improving zero-shot accuracy. Our code and model can be found at https://github.com/OpenMatch/COCO-DR.

Large Vision-Language Models (LVLMs) have achieved significant progress in combining visual comprehension with language generation. Despite this success, the training data of LVLMs still suffers from Long-Tail (LT) problems, where the data distribution is highly imbalanced. Previous works have mainly focused on traditional VLM architectures, i.e., CLIP or ViT, and specific tasks such as recognition and classification. Nevertheless, the exploration of LVLM (e.g. LLaVA) and more general tasks (e.g. Visual Question Answering and Visual Reasoning) remains under-explored. In this paper, we first conduct an in-depth analysis of the LT issues in LVLMs and identify two core causes: the overrepresentation of head concepts and the underrepresentation of tail concepts. Based on the above observation, we propose an Adaptive Data Refinement Framework (ADR), which consists of two stages: Data Rebalancing (DR) and Data Synthesis (DS). In the DR stage, we adaptively rebalance the redundant data based on entity distributions, while in the DS stage, we leverage Denoising Diffusion Probabilistic Models (DDPMs) and scarce images to supplement underrepresented portions. Through comprehensive evaluations across eleven benchmarks, our proposed ADR effectively mitigates the long-tail problem in the training data, improving the average performance of LLaVA 1.5 relatively by 4.36%, without increasing the training data volume.

Recently, we have witnessed a rise in the use of Large Language Models (LLMs), especially in applications like chatbot assistants. Safety mechanisms and specialized training procedures are implemented to prevent improper responses from these assistants. In this work, we bypass these measures for ChatGPT and Gemini (and, to some extent, Bing chat) by making them impersonate complex personas with personality characteristics that are not aligned with a truthful assistant. We start by creating elaborate biographies of these personas, which we then use in a new session with the same chatbots. Our conversations then follow a role-play style to elicit prohibited responses. Using personas, we show that prohibited responses are actually provided, making it possible to obtain unauthorized, illegal, or harmful information. This work shows that by using adversarial personas, one can overcome safety mechanisms set out by ChatGPT and Gemini. We also introduce several ways of activating such adversarial personas, which show that both chatbots are vulnerable to this kind of attack. With the same principle, we introduce two defenses that push the model to interpret trustworthy personalities and make it more robust against such attacks.

Recent studies have demonstrated that Large Language Models (LLMs) have strong mathematical reasoning abilities but rely on hundreds of billions of parameters. To tackle the challenge of poor reasoning in Small Language Models (SLMs), existing methods typically leverage LLMs to generate massive amounts of data for cramming training. In psychology, they are akin to System 1 thinking, which resolves reasoning problems rapidly based on experience and intuition. However, human learning also requires System 2 thinking, where knowledge is first acquired and then reinforced through practice. Inspired by such two distinct modes of thinking, we propose a novel method based on the multi-LoRA Interaction for mathematical reasoning Distillation (LoRID). First, we input the question and reasoning of each sample into an LLM to create knowledge-enhanced datasets. Subsequently, we train a LoRA block on the student model as an Intuitive Reasoner (IR), which directly generates Chain-of-Thoughts for problem-solving. Then, to imitate System 2 thinking, we train the Knowledge Generator (KG) and Deep Reasoner (DR), respectively. The former outputs only knowledge after receiving problems, while the latter uses that knowledge to perform reasoning. Finally, to address the randomness in the generation of IR and DR, we evaluate whether their outputs are consistent, and the inference process needs to be iterated if not. This step can enhance the mathematical reasoning ability of SLMs through mutual feedback. Experimental results show that LoRID achieves state-of-the-art performance, especially on the GSM8K dataset, where it outperforms the second-best method by 2.3%, 16.1%, 2.4%, 12.3%, and 1.8% accuracy across the five base models, respectively.

This work is the first to openly reproduce the Reinforcement Learning from Human Feedback (RLHF) scaling behaviors reported in OpenAI's seminal TL;DR summarization work. We create an RLHF pipeline from scratch, enumerate over 20 key implementation details, and share key insights during the reproduction. Our RLHF-trained Pythia models demonstrate significant gains in response quality that scale with model size, with our 2.8B, 6.9B models outperforming OpenAI's released 1.3B checkpoint. We publicly release the trained model checkpoints and code to facilitate further research and accelerate progress in the field (https://github.com/vwxyzjn/summarize_from_feedback_details).

Many decision-making tasks, where both accuracy and efficiency matter, still require human supervision. For example, tasks like traffic officers reviewing hour-long dashcam footage or researchers screening conference videos can benefit from concise summaries that reduce cognitive load and save time. Yet current vision-language models (VLMs) often produce verbose, redundant outputs that hinder task performance. Existing video caption evaluation depends on costly human annotations and overlooks the summaries' utility in downstream tasks. We address these gaps with Video-to-text Information Bottleneck Evaluation (VIBE), an annotation-free method that scores VLM outputs using two metrics: grounding (how well the summary aligns with visual content) and utility (how informative it is for the task). VIBE selects from randomly sampled VLM outputs by ranking them according to the two scores to support effective human decision-making. Human studies on LearningPaper24, SUTD-TrafficQA, and LongVideoBench show that summaries selected by VIBE consistently improve performance-boosting task accuracy by up to 61.23% and reducing response time by 75.77% compared to naive VLM summaries or raw video.

Reward learning enables the application of reinforcement learning (RL) to tasks where reward is defined by human judgment, building a model of reward by asking humans questions. Most work on reward learning has used simulated environments, but complex information about values is often expressed in natural language, and we believe reward learning for language is a key to making RL practical and safe for real-world tasks. In this paper, we build on advances in generative pretraining of language models to apply reward learning to four natural language tasks: continuing text with positive sentiment or physically descriptive language, and summarization tasks on the TL;DR and CNN/Daily Mail datasets. For stylistic continuation we achieve good results with only 5,000 comparisons evaluated by humans. For summarization, models trained with 60,000 comparisons copy whole sentences from the input but skip irrelevant preamble; this leads to reasonable ROUGE scores and very good performance according to our human labelers, but may be exploiting the fact that labelers rely on simple heuristics.

Recent advancements in large language models (LLMs) have greatly improved their capabilities on complex reasoning tasks through Long Chain-of-Thought (CoT). However, this approach often results in substantial redundancy, impairing computational efficiency and causing significant delays in real-time applications. To improve the efficiency, current methods often rely on human-defined difficulty priors, which do not align with the LLM's self-awared difficulty, leading to inefficiencies. In this paper, we introduce the Dynamic Reasoning-Boundary Self-Awareness Framework (DR. SAF), which enables models to dynamically assess and adjust their reasoning depth in response to problem complexity. DR. SAF integrates three key components: Boundary Self-Awareness Alignment, Adaptive Reward Management, and a Boundary Preservation Mechanism. These components allow models to optimize their reasoning processes, balancing efficiency and accuracy without compromising performance. Our experimental results demonstrate that DR. SAF achieves a 49.27% reduction in total response tokens with minimal loss in accuracy. The framework also delivers a 6.59x gain in token efficiency and a 5x reduction in training time, making it well-suited to resource-limited settings. During extreme training, DR. SAF can even surpass traditional instruction-based models in token efficiency with more than 16% accuracy improvement.

Large Language Models (LLMs) can inadvertently reflect societal biases present in their training data, leading to harmful or prejudiced outputs. In the Indian context, our empirical evaluations across a suite of models reveal that biases around caste and religion are particularly salient. Yet, most existing mitigation strategies are Western-centric and fail to address these local nuances. We propose AMBEDKAR, a framework inspired by the egalitarian vision of Dr B. R. Ambedkar, architect of the Indian Constitution, to guide LLM outputs toward fairness, neutrality, and inclusion in line with Articles 14 to 17. Our approach introduces a Constitution-Aware Decoding Layer, guided by the AI Constitution of India and applied only at inference time, without any parameter updates to the base model. We incorporate a speculative decoding algorithm that proactively reduces casteist and communal bias during generation. This mitigation layer operates directly within the decoding process, avoiding changes to model internals and lowering the computational and infrastructural costs associated with retraining. We reinterpret speculative decoding not merely as an efficiency tool but as a mechanism for fairness. In this framework, a Small Language Model (SLM) acts as a potentially biased generator, while a constitutionally guided Large Language Model (LLM) serves as the verifier. Rather than accelerating generation, the LLM enforces bias-robust trajectories in the SLM outputs. This inversion of roles gives rise to a fairness-by-speculation paradigm. Our approach yields an absolute reduction of bias up to 26.41 percent compared to baseline. Our source code, datasets, and results are available at https://anonymous.4open.science/r/AMBEDKAR-983B/

Radiology reports are one of the main forms of communication between radiologists and other clinicians and contain important information for patient care. In order to use this information for research and automated patient care programs, it is necessary to convert the raw text into structured data suitable for analysis. State-of-the-art natural language processing (NLP) domain-specific contextual word embeddings have been shown to achieve impressive accuracy for these tasks in medicine, but have yet to be utilized for section structure segmentation. In this work, we pre-trained a contextual embedding BERT model using breast radiology reports and developed a classifier that incorporated the embedding with auxiliary global textual features in order to perform section segmentation. This model achieved a 98% accuracy at segregating free text reports sentence by sentence into sections of information outlined in the Breast Imaging Reporting and Data System (BI-RADS) lexicon, a significant improvement over the Classic BERT model without auxiliary information. We then evaluated whether using section segmentation improved the downstream extraction of clinically relevant information such as modality/procedure, previous cancer, menopausal status, the purpose of the exam, breast density, and breast MRI background parenchymal enhancement. Using the BERT model pre-trained on breast radiology reports combined with section segmentation resulted in an overall accuracy of 95.9% in the field extraction tasks. This is a 17% improvement compared to an overall accuracy of 78.9% for field extraction with models using Classic BERT embeddings and not using section segmentation. Our work shows the strength of using BERT in radiology report analysis and the advantages of section segmentation in identifying key features of patient factors recorded in breast radiology reports.

In this research paper, we delve into the topics of Speech Diarization and Automatic Speech Recognition (ASR). Speech diarization involves the separation of individual speakers within an audio stream. By employing the ASR transcript, the diarization process aims to segregate each speaker's utterances, grouping them based on their unique audio characteristics. On the other hand, Automatic Speech Recognition refers to the capability of a machine or program to identify and convert spoken words and phrases into a machine-readable format. In our speech diarization approach, we utilize the Gaussian Mixer Model (GMM) to represent speech segments. The inter-cluster distance is computed based on the GMM parameters, and the distance threshold serves as the stopping criterion. ASR entails the conversion of an unknown speech waveform into a corresponding written transcription. The speech signal is analyzed using synchronized algorithms, taking into account the pitch frequency. Our primary objective typically revolves around developing a model that minimizes the Word Error Rate (WER) metric during speech transcription.

Transformer based architectures have shown notable results on many down streaming tasks including question answering. The availability of data, on the other hand, impedes obtaining legitimate performance for low-resource languages. In this paper, we investigate the applicability of pre-trained multilingual models to improve the performance of question answering in low-resource languages. We tested four combinations of language and task adapters using multilingual transformer architectures on seven languages similar to MLQA dataset. Additionally, we have also proposed zero-shot transfer learning of low-resource question answering using language and task adapters. We observed that stacking the language and the task adapters improves the multilingual transformer models' performance significantly for low-resource languages.

: Deep learning methodologies have been used to create applications that can cause threats to privacy, democracy and national security and could be used to further amplify malicious activities. One of those deep learning-powered applications in recent times is synthesized videos of famous personalities. According to Forbes, Generative Adversarial Networks(GANs) generated fake videos growing exponentially every year and the organization known as Deeptrace had estimated an increase of deepfakes by 84% from the year 2018 to 2019. They are used to generate and modify human faces, where most of the existing fake videos are of prurient non-consensual nature, of which its estimates to be around 96% and some carried out impersonating personalities for cyber crime. In this paper, available video datasets are identified and a pretrained model BlazeFace is used to detect faces, and a ResNet and Xception ensembled architectured neural network trained on the dataset to achieve the goal of detection of fake faces in videos. The model is optimized over a loss value and log loss values and evaluated over its F1 score. Over a sample of data, it is observed that focal loss provides better accuracy, F1 score and loss as the gamma of the focal loss becomes a hyper parameter. This provides a k-folded accuracy of around 91% at its peak in a training cycle with the real world accuracy subjected to change over time as the model decays.

Deep Research (DR) agents built on Large Language Models (LLMs) can perform complex, multi-step research by decomposing tasks, retrieving online information, and synthesizing detailed reports. However, the misuse of LLMs with such powerful capabilities can lead to even greater risks. This is especially concerning in high-stakes and knowledge-intensive domains such as biosecurity, where DR can generate a professional report containing detailed forbidden knowledge. Unfortunately, we have found such risks in practice: simply submitting a harmful query, which a standalone LLM directly rejects, can elicit a detailed and dangerous report from DR agents. This highlights the elevated risks and underscores the need for a deeper safety analysis. Yet, jailbreak methods designed for LLMs fall short in exposing such unique risks, as they do not target the research ability of DR agents. To address this gap, we propose two novel jailbreak strategies: Plan Injection, which injects malicious sub-goals into the agent's plan; and Intent Hijack, which reframes harmful queries as academic research questions. We conducted extensive experiments across different LLMs and various safety benchmarks, including general and biosecurity forbidden prompts. These experiments reveal 3 key findings: (1) Alignment of the LLMs often fail in DR agents, where harmful prompts framed in academic terms can hijack agent intent; (2) Multi-step planning and execution weaken the alignment, revealing systemic vulnerabilities that prompt-level safeguards cannot address; (3) DR agents not only bypass refusals but also produce more coherent, professional, and dangerous content, compared with standalone LLMs. These results demonstrate a fundamental misalignment in DR agents and call for better alignment techniques tailored to DR agents. Code and datasets are available at https://chenxshuo.github.io/deeper-harm.

Large language models (LLMs) excel at factual recall yet still propagate stale or incorrect knowledge. In-context knowledge editing offers a gradient-free remedy suitable for black-box APIs, but current editors rely on static demonstration sets chosen by surface-level similarity, leading to two persistent obstacles: (i) a quantity-quality trade-off, and (ii) lack of adaptivity to task difficulty. We address these issues by dynamically selecting supporting demonstrations according to their utility for the edit. We propose Dynamic Retriever for In-Context Knowledge Editing (DR-IKE), a lightweight framework that (1) trains a BERT retriever with REINFORCE to rank demonstrations by editing reward, and (2) employs a learnable threshold to prune low-value examples, shortening the prompt when the edit is easy and expanding it when the task is hard. DR-IKE performs editing without modifying model weights, relying solely on forward passes for compatibility with black-box LLMs. On the COUNTERFACT benchmark, it improves edit success by up to 17.1%, reduces latency by 41.6%, and preserves accuracy on unrelated queries, demonstrating scalable and adaptive knowledge editing. The code is available at https://github.com/mwnafee/DR-IKE .

Deep Research (DR) is an emerging agent application that leverages large language models (LLMs) to address open-ended queries. It requires the integration of several capabilities, including multi-step reasoning, cross-document synthesis, and the generation of evidence-backed, long-form answers. Evaluating DR remains challenging because responses are lengthy and diverse, admit many valid solutions, and often depend on dynamic information sources. We introduce ResearchRubrics, a standardized benchmark for DR built with over 2,800+ hours of human labor that pairs realistic, domain-diverse prompts with 2,500+ expert-written, fine-grained rubrics to assess factual grounding, reasoning soundness, and clarity. We also propose a new complexity framework for categorizing DR tasks along three axes: conceptual breadth, logical nesting, and exploration. In addition, we develop human and model-based evaluation protocols that measure rubric adherence for DR agents. We evaluate several state-of-the-art DR systems and find that even leading agents like Gemini's DR and OpenAI's DR achieve under 68% average compliance with our rubrics, primarily due to missed implicit context and inadequate reasoning about retrieved information. Our results highlight the need for robust, scalable assessment of deep research capabilities, to which end we release ResearchRubrics(including all prompts, rubrics, and evaluation code) to facilitate progress toward well-justified research assistants.

Robust alignment is vital for safely deploying large language models (LLMs). Existing techniques are either reward-based -- training a reward model on preference pairs and optimizing with reinforcement learning (RL) -- or reward-free -- directly fine-tuning on ranked outputs. Recent research shows that well-tuned reward-based pipelines remain the most robust, and single-response demonstrations can outperform pairwise preference data. However, two key challenges remain: (i) imbalanced safety datasets that over-represent common hazards while neglecting long-tail threats; and (ii) static reward models that ignore task difficulty, limiting optimization efficiency and attainable gains. To address these limitations, we propose DR-IRL, which dynamically adjusts rewards through inverse reinforcement learning. We first construct a balanced safety dataset of seven harmful categories using Chain-of-Draft (CoD) template prompts, which reduce token usage and generation time compared to Chain-of-Thought (CoT). We then train category-specific reward models on this dataset via IRL. Finally, to align the LLM, we introduce GRPO-S (Group Relative Policy Optimization--Scaling), a variant of GRPO that scales the reward during optimization to task difficulty -- data-level hardness measured by CLIP similarity and model-level responsiveness measured by reward gaps. Extensive experiments on multiple benchmarks and LLMs demonstrate that DR-IRL outperforms all baselines in safety alignment while maintaining usefulness.

Foundation image-text models such as CLIP with zero-shot capabilities enable a wide array of applications. MobileCLIP is a recent family of image-text models at 3-15ms latency and 50-150M parameters with state-of-the-art zero-shot accuracy. The main ingredients in MobileCLIP were its low-latency and light architectures and a novel multi-modal reinforced training that made knowledge distillation from multiple caption-generators and CLIP teachers efficient, scalable, and reproducible. In this paper, we improve the multi-modal reinforced training of MobileCLIP through: 1) better CLIP teacher ensembles trained on the DFN dataset, 2) improved captioner teachers trained on the DFN dataset and fine-tuned on a diverse selection of high-quality image-caption datasets. We discover new insights through ablations such as the importance of temperature tuning in contrastive knowledge distillation, the effectiveness of caption-generator fine-tuning for caption diversity, and the additive improvement from combining synthetic captions generated by multiple models. We train a new family of models called MobileCLIP2 and achieve state-of-the-art ImageNet-1k zero-shot accuracies at low latencies. In particular, we observe 2.2% improvement in ImageNet-1k accuracy for MobileCLIP2-B compared with MobileCLIP-B architecture. Notably, MobileCLIP2-S4 matches the zero-shot accuracy of SigLIP-SO400M/14 on ImageNet-1k while being 2times smaller and improves on DFN ViT-L/14 at 2.5times lower latency. We release our pretrained models (https://github.com/apple/ml-mobileclip) and the data generation code (https://github.com/apple/ml-mobileclip-dr). The data generation code makes it easy to create new reinforced datasets with arbitrary teachers using distributed scalable processing.

Deep Research (DR) agents, powered by advanced Large Language Models (LLMs), have recently garnered increasing attention for their capability in conducting complex research tasks. However, existing literature lacks a rigorous and systematic evaluation of DR Agent's capabilities in critical research analysis. To address this gap, we first propose HisRubric, a novel evaluation framework with a hierarchical analytical structure and a fine-grained grading rubric for rigorously assessing DR agents' capabilities in corporate financial analysis. This framework mirrors the professional analyst's workflow, progressing from data recognition to metric calculation, and finally to strategic summarization and interpretation. Built on this framework, we construct a FinDeepResearch benchmark that comprises 64 listed companies from 8 financial markets across 4 languages, encompassing a total of 15,808 grading items. We further conduct extensive experiments on the FinDeepResearch using 16 representative methods, including 6 DR agents, 5 LLMs equipped with both deep reasoning and search capabilities, and 5 LLMs with deep reasoning capabilities only. The results reveal the strengths and limitations of these approaches across diverse capabilities, financial markets, and languages, offering valuable insights for future research and development. The benchmark and evaluation code will be made publicly available.

The rapid progress of Large Language Models (LLMs) has given rise to a new category of autonomous AI systems, referred to as Deep Research (DR) agents. These agents are designed to tackle complex, multi-turn informational research tasks by leveraging a combination of dynamic reasoning, adaptive long-horizon planning, multi-hop information retrieval, iterative tool use, and the generation of structured analytical reports. In this paper, we conduct a detailed analysis of the foundational technologies and architectural components that constitute Deep Research agents. We begin by reviewing information acquisition strategies, contrasting API-based retrieval methods with browser-based exploration. We then examine modular tool-use frameworks, including code execution, multimodal input processing, and the integration of Model Context Protocols (MCPs) to support extensibility and ecosystem development. To systematize existing approaches, we propose a taxonomy that differentiates between static and dynamic workflows, and we classify agent architectures based on planning strategies and agent composition, including single-agent and multi-agent configurations. We also provide a critical evaluation of current benchmarks, highlighting key limitations such as restricted access to external knowledge, sequential execution inefficiencies, and misalignment between evaluation metrics and the practical objectives of DR agents. Finally, we outline open challenges and promising directions for future research. A curated and continuously updated repository of DR agent research is available at: {https://github.com/ai-agents-2030/awesome-deep-research-agent}.

We introduce DRBench, a benchmark for evaluating AI agents on complex, open-ended deep research tasks in enterprise settings. Unlike prior benchmarks that focus on simple questions or web-only queries, DRBench evaluates agents on multi-step queries (for example, ``What changes should we make to our product roadmap to ensure compliance with this standard?") that require identifying supporting facts from both the public web and private company knowledge base. Each task is grounded in realistic user personas and enterprise context, spanning a heterogeneous search space that includes productivity software, cloud file systems, emails, chat conversations, and the open web. Tasks are generated through a carefully designed synthesis pipeline with human-in-the-loop verification, and agents are evaluated on their ability to recall relevant insights, maintain factual accuracy, and produce coherent, well-structured reports. We release 15 deep research tasks across 10 domains, such as Sales, Cybersecurity, and Compliance. We demonstrate the effectiveness of DRBench by evaluating diverse DR agents across open- and closed-source models (such as GPT, Llama, and Qwen) and DR strategies, highlighting their strengths, weaknesses, and the critical path for advancing enterprise deep research. Code is available at https://github.com/ServiceNow/drbench.

This paper examines the problems of severe image-text misalignment and high redundancy in the widely-used large-scale Vision-Language Pre-Training (VLP) datasets. To address these issues, we propose an efficient and straightforward Vision-Language learning algorithm called TL;DR, which aims to compress the existing large VLP data into a small, high-quality set. Our approach consists of two major steps. First, a codebook-based encoder-decoder captioner is developed to select representative samples. Second, a new caption is generated to complement the original captions for selected samples, mitigating the text-image misalignment problem while maintaining uniqueness. As the result, TL;DR enables us to reduce the large dataset into a small set of high-quality data, which can serve as an alternative pre-training dataset. This algorithm significantly speeds up the time-consuming pretraining process. Specifically, TL;DR can compress the mainstream VLP datasets at a high ratio, e.g., reduce well-cleaned CC3M dataset from 2.82M to 0.67M (sim24\%) and noisy YFCC15M from 15M to 2.5M (sim16.7\%). Extensive experiments with three popular VLP models over seven downstream tasks show that VLP model trained on the compressed dataset provided by TL;DR can perform similar or even better results compared with training on the full-scale dataset. The code will be made available at https://github.com/showlab/datacentric.vlp.

As language models become more powerful, training and evaluation are increasingly bottlenecked by the data and metrics used for a particular task. For example, summarization models are often trained to predict human reference summaries and evaluated using ROUGE, but both of these metrics are rough proxies for what we really care about -- summary quality. In this work, we show that it is possible to significantly improve summary quality by training a model to optimize for human preferences. We collect a large, high-quality dataset of human comparisons between summaries, train a model to predict the human-preferred summary, and use that model as a reward function to fine-tune a summarization policy using reinforcement learning. We apply our method to a version of the TL;DR dataset of Reddit posts and find that our models significantly outperform both human reference summaries and much larger models fine-tuned with supervised learning alone. Our models also transfer to CNN/DM news articles, producing summaries nearly as good as the human reference without any news-specific fine-tuning. We conduct extensive analyses to understand our human feedback dataset and fine-tuned models We establish that our reward model generalizes to new datasets, and that optimizing our reward model results in better summaries than optimizing ROUGE according to humans. We hope the evidence from our paper motivates machine learning researchers to pay closer attention to how their training loss affects the model behavior they actually want.

Various techniques have been developed in recent years to improve dense retrieval (DR), such as unsupervised contrastive learning and pseudo-query generation. Existing DRs, however, often suffer from effectiveness tradeoffs between supervised and zero-shot retrieval, which some argue was due to the limited model capacity. We contradict this hypothesis and show that a generalizable DR can be trained to achieve high accuracy in both supervised and zero-shot retrieval without increasing model size. In particular, we systematically examine the contrastive learning of DRs, under the framework of Data Augmentation (DA). Our study shows that common DA practices such as query augmentation with generative models and pseudo-relevance label creation using a cross-encoder, are often inefficient and sub-optimal. We hence propose a new DA approach with diverse queries and sources of supervision to progressively train a generalizable DR. As a result, DRAGON, our dense retriever trained with diverse augmentation, is the first BERT-base-sized DR to achieve state-of-the-art effectiveness in both supervised and zero-shot evaluations and even competes with models using more complex late interaction (ColBERTv2 and SPLADE++).

Passage retrieval and ranking is a key task in open-domain question answering and information retrieval. Current effective approaches mostly rely on pre-trained deep language model-based retrievers and rankers. These methods have been shown to effectively model the semantic matching between queries and passages, also in presence of keyword mismatch, i.e. passages that are relevant to a query but do not contain important query keywords. In this paper we consider the Dense Retriever (DR), a passage retrieval method, and the BERT re-ranker, a popular passage re-ranking method. In this context, we formally investigate how these models respond and adapt to a specific type of keyword mismatch -- that caused by keyword typos occurring in queries. Through empirical investigation, we find that typos can lead to a significant drop in retrieval and ranking effectiveness. We then propose a simple typos-aware training framework for DR and BERT re-ranker to address this issue. Our experimental results on the MS MARCO passage ranking dataset show that, with our proposed typos-aware training, DR and BERT re-ranker can become robust to typos in queries, resulting in significantly improved effectiveness compared to models trained without appropriately accounting for typos.

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

In this study, we aim to initiate the development of Radiology Foundation Model, termed as RadFM.We consider the construction of foundational models from the perspectives of data, model design, and evaluation thoroughly. Our contribution can be concluded as follows: (i), we construct a large-scale Medical Multi-modal Dataset, MedMD, consisting of 16M 2D and 3D medical scans. To the best of our knowledge, this is the first multi-modal dataset containing 3D medical scans. (ii), We propose an architecture that enables visually conditioned generative pre-training, allowing for the integration of text input interleaved with 2D or 3D medical scans to generate response for diverse radiologic tasks. The model was initially pre-trained on MedMD and subsequently domain-specific fine-tuned on RadMD, a radiologic cleaned version of MedMD, containing 3M radiologic visual-language pairs. (iii), we propose a new evaluation benchmark that comprises five tasks, aiming to comprehensively assess the capability of foundation models in handling practical clinical problems. Our experimental results confirm that RadFM significantly outperforms existing multi-modal foundation models. The codes, data, and model checkpoint will all be made publicly available to promote further research and development in the field.

Recent large language models (LLMs) in the general domain, such as ChatGPT, have shown remarkable success in following instructions and producing human-like responses. However, such language models have not been learned individually and carefully for the medical domain, resulting in poor diagnostic accuracy and inability to give correct recommendations for medical diagnosis, medications, etc. To address this issue, we collected more than 700 diseases and their corresponding symptoms, recommended medications, and required medical tests, and then generated 5K doctor-patient conversations. By fine-tuning models of doctor-patient conversations, these models emerge with great potential to understand patients' needs, provide informed advice, and offer valuable assistance in a variety of medical-related fields. The integration of these advanced language models into healthcare can revolutionize the way healthcare professionals and patients communicate, ultimately improving the overall quality of care and patient outcomes. In addition, we will open all source code, datasets and model weights to advance the further development of dialogue models in the medical field. In addition, the training data, code, and weights of this project are available at: https://github.com/Kent0n-Li/ChatDoctor.

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

The successes of foundation models such as ChatGPT and AlphaFold have spurred significant interest in building similar models for electronic medical records (EMRs) to improve patient care and hospital operations. However, recent hype has obscured critical gaps in our understanding of these models' capabilities. We review over 80 foundation models trained on non-imaging EMR data (i.e. clinical text and/or structured data) and create a taxonomy delineating their architectures, training data, and potential use cases. We find that most models are trained on small, narrowly-scoped clinical datasets (e.g. MIMIC-III) or broad, public biomedical corpora (e.g. PubMed) and are evaluated on tasks that do not provide meaningful insights on their usefulness to health systems. In light of these findings, we propose an improved evaluation framework for measuring the benefits of clinical foundation models that is more closely grounded to metrics that matter in healthcare.

This study evaluates the performance of large language models (LLMs) as medical agents in Portuguese, aiming to develop a reliable and relevant virtual assistant for healthcare professionals. The HealthCareMagic-100k-en and MedQuAD datasets, translated from English using GPT-3.5, were used to fine-tune the ChatBode-7B model using the PEFT-QLoRA method. The InternLM2 model, with initial training on medical data, presented the best overall performance, with high precision and adequacy in metrics such as accuracy, completeness and safety. However, DrBode models, derived from ChatBode, exhibited a phenomenon of catastrophic forgetting of acquired medical knowledge. Despite this, these models performed frequently or even better in aspects such as grammaticality and coherence. A significant challenge was low inter-rater agreement, highlighting the need for more robust assessment protocols. This work paves the way for future research, such as evaluating multilingual models specific to the medical field, improving the quality of training data, and developing more consistent evaluation methodologies for the medical field.

Since the emergence of the Transformer architecture, language model development has increased, driven by their promising potential. However, releasing these models into production requires properly understanding their behavior, particularly in sensitive domains such as medicine. Despite this need, the medical literature still lacks technical assessments of pre-trained language models, which are especially valuable in resource-constrained settings in terms of computational power or limited budget. To address this gap, we provide a comprehensive survey of language models in the medical domain. In addition, we selected a subset of these models for thorough evaluation, focusing on classification and text generation tasks. Our subset encompasses 53 models, ranging from 110 million to 13 billion parameters, spanning the three families of Transformer-based models and from diverse knowledge domains. This study employs a series of approaches for text classification together with zero-shot prompting instead of model training or fine-tuning, which closely resembles the limited resource setting in which many users of language models find themselves. Encouragingly, our findings reveal remarkable performance across various tasks and datasets, underscoring the latent potential of certain models to contain medical knowledge, even without domain specialization. Consequently, our study advocates for further exploration of model applications in medical contexts, particularly in resource-constrained settings. The code is available on https://github.com/anpoc/Language-models-in-medicine.

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

Models such as GPT-4 and Med-PaLM 2 have demonstrated impressive performance on a wide variety of biomedical NLP tasks. However, these models have hundreds of billions of parameters, are computationally expensive to run, require users to send their input data over the internet, and are trained on unknown data sources. Can smaller, more targeted models compete? To address this question, we build and release BioMedLM, a 2.7 billion parameter GPT-style autoregressive model trained exclusively on PubMed abstracts and full articles. When fine-tuned, BioMedLM can produce strong multiple-choice biomedical question-answering results competitive with much larger models, such as achieving a score of 57.3% on MedMCQA (dev) and 69.0% on the MMLU Medical Genetics exam. BioMedLM can also be fine-tuned to produce useful answers to patient questions on medical topics. This demonstrates that smaller models can potentially serve as transparent, privacy-preserving, economical and environmentally friendly foundations for particular NLP applications, such as in biomedicine. The model is available on the Hugging Face Hub: https://huggingface.co/stanford-crfm/BioMedLM.

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.

AI-driven discovery can greatly reduce design time and enhance new therapeutics' effectiveness. Models using simulators explore broad design spaces but risk violating implicit constraints due to a lack of experimental priors. For example, in a new analysis we performed on a diverse set of models on the GuacaMol benchmark using supervised classifiers, over 60\% of molecules proposed had high probability of being mutagenic. In this work, we introduce \ourdataset, a dataset of priors for design problems extracted from literature describing compounds used in lab settings. It is constructed with LLM pipelines for discovering therapeutic entities in relevant paragraphs and summarizing information in concise fair-use facts. \ourdataset~ consists of 32.3 million pairs of natural language facts, and appropriate entity representations (i.e. SMILES or refseq IDs). To demonstrate the potential of the data, we train LLM, CLIP, and LLava architectures to reason jointly about text and design targets and evaluate on tasks from the Therapeutic Data Commons (TDC). \ourdataset~is highly effective for creating models with strong priors: in supervised prediction problems that use our data as pretraining, our best models with 15M learnable parameters outperform larger 2B TxGemma on both regression and classification TDC tasks, and perform comparably to 9B models on average. Models built with \ourdataset~can be used as constraints while optimizing for novel molecules in GuacaMol, resulting in proposals that are safer and nearly as effective. We release our dataset at https://huggingface.co/datasets/medexanon/Medex{huggingface.co/datasets/medexanon/Medex}, and will provide expanded versions as available literature grows.

Med42-v2 introduces a suite of clinical large language models (LLMs) designed to address the limitations of generic models in healthcare settings. These models are built on Llama3 architecture and fine-tuned using specialized clinical data. They underwent multi-stage preference alignment to effectively respond to natural prompts. While generic models are often preference-aligned to avoid answering clinical queries as a precaution, Med42-v2 is specifically trained to overcome this limitation, enabling its use in clinical settings. Med42-v2 models demonstrate superior performance compared to the original Llama3 models in both 8B and 70B parameter configurations and GPT-4 across various medical benchmarks. These LLMs are developed to understand clinical queries, perform reasoning tasks, and provide valuable assistance in clinical environments. The models are now publicly available at https://huggingface.co/m42-health{https://huggingface.co/m42-health}.

The increasing use of tools and solutions based on Large Language Models (LLMs) for various tasks in the medical domain has become a prominent trend. Their use in this highly critical and sensitive domain has thus raised important questions about their robustness, especially in response to variations in input, and the reliability of the generated outputs. This study addresses these questions by constructing a textual dataset based on the ICD-10-CM code descriptions, widely used in US hospitals and containing many clinical terms, and their easily reproducible rephrasing. We then benchmarked existing embedding models, either generalist or specialized in the clinical domain, in a semantic search task where the goal was to correctly match the rephrased text to the original description. Our results showed that generalist models performed better than clinical models, suggesting that existing clinical specialized models are more sensitive to small changes in input that confuse them. The highlighted problem of specialized models may be due to the fact that they have not been trained on sufficient data, and in particular on datasets that are not diverse enough to have a reliable global language understanding, which is still necessary for accurate handling of medical documents.

The professionalism of a human doctor in outpatient service depends on two core abilities: the ability to make accurate medical decisions and the medical consultation skill to conduct strategic, empathetic patient inquiry. Existing Large Language Models (LLMs) have achieved remarkable accuracy on medical decision-making benchmarks. However, they often lack the ability to conduct the strategic and empathetic consultation, which is essential for real-world clinical scenarios. To address this gap, we propose Doctor-R1, an AI doctor agent trained to master both of the capabilities by ask high-yield questions and conduct strategic multi-turn inquiry to guide decision-making. Our framework introduces three key components: a multi-agent interactive environment, a two-tiered reward architecture that separately optimizes clinical decision-making and communicative inquiry skills, and an experience repository to ground policy learning in high-quality prior trajectories. We evaluate Doctor-R1 on OpenAI's HealthBench and MAQuE, assessed across multi-facet metrics, such as communication quality, user experience, and task accuracy. Remarkably, Doctor-R1 surpasses state-of-the-art open-source specialized LLMs by a substantial margin with higher parameter efficiency and outperforms powerful proprietary models. Furthermore, the human evaluations show a strong preference for Doctor-R1 to generate human-preferred clinical dialogue, demonstrating the effectiveness of the framework.

Over the recent years, the emergence of large language models (LLMs) has given rise to a proliferation of domain-specific models that are intended to reflect the particularities of linguistic context and content as a correlate of the originating domain. This paper details the conception, design, training and evaluation of DAEDRA, a LLM designed to detect regulatory-relevant outcomes (mortality, ER attendance and hospitalisation) in adverse event reports elicited through passive reporting (PR). While PR is a highly cost-efficient way of eliciting information from a wide and diverse audience -- typically including not only physicians and healthcare providers but also patients, family members and other lay stakeholders --, this diversity makes PR corpora difficult to analyse. Generic language models may not capture the complex clinical dimensions while specific clinical or biomedical models may not perform well on lay reports. To evaluate the utility of a subdomain-specific language model, an adaptive training approach was adapted, wherein base language model candidates were evaluated on a subset of the corpus, and the best performer was trained on the entire corpus. This yielded a small but significant improvement in F_1 (+1%), precision (+2.5%) and recall (+3.8%), at a relatively low training cost and a single-day training time. Subdomain-specific LLMs continue to be viable options for better results when analysing highly specialised corpora.

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

We present a statistical model for German medical natural language processing trained for named entity recognition (NER) as an open, publicly available model. The work serves as a refined successor to our first GERNERMED model which is substantially outperformed by our work. We demonstrate the effectiveness of combining multiple techniques in order to achieve strong results in entity recognition performance by the means of transfer-learning on pretrained deep language models (LM), word-alignment and neural machine translation. Due to the sparse situation on open, public medical entity recognition models for German texts, this work offers benefits to the German research community on medical NLP as a baseline model. Since our model is based on public English data, its weights are provided without legal restrictions on usage and distribution. The sample code and the statistical model is available at: https://github.com/frankkramer-lab/GERNERMED-pp

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.

In this paper, we introduce InMD-X, a collection of multiple large language models specifically designed to cater to the unique characteristics and demands of Internal Medicine Doctors (IMD). InMD-X represents a groundbreaking development in natural language processing, offering a suite of language models fine-tuned for various aspects of the internal medicine field. These models encompass a wide range of medical sub-specialties, enabling IMDs to perform more efficient and accurate research, diagnosis, and documentation. InMD-X's versatility and adaptability make it a valuable tool for improving the healthcare industry, enhancing communication between healthcare professionals, and advancing medical research. Each model within InMD-X is meticulously tailored to address specific challenges faced by IMDs, ensuring the highest level of precision and comprehensiveness in clinical text analysis and decision support. This paper provides an overview of the design, development, and evaluation of InMD-X, showcasing its potential to revolutionize the way internal medicine practitioners interact with medical data and information. We present results from extensive testing, demonstrating the effectiveness and practical utility of InMD-X in real-world medical scenarios.

The integration of large language models (LLMs) into medical practice holds transformative potential, yet their real-world clinical utility remains limited by critical alignment challenges: (1) a disconnect between static evaluation benchmarks and dynamic clinical cognitive needs, (2) difficulties in adapting to evolving, multi-source medical standards, and (3) the inability of conventional reward models to capture nuanced, multi-dimensional medical quality criteria. To address these gaps, we propose MR-RML (Multidimensional Rubric-oriented Reward Model Learning) via GPRC (Geometric Projection Reference Constraints), a novel alignment framework that integrates medical standards into a structured "Dimensions-Scenarios-Disciplines" matrix to guide data generation and model optimization. MR-RML introduces three core innovations: (1) a "Dimensions-Scenarios-Disciplines" medical standard system that embeds domain standards into the full training pipeline; (2) an independent multi-dimensional reward model that decomposes evaluation criteria, shifting from real-time rubric-based scoring to internalized reward modeling for improved consistency and cost-efficiency; (3) geometric projection reference constraints that transform medical cognitive logic into mathematical regularization, aligning scoring gradients with clinical reasoning and enabling synthetic data-driven training. Through extensive evaluations on the authoritative medical benchmark Healthbench, our method yields substantial performance gains over the base LLM Qwen-32B (45% on the full subset and 85% on Hard subset, respectively). It achieves a SOTA among open-source LLMs with scores of 62.7 (full subset) and 44.7 (hard subset), while also outperforming the majority of closed-source models.

Since radiology reports needed for clinical practice and research are written and stored in free-text narrations, extraction of relative information for further analysis is difficult. In these circumstances, natural language processing (NLP) techniques can facilitate automatic information extraction and transformation of free-text formats to structured data. In recent years, deep learning (DL)-based models have been adapted for NLP experiments with promising results. Despite the significant potential of DL models based on artificial neural networks (ANN) and convolutional neural networks (CNN), the models face some limitations to implement in clinical practice. Transformers, another new DL architecture, have been increasingly applied to improve the process. Therefore, in this study, we propose a transformer-based fine-grained named entity recognition (NER) architecture for clinical information extraction. We collected 88 abdominopelvic sonography reports in free-text formats and annotated them based on our developed information schema. The text-to-text transfer transformer model (T5) and Scifive, a pre-trained domain-specific adaptation of the T5 model, were applied for fine-tuning to extract entities and relations and transform the input into a structured format. Our transformer-based model in this study outperformed previously applied approaches such as ANN and CNN models based on ROUGE-1, ROUGE-2, ROUGE-L, and BLEU scores of 0.816, 0.668, 0.528, and 0.743, respectively, while providing an interpretable structured report.

Large Language Models (LLMs) have demonstrated remarkable capabilities across various domains and are moving towards more specialized areas. Recent advanced proprietary models such as GPT-4 and Gemini have achieved significant advancements in biomedicine, which have also raised privacy and security challenges. The construction of specialized generalists hinges largely on high-quality datasets, enhanced by techniques like supervised fine-tuning and reinforcement learning from human or AI feedback, and direct preference optimization. However, these leading technologies (e.g., preference learning) are still significantly limited in the open source community due to the scarcity of specialized data. In this paper, we present the UltraMedical collections, which consist of high-quality manual and synthetic datasets in the biomedicine domain, featuring preference annotations across multiple advanced LLMs. By utilizing these datasets, we fine-tune a suite of specialized medical models based on Llama-3 series, demonstrating breathtaking capabilities across various medical benchmarks. Moreover, we develop powerful reward models skilled in biomedical and general reward benchmark, enhancing further online preference learning within the biomedical LLM community.

In recent years, pre-trained language models (PLMs) achieve the best performance on a wide range of natural language processing (NLP) tasks. While the first models were trained on general domain data, specialized ones have emerged to more effectively treat specific domains. In this paper, we propose an original study of PLMs in the medical domain on French language. We compare, for the first time, the performance of PLMs trained on both public data from the web and private data from healthcare establishments. We also evaluate different learning strategies on a set of biomedical tasks. In particular, we show that we can take advantage of already existing biomedical PLMs in a foreign language by further pre-train it on our targeted data. Finally, we release the first specialized PLMs for the biomedical field in French, called DrBERT, as well as the largest corpus of medical data under free license on which these models are trained.

The emergence of powerful, general-purpose omnimodels capable of processing diverse data modalities has raised a critical question: can these ``jack-of-all-trades'' systems perform on par with highly specialized models in knowledge-intensive domains? This work investigates this question within the high-stakes field of medical image segmentation. We conduct a comparative study analyzing the zero-shot performance of a state-of-the-art omnimodel (Gemini 2.5 Pro, the ``Nano Banana'' model) against domain-specific deep learning models on three distinct tasks: polyp (endoscopy), retinal vessel (fundus), and breast tumor segmentation (ultrasound). Our study focuses on performance at the extremes by curating subsets of the ``easiest'' and ``hardest'' cases based on the specialist models' accuracy. Our findings reveal a nuanced and task-dependent landscape. For polyp and breast tumor segmentation, specialist models excel on easy samples, but the omnimodel demonstrates greater robustness on hard samples where specialists fail catastrophically. Conversely, for the fine-grained task of retinal vessel segmentation, the specialist model maintains superior performance across both easy and hard cases. Intriguingly, qualitative analysis suggests omnimodels may possess higher sensitivity, identifying subtle anatomical features missed by human annotators. Our results indicate that while current omnimodels are not yet a universal replacement for specialists, their unique strengths suggest a potential complementary role with specialist models, particularly in enhancing robustness on challenging edge cases.

The emerging trend of advancing generalist artificial intelligence, such as GPTv4 and Gemini, has reshaped the landscape of research (academia and industry) in machine learning and many other research areas. However, domain-specific applications of such foundation models (e.g., in medicine) remain untouched or often at their very early stages. It will require an individual set of transfer learning and model adaptation techniques by further expanding and injecting these models with domain knowledge and data. The development of such technologies could be largely accelerated if the bundle of data, algorithms, and pre-trained foundation models were gathered together and open-sourced in an organized manner. In this work, we present OpenMEDLab, an open-source platform for multi-modality foundation models. It encapsulates not only solutions of pioneering attempts in prompting and fine-tuning large language and vision models for frontline clinical and bioinformatic applications but also building domain-specific foundation models with large-scale multi-modal medical data. Importantly, it opens access to a group of pre-trained foundation models for various medical image modalities, clinical text, protein engineering, etc. Inspiring and competitive results are also demonstrated for each collected approach and model in a variety of benchmarks for downstream tasks. We welcome researchers in the field of medical artificial intelligence to continuously contribute cutting-edge methods and models to OpenMEDLab, which can be accessed via https://github.com/openmedlab.

The current state of adoption of well-structured electronic health records and integration of digital methods for storing medical patient data in structured formats can often considered as inferior compared to the use of traditional, unstructured text based patient data documentation. Data mining in the field of medical data analysis often needs to rely solely on processing of unstructured data to retrieve relevant data. In natural language processing (NLP), statistical models have been shown successful in various tasks like part-of-speech tagging, relation extraction (RE) and named entity recognition (NER). In this work, we present GERNERMED, the first open, neural NLP model for NER tasks dedicated to detect medical entity types in German text data. Here, we avoid the conflicting goals of protection of sensitive patient data from training data extraction and the publication of the statistical model weights by training our model on a custom dataset that was translated from publicly available datasets in foreign language by a pretrained neural machine translation model. The sample code and the statistical model is available at: https://github.com/frankkramer-lab/GERNERMED

Machine learning techniques are effective for building predictive models because they identify patterns in large datasets. Development of a model for complex real-life problems often stop at the point of publication, proof of concept or when made accessible through some mode of deployment. However, a model in the medical domain risks becoming obsolete as patient demographics, systems and clinical practices change. The maintenance and monitoring of predictive model performance post-publication is crucial to enable their safe and effective long-term use. We will assess the infrastructure required to monitor the outputs of a machine learning algorithm, and present two scenarios with examples of monitoring and updates of models, firstly on a breast cancer prognosis model trained on public longitudinal data, and secondly on a neurodegenerative stratification algorithm that is currently being developed and tested in clinic.

Several recent works seek to develop foundation models specifically for medical applications, adapting general-purpose large language models (LLMs) and vision-language models (VLMs) via continued pretraining on publicly available biomedical corpora. These works typically claim that such domain-adaptive pretraining (DAPT) improves performance on downstream medical tasks, such as answering medical licensing exam questions. In this paper, we compare seven public "medical" LLMs and two VLMs against their corresponding base models, arriving at a different conclusion: all medical VLMs and nearly all medical LLMs fail to consistently improve over their base models in the zero-/few-shot prompting regime for medical question-answering (QA) tasks. For instance, across the tasks and model pairs we consider in the 3-shot setting, medical LLMs only outperform their base models in 12.1% of cases, reach a (statistical) tie in 49.8% of cases, and are significantly worse than their base models in the remaining 38.2% of cases. Our conclusions are based on (i) comparing each medical model head-to-head, directly against the corresponding base model; (ii) optimizing the prompts for each model separately; and (iii) accounting for statistical uncertainty in comparisons. While these basic practices are not consistently adopted in the literature, our ablations show that they substantially impact conclusions. Our findings suggest that state-of-the-art general-domain models may already exhibit strong medical knowledge and reasoning capabilities, and offer recommendations to strengthen the conclusions of future studies.

Although recent advances in scaling large language models (LLMs) have resulted in improvements on many NLP tasks, it remains unclear whether these models trained primarily with general web text are the right tool in highly specialized, safety critical domains such as clinical text. Recent results have suggested that LLMs encode a surprising amount of medical knowledge. This raises an important question regarding the utility of smaller domain-specific language models. With the success of general-domain LLMs, is there still a need for specialized clinical models? To investigate this question, we conduct an extensive empirical analysis of 12 language models, ranging from 220M to 175B parameters, measuring their performance on 3 different clinical tasks that test their ability to parse and reason over electronic health records. As part of our experiments, we train T5-Base and T5-Large models from scratch on clinical notes from MIMIC III and IV to directly investigate the efficiency of clinical tokens. We show that relatively small specialized clinical models substantially outperform all in-context learning approaches, even when finetuned on limited annotated data. Further, we find that pretraining on clinical tokens allows for smaller, more parameter-efficient models that either match or outperform much larger language models trained on general text. We release the code and the models used under the PhysioNet Credentialed Health Data license and data use agreement.

Multi-Modal Large Language Models (MLLMs), despite being successful, exhibit limited generality and often fall short when compared to specialized models. Recently, LLM-based agents have been developed to address these challenges by selecting appropriate specialized models as tools based on user inputs. However, such advancements have not been extensively explored within the medical domain. To bridge this gap, this paper introduces the first agent explicitly designed for the medical field, named Multi-modal Medical Agent (MMedAgent). We curate an instruction-tuning dataset comprising six medical tools solving seven tasks across five modalities, enabling the agent to choose the most suitable tools for a given task. Comprehensive experiments demonstrate that MMedAgent achieves superior performance across a variety of medical tasks compared to state-of-the-art open-source methods and even the closed-source model, GPT-4o. Furthermore, MMedAgent exhibits efficiency in updating and integrating new medical tools. Codes and models are all available.

Purpose: With advancements in Large Language Models (LLMs) for healthcare, the need arises for competitive open-source models to protect the public interest. This work contributes to the field of open medical LLMs by optimizing key stages of data preprocessing and training, while showing how to improve model safety (through DPO) and efficacy (through RAG). The evaluation methodology used, which includes four different types of tests, defines a new standard for the field. The resultant models, shown to be competitive with the best private alternatives, are released with a permisive license. Methods: Building on top of strong base models like Llama 3.1 and Qwen 2.5, Aloe Beta uses a custom dataset to enhance public data with synthetic Chain of Thought examples. The models undergo alignment with Direct Preference Optimization, emphasizing ethical and policy-aligned performance in the presence of jailbreaking attacks. Evaluation includes close-ended, open-ended, safety and human assessments, to maximize the reliability of results. Results: Recommendations are made across the entire pipeline, backed by the solid performance of the Aloe Family. These models deliver competitive performance across healthcare benchmarks and medical fields, and are often preferred by healthcare professionals. On bias and toxicity, the Aloe Beta models significantly improve safety, showing resilience to unseen jailbreaking attacks. For a responsible release, a detailed risk assessment specific to healthcare is attached to the Aloe Family models. Conclusion: The Aloe Beta models, and the recipe that leads to them, are a significant contribution to the open-source medical LLM field, offering top-of-the-line performance while maintaining high ethical requirements. This work sets a new standard for developing and reporting aligned LLMs in healthcare.

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.

In medical imaging, the diffusion models have shown great potential in synthetic image generation tasks. However, these models often struggle with the interpretable connections between the generated and existing images and could create illusions. To address these challenges, our research proposes a novel diffusion-based generative model based on deformation diffusion and recovery. This model, named Deformation-Recovery Diffusion Model (DRDM), diverges from traditional score/intensity and latent feature-based approaches, emphasizing morphological changes through deformation fields rather than direct image synthesis. This is achieved by introducing a topological-preserving deformation field generation method, which randomly samples and integrates a set of multi-scale Deformation Vector Fields (DVF). DRDM is trained to learn to recover unreasonable deformation components, thereby restoring each randomly deformed image to a realistic distribution. These innovations facilitate the generation of diverse and anatomically plausible deformations, enhancing data augmentation and synthesis for further analysis in downstream tasks, such as few-shot learning and image registration. Experimental results in cardiac MRI and pulmonary CT show DRDM is capable of creating diverse, large (over 10\% image size deformation scale), and high-quality (negative rate of the Jacobian matrix's determinant is lower than 1\%) deformation fields. The further experimental results in downstream tasks, 2D image segmentation and 3D image registration, indicate significant improvements resulting from DRDM, showcasing the potential of our model to advance image manipulation and synthesis in medical imaging and beyond. Project page: https://jianqingzheng.github.io/def_diff_rec/

Model selection/optimization in conformal inference is challenging, since it may break the exchangeability between labeled and unlabeled data. We study this problem in the context of conformal selection, which uses conformal p-values to select ``interesting'' instances with large unobserved labels from a pool of unlabeled data, while controlling the FDR in finite sample. For validity, existing solutions require the model choice to be independent of the data used to construct the p-values and calibrate the selection set. However, when presented with many model choices and limited labeled data, it is desirable to (i) select the best model in a data-driven manner, and (ii) mitigate power loss due to sample splitting. This paper presents OptCS, a general framework that allows valid statistical testing (selection) after flexible data-driven model optimization. We introduce general conditions under which OptCS constructs valid conformal p-values despite substantial data reuse and handles complex p-value dependencies to maintain finite-sample FDR control via a novel multiple testing procedure. We instantiate this general recipe to propose three FDR-controlling procedures, each optimizing the models differently: (i) selecting the most powerful one among multiple pre-trained candidate models, (ii) using all data for model fitting without sample splitting, and (iii) combining full-sample model fitting and selection. We demonstrate the efficacy of our methods via simulation studies and real applications in drug discovery and alignment of large language models in radiology report generation.

Xmodel-2 is a 1.2-billion-parameter large language model designed specifically for reasoning tasks. Its architecture enables different model scales to share a unified set of hyperparameters, allowing for extensive experimentation on smaller models and seamless transfer of optimal configurations to larger models. To maximize training efficiency and stability, Xmodel-2 employs the WSD learning rate scheduler from MiniCPM. Pretrained on 1.5 trillion tokens from diverse sources, Xmodel-2 achieves state-of-the-art performance in complex reasoning and agent-based tasks, while maintaining low training costs. These results highlight the potential of efficient model design and training strategies in advancing reasoning capabilities. Model checkpoints and code are publicly available on GitHub at https://github.com/XiaoduoAILab/Xmodel-2

People with diabetes are at risk of developing an eye disease called diabetic retinopathy (DR). This disease occurs when high blood glucose levels cause damage to blood vessels in the retina. Computer-aided DR diagnosis is a promising tool for early detection of DR and severity grading, due to the great success of deep learning. However, most current DR diagnosis systems do not achieve satisfactory performance or interpretability for ophthalmologists, due to the lack of training data with consistent and fine-grained annotations. To address this problem, we construct a large fine-grained annotated DR dataset containing 2,842 images (FGADR). This dataset has 1,842 images with pixel-level DR-related lesion annotations, and 1,000 images with image-level labels graded by six board-certified ophthalmologists with intra-rater consistency. The proposed dataset will enable extensive studies on DR diagnosis. We set up three benchmark tasks for evaluation: 1. DR lesion segmentation; 2. DR grading by joint classification and segmentation; 3. Transfer learning for ocular multi-disease identification. Moreover, a novel inductive transfer learning method is introduced for the third task. Extensive experiments using different state-of-the-art methods are conducted on our FGADR dataset, which can serve as baselines for future research.

Transforming two-dimensional (2D) images into three-dimensional (3D) volumes is a well-known yet challenging problem for the computer vision community. In the medical domain, a few previous studies attempted to convert two or more input radiographs into computed tomography (CT) volumes. Following their effort, we introduce a diffusion model-based technology that can rotate the anatomical content of any input radiograph in 3D space, potentially enabling the visualization of the entire anatomical content of the radiograph from any viewpoint in 3D. Similar to previous studies, we used CT volumes to create Digitally Reconstructed Radiographs (DRRs) as the training data for our model. However, we addressed two significant limitations encountered in previous studies: 1. We utilized conditional diffusion models with classifier-free guidance instead of Generative Adversarial Networks (GANs) to achieve higher mode coverage and improved output image quality, with the only trade-off being slower inference time, which is often less critical in medical applications; and 2. We demonstrated that the unreliable output of style transfer deep learning (DL) models, such as Cycle-GAN, to transfer the style of actual radiographs to DRRs could be replaced with a simple yet effective training transformation that randomly changes the pixel intensity histograms of the input and ground-truth imaging data during training. This transformation makes the diffusion model agnostic to any distribution variations of the input data pixel intensity, enabling the reliable training of a DL model on input DRRs and applying the exact same model to conventional radiographs (or DRRs) during inference.

With the proliferation of domain-specific models, model merging has emerged as a set of techniques that combine the capabilities of multiple models into one that can multitask without the cost of additional training. In this paper, we propose a new model merging technique, Drop and rEscaLe via sampLing with mAgnitude (DELLA-Merging), that employs a novel pruning technique, MAGPRUNE, which shows significant advantages over DARE and TIES. MAGPRUNE first ranks the parameters in order of their magnitude and assigns higher dropout probabilities (p) to parameters with lower ranks corresponding to lower magnitudes. To approximate the original embeddings, MAGPRUNE employs a rescaling operation on the parameters that survive the random dropping by 1/(1 - p). On three different expert models considered for merging (LM, Math, Code) and corresponding benchmark datasets (AlpacaEval, GSM8K, MBPP), DELLA shows an average improvement of 2.4 points over baseline methods employing delta parameter pruning (an improvement of 3.6 points over TIES, 1.2 points over DARE), and 11.1 points over the no-pruning baseline (TA). We release the source code at: https://github.com/declare-lab/della.

Current artificial intelligence models for medical imaging are predominantly single modality and single disease. Attempts to create multimodal and multi-disease models have resulted in inconsistent clinical accuracy. Furthermore, training these models typically requires large, labour-intensive, well-labelled datasets. We developed MerMED-FM, a state-of-the-art multimodal, multi-specialty foundation model trained using self-supervised learning and a memory module. MerMED-FM was trained on 3.3 million medical images from over ten specialties and seven modalities, including computed tomography (CT), chest X-rays (CXR), ultrasound (US), pathology patches, color fundus photography (CFP), optical coherence tomography (OCT) and dermatology images. MerMED-FM was evaluated across multiple diseases and compared against existing foundational models. Strong performance was achieved across all modalities, with AUROCs of 0.988 (OCT); 0.982 (pathology); 0.951 (US); 0.943 (CT); 0.931 (skin); 0.894 (CFP); 0.858 (CXR). MerMED-FM has the potential to be a highly adaptable, versatile, cross-specialty foundation model that enables robust medical imaging interpretation across diverse medical disciplines.

In the domain of model-based engineering, models are essential components that enable system design and analysis. Traditionally, the creation of these models has been a manual process requiring not only deep modeling expertise but also substantial domain knowledge of target systems. With the rapid advancement of generative artificial intelligence, large language models (LLMs) show potential for automating model generation. This work explores the generation of instance models using LLMs, focusing specifically on producing XMI-based instance models from Ecore metamodels and natural language specifications. We observe that current LLMs struggle to directly generate valid XMI models. To address this, we propose a two-step approach: first, using LLMs to produce a simplified structured output containing all necessary instance model information, namely a conceptual instance model, and then compiling this intermediate representation into a valid XMI file. The conceptual instance model is format-independent, allowing it to be transformed into various modeling formats via different compilers. The feasibility of the proposed method has been demonstrated using several LLMs, including GPT-4o, o1-preview, Llama 3.1 (8B and 70B). Results show that the proposed method significantly improves the usability of LLMs for instance model generation tasks. Notably, the smaller open-source model, Llama 3.1 70B, demonstrated performance comparable to proprietary GPT models within the proposed framework.

While deep networks have achieved broad success in analyzing natural images, when applied to medical scans, they often fail in unexcepted situations. We investigate this challenge and focus on model sensitivity to domain shifts, such as data sampled from different hospitals or data confounded by demographic variables such as sex, race, etc, in the context of chest X-rays and skin lesion images. A key finding we show empirically is that existing visual backbones lack an appropriate prior from the architecture for reliable generalization in these settings. Taking inspiration from medical training, we propose giving deep networks a prior grounded in explicit medical knowledge communicated in natural language. To this end, we introduce Knowledge-enhanced Bottlenecks (KnoBo), a class of concept bottleneck models that incorporates knowledge priors that constrain it to reason with clinically relevant factors found in medical textbooks or PubMed. KnoBo uses retrieval-augmented language models to design an appropriate concept space paired with an automatic training procedure for recognizing the concept. We evaluate different resources of knowledge and recognition architectures on a broad range of domain shifts across 20 datasets. In our comprehensive evaluation with two imaging modalities, KnoBo outperforms fine-tuned models on confounded datasets by 32.4% on average. Finally, evaluations reveal that PubMed is a promising resource for making medical models less sensitive to domain shift, outperforming other resources on both diversity of information and final prediction performance.

Recent developments in Large Language Model (LLM)-based agents have shown impressive capabilities spanning multiple domains, exemplified by deep research systems that demonstrate superior performance on complex information-seeking and synthesis tasks. While general-purpose deep research agents have shown impressive capabilities, they struggle significantly with medical domain challenges, as evidenced by leading proprietary systems achieving limited accuracy on complex medical benchmarks. The key limitations are: (1) the model lacks sufficient dense medical knowledge for clinical reasoning, and (2) the framework is constrained by the absence of specialized retrieval tools tailored for medical contexts.We present a medical deep research agent that addresses these challenges through two core innovations. First, we develop a novel data synthesis framework using medical knowledge graphs, extracting the longest chains from subgraphs around rare medical entities to generate complex multi-hop question-answer pairs. Second, we integrate a custom-built private medical retrieval engine alongside general-purpose tools, enabling accurate medical information synthesis. Our approach generates 2100+ diverse trajectories across 12 medical specialties, each averaging 4.2 tool interactions.Through a two-stage training paradigm combining supervised fine-tuning and online reinforcement learning with composite rewards, our MedResearcher-R1-32B model demonstrates exceptional performance, establishing new state-of-the-art results on medical benchmarks while maintaining competitive performance on general deep research tasks. Our work demonstrates that strategic domain-specific innovations in architecture, tool design, and training data construction can enable smaller open-source models to outperform much larger proprietary systems in specialized domains.

Considering the increased workload in pathology laboratories today, automated tools such as artificial intelligence models can help pathologists with their tasks and ease the workload. In this paper, we are proposing a segmentation model (DRU-Net) that can provide a delineation of human non-small cell lung carcinomas and an augmentation method that can improve classification results. The proposed model is a fused combination of truncated pre-trained DenseNet201 and ResNet101V2 as a patch-wise classifier followed by a lightweight U-Net as a refinement model. We have used two datasets (Norwegian Lung Cancer Biobank and Haukeland University Hospital lung cancer cohort) to create our proposed model. The DRU-Net model achieves an average of 0.91 Dice similarity coefficient. The proposed spatial augmentation method (multi-lens distortion) improved the network performance by 3%. Our findings show that choosing image patches that specifically include regions of interest leads to better results for the patch-wise classifier compared to other sampling methods. The qualitative analysis showed that the DRU-Net model is generally successful in detecting the tumor. On the test set, some of the cases showed areas of false positive and false negative segmentation in the periphery, particularly in tumors with inflammatory and reactive changes.

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.

Clinical decision-making routinely demands reasoning over heterogeneous data, yet existing multimodal language models (MLLMs) remain largely vision-centric and fail to generalize across clinical specialties. To bridge this gap, we introduce QoQ-Med-7B/32B, the first open generalist clinical foundation model that jointly reasons across medical images, time-series signals, and text reports. QoQ-Med is trained with Domain-aware Relative Policy Optimization (DRPO), a novel reinforcement-learning objective that hierarchically scales normalized rewards according to domain rarity and modality difficulty, mitigating performance imbalance caused by skewed clinical data distributions. Trained on 2.61 million instruction tuning pairs spanning 9 clinical domains, we show that DRPO training boosts diagnostic performance by 43% in macro-F1 on average across all visual domains as compared to other critic-free training methods like GRPO. Furthermore, with QoQ-Med trained on intensive segmentation data, it is able to highlight salient regions related to the diagnosis, with an IoU 10x higher than open models while reaching the performance of OpenAI o4-mini. To foster reproducibility and downstream research, we release (i) the full model weights, (ii) the modular training pipeline, and (iii) all intermediate reasoning traces at https://github.com/DDVD233/QoQ_Med.

Large multimodal models (LMMs) have demonstrated significant potential in providing innovative solutions for various biomedical tasks, including pathology analysis, radiology report generation, and biomedical assistance. However, the existing multimodal biomedical AI is typically based on foundation LLMs, thus hindering the understanding of intricate medical concepts with limited medical training data. Moreover, recent LLaVA-induced medical LMMs struggle to effectively capture the intricate relationship between the texts and the images. Therefore, we introduce Doctor Sun, a large multimodal generative model specialized in medicine, developed to encode, integrate, and interpret diverse biomedical data modalities such as text and images. In particular, Doctor Sun integrates a pre-trained vision encoder with a medical LLM and conducts two-stage training on various medical datasets, focusing on feature alignment and instruction tuning. Moreover, we release SunMed-VL, a wide-range bilingual medical multimodal dataset, along with all associated models, code, and resources, to freely support the advancement of biomedical multimodal research.

The integration of Large Language Models (LLMs) into healthcare promises to transform medical diagnostics, research, and patient care. Yet, the progression of medical LLMs faces obstacles such as complex training requirements, rigorous evaluation demands, and the dominance of proprietary models that restrict academic exploration. Transparent, comprehensive access to LLM resources is essential for advancing the field, fostering reproducibility, and encouraging innovation in healthcare AI. We present Hippocrates, an open-source LLM framework specifically developed for the medical domain. In stark contrast to previous efforts, it offers unrestricted access to its training datasets, codebase, checkpoints, and evaluation protocols. This open approach is designed to stimulate collaborative research, allowing the community to build upon, refine, and rigorously evaluate medical LLMs within a transparent ecosystem. Also, we introduce Hippo, a family of 7B models tailored for the medical domain, fine-tuned from Mistral and LLaMA2 through continual pre-training, instruction tuning, and reinforcement learning from human and AI feedback. Our models outperform existing open medical LLMs models by a large-margin, even surpassing models with 70B parameters. Through Hippocrates, we aspire to unlock the full potential of LLMs not just to advance medical knowledge and patient care but also to democratize the benefits of AI research in healthcare, making them available across the globe.

Price responsiveness is a major feature of end use customers (EUCs) that participate in demand response (DR) programs, and has been conventionally modeled with static demand functions, which take the electricity price as the input and the aggregate energy consumption as the output. This, however, neglects the inherent temporal correlation of the EUC behaviors, and may result in large errors when predicting the actual responses of EUCs in real-time pricing (RTP) programs. In this paper, we propose a dynamical DR model so as to capture the temporal behavior of the EUCs. The states in the proposed dynamical DR model can be explicitly chosen, in which case the model can be represented by a linear function or a multi-layer feedforward neural network, or implicitly chosen, in which case the model can be represented by a recurrent neural network or a long short-term memory unit network. In both cases, the dynamical DR model can be learned from historical price and energy consumption data. Numerical simulation illustrated how the states are chosen and also showed the proposed dynamical DR model significantly outperforms the static ones.

Foundation models (FMs) trained on electronic health records (EHRs) have shown strong performance on a range of clinical prediction tasks. However, adapting these models to local health systems remains challenging due to limited data availability and resource constraints. In this study, we investigated what these models learn and evaluated the transferability of an FM trained on MIMIC-IV to an institutional EHR dataset at the University of Chicago Medical Center. We assessed their ability to identify outlier patients and examined representation-space patient trajectories in relation to future clinical outcomes. We also evaluated the performance of supervised fine-tuned classifiers on both source and target datasets. Our findings offer insights into the adaptability of FMs across different healthcare systems, highlight considerations for their effective implementation, and provide an empirical analysis of the underlying factors that contribute to their predictive performance.

Medical image analysis is a fundamental component. As deep learning progresses, the focus has shifted from single-task applications, such as classification and segmentation, to more complex multimodal tasks, including medical visual question answering and report generation. Traditional shallow and task-specific models are increasingly limited in addressing the complexity and scalability required in clinical practice. The emergence of large language models (LLMs) has driven the development of medical Large Vision-Language Models (LVLMs), offering a unified solution for diverse vision-language tasks. In this study, we investigate various architectural designs for medical LVLMs based on the widely adopted LLaVA framework, which follows an encoder-connector-LLM paradigm. We construct two distinct models targeting 2D and 3D modalities, respectively. These models are designed to support both general-purpose medical tasks and domain-specific fine-tuning, thereby serving as effective foundation models. To facilitate reproducibility and further research, we develop a modular and extensible codebase, MedM-VL, and release two LVLM variants: MedM-VL-2D for 2D medical image analysis and MedM-VL-CT-Chest for 3D CT-based applications. The code and models are available at: https://github.com/MSIIP/MedM-VL

The recent success of Large Language Models (LLMs) has had a significant impact on the healthcare field, providing patients with medical advice, diagnostic information, and more. However, due to a lack of professional medical knowledge, patients are easily misled by generated erroneous information from LLMs, which may result in serious medical problems. To address this issue, we focus on tuning the LLMs to be medical assistants who collaborate with more experienced doctors. We first conduct a two-stage survey by inspiration-feedback to gain a broad understanding of the real needs of doctors for medical assistants. Based on this, we construct a Chinese medical dataset called DoctorFLAN to support the entire workflow of doctors, which includes 92K Q\&A samples from 22 tasks and 27 specialists. Moreover, we evaluate LLMs in doctor-oriented scenarios by constructing the DoctorFLAN-test containing 550 single-turn Q\&A and DotaBench containing 74 multi-turn conversations. The evaluation results indicate that being a medical assistant still poses challenges for existing open-source models, but DoctorFLAN can help them significantly. It demonstrates that the doctor-oriented dataset and benchmarks we construct can complement existing patient-oriented work and better promote medical LLMs research.

The rapid development of Large Language Models (LLMs) for healthcare applications has spurred calls for holistic evaluation beyond frequently-cited benchmarks like USMLE, to better reflect real-world performance. While real-world assessments are valuable indicators of utility, they often lag behind the pace of LLM evolution, likely rendering findings obsolete upon deployment. This temporal disconnect necessitates a comprehensive upfront evaluation that can guide model selection for specific clinical applications. We introduce MEDIC, a framework assessing LLMs across five critical dimensions of clinical competence: medical reasoning, ethics and bias, data and language understanding, in-context learning, and clinical safety. MEDIC features a novel cross-examination framework quantifying LLM performance across areas like coverage and hallucination detection, without requiring reference outputs. We apply MEDIC to evaluate LLMs on medical question-answering, safety, summarization, note generation, and other tasks. Our results show performance disparities across model sizes, baseline vs medically finetuned models, and have implications on model selection for applications requiring specific model strengths, such as low hallucination or lower cost of inference. MEDIC's multifaceted evaluation reveals these performance trade-offs, bridging the gap between theoretical capabilities and practical implementation in healthcare settings, ensuring that the most promising models are identified and adapted for diverse healthcare applications.

Trained machine learning models are increasingly used to perform high-impact tasks in areas such as law enforcement, medicine, education, and employment. In order to clarify the intended use cases of machine learning models and minimize their usage in contexts for which they are not well suited, we recommend that released models be accompanied by documentation detailing their performance characteristics. In this paper, we propose a framework that we call model cards, to encourage such transparent model reporting. Model cards are short documents accompanying trained machine learning models that provide benchmarked evaluation in a variety of conditions, such as across different cultural, demographic, or phenotypic groups (e.g., race, geographic location, sex, Fitzpatrick skin type) and intersectional groups (e.g., age and race, or sex and Fitzpatrick skin type) that are relevant to the intended application domains. Model cards also disclose the context in which models are intended to be used, details of the performance evaluation procedures, and other relevant information. While we focus primarily on human-centered machine learning models in the application fields of computer vision and natural language processing, this framework can be used to document any trained machine learning model. To solidify the concept, we provide cards for two supervised models: One trained to detect smiling faces in images, and one trained to detect toxic comments in text. We propose model cards as a step towards the responsible democratization of machine learning and related AI technology, increasing transparency into how well AI technology works. We hope this work encourages those releasing trained machine learning models to accompany model releases with similar detailed evaluation numbers and other relevant documentation.

Online medical service provides patients convenient access to doctors, but effectively ranking doctors based on specific medical needs remains challenging. Current ranking approaches typically lack the interpretability crucial for patient trust and informed decision-making. Additionally, the scarcity of standardized benchmarks and labeled data for supervised learning impedes progress in expertise-aware doctor ranking. To address these challenges, we propose an explainable ranking framework for doctor ranking powered by large language models in a zero-shot setting. Our framework dynamically generates disease-specific ranking criteria to guide the large language model in assessing doctor relevance with transparency and consistency. It further enhances interpretability by generating step-by-step rationales for its ranking decisions, improving the overall explainability of the information retrieval process. To support rigorous evaluation, we built and released DrRank, a novel expertise-driven dataset comprising 38 disease-treatment pairs and 4,325 doctor profiles. On this benchmark, our framework significantly outperforms the strongest baseline by +6.45 NDCG@10. Comprehensive analyses also show our framework is fair across disease types, patient gender, and geographic regions. Furthermore, verification by medical experts confirms the reliability and interpretability of our approach, reinforcing its potential for trustworthy, real-world doctor recommendation. To demonstrate its broader applicability, we validate our framework on two datasets from BEIR benchmark, where it again achieves superior performance. The code and associated data are available at: https://github.com/YangLab-BUPT/DrRank.

Specialised pre-trained language models are becoming more frequent in NLP since they can potentially outperform models trained on generic texts. BioBERT and BioClinicalBERT are two examples of such models that have shown promise in medical NLP tasks. Many of these models are overparametrised and resource-intensive, but thanks to techniques like Knowledge Distillation (KD), it is possible to create smaller versions that perform almost as well as their larger counterparts. In this work, we specifically focus on development of compact language models for processing clinical texts (i.e. progress notes, discharge summaries etc). We developed a number of efficient lightweight clinical transformers using knowledge distillation and continual learning, with the number of parameters ranging from 15 million to 65 million. These models performed comparably to larger models such as BioBERT and ClinicalBioBERT and significantly outperformed other compact models trained on general or biomedical data. Our extensive evaluation was done across several standard datasets and covered a wide range of clinical text-mining tasks, including Natural Language Inference, Relation Extraction, Named Entity Recognition, and Sequence Classification. To our knowledge, this is the first comprehensive study specifically focused on creating efficient and compact transformers for clinical NLP tasks. The models and code used in this study can be found on our Huggingface profile at https://huggingface.co/nlpie and Github page at https://github.com/nlpie-research/Lightweight-Clinical-Transformers, respectively, promoting reproducibility of our results.

Large Language Models (LLMs) have been widely applied in various professional fields. By fine-tuning the models using domain specific question and answer datasets, the professional domain knowledge and Q\&A abilities of these models have significantly improved, for example, medical professional LLMs that use fine-tuning of doctor-patient Q\&A data exhibit extraordinary disease diagnostic abilities. However, we observed that despite improvements in specific domain knowledge, the performance of medical LLM in long-context understanding has significantly declined, especially compared to general language models with similar parameters. The purpose of this study is to investigate the phenomenon of reduced performance in understanding long-context in medical LLM. We designed a series of experiments to conduct open-book professional knowledge exams on all models to evaluate their ability to read long-context. By adjusting the proportion and quantity of general data and medical data in the process of fine-tuning, we can determine the best data composition to optimize the professional model and achieve a balance between long-context performance and specific domain knowledge.

Purpose: To introduce a deep learning model capable of multi-organ segmentation in MRI scans, offering a solution to the current limitations in MRI analysis due to challenges in resolution, standardized intensity values, and variability in sequences. Materials and Methods: he model was trained on 1,200 manually annotated MRI scans from the UK Biobank, 221 in-house MRI scans and 1228 CT scans, leveraging cross-modality transfer learning from CT segmentation models. A human-in-the-loop annotation workflow was employed to efficiently create high-quality segmentations. The model's performance was evaluated on NAKO and the AMOS22 dataset containing 600 and 60 MRI examinations. Dice Similarity Coefficient (DSC) and Hausdorff Distance (HD) was used to assess segmentation accuracy. The model will be open sourced. Results: The model showcased high accuracy in segmenting well-defined organs, achieving Dice Similarity Coefficient (DSC) scores of 0.97 for the right and left lungs, and 0.95 for the heart. It also demonstrated robustness in organs like the liver (DSC: 0.96) and kidneys (DSC: 0.95 left, 0.95 right), which present more variability. However, segmentation of smaller and complex structures such as the portal and splenic veins (DSC: 0.54) and adrenal glands (DSC: 0.65 left, 0.61 right) revealed the need for further model optimization. Conclusion: The proposed model is a robust, tool for accurate segmentation of 40 anatomical structures in MRI and CT images. By leveraging cross-modality learning and interactive annotation, the model achieves strong performance and generalizability across diverse datasets, making it a valuable resource for researchers and clinicians. It is open source and can be downloaded from https://github.com/hhaentze/MRSegmentator.

We propose DISC-MedLLM, a comprehensive solution that leverages Large Language Models (LLMs) to provide accurate and truthful medical response in end-to-end conversational healthcare services. To construct high-quality Supervised Fine-Tuning (SFT) datasets, we employ three strategies: utilizing medical knowledge-graphs, reconstructing real-world dialogues, and incorporating human-guided preference rephrasing. These datasets are instrumental in training DISC-MedLLM, surpassing existing medical LLMs in both single-turn and multi-turn consultation scenarios. Extensive experimental results demonstrate the effectiveness of the proposed model in bridging the gap between general language models and real-world medical consultation. Additionally, we release the constructed dataset and model weights to further contribute to research and development. Further details and resources can be found at https://github.com/FudanDISC/DISC-MedLLM

A 20% rise in car crashes in 2021 compared to 2020 has been observed as a result of increased distraction and drowsiness. Drowsy and distracted driving are the cause of 45% of all car crashes. As a means to decrease drowsy and distracted driving, detection methods using computer vision can be designed to be low-cost, accurate, and minimally invasive. This work investigated the use of the vision transformer to outperform state-of-the-art accuracy from 3D-CNNs. Two separate transformers were trained for drowsiness and distractedness. The drowsy video transformer model was trained on the National Tsing-Hua University Drowsy Driving Dataset (NTHU-DDD) with a Video Swin Transformer model for 10 epochs on two classes -- drowsy and non-drowsy simulated over 10.5 hours. The distracted video transformer was trained on the Driver Monitoring Dataset (DMD) with Video Swin Transformer for 50 epochs over 9 distraction-related classes. The accuracy of the drowsiness model reached 44% and a high loss value on the test set, indicating overfitting and poor model performance. Overfitting indicates limited training data and applied model architecture lacked quantifiable parameters to learn. The distracted model outperformed state-of-the-art models on DMD reaching 97.5%, indicating that with sufficient data and a strong architecture, transformers are suitable for unfit driving detection. Future research should use newer and stronger models such as TokenLearner to achieve higher accuracy and efficiency, merge existing datasets to expand to detecting drunk driving and road rage to create a comprehensive solution to prevent traffic crashes, and deploying a functioning prototype to revolutionize the automotive safety industry.

Several recent works seek to develop foundation models specifically for medical applications, adapting general-purpose large language models (LLMs) and vision-language models (VLMs) via continued pretraining on publicly available biomedical corpora. These works typically claim that such domain-adaptive pretraining (DAPT) improves performance on downstream medical tasks, such as answering medical licensing exam questions. In this paper, we compare ten public "medical" LLMs and two VLMs against their corresponding base models, arriving at a different conclusion: all medical VLMs and nearly all medical LLMs fail to consistently improve over their base models in the zero-/few-shot prompting and supervised fine-tuning regimes for medical question-answering (QA). For instance, across all tasks and model pairs we consider in the 3-shot setting, medical LLMs only outperform their base models in 22.7% of cases, reach a (statistical) tie in 36.8% of cases, and are significantly worse than their base models in the remaining 40.5% of cases. Our conclusions are based on (i) comparing each medical model head-to-head, directly against the corresponding base model; (ii) optimizing the prompts for each model separately in zero-/few-shot prompting; and (iii) accounting for statistical uncertainty in comparisons. While these basic practices are not consistently adopted in the literature, our ablations show that they substantially impact conclusions. Meanwhile, we find that after fine-tuning on specific QA tasks, medical LLMs can show performance improvements, but the benefits do not carry over to tasks based on clinical notes. Our findings suggest that state-of-the-art general-domain models may already exhibit strong medical knowledge and reasoning capabilities, and offer recommendations to strengthen the conclusions of future studies.

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.

Recent advances in generative models, including large language models (LLMs), vision language models (VLMs), and diffusion models, have accelerated the field of natural language and image processing in medicine and marked a significant paradigm shift in how biomedical models can be developed and deployed. While these models are highly adaptable to new tasks, scaling and evaluating their usage presents new challenges not addressed in previous frameworks. In particular, the ability of these models to produce useful outputs with little to no specialized training data ("zero-" or "few-shot" approaches), as well as the open-ended nature of their outputs, necessitate the development of new guidelines for robust reporting of clinical generative model research. In response to gaps in standards and best practices for the development of clinical AI tools identified by US Executive Order 141103 and several emerging national networks for clinical AI evaluation, we begin to formalize some of these guidelines by building on the original MI-CLAIM checklist. The new checklist, MI-CLAIM-GEN (Table 1), aims to address differences in training, evaluation, interpretability, and reproducibility of new generative models compared to non-generative ("predictive") AI models. This MI-CLAIM-GEN checklist also seeks to clarify cohort selection reporting with unstructured clinical data and adds additional items on alignment with ethical standards for clinical AI research.

With the rapid development of large language models in recent years, there has been an increasing demand for domain-specific Agents that can cater to the unique needs of enterprises and organizations. Unlike general models, which strive for broad coverage, these specialized Agents rely on focused datasets tailored to their intended applications. This research proposes a pipeline that leverages the power of LLMs and the Retrieval-Augmented Generation related framework to construct high-quality instruction datasets for fine-tuning on specific domains using custom document collections. By ingesting domain-specific documents, the pipeline generates relevant and contextually appropriate instructions, thus effectively creating a comprehensive dataset for fine-tuning LLMs on the target domain. This approach overcomes the limitations of traditional dataset creation methods, which often rely on manual curation or web-scraping techniques that may introduce noise and irrelevant data. Notably, our pipeline offers a dynamic solution that can quickly adapt to updates or modifications in the domain-specific document collection, eliminating the need for complete retraining. Additionally, it addresses the challenge of data scarcity by enabling the generation of instruction datasets from a limited set of initial documents, rendering it suitable for unpopular or specialized domains where comprehensive datasets are scarce. As a case study, we apply this approach to the domain of psychiatry, a field requiring specialized knowledge and sensitive handling of patient information. The resulting fine-tuned LLM demonstrates showcases the viability of the proposed approach and underscores its potential for widespread adoption across various industries and domains where tailored, accurate, and contextually relevant language models are indispensable.

Large Language Models (LLMs) have demonstrated remarkable versatility in recent years, offering potential applications across specialized domains such as healthcare and medicine. Despite the availability of various open-source LLMs tailored for health contexts, adapting general-purpose LLMs to the medical domain presents significant challenges. In this paper, we introduce BioMistral, an open-source LLM tailored for the biomedical domain, utilizing Mistral as its foundation model and further pre-trained on PubMed Central. We conduct a comprehensive evaluation of BioMistral on a benchmark comprising 10 established medical question-answering (QA) tasks in English. We also explore lightweight models obtained through quantization and model merging approaches. Our results demonstrate BioMistral's superior performance compared to existing open-source medical models and its competitive edge against proprietary counterparts. Finally, to address the limited availability of data beyond English and to assess the multilingual generalization of medical LLMs, we automatically translated and evaluated this benchmark into 7 other languages. This marks the first large-scale multilingual evaluation of LLMs in the medical domain. Datasets, multilingual evaluation benchmarks, scripts, and all the models obtained during our experiments are freely released.

Multimodal large language models (MLLMs) hold significant potential in medical applications, including disease diagnosis and clinical decision-making. However, these tasks require highly accurate, context-sensitive, and professionally aligned responses, making reliable reward models and judges critical. Despite their importance, medical reward models (MRMs) and judges remain underexplored, with no dedicated benchmarks addressing clinical requirements. Existing benchmarks focus on general MLLM capabilities or evaluate models as solvers, neglecting essential evaluation dimensions like diagnostic accuracy and clinical relevance. To address this, we introduce Med-RewardBench, the first benchmark specifically designed to evaluate MRMs and judges in medical scenarios. Med-RewardBench features a multimodal dataset spanning 13 organ systems and 8 clinical departments, with 1,026 expert-annotated cases. A rigorous three-step process ensures high-quality evaluation data across six clinically critical dimensions. We evaluate 32 state-of-the-art MLLMs, including open-source, proprietary, and medical-specific models, revealing substantial challenges in aligning outputs with expert judgment. Additionally, we develop baseline models that demonstrate substantial performance improvements through fine-tuning.

Developing clinical prediction models (e.g., mortality prediction) based on electronic health records (EHRs) typically relies on expert opinion for feature selection and adjusting observation window size. This burdens experts and creates a bottleneck in the development process. We propose Retrieval-Enhanced Medical prediction model (REMed) to address such challenges. REMed can essentially evaluate an unlimited number of clinical events, select the relevant ones, and make predictions. This approach effectively eliminates the need for manual feature selection and enables an unrestricted observation window. We verified these properties through experiments on 27 clinical tasks and two independent cohorts from publicly available EHR datasets, where REMed outperformed other contemporary architectures that aim to handle as many events as possible. Notably, we found that the preferences of REMed align closely with those of medical experts. We expect our approach to significantly expedite the development of EHR prediction models by minimizing clinicians' need for manual involvement.

Recent advancements in language models (LMs) have led to the emergence of powerful models such as Small LMs (e.g., T5) and Large LMs (e.g., GPT-4). These models have demonstrated exceptional capabilities across a wide range of tasks, such as name entity recognition (NER) in the general domain. (We define SLMs as pre-trained models with fewer parameters compared to models like GPT-3/3.5/4, such as T5, BERT, and others.) Nevertheless, their efficacy in the medical section remains uncertain and the performance of medical NER always needs high accuracy because of the particularity of the field. This paper aims to provide a thorough investigation to compare the performance of LMs in medical few-shot NER and answer How far is LMs from 100\% Few-shot NER in Medical Domain, and moreover to explore an effective entity recognizer to help improve the NER performance. Based on our extensive experiments conducted on 16 NER models spanning from 2018 to 2023, our findings clearly indicate that LLMs outperform SLMs in few-shot medical NER tasks, given the presence of suitable examples and appropriate logical frameworks. Despite the overall superiority of LLMs in few-shot medical NER tasks, it is important to note that they still encounter some challenges, such as misidentification, wrong template prediction, etc. Building on previous findings, we introduce a simple and effective method called RT (Retrieving and Thinking), which serves as retrievers, finding relevant examples, and as thinkers, employing a step-by-step reasoning process. Experimental results show that our proposed RT framework significantly outperforms the strong open baselines on the two open medical benchmark datasets

Large Language Models (LLMs), although powerful in general domains, often perform poorly on domain-specific tasks like medical question answering (QA). Moreover, they tend to function as "black-boxes," making it challenging to modify their behavior. Addressing this, our study delves into model editing utilizing in-context learning, aiming to improve LLM responses without the need for fine-tuning or retraining. Specifically, we propose a comprehensive retrieval strategy to extract medical facts from an external knowledge base, and then we incorporate them into the query prompt for the LLM. Focusing on medical QA using the MedQA-SMILE dataset, we evaluate the impact of different retrieval models and the number of facts provided to the LLM. Notably, our edited Vicuna model exhibited an accuracy improvement from 44.46% to 48.54%. This work underscores the potential of model editing to enhance LLM performance, offering a practical approach to mitigate the challenges of black-box LLMs.

Deep recommender systems (DRS) are intensively applied in modern web services. To deal with the massive web contents, DRS employs a two-stage workflow: retrieval and ranking, to generate its recommendation results. The retriever aims to select a small set of relevant candidates from the entire items with high efficiency; while the ranker, usually more precise but time-consuming, is supposed to further refine the best items from the retrieved candidates. Traditionally, the two components are trained either independently or within a simple cascading pipeline, which is prone to poor collaboration effect. Though some latest works suggested to train retriever and ranker jointly, there still exist many severe limitations: item distribution shift between training and inference, false negative, and misalignment of ranking order. As such, it remains to explore effective collaborations between retriever and ranker.

Named-entity recognition (NER) is fundamental to extracting structured information from the >80% of healthcare data that resides in unstructured clinical notes and biomedical literature. Despite recent advances with large language models, achieving state-of-the-art performance across diverse entity types while maintaining computational efficiency remains a significant challenge. We introduce OpenMed NER, a suite of open-source, domain-adapted transformer models that combine lightweight domain-adaptive pre-training (DAPT) with parameter-efficient Low-Rank Adaptation (LoRA). Our approach performs cost-effective DAPT on a 350k-passage corpus compiled from ethically sourced, publicly available research repositories and de-identified clinical notes (PubMed, arXiv, and MIMIC-III) using DeBERTa-v3, PubMedBERT, and BioELECTRA backbones. This is followed by task-specific fine-tuning with LoRA, which updates less than 1.5% of model parameters. We evaluate our models on 12 established biomedical NER benchmarks spanning chemicals, diseases, genes, and species. OpenMed NER achieves new state-of-the-art micro-F1 scores on 10 of these 12 datasets, with substantial gains across diverse entity types. Our models advance the state-of-the-art on foundational disease and chemical benchmarks (e.g., BC5CDR-Disease, +2.70 pp), while delivering even larger improvements of over 5.3 and 9.7 percentage points on more specialized gene and clinical cell line corpora. This work demonstrates that strategically adapted open-source models can surpass closed-source solutions. This performance is achieved with remarkable efficiency: training completes in under 12 hours on a single GPU with a low carbon footprint (< 1.2 kg CO2e), producing permissively licensed, open-source checkpoints designed to help practitioners facilitate compliance with emerging data protection and AI regulations, such as the EU AI Act.

Medical coding is the task of assigning medical codes to clinical free-text documentation. Healthcare professionals manually assign such codes to track patient diagnoses and treatments. Automated medical coding can considerably alleviate this administrative burden. In this paper, we reproduce, compare, and analyze state-of-the-art automated medical coding machine learning models. We show that several models underperform due to weak configurations, poorly sampled train-test splits, and insufficient evaluation. In previous work, the macro F1 score has been calculated sub-optimally, and our correction doubles it. We contribute a revised model comparison using stratified sampling and identical experimental setups, including hyperparameters and decision boundary tuning. We analyze prediction errors to validate and falsify assumptions of previous works. The analysis confirms that all models struggle with rare codes, while long documents only have a negligible impact. Finally, we present the first comprehensive results on the newly released MIMIC-IV dataset using the reproduced models. We release our code, model parameters, and new MIMIC-III and MIMIC-IV training and evaluation pipelines to accommodate fair future comparisons.

Large language models exhibit promising general capabilities but often lack specialized knowledge for domain-specific tasks. Developing domain experts from a base model enables a range of applications without prohibitive training costs. This work demonstrates a method using continuous training and instruction fine-tuning to rapidly adapt Llama 2 base models to the Chinese medical domain. We first conduct continuous training on 1B tokens from Chinese medical references to teach relevant vocabulary and knowledge. The models are then fine-tuned on 54K examples sourced from the Chinese National Medical Licensing Examination. Experiments on Chinese medical data confirm the effectiveness of this approach, producing a model comparable to GPT-3.5-turbo while using way less computational resource. The resulting domain-specific model could be useful for various Chinese medical applications. More broadly, this provides a template for domain-specific training of large language models in areas where pre-trained models lack the required expertise, such as law, science, and engineering.

Reinforcement Learning (RL) from Human Preference-based feedback is a popular paradigm for fine-tuning generative models, which has produced impressive models such as GPT-4 and Claude3 Opus. This framework often consists of two steps: learning a reward model from an offline preference dataset followed by running online RL to optimize the learned reward model. In this work, leveraging the idea of reset, we propose a new RLHF algorithm with provable guarantees. Motivated by the fact that offline preference dataset provides informative states (i.e., data that is preferred by the labelers), our new algorithm, Dataset Reset Policy Optimization (DR-PO), integrates the existing offline preference dataset into the online policy training procedure via dataset reset: it directly resets the policy optimizer to the states in the offline dataset, instead of always starting from the initial state distribution. In theory, we show that DR-PO learns to perform at least as good as any policy that is covered by the offline dataset under general function approximation with finite sample complexity. In experiments, we demonstrate that on both the TL;DR summarization and the Anthropic Helpful Harmful (HH) dataset, the generation from DR-PO is better than that from Proximal Policy Optimization (PPO) and Direction Preference Optimization (DPO), under the metric of GPT4 win-rate. Code for this work can be found at https://github.com/Cornell-RL/drpo.

In recent years, there is strong emphasis on mining medical data using machine learning techniques. A common problem is to obtain a noiseless set of textual documents, with a relevant content for the research question, and developing a Question Answering (QA) model for a specific medical field. The purpose of this paper is to present a new methodology for building a medical dataset and obtain a QA model for analysis of symptoms and impact on daily life for a specific disease domain. The ``Mental Health'' forum was used, a forum dedicated to people suffering from schizophrenia and different mental disorders. Relevant posts of active users, who regularly participate, were extrapolated providing a new method of obtaining low-bias content and without privacy issues. Furthermore, it is shown how to pre-process the dataset to convert it into a QA dataset. The Bidirectional Encoder Representations from Transformers (BERT), DistilBERT, RoBERTa, and BioBERT models were fine-tuned and evaluated via F1-Score, Exact Match, Precision and Recall. Accurate empirical experiments demonstrated the effectiveness of the proposed method for obtaining an accurate dataset for QA model implementation. By fine-tuning the BioBERT QA model, we achieved an F1 score of 0.885, showing a considerable improvement and outperforming the state-of-the-art model for mental disorders domain.

The objective of personalized medicine is to tailor interventions to an individual patient's unique characteristics. A key technology for this purpose involves medical digital twins, computational models of human biology that can be personalized and dynamically updated to incorporate patient-specific data collected over time. Certain aspects of human biology, such as the immune system, are not easily captured with physics-based models, such as differential equations. Instead, they are often multi-scale, stochastic, and hybrid. This poses a challenge to existing model-based control and optimization approaches that cannot be readily applied to such models. Recent advances in automatic differentiation and neural-network control methods hold promise in addressing complex control problems. However, the application of these approaches to biomedical systems is still in its early stages. This work introduces dynamics-informed neural-network controllers as an alternative approach to control of medical digital twins. As a first use case for this method, the focus is on agent-based models, a versatile and increasingly common modeling platform in biomedicine. The effectiveness of the proposed neural-network control method is illustrated and benchmarked against other methods with two widely-used agent-based model types. The relevance of the method introduced here extends beyond medical digital twins to other complex dynamical systems.

As the capabilities of Large Language Models (LLMs) in healthcare and medicine continue to advance, there is a growing need for competitive open-source models that can safeguard public interest. With the increasing availability of highly competitive open base models, the impact of continued pre-training is increasingly uncertain. In this work, we explore the role of instruct tuning, model merging, alignment, red teaming and advanced inference schemes, as means to improve current open models. To that end, we introduce the Aloe family, a set of open medical LLMs highly competitive within its scale range. Aloe models are trained on the current best base models (Mistral, LLaMA 3), using a new custom dataset which combines public data sources improved with synthetic Chain of Thought (CoT). Aloe models undergo an alignment phase, becoming one of the first few policy-aligned open healthcare LLM using Direct Preference Optimization, setting a new standard for ethical performance in healthcare LLMs. Model evaluation expands to include various bias and toxicity datasets, a dedicated red teaming effort, and a much-needed risk assessment for healthcare LLMs. Finally, to explore the limits of current LLMs in inference, we study several advanced prompt engineering strategies to boost performance across benchmarks, yielding state-of-the-art results for open healthcare 7B LLMs, unprecedented at this scale.