Daily Papers

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.

The bootstrap is a popular data-driven method to quantify statistical uncertainty, but for modern high-dimensional problems, it could suffer from huge computational costs due to the need to repeatedly generate resamples and refit models. We study the use of bootstraps in high-dimensional environments with a small number of resamples. In particular, we show that with a recent "cheap" bootstrap perspective, using a number of resamples as small as one could attain valid coverage even when the dimension grows closely with the sample size, thus strongly supporting the implementability of the bootstrap for large-scale problems. We validate our theoretical results and compare the performance of our approach with other benchmarks via a range of experiments.

Experiments with pre-trained models such as BERT are often based on a single checkpoint. While the conclusions drawn apply to the artifact tested in the experiment (i.e., the particular instance of the model), it is not always clear whether they hold for the more general procedure which includes the architecture, training data, initialization scheme, and loss function. Recent work has shown that repeating the pre-training process can lead to substantially different performance, suggesting that an alternate strategy is needed to make principled statements about procedures. To enable researchers to draw more robust conclusions, we introduce the MultiBERTs, a set of 25 BERT-Base checkpoints, trained with similar hyper-parameters as the original BERT model but differing in random weight initialization and shuffling of training data. We also define the Multi-Bootstrap, a non-parametric bootstrap method for statistical inference designed for settings where there are multiple pre-trained models and limited test data. To illustrate our approach, we present a case study of gender bias in coreference resolution, in which the Multi-Bootstrap lets us measure effects that may not be detected with a single checkpoint. We release our models and statistical library along with an additional set of 140 intermediate checkpoints captured during pre-training to facilitate research on learning dynamics.

We present HealthGPT, a powerful Medical Large Vision-Language Model (Med-LVLM) that integrates medical visual comprehension and generation capabilities within a unified autoregressive paradigm. Our bootstrapping philosophy is to progressively adapt heterogeneous comprehension and generation knowledge to pre-trained large language models (LLMs). This is achieved through a novel heterogeneous low-rank adaptation (H-LoRA) technique, which is complemented by a tailored hierarchical visual perception approach and a three-stage learning strategy. To effectively learn the HealthGPT, we devise a comprehensive medical domain-specific comprehension and generation dataset called VL-Health. Experimental results demonstrate exceptional performance and scalability of HealthGPT in medical visual unified tasks. Our project can be accessed at https://github.com/DCDmllm/HealthGPT.

Assessing sampling uncertainty in extremum estimation can be challenging when the asymptotic variance is not analytically tractable. Bootstrap inference offers a feasible solution but can be computationally costly especially when the model is complex. This paper uses iterates of a specially designed stochastic optimization algorithm as draws from which both point estimates and bootstrap standard errors can be computed in a single run. The draws are generated by the gradient and Hessian computed from batches of data that are resampled at each iteration. We show that these draws yield consistent estimates and asymptotically valid frequentist inference for a large class of regular problems. The algorithm provides accurate standard errors in simulation examples and empirical applications at low computational costs. The draws from the algorithm also provide a convenient way to detect data irregularities.

Clinical diagnosis is critical in medical practice, typically requiring a continuous and evolving process that includes primary diagnosis, differential diagnosis, and final diagnosis. However, most existing clinical diagnostic tasks are single-step processes, which does not align with the complex multi-step diagnostic procedures found in real-world clinical settings. In this paper, we propose a multi-step diagnostic task and annotate a clinical diagnostic dataset (MSDiagnosis). This dataset includes primary diagnosis, differential diagnosis, and final diagnosis questions. Additionally, we propose a novel and effective framework. This framework combines forward inference, backward inference, reflection, and refinement, enabling the LLM to self-evaluate and adjust its diagnostic results. To assess the effectiveness of our proposed method, we design and conduct extensive experiments. The experimental results demonstrate the effectiveness of the proposed method. We also provide a comprehensive experimental analysis and suggest future research directions for this task.

Learning causal graphs from multivariate time series is a ubiquitous challenge in all application domains dealing with time-dependent systems, such as in Earth sciences, biology, or engineering, to name a few. Recent developments for this causal discovery learning task have shown considerable skill, notably the specific time-series adaptations of the popular conditional independence-based learning framework. However, uncertainty estimation is challenging for conditional independence-based methods. Here, we introduce a novel bootstrap approach designed for time series causal discovery that preserves the temporal dependencies and lag structure. It can be combined with a range of time series causal discovery methods and provides a measure of confidence for the links of the time series graphs. Furthermore, next to confidence estimation, an aggregation, also called bagging, of the bootstrapped graphs by majority voting results in bagged causal discovery methods. In this work, we combine this approach with the state-of-the-art conditional-independence-based algorithm PCMCI+. With extensive numerical experiments we empirically demonstrate that, in addition to providing confidence measures for links, Bagged-PCMCI+ improves in precision and recall as compared to its base algorithm PCMCI+, at the cost of higher computational demands. These statistical performance improvements are especially pronounced in the more challenging settings (short time sample size, large number of variables, high autocorrelation). Our bootstrap approach can also be combined with other time series causal discovery algorithms and can be of considerable use in many real-world applications.

Medical imaging plays a pivotal role in modern healthcare, with computed tomography pulmonary angiography (CTPA) being a critical tool for diagnosing pulmonary embolism and other thoracic conditions. However, the complexity of interpreting CTPA scans and generating accurate radiology reports remains a significant challenge. This paper introduces Abn-BLIP (Abnormality-aligned Bootstrapping Language-Image Pretraining), an advanced diagnosis model designed to align abnormal findings to generate the accuracy and comprehensiveness of radiology reports. By leveraging learnable queries and cross-modal attention mechanisms, our model demonstrates superior performance in detecting abnormalities, reducing missed findings, and generating structured reports compared to existing methods. Our experiments show that Abn-BLIP outperforms state-of-the-art medical vision-language models and 3D report generation methods in both accuracy and clinical relevance. These results highlight the potential of integrating multimodal learning strategies for improving radiology reporting. The source code is available at https://github.com/zzs95/abn-blip.

The correct use of model evaluation, model selection, and algorithm selection techniques is vital in academic machine learning research as well as in many industrial settings. This article reviews different techniques that can be used for each of these three subtasks and discusses the main advantages and disadvantages of each technique with references to theoretical and empirical studies. Further, recommendations are given to encourage best yet feasible practices in research and applications of machine learning. Common methods such as the holdout method for model evaluation and selection are covered, which are not recommended when working with small datasets. Different flavors of the bootstrap technique are introduced for estimating the uncertainty of performance estimates, as an alternative to confidence intervals via normal approximation if bootstrapping is computationally feasible. Common cross-validation techniques such as leave-one-out cross-validation and k-fold cross-validation are reviewed, the bias-variance trade-off for choosing k is discussed, and practical tips for the optimal choice of k are given based on empirical evidence. Different statistical tests for algorithm comparisons are presented, and strategies for dealing with multiple comparisons such as omnibus tests and multiple-comparison corrections are discussed. Finally, alternative methods for algorithm selection, such as the combined F-test 5x2 cross-validation and nested cross-validation, are recommended for comparing machine learning algorithms when datasets are small.

Clinical diagnosis is a highly specialized discipline requiring both domain expertise and strict adherence to rigorous guidelines. While current AI-driven medical research predominantly focuses on knowledge graphs or natural text pretraining paradigms to incorporate medical knowledge, these approaches primarily rely on implicitly encoded knowledge within model parameters, neglecting task-specific knowledge required by diverse downstream tasks. To address this limitation, we propose Retrieval-Augmented Diagnosis (RAD), a novel framework that explicitly injects external knowledge into multimodal models directly on downstream tasks. Specifically, RAD operates through three key mechanisms: retrieval and refinement of disease-centered knowledge from multiple medical sources, a guideline-enhanced contrastive loss that constrains the latent distance between multi-modal features and guideline knowledge, and the dual transformer decoder that employs guidelines as queries to steer cross-modal fusion, aligning the models with clinical diagnostic workflows from guideline acquisition to feature extraction and decision-making. Moreover, recognizing the lack of quantitative evaluation of interpretability for multimodal diagnostic models, we introduce a set of criteria to assess the interpretability from both image and text perspectives. Extensive evaluations across four datasets with different anatomies demonstrate RAD's generalizability, achieving state-of-the-art performance. Furthermore, RAD enables the model to concentrate more precisely on abnormal regions and critical indicators, ensuring evidence-based, trustworthy diagnosis. Our code is available at https://github.com/tdlhl/RAD.

We present an efficient algorithm for simultaneously training sparse generalized linear models across many related problems, which may arise from bootstrapping, cross-validation and nonparametric permutation testing. Our approach leverages the redundancies across problems to obtain significant computational improvements relative to solving the problems sequentially by a conventional algorithm. We demonstrate our fast simultaneous training of generalized linear models (FaSTGLZ) algorithm on a number of real-world datasets, and we run otherwise computationally intensive bootstrapping and permutation test analyses that are typically necessary for obtaining statistically rigorous classification results and meaningful interpretation. Code is freely available at http://liinc.bme.columbia.edu/fastglz.

Conventional multi-label classification (MLC) methods assume that all samples are fully labeled and identically distributed. Unfortunately, this assumption is unrealistic in large-scale MLC data that has long-tailed (LT) distribution and partial labels (PL). To address the problem, we introduce a novel task, Partial labeling and Long-Tailed Multi-Label Classification (PLT-MLC), to jointly consider the above two imperfect learning environments. Not surprisingly, we find that most LT-MLC and PL-MLC approaches fail to solve the PLT-MLC, resulting in significant performance degradation on the two proposed PLT-MLC benchmarks. Therefore, we propose an end-to-end learning framework: COrrection rightarrow ModificatIon rightarrow balanCe, abbreviated as \method{}. Our bootstrapping philosophy is to simultaneously correct the missing labels (Correction) with convinced prediction confidence over a class-aware threshold and to learn from these recall labels during training. We next propose a novel multi-focal modifier loss that simultaneously addresses head-tail imbalance and positive-negative imbalance to adaptively modify the attention to different samples (Modification) under the LT class distribution. In addition, we develop a balanced training strategy by distilling the model's learning effect from head and tail samples, and thus design a balanced classifier (Balance) conditioned on the head and tail learning effect to maintain stable performance for all samples. Our experimental study shows that the proposed significantly outperforms general MLC, LT-MLC and PL-MLC methods in terms of effectiveness and robustness on our newly created PLT-MLC datasets.

In this paper, we present a framework for training large language models (LLMs) as diagnostic agents with reinforcement learning, enabling them to manage multi-turn diagnostic processes, adaptively select examinations, and commit to final diagnoses. Unlike instruction-tuned models trained on static case summaries, our method acquires diagnostic strategies through interactive exploration and outcome-based feedback. Our contributions are fourfold: (i) We present DiagGym, a diagnostics world model trained with electronic health records that emits examination outcomes conditioned on patient history and recommended examination, serving as a virtual clinical environment for realistic diagnosis training and evaluation; (ii) We train DiagAgent via end-to-end, multi-turn reinforcement learning to learn diagnostic policies that optimize both information yield and diagnostic accuracy; (iii) We introduce DiagBench, a diagnostic benchmark comprising 750 cases with physician-validated examination recommendations and 99 cases annotated with 973 physician-written rubrics on diagnosis process; (iv) we demonstrate superior performance across diverse diagnostic settings. DiagAgent significantly outperforms 10 state-of-the-art LLMs, including DeepSeek-v3 and GPT-4o, as well as two prompt-engineered agents. In single-turn settings, DiagAgent achieves 9.34% higher diagnostic accuracy and 44.03% improvement in examination recommendation hit ratio. In end-to-end settings, it delivers 15.12% increase in diagnostic accuracy and 23.09% boost in examination recommendation F1 score. In rubric-based evaluation, it surpasses the next-best model, Claude-sonnet-4, by 7.1% in weighted rubric score. These findings indicate that learning policies in interactive clinical environments confers dynamic and clinically meaningful diagnostic management abilities unattainable through passive training alone.

Reliable uncertainty quantification remains a central challenge in predictive modeling. While Bayesian methods are theoretically appealing, their predictive intervals can exhibit poor frequentist calibration, particularly with small sample sizes or model misspecification. We introduce a practical and broadly applicable Bayesian conformal approach based on the influence-function Bayesian bootstrap (BB) with data-driven tuning of the Dirichlet concentration parameter, α. By efficiently approximating the Bayesian bootstrap predictive distribution via influence functions and calibrating α to optimize empirical coverage or average log-probability, our method constructs prediction intervals and distributions that are both well-calibrated and sharp. Across a range of regression models and data settings, this Bayesian conformal framework consistently yields improved empirical coverage and log-score compared to standard Bayesian posteriors. Our procedure is fast, easy to implement, and offers a flexible approach for distributional calibration in predictive modeling.

This paper explores the use of latent bootstrapping, an alternative self-supervision technique, for pretraining language models. Unlike the typical practice of using self-supervision on discrete subwords, latent bootstrapping leverages contextualized embeddings for a richer supervision signal. We conduct experiments to assess how effective this approach is for acquiring linguistic knowledge from limited resources. Specifically, our experiments are based on the BabyLM shared task, which includes pretraining on two small curated corpora and an evaluation on four linguistic benchmarks.

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.

The learning and deployment of long-LLMs remains a challenging problem despite recent progresses. In this work, we argue that the long-LLMs are not a necessity to solve long-context tasks, as common long-context tasks are short-context solvable, i.e. they can be solved by purely working with oracle short-contexts within the long-context tasks' inputs. On top of this argument, we propose a framework called LC-Boost (Long-Context Bootstrapper), which enables a short-LLM to address the long-context tasks in a bootstrapping manner. In our framework, the short-LLM prompts itself to reason for two critical decisions: 1) how to access to the appropriate part of context within the input, 2) how to make effective use of the accessed context. By adaptively accessing and utilizing the context based on the presented tasks, LC-Boost can serve as a general framework to handle diversified long-context processing problems. We comprehensively evaluate different types of tasks from popular long-context benchmarks, where LC-Boost is able to achieve a substantially improved performance with a much smaller consumption of resource.

Recent advancements in Large Language Models (LLMs) have demonstrated significant promise in clinical diagnosis. However, current models struggle to emulate the iterative, diagnostic hypothesis-driven reasoning of real clinical scenarios. Specifically, current LLMs suffer from three critical limitations: (1) generating hallucinated medical content due to weak grounding in verified knowledge, (2) asking redundant or inefficient questions rather than discriminative ones that hinder diagnostic progress, and (3) losing coherence over multi-turn dialogues, leading to contradictory or inconsistent conclusions. To address these challenges, we propose MedKGI, a diagnostic framework grounded in clinical practices. MedKGI integrates a medical knowledge graph (KG) to constrain reasoning to validated medical ontologies, selects questions based on information gain to maximize diagnostic efficiency, and adopts an OSCE-format structured state to maintain consistent evidence tracking across turns. Experiments on clinical benchmarks show that MedKGI outperforms strong LLM baselines in both diagnostic accuracy and inquiry efficiency, improving dialogue efficiency by 30% on average while maintaining state-of-the-art accuracy.

Monitoring machine learning models once they are deployed is challenging. It is even more challenging to decide when to retrain models in real-case scenarios when labeled data is beyond reach, and monitoring performance metrics becomes unfeasible. In this work, we use non-parametric bootstrapped uncertainty estimates and SHAP values to provide explainable uncertainty estimation as a technique that aims to monitor the deterioration of machine learning models in deployment environments, as well as determine the source of model deterioration when target labels are not available. Classical methods are purely aimed at detecting distribution shift, which can lead to false positives in the sense that the model has not deteriorated despite a shift in the data distribution. To estimate model uncertainty we construct prediction intervals using a novel bootstrap method, which improves upon the work of Kumar & Srivastava (2012). We show that both our model deterioration detection system as well as our uncertainty estimation method achieve better performance than the current state-of-the-art. Finally, we use explainable AI techniques to gain an understanding of the drivers of model deterioration. We release an open source Python package, doubt, which implements our proposed methods, as well as the code used to reproduce our experiments.

Clinical diagnosis prediction models, when provided with a patient's medical history, aim to detect potential diseases early, facilitating timely intervention and improving prognostic outcomes. However, the inherent scarcity of patient data and large disease candidate space often pose challenges in developing satisfactory models for this intricate task. The exploration of leveraging Large Language Models (LLMs) for encapsulating clinical decision processes has been limited. We introduce MERA, a clinical diagnosis prediction model that bridges pertaining natural language knowledge with medical practice. We apply hierarchical contrastive learning on a disease candidate ranking list to alleviate the large decision space issue. With concept memorization through fine-tuning, we bridge the natural language clinical knowledge with medical codes. Experimental results on MIMIC-III and IV datasets show that MERA achieves the state-of-the-art diagnosis prediction performance and dramatically elevates the diagnosis prediction capabilities of generative LMs.

The field of medical diagnosis has undergone a significant transformation with the advent of large language models (LLMs), yet the challenges of interpretability within these models remain largely unaddressed. This study introduces Chain-of-Diagnosis (CoD) to enhance the interpretability of LLM-based medical diagnostics. CoD transforms the diagnostic process into a diagnostic chain that mirrors a physician's thought process, providing a transparent reasoning pathway. Additionally, CoD outputs the disease confidence distribution to ensure transparency in decision-making. This interpretability makes model diagnostics controllable and aids in identifying critical symptoms for inquiry through the entropy reduction of confidences. With CoD, we developed DiagnosisGPT, capable of diagnosing 9604 diseases. Experimental results demonstrate that DiagnosisGPT outperforms other LLMs on diagnostic benchmarks. Moreover, DiagnosisGPT provides interpretability while ensuring controllability in diagnostic rigor.

The differential diagnosis of neurodegenerative dementias is a challenging clinical task, mainly because of the overlap in symptom presentation and the similarity of patterns observed in structural neuroimaging. To improve diagnostic efficiency and accuracy, deep learning-based methods such as Convolutional Neural Networks and Vision Transformers have been proposed for the automatic classification of brain MRIs. However, despite their strong predictive performance, these models find limited clinical utility due to their opaque decision making. In this work, we propose a framework that integrates two core components to enhance diagnostic transparency. First, we introduce a modular pipeline for converting 3D T1-weighted brain MRIs into textual radiology reports. Second, we explore the potential of modern Large Language Models (LLMs) to assist clinicians in the differential diagnosis between Frontotemporal dementia subtypes, Alzheimer's disease, and normal aging based on the generated reports. To bridge the gap between predictive accuracy and explainability, we employ reinforcement learning to incentivize diagnostic reasoning in LLMs. Without requiring supervised reasoning traces or distillation from larger models, our approach enables the emergence of structured diagnostic rationales grounded in neuroimaging findings. Unlike post-hoc explainability methods that retrospectively justify model decisions, our framework generates diagnostic rationales as part of the inference process-producing causally grounded explanations that inform and guide the model's decision-making process. In doing so, our framework matches the diagnostic performance of existing deep learning methods while offering rationales that support its diagnostic conclusions.

Natural Language Processing (NLP) systems are increasingly taking the form of multi-stage pipelines involving multiple distinct language models (LMs) and prompting strategies. Here we address the question of how to fine-tune such systems to improve their performance. We cast this as a problem of optimizing the underlying LM weights and the prompting strategies together, and consider a challenging but highly realistic scenario in which we have no gold labels for any intermediate stages in the pipeline. To address this challenge, we evaluate approximate optimization strategies in which we bootstrap training labels for all pipeline stages and use these to optimize the pipeline's prompts and fine-tune its weights alternatingly. In experiments with multi-hop QA, mathematical reasoning, and feature-based classification, we find that simple approaches for optimizing the prompts and weights together outperform directly optimizing weights alone and prompts alone by up to 65% and 5%, respectively, on average across LMs and tasks. We will release our new optimizers in DSPy at http://dspy.ai

We study the problem of optimizing biological sequences, e.g., proteins, DNA, and RNA, to maximize a black-box score function that is only evaluated in an offline dataset. We propose a novel solution, bootstrapped training of score-conditioned generator (BootGen) algorithm. Our algorithm repeats a two-stage process. In the first stage, our algorithm trains the biological sequence generator with rank-based weights to enhance the accuracy of sequence generation based on high scores. The subsequent stage involves bootstrapping, which augments the training dataset with self-generated data labeled by a proxy score function. Our key idea is to align the score-based generation with a proxy score function, which distills the knowledge of the proxy score function to the generator. After training, we aggregate samples from multiple bootstrapped generators and proxies to produce a diverse design. Extensive experiments show that our method outperforms competitive baselines on biological sequential design tasks. We provide reproducible source code: https://github.com/kaist-silab/bootgen{https://github.com/kaist-silab/bootgen}.

The ROC curve is the major tool for assessing not only the performance but also the fairness properties of a similarity scoring function. In order to draw reliable conclusions based on empirical ROC analysis, accurately evaluating the uncertainty level related to statistical versions of the ROC curves of interest is absolutely necessary, especially for applications with considerable societal impact such as Face Recognition. In this article, we prove asymptotic guarantees for empirical ROC curves of similarity functions as well as for by-product metrics useful to assess fairness. We also explain that, because the false acceptance/rejection rates are of the form of U-statistics in the case of similarity scoring, the naive bootstrap approach may jeopardize the assessment procedure. A dedicated recentering technique must be used instead. Beyond the theoretical analysis carried out, various experiments using real face image datasets provide strong empirical evidence of the practical relevance of the methods promoted here, when applied to several ROC-based measures such as popular fairness metrics.

Assessing scientific claims requires identifying, extracting, and reasoning with multimodal data expressed in information-rich figures in scientific literature. Despite the large body of work in scientific QA, figure captioning, and other multimodal reasoning tasks over chart-based data, there are no readily usable multimodal benchmarks that directly test claim verification abilities. To remedy this gap, we introduce a new benchmark MuSciClaims accompanied by diagnostics tasks. We automatically extract supported claims from scientific articles, which we manually perturb to produce contradicted claims. The perturbations are designed to test for a specific set of claim verification capabilities. We also introduce a suite of diagnostic tasks that help understand model failures. Our results show most vision-language models are poor (~0.3-0.5 F1), with even the best model only achieving 0.72 F1. They are also biased towards judging claims as supported, likely misunderstanding nuanced perturbations within the claims. Our diagnostics show models are bad at localizing correct evidence within figures, struggle with aggregating information across modalities, and often fail to understand basic components of the figure.

Large language models (LLMs) often generate outdated or inaccurate information based on static training datasets. Retrieval-augmented generation (RAG) mitigates this by integrating outside data sources. While previous RAG systems used pre-assembled, fixed databases with limited flexibility, we have developed Radiology RAG (RadioRAG), an end-to-end framework that retrieves data from authoritative radiologic online sources in real-time. We evaluate the diagnostic accuracy of various LLMs when answering radiology-specific questions with and without access to additional online information via RAG. Using 80 questions from the RSNA Case Collection across radiologic subspecialties and 24 additional expert-curated questions with reference standard answers, LLMs (GPT-3.5-turbo, GPT-4, Mistral-7B, Mixtral-8x7B, and Llama3 [8B and 70B]) were prompted with and without RadioRAG in a zero-shot inference scenario RadioRAG retrieved context-specific information from Radiopaedia in real-time. Accuracy was investigated. Statistical analyses were performed using bootstrapping. The results were further compared with human performance. RadioRAG improved diagnostic accuracy across most LLMs, with relative accuracy increases ranging up to 54% for different LLMs. It matched or exceeded non-RAG models and the human radiologist in question answering across radiologic subspecialties, particularly in breast imaging and emergency radiology. However, the degree of improvement varied among models; GPT-3.5-turbo and Mixtral-8x7B-instruct-v0.1 saw notable gains, while Mistral-7B-instruct-v0.2 showed no improvement, highlighting variability in RadioRAG's effectiveness. LLMs benefit when provided access to domain-specific data beyond their training data. RadioRAG shows potential to improve LLM accuracy and factuality in radiology question answering by integrating real-time domain-specific data.

Accurate diagnosis with medical large language models is hindered by knowledge gaps and hallucinations. Retrieval and tool-augmented methods help, but their impact is limited by weak use of external knowledge and poor feedback-reasoning traceability. To address these challenges, We introduce Deep-DxSearch, an agentic RAG system trained end-to-end with reinforcement learning (RL) that enables steer tracebale retrieval-augmented reasoning for medical diagnosis. In Deep-DxSearch, we first construct a large-scale medical retrieval corpus comprising patient records and reliable medical knowledge sources to support retrieval-aware reasoning across diagnostic scenarios. More crutially, we frame the LLM as the core agent and the retrieval corpus as its environment, using tailored rewards on format, retrieval, reasoning structure, and diagnostic accuracy, thereby evolving the agentic RAG policy from large-scale data through RL. Experiments demonstrate that our end-to-end agentic RL training framework consistently outperforms prompt-engineering and training-free RAG approaches across multiple data centers. After training, Deep-DxSearch achieves substantial gains in diagnostic accuracy, surpassing strong diagnostic baselines such as GPT-4o, DeepSeek-R1, and other medical-specific frameworks for both common and rare disease diagnosis under in-distribution and out-of-distribution settings. Moreover, ablation studies on reward design and retrieval corpus components confirm their critical roles, underscoring the uniqueness and effectiveness of our approach compared with traditional implementations. Finally, case studies and interpretability analyses highlight improvements in Deep-DxSearch's diagnostic policy, providing deeper insight into its performance gains and supporting clinicians in delivering more reliable and precise preliminary diagnoses. See https://github.com/MAGIC-AI4Med/Deep-DxSearch.

Self-alignment is an effective way to reduce the cost of human annotation while ensuring promising model capability. However, most current methods complete the data collection and training steps in a single round, which may overlook the continuously improving ability of self-aligned models. This gives rise to a key query: What if we do multi-time bootstrapping self-alignment? Does this strategy enhance model performance or lead to rapid degradation? In this paper, our pioneering exploration delves into the impact of bootstrapping self-alignment on large language models. Our findings reveal that bootstrapping self-alignment markedly surpasses the single-round approach, by guaranteeing data diversity from in-context learning. To further exploit the capabilities of bootstrapping, we investigate and adjust the training order of data, which yields improved performance of the model. Drawing on these findings, we propose Step-On-Feet Tuning (SOFT) which leverages model's continuously enhanced few-shot ability to boost zero or one-shot performance. Based on easy-to-hard training recipe, we propose SOFT+ which further boost self-alignment's performance. Our experiments demonstrate the efficiency of SOFT (SOFT+) across various classification and generation tasks, highlighting the potential of bootstrapping self-alignment on continually enhancing model alignment performance.

This paper introduces a structural equation formulation that gives rise to a new family of quasi-periodic Gaussian processes, useful to process a broad class of natural and physiological signals. The proposed formulation simplifies generation and forecasting, and provides hyperparameter estimates, which we exploit in a convergent and consistent iterative estimation algorithm. A bootstrap approach for standard error estimation and confidence intervals is also provided. We demonstrate the computational and scaling benefits of the proposed approach on a broad class of problems, including water level tidal analysis, CO_{2} emission data, and sunspot numbers data. By leveraging the structural equations, our method reduces the cost of likelihood evaluations and predictions from O(k^2 p^2) to O(p^2), significantly improving scalability.

Automated diagnosis prediction from medical images is a valuable resource to support clinical decision-making. However, such systems usually need to be trained on large amounts of annotated data, which often is scarce in the medical domain. Zero-shot methods address this challenge by allowing a flexible adaption to new settings with different clinical findings without relying on labeled data. Further, to integrate automated diagnosis in the clinical workflow, methods should be transparent and explainable, increasing medical professionals' trust and facilitating correctness verification. In this work, we introduce Xplainer, a novel framework for explainable zero-shot diagnosis in the clinical setting. Xplainer adapts the classification-by-description approach of contrastive vision-language models to the multi-label medical diagnosis task. Specifically, instead of directly predicting a diagnosis, we prompt the model to classify the existence of descriptive observations, which a radiologist would look for on an X-Ray scan, and use the descriptor probabilities to estimate the likelihood of a diagnosis. Our model is explainable by design, as the final diagnosis prediction is directly based on the prediction of the underlying descriptors. We evaluate Xplainer on two chest X-ray datasets, CheXpert and ChestX-ray14, and demonstrate its effectiveness in improving the performance and explainability of zero-shot diagnosis. Our results suggest that Xplainer provides a more detailed understanding of the decision-making process and can be a valuable tool for clinical diagnosis.

We present Diversity-Aware Meta Visual Prompting~(DAM-VP), an efficient and effective prompting method for transferring pre-trained models to downstream tasks with frozen backbone. A challenging issue in visual prompting is that image datasets sometimes have a large data diversity whereas a per-dataset generic prompt can hardly handle the complex distribution shift toward the original pretraining data distribution properly. To address this issue, we propose a dataset Diversity-Aware prompting strategy whose initialization is realized by a Meta-prompt. Specifically, we cluster the downstream dataset into small homogeneity subsets in a diversity-adaptive way, with each subset has its own prompt optimized separately. Such a divide-and-conquer design reduces the optimization difficulty greatly and significantly boosts the prompting performance. Furthermore, all the prompts are initialized with a meta-prompt, which is learned across several datasets. It is a bootstrapped paradigm, with the key observation that the prompting knowledge learned from previous datasets could help the prompt to converge faster and perform better on a new dataset. During inference, we dynamically select a proper prompt for each input, based on the feature distance between the input and each subset. Through extensive experiments, our DAM-VP demonstrates superior efficiency and effectiveness, clearly surpassing previous prompting methods in a series of downstream datasets for different pretraining models. Our code is available at: https://github.com/shikiw/DAM-VP.

We use tools from geometric statistics to analyze the usual estimation procedure of a template shape. This applies to shapes from landmarks, curves, surfaces, images etc. We demonstrate the asymptotic bias of the template shape estimation using the stratified geometry of the shape space. We give a Taylor expansion of the bias with respect to a parameter sigma describing the measurement error on the data. We propose two bootstrap procedures that quantify the bias and correct it, if needed. They are applicable for any type of shape data. We give a rule of thumb to provide intuition on whether the bias has to be corrected. This exhibits the parameters that control the bias' magnitude. We illustrate our results on simulated and real shape data.

A plethora of sentence embedding models makes it challenging to choose one, especially for domains such as telecom, rich with specialized vocabulary. We evaluate multiple embeddings obtained from publicly available models and their domain-adapted variants, on both point retrieval accuracies as well as their (95\%) confidence intervals. We establish a systematic method to obtain thresholds for similarity scores for different embeddings. We observe that fine-tuning improves mean bootstrapped accuracies as well as tightens confidence intervals. The pre-training combined with fine-tuning makes confidence intervals even tighter. To understand these variations, we analyse and report significant correlations between the distributional overlap between top-K, correct and random sentence similarities with retrieval accuracies and similarity thresholds. Following current literature, we analyze if retrieval accuracy variations can be attributed to isotropy of embeddings. Our conclusions are that isotropy of embeddings (as measured by two independent state-of-the-art isotropy metric definitions) cannot be attributed to better retrieval performance. However, domain adaptation which improves retrieval accuracies also improves isotropy. We establish that domain adaptation moves domain specific embeddings further away from general domain embeddings.

Automatic medical report generation (MRG) is of great research value as it has the potential to relieve radiologists from the heavy burden of report writing. Despite recent advancements, accurate MRG remains challenging due to the need for precise clinical understanding and the identification of clinical findings. Moreover, the imbalanced distribution of diseases makes the challenge even more pronounced, as rare diseases are underrepresented in training data, making their diagnostic performance unreliable. To address these challenges, we propose diagnosis-driven prompts for medical report generation (PromptMRG), a novel framework that aims to improve the diagnostic accuracy of MRG with the guidance of diagnosis-aware prompts. Specifically, PromptMRG is based on encoder-decoder architecture with an extra disease classification branch. When generating reports, the diagnostic results from the classification branch are converted into token prompts to explicitly guide the generation process. To further improve the diagnostic accuracy, we design cross-modal feature enhancement, which retrieves similar reports from the database to assist the diagnosis of a query image by leveraging the knowledge from a pre-trained CLIP. Moreover, the disease imbalanced issue is addressed by applying an adaptive logit-adjusted loss to the classification branch based on the individual learning status of each disease, which overcomes the barrier of text decoder's inability to manipulate disease distributions. Experiments on two MRG benchmarks show the effectiveness of the proposed method, where it obtains state-of-the-art clinical efficacy performance on both datasets.

In natural language processing, a recently popular line of work explores how to best report the experimental results of neural networks. One exemplar publication, titled "Show Your Work: Improved Reporting of Experimental Results," advocates for reporting the expected validation effectiveness of the best-tuned model, with respect to the computational budget. In the present work, we critically examine this paper. As far as statistical generalizability is concerned, we find unspoken pitfalls and caveats with this approach. We analytically show that their estimator is biased and uses error-prone assumptions. We find that the estimator favors negative errors and yields poor bootstrapped confidence intervals. We derive an unbiased alternative and bolster our claims with empirical evidence from statistical simulation. Our codebase is at http://github.com/castorini/meanmax.

This paper presents the key algorithmic techniques behind CatBoost, a new gradient boosting toolkit. Their combination leads to CatBoost outperforming other publicly available boosting implementations in terms of quality on a variety of datasets. Two critical algorithmic advances introduced in CatBoost are the implementation of ordered boosting, a permutation-driven alternative to the classic algorithm, and an innovative algorithm for processing categorical features. Both techniques were created to fight a prediction shift caused by a special kind of target leakage present in all currently existing implementations of gradient boosting algorithms. In this paper, we provide a detailed analysis of this problem and demonstrate that proposed algorithms solve it effectively, leading to excellent empirical results.

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.

Frontier AI models have achieved remarkable progress, yet recent studies suggest they struggle with compositional reasoning, often performing at or below random chance on established benchmarks. We revisit this problem and show that widely used evaluation metrics systematically underestimate model capability. To address this, we introduce a group matching score that better exploits group structure and reveals substantial hidden capability in both contrastive vision-language models (VLMs) and multimodal large language models (MLLMs). Moreover, simply overfitting to the induced group matchings at test time transfers this hidden capability into higher scores under standard evaluation metrics, closing much of the reported gap. This adjustment enables SigLIP-B16 to surpass all previous results and GPT-4.1 to yield the first result surpassing estimated human performance on Winoground. Building on this insight, we propose Test-Time Matching (TTM), an iterative, self-improving algorithm that further bootstraps model performance without any external supervision. TTM delivers additional, non-trivial improvements: for example, TTM enables SigLIP-B16 to surpass GPT-4.1 on MMVP-VLM, establishing a new state of the art. Importantly, TTM remains broadly effective even on benchmarks without metric-induced effects or group structures, achieving relative gains up to 85.7% on challenging datasets such as WhatsUp. Across 16 dataset variants spanning diverse setups, our experiments demonstrate that TTM consistently improves model performance and advances the frontier of compositional reasoning.

Large language models (LLMs) can achieve highly effective performance on various reasoning tasks by incorporating step-by-step chain-of-thought (CoT) prompting as demonstrations. However, the reasoning chains of demonstrations generated by LLMs are prone to errors, which can subsequently lead to incorrect reasoning during inference. Furthermore, inappropriate exemplars (overly simplistic or complex), can affect overall performance among varying levels of difficulty. We introduce Iter-CoT (Iterative bootstrapping in Chain-of-Thoughts Prompting), an iterative bootstrapping approach for selecting exemplars and generating reasoning chains. By utilizing iterative bootstrapping, our approach enables LLMs to autonomously rectify errors, resulting in more precise and comprehensive reasoning chains. Simultaneously, our approach selects challenging yet answerable questions accompanied by reasoning chains as exemplars with a moderate level of difficulty, which enhances the LLMs' generalizability across varying levels of difficulty. Experimental results indicate that Iter-CoT exhibits superiority, achieving competitive performance across three distinct reasoning tasks on ten datasets.

The recent surge of foundation models in computer vision and natural language processing opens up perspectives in utilizing multi-modal clinical data to train large models with strong generalizability. Yet pathological image datasets often lack biomedical text annotation and enrichment. Guiding data-efficient image diagnosis from the use of biomedical text knowledge becomes a substantial interest. In this paper, we propose to Connect Image and Text Embeddings (CITE) to enhance pathological image classification. CITE injects text insights gained from language models pre-trained with a broad range of biomedical texts, leading to adapt foundation models towards pathological image understanding. Through extensive experiments on the PatchGastric stomach tumor pathological image dataset, we demonstrate that CITE achieves leading performance compared with various baselines especially when training data is scarce. CITE offers insights into leveraging in-domain text knowledge to reinforce data-efficient pathological image classification. Code is available at https://github.com/Yunkun-Zhang/CITE.

Automatic disease diagnosis has become increasingly valuable in clinical practice. The advent of large language models (LLMs) has catalyzed a paradigm shift in artificial intelligence, with growing evidence supporting the efficacy of LLMs in diagnostic tasks. Despite the increasing attention in this field, a holistic view is still lacking. Many critical aspects remain unclear, such as the diseases and clinical data to which LLMs have been applied, the LLM techniques employed, and the evaluation methods used. In this article, we perform a comprehensive review of LLM-based methods for disease diagnosis. Our review examines the existing literature across various dimensions, including disease types and associated clinical specialties, clinical data, LLM techniques, and evaluation methods. Additionally, we offer recommendations for applying and evaluating LLMs for diagnostic tasks. Furthermore, we assess the limitations of current research and discuss future directions. To our knowledge, this is the first comprehensive review for LLM-based disease diagnosis.

The emergence of vision-language models (VLMs) has opened new possibilities for clinical reasoning and has shown promising performance in dermatological diagnosis. However, their trustworthiness and clinical utility are often limited by three major factors: (1) Data heterogeneity, where diverse datasets lack consistent diagnostic labels and clinical concept annotations; (2) Absence of grounded diagnostic rationales, leading to a scarcity of reliable reasoning supervision; and (3) Limited scalability and generalization, as models trained on small, densely annotated datasets struggle to transfer nuanced reasoning to large, sparsely-annotated ones. To address these limitations, we propose SkinR1, a novel dermatological VLM that combines deep, textbook-based reasoning with the broad generalization capabilities of reinforcement learning (RL). SkinR1 systematically resolves the key challenges through a unified, end-to-end framework. First, we design a textbook-based reasoning generator that synthesizes high-fidelity, hierarchy-aware, and differential-diagnosis (DDx)-informed trajectories, providing reliable expert-level supervision. Second, we leverage the constructed trajectories for supervised fine-tuning (SFT) empowering the model with grounded reasoning ability. Third, we develop a novel RL paradigm that, by incorporating the hierarchical structure of diseases, effectively transfers these grounded reasoning patterns to large-scale, sparse data. Extensive experiments on multiple dermatology datasets demonstrate that SkinR1 achieves superior diagnostic accuracy. The ablation study demonstrates the importance of the reasoning foundation instilled by SFT.

Webly supervised learning has attracted increasing attention for its effectiveness in exploring publicly accessible data at scale without manual annotation. However, most existing methods of learning with web datasets are faced with challenges from label noise, and they have limited assumptions on clean samples under various noise. For instance, web images retrieved with queries of tiger cat (a cat species) and drumstick (a musical instrument) are almost dominated by images of tigers and chickens, which exacerbates the challenge of fine-grained visual concept learning. In this case, exploiting both web images and their associated texts is a requisite solution to combat real-world noise. In this paper, we propose Cross-modality Aligned Prototypes (CAPro), a unified prototypical contrastive learning framework to learn visual representations with correct semantics. For one thing, we leverage textual prototypes, which stem from the distinct concept definition of classes, to select clean images by text matching and thus disambiguate the formation of visual prototypes. For another, to handle missing and mismatched noisy texts, we resort to the visual feature space to complete and enhance individual texts and thereafter improve text matching. Such semantically aligned visual prototypes are further polished up with high-quality samples, and engaged in both cluster regularization and noise removal. Besides, we propose collective bootstrapping to encourage smoother and wiser label reference from appearance-similar instances in a manner of dictionary look-up. Extensive experiments on WebVision1k and NUS-WIDE (Web) demonstrate that CAPro well handles realistic noise under both single-label and multi-label scenarios. CAPro achieves new state-of-the-art performance and exhibits robustness to open-set recognition. Codes are available at https://github.com/yuleiqin/capro.

Minimum Bayes risk (MBR) decoding outputs the hypothesis with the highest expected utility over the model distribution for some utility function. It has been shown to improve accuracy over beam search in conditional language generation problems and especially neural machine translation, in both human and automatic evaluations. However, the standard sampling-based algorithm for MBR is substantially more computationally expensive than beam search, requiring a large number of samples as well as a quadratic number of calls to the utility function, limiting its applicability. We describe an algorithm for MBR which gradually grows the number of samples used to estimate the utility while pruning hypotheses that are unlikely to have the highest utility according to confidence estimates obtained with bootstrap sampling. Our method requires fewer samples and drastically reduces the number of calls to the utility function compared to standard MBR while being statistically indistinguishable in terms of accuracy. We demonstrate the effectiveness of our approach in experiments on three language pairs, using chrF++ and COMET as utility/evaluation metrics.

Despite the great interest in the bandit problem, designing efficient algorithms for complex models remains challenging, as there is typically no analytical way to quantify uncertainty. In this paper, we propose Multiplier Bootstrap-based Exploration (MBE), a novel exploration strategy that is applicable to any reward model amenable to weighted loss minimization. We prove both instance-dependent and instance-independent rate-optimal regret bounds for MBE in sub-Gaussian multi-armed bandits. With extensive simulation and real data experiments, we show the generality and adaptivity of MBE.

LLMs for clinical decision support often fail under small but clinically meaningful input shifts such as masking a symptom or negating a finding, despite high performance on static benchmarks. These reasoning failures frequently go undetected by standard NLP metrics, which are insensitive to latent representation shifts that drive diagnosis instability. We propose a geometry-aware evaluation framework, LAPD (Latent Agentic Perturbation Diagnostics), which systematically probes the latent robustness of clinical LLMs under structured adversarial edits. Within this framework, we introduce Latent Diagnosis Flip Rate (LDFR), a model-agnostic diagnostic signal that captures representational instability when embeddings cross decision boundaries in PCA-reduced latent space. Clinical notes are generated using a structured prompting pipeline grounded in diagnostic reasoning, then perturbed along four axes: masking, negation, synonym replacement, and numeric variation to simulate common ambiguities and omissions. We compute LDFR across both foundation and clinical LLMs, finding that latent fragility emerges even under minimal surface-level changes. Finally, we validate our findings on 90 real clinical notes from the DiReCT benchmark (MIMIC-IV), confirming the generalizability of LDFR beyond synthetic settings. Our results reveal a persistent gap between surface robustness and semantic stability, underscoring the importance of geometry-aware auditing in safety-critical clinical AI.

Rare diseases affect hundreds of millions worldwide, yet diagnosis often spans years. Convectional pipelines decouple noisy evidence extraction from downstream inferential diagnosis, and general/medical large language models (LLMs) face scarce real world electronic health records (EHRs), stale domain knowledge, and hallucinations. We assemble a large, domain specialized clinical corpus and a clinician validated reasoning set, and develop RareSeek R1 via staged instruction tuning, chain of thought learning, and graph grounded retrieval. Across multicenter EHR narratives and public benchmarks, RareSeek R1 attains state of the art accuracy, robust generalization, and stability under noisy or overlapping phenotypes. Augmented retrieval yields the largest gains when narratives pair with prioritized variants by resolving ambiguity and aligning candidates to mechanisms. Human studies show performance on par with experienced physicians and consistent gains in assistive use. Notably, transparent reasoning highlights decisive non phenotypic evidence (median 23.1%, such as imaging, interventions, functional tests) underpinning many correct diagnoses. This work advances a narrative first, knowledge integrated reasoning paradigm that shortens the diagnostic odyssey and enables auditable, clinically translatable decision support.

Natural language inference (NLI) is critical for complex decision-making in biomedical domain. One key question, for example, is whether a given biomedical mechanism is supported by experimental evidence. This can be seen as an NLI problem but there are no directly usable datasets to address this. The main challenge is that manually creating informative negative examples for this task is difficult and expensive. We introduce a novel semi-supervised procedure that bootstraps an NLI dataset from existing biomedical dataset that pairs mechanisms with experimental evidence in abstracts. We generate a range of negative examples using nine strategies that manipulate the structure of the underlying mechanisms both with rules, e.g., flip the roles of the entities in the interaction, and, more importantly, as perturbations via logical constraints in a neuro-logical decoding system. We use this procedure to create a novel dataset for NLI in the biomedical domain, called BioNLI and benchmark two state-of-the-art biomedical classifiers. The best result we obtain is around mid 70s in F1, suggesting the difficulty of the task. Critically, the performance on the different classes of negative examples varies widely, from 97% F1 on the simple role change negative examples, to barely better than chance on the negative examples generated using neuro-logic decoding.

Differential Diagnosis (DDx) is a fundamental yet complex aspect of clinical decision-making, in which physicians iteratively refine a ranked list of possible diseases based on symptoms, antecedents, and medical knowledge. While recent advances in large language models (LLMs) have shown promise in supporting DDx, existing approaches face key limitations, including single-dataset evaluations, isolated optimization of components, unrealistic assumptions about complete patient profiles, and single-attempt diagnosis. We introduce a Modular Explainable DDx Agent (MEDDxAgent) framework designed for interactive DDx, where diagnostic reasoning evolves through iterative learning, rather than assuming a complete patient profile is accessible. MEDDxAgent integrates three modular components: (1) an orchestrator (DDxDriver), (2) a history taking simulator, and (3) two specialized agents for knowledge retrieval and diagnosis strategy. To ensure robust evaluation, we introduce a comprehensive DDx benchmark covering respiratory, skin, and rare diseases. We analyze single-turn diagnostic approaches and demonstrate the importance of iterative refinement when patient profiles are not available at the outset. Our broad evaluation demonstrates that MEDDxAgent achieves over 10% accuracy improvements in interactive DDx across both large and small LLMs, while offering critical explainability into its diagnostic reasoning process.

LLM-based web agents have recently made significant progress, but much of it has occurred in closed-source systems, widening the gap with open-source alternatives. Progress has been held back by two key challenges: first, a narrow focus on single-step tasks that overlooks the complexity of multi-step web interactions; and second, the high compute costs required to post-train LLM-based web agents. To address this, we present the first statistically grounded study on compute allocation for LLM web-agent post-training. Our approach uses a two-stage pipeline, training a Llama 3.1 8B student to imitate a Llama 3.3 70B teacher via supervised fine-tuning (SFT), followed by on-policy reinforcement learning. We find this process highly sensitive to hyperparameter choices, making exhaustive sweeps impractical. To spare others from expensive trial-and-error, we sample 1,370 configurations and use bootstrapping to estimate effective hyperparameters. Our results show that combining SFT with on-policy RL consistently outperforms either approach alone on both WorkArena and MiniWob++. Further, this strategy requires only 55% of the compute to match the peak performance of pure SFT on MiniWob++, effectively pushing the compute-performance Pareto frontier, and is the only strategy that can close the gap with closed-source models.

We introduce a new framework for sample-efficient model evaluation that we call active testing. While approaches like active learning reduce the number of labels needed for model training, existing literature largely ignores the cost of labeling test data, typically unrealistically assuming large test sets for model evaluation. This creates a disconnect to real applications, where test labels are important and just as expensive, e.g. for optimizing hyperparameters. Active testing addresses this by carefully selecting the test points to label, ensuring model evaluation is sample-efficient. To this end, we derive theoretically-grounded and intuitive acquisition strategies that are specifically tailored to the goals of active testing, noting these are distinct to those of active learning. As actively selecting labels introduces a bias; we further show how to remove this bias while reducing the variance of the estimator at the same time. Active testing is easy to implement and can be applied to any supervised machine learning method. We demonstrate its effectiveness on models including WideResNets and Gaussian processes on datasets including Fashion-MNIST and CIFAR-100.

Generalist Large Language Models (LLMs), such as GPT-4, have shown considerable promise in various domains, including medical diagnosis. Rare diseases, affecting approximately 300 million people worldwide, often have unsatisfactory clinical diagnosis rates primarily due to a lack of experienced physicians and the complexity of differentiating among many rare diseases. In this context, recent news such as "ChatGPT correctly diagnosed a 4-year-old's rare disease after 17 doctors failed" underscore LLMs' potential, yet underexplored, role in clinically diagnosing rare diseases. To bridge this research gap, we introduce RareBench, a pioneering benchmark designed to systematically evaluate the capabilities of LLMs on 4 critical dimensions within the realm of rare diseases. Meanwhile, we have compiled the largest open-source dataset on rare disease patients, establishing a benchmark for future studies in this domain. To facilitate differential diagnosis of rare diseases, we develop a dynamic few-shot prompt methodology, leveraging a comprehensive rare disease knowledge graph synthesized from multiple knowledge bases, significantly enhancing LLMs' diagnostic performance. Moreover, we present an exhaustive comparative study of GPT-4's diagnostic capabilities against those of specialist physicians. Our experimental findings underscore the promising potential of integrating LLMs into the clinical diagnostic process for rare diseases. This paves the way for exciting possibilities in future advancements in this field.

Large Language Models (LLMs) have shown remarkable success in supporting a wide range of knowledge-intensive tasks. In specialized domains, there is growing interest in leveraging LLMs to assist subject matter experts with domain-specific challenges. However, deploying LLMs as SaaS solutions raises data privacy concerns, while many open-source models demand significant computational resources for effective domain adaptation and deployment. A promising alternative is to develop smaller, domain-specialized LLMs, though this approach is often constrained by the lack of high-quality domain-specific training data. In this work, we address these limitations by presenting a cost-efficient and scalable training pipeline that combines guided synthetic data generation from a small seed corpus with bottom-up domain data curation. Our pipeline integrates Domain-Adaptive Pretraining (DAPT), Domain-specific Supervised Fine-tuning (DSFT), and Direct Preference Optimization (DPO) to train effective small-scale models for specialized use cases. We demonstrate this approach through DiagnosticSLM, a 3B-parameter domain-specific model tailored for fault diagnosis, root cause analysis, and repair recommendation in industrial settings. To evaluate model performance, we introduce four domain-specific benchmarks: multiple-choice questions (DiagnosticMCQ), question answering (DiagnosticQA), sentence completion (DiagnosticComp), and summarization (DiagnosticSum). DiagnosticSLM achieves up to 25% accuracy improvement over open-source models of comparable or larger size (2B-9B) on the MCQ task, while also outperforming or matching them in other tasks, demonstrating effective domain-specific reasoning and generalization capabilities.

This paper presents our team's participation in the MEDIQA-ClinicalNLP2024 shared task B. We present a novel approach to diagnosing clinical dermatology cases by integrating large multimodal models, specifically leveraging the capabilities of GPT-4V under a retriever and a re-ranker framework. Our investigation reveals that GPT-4V, when used as a retrieval agent, can accurately retrieve the correct skin condition 85% of the time using dermatological images and brief patient histories. Additionally, we empirically show that Naive Chain-of-Thought (CoT) works well for retrieval while Medical Guidelines Grounded CoT is required for accurate dermatological diagnosis. Further, we introduce a Multi-Agent Conversation (MAC) framework and show its superior performance and potential over the best CoT strategy. The experiments suggest that using naive CoT for retrieval and multi-agent conversation for critique-based diagnosis, GPT-4V can lead to an early and accurate diagnosis of dermatological conditions. The implications of this work extend to improving diagnostic workflows, supporting dermatological education, and enhancing patient care by providing a scalable, accessible, and accurate diagnostic tool.

The use of deep neural models for diagnosis prediction from clinical text has shown promising results. However, in clinical practice such models must not only be accurate, but provide doctors with interpretable and helpful results. We introduce ProtoPatient, a novel method based on prototypical networks and label-wise attention with both of these abilities. ProtoPatient makes predictions based on parts of the text that are similar to prototypical patients - providing justifications that doctors understand. We evaluate the model on two publicly available clinical datasets and show that it outperforms existing baselines. Quantitative and qualitative evaluations with medical doctors further demonstrate that the model provides valuable explanations for clinical decision support.

We present Natural Gradient Boosting (NGBoost), an algorithm for generic probabilistic prediction via gradient boosting. Typical regression models return a point estimate, conditional on covariates, but probabilistic regression models output a full probability distribution over the outcome space, conditional on the covariates. This allows for predictive uncertainty estimation -- crucial in applications like healthcare and weather forecasting. NGBoost generalizes gradient boosting to probabilistic regression by treating the parameters of the conditional distribution as targets for a multiparameter boosting algorithm. Furthermore, we show how the Natural Gradient is required to correct the training dynamics of our multiparameter boosting approach. NGBoost can be used with any base learner, any family of distributions with continuous parameters, and any scoring rule. NGBoost matches or exceeds the performance of existing methods for probabilistic prediction while offering additional benefits in flexibility, scalability, and usability. An open-source implementation is available at github.com/stanfordmlgroup/ngboost.

Meta-learning empowers artificial intelligence to increase its efficiency by learning how to learn. Unlocking this potential involves overcoming a challenging meta-optimisation problem. We propose an algorithm that tackles this problem by letting the meta-learner teach itself. The algorithm first bootstraps a target from the meta-learner, then optimises the meta-learner by minimising the distance to that target under a chosen (pseudo-)metric. Focusing on meta-learning with gradients, we establish conditions that guarantee performance improvements and show that the metric can control meta-optimisation. Meanwhile, the bootstrapping mechanism can extend the effective meta-learning horizon without requiring backpropagation through all updates. We achieve a new state-of-the art for model-free agents on the Atari ALE benchmark and demonstrate that it yields both performance and efficiency gains in multi-task meta-learning. Finally, we explore how bootstrapping opens up new possibilities and find that it can meta-learn efficient exploration in an epsilon-greedy Q-learning agent, without backpropagating through the update rule.

Accurate and interpretable multi-disease diagnosis remains a critical challenge in medical research, particularly when leveraging heterogeneous multimodal medical data. Current approaches often rely on single-modal data, limiting their ability to comprehensively understand complex diseases. To address this, we propose MedTVT-R1, a novel Multimodal Large Language Model (MLLM) framework designed to integrate clinical multimodal data for reasoning and diagnosing multiple diseases. We construct MedTVT-QA, a curated instruction dataset that provides question-answer pairs for physiological-level interpretations and disease-level diagnoses with a Chain of Evidence approach. MedTVT-R1 incorporates a modality perception layer to capture inter-modal dependencies and adaptively weight modality contributions. Additionally, we employ Group Relative Policy Optimization (GRPO)-based Reinforcement Fine-Tuning with a Jaccard Reward function to enhance diagnostic reasoning. Experimental results demonstrate MedTVT-R1's superiority in multimodal feature utilization and multi-disease diagnosis, offering significant potential for clinical applications such as diagnostic report generation and comorbidity reasoning. The dataset and code are available at https://github.com/keke-nice/MedTVT-R1.

Tool-augmented large language models (LLMs) are rapidly being integrated into real-world applications. Due to the lack of benchmarks, the community still needs to fully understand the hallucination issues within these models. To address this challenge, we introduce a comprehensive diagnostic benchmark, ToolBH. Specifically, we assess the LLM's hallucinations through two perspectives: depth and breadth. In terms of depth, we propose a multi-level diagnostic process, including (1) solvability detection, (2) solution planning, and (3) missing-tool analysis. For breadth, we consider three scenarios based on the characteristics of the toolset: missing necessary tools, potential tools, and limited functionality tools. Furthermore, we developed seven tasks and collected 700 evaluation samples through multiple rounds of manual annotation. The results show the significant challenges presented by the ToolBH benchmark. The current advanced models Gemini-1.5-Pro and GPT-4o only achieve a total score of 45.3 and 37.0, respectively, on a scale of 100. In this benchmark, larger model parameters do not guarantee better performance; the training data and response strategies also play a crucial role in tool-enhanced LLM scenarios. Our diagnostic analysis indicates that the primary reason for model errors lies in assessing task solvability. Additionally, open-weight models suffer from performance drops with verbose replies, whereas proprietary models excel with longer reasoning.

Hypothesis generation is a fundamental step in scientific discovery, yet it is increasingly challenged by information overload and disciplinary fragmentation. Recent advances in Large Language Models (LLMs) have sparked growing interest in their potential to enhance and automate this process. This paper presents a comprehensive survey of hypothesis generation with LLMs by (i) reviewing existing methods, from simple prompting techniques to more complex frameworks, and proposing a taxonomy that categorizes these approaches; (ii) analyzing techniques for improving hypothesis quality, such as novelty boosting and structured reasoning; (iii) providing an overview of evaluation strategies; and (iv) discussing key challenges and future directions, including multimodal integration and human-AI collaboration. Our survey aims to serve as a reference for researchers exploring LLMs for hypothesis generation.

In self-supervised learning, a system is tasked with achieving a surrogate objective by defining alternative targets on a set of unlabeled data. The aim is to build useful representations that can be used in downstream tasks, without costly manual annotation. In this work, we propose a novel self-supervised formulation of relational reasoning that allows a learner to bootstrap a signal from information implicit in unlabeled data. Training a relation head to discriminate how entities relate to themselves (intra-reasoning) and other entities (inter-reasoning), results in rich and descriptive representations in the underlying neural network backbone, which can be used in downstream tasks such as classification and image retrieval. We evaluate the proposed method following a rigorous experimental procedure, using standard datasets, protocols, and backbones. Self-supervised relational reasoning outperforms the best competitor in all conditions by an average 14% in accuracy, and the most recent state-of-the-art model by 3%. We link the effectiveness of the method to the maximization of a Bernoulli log-likelihood, which can be considered as a proxy for maximizing the mutual information, resulting in a more efficient objective with respect to the commonly used contrastive losses.

Database administrators (DBAs) play an important role in managing, maintaining and optimizing database systems. However, it is hard and tedious for DBAs to manage a large number of databases and give timely response (waiting for hours is intolerable in many online cases). In addition, existing empirical methods only support limited diagnosis scenarios, which are also labor-intensive to update the diagnosis rules for database version updates. Recently large language models (LLMs) have shown great potential in various fields. Thus, we propose D-Bot, an LLM-based database diagnosis system that can automatically acquire knowledge from diagnosis documents, and generate reasonable and well-founded diagnosis report (i.e., identifying the root causes and solutions) within acceptable time (e.g., under 10 minutes compared to hours by a DBA). The techniques in D-Bot include (i) offline knowledge extraction from documents, (ii) automatic prompt generation (e.g., knowledge matching, tool retrieval), (iii) root cause analysis using tree search algorithm, and (iv) collaborative mechanism for complex anomalies with multiple root causes. We verify D-Bot on real benchmarks (including 539 anomalies of six typical applications), and the results show that D-Bot can effectively analyze the root causes of unseen anomalies and significantly outperforms traditional methods and vanilla models like GPT-4.

Most positive and unlabeled data is subject to selection biases. The labeled examples can, for example, be selected from the positive set because they are easier to obtain or more obviously positive. This paper investigates how learning can be ena BHbled in this setting. We propose and theoretically analyze an empirical-risk-based method for incorporating the labeling mechanism. Additionally, we investigate under which assumptions learning is possible when the labeling mechanism is not fully understood and propose a practical method to enable this. Our empirical analysis supports the theoretical results and shows that taking into account the possibility of a selection bias, even when the labeling mechanism is unknown, improves the trained classifiers.

Discovering novel concepts in unlabelled datasets and in a continuous manner is an important desideratum of lifelong learners. In the literature such problems have been partially addressed under very restricted settings, where novel classes are learned by jointly accessing a related labelled set (e.g., NCD) or by leveraging only a supervisedly pre-trained model (e.g., class-iNCD). In this work we challenge the status quo in class-iNCD and propose a learning paradigm where class discovery occurs continuously and truly unsupervisedly, without needing any related labelled set. In detail, we propose to exploit the richer priors from strong self-supervised pre-trained models (PTM). To this end, we propose simple baselines, composed of a frozen PTM backbone and a learnable linear classifier, that are not only simple to implement but also resilient under longer learning scenarios. We conduct extensive empirical evaluation on a multitude of benchmarks and show the effectiveness of our proposed baselines when compared with sophisticated state-of-the-art methods. The code is open source.

In order to minimize the generalization error in neural networks, a novel technique to identify overfitting phenomena when training the learner is formally introduced. This enables support of a reliable and trustworthy early stopping condition, thus improving the predictive power of that type of modeling. Our proposal exploits the correlation over time in a collection of online indicators, namely characteristic functions for indicating if a set of hypotheses are met, associated with a range of independent stopping conditions built from a canary judgment to evaluate the presence of overfitting. That way, we provide a formal basis for decision making in terms of interrupting the learning process. As opposed to previous approaches focused on a single criterion, we take advantage of subsidiarities between independent assessments, thus seeking both a wider operating range and greater diagnostic reliability. With a view to illustrating the effectiveness of the halting condition described, we choose to work in the sphere of natural language processing, an operational continuum increasingly based on machine learning. As a case study, we focus on parser generation, one of the most demanding and complex tasks in the domain. The selection of cross-validation as a canary function enables an actual comparison with the most representative early stopping conditions based on overfitting identification, pointing to a promising start toward an optimal bias and variance control.

The recently proposed SparseFormer architecture provides an alternative approach to visual understanding by utilizing a significantly lower number of visual tokens via adjusting RoIs, greatly reducing computational costs while still achieving promising performance. However, training SparseFormers from scratch is still expensive, and scaling up the number of parameters can be challenging. In this paper, we propose to bootstrap SparseFormers from ViT-based vision foundation models in a simple and efficient way. Since the majority of SparseFormer blocks are the standard transformer ones, we can inherit weights from large-scale pre-trained vision transformers and freeze them as much as possible. Therefore, we only need to train the SparseFormer-specific lightweight focusing transformer to adjust token RoIs and fine-tune a few early pre-trained blocks to align the final token representation. In such a way, we can bootstrap SparseFormer architectures from various large-scale pre-trained models (e.g., IN-21K pre-trained AugRegs or CLIPs) using a rather smaller amount of training samples (e.g., IN-1K) and without labels or captions within just a few hours. As a result, the bootstrapped unimodal SparseFormer (from AugReg-ViT-L/16-384) can reach 84.9% accuracy on IN-1K with only 49 tokens, and the multimodal SparseFormer from CLIPs also demonstrates notable zero-shot performance with highly reduced computational cost without seeing any caption during the bootstrapping procedure. In addition, CLIP-bootstrapped SparseFormers, which align the output space with language without seeing a word, can serve as efficient vision encoders in multimodal large language models. Code will be publicly available at https://github.com/showlab/sparseformer

Rare diseases, including Inborn Errors of Metabolism (IEM), pose significant diagnostic challenges. Case reports serve as key but computationally underutilized resources to inform diagnosis. Clinical dense information extraction refers to organizing medical information into structured predefined categories. Large Language Models (LLMs) may enable scalable information extraction from case reports but are rarely evaluated for this task. We introduce CaseReportBench, an expert-annotated dataset for dense information extraction of case reports, focusing on IEMs. Using this dataset, we assess various models and prompting strategies, introducing novel approaches such as category-specific prompting and subheading-filtered data integration. Zero-shot chain-of-thought prompting offers little advantage over standard zero-shot prompting. Category-specific prompting improves alignment with the benchmark. The open-source model Qwen2.5-7B outperforms GPT-4o for this task. Our clinician evaluations show that LLMs can extract clinically relevant details from case reports, supporting rare disease diagnosis and management. We also highlight areas for improvement, such as LLMs' limitations in recognizing negative findings important for differential diagnosis. This work advances LLM-driven clinical natural language processing and paves the way for scalable medical AI applications.

Current medical language models, adapted from large language models (LLMs), typically predict ICD code-based diagnosis from electronic health records (EHRs) because these labels are readily available. However, ICD codes do not capture the nuanced, context-rich reasoning clinicians use for diagnosis. Clinicians synthesize diverse patient data and reference clinical practice guidelines (CPGs) to make evidence-based decisions. This misalignment limits the clinical utility of existing models. We introduce GARMLE-G, a Generation-Augmented Retrieval framework that grounds medical language model outputs in authoritative CPGs. Unlike conventional Retrieval-Augmented Generation based approaches, GARMLE-G enables hallucination-free outputs by directly retrieving authoritative guideline content without relying on model-generated text. It (1) integrates LLM predictions with EHR data to create semantically rich queries, (2) retrieves relevant CPG knowledge snippets via embedding similarity, and (3) fuses guideline content with model output to generate clinically aligned recommendations. A prototype system for hypertension diagnosis was developed and evaluated on multiple metrics, demonstrating superior retrieval precision, semantic relevance, and clinical guideline adherence compared to RAG-based baselines, while maintaining a lightweight architecture suitable for localized healthcare deployment. This work provides a scalable, low-cost, and hallucination-free method for grounding medical language models in evidence-based clinical practice, with strong potential for broader clinical deployment.

Selective Classification, wherein models can reject low-confidence predictions, promises reliable translation of machine-learning based classification systems to real-world scenarios such as clinical diagnostics. While current evaluation of these systems typically assumes fixed working points based on pre-defined rejection thresholds, methodological progress requires benchmarking the general performance of systems akin to the AUROC in standard classification. In this work, we define 5 requirements for multi-threshold metrics in selective classification regarding task alignment, interpretability, and flexibility, and show how current approaches fail to meet them. We propose the Area under the Generalized Risk Coverage curve (AUGRC), which meets all requirements and can be directly interpreted as the average risk of undetected failures. We empirically demonstrate the relevance of AUGRC on a comprehensive benchmark spanning 6 data sets and 13 confidence scoring functions. We find that the proposed metric substantially changes metric rankings on 5 out of the 6 data sets.

Recent text-to-image generation models have demonstrated incredible success in generating images that faithfully follow input prompts. However, the requirement of using words to describe a desired concept provides limited control over the appearance of the generated concepts. In this work, we address this shortcoming by proposing an approach to enable personalization capabilities in existing text-to-image diffusion models. We propose a novel architecture (BootPIG) that allows a user to provide reference images of an object in order to guide the appearance of a concept in the generated images. The proposed BootPIG architecture makes minimal modifications to a pretrained text-to-image diffusion model and utilizes a separate UNet model to steer the generations toward the desired appearance. We introduce a training procedure that allows us to bootstrap personalization capabilities in the BootPIG architecture using data generated from pretrained text-to-image models, LLM chat agents, and image segmentation models. In contrast to existing methods that require several days of pretraining, the BootPIG architecture can be trained in approximately 1 hour. Experiments on the DreamBooth dataset demonstrate that BootPIG outperforms existing zero-shot methods while being comparable with test-time finetuning approaches. Through a user study, we validate the preference for BootPIG generations over existing methods both in maintaining fidelity to the reference object's appearance and aligning with textual prompts.

Self-supervised learning provides a promising path towards eliminating the need for costly label information in representation learning on graphs. However, to achieve state-of-the-art performance, methods often need large numbers of negative examples and rely on complex augmentations. This can be prohibitively expensive, especially for large graphs. To address these challenges, we introduce Bootstrapped Graph Latents (BGRL) - a graph representation learning method that learns by predicting alternative augmentations of the input. BGRL uses only simple augmentations and alleviates the need for contrasting with negative examples, and is thus scalable by design. BGRL outperforms or matches prior methods on several established benchmarks, while achieving a 2-10x reduction in memory costs. Furthermore, we show that BGRL can be scaled up to extremely large graphs with hundreds of millions of nodes in the semi-supervised regime - achieving state-of-the-art performance and improving over supervised baselines where representations are shaped only through label information. In particular, our solution centered on BGRL constituted one of the winning entries to the Open Graph Benchmark - Large Scale Challenge at KDD Cup 2021, on a graph orders of magnitudes larger than all previously available benchmarks, thus demonstrating the scalability and effectiveness of our approach.

Bootstrapping from pre-trained language models has been proven to be an efficient approach for building vision-language models (VLM) for tasks such as image captioning or visual question answering. However, outputs of these models rarely align with user's rationales for specific answers. In order to improve this alignment and reinforce commonsense reasons, we propose a tuning paradigm based on human interactions with machine generated data. Our ILLUME executes the following loop: Given an image-question-answer prompt, the VLM samples multiple candidate rationales, and a human critic provides minimal feedback via preference selection, used for fine-tuning. This loop increases the training data and gradually carves out the VLM's rationalization capabilities that are aligned with human intend. Our exhaustive experiments demonstrate that ILLUME is competitive with standard supervised fine-tuning while using significantly fewer training data and only requiring minimal feedback.

Recent progress in weakly supervised object detection is featured by a combination of multiple instance detection networks (MIDN) and ordinal online refinement. However, with only image-level annotation, MIDN inevitably assigns high scores to some unexpected region proposals when generating pseudo labels. These inaccurate high-scoring region proposals will mislead the training of subsequent refinement modules and thus hamper the detection performance. In this work, we explore how to ameliorate the quality of pseudo-labeling in MIDN. Formally, we devise Cyclic-Bootstrap Labeling (CBL), a novel weakly supervised object detection pipeline, which optimizes MIDN with rank information from a reliable teacher network. Specifically, we obtain this teacher network by introducing a weighted exponential moving average strategy to take advantage of various refinement modules. A novel class-specific ranking distillation algorithm is proposed to leverage the output of weighted ensembled teacher network for distilling MIDN with rank information. As a result, MIDN is guided to assign higher scores to accurate proposals among their neighboring ones, thus benefiting the subsequent pseudo labeling. Extensive experiments on the prevalent PASCAL VOC 2007 \& 2012 and COCO datasets demonstrate the superior performance of our CBL framework. Code will be available at https://github.com/Yinyf0804/WSOD-CBL/.

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

Due to the unsupervised nature of anomaly detection, the key to fueling deep models is finding supervisory signals. Different from current reconstruction-guided generative models and transformation-based contrastive models, we devise novel data-driven supervision for tabular data by introducing a characteristic -- scale -- as data labels. By representing varied sub-vectors of data instances, we define scale as the relationship between the dimensionality of original sub-vectors and that of representations. Scales serve as labels attached to transformed representations, thus offering ample labeled data for neural network training. This paper further proposes a scale learning-based anomaly detection method. Supervised by the learning objective of scale distribution alignment, our approach learns the ranking of representations converted from varied subspaces of each data instance. Through this proxy task, our approach models inherent regularities and patterns within data, which well describes data "normality". Abnormal degrees of testing instances are obtained by measuring whether they fit these learned patterns. Extensive experiments show that our approach leads to significant improvement over state-of-the-art generative/contrastive anomaly detection methods.

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

In this paper we introduce Feature Gradients, a gradient-based search algorithm for feature selection. Our approach extends a recent result on the estimation of learnability in the sublinear data regime by showing that the calculation can be performed iteratively (i.e., in mini-batches) and in linear time and space with respect to both the number of features D and the sample size N . This, along with a discrete-to-continuous relaxation of the search domain, allows for an efficient, gradient-based search algorithm among feature subsets for very large datasets. Crucially, our algorithm is capable of finding higher-order correlations between features and targets for both the N > D and N < D regimes, as opposed to approaches that do not consider such interactions and/or only consider one regime. We provide experimental demonstration of the algorithm in small and large sample-and feature-size settings.

Medical image classification is a critical problem for healthcare, with the potential to alleviate the workload of doctors and facilitate diagnoses of patients. However, two challenges arise when deploying deep learning models to real-world healthcare applications. First, neural models tend to learn spurious correlations instead of desired features, which could fall short when generalizing to new domains (e.g., patients with different ages). Second, these black-box models lack interpretability. When making diagnostic predictions, it is important to understand why a model makes a decision for trustworthy and safety considerations. In this paper, to address these two limitations, we propose a new paradigm to build robust and interpretable medical image classifiers with natural language concepts. Specifically, we first query clinical concepts from GPT-4, then transform latent image features into explicit concepts with a vision-language model. We systematically evaluate our method on eight medical image classification datasets to verify its effectiveness. On challenging datasets with strong confounding factors, our method can mitigate spurious correlations thus substantially outperform standard visual encoders and other baselines. Finally, we show how classification with a small number of concepts brings a level of interpretability for understanding model decisions through case studies in real medical data.

Independence testing is a fundamental and classical statistical problem that has been extensively studied in the batch setting when one fixes the sample size before collecting data. However, practitioners often prefer procedures that adapt to the complexity of a problem at hand instead of setting sample size in advance. Ideally, such procedures should (a) allow stopping earlier on easy tasks (and later on harder tasks), hence making better use of available resources, and (b) continuously monitor the data and efficiently incorporate statistical evidence after collecting new data, while controlling the false alarm rate. It is well known that classical batch tests are not tailored for streaming data settings: valid inference after data peeking requires correcting for multiple testing but such corrections generally result in low power. Following the principle of testing by betting, we design sequential kernelized independence tests (SKITs) that overcome such shortcomings. We exemplify our broad framework using bets inspired by kernelized dependence measures, e.g, the Hilbert-Schmidt independence criterion. Our test is valid under non-i.i.d. time-varying settings, for which there exist no batch tests. We demonstrate the power of our approaches on both simulated and real data.

We present a foundation model-derived method to identify highly informative tokens and events in electronic health records. Our approach considers incoming data in the entire context of a patient's hospitalization and so can flag anomalous events that rule-based approaches would consider within a normal range. We demonstrate that the events our model flags are significant for predicting downstream patient outcomes and that a fraction of events identified as carrying little information can safely be dropped. Additionally, we show how informativeness can help interpret the predictions of prognostic models trained on foundation model-derived representations.

Novel Class Discovery (NCD) is a growing field where we are given during training a labeled set of known classes and an unlabeled set of different classes that must be discovered. In recent years, many methods have been proposed to address this problem, and the field has begun to mature. In this paper, we provide a comprehensive survey of the state-of-the-art NCD methods. We start by formally defining the NCD problem and introducing important notions. We then give an overview of the different families of approaches, organized by the way they transfer knowledge from the labeled set to the unlabeled set. We find that they either learn in two stages, by first extracting knowledge from the labeled data only and then applying it to the unlabeled data, or in one stage by conjointly learning on both sets. For each family, we describe their general principle and detail a few representative methods. Then, we briefly introduce some new related tasks inspired by the increasing number of NCD works. We also present some common tools and techniques used in NCD, such as pseudo labeling, self-supervised learning and contrastive learning. Finally, to help readers unfamiliar with the NCD problem differentiate it from other closely related domains, we summarize some of the closest areas of research and discuss their main differences.

Traditionally, AI research in medical diagnosis has largely centered on image analysis. While this has led to notable advancements, the absence of patient-reported symptoms continues to hinder diagnostic accuracy. To address this, we propose a Pre-Consultation Dialogue Framework (PCDF) that mimics real-world diagnostic procedures, where doctors iteratively query patients before reaching a conclusion. Specifically, we simulate diagnostic dialogues between two vision-language models (VLMs): a DocVLM, which generates follow-up questions based on the image and dialogue history, and a PatientVLM, which responds using a symptom profile derived from the ground-truth diagnosis. We additionally conducted a small-scale clinical validation of the synthetic symptoms generated by our framework, with licensed clinicians confirming their clinical relevance, symptom coverage, and overall realism. These findings indicate that the resulting DocVLM-PatientVLM interactions form coherent, multi-turn consultations paired with images and diagnoses, which we then use to fine-tune the DocVLM. This dialogue-based supervision leads to substantial gains over image-only training, highlighting the value of realistic symptom elicitation for diagnosis.

Medical vision-language models (VLMs) excel at image-text understanding but typically rely on a single-pass reasoning that neglects localized visual cues. In clinical practice, however, human experts iteratively scan, focus, and refine the regions of interest before reaching a final diagnosis. To narrow this machine-human perception gap, we introduce ViTAR, a novel VLM framework that emulates the iterative reasoning process of human experts through a cognitive chain of "think-act-rethink-answer". ViTAR treats medical images as interactive objects, enabling models to engage multi-step visual reasoning. To support this approach, we curate a high-quality instruction dataset comprising 1K interactive examples that encode expert-like diagnostic behaviors. In addition, a 16K visual question answering training data has been curated towards fine-grained visual diagnosis. We introduce a two-stage training strategy that begins with supervised fine-tuning to guide cognitive trajectories, followed by the reinforcement learning to optimize decision-making. Extensive evaluations demonstrate that ViTAR outperforms strong state-of-the-art models. Visual attention analysis reveals that from the "think" to "rethink" rounds, ViTAR increasingly anchors visual grounding to clinically critical regions and maintains high attention allocation to visual tokens during reasoning, providing mechanistic insight into its improved performance. These findings demonstrate that embedding expert-style iterative thinking chains into VLMs enhances both performance and trustworthiness of medical AI.

The emergence of groundbreaking large language models capable of performing complex reasoning tasks holds significant promise for addressing various scientific challenges, including those arising in complex clinical scenarios. To enable their safe and effective deployment in real-world healthcare settings, it is urgently necessary to benchmark the diagnostic capabilities of current models systematically. Given the limitations of existing medical benchmarks in evaluating advanced diagnostic reasoning, we present DiagnosisArena, a comprehensive and challenging benchmark designed to rigorously assess professional-level diagnostic competence. DiagnosisArena consists of 1,113 pairs of segmented patient cases and corresponding diagnoses, spanning 28 medical specialties, deriving from clinical case reports published in 10 top-tier medical journals. The benchmark is developed through a meticulous construction pipeline, involving multiple rounds of screening and review by both AI systems and human experts, with thorough checks conducted to prevent data leakage. Our study reveals that even the most advanced reasoning models, o3-mini, o1, and DeepSeek-R1, achieve only 45.82%, 31.09%, and 17.79% accuracy, respectively. This finding highlights a significant generalization bottleneck in current large language models when faced with clinical diagnostic reasoning challenges. Through DiagnosisArena, we aim to drive further advancements in AIs diagnostic reasoning capabilities, enabling more effective solutions for real-world clinical diagnostic challenges. We provide the benchmark and evaluation tools for further research and development https://github.com/SPIRAL-MED/DiagnosisArena.

Large Vision-Language Models (LVLMs) have demonstrated remarkable capabilities across multimodal tasks such as visual perception and reasoning, leading to good performance on various multimodal evaluation benchmarks. However, these benchmarks keep a static nature and overlap with the pre-training data, resulting in fixed complexity constraints and data contamination issues. This raises the concern regarding the validity of the evaluation. To address these two challenges, we introduce a dynamic multimodal evaluation protocol called Vision-Language Bootstrapping (VLB). VLB provides a robust and comprehensive assessment for LVLMs with reduced data contamination and flexible complexity. To this end, VLB dynamically generates new visual question-answering samples through a multimodal bootstrapping module that modifies both images and language, while ensuring that newly generated samples remain consistent with the original ones by a judge module. By composing various bootstrapping strategies, VLB offers dynamic variants of existing benchmarks with diverse complexities, enabling the evaluation to co-evolve with the ever-evolving capabilities of LVLMs. Extensive experimental results across multiple benchmarks, including SEEDBench, MMBench, and MME, show that VLB significantly reduces data contamination and exposes performance limitations of LVLMs.

We describe PromptBoosting, a query-efficient procedure for building a text classifier from a neural language model (LM) without access to the LM's parameters, gradients, or hidden representations. This form of "black-box" classifier training has become increasingly important as the cost of training and inference in large-scale LMs grows. But existing black-box LM classifier learning approaches are themselves computationally inefficient, typically specializing LMs to the target task by searching in a large space of (discrete or continuous) prompts using zeroth-order optimization methods. Instead of directly optimizing in prompt space, PromptBoosting obtains a small pool of prompts via a gradient-free approach and then constructs a large pool of weak learners by pairing these prompts with different elements of the LM's output distribution. These weak learners are then ensembled using the AdaBoost algorithm. The entire learning process requires only a small number of forward passes and no backward pass. Experiments show that PromptBoosting achieves state-of-the-art performance in multiple black-box few-shot classification tasks, and matches or outperforms full fine-tuning in both few-shot and standard learning paradigms, while training 10x faster than existing black-box methods.

Accurate blind docking has the potential to lead to new biological breakthroughs, but for this promise to be realized, docking methods must generalize well across the proteome. Existing benchmarks, however, fail to rigorously assess generalizability. Therefore, we develop DockGen, a new benchmark based on the ligand-binding domains of proteins, and we show that existing machine learning-based docking models have very weak generalization abilities. We carefully analyze the scaling laws of ML-based docking and show that, by scaling data and model size, as well as integrating synthetic data strategies, we are able to significantly increase the generalization capacity and set new state-of-the-art performance across benchmarks. Further, we propose Confidence Bootstrapping, a new training paradigm that solely relies on the interaction between diffusion and confidence models and exploits the multi-resolution generation process of diffusion models. We demonstrate that Confidence Bootstrapping significantly improves the ability of ML-based docking methods to dock to unseen protein classes, edging closer to accurate and generalizable blind docking methods.

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

We study simplified bootstrap problems for probability distributions on the infinite line and the circle. We show that the rapid convergence of the bootstrap method for problems on the infinite line is related to the fact that the smallest eigenvalue of the positive matrices in the exact solution becomes exponentially small for large matrices, while the moments grow factorially. As a result, the positivity condition is very finely tuned. For problems on the circle we show instead that the entries of the positive matrix of Fourier modes of the distribution depend linearly on the initial data of the recursion, with factorially growing coefficients. By positivity, these matrix elements are bounded in absolute value by one, so the initial data must also be fine-tuned. Additionally, we find that we can largely bypass the semi-definite program (SDP) nature of the problem on a circle by recognizing that these Fourier modes must be asymptotically exponentially small. With a simple ansatz, which we call the shoestring bootstrap, we can efficiently identify an interior point of the set of allowed matrices with much higher precision than conventional SDP bounds permit. We apply this method to solving unitary matrix model integrals by numerically constructing the orthogonal polynomials associated with the circle distribution.

Hierarchical reasoning model (HRM) achieves extraordinary performance on various reasoning tasks, significantly outperforming large language model-based reasoners. To understand the strengths and potential failure modes of HRM, we conduct a mechanistic study on its reasoning patterns and find three surprising facts: (a) Failure of extremely simple puzzles, e.g., HRM can fail on a puzzle with only one unknown cell. We attribute this failure to the violation of the fixed point property, a fundamental assumption of HRM. (b) "Grokking" dynamics in reasoning steps, i.e., the answer is not improved uniformly, but instead there is a critical reasoning step that suddenly makes the answer correct; (c) Existence of multiple fixed points. HRM "guesses" the first fixed point, which could be incorrect, and gets trapped there for a while or forever. All facts imply that HRM appears to be "guessing" instead of "reasoning". Leveraging this "guessing" picture, we propose three strategies to scale HRM's guesses: data augmentation (scaling the quality of guesses), input perturbation (scaling the number of guesses by leveraging inference randomness), and model bootstrapping (scaling the number of guesses by leveraging training randomness). On the practical side, by combining all methods, we develop Augmented HRM, boosting accuracy on Sudoku-Extreme from 54.5% to 96.9%. On the scientific side, our analysis provides new insights into how reasoning models "reason".

Multimodal large language models (MLLMs) have made significant strides, yet they face challenges in the medical domain due to limited specialized knowledge. While recent medical MLLMs demonstrate strong performance in lab settings, they often struggle in real-world applications, highlighting a substantial gap between research and practice. In this paper, we seek to address this gap at various stages of the end-to-end learning pipeline, including data collection, model fine-tuning, and evaluation. At the data collection stage, we introduce SemiHVision, a dataset that combines human annotations with automated augmentation techniques to improve both medical knowledge representation and diagnostic reasoning. For model fine-tuning, we trained PMC-Cambrian-8B-AN over 2400 H100 GPU hours, resulting in performance that surpasses public medical models like HuatuoGPT-Vision-34B (79.0% vs. 66.7%) and private general models like Claude3-Opus (55.7%) on traditional benchmarks such as SLAKE and VQA-RAD. In the evaluation phase, we observed that traditional benchmarks cannot accurately reflect realistic clinical task capabilities. To overcome this limitation and provide more targeted guidance for model evaluation, we introduce the JAMA Clinical Challenge, a novel benchmark specifically designed to evaluate diagnostic reasoning. On this benchmark, PMC-Cambrian-AN achieves state-of-the-art performance with a GPT-4 score of 1.29, significantly outperforming HuatuoGPT-Vision-34B (1.13) and Claude3-Opus (1.17), demonstrating its superior diagnostic reasoning abilities.

We introduce Synthetic Bootstrapped Pretraining (SBP), a language model (LM) pretraining procedure that first learns a model of relations between documents from the pretraining dataset and then leverages it to synthesize a vast new corpus for joint training. While the standard pretraining teaches LMs to learn causal correlations among tokens within a single document, it is not designed to efficiently model the rich, learnable inter-document correlations that can potentially lead to better performance. We validate SBP by designing a compute-matched pretraining setup and pretrain a 3B-parameter model on up to 1T tokens from scratch. We find SBP consistently improves upon a strong repetition baseline and delivers a significant fraction of performance improvement attainable by an oracle upper bound with access to 20x more unique data. Qualitative analysis reveals that the synthesized documents go beyond mere paraphrases -- SBP first abstracts a core concept from the seed material and then crafts a new narration on top of it. Besides strong empirical performance, SBP admits a natural Bayesian interpretation: the synthesizer implicitly learns to abstract the latent concepts shared between related documents.

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

We might hope that when faced with unexpected inputs, well-designed software systems would fire off warnings. Machine learning (ML) systems, however, which depend strongly on properties of their inputs (e.g. the i.i.d. assumption), tend to fail silently. This paper explores the problem of building ML systems that fail loudly, investigating methods for detecting dataset shift, identifying exemplars that most typify the shift, and quantifying shift malignancy. We focus on several datasets and various perturbations to both covariates and label distributions with varying magnitudes and fractions of data affected. Interestingly, we show that across the dataset shifts that we explore, a two-sample-testing-based approach, using pre-trained classifiers for dimensionality reduction, performs best. Moreover, we demonstrate that domain-discriminating approaches tend to be helpful for characterizing shifts qualitatively and determining if they are harmful.

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

Building upon our previous investigations of O1 replication (Part 1: Journey Learning [Qin et al., 2024] and Part 2: Distillation [Huang et al., 2024]), this work explores the potential of inference-time scaling in large language models (LLMs) for medical reasoning tasks, ranging from diagnostic decision-making to treatment planning. Through extensive experiments on medical benchmarks of varying complexity (MedQA, Medbullets, and JAMA Clinical Challenges), our investigation reveals several key insights: (1) Increasing inference time does lead to improved performance. With a modest training set of 500 samples, our model yields substantial performance improvements of 6%-11%. (2) Task complexity directly correlates with the required length of reasoning chains, confirming the necessity of extended thought processes for challenging problems. (3) The differential diagnoses generated by our model adhere to the principles of the hypothetico-deductive method, producing a list of potential conditions that may explain a patient's symptoms and systematically narrowing these possibilities by evaluating the evidence. These findings demonstrate the promising synergy between inference-time scaling and journey learning in advancing LLMs' real-world clinical reasoning capabilities.

Zero-shot medical detection can further improve detection performance without relying on annotated medical images even upon the fine-tuned model, showing great clinical value. Recent studies leverage grounded vision-language models (GLIP) to achieve this by using detailed disease descriptions as prompts for the target disease name during the inference phase. However, these methods typically treat prompts as equivalent context to the target name, making it difficult to assign specific disease knowledge based on visual information, leading to a coarse alignment between images and target descriptions. In this paper, we propose StructuralGLIP, which introduces an auxiliary branch to encode prompts into a latent knowledge bank layer-by-layer, enabling more context-aware and fine-grained alignment. Specifically, in each layer, we select highly similar features from both the image representation and the knowledge bank, forming structural representations that capture nuanced relationships between image patches and target descriptions. These features are then fused across modalities to further enhance detection performance. Extensive experiments demonstrate that StructuralGLIP achieves a +4.1\% AP improvement over prior state-of-the-art methods across seven zero-shot medical detection benchmarks, and consistently improves fine-tuned models by +3.2\% AP on endoscopy image datasets.

Most current medical vision language models struggle to jointly generate diagnostic text and pixel-level segmentation masks in response to complex visual questions. This represents a major limitation towards clinical application, as assistive systems that fail to provide both modalities simultaneously offer limited value to medical practitioners. To alleviate this limitation, we first introduce RadDiagSeg-D, a dataset combining abnormality detection, diagnosis, and multi-target segmentation into a unified and hierarchical task. RadDiagSeg-D covers multiple imaging modalities and is precisely designed to support the development of models that produce descriptive text and corresponding segmentation masks in tandem. Subsequently, we leverage the dataset to propose a novel vision-language model, RadDiagSeg-M, capable of joint abnormality detection, diagnosis, and flexible segmentation. RadDiagSeg-M provides highly informative and clinically useful outputs, effectively addressing the need to enrich contextual information for assistive diagnosis. Finally, we benchmark RadDiagSeg-M and showcase its strong performance across all components involved in the task of multi-target text-and-mask generation, establishing a robust and competitive baseline.

There has been a rapidly growing interest in Automatic Symptom Detection (ASD) and Automatic Diagnosis (AD) systems in the machine learning research literature, aiming to assist doctors in telemedicine services. These systems are designed to interact with patients, collect evidence about their symptoms and relevant antecedents, and possibly make predictions about the underlying diseases. Doctors would review the interactions, including the evidence and the predictions, collect if necessary additional information from patients, before deciding on next steps. Despite recent progress in this area, an important piece of doctors' interactions with patients is missing in the design of these systems, namely the differential diagnosis. Its absence is largely due to the lack of datasets that include such information for models to train on. In this work, we present a large-scale synthetic dataset of roughly 1.3 million patients that includes a differential diagnosis, along with the ground truth pathology, symptoms and antecedents for each patient. Unlike existing datasets which only contain binary symptoms and antecedents, this dataset also contains categorical and multi-choice symptoms and antecedents useful for efficient data collection. Moreover, some symptoms are organized in a hierarchy, making it possible to design systems able to interact with patients in a logical way. As a proof-of-concept, we extend two existing AD and ASD systems to incorporate the differential diagnosis, and provide empirical evidence that using differentials as training signals is essential for the efficiency of such systems or for helping doctors better understand the reasoning of those systems.

The optimization of expensive-to-evaluate black-box functions is prevalent in various scientific disciplines. Bayesian optimization is an automatic, general and sample-efficient method to solve these problems with minimal knowledge of the underlying function dynamics. However, the ability of Bayesian optimization to incorporate prior knowledge or beliefs about the function at hand in order to accelerate the optimization is limited, which reduces its appeal for knowledgeable practitioners with tight budgets. To allow domain experts to customize the optimization routine, we propose ColaBO, the first Bayesian-principled framework for incorporating prior beliefs beyond the typical kernel structure, such as the likely location of the optimizer or the optimal value. The generality of ColaBO makes it applicable across different Monte Carlo acquisition functions and types of user beliefs. We empirically demonstrate ColaBO's ability to substantially accelerate optimization when the prior information is accurate, and to retain approximately default performance when it is misleading.

Leveraging nearest neighbor retrieval for self-supervised representation learning has proven beneficial with object-centric images. However, this approach faces limitations when applied to scene-centric datasets, where multiple objects within an image are only implicitly captured in the global representation. Such global bootstrapping can lead to undesirable entanglement of object representations. Furthermore, even object-centric datasets stand to benefit from a finer-grained bootstrapping approach. In response to these challenges, we introduce a novel Cross-Image Object-Level Bootstrapping method tailored to enhance dense visual representation learning. By employing object-level nearest neighbor bootstrapping throughout the training, CrIBo emerges as a notably strong and adequate candidate for in-context learning, leveraging nearest neighbor retrieval at test time. CrIBo shows state-of-the-art performance on the latter task while being highly competitive in more standard downstream segmentation tasks. Our code and pretrained models are publicly available at https://github.com/tileb1/CrIBo.

Despite the rise to dominance of deep learning in unstructured data domains, tree-based methods such as Random Forests (RF) and Gradient Boosted Decision Trees (GBDT) are still the workhorses for handling discriminative tasks on tabular data. We explore generative extensions of these popular algorithms with a focus on explicitly modeling the data density (up to a normalization constant), thus enabling other applications besides sampling. As our main contribution we propose an energy-based generative boosting algorithm that is analogous to the second order boosting implemented in popular packages like XGBoost. We show that, despite producing a generative model capable of handling inference tasks over any input variable, our proposed algorithm can achieve similar discriminative performance to GBDT on a number of real world tabular datasets, outperforming alternative generative approaches. At the same time, we show that it is also competitive with neural network based models for sampling.

Users of social platforms often perceive these sites as supportive spaces to post about their mental health issues. Those conversations contain important traces about individuals' health risks. Recently, researchers have exploited this online information to construct mental health detection models, which aim to identify users at risk on platforms like Twitter, Reddit or Facebook. Most of these models are centred on achieving good classification results, ignoring the explainability and interpretability of the decisions. Recent research has pointed out the importance of using clinical markers, such as the use of symptoms, to improve trust in the computational models by health professionals. In this paper, we propose using transformer-based architectures to detect and explain the appearance of depressive symptom markers in the users' writings. We present two approaches: i) train a model to classify, and another one to explain the classifier's decision separately and ii) unify the two tasks simultaneously using a single model. Additionally, for this latter manner, we also investigated the performance of recent conversational LLMs when using in-context learning. Our natural language explanations enable clinicians to interpret the models' decisions based on validated symptoms, enhancing trust in the automated process. We evaluate our approach using recent symptom-based datasets, employing both offline and expert-in-the-loop metrics to assess the quality of the explanations generated by our models. The experimental results show that it is possible to achieve good classification results while generating interpretable symptom-based explanations.

Pre-training and fine-tuning have achieved remarkable success in many downstream natural language processing (NLP) tasks. Recently, pre-training methods tailored for information retrieval (IR) have also been explored, and the latest success is the PROP method which has reached new SOTA on a variety of ad-hoc retrieval benchmarks. The basic idea of PROP is to construct the representative words prediction (ROP) task for pre-training inspired by the query likelihood model. Despite its exciting performance, the effectiveness of PROP might be bounded by the classical unigram language model adopted in the ROP task construction process. To tackle this problem, we propose a bootstrapped pre-training method (namely B-PROP) based on BERT for ad-hoc retrieval. The key idea is to use the powerful contextual language model BERT to replace the classical unigram language model for the ROP task construction, and re-train BERT itself towards the tailored objective for IR. Specifically, we introduce a novel contrastive method, inspired by the divergence-from-randomness idea, to leverage BERT's self-attention mechanism to sample representative words from the document. By further fine-tuning on downstream ad-hoc retrieval tasks, our method achieves significant improvements over baselines without pre-training or with other pre-training methods, and further pushes forward the SOTA on a variety of ad-hoc retrieval tasks.

Deep Learning based models are currently dominating most state-of-the-art solutions for disease prediction. Existing works employ RNNs along with multiple levels of attention mechanisms to provide interpretability. These deep learning models, with trainable parameters running into millions, require huge amounts of compute and data to train and deploy. These requirements are sometimes so huge that they render usage of such models as unfeasible. We address these challenges by developing a simpler yet interpretable non-deep learning based model for application to EHR data. We model and showcase our work's results on the task of predicting first occurrence of a diagnosis, often overlooked in existing works. We push the capabilities of a tree based model and come up with a strong baseline for more sophisticated models. Its performance shows an improvement over deep learning based solutions (both, with and without the first-occurrence constraint) all the while maintaining interpretability.

This paper introduces MedTrinity-25M, a comprehensive, large-scale multimodal dataset for medicine, covering over 25 million images across 10 modalities, with multigranular annotations for more than 65 diseases. These enriched annotations encompass both global textual information, such as disease/lesion type, modality, region-specific descriptions, and inter-regional relationships, as well as detailed local annotations for regions of interest (ROIs), including bounding boxes, segmentation masks. Unlike existing approach which is limited by the availability of image-text pairs, we have developed the first automated pipeline that scales up multimodal data by generating multigranular visual and texual annotations (in the form of image-ROI-description triplets) without the need for any paired text descriptions. Specifically, data from over 90 different sources have been collected, preprocessed, and grounded using domain-specific expert models to identify ROIs related to abnormal regions. We then build a comprehensive knowledge base and prompt multimodal large language models to perform retrieval-augmented generation with the identified ROIs as guidance, resulting in multigranular texual descriptions. Compared to existing datasets, MedTrinity-25M provides the most enriched annotations, supporting a comprehensive range of multimodal tasks such as captioning and report generation, as well as vision-centric tasks like classification and segmentation. Pretraining on MedTrinity-25M, our model achieves state-of-the-art performance on VQA-RAD and PathVQA, surpassing both multimodal large language models and other representative SoTA approaches. This dataset can also be utilized to support large-scale pre-training of multimodal medical AI models, contributing to the development of future foundation models in the medical domain.

As Large Multimodal Models (LMMs) scale up and reinforcement learning (RL) methods mature, LMMs have made notable progress in complex reasoning and decision making. Yet training still relies on static data and fixed recipes, making it difficult to diagnose capability blind spots or provide dynamic, targeted reinforcement. Motivated by findings that test driven error exposure and feedback based correction outperform repetitive practice, we propose Diagnostic-driven Progressive Evolution (DPE), a spiral loop where diagnosis steers data generation and reinforcement, and each iteration re-diagnoses the updated model to drive the next round of targeted improvement. DPE has two key components. First, multiple agents annotate and quality control massive unlabeled multimodal data, using tools such as web search and image editing to produce diverse, realistic samples. Second, DPE attributes failures to specific weaknesses, dynamically adjusts the data mixture, and guides agents to generate weakness focused data for targeted reinforcement. Experiments on Qwen3-VL-8B-Instruct and Qwen2.5-VL-7B-Instruct show stable, continual gains across eleven benchmarks, indicating DPE as a scalable paradigm for continual LMM training under open task distributions. Our code, models, and data are publicly available at https://github.com/hongruijia/DPE.

Doctors and patients alike increasingly use Large Language Models (LLMs) to diagnose clinical cases. However, unlike domains such as math or coding, where correctness can be objectively defined by the final answer, medical diagnosis requires both the outcome and the reasoning process to be accurate. Currently, widely used medical benchmarks like MedQA and MMLU assess only accuracy in the final answer, overlooking the quality and faithfulness of the clinical reasoning process. To address this limitation, we introduce MedCaseReasoning, the first open-access dataset for evaluating LLMs on their ability to align with clinician-authored diagnostic reasoning. The dataset includes 14,489 diagnostic question-and-answer cases, each paired with detailed reasoning statements derived from open-access medical case reports. We evaluate state-of-the-art reasoning LLMs on MedCaseReasoning and find significant shortcomings in their diagnoses and reasoning: for instance, the top-performing open-source model, DeepSeek-R1, achieves only 48% 10-shot diagnostic accuracy and mentions only 64% of the clinician reasoning statements (recall). However, we demonstrate that fine-tuning LLMs on the reasoning traces derived from MedCaseReasoning significantly improves diagnostic accuracy and clinical reasoning recall by an average relative gain of 29% and 41%, respectively. The open-source dataset, code, and models are available at https://github.com/kevinwu23/Stanford-MedCaseReasoning.

The rapid increase of computed tomography (CT) scans and their time-consuming manual analysis have created an urgent need for robust automated analysis techniques in clinical settings. These aim to assist radiologists and help them managing their growing workload. Existing methods typically generate entire reports directly from 3D CT images, without explicitly focusing on observed abnormalities. This unguided approach often results in repetitive content or incomplete reports, failing to prioritize anomaly-specific descriptions. We propose a new anomaly-guided report generation model, which first predicts abnormalities and then generates targeted descriptions for each. Evaluation on a public dataset demonstrates significant improvements in report quality and clinical relevance. We extend our work by conducting an ablation study to demonstrate its effectiveness.

Medical decision-making requires integrating diverse medical information, from imaging to clinical narratives. These medical modalities are often acquired in a many-to-many manner. However, current medical vision-language pretraining models (Med-VLPMs) fail to directly account for this many-to-many mapping in their model training and embeddings. To address this, we present Probabilistic Modality-Enhanced Diagnosis (ProbMED), a multimodal Med-VLPM that employs probabilistic contrastive learning to model distributions over embeddings rather than deterministic estimates. ProbMED aligns four distinct modalities -- chest X-rays, electrocardiograms, echocardiograms, and clinical text -- into a unified probabilistic embedding space. We use InfoNCE loss with Hellinger distance to integrate inter-modality distributions. We introduce a probabilistic synthetic sampling loss that captures modality-specific mean and variance to improve intra-modality binding. Extensive experiments across 13 medical datasets demonstrate that our model outperforms current Med-VLPMs in cross-modality retrieval, zero-shot, and few-shot classification. We also demonstrate the robust integration of multiple modalities for prognostication, showing improved intra- and inter-medical modality binding.

Large datasets have become commonplace in NLP research. However, the increased emphasis on data quantity has made it challenging to assess the quality of data. We introduce Data Maps---a model-based tool to characterize and diagnose datasets. We leverage a largely ignored source of information: the behavior of the model on individual instances during training (training dynamics) for building data maps. This yields two intuitive measures for each example---the model's confidence in the true class, and the variability of this confidence across epochs---obtained in a single run of training. Experiments across four datasets show that these model-dependent measures reveal three distinct regions in the data map, each with pronounced characteristics. First, our data maps show the presence of "ambiguous" regions with respect to the model, which contribute the most towards out-of-distribution generalization. Second, the most populous regions in the data are "easy to learn" for the model, and play an important role in model optimization. Finally, data maps uncover a region with instances that the model finds "hard to learn"; these often correspond to labeling errors. Our results indicate that a shift in focus from quantity to quality of data could lead to robust models and improved out-of-distribution generalization.

Large language models (LLMs) have demonstrated impressive capabilities in disease diagnosis. However, their effectiveness in identifying rarer diseases, which are inherently more challenging to diagnose, remains an open question. Rare disease performance is critical with the increasing use of LLMs in healthcare settings. This is especially true if a primary care physician needs to make a rarer prognosis from only a patient conversation so that they can take the appropriate next step. To that end, several clinical decision support systems are designed to support providers in rare disease identification. Yet their utility is limited due to their lack of knowledge of common disorders and difficulty of use. In this paper, we propose RareScale to combine the knowledge LLMs with expert systems. We use jointly use an expert system and LLM to simulate rare disease chats. This data is used to train a rare disease candidate predictor model. Candidates from this smaller model are then used as additional inputs to black-box LLM to make the final differential diagnosis. Thus, RareScale allows for a balance between rare and common diagnoses. We present results on over 575 rare diseases, beginning with Abdominal Actinomycosis and ending with Wilson's Disease. Our approach significantly improves the baseline performance of black-box LLMs by over 17% in Top-5 accuracy. We also find that our candidate generation performance is high (e.g. 88.8% on gpt-4o generated chats).

This study is based on the Alzheimer's Disease Neuroimaging Initiative (ADNI) dataset and aims to explore early detection and disease progression in Alzheimer's disease (AD). We employ innovative data preprocessing strategies, including the use of the random forest algorithm to fill missing data and the handling of outliers and invalid data, thereby fully mining and utilizing these limited data resources. Through Spearman correlation coefficient analysis, we identify some features strongly correlated with AD diagnosis. We build and test three machine learning models using these features: random forest, XGBoost, and support vector machine (SVM). Among them, the XGBoost model performs the best in terms of diagnostic performance, achieving an accuracy of 91%. Overall, this study successfully overcomes the challenge of missing data and provides valuable insights into early detection of Alzheimer's disease, demonstrating its unique research value and practical significance.

Recent advances in Large Language Models (LLMs) have highlighted the challenge of handling long-context tasks, where models need to reason over extensive input contexts to aggregate target information. While Chain-of-Thought (CoT) prompting has shown promise for multi-step reasoning, its effectiveness for long-context scenarios remains underexplored. Through systematic investigation across diverse tasks, we demonstrate that CoT's benefits generalize across most long-context scenarios and amplify with increasing context length. Motivated by this critical observation, we propose LongRePS, a process-supervised framework that teaches models to generate high-quality reasoning paths for enhanced long-context performance. Our framework incorporates a self-sampling mechanism to bootstrap reasoning paths and a novel quality assessment protocol specifically designed for long-context scenarios. Experimental results on various long-context benchmarks demonstrate the effectiveness of our approach, achieving significant improvements over outcome supervision baselines on both in-domain tasks (+13.6/+3.8 points for LLaMA/Qwen on MuSiQue) and cross-domain generalization (+9.3/+8.1 points on average across diverse QA tasks). Our code, data and trained models are made public to facilitate future research.

Diabetes, resulting from inadequate insulin production or utilization, causes extensive harm to the body. Existing diagnostic methods are often invasive and come with drawbacks, such as cost constraints. Although there are machine learning models like Classwise k Nearest Neighbor (CkNN) and General Regression Neural Network (GRNN), they struggle with imbalanced data and result in under-performance. Leveraging advancements in sensor technology and machine learning, we propose a non-invasive diabetes diagnosis using a Back Propagation Neural Network (BPNN) with batch normalization, incorporating data re-sampling and normalization for class balancing. Our method addresses existing challenges such as limited performance associated with traditional machine learning. Experimental results on three datasets show significant improvements in overall accuracy, sensitivity, and specificity compared to traditional methods. Notably, we achieve accuracies of 89.81% in Pima diabetes dataset, 75.49% in CDC BRFSS2015 dataset, and 95.28% in Mesra Diabetes dataset. This underscores the potential of deep learning models for robust diabetes diagnosis. See project website https://steve-zeyu-zhang.github.io/DiabetesDiagnosis/

Medical report generation has achieved remarkable advancements yet has still been faced with several challenges. First, the inherent imbalance in the distribution of normal and abnormal cases may lead models to exhibit a biased focus on normal samples, resulting in unreliable diagnoses. Second, the frequent occurrence of common template sentences in the reports may overwhelm the critical abnormal information. Moreover, existing works focus on 2D chest X-rays, leaving CT report generation underexplored due to the high-dimensional nature of CT images and the limited availability of CT-report pairs. Recently, LLM has shown a great ability to generate reliable answers with appropriate prompts, which shed light on addressing the aforementioned challenges. In this paper, we propose Dia-LLaMA, a framework to adapt the LLaMA2-7B for CT report generation by incorporating diagnostic information as guidance prompts. Considering the high dimension of CT, we leverage a pre-trained ViT3D with perceiver to extract the visual information. To tailor the LLM for report generation and emphasize abnormality, we extract additional diagnostic information by referring to a disease prototype memory bank, which is updated during training to capture common disease representations. Furthermore, we introduce disease-aware attention to enable the model to adjust attention for different diseases. Experiments on the chest CT dataset demonstrated that our proposed method outperformed previous methods and achieved state-of-the-art on both clinical efficacy performance and natural language generation metrics. The code will be made publically available.

The goal of the change-point detection is to discover changes of time series distribution. One of the state of the art approaches of the change-point detection are based on direct density ratio estimation. In this work we show how existing algorithms can be generalized using various binary classification and regression models. In particular, we show that the Gradient Boosting over Decision Trees and Neural Networks can be used for this purpose. The algorithms are tested on several synthetic and real-world datasets. The results show that the proposed methods outperform classical RuLSIF algorithm. Discussion of cases where the proposed algorithms have advantages over existing methods are also provided.

Visual Language Models (VLMs) have demonstrated impressive capabilities in visual grounding tasks. However, their effectiveness in the medical domain, particularly for abnormality detection and localization within medical images, remains underexplored. A major challenge is the complex and abstract nature of medical terminology, which makes it difficult to directly associate pathological anomaly terms with their corresponding visual features. In this work, we introduce a novel approach to enhance VLM performance in medical abnormality detection and localization by leveraging decomposed medical knowledge. Instead of directly prompting models to recognize specific abnormalities, we focus on breaking down medical concepts into fundamental attributes and common visual patterns. This strategy promotes a stronger alignment between textual descriptions and visual features, improving both the recognition and localization of abnormalities in medical images.We evaluate our method on the 0.23B Florence-2 base model and demonstrate that it achieves comparable performance in abnormality grounding to significantly larger 7B LLaVA-based medical VLMs, despite being trained on only 1.5% of the data used for such models. Experimental results also demonstrate the effectiveness of our approach in both known and previously unseen abnormalities, suggesting its strong generalization capabilities.

Prediction sets can wrap around any ML model to cover unknown test outcomes with a guaranteed probability. Yet, it remains unclear how to use them optimally for downstream decision-making. Here, we propose a decision-theoretic framework that seeks to minimize the expected loss (risk) against a worst-case distribution consistent with the prediction set's coverage guarantee. We first characterize the minimax optimal policy for a fixed prediction set, showing that it balances the worst-case loss inside the set with a penalty for potential losses outside the set. Building on this, we derive the optimal prediction set construction that minimizes the resulting robust risk subject to a coverage constraint. Finally, we introduce Risk-Optimal Conformal Prediction (ROCP), a practical algorithm that targets these risk-minimizing sets while maintaining finite-sample distribution-free marginal coverage. Empirical evaluations on medical diagnosis and safety-critical decision-making tasks demonstrate that ROCP reduces critical mistakes compared to baselines, particularly when out-of-set errors are costly.