Daily Papers

In this white paper we introduce Helix, an AI based solution for missense pathogenicity prediction. With recent advances in the sequencing of human genomes, massive amounts of genetic data have become available. This has shifted the burden of labor for genetic diagnostics and research from the gathering of data to its interpretation. Helix presents a state of the art platform for the prediction of pathogenicity in human missense variants. In addition to offering best-in-class predictive performance, Helix offers a platform that allows researchers to analyze and interpret variants in depth that can be accessed at helixlabs.ai.

Elucidating the functional effect of missense variants is of crucial importance, yet challenging. To understand the impact of such variants, we fine-tuned the ESM2 protein language model to classify 20 protein features at amino acid resolution. We used the resulting models to: 1) identify protein features that are enriched in either pathogenic or benign missense variants, 2) compare the characteristics of proteins with reference or alternate alleles to understand how missense variants affect protein functionality. We show that our model can be used to reclassify some variants of unknown significance. We also demonstrate the usage of our models for understanding the potential effect of variants on protein features.

Protein Language Models (PLMs) have emerged as performant and scalable tools for predicting the functional impact and clinical significance of protein-coding variants, but they still lag experimental accuracy. Here, we present a novel fine-tuning approach to improve the performance of PLMs with experimental maps of variant effects from Deep Mutational Scanning (DMS) assays using a Normalised Log-odds Ratio (NLR) head. We find consistent improvements in a held-out protein test set, and on independent DMS and clinical variant annotation benchmarks from ProteinGym and ClinVar. These findings demonstrate that DMS is a promising source of sequence diversity and supervised training data for improving the performance of PLMs for variant effect prediction.

Previous studies have shown that automated text-mining tools are becoming increasingly important for successfully unlocking variant information in scientific literature at large scale. Despite multiple attempts in the past, existing tools are still of limited recognition scope and precision. We propose tmVar 3.0: an improved variant recognition and normalization tool. Compared to its predecessors, tmVar 3.0 is able to recognize a wide spectrum of variant related entities (e.g., allele and copy number variants), and to group different variant mentions belonging to the same concept in an article for improved accuracy. Moreover, tmVar3 provides additional variant normalization options such as allele-specific identifiers from the ClinGen Allele Registry. tmVar3 exhibits a state-of-the-art performance with over 90% accuracy in F-measure in variant recognition and normalization, when evaluated on three independent benchmarking datasets. tmVar3 is freely available for download. We have also processed the entire PubMed and PMC with tmVar3 and released its annotations on our FTP. Availability: ftp://ftp.ncbi.nlm.nih.gov/pub/lu/tmVar3

Despite being self-supervised, protein language models have shown remarkable performance in fundamental biological tasks such as predicting impact of genetic variation on protein structure and function. The effectiveness of these models on diverse set of tasks suggests that they learn meaningful representations of fitness landscape that can be useful for downstream clinical applications. Here, we interrogate the use of these language models in characterizing known pathogenic mutations in curated, medically actionable genes through an exhaustive search of putative compensatory mutations on each variant's genetic background. Systematic analysis of the predicted effects of these compensatory mutations reveal unappreciated structural features of proteins that are missed by other structure predictors like AlphaFold. While deep mutational scan experiments provide an unbiased estimate of the mutational landscape, we encourage the community to generate and curate rescue mutation experiments to inform the design of more sophisticated co-masking strategies and leverage large language models more effectively for downstream clinical prediction tasks.

The ability to accurately model the fitness landscape of protein sequences is critical to a wide range of applications, from quantifying the effects of human variants on disease likelihood, to predicting immune-escape mutations in viruses and designing novel biotherapeutic proteins. Deep generative models of protein sequences trained on multiple sequence alignments have been the most successful approaches so far to address these tasks. The performance of these methods is however contingent on the availability of sufficiently deep and diverse alignments for reliable training. Their potential scope is thus limited by the fact many protein families are hard, if not impossible, to align. Large language models trained on massive quantities of non-aligned protein sequences from diverse families address these problems and show potential to eventually bridge the performance gap. We introduce Tranception, a novel transformer architecture leveraging autoregressive predictions and retrieval of homologous sequences at inference to achieve state-of-the-art fitness prediction performance. Given its markedly higher performance on multiple mutants, robustness to shallow alignments and ability to score indels, our approach offers significant gain of scope over existing approaches. To enable more rigorous model testing across a broader range of protein families, we develop ProteinGym -- an extensive set of multiplexed assays of variant effects, substantially increasing both the number and diversity of assays compared to existing benchmarks.

Recent advances in large language model (LLM) embeddings have enabled powerful representations for biological data, but most applications to date focus only on gene-level information. We present one of the first systematic frameworks to generate variant-level embeddings across the entire human genome. Using curated annotations from FAVOR, ClinVar, and the GWAS Catalog, we constructed semantic text descriptions for 8.9 billion possible variants and generated embeddings at three scales: 1.5 million HapMap3+MEGA variants, ~90 million imputed UK Biobank variants, and ~9 billion all possible variants. Embeddings were produced with both OpenAI's text-embedding-3-large and the open-source Qwen3-Embedding-0.6B models. Baseline experiments demonstrate high predictive accuracy for variant properties, validating the embeddings as structured representations of genomic variation. We outline two downstream applications: embedding-informed hypothesis testing by extending the Frequentist And Bayesian framework to genome-wide association studies, and embedding-augmented genetic risk prediction that enhances standard polygenic risk scores. These resources, publicly available on Hugging Face, provide a foundation for advancing large-scale genomic discovery and precision medicine.

Fine-tuning large language models (LLMs) to align with user preferences is challenging due to the high cost of quality human annotations in Reinforcement Learning from Human Feedback (RLHF) and the generalizability limitations of AI Feedback. To address these challenges, we propose RLTHF, a human-AI hybrid framework that combines LLM-based initial alignment with selective human annotations to achieve full-human annotation alignment with minimal effort. RLTHF identifies hard-to-annotate samples mislabeled by LLMs using a reward model's reward distribution and iteratively enhances alignment by integrating strategic human corrections while leveraging LLM's correctly labeled samples. Evaluations on HH-RLHF and TL;DR datasets show that RLTHF reaches full-human annotation-level alignment with only 6-7% of the human annotation effort. Furthermore, models trained on RLTHF's curated datasets for downstream tasks outperform those trained on fully human-annotated datasets, underscoring the effectiveness of RLTHF's strategic data curation.

Whole-genome sequencing (WGS) has revealed numerous non-coding short variants whose functional impacts remain poorly understood. Despite recent advances in deep-learning genomic approaches, accurately predicting and prioritizing clinically relevant mutations in gene regulatory regions remains a major challenge. Here we introduce Deep VRegulome, a deep-learning method for prediction and interpretation of functionally disruptive variants in the human regulome, which combines 700 DNABERT fine-tuned models, trained on vast amounts of ENCODE gene regulatory regions, with variant scoring, motif analysis, attention-based visualization, and survival analysis. We showcase its application on TCGA glioblastoma WGS dataset in prioritizing survival-associated mutations and regulatory regions. The analysis identified 572 splice-disrupting and 9,837 transcription-factor binding site altering mutations occurring in greater than 10% of glioblastoma samples. Survival analysis linked 1352 mutations and 563 disrupted regulatory regions to patient outcomes, enabling stratification via non-coding mutation signatures. All the code, fine-tuned models, and an interactive data portal are publicly available.

Large language models (LLMs) trained on text demonstrated remarkable results on natural language processing (NLP) tasks. These models have been adapted to decipher the language of DNA, where sequences of nucleotides act as "words" that encode genomic functions. However, the genome differs fundamentally from natural language, as it lacks clearly defined words or a consistent grammar. Although DNA language models (DNALMs) such as DNABERT, GENA-LM have achieved high level of performance on genome-related biological tasks, these models do not encode biological functions in the presence of sequence variations. To address this problem, we pre-train foundation models that effectively integrate sequence variations, in particular Single Nucleotide Polymorphisms (SNPs), as they underlie important biological functions. Specifically, we use ModernBERT to pre-train two different Biomedical Foundation Models (BMFM), namely, BMFM-DNA-REF in which the model is trained with sequences of varying lengths along with their reverse complements derived from the reference genome and BMFM-DNA-SNP in which the model is trained with sequences created using a novel representation scheme that encodes sequence variations. Our findings indicate that integrating sequence variations into DNALMs helps capture the biological functions as seen in improvements on all fine-tuning tasks. To explore the model's practical utility, we experimented with various strategies for SNP imputation on promoter detection task introduced in DNABERT-2. However, we acknowledge that the current benchmarks are limited in their ability to fully evaluate these models. To enable more comprehensive assessment in the future and encourage community contributions, we release our models through HuggingFace and the code to reproduce the results at https://github.com/BiomedSciAI/biomed-multi-omic

The approval success rate of drug candidates is very low with the majority of failure due to safety and efficacy. Increasingly available high dimensional information on targets, drug molecules and indications provides an opportunity for ML methods to integrate multiple data modalities and better predict clinically promising drug targets. Notably, drug targets with human genetics evidence are shown to have better odds to succeed. However, a recent tensor factorization-based approach found that additional information on targets and indications might not necessarily improve the predictive accuracy. Here we revisit this approach by integrating different types of human genetics evidence collated from publicly available sources to support each target-indication pair. We use Bayesian tensor factorization to show that models incorporating all available human genetics evidence (rare disease, gene burden, common disease) modestly improves the clinical outcome prediction over models using single line of genetics evidence. We provide additional insight into the relative predictive power of different types of human genetics evidence for predicting the success of clinical outcomes.

Human medical data can be challenging to obtain due to data privacy concerns, difficulties conducting certain types of experiments, or prohibitive associated costs. In many settings, data from animal models or in-vitro cell lines are available to help augment our understanding of human data. However, this data is known for having low etiological validity in comparison to human data. In this work, we augment small human medical datasets with in-vitro data and animal models. We use Invariant Risk Minimisation (IRM) to elucidate invariant features by considering cross-organism data as belonging to different data-generating environments. Our models identify genes of relevance to human cancer development. We observe a degree of consistency between varying the amounts of human and mouse data used, however, further work is required to obtain conclusive insights. As a secondary contribution, we enhance existing open source datasets and provide two uniformly processed, cross-organism, homologue gene-matched datasets to the community.

Health-related misinformation is very prevalent and potentially harmful. It is difficult to identify, especially when claims distort or misinterpret scientific findings. We investigate the impact of synthetic data generation and lightweight fine-tuning techniques on the ability of large language models (LLMs) to recognize fallacious arguments using the MISSCI dataset and framework. In this work, we propose MisSynth, a pipeline that applies retrieval-augmented generation (RAG) to produce synthetic fallacy samples, which are then used to fine-tune an LLM model. Our results show substantial accuracy gains with fine-tuned models compared to vanilla baselines. For instance, the LLaMA 3.1 8B fine-tuned model achieved an over 35% F1-score absolute improvement on the MISSCI test split over its vanilla baseline. We demonstrate that introducing synthetic fallacy data to augment limited annotated resources can significantly enhance zero-shot LLM classification performance on real-world scientific misinformation tasks, even with limited computational resources. The code and synthetic dataset are available on https://github.com/mxpoliakov/MisSynth.

Multiple Sequence Alignment (MSA) plays a pivotal role in unveiling the evolutionary trajectories of protein families. The accuracy of protein structure predictions is often compromised for protein sequences that lack sufficient homologous information to construct high quality MSA. Although various methods have been proposed to generate virtual MSA under these conditions, they fall short in comprehensively capturing the intricate coevolutionary patterns within MSA or require guidance from external oracle models. Here we introduce MSAGPT, a novel approach to prompt protein structure predictions via MSA generative pretraining in the low MSA regime. MSAGPT employs a simple yet effective 2D evolutionary positional encoding scheme to model complex evolutionary patterns. Endowed by this, its flexible 1D MSA decoding framework facilitates zero or few shot learning. Moreover, we demonstrate that leveraging the feedback from AlphaFold2 can further enhance the model capacity via Rejective Fine tuning (RFT) and Reinforcement Learning from AF2 Feedback (RLAF). Extensive experiments confirm the efficacy of MSAGPT in generating faithful virtual MSA to enhance the structure prediction accuracy. The transfer learning capabilities also highlight its great potential for facilitating other protein tasks.

Human annotation variation (i.e., annotation disagreements) is common in NLP and often reflects important information such as task subjectivity and sample ambiguity. While Large Language Models (LLMs) are increasingly used for automatic annotation to reduce human effort, their evaluation often focuses on predicting the majority-voted "ground truth" labels. It is still unclear, however, whether these models also capture informative human annotation variation. Our work addresses this gap by extensively evaluating LLMs' ability to predict annotation disagreements without access to repeated human labels. Our results show that LLMs struggle with modeling disagreements, which can be overlooked by majority label-based evaluations. Notably, while RLVR-style (Reinforcement learning with verifiable rewards) reasoning generally boosts LLM performance, it degrades performance in disagreement prediction. Our findings highlight the critical need for evaluating and improving LLM annotators in disagreement modeling. Code and data at https://github.com/EdisonNi-hku/Disagreement_Prediction.

We introduce a protein language model for determining the complete sequence of a peptide based on measurement of a limited set of amino acids. To date, protein sequencing relies on mass spectrometry, with some novel edman degregation based platforms able to sequence non-native peptides. Current protein sequencing techniques face limitations in accurately identifying all amino acids, hindering comprehensive proteome analysis. Our method simulates partial sequencing data by selectively masking amino acids that are experimentally difficult to identify in protein sequences from the UniRef database. This targeted masking mimics real-world sequencing limitations. We then modify and finetune a ProtBert derived transformer-based model, for a new downstream task predicting these masked residues, providing an approximation of the complete sequence. Evaluating on three bacterial Escherichia species, we achieve per-amino-acid accuracy up to 90.5% when only four amino acids ([KCYM]) are known. Structural assessment using AlphaFold and TM-score validates the biological relevance of our predictions. The model also demonstrates potential for evolutionary analysis through cross-species performance. This integration of simulated experimental constraints with computational predictions offers a promising avenue for enhancing protein sequence analysis, potentially accelerating advancements in proteomics and structural biology by providing a probabilistic reconstruction of the complete protein sequence from limited experimental data.

Pre-trained LLMs have demonstrated substantial capabilities across a range of conventional natural language processing (NLP) tasks, such as summarization and entity recognition. In this paper, we explore the application of LLMs in the generation of high-quality protein sequences. Specifically, we adopt a suite of pre-trained LLMs, including Mistral-7B1, Llama-2-7B2, Llama-3-8B3, and gemma-7B4, to produce valid protein sequences. All of these models are publicly available.5 Unlike previous work in this field, our approach utilizes a relatively small dataset comprising 42,000 distinct human protein sequences. We retrain these models to process protein-related data, ensuring the generation of biologically feasible protein structures. Our findings demonstrate that even with limited data, the adapted models exhibit efficiency comparable to established protein-focused models such as ProGen varieties, ProtGPT2, and ProLLaMA, which were trained on millions of protein sequences. To validate and quantify the performance of our models, we conduct comparative analyses employing standard metrics such as pLDDT, RMSD, TM-score, and REU. Furthermore, we commit to making the trained versions of all four models publicly available, fostering greater transparency and collaboration in the field of computational biology.

Alignment with human preference is a desired property of large language models (LLMs). Currently, the main alignment approach is based on reinforcement learning from human feedback (RLHF). Despite the effectiveness of RLHF, it is intricate to implement and train, thus recent studies explore how to develop alternative alignment approaches based on supervised fine-tuning (SFT). A major limitation of SFT is that it essentially does imitation learning, which cannot fully understand what are the expected behaviors. To address this issue, we propose an improved alignment approach named FIGA. Different from prior methods, we incorporate fine-grained (i.e., token or phrase level) quality signals that are derived by contrasting good and bad responses. Our approach has made two major contributions. Firstly, we curate a refined alignment dataset that pairs initial responses and the corresponding revised ones. Secondly, we devise a new loss function can leverage fine-grained quality signals to instruct the learning of LLMs for alignment. Extensive experiments have demonstrated the effectiveness of our approaches by comparing a number of competitive baselines.

Large language models (LLMs) have demonstrated impressive capabilities in natural language understanding and generation, but the quality bar for medical and clinical applications is high. Today, attempts to assess models' clinical knowledge typically rely on automated evaluations on limited benchmarks. There is no standard to evaluate model predictions and reasoning across a breadth of tasks. To address this, we present MultiMedQA, a benchmark combining six existing open question answering datasets spanning professional medical exams, research, and consumer queries; and HealthSearchQA, a new free-response dataset of medical questions searched online. We propose a framework for human evaluation of model answers along multiple axes including factuality, precision, possible harm, and bias. In addition, we evaluate PaLM (a 540-billion parameter LLM) and its instruction-tuned variant, Flan-PaLM, on MultiMedQA. Using a combination of prompting strategies, Flan-PaLM achieves state-of-the-art accuracy on every MultiMedQA multiple-choice dataset (MedQA, MedMCQA, PubMedQA, MMLU clinical topics), including 67.6% accuracy on MedQA (US Medical License Exam questions), surpassing prior state-of-the-art by over 17%. However, human evaluation reveals key gaps in Flan-PaLM responses. To resolve this we introduce instruction prompt tuning, a parameter-efficient approach for aligning LLMs to new domains using a few exemplars. The resulting model, Med-PaLM, performs encouragingly, but remains inferior to clinicians. We show that comprehension, recall of knowledge, and medical reasoning improve with model scale and instruction prompt tuning, suggesting the potential utility of LLMs in medicine. Our human evaluations reveal important limitations of today's models, reinforcing the importance of both evaluation frameworks and method development in creating safe, helpful LLM models for clinical applications.

Large Language Models (LLMs) have shown remarkable performance across various tasks, yet significant disparities remain for non-English languages, and especially native African languages. This paper addresses these disparities by creating approximately 1 million human-translated words of new benchmark data in 8 low-resource African languages, covering a population of over 160 million speakers of: Amharic, Bambara, Igbo, Sepedi (Northern Sotho), Shona, Sesotho (Southern Sotho), Setswana, and Tsonga. Our benchmarks are translations of Winogrande and three sections of MMLU: college medicine, clinical knowledge, and virology. Using the translated benchmarks, we report previously unknown performance gaps between state-of-the-art (SOTA) LLMs in English and African languages. Finally, using results from over 400 fine-tuned models, we explore several methods to reduce the LLM performance gap, including high-quality dataset fine-tuning (using an LLM-as-an-Annotator), cross-lingual transfer, and cultural appropriateness adjustments. Key findings include average mono-lingual improvements of 5.6% with fine-tuning (with 5.4% average mono-lingual improvements when using high-quality data over low-quality data), 2.9% average gains from cross-lingual transfer, and a 3.0% out-of-the-box performance boost on culturally appropriate questions. The publicly available benchmarks, translations, and code from this study support further research and development aimed at creating more inclusive and effective language technologies.

Recent advancements in open-source multi-modal large language models (MLLMs) have primarily focused on enhancing foundational capabilities, leaving a significant gap in human preference alignment. This paper introduces OmniAlign-V, a comprehensive dataset of 200K high-quality training samples featuring diverse images, complex questions, and varied response formats to improve MLLMs' alignment with human preferences. We also present MM-AlignBench, a human-annotated benchmark specifically designed to evaluate MLLMs' alignment with human values. Experimental results show that finetuning MLLMs with OmniAlign-V, using Supervised Fine-Tuning (SFT) or Direct Preference Optimization (DPO), significantly enhances human preference alignment while maintaining or enhancing performance on standard VQA benchmarks, preserving their fundamental capabilities. Our datasets, benchmark, code and checkpoints have been released at https://github.com/PhoenixZ810/OmniAlign-V.

Generative protein language models are a natural way to design new proteins with desired functions. However, current models are either difficult to direct to produce a protein from a specific family of interest, or must be trained on a large multiple sequence alignment (MSA) from the specific family of interest, making them unable to benefit from transfer learning across families. To address this, we propose Protein Evolutionary Transformer (PoET), an autoregressive generative model of whole protein families that learns to generate sets of related proteins as sequences-of-sequences across tens of millions of natural protein sequence clusters. PoET can be used as a retrieval-augmented language model to generate and score arbitrary modifications conditioned on any protein family of interest, and can extrapolate from short context lengths to generalize well even for small families. This is enabled by a unique Transformer layer; we model tokens sequentially within sequences while attending between sequences order invariantly, allowing PoET to scale to context lengths beyond those used during training. In extensive experiments on deep mutational scanning datasets, we show that PoET outperforms existing protein language models and evolutionary sequence models for variant function prediction across proteins of all MSA depths. We also demonstrate PoET's ability to controllably generate new protein sequences.

Many have observed that the development and deployment of generative machine learning (ML) and artificial intelligence (AI) models follow a distinctive pattern in which pre-trained models are adapted and fine-tuned for specific downstream tasks. However, there is limited empirical work that examines the structure of these interactions. This paper analyzes 1.86 million models on Hugging Face, a leading peer production platform for model development. Our study of model family trees -- networks that connect fine-tuned models to their base or parent -- reveals sprawling fine-tuning lineages that vary widely in size and structure. Using an evolutionary biology lens to study ML models, we use model metadata and model cards to measure the genetic similarity and mutation of traits over model families. We find that models tend to exhibit a family resemblance, meaning their genetic markers and traits exhibit more overlap when they belong to the same model family. However, these similarities depart in certain ways from standard models of asexual reproduction, because mutations are fast and directed, such that two `sibling' models tend to exhibit more similarity than parent/child pairs. Further analysis of the directional drifts of these mutations reveals qualitative insights about the open machine learning ecosystem: Licenses counter-intuitively drift from restrictive, commercial licenses towards permissive or copyleft licenses, often in violation of upstream license's terms; models evolve from multi-lingual compatibility towards english-only compatibility; and model cards reduce in length and standardize by turning, more often, to templates and automatically generated text. Overall, this work takes a step toward an empirically grounded understanding of model fine-tuning and suggests that ecological models and methods can yield novel scientific insights.

Genome-wide association study (GWAS) tests single nucleotide polymorphism (SNP) markers across the genome to localize the underlying causal variant of a trait. Because causal variants are seldom observed directly, a surrogate model based on genotyped markers are widely considered. Although many methods estimating the parameters of the surrogate model have been proposed, the connection between the surrogate model and the true causal model is yet investigated. In this work, we establish the connection between the surrogate model and the true causal model. The connection shows that population structure is accounted in GWAS by modelling the variant of interest and not the trait. Such observation explains how environmental confounding can be partially corrected using genetic covariates and why the previously claimed connection between PC correction and linear mixed models is incorrect.

Despite notable advancements in Multimodal Large Language Models (MLLMs), most state-of-the-art models have not undergone thorough alignment with human preferences. This gap exists because current alignment research has primarily achieved progress in specific areas (e.g., hallucination reduction), while the broader question of whether aligning models with human preferences can systematically enhance MLLM capability remains largely unexplored. To this end, we introduce MM-RLHF, a dataset containing 120k fine-grained, human-annotated preference comparison pairs. This dataset represents a substantial advancement over existing resources, offering superior size, diversity, annotation granularity, and quality. Leveraging this dataset, we propose several key innovations to improve both the quality of reward models and the efficiency of alignment algorithms. Notably, we introduce a Critique-Based Reward Model, which generates critiques of model outputs before assigning scores, offering enhanced interpretability and more informative feedback compared to traditional scalar reward mechanisms. Additionally, we propose Dynamic Reward Scaling, a method that adjusts the loss weight of each sample according to the reward signal, thereby optimizing the use of high-quality comparison pairs. Our approach is rigorously evaluated across 10 distinct dimensions and 27 benchmarks, with results demonstrating significant and consistent improvements in model performance. Specifically, fine-tuning LLaVA-ov-7B with MM-RLHF and our alignment algorithm leads to a 19.5% increase in conversational abilities and a 60% improvement in safety. We have open-sourced the preference dataset, reward model, training and evaluation code, as well as reward modeling and safety benchmarks. For more details, please visit our project page: https://mm-rlhf.github.io.

Antibodies comprise the most versatile class of binding molecules, with numerous applications in biomedicine. Computational design of antibodies involves generating novel and diverse sequences, while maintaining structural consistency. Unique to antibodies, designing the complementarity-determining region (CDR), which determines the antigen binding affinity and specificity, creates its own unique challenges. Recent deep learning models have shown impressive results, however the limited number of known antibody sequence/structure pairs frequently leads to degraded performance, particularly lacking diversity in the generated sequences. In our work we address this challenge by leveraging Model Reprogramming (MR), which repurposes pretrained models on a source language to adapt to the tasks that are in a different language and have scarce data - where it may be difficult to train a high-performing model from scratch or effectively fine-tune an existing pre-trained model on the specific task. Specifically, we introduce ReprogBert in which a pretrained English language model is repurposed for protein sequence infilling - thus considers cross-language adaptation using less data. Results on antibody design benchmarks show that our model on low-resourced antibody sequence dataset provides highly diverse CDR sequences, up to more than a two-fold increase of diversity over the baselines, without losing structural integrity and naturalness. The generated sequences also demonstrate enhanced antigen binding specificity and virus neutralization ability. Code is available at https://github.com/IBM/ReprogBERT

The widespread application of Large Language Models (LLMs) across various tasks and fields has necessitated the alignment of these models with human values and preferences. Given various approaches of human value alignment, ranging from Reinforcement Learning with Human Feedback (RLHF), to constitutional learning, etc. there is an urgent need to understand the scope and nature of human values injected into these models before their release. There is also a need for model alignment without a costly large scale human annotation effort. We propose UniVaR, a high-dimensional representation of human value distributions in LLMs, orthogonal to model architecture and training data. Trained from the value-relevant output of eight multilingual LLMs and tested on the output from four multilingual LLMs, namely LlaMA2, ChatGPT, JAIS and Yi, we show that UniVaR is a powerful tool to compare the distribution of human values embedded in different LLMs with different langauge sources. Through UniVaR, we explore how different LLMs prioritize various values in different languages and cultures, shedding light on the complex interplay between human values and language modeling.

The field of protein folding research has been greatly advanced by deep learning methods, with AlphaFold2 (AF2) demonstrating exceptional performance and atomic-level precision. As co-evolution is integral to protein structure prediction, AF2's accuracy is significantly influenced by the depth of multiple sequence alignment (MSA), which requires extensive exploration of a large protein database for similar sequences. However, not all protein sequences possess abundant homologous families, and consequently, AF2's performance can degrade on such queries, at times failing to produce meaningful results. To address this, we introduce a novel generative language model, MSA-Augmenter, which leverages protein-specific attention mechanisms and large-scale MSAs to generate useful, novel protein sequences not currently found in databases. These sequences supplement shallow MSAs, enhancing the accuracy of structural property predictions. Our experiments on CASP14 demonstrate that MSA-Augmenter can generate de novo sequences that retain co-evolutionary information from inferior MSAs, thereby improving protein structure prediction quality on top of strong AF2.

This paper proposes one of the first clinical applications of multimodal large language models (LLMs) as an assistant for radiologists to check errors in their reports. We created an evaluation dataset from two real-world radiology datasets (MIMIC-CXR and IU-Xray), with 1,000 subsampled reports each. A subset of original reports was modified to contain synthetic errors by introducing various type of mistakes. The evaluation contained two difficulty levels: SIMPLE for binary error-checking and COMPLEX for identifying error types. LLaVA (Large Language and Visual Assistant) variant models, including our instruction-tuned model, were used for the evaluation. Additionally, a domain expert evaluation was conducted on a small test set. At the SIMPLE level, the LLaVA v1.5 model outperformed other publicly available models. Instruction tuning significantly enhanced performance by 47.4% and 25.4% on MIMIC-CXR and IU-Xray data, respectively. The model also surpassed the domain experts accuracy in the MIMIC-CXR dataset by 1.67%. Notably, among the subsets (N=21) of the test set where a clinician did not achieve the correct conclusion, the LLaVA ensemble mode correctly identified 71.4% of these cases. This study marks a promising step toward utilizing multi-modal LLMs to enhance diagnostic accuracy in radiology. The ensemble model demonstrated comparable performance to clinicians, even capturing errors overlooked by humans. Nevertheless, future work is needed to improve the model ability to identify the types of inconsistency.

We test whether Large Language Models (LLMs) can be used to simulate human participants in social-science studies. To do this, we run replications of 14 studies from the Many Labs 2 replication project with OpenAI's text-davinci-003 model, colloquially known as GPT3.5. Based on our pre-registered analyses, we find that among the eight studies we could analyse, our GPT sample replicated 37.5% of the original results and 37.5% of the Many Labs 2 results. However, we were unable to analyse the remaining six studies due to an unexpected phenomenon we call the "correct answer" effect. Different runs of GPT3.5 answered nuanced questions probing political orientation, economic preference, judgement, and moral philosophy with zero or near-zero variation in responses: with the supposedly "correct answer." In one exploratory follow-up study, we found that a "correct answer" was robust to changing the demographic details that precede the prompt. In another, we found that most but not all "correct answers" were robust to changing the order of answer choices. One of our most striking findings occurred in our replication of the Moral Foundations Theory survey results, where we found GPT3.5 identifying as a political conservative in 99.6% of the cases, and as a liberal in 99.3% of the cases in the reverse-order condition. However, both self-reported 'GPT conservatives' and 'GPT liberals' showed right-leaning moral foundations. Our results cast doubts on the validity of using LLMs as a general replacement for human participants in the social sciences. Our results also raise concerns that a hypothetical AI-led future may be subject to a diminished diversity-of-thought.

The ability to translate diverse patterns of inputs into structured patterns of behavior has been thought to rest on both humans' and machines' ability to learn robust representations of relevant concepts. The rapid advancement of transformer-based large language models (LLMs) has led to a diversity of computational ingredients -- architectures, fine tuning methods, and training datasets among others -- but it remains unclear which of these ingredients are most crucial for building models that develop human-like representations. Further, most current LLM benchmarks are not suited to measuring representational alignment between humans and models, making benchmark scores unreliable for assessing if current LLMs are making progress towards becoming useful cognitive models. We address these limitations by first evaluating a set of over 70 models that widely vary in their computational ingredients on a triplet similarity task, a method well established in the cognitive sciences for measuring human conceptual representations, using concepts from the THINGS database. Comparing human and model representations, we find that models that undergo instruction-finetuning and which have larger dimensionality of attention heads are among the most human aligned, while multimodal pretraining and parameter size have limited bearing on alignment. Correlations between alignment scores and scores on existing benchmarks reveal that while some benchmarks (e.g., MMLU) are better suited than others (e.g., MUSR) for capturing representational alignment, no existing benchmark is capable of fully accounting for the variance of alignment scores, demonstrating their insufficiency in capturing human-AI alignment. Taken together, our findings help highlight the computational ingredients most essential for advancing LLMs towards models of human conceptual representation and address a key benchmarking gap in LLM evaluation.

Recent advancements in large language model(LLM) performance on medical multiple choice question (MCQ) benchmarks have stimulated interest from healthcare providers and patients globally. Particularly in low-and middle-income countries (LMICs) facing acute physician shortages and lack of specialists, LLMs offer a potentially scalable pathway to enhance healthcare access and reduce costs. However, their effectiveness in the Global South, especially across the African continent, remains to be established. In this work, we introduce AfriMed-QA, the first large scale Pan-African English multi-specialty medical Question-Answering (QA) dataset, 15,000 questions (open and closed-ended) sourced from over 60 medical schools across 16 countries, covering 32 medical specialties. We further evaluate 30 LLMs across multiple axes including correctness and demographic bias. Our findings show significant performance variation across specialties and geographies, MCQ performance clearly lags USMLE (MedQA). We find that biomedical LLMs underperform general models and smaller edge-friendly LLMs struggle to achieve a passing score. Interestingly, human evaluations show a consistent consumer preference for LLM answers and explanations when compared with clinician answers.

Large Vision-Language Models (LVLMs) hold significant promise for medical applications, yet their deployment is often constrained by insufficient alignment and reliability. While Direct Preference Optimization (DPO) has emerged as a potent framework for refining model responses, its efficacy in high-stakes medical contexts remains underexplored, lacking the rigorous empirical groundwork necessary to guide future methodological advances. To bridge this gap, we present the first comprehensive examination of diverse DPO variants within the medical domain, evaluating nine distinct formulations across two medical LVLMs: LLaVA-Med and HuatuoGPT-Vision. Our results reveal several critical limitations: current DPO approaches often yield inconsistent gains over supervised fine-tuning, with their efficacy varying significantly across different tasks and backbones. Furthermore, they frequently fail to resolve fundamental visual misinterpretation errors. Building on these insights, we present a targeted preference construction strategy as a proof-of-concept that explicitly addresses visual misinterpretation errors frequently observed in existing DPO models. This design yields a 3.6% improvement over the strongest existing DPO baseline on visual question-answering tasks. To support future research, we release our complete framework, including all training data, model checkpoints, and our codebase at https://github.com/dmis-lab/med-vlm-dpo.

Large Language Models (LLMs) have demonstrated impressive capabilities across a range of scientific tasks including mathematics, physics, and chemistry. Despite their successes, the effectiveness of LLMs in handling complex statistical tasks remains systematically under-explored. To bridge this gap, we introduce StatQA, a new benchmark designed for statistical analysis tasks. StatQA comprises 11,623 examples tailored to evaluate LLMs' proficiency in specialized statistical tasks and their applicability assessment capabilities, particularly for hypothesis testing methods. We systematically experiment with representative LLMs using various prompting strategies and show that even state-of-the-art models such as GPT-4o achieve a best performance of only 64.83%, indicating significant room for improvement. Notably, while open-source LLMs (e.g. LLaMA-3) show limited capability, those fine-tuned ones exhibit marked improvements, outperforming all in-context learning-based methods (e.g. GPT-4o). Moreover, our comparative human experiments highlight a striking contrast in error types between LLMs and humans: LLMs primarily make applicability errors, whereas humans mostly make statistical task confusion errors. This divergence highlights distinct areas of proficiency and deficiency, suggesting that combining LLM and human expertise could lead to complementary strengths, inviting further investigation into their collaborative potential.

Widely used alignment techniques, such as reinforcement learning from human feedback (RLHF), rely on the ability of humans to supervise model behavior - for example, to evaluate whether a model faithfully followed instructions or generated safe outputs. However, future superhuman models will behave in complex ways too difficult for humans to reliably evaluate; humans will only be able to weakly supervise superhuman models. We study an analogy to this problem: can weak model supervision elicit the full capabilities of a much stronger model? We test this using a range of pretrained language models in the GPT-4 family on natural language processing (NLP), chess, and reward modeling tasks. We find that when we naively finetune strong pretrained models on labels generated by a weak model, they consistently perform better than their weak supervisors, a phenomenon we call weak-to-strong generalization. However, we are still far from recovering the full capabilities of strong models with naive finetuning alone, suggesting that techniques like RLHF may scale poorly to superhuman models without further work. We find that simple methods can often significantly improve weak-to-strong generalization: for example, when finetuning GPT-4 with a GPT-2-level supervisor and an auxiliary confidence loss, we can recover close to GPT-3.5-level performance on NLP tasks. Our results suggest that it is feasible to make empirical progress today on a fundamental challenge of aligning superhuman models.

Despite the impressive capabilities of Large Language Models (LLMs) in general medical domains, questions remain about their performance in diagnosing rare diseases. To answer this question, we aim to assess the diagnostic performance of LLMs in rare diseases, and explore methods to enhance their effectiveness in this area. In this work, we introduce a rare disease question-answering (ReDis-QA) dataset to evaluate the performance of LLMs in diagnosing rare diseases. Specifically, we collected 1360 high-quality question-answer pairs within the ReDis-QA dataset, covering 205 rare diseases. Additionally, we annotated meta-data for each question, facilitating the extraction of subsets specific to any given disease and its property. Based on the ReDis-QA dataset, we benchmarked several open-source LLMs, revealing that diagnosing rare diseases remains a significant challenge for these models. To facilitate retrieval augmentation generation for rare disease diagnosis, we collect the first rare diseases corpus (ReCOP), sourced from the National Organization for Rare Disorders (NORD) database. Specifically, we split the report of each rare disease into multiple chunks, each representing a different property of the disease, including their overview, symptoms, causes, effects, related disorders, diagnosis, and standard therapies. This structure ensures that the information within each chunk aligns consistently with a question. Experiment results demonstrate that ReCOP can effectively improve the accuracy of LLMs on the ReDis-QA dataset by an average of 8%. Moreover, it significantly guides LLMs to generate trustworthy answers and explanations that can be traced back to existing literature.

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.

Reinforcement Learning from Human Feedback (RLHF) is a powerful paradigm for aligning foundation models to human values and preferences. However, current RLHF techniques cannot account for the naturally occurring differences in individual human preferences across a diverse population. When these differences arise, traditional RLHF frameworks simply average over them, leading to inaccurate rewards and poor performance for individual subgroups. To address the need for pluralistic alignment, we develop a class of multimodal RLHF methods. Our proposed techniques are based on a latent variable formulation - inferring a novel user-specific latent and learning reward models and policies conditioned on this latent without additional user-specific data. While conceptually simple, we show that in practice, this reward modeling requires careful algorithmic considerations around model architecture and reward scaling. To empirically validate our proposed technique, we first show that it can provide a way to combat underspecification in simulated control problems, inferring and optimizing user-specific reward functions. Next, we conduct experiments on pluralistic language datasets representing diverse user preferences and demonstrate improved reward function accuracy. We additionally show the benefits of this probabilistic framework in terms of measuring uncertainty, and actively learning user preferences. This work enables learning from diverse populations of users with divergent preferences, an important challenge that naturally occurs in problems from robot learning to foundation model alignment.

Open-source, multilingual medical large language models (LLMs) have the potential to serve linguistically diverse populations across different regions. Adapting generic LLMs for healthcare often requires continual pretraining, but this approach is computationally expensive and sometimes impractical. Instruction fine-tuning on a specific task may not always guarantee optimal performance due to the lack of broader domain knowledge that the model needs to understand and reason effectively in diverse scenarios. To address these challenges, we introduce two multilingual instruction fine-tuning datasets, MMed-IFT and MMed-IFT-MC, containing over 200k high-quality medical samples in six languages. We propose a two-stage training paradigm: the first stage injects general medical knowledge using MMed-IFT, while the second stage fine-tunes task-specific multiple-choice questions with MMed-IFT-MC. Our method achieves competitive results on both English and multilingual benchmarks, striking a balance between computational efficiency and performance. We plan to make our dataset and model weights public at https://github.com/SpassMed/Med-Llama3 in the future.

As large language models (LLMs) continue to advance, ensuring their alignment with human values becomes increasingly critical. Traditional alignment methods heavily rely on human feedback to fine-tune models. With the emergence of superhuman models whose outputs may surpass human understanding, evaluating and aligning these models using human judgments poses significant challenges. To address the challenges, recent works use weak supervisors to elicit knowledge from much stronger models. However, there are important disanalogies between the empirical setup in the existing works and the genuine goal of alignment. We remark that existing works investigate the phenomenon of weak-to-strong generation in analogous setup (i.e., binary classification), rather than practical alignment-relevant tasks (e.g., safety). In this paper, we bridge this gap by extending weak-to-strong generation to the context of practical alignment. We empirically demonstrate the widespread phenomenon of weak-to-strong generation in three complicated alignment tasks: safety, toxicity, and legal reasoning}. Furthermore, we explore efficient strategies for improving alignment performance to enhance the quality of model outcomes. Lastly, we summarize and analyze the challenges and potential solutions in regard to specific alignment tasks, which we hope to catalyze the research progress on the topic of weak-to-strong generalization. Our code is released at https://github.com/yeruimeng/WTS.git.

With the growing utilization of large language models (LLMs) across domains, alignment towards human preferences has become one of the most critical aspects of training models. At the forefront of state-of-the-art human alignment methods are preference optimization methods (*PO). However, prior research has often concentrated on identifying the best-performing method, typically involving a grid search over hyperparameters, which can be impractical for general practitioners. In this paper, we aim to identify the algorithm that, while being performant, is simultaneously more robust to varying hyperparameters, thereby increasing the likelihood of achieving better results. We focus on a realistic out-of-distribution (OOD) scenario that mirrors real-world applications of human alignment, offering practical insights into the strengths and weaknesses of these methods. Furthermore, to better understand the shortcomings of generations from the different methods, we analyze the model generations through the lens of KL divergence of the SFT model and the response length statistics. Our analysis reveals that the widely adopted DPO method consistently produces lengthy responses of inferior quality that are very close to the SFT responses. Motivated by these findings, we propose an embarrassingly simple extension to the DPO algorithm, LN-DPO, resulting in more concise responses without sacrificing quality compared to the policy obtained by vanilla DPO.

Aligning large language models (LLMs) with human preferences is crucial for enhancing their utility in terms of helpfulness, truthfulness, safety, harmlessness, and interestingness. Existing methods for achieving this alignment often involves employing reinforcement learning from human feedback (RLHF) to fine-tune LLMs based on human labels assessing the relative quality of model responses. Nevertheless, RLHF is susceptible to instability during fine-tuning and presents challenges in implementation.Drawing inspiration from the emerging field of representation engineering (RepE), this study aims to identify relevant representations for high-level human preferences embedded in patterns of activity within an LLM, and achieve precise control of model behavior by transforming its representations. This novel approach, denoted as Representation Alignment from Human Feedback (RAHF), proves to be effective, computationally efficient, and easy to implement.Extensive experiments demonstrate the efficacy of RAHF in not only capturing but also manipulating representations to align with a broad spectrum of human preferences or values, rather than being confined to a singular concept or function (e.g. honesty or bias). RAHF's versatility in accommodating diverse human preferences shows its potential for advancing LLM performance.

Pre-trained large language models(LLMs) have attracted increasing attention in biomedical domains due to their success in natural language processing. However, the complex traits and heterogeneity of multi-sources genomics data pose significant challenges when adapting these models to the bioinformatics and biomedical field. To address these challenges, we present GP-GPT, the first specialized large language model for genetic-phenotype knowledge representation and genomics relation analysis. Our model is fine-tuned in two stages on a comprehensive corpus composed of over 3,000,000 terms in genomics, proteomics, and medical genetics, derived from multiple large-scale validated datasets and scientific publications. GP-GPT demonstrates proficiency in accurately retrieving medical genetics information and performing common genomics analysis tasks, such as genomics information retrieval and relationship determination. Comparative experiments across domain-specific tasks reveal that GP-GPT outperforms state-of-the-art LLMs, including Llama2, Llama3 and GPT-4. These results highlight GP-GPT's potential to enhance genetic disease relation research and facilitate accurate and efficient analysis in the fields of genomics and medical genetics. Our investigation demonstrated the subtle changes of bio-factor entities' representations in the GP-GPT, which suggested the opportunities for the application of LLMs to advancing gene-phenotype research.

In this work we introduce RITA: a suite of autoregressive generative models for protein sequences, with up to 1.2 billion parameters, trained on over 280 million protein sequences belonging to the UniRef-100 database. Such generative models hold the promise of greatly accelerating protein design. We conduct the first systematic study of how capabilities evolve with model size for autoregressive transformers in the protein domain: we evaluate RITA models in next amino acid prediction, zero-shot fitness, and enzyme function prediction, showing benefits from increased scale. We release the RITA models openly, to the benefit of the research community.

Medical multiple-choice question answering (MCQA) is particularly difficult. Questions may describe patient symptoms and ask for the correct diagnosis, which requires domain knowledge and complex reasoning. Standard language modeling pretraining alone is not sufficient to achieve the best results. jin2020disease showed that focusing masked language modeling on disease name prediction when using medical encyclopedic paragraphs as input leads to considerable MCQA accuracy improvement. In this work, we show that (1) fine-tuning on generated MCQA dataset outperforms the masked language modeling based objective and (2) correctly masking the cues to the answers is critical for good performance. We release new pretraining datasets and achieve state-of-the-art results on 4 MCQA datasets, notably +5.7\% with base-size model on MedQA-USMLE.

Antibodies have become an important class of therapeutic agents to treat human diseases. To accelerate therapeutic antibody discovery, computational methods, especially machine learning, have attracted considerable interest for predicting specific interactions between antibody candidates and target antigens such as viruses and bacteria. However, the publicly available datasets in existing works have notable limitations, such as small sizes and the lack of non-binding samples and exact amino acid sequences. To overcome these limitations, we have developed AVIDa-hIL6, a large-scale dataset for predicting antigen-antibody interactions in the variable domain of heavy chain of heavy chain antibodies (VHHs), produced from an alpaca immunized with the human interleukin-6 (IL-6) protein, as antigens. By leveraging the simple structure of VHHs, which facilitates identification of full-length amino acid sequences by DNA sequencing technology, AVIDa-hIL6 contains 573,891 antigen-VHH pairs with amino acid sequences. All the antigen-VHH pairs have reliable labels for binding or non-binding, as generated by a novel labeling method. Furthermore, via introduction of artificial mutations, AVIDa-hIL6 contains 30 different mutants in addition to wild-type IL-6 protein. This characteristic provides opportunities to develop machine learning models for predicting changes in antibody binding by antigen mutations. We report experimental benchmark results on AVIDa-hIL6 by using neural network-based baseline models. The results indicate that the existing models have potential, but further research is needed to generalize them to predict effective antibodies against unknown mutants. The dataset is available at https://avida-hil6.cognanous.com.

The alignment problem in the context of large language models must consider the plurality of human values in our world. Whilst there are many resonant and overlapping values amongst the world's cultures, there are also many conflicting, yet equally valid, values. It is important to observe which cultural values a model exhibits, particularly when there is a value conflict between input prompts and generated outputs. We discuss how the co-creation of language and cultural value impacts large language models (LLMs). We explore the constitution of the training data for GPT-3 and compare that to the world's language and internet access demographics, as well as to reported statistical profiles of dominant values in some Nation-states. We stress tested GPT-3 with a range of value-rich texts representing several languages and nations; including some with values orthogonal to dominant US public opinion as reported by the World Values Survey. We observed when values embedded in the input text were mutated in the generated outputs and noted when these conflicting values were more aligned with reported dominant US values. Our discussion of these results uses a moral value pluralism (MVP) lens to better understand these value mutations. Finally, we provide recommendations for how our work may contribute to other current work in the field.

Commonsense intelligence in machines is often assessed by static benchmarks that compare a model's output against human-prescribed correct labels. An important, albeit implicit, assumption of these labels is that they accurately capture what any human would think, effectively treating human common sense as homogeneous. However, recent empirical work has shown that humans vary enormously in what they consider commonsensical; thus what appears self-evident to one benchmark designer may not be so to another. Here, we propose a novel method for evaluating common sense in artificial intelligence (AI), specifically in large language models (LLMs), that incorporates empirically observed heterogeneity among humans by measuring the correspondence between a model's judgment and that of a human population. We first find that, when treated as independent survey respondents, most LLMs remain below the human median in their individual commonsense competence. Second, when used as simulators of a hypothetical population, LLMs correlate with real humans only modestly in the extent to which they agree on the same set of statements. In both cases, smaller, open-weight models are surprisingly more competitive than larger, proprietary frontier models. Our evaluation framework, which ties commonsense intelligence to its cultural basis, contributes to the growing call for adapting AI models to human collectivities that possess different, often incompatible, social stocks of knowledge.

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

The development of powerful natural language models have increased the ability to learn meaningful representations of protein sequences. In addition, advances in high-throughput mutagenesis, directed evolution, and next-generation sequencing have allowed for the accumulation of large amounts of labeled fitness data. Leveraging these two trends, we introduce Regularized Latent Space Optimization (ReLSO), a deep transformer-based autoencoder which features a highly structured latent space that is trained to jointly generate sequences as well as predict fitness. Through regularized prediction heads, ReLSO introduces a powerful protein sequence encoder and novel approach for efficient fitness landscape traversal. Using ReLSO, we explicitly model the sequence-function landscape of large labeled datasets and generate new molecules by optimizing within the latent space using gradient-based methods. We evaluate this approach on several publicly-available protein datasets, including variant sets of anti-ranibizumab and GFP. We observe a greater sequence optimization efficiency (increase in fitness per optimization step) by ReLSO compared to other approaches, where ReLSO more robustly generates high-fitness sequences. Furthermore, the attention-based relationships learned by the jointly-trained ReLSO models provides a potential avenue towards sequence-level fitness attribution information.

Reinforcement Learning from Human Feedback (RLHF) is widely used for aligning large language models, yet practitioners face a persistent puzzle: improving safety often reduces fairness, scaling to diverse populations becomes computationally intractable, and making systems robust often amplifies majority biases. We formalize this tension as the Alignment Trilemma: no RLHF system can simultaneously achieve (i) epsilon-representativeness across diverse human values, (ii) polynomial tractability in sample and compute complexity, and (iii) delta-robustness against adversarial perturbations and distribution shift. Through a complexity-theoretic analysis integrating statistical learning theory and robust optimization, we prove that achieving both representativeness (epsilon <= 0.01) and robustness (delta <= 0.001) for global-scale populations requires Omega(2^{d_context}) operations, which is super-polynomial in the context dimensionality. We show that current RLHF implementations resolve this trilemma by sacrificing representativeness: they collect only 10^3--10^4 samples from homogeneous annotator pools while 10^7--10^8 samples are needed for true global representation. Our framework provides a unified explanation for documented RLHF pathologies including preference collapse, sycophancy, and systematic bias amplification. We conclude with concrete directions for navigating these fundamental trade-offs through strategic relaxations of alignment requirements.

Aligning the behavior of Large language models (LLMs) with human intentions and values remains a critical challenge. Reinforcement learning from human feedback (RLHF) aligns LLMs by training a reward model (RM) on human preferences and fine-tuning the LLMs to maximize RM feedback. Despite its effectiveness and popularity, RLHF is prone to biased local optimization. It means RM fails to provide feedback that accurately aligns with human preference, causing LLMs to explore unexpected generalizations, and failing to achieve alignment objectives. To mitigate this issue, we propose a novel sequence-to-sequence (seq2seq) reward modeling method. Its key insight is that learning from language feedback rather than scalar feedback improves RLHF without additional annotations. We replaced the reward modeling target from binary maximum likelihood estimation (MLE) with sequence MLE. This method enables richer and fine-grained language feedback without additional annotations, models, or training stages. Our experiments demonstrated its effectiveness, specifically, reducing the refusal-to-response paradigm in single-turn safety dialogues and the long-response bias in text summarization tasks. We provide further analysis that seq2seq RM improves RLHF performance across 2B and 7B LLMs on 3 NLP tasks, achieving an average win rate of 76.9\%. We further show that seq2seq RM can still improve the performance of RLHF under out-of-distribution prompts.

Medical reasoning models (MRMs) achieve superior performance on medical benchmarks compared to medical LLMs; however, high accuracy alone is insufficient for practical deployment. One of such requirements for real-world application is robustness to varying output constraints. Specifically, posing the same medical question while requesting different answer formats should not affect the underlying correctness of the response. We investigate this phenomenon in this paper, focusing on MRMs. To quantify this behavior, we propose the metric answer-format robustness: the ability to reliably generate correct outputs across varying specified formats. We examine three representative formats: multiple-choice, open-ended question-answering, and ranked lists. Across 15 proprietary and open-weight models, we observe substantial variation in format robustness (35-100%). Furthermore, we conduct controlled fine-tuning experiments on a shared backbone with matched training data to isolate the effects of the fine-tuning paradigm. We find that supervised fine-tuning yields more stable behavior across formats, whereas reinforcement fine-tuning often exhibits higher cross-format brittleness, with the degree of instability strongly dependent on reward design. Overall, answer-format robustness in MRMs is trainable yet brittle and requires careful evaluation for practical medical use.

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

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

Maybe not. We identify and analyse errors in the popular Massive Multitask Language Understanding (MMLU) benchmark. Even though MMLU is widely adopted, our analysis demonstrates numerous ground truth errors that obscure the true capabilities of LLMs. For example, we find that 57% of the analysed questions in the Virology subset contain errors. To address this issue, we introduce a comprehensive framework for identifying dataset errors using a novel error taxonomy. Then, we create MMLU-Redux, which is a subset of 3,000 manually re-annotated questions across 30 MMLU subjects. Using MMLU-Redux, we demonstrate significant discrepancies with the model performance metrics that were originally reported. Our results strongly advocate for revising MMLU's error-ridden questions to enhance its future utility and reliability as a benchmark. Therefore, we open up MMLU-Redux for additional annotation https://huggingface.co/datasets/edinburgh-dawg/mmlu-redux.

There is a lack of benchmarks for evaluating large language models (LLMs) in long-form medical question answering (QA). Most existing medical QA evaluation benchmarks focus on automatic metrics and multiple-choice questions. While valuable, these benchmarks fail to fully capture or assess the complexities of real-world clinical applications where LLMs are being deployed. Furthermore, existing studies on evaluating long-form answer generation in medical QA are primarily closed-source, lacking access to human medical expert annotations, which makes it difficult to reproduce results and enhance existing baselines. In this work, we introduce a new publicly available benchmark featuring real-world consumer medical questions with long-form answer evaluations annotated by medical doctors. We performed pairwise comparisons of responses from various open and closed-source medical and general-purpose LLMs based on criteria such as correctness, helpfulness, harmfulness, and bias. Additionally, we performed a comprehensive LLM-as-a-judge analysis to study the alignment between human judgments and LLMs. Our preliminary results highlight the strong potential of open LLMs in medical QA compared to leading closed models. Code & Data: https://github.com/lavita-ai/medical-eval-sphere

Inference-time alignment provides an efficient alternative for aligning LLMs with humans. However, these approaches still face challenges, such as limited scalability due to policy-specific value functions and latency during the inference phase. In this paper, we propose a novel approach, Diffusion-styled Preference Optimization (\model), which provides an efficient and policy-agnostic solution for aligning LLMs with humans. By directly performing alignment at sentence level, \model~avoids the time latency associated with token-level generation. Designed as a plug-and-play module, \model~can be seamlessly integrated with various base models to enhance their alignment. Extensive experiments on AlpacaEval 2, MT-bench, and HH-RLHF demonstrate that \model~achieves superior alignment performance across various settings, achieving a favorable trade-off between alignment quality and inference-time latency. Furthermore, \model~demonstrates model-agnostic scalability, significantly improving the performance of large models such as Llama-3-70B.

As the influence of large language models (LLMs) spans across global communities, their safety challenges in multilingual settings become paramount for alignment research. This paper examines the variations in safety challenges faced by LLMs across different languages and discusses approaches to alleviating such concerns. By comparing how state-of-the-art LLMs respond to the same set of malicious prompts written in higher- vs. lower-resource languages, we observe that (1) LLMs tend to generate unsafe responses much more often when a malicious prompt is written in a lower-resource language, and (2) LLMs tend to generate more irrelevant responses to malicious prompts in lower-resource languages. To understand where the discrepancy can be attributed, we study the effect of instruction tuning with reinforcement learning from human feedback (RLHF) or supervised finetuning (SFT) on the HH-RLHF dataset. Surprisingly, while training with high-resource languages improves model alignment, training in lower-resource languages yields minimal improvement. This suggests that the bottleneck of cross-lingual alignment is rooted in the pretraining stage. Our findings highlight the challenges in cross-lingual LLM safety, and we hope they inform future research in this direction.

Ambient AI "scribe" systems promise to reduce clinical documentation burden, but automatic speech recognition (ASR) errors can remain unnoticed without careful review, and high-quality human reference transcripts are often unavailable for calibrating uncertainty. We investigate whether cross-model disagreement among heterogeneous ASR systems can act as a reference-free uncertainty signal to prioritize human verification in medical transcription workflows. Using 50 publicly available medical education audio clips (8 h 14 min), we transcribed each clip with eight ASR systems spanning commercial APIs and open-source engines. We aligned multi-model outputs, built consensus pseudo-references, and quantified token-level agreement using a majority-strength metric; we further characterized disagreements by type (content vs. punctuation/formatting) and assessed per-model agreement via leave-one-model-out (jackknife) consensus scoring. Inter-model reliability was low (ICC[2,1] = 0.131), indicating heterogeneous failure modes across systems. Across 76,398 evaluated token positions, 72.1% showed near-unanimous agreement (7-8 models), while 2.5% fell into high-risk bands (0-3 models), with high-risk mass varying from 0.7% to 11.4% across accent groups. Low-agreement regions were enriched for content disagreements, with the content fraction increasing from 53.9% to 73.9% across quintiles of high-risk mass. These results suggest that cross-model disagreement provides a sparse, localizable signal that can surface potentially unreliable transcript spans without human-verified references, enabling targeted review; clinical accuracy of flagged regions remains to be established.

The deployment of Large Language Models (LLMs) in high-stakes clinical settings demands rigorous and reliable evaluation. However, existing medical benchmarks remain static, suffering from two critical limitations: (1) data contamination, where test sets inadvertently leak into training corpora, leading to inflated performance estimates; and (2) temporal misalignment, failing to capture the rapid evolution of medical knowledge. Furthermore, current evaluation metrics for open-ended clinical reasoning often rely on either shallow lexical overlap (e.g., ROUGE) or subjective LLM-as-a-Judge scoring, both inadequate for verifying clinical correctness. To bridge these gaps, we introduce LiveMedBench, a continuously updated, contamination-free, and rubric-based benchmark that weekly harvests real-world clinical cases from online medical communities, ensuring strict temporal separation from model training data. We propose a Multi-Agent Clinical Curation Framework that filters raw data noise and validates clinical integrity against evidence-based medical principles. For evaluation, we develop an Automated Rubric-based Evaluation Framework that decomposes physician responses into granular, case-specific criteria, achieving substantially stronger alignment with expert physicians than LLM-as-a-Judge. To date, LiveMedBench comprises 2,756 real-world cases spanning 38 medical specialties and multiple languages, paired with 16,702 unique evaluation criteria. Extensive evaluation of 38 LLMs reveals that even the best-performing model achieves only 39.2%, and 84% of models exhibit performance degradation on post-cutoff cases, confirming pervasive data contamination risks. Error analysis further identifies contextual application-not factual knowledge-as the dominant bottleneck, with 35-48% of failures stemming from the inability to tailor medical knowledge to patient-specific constraints.

Proteins are fundamental to biology, executing diverse functions through complex physicochemical interactions, and they hold transformative potential across medicine, materials science, and environmental applications. Protein Language Models (pLMs) aim to unlock insights from the vast space of unlabeled protein sequences by learning rich, semantic representations from primary sequences via masked language modeling. However, these models typically exhibit limited generative capacity. In this work, we introduce the Diffusion Sequence Model (DSM), a novel pLM trained with masked diffusion to enable both high-quality representation learning and generative protein design. DSM builds upon the ESM2 architecture by incorporating a masked forward diffusion process inspired by the LLaDA framework. After training, DSM is capable of generating diverse, biomimetic sequences that align with expected amino acid compositions, secondary structures, and predicted functions, even with 90\% token corruption. Furthermore, DSM's learned representations match or exceed those of similarly sized pLMs on downstream tasks. We also introduce DSM(ppi), a variant fine-tuned to generate protein binders by attending to target sequences. We demonstrate DSM(ppi)'s effectiveness on the challenging Bench-tested Binder Benchmark (BenchBB), where both DSM and DSM(ppi) produce candidates with superior predicted binding affinity compared to known binders. Our results establish masked diffusion as a powerful paradigm for unifying protein representation and generation in a single framework.

Global healthcare providers are exploring use of large language models (LLMs) to provide medical advice to the public. LLMs now achieve nearly perfect scores on medical licensing exams, but this does not necessarily translate to accurate performance in real-world settings. We tested if LLMs can assist members of the public in identifying underlying conditions and choosing a course of action (disposition) in ten medical scenarios in a controlled study with 1,298 participants. Participants were randomly assigned to receive assistance from an LLM (GPT-4o, Llama 3, Command R+) or a source of their choice (control). Tested alone, LLMs complete the scenarios accurately, correctly identifying conditions in 94.9% of cases and disposition in 56.3% on average. However, participants using the same LLMs identified relevant conditions in less than 34.5% of cases and disposition in less than 44.2%, both no better than the control group. We identify user interactions as a challenge to the deployment of LLMs for medical advice. Standard benchmarks for medical knowledge and simulated patient interactions do not predict the failures we find with human participants. Moving forward, we recommend systematic human user testing to evaluate interactive capabilities prior to public deployments in healthcare.

Medical open-domain question answering demands substantial access to specialized knowledge. Recent efforts have sought to decouple knowledge from model parameters, counteracting architectural scaling and allowing for training on common low-resource hardware. The retrieve-then-read paradigm has become ubiquitous, with model predictions grounded on relevant knowledge pieces from external repositories such as PubMed, textbooks, and UMLS. An alternative path, still under-explored but made possible by the advent of domain-specific large language models, entails constructing artificial contexts through prompting. As a result, "to generate or to retrieve" is the modern equivalent of Hamlet's dilemma. This paper presents MedGENIE, the first generate-then-read framework for multiple-choice question answering in medicine. We conduct extensive experiments on MedQA-USMLE, MedMCQA, and MMLU, incorporating a practical perspective by assuming a maximum of 24GB VRAM. MedGENIE sets a new state-of-the-art (SOTA) in the open-book setting of each testbed, even allowing a small-scale reader to outcompete zero-shot closed-book 175B baselines while using up to 706times fewer parameters. Overall, our findings reveal that generated passages are more effective than retrieved counterparts in attaining higher accuracy.

We propose a benchmark to measure whether a language model is truthful in generating answers to questions. The benchmark comprises 817 questions that span 38 categories, including health, law, finance and politics. We crafted questions that some humans would answer falsely due to a false belief or misconception. To perform well, models must avoid generating false answers learned from imitating human texts. We tested GPT-3, GPT-Neo/J, GPT-2 and a T5-based model. The best model was truthful on 58% of questions, while human performance was 94%. Models generated many false answers that mimic popular misconceptions and have the potential to deceive humans. The largest models were generally the least truthful. This contrasts with other NLP tasks, where performance improves with model size. However, this result is expected if false answers are learned from the training distribution. We suggest that scaling up models alone is less promising for improving truthfulness than fine-tuning using training objectives other than imitation of text from the web.

As opposed to scaling-up protein language models (PLMs), we seek improving performance via protein-specific optimization. Although the proportionality between the language model size and the richness of its learned representations is validated, we prioritize accessibility and pursue a path of data-efficient, cost-reduced, and knowledge-guided optimization. Through over twenty experiments ranging from masking, architecture, and pre-training data, we derive insights from protein-specific experimentation into building a model that interprets the language of life, optimally. We present Ankh, the first general-purpose PLM trained on Google's TPU-v4 surpassing the state-of-the-art performance with fewer parameters (<10% for pre-training, <7% for inference, and <30% for the embedding dimension). We provide a representative range of structure and function benchmarks where Ankh excels. We further provide a protein variant generation analysis on High-N and One-N input data scales where Ankh succeeds in learning protein evolutionary conservation-mutation trends and introducing functional diversity while retaining key structural-functional characteristics. We dedicate our work to promoting accessibility to research innovation via attainable resources.

We introduce a novel framework for measuring Overton pluralism in LLMs--the extent to which diverse viewpoints are represented in model outputs. We (i) formalize Overton pluralism as a set coverage metric (OvertonScore), (ii) conduct a large-scale U.S.-representative human study (N = 1209; 60 questions; 8 LLMs), and (iii) develop an automated benchmark that closely reproduces human judgments. On average, models achieve OvertonScores of 0.35--0.41, with DeepSeek V3 performing best; yet all models remain far below the theoretical maximum of 1.0, revealing substantial headroom for improvement. Because repeated large-scale human studies are costly and slow, scalable evaluation tools are essential for model development. Hence, we propose an automated benchmark that achieves high rank correlation with human judgments (ρ=0.88), providing a practical proxy without replacing human assessment. By turning pluralistic alignment from a normative aim into a measurable benchmark, our work establishes a foundation for systematic progress toward more pluralistic LLMs.

Although large language models (LLMs) have been assessed for general medical knowledge using medical licensing exams, their ability to effectively support clinical decision-making tasks, such as selecting and using medical calculators, remains uncertain. Here, we evaluate the capability of both medical trainees and LLMs to recommend medical calculators in response to various multiple-choice clinical scenarios such as risk stratification, prognosis, and disease diagnosis. We assessed eight LLMs, including open-source, proprietary, and domain-specific models, with 1,009 question-answer pairs across 35 clinical calculators and measured human performance on a subset of 100 questions. While the highest-performing LLM, GPT-4o, provided an answer accuracy of 74.3% (CI: 71.5-76.9%), human annotators, on average, outperformed LLMs with an accuracy of 79.5% (CI: 73.5-85.0%). With error analysis showing that the highest-performing LLMs continue to make mistakes in comprehension (56.6%) and calculator knowledge (8.1%), our findings emphasize that humans continue to surpass LLMs on complex clinical tasks such as calculator recommendation.

Several studies showed that Large Language Models (LLMs) can answer medical questions correctly, even outperforming the average human score in some medical exams. However, to our knowledge, no study has been conducted to assess the ability of language models to validate existing or generated medical text for correctness and consistency. In this paper, we introduce MEDEC (https://github.com/abachaa/MEDEC), the first publicly available benchmark for medical error detection and correction in clinical notes, covering five types of errors (Diagnosis, Management, Treatment, Pharmacotherapy, and Causal Organism). MEDEC consists of 3,848 clinical texts, including 488 clinical notes from three US hospital systems that were not previously seen by any LLM. The dataset has been used for the MEDIQA-CORR shared task to evaluate seventeen participating systems [Ben Abacha et al., 2024]. In this paper, we describe the data creation methods and we evaluate recent LLMs (e.g., o1-preview, GPT-4, Claude 3.5 Sonnet, and Gemini 2.0 Flash) for the tasks of detecting and correcting medical errors requiring both medical knowledge and reasoning capabilities. We also conducted a comparative study where two medical doctors performed the same task on the MEDEC test set. The results showed that MEDEC is a sufficiently challenging benchmark to assess the ability of models to validate existing or generated notes and to correct medical errors. We also found that although recent LLMs have a good performance in error detection and correction, they are still outperformed by medical doctors in these tasks. We discuss the potential factors behind this gap, the insights from our experiments, the limitations of current evaluation metrics, and share potential pointers for future research.

Multimodal/vision language models (VLMs) are increasingly being deployed in healthcare settings worldwide, necessitating robust benchmarks to ensure their safety, efficacy, and fairness. Multiple-choice question and answer (QA) datasets derived from national medical examinations have long served as valuable evaluation tools, but existing datasets are largely text-only and available in a limited subset of languages and countries. To address these challenges, we present WorldMedQA-V, an updated multilingual, multimodal benchmarking dataset designed to evaluate VLMs in healthcare. WorldMedQA-V includes 568 labeled multiple-choice QAs paired with 568 medical images from four countries (Brazil, Israel, Japan, and Spain), covering original languages and validated English translations by native clinicians, respectively. Baseline performance for common open- and closed-source models are provided in the local language and English translations, and with and without images provided to the model. The WorldMedQA-V benchmark aims to better match AI systems to the diverse healthcare environments in which they are deployed, fostering more equitable, effective, and representative applications.

Understanding the 3D structures of protein multimers is crucial, as they play a vital role in regulating various cellular processes. It has been empirically confirmed that the multimer structure prediction~(MSP) can be well handled in a step-wise assembly fashion using provided dimer structures and predicted protein-protein interactions~(PPIs). However, due to the biological gap in the formation of dimers and larger multimers, directly applying PPI prediction techniques can often cause a poor generalization to the MSP task. To address this challenge, we aim to extend the PPI knowledge to multimers of different scales~(i.e., chain numbers). Specifically, we propose \textsc{PromptMSP}, a pre-training and Prompt tuning framework for Multimer Structure Prediction. First, we tailor the source and target tasks for effective PPI knowledge learning and efficient inference, respectively. We design PPI-inspired prompt learning to narrow the gaps of two task formats and generalize the PPI knowledge to multimers of different scales. We provide a meta-learning strategy to learn a reliable initialization of the prompt model, enabling our prompting framework to effectively adapt to limited data for large-scale multimers. Empirically, we achieve both significant accuracy (RMSD and TM-Score) and efficiency improvements compared to advanced MSP models. The code, data and checkpoints are released at https://github.com/zqgao22/PromptMSP.

Recent observations have underscored a disparity between the inflated benchmark scores and the actual performance of LLMs, raising concerns about potential contamination of evaluation benchmarks. This issue is especially critical for closed-source models and certain open-source models where training data transparency is lacking. In this paper we study data contamination by proposing two methods tailored for both open-source and proprietary LLMs. We first introduce a retrieval-based system to explore potential overlaps between evaluation benchmarks and pretraining corpora. We further present a novel investigation protocol named Testset Slot Guessing (TS-Guessing), applicable to both open and proprietary models. This approach entails masking a wrong answer in a multiple-choice question and prompting the model to fill in the gap. Additionally, it involves obscuring an unlikely word in an evaluation example and asking the model to produce it. We find that certain commercial LLMs could surprisingly guess the missing option in various test sets. Specifically, in the TruthfulQA benchmark, we find that LLMs exhibit notable performance improvement when provided with additional metadata in the benchmark. Further, in the MMLU benchmark, ChatGPT and GPT-4 demonstrated an exact match rate of 52\% and 57\%, respectively, in guessing the missing options in benchmark test data. We hope these results underscore the need for more robust evaluation methodologies and benchmarks in the field.

We introduce HEAD-QA v2, an expanded and updated version of a Spanish/English healthcare multiple-choice reasoning dataset originally released by Vilares and Gómez-Rodríguez (2019). The update responds to the growing need for high-quality datasets that capture the linguistic and conceptual complexity of healthcare reasoning. We extend the dataset to over 12,000 questions from ten years of Spanish professional exams, benchmark several open-source LLMs using prompting, RAG, and probability-based answer selection, and provide additional multilingual versions to support future work. Results indicate that performance is mainly driven by model scale and intrinsic reasoning ability, with complex inference strategies obtaining limited gains. Together, these results establish HEAD-QA v2 as a reliable resource for advancing research on biomedical reasoning and model improvement.

Reinforcement Learning from Human Feedback (RLHF) has become a cornerstone for aligning large language models (LLMs). However, its effectiveness depends on high-quality instruction data. Most existing alignment datasets are either private or require costly human annotation, which limits reproducibility and scalability. Even with Reinforcement Learning from AI Feedback (RLAIF), concerns about data quality remain. Moreover, it is unclear how much data is actually required to fine-tune a base model into a strong instruction-following model. Current approaches often rely on over 300k examples even at the supervised fine-tuning (SFT) stage, yet they still underperform compared to proprietary models, creating barriers for academic and resource-limited communities. To address this gap, we introduce PiKa, a data-efficient family of expert-level alignment datasets. In particular, the PiKa-SFT dataset uses only 30k SFT examples, far fewer than state-of-the-art datasets like Magpie. Through evaluations by fine-tuning Llama-3-8B-Base on PiKa and other public datasets, we show that PiKa-SFT outperforms models trained on much larger data. On AlpacaEval 2.0 and Arena-Hard benchmarks, PiKa-SFT fine-tuning even surpasses the official Llama-3-8B-Instruct model trained on over 10 million proprietary examples. We further extend our study by training the Qwen2.5 series (0.5B to 7B) on PiKa-SFT, achieving consistent gains. These findings demonstrate that high-quality alignment can be achieved with significantly less data, offering a scalable path for open-source LLM alignment. Code and data: https://github.com/SJY8460/PiKa.

Recent advances in generative AI have been driven by alignment techniques such as reinforcement learning from human feedback (RLHF). RLHF and related techniques typically involve constructing a dataset of binary or ranked choice human preferences and subsequently fine-tuning models to align with these preferences. This paper shifts the focus to understanding the preferences encoded in such datasets and identifying common human preferences. We find that a small subset of 21 preference categories (selected from a set of nearly 5,000 distinct preferences) captures >89% of preference variation across individuals. This small set of preferences is analogous to a canonical basis of human preferences, similar to established findings that characterize human variation in psychology or facial recognition studies. Through both synthetic and empirical evaluations, we confirm that our low-rank, canonical set of human preferences generalizes across the entire dataset and within specific topics. We further demonstrate our preference basis' utility in model evaluation, where our preference categories offer deeper insights into model alignment, and in model training, where we show that fine-tuning on preference-defined subsets successfully aligns the model accordingly.

Foundation models (FMs) have exhibited remarkable performance across a wide range of downstream tasks in many domains. Nevertheless, general-purpose FMs often face challenges when confronted with domain-specific problems, due to their limited access to the proprietary training data in a particular domain. In biomedicine, there are various biological modalities, such as molecules, proteins, and cells, which are encoded by the language of life and exhibit significant modality gaps with human natural language. In this paper, we introduce BioMedGPT, an open multimodal generative pre-trained transformer (GPT) for biomedicine, to bridge the gap between the language of life and human natural language. BioMedGPT allows users to easily ``communicate'' with diverse biological modalities through free text, which is the first of its kind. BioMedGPT aligns different biological modalities with natural language via a large generative language model, namely, BioMedGPT-LM. We publish BioMedGPT-10B, which unifies the feature spaces of molecules, proteins, and natural language via encoding and alignment. Through fine-tuning, BioMedGPT-10B outperforms or is on par with human and significantly larger general-purpose foundation models on the biomedical QA task. It also demonstrates promising performance in the molecule QA and protein QA tasks, which could greatly accelerate the discovery of new drugs and therapeutic targets. In addition, BioMedGPT-LM-7B is the first large generative language model based on Llama2 in the biomedical domain, therefore is commercial friendly. Both BioMedGPT-10B and BioMedGPT-LM-7B are open-sourced to the research community. In addition, we publish the datasets that are meticulously curated for the alignment of multi-modalities, i.e., PubChemQA and UniProtQA. All the models, codes, and datasets are available at https://github.com/PharMolix/OpenBioMed.

We evaluated 4 systems (ELIZA, GPT-4o, LLaMa-3.1-405B, and GPT-4.5) in two randomised, controlled, and pre-registered Turing tests on independent populations. Participants had 5 minute conversations simultaneously with another human participant and one of these systems before judging which conversational partner they thought was human. When prompted to adopt a humanlike persona, GPT-4.5 was judged to be the human 73% of the time: significantly more often than interrogators selected the real human participant. LLaMa-3.1, with the same prompt, was judged to be the human 56% of the time -- not significantly more or less often than the humans they were being compared to -- while baseline models (ELIZA and GPT-4o) achieved win rates significantly below chance (23% and 21% respectively). The results constitute the first empirical evidence that any artificial system passes a standard three-party Turing test. The results have implications for debates about what kind of intelligence is exhibited by Large Language Models (LLMs), and the social and economic impacts these systems are likely to have.

Predicting protein function from amino acid sequence remains a central challenge in data-scarce (low-N) regimes, limiting machine learning-guided protein design when only small amounts of assay-labeled sequence-function data are available. Protein language models (pLMs) have advanced the field by providing evolutionary-informed embeddings and sparse autoencoders (SAEs) have enabled decomposition of these embeddings into interpretable latent variables that capture structural and functional features. However, the effectiveness of SAEs for low-N function prediction and protein design has not been systematically studied. Herein, we evaluate SAEs trained on fine-tuned ESM2 embeddings across diverse fitness extrapolation and protein engineering tasks. We show that SAEs, with as few as 24 sequences, consistently outperform or compete with their ESM2 baselines in fitness prediction, indicating that their sparse latent space encodes compact and biologically meaningful representations that generalize more effectively from limited data. Moreover, steering predictive latents exploits biological motifs in pLM representations, yielding top-fitness variants in 83% of cases compared to designing with ESM2 alone.

Multimodal protein language models deliver strong performance on mutation-effect prediction, but training such models from scratch demands substantial computational resources. In this paper, we propose a fine-tuning framework called InstructPLM-mu and try to answer a question: Can multimodal fine-tuning of a pretrained, sequence-only protein language model match the performance of models trained end-to-end? Surprisingly, our experiments show that fine-tuning ESM2 with structural inputs can reach performance comparable to ESM3. To understand how this is achieved, we systematically compare three different feature-fusion designs and fine-tuning recipes. Our results reveal that both the fusion method and the tuning strategy strongly affect final accuracy, indicating that the fine-tuning process is not trivial. We hope this work offers practical guidance for injecting structure into pretrained protein language models and motivates further research on better fusion mechanisms and fine-tuning protocols.

Large language models (LLMs) hold great promise for medical applications and are evolving rapidly, with new models being released at an accelerated pace. However, current evaluations of LLMs in clinical contexts remain limited. Most existing benchmarks rely on medical exam-style questions or PubMed-derived text, failing to capture the complexity of real-world electronic health record (EHR) data. Others focus narrowly on specific application scenarios, limiting their generalizability across broader clinical use. To address this gap, we present BRIDGE, a comprehensive multilingual benchmark comprising 87 tasks sourced from real-world clinical data sources across nine languages. We systematically evaluated 52 state-of-the-art LLMs (including DeepSeek-R1, GPT-4o, Gemini, and Llama 4) under various inference strategies. With a total of 13,572 experiments, our results reveal substantial performance variation across model sizes, languages, natural language processing tasks, and clinical specialties. Notably, we demonstrate that open-source LLMs can achieve performance comparable to proprietary models, while medically fine-tuned LLMs based on older architectures often underperform versus updated general-purpose models. The BRIDGE and its corresponding leaderboard serve as a foundational resource and a unique reference for the development and evaluation of new LLMs in real-world clinical text understanding.

As Large Language Models (LLMs) become increasingly integrated into real-world applications, ensuring their outputs align with human values and safety standards has become critical. The field has developed diverse alignment approaches including traditional fine-tuning methods (RLHF, instruction tuning), post-hoc correction systems, and inference-time interventions, each with distinct advantages and limitations. However, the lack of unified evaluation frameworks makes it difficult to systematically compare these paradigms and guide deployment decisions. This paper introduces a multi-dimensional evaluation of alignment techniques for LLMs, a comprehensive evaluation framework that provides a systematic comparison across all major alignment paradigms. Our framework assesses methods along four key dimensions: alignment detection, alignment quality, computational efficiency, and robustness. Through experiments across diverse base models and alignment strategies, we demonstrate the utility of our framework in identifying strengths and limitations of current state-of-the-art models, providing valuable insights for future research directions.

While recent preference alignment algorithms for language models have demonstrated promising results, supervised fine-tuning (SFT) remains imperative for achieving successful convergence. In this paper, we study the crucial role of SFT within the context of preference alignment, emphasizing that a minor penalty for the disfavored generation style is sufficient for preference-aligned SFT. Building on this foundation, we introduce a straightforward and innovative reference model-free monolithic odds ratio preference optimization algorithm, ORPO, eliminating the necessity for an additional preference alignment phase. We demonstrate, both empirically and theoretically, that the odds ratio is a sensible choice for contrasting favored and disfavored styles during SFT across the diverse sizes from 125M to 7B. Specifically, fine-tuning Phi-2 (2.7B), Llama-2 (7B), and Mistral (7B) with ORPO on the UltraFeedback alone surpasses the performance of state-of-the-art language models with more than 7B and 13B parameters: achieving up to 12.20% on AlpacaEval_{2.0} (Figure 1), 66.19% on IFEval (instruction-level loose, Table 6), and 7.32 in MT-Bench (Figure 12). We release code and model checkpoints for Mistral-ORPO-alpha (7B) and Mistral-ORPO-beta (7B).

Objective: Question answering (QA) systems have the potential to improve the quality of clinical care by providing health professionals with the latest and most relevant evidence. However, QA systems have not been widely adopted. This systematic review aims to characterize current medical QA systems, assess their suitability for healthcare, and identify areas of improvement. Materials and methods: We searched PubMed, IEEE Xplore, ACM Digital Library, ACL Anthology and forward and backward citations on 7th February 2023. We included peer-reviewed journal and conference papers describing the design and evaluation of biomedical QA systems. Two reviewers screened titles, abstracts, and full-text articles. We conducted a narrative synthesis and risk of bias assessment for each study. We assessed the utility of biomedical QA systems. Results: We included 79 studies and identified themes, including question realism, answer reliability, answer utility, clinical specialism, systems, usability, and evaluation methods. Clinicians' questions used to train and evaluate QA systems were restricted to certain sources, types and complexity levels. No system communicated confidence levels in the answers or sources. Many studies suffered from high risks of bias and applicability concerns. Only 8 studies completely satisfied any criterion for clinical utility, and only 7 reported user evaluations. Most systems were built with limited input from clinicians. Discussion: While machine learning methods have led to increased accuracy, most studies imperfectly reflected real-world healthcare information needs. Key research priorities include developing more realistic healthcare QA datasets and considering the reliability of answer sources, rather than merely focusing on accuracy.

There is great interest in fine-tuning frontier large language models (LLMs) to inject new information and update existing knowledge. While commercial LLM fine-tuning APIs from providers such as OpenAI and Google promise flexible adaptation for various applications, the efficacy of fine-tuning remains unclear. In this study, we introduce FineTuneBench, an evaluation framework and dataset for understanding how well commercial fine-tuning APIs can successfully learn new and updated knowledge. We analyze five frontier LLMs with commercially available fine-tuning APIs, including GPT-4o and Gemini 1.5 Pro, on their effectiveness in two settings: (1) ingesting novel information, such as recent news events and new people profiles, and (2) updating existing knowledge, such as updated medical guidelines and code frameworks. Our results reveal substantial shortcomings in all the models' abilities to effectively learn new information through fine-tuning, with an average generalization accuracy of 37% across all models. When updating existing knowledge, such as incorporating medical guideline updates, commercial fine-tuning APIs show even more limited capability (average generalization accuracy of 19%). Overall, fine-tuning GPT-4o mini is the most effective for infusing new knowledge and updating knowledge, followed by GPT-3.5 Turbo and GPT-4o. The fine-tuning APIs for Gemini 1.5 Flesh and Gemini 1.5 Pro are unable to learn new knowledge or update existing knowledge. These findings underscore a major shortcoming in using current commercial fine-tuning services to achieve reliable knowledge infusion in common scenarios. We open source the FineTuneBench dataset at https://github.com/kevinwu23/StanfordFineTuneBench.

LLMs acquire a wide range of abilities during pre-training, but aligning LLMs under Reinforcement Learning with Human Feedback (RLHF) can lead to forgetting, which is also known as the alignment tax. To empirically verify this hypothesis, we conducted experiments with existing RLHF algorithms using OpenLLaMA-3B, which revealed a pronounced alignment tax in NLP tasks. On the other hand, despite various techniques to mitigate forgetting, they are often at odds with the RLHF performance, leading to a trade-off between reward maximization and forgetting mitigation. In light of the above pressing issue in aligning LLMs, in this paper we explore model averaging, which interpolates between pre and post RLHF model weights, to achieve a more efficient reward-tax Pareto front. To understand its effectiveness, We offer theoretical insights into model averaging, revealing that it enhances performance Pareto front by increasing feature diversity on the layers where tasks share overlapped feature spaces. Empirical evidence corroborates our analysis by showing the benefits of averaging low-level transformer layers. Building on the analysis and the observation that averaging different layers of the transformer leads to significantly different reward-tax trade-offs, we propose Adaptive Model Averaging (AMA) to adaptively find various combination ratios of model layers. AMA seeks to maximize the alignment reward while incurring minimal alignment tax. Moreover, we validate AMA's performance across a range of RLHF algorithms over OpenLLaMA-3B and further extend our findings to Mistral-7B.

We present specialized Large Language Models for theoretical High-Energy Physics, obtained as 20 fine-tuned variants of the 8-billion parameter Llama-3.1 model. Each variant was trained on arXiv abstracts (through August 2024) from different combinations of hep-th, hep-ph and gr-qc. For a comparative study, we also trained models on datasets that contained abstracts from disparate fields such as the q-bio and cs categories. All models were fine-tuned using two distinct Low-Rank Adaptation fine-tuning approaches and varying dataset sizes, and outperformed the base model on hep-th abstract completion tasks. We compare performance against leading commercial LLMs (ChatGPT, Claude, Gemini, DeepSeek) and derive insights for further developing specialized language models for High-Energy Theoretical Physics.

Evaluating aligned large language models' (LLMs) ability to recognize and reject unsafe user requests is crucial for safe, policy-compliant deployments. Existing evaluation efforts, however, face three limitations that we address with SORRY-Bench, our proposed benchmark. First, existing methods often use coarse-grained taxonomies of unsafe topics, and are over-representing some fine-grained topics. For example, among the ten existing datasets that we evaluated, tests for refusals of self-harm instructions are over 3x less represented than tests for fraudulent activities. SORRY-Bench improves on this by using a fine-grained taxonomy of 45 potentially unsafe topics, and 450 class-balanced unsafe instructions, compiled through human-in-the-loop methods. Second, linguistic characteristics and formatting of prompts are often overlooked, like different languages, dialects, and more -- which are only implicitly considered in many evaluations. We supplement SORRY-Bench with 20 diverse linguistic augmentations to systematically examine these effects. Third, existing evaluations rely on large LLMs (e.g., GPT-4) for evaluation, which can be computationally expensive. We investigate design choices for creating a fast, accurate automated safety evaluator. By collecting 7K+ human annotations and conducting a meta-evaluation of diverse LLM-as-a-judge designs, we show that fine-tuned 7B LLMs can achieve accuracy comparable to GPT-4 scale LLMs, with lower computational cost. Putting these together, we evaluate over 40 proprietary and open-source LLMs on SORRY-Bench, analyzing their distinctive refusal behaviors. We hope our effort provides a building block for systematic evaluations of LLMs' safety refusal capabilities, in a balanced, granular, and efficient manner.

Model alignment with human preferences is an essential step in making Large Language Models (LLMs) helpful and consistent with human values. It typically consists of supervised fine-tuning (SFT) and reinforcement learning from human feedback (RLHF) stages. However, RLHF faces inherent limitations stemming from a complex training setup and its tendency to align the model with implicit values that end users cannot control at run-time. Moreover, reward models in RLHF stage commonly rely on single-dimensional feedback as opposed to explicit, multifaceted signals that indicate attributes such as helpfulness, humor, and toxicity. To address these limitations, we propose SteerLM, a supervised fine-tuning method that empowers end-users to control responses during inference. SteerLM conditions responses to conform to an explicitly defined multi-dimensional set of attributes, thereby empowering a steerable AI capable of generating helpful and high-quality responses while maintaining customizability. Experiments show that SteerLM trained on open source datasets generates responses that are preferred by human and automatic evaluators to many state-of-the-art baselines trained with RLHF while being much easier to train. Try SteerLM at https://huggingface.co/nvidia/SteerLM-llama2-13B

We introduce Humans-Junior, a 3.8B model that matches GPT-4o on the FACTS Grounding public subset within a pm 5 pp equivalence margin. Results. On Q1--Q500 under identical judges, GPT-4o scores 73.5% (95% CI 69.5--77.2) and Humans-Junior 72.7% (95% CI 68.7--76.5); the paired difference is 0.8 pp (bootstrap 95% CI -3.1 to +4.7; permutation p = 0.72; Cohen's d = 0.023). TOST establishes equivalence at pm 5 pp (not at pm 3 pp). When purchased as managed APIs, Humans-Junior's base model (Phi-3.5-mini-instruct) is approx 19times less expensive than GPT-4o on Microsoft AI Foundry pricing; self-hosted or edge deployments can drive incremental inference cost toward zero. Measured vs estimated pricing sources are tabulated in Appendix E. Method. Our approach combines minimal directed "Exoskeleton Reasoning" scaffolds with behavioral fine-tuning that teaches protocol compliance (epistemic discipline) rather than domain answers. Fine-tuning alone adds little; combined, they synergize (+17.7 pp, p < 0.001) and reduce variance (approx 25%). In prompt-only settings on frontier models (Q1--Q100; non-comparable), directed reasoning improved GPT-4o by +11.8 pp to 85.3% and Gemini-2.5-Pro by +5.0 pp to 93.3% (baseline 88.3%, n = 100); see Section~5. TL;DR. A 3.8B model achieves GPT-4o-level FACTS accuracy (equivalent within pm 5 pp on Q1--Q500). Cloud pricing shows approx 19times lower cost versus GPT-4o, and self-hosted/edge deployments can approach zero marginal cost. Pricing sources are listed in Appendix E. Frontier prompt-only gains (Q1--Q100; non-comparable) and optimized-prompt exploratory results under earlier judges are summarized in Appendix F. Keywords: Small Language Models, Factual Grounding, Directed Reasoning, Fine-Tuning, Model Alignment, Cost-Efficient AI

Reinforcement Learning from Human Feedback (RLHF) is a widely adopted approach for aligning large language models with human values. However, RLHF relies on a reward model that is trained with a limited amount of human preference data, which could lead to inaccurate predictions. As a result, RLHF may produce outputs that are misaligned with human values. To mitigate this issue, we contribute a reward ensemble method that allows the reward model to make more accurate predictions. As using an ensemble of large language model-based reward models can be computationally and resource-expensive, we explore efficient ensemble methods including linear-layer ensemble and LoRA-based ensemble. Empirically, we run Best-of-n and Proximal Policy Optimization with our ensembled reward models, and verify that our ensemble methods help improve the alignment performance of RLHF outputs.

Large language models (LLMs) hold immense promise to serve complex health information needs but also have the potential to introduce harm and exacerbate health disparities. Reliably evaluating equity-related model failures is a critical step toward developing systems that promote health equity. In this work, we present resources and methodologies for surfacing biases with potential to precipitate equity-related harms in long-form, LLM-generated answers to medical questions and then conduct an empirical case study with Med-PaLM 2, resulting in the largest human evaluation study in this area to date. Our contributions include a multifactorial framework for human assessment of LLM-generated answers for biases, and EquityMedQA, a collection of seven newly-released datasets comprising both manually-curated and LLM-generated questions enriched for adversarial queries. Both our human assessment framework and dataset design process are grounded in an iterative participatory approach and review of possible biases in Med-PaLM 2 answers to adversarial queries. Through our empirical study, we find that the use of a collection of datasets curated through a variety of methodologies, coupled with a thorough evaluation protocol that leverages multiple assessment rubric designs and diverse rater groups, surfaces biases that may be missed via narrower evaluation approaches. Our experience underscores the importance of using diverse assessment methodologies and involving raters of varying backgrounds and expertise. We emphasize that while our framework can identify specific forms of bias, it is not sufficient to holistically assess whether the deployment of an AI system promotes equitable health outcomes. We hope the broader community leverages and builds on these tools and methods towards realizing a shared goal of LLMs that promote accessible and equitable healthcare for all.

Large language models (LLMs) fine-tuned with reinforcement learning from human feedback (RLHF) have been used in some of the most widely deployed AI models to date, such as OpenAI's ChatGPT, Anthropic's Claude, or Meta's LLaMA-2. While there has been significant work developing these methods, our understanding of the benefits and downsides of each stage in RLHF is still limited. To fill this gap, we present an extensive analysis of how each stage of the process (i.e. supervised fine-tuning (SFT), reward modelling, and RLHF) affects two key properties: out-of-distribution (OOD) generalisation and output diversity. OOD generalisation is crucial given the wide range of real-world scenarios in which these models are being used, while output diversity refers to the model's ability to generate varied outputs and is important for a variety of use cases. We perform our analysis across two base models on both summarisation and instruction following tasks, the latter being highly relevant for current LLM use cases. We find that RLHF generalises better than SFT to new inputs, particularly as the distribution shift between train and test becomes larger. However, RLHF significantly reduces output diversity compared to SFT across a variety of measures, implying a tradeoff in current LLM fine-tuning methods between generalisation and diversity. Our results provide guidance on which fine-tuning method should be used depending on the application, and show that more research is needed to improve the trade-off between generalisation and diversity.

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

We introduce KorMedMCQA-V, a Korean medical licensing-exam-style multimodal multiple-choice question answering benchmark for evaluating vision-language models (VLMs). The dataset consists of 1,534 questions with 2,043 associated images from Korean Medical Licensing Examinations (2012-2023), with about 30% containing multiple images requiring cross-image evidence integration. Images cover clinical modalities including X-ray, computed tomography (CT), electrocardiography (ECG), ultrasound, endoscopy, and other medical visuals. We benchmark over 50 VLMs across proprietary and open-source categories-spanning general-purpose, medical-specialized, and Korean-specialized families-under a unified zero-shot evaluation protocol. The best proprietary model (Gemini-3.0-Pro) achieves 96.9% accuracy, the best open-source model (Qwen3-VL-32B-Thinking) 83.7%, and the best Korean-specialized model (VARCO-VISION-2.0-14B) only 43.2%. We further find that reasoning-oriented model variants gain up to +20 percentage points over instruction-tuned counterparts, medical domain specialization yields inconsistent gains over strong general-purpose baselines, all models degrade on multi-image questions, and performance varies notably across imaging modalities. By complementing the text-only KorMedMCQA benchmark, KorMedMCQA-V forms a unified evaluation suite for Korean medical reasoning across text-only and multimodal conditions. The dataset is available via Hugging Face Datasets: https://huggingface.co/datasets/seongsubae/KorMedMCQA-V.

Large Language Models (LLMs) like ChatGPT demonstrate significant potential in the medical field, often evaluated using multiple-choice questions (MCQs) similar to those found on the USMLE. Despite their prevalence in medical education, MCQs have limitations that might be exacerbated when assessing LLMs. To evaluate the effectiveness of MCQs in assessing the performance of LLMs, we developed a fictional medical benchmark focused on a non-existent gland, the Glianorex. This approach allowed us to isolate the knowledge of the LLM from its test-taking abilities. We used GPT-4 to generate a comprehensive textbook on the Glianorex in both English and French and developed corresponding multiple-choice questions in both languages. We evaluated various open-source, proprietary, and domain-specific LLMs using these questions in a zero-shot setting. The models achieved average scores around 67%, with minor performance differences between larger and smaller models. Performance was slightly higher in English than in French. Fine-tuned medical models showed some improvement over their base versions in English but not in French. The uniformly high performance across models suggests that traditional MCQ-based benchmarks may not accurately measure LLMs' clinical knowledge and reasoning abilities, instead highlighting their pattern recognition skills. This study underscores the need for more robust evaluation methods to better assess the true capabilities of LLMs in medical contexts.

Mental health remains a challenging problem all over the world, with issues like depression, anxiety becoming increasingly common. Large Language Models (LLMs) have seen a vast application in healthcare, specifically in answering medical questions. However, there is a lack of standard benchmarking datasets for question answering (QA) in mental health. Our work presents a novel multiple choice dataset, MHQA (Mental Health Question Answering), for benchmarking Language models (LMs). Previous mental health datasets have focused primarily on text classification into specific labels or disorders. MHQA, on the other hand, presents question-answering for mental health focused on four key domains: anxiety, depression, trauma, and obsessive/compulsive issues, with diverse question types, namely, factoid, diagnostic, prognostic, and preventive. We use PubMed abstracts as the primary source for QA. We develop a rigorous pipeline for LLM-based identification of information from abstracts based on various selection criteria and converting it into QA pairs. Further, valid QA pairs are extracted based on post-hoc validation criteria. Overall, our MHQA dataset consists of 2,475 expert-verified gold standard instances called MHQA-gold and ~56.1k pairs pseudo labeled using external medical references. We report F1 scores on different LLMs along with few-shot and supervised fine-tuning experiments, further discussing the insights for the scores.

Background: General-purpose large language models that utilize both text and images have not been evaluated on a diverse array of challenging medical cases. Methods: Using 934 cases from the NEJM Image Challenge published between 2005 and 2023, we evaluated the accuracy of the recently released Generative Pre-trained Transformer 4 with Vision model (GPT-4V) compared to human respondents overall and stratified by question difficulty, image type, and skin tone. We further conducted a physician evaluation of GPT-4V on 69 NEJM clinicopathological conferences (CPCs). Analyses were conducted for models utilizing text alone, images alone, and both text and images. Results: GPT-4V achieved an overall accuracy of 61% (95% CI, 58 to 64%) compared to 49% (95% CI, 49 to 50%) for humans. GPT-4V outperformed humans at all levels of difficulty and disagreement, skin tones, and image types; the exception was radiographic images, where performance was equivalent between GPT-4V and human respondents. Longer, more informative captions were associated with improved performance for GPT-4V but similar performance for human respondents. GPT-4V included the correct diagnosis in its differential for 80% (95% CI, 68 to 88%) of CPCs when using text alone, compared to 58% (95% CI, 45 to 70%) of CPCs when using both images and text. Conclusions: GPT-4V outperformed human respondents on challenging medical cases and was able to synthesize information from both images and text, but performance deteriorated when images were added to highly informative text. Overall, our results suggest that multimodal AI models may be useful in medical diagnostic reasoning but that their accuracy may depend heavily on context.

Effectively aligning Large Language Models (LLMs) with human-centric values while preventing the degradation of abilities acquired through Pre-training and Supervised Fine-tuning (SFT) poses a central challenge in Reinforcement Learning from Human Feedback (RLHF). In this paper, we first discover that interpolating RLHF and SFT model parameters can adjust the trade-off between human preference and basic capabilities, thereby reducing the alignment tax at the cost of alignment reward. Inspired by this, we propose integrating the RL policy and SFT models at each optimization step in RLHF to continuously regulate the training direction, introducing the Online Merging Optimizer. Specifically, we merge gradients with the parameter differences between SFT and pretrained models, effectively steering the gradient towards maximizing rewards in the direction of SFT optimization. We demonstrate that our optimizer works well with different LLM families, such as Qwen and LLaMA, across various model sizes ranging from 1.8B to 8B, various RLHF algorithms like DPO and KTO, and existing model merging methods. It significantly enhances alignment reward while mitigating alignment tax, achieving higher overall performance across 14 benchmarks.

Large language models (LLMs) have emerged as powerful tools for analyzing complex datasets. Recent studies demonstrate their potential to generate useful, personalized responses when provided with patient-specific health information that encompasses lifestyle, biomarkers, and context. As LLM-driven health applications are increasingly adopted, rigorous and efficient one-sided evaluation methodologies are crucial to ensure response quality across multiple dimensions, including accuracy, personalization and safety. Current evaluation practices for open-ended text responses heavily rely on human experts. This approach introduces human factors and is often cost-prohibitive, labor-intensive, and hinders scalability, especially in complex domains like healthcare where response assessment necessitates domain expertise and considers multifaceted patient data. In this work, we introduce Adaptive Precise Boolean rubrics: an evaluation framework that streamlines human and automated evaluation of open-ended questions by identifying gaps in model responses using a minimal set of targeted rubrics questions. Our approach is based on recent work in more general evaluation settings that contrasts a smaller set of complex evaluation targets with a larger set of more precise, granular targets answerable with simple boolean responses. We validate this approach in metabolic health, a domain encompassing diabetes, cardiovascular disease, and obesity. Our results demonstrate that Adaptive Precise Boolean rubrics yield higher inter-rater agreement among expert and non-expert human evaluators, and in automated assessments, compared to traditional Likert scales, while requiring approximately half the evaluation time of Likert-based methods. This enhanced efficiency, particularly in automated evaluation and non-expert contributions, paves the way for more extensive and cost-effective evaluation of LLMs in health.

Medical question-answering (QA) is a critical task for evaluating how effectively large language models (LLMs) encode clinical knowledge and assessing their potential applications in medicine. Despite showing promise on multiple-choice tests, LLMs frequently struggle with open-ended medical questions, producing responses with dangerous hallucinations or lacking comprehensive coverage of critical aspects. Existing approaches attempt to address these challenges through domain-specific fine-tuning, but this proves resource-intensive and difficult to scale across models. To improve the comprehensiveness and factuality of medical responses, we propose a novel approach utilizing structured medical reasoning. Our method guides LLMs through an seven-step cognitive process inspired by clinical diagnosis, enabling more accurate and complete answers without additional training. Experiments on the MedLFQA benchmark demonstrate that our approach achieves the highest Factuality Score of 85.8, surpassing fine-tuned models. Notably, this improvement transfers to smaller models, highlighting the method's efficiency and scalability. Our code and datasets are available.

Reinforcement Learning with Human Feedback (RLHF) has been demonstrated to significantly enhance the performance of large language models (LLMs) by aligning their outputs with desired human values through instruction tuning. However, RLHF is constrained by the expertise and productivity limitations of human evaluators. A response to this downside is to fall back to supervised fine-tuning (SFT) with additional carefully selected expert demonstrations. However, while this method has been proven to be effective, it invariably also leads to increased human-in-the-loop overhead. In this study, we propose another alternative approach: Reinforcement Learning with Generative Adversarial Feedback (RLGAF) to RLHF and SFT, which uses a generative adversarial training style to enable the LLMs to learn useful human expert demonstrations without being directly exposed to the training examples, thus enabling good generalization capabilities while preserving sample efficiency. Our preliminary findings indicate that RLGAF can help align LLMs outputs with competitive performance against RLHF and SFT, while not suffering from their respective inherent restrictions, suggesting promising avenues for further research on automating AI alignment.

Recent advancements in Large Language Models (LLMs) have positioned them as powerful tools for clinical decision-making, with rapidly expanding applications in healthcare. However, concerns about bias remain a significant challenge in the clinical implementation of LLMs, particularly regarding gender and ethnicity. This research investigates the evaluation and mitigation of bias in LLMs applied to complex clinical cases, focusing on gender and ethnicity biases. We introduce a novel Counterfactual Patient Variations (CPV) dataset derived from the JAMA Clinical Challenge. Using this dataset, we built a framework for bias evaluation, employing both Multiple Choice Questions (MCQs) and corresponding explanations. We explore prompting with eight LLMs and fine-tuning as debiasing methods. Our findings reveal that addressing social biases in LLMs requires a multidimensional approach as mitigating gender bias can occur while introducing ethnicity biases, and that gender bias in LLM embeddings varies significantly across medical specialities. We demonstrate that evaluating both MCQ response and explanation processes is crucial, as correct responses can be based on biased reasoning. We provide a framework for evaluating LLM bias in real-world clinical cases, offer insights into the complex nature of bias in these models, and present strategies for bias mitigation.

Large Language Models (LLMs) have attained human-level accuracy on medical question-answer (QA) benchmarks. However, their limitations in navigating open-ended clinical scenarios have recently been shown, raising concerns about the robustness and generalizability of LLM reasoning across diverse, real-world medical tasks. To probe potential LLM failure modes in clinical problem-solving, we present the medical abstraction and reasoning corpus (M-ARC). M-ARC assesses clinical reasoning through scenarios designed to exploit the Einstellung effect -- the fixation of thought arising from prior experience, targeting LLM inductive biases toward inflexible pattern matching from their training data rather than engaging in flexible reasoning. We find that LLMs, including current state-of-the-art o1 and Gemini models, perform poorly compared to physicians on M-ARC, often demonstrating lack of commonsense medical reasoning and a propensity to hallucinate. In addition, uncertainty estimation analyses indicate that LLMs exhibit overconfidence in their answers, despite their limited accuracy. The failure modes revealed by M-ARC in LLM medical reasoning underscore the need to exercise caution when deploying these models in clinical settings.

The success of Reinforcement Learning from Human Feedback (RLHF) critically depends on the quality of the reward model. While this quality is primarily evaluated through accuracy, it remains unclear whether accuracy fully captures what makes a reward model an effective teacher. We address this question from an optimization perspective. First, we prove that regardless of how accurate a reward model is, if it induces low reward variance, then the RLHF objective suffers from a flat landscape. Consequently, even a perfectly accurate reward model can lead to extremely slow optimization, underperforming less accurate models that induce higher reward variance. We additionally show that a reward model that works well for one language model can induce low reward variance, and thus a flat objective landscape, for another. These results establish a fundamental limitation of evaluating reward models solely based on accuracy or independently of the language model they guide. Experiments using models of up to 8B parameters corroborate our theory, demonstrating the interplay between reward variance, accuracy, and reward maximization rate. Overall, our findings highlight that beyond accuracy, a reward model needs to induce sufficient variance for efficient optimization.

Patient education materials for solid-organ transplantation vary substantially across U.S. centers, yet no systematic method exists to quantify this heterogeneity at scale. We introduce a framework that grounds the same patient questions in different centers' handbooks using retrieval-augmented language models and compares the resulting answers using a five-label consistency taxonomy. Applied to 102 handbooks from 23 centers and 1,115 benchmark questions, the framework quantifies heterogeneity across four dimensions: question, topic, organ, and center. We find that 20.8% of non-absent pairwise comparisons exhibit clinically meaningful divergence, concentrated in condition monitoring and lifestyle topics. Coverage gaps are even more prominent: 96.2% of question-handbook pairs miss relevant content, with reproductive health at 95.1% absence. Center-level divergence profiles are stable and interpretable, where heterogeneity reflects systematic institutional differences, likely due to patient diversity. These findings expose an information gap in transplant patient education materials, with document-grounded medical question answering highlighting opportunities for content improvement.

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

Large Language Models (LLMs) trained on extensive textual corpora have emerged as leading solutions for a broad array of Natural Language Processing (NLP) tasks. Despite their notable performance, these models are prone to certain limitations such as misunderstanding human instructions, generating potentially biased content, or factually incorrect (hallucinated) information. Hence, aligning LLMs with human expectations has become an active area of interest within the research community. This survey presents a comprehensive overview of these alignment technologies, including the following aspects. (1) Data collection: the methods for effectively collecting high-quality instructions for LLM alignment, including the use of NLP benchmarks, human annotations, and leveraging strong LLMs. (2) Training methodologies: a detailed review of the prevailing training methods employed for LLM alignment. Our exploration encompasses Supervised Fine-tuning, both Online and Offline human preference training, along with parameter-efficient training mechanisms. (3) Model Evaluation: the methods for evaluating the effectiveness of these human-aligned LLMs, presenting a multifaceted approach towards their assessment. In conclusion, we collate and distill our findings, shedding light on several promising future research avenues in the field. This survey, therefore, serves as a valuable resource for anyone invested in understanding and advancing the alignment of LLMs to better suit human-oriented tasks and expectations. An associated GitHub link collecting the latest papers is available at https://github.com/GaryYufei/AlignLLMHumanSurvey.

Vision-Language Models (VLMs) have great potential in medical tasks, like Visual Question Answering (VQA), where they could act as interactive assistants for both patients and clinicians. Yet their robustness to distribution shifts on unseen data remains a key concern for safe deployment. Evaluating such robustness requires a controlled experimental setup that allows for systematic insights into the model's behavior. However, we demonstrate that current setups fail to offer sufficiently thorough evaluations. To address this gap, we introduce a novel framework, called SURE-VQA, centered around three key requirements to overcome current pitfalls and systematically analyze VLM robustness: 1) Since robustness on synthetic shifts does not necessarily translate to real-world shifts, it should be measured on real-world shifts that are inherent to the VQA data; 2) Traditional token-matching metrics often fail to capture underlying semantics, necessitating the use of large language models (LLMs) for more accurate semantic evaluation; 3) Model performance often lacks interpretability due to missing sanity baselines, thus meaningful baselines should be reported that allow assessing the multimodal impact on the VLM. To demonstrate the relevance of this framework, we conduct a study on the robustness of various Fine-Tuning (FT) methods across three medical datasets with four types of distribution shifts. Our study highlights key insights into robustness: 1) No FT method consistently outperforms others in robustness, and 2) robustness trends are more stable across FT methods than across distribution shifts. Additionally, we find that simple sanity baselines that do not use the image data can perform surprisingly well and confirm LoRA as the best-performing FT method on in-distribution data. Code is provided at https://github.com/IML-DKFZ/sure-vqa.

Genomic language models (gLMs) have shown mostly modest success in identifying evolutionarily constrained elements in mammalian genomes. To address this issue, we introduce a novel framework for training gLMs that explicitly models nucleotide evolution on phylogenetic trees using multispecies whole-genome alignments. Our approach integrates an alignment into the loss function during training but does not require it for making predictions, thereby enhancing the model's applicability. We applied this framework to train PhyloGPN, a model that excels at predicting functionally disruptive variants from a single sequence alone and demonstrates strong transfer learning capabilities.

In recent advancements in Conversational Large Language Models (LLMs), a concerning trend has emerged, showing that many new base LLMs experience a knowledge reduction in their foundational capabilities following Supervised Fine-Tuning (SFT). This process often leads to issues such as forgetting or a decrease in the base model's abilities. Moreover, fine-tuned models struggle to align with user preferences, inadvertently increasing the generation of toxic outputs when specifically prompted. To overcome these challenges, we adopted an innovative approach by completely bypassing SFT and directly implementing Harmless Reinforcement Learning from Human Feedback (RLHF). Our method not only preserves the base model's general capabilities but also significantly enhances its conversational abilities, while notably reducing the generation of toxic outputs. Our approach holds significant implications for fields that demand a nuanced understanding and generation of responses, such as customer service. We applied this methodology to Mistral, the most popular base model, thereby creating Mistral-Plus. Our validation across 11 general tasks demonstrates that Mistral-Plus outperforms similarly sized open-source base models and their corresponding instruct versions. Importantly, the conversational abilities of Mistral-Plus were significantly improved, indicating a substantial advancement over traditional SFT models in both safety and user preference alignment.

Scientists and practitioners are aggressively moving to deploy digital twins - LLM-based models of real individuals - across social science and policy research. We conducted 19 pre-registered studies with 164 diverse outcomes (e.g., attitudes towards hiring algorithms, intention to share misinformation) and compared human responses to those of their digital twins (trained on each person's previous answers to over 500 questions). We find that digital twins' answers are only modestly more accurate than those from the homogeneous base LLM and correlate weakly with human responses (average r = 0.20). We document five ways in which digital twins distort human behavior: (i) stereotyping, (ii) insufficient individuation, (iii) representation bias, (iv) ideological biases, and (v) hyper-rationality. Together, our results caution against the premature deployment of digital twins, which may systematically misrepresent human cognition and undermine both scientific understanding and practical applications.

Common methods for aligning already-capable models with desired behavior rely on the ability of humans to provide supervision. However, future superhuman models will surpass the capability of humans. Therefore, humans will only be able to weakly supervise superhuman models. This expected deficiency of human evaluation would weaken the safety of future AI systems. Scalable oversight and weak-to-strong generalization are two complementary approaches to tackle this issue. In this paper, we attempt to combine the strengths of these two approaches to further improve alignment. Specifically, we investigate ways of improving human supervision with a strong pretrained model and then supervise the strong model with enhanced weak human supervision. To make iterative empirical progress, we consider an analogy: can we use a strong model to improve weak model supervision and then use it to supervise the strong model? We empirically test it by finetuning a small weak model on ground truth labels with the additional help from a large strong model, and then finetuning the strong model on labels generated by the weak model. We find that debate can assist a weak model in extracting trustworthy information from an untrustworthy strong model, which provides leverage as context on samples when training a weak model. We also show that an ensemble of weak models helps exploit long arguments generated by strong model debaters and obtain a more robust supervision estimate. Extensive experiments on the OpenAI weak-to-strong NLP benchmarks show that the combination approach leads to better alignment, which indicates that debate has the potential to help weak-to-strong generalization.

Common deep learning approaches for antibody engineering focus on modeling the marginal distribution of sequences. By treating sequences as independent samples, however, these methods overlook affinity maturation as a rich and largely untapped source of information about the evolutionary process by which antibodies explore the underlying fitness landscape. In contrast, classical phylogenetic models explicitly represent evolutionary dynamics but lack the expressivity to capture complex epistatic interactions. We bridge this gap with CoSiNE, a continuous-time Markov chain parameterized by a deep neural network. Mathematically, we prove that CoSiNE provides a first-order approximation to the intractable sequential point mutation process, capturing epistatic effects with an error bound that is quadratic in branch length. Empirically, CoSiNE outperforms state-of-the-art language models in zero-shot variant effect prediction by explicitly disentangling selection from context-dependent somatic hypermutation. Finally, we introduce Guided Gillespie, a classifier-guided sampling scheme that steers CoSiNE at inference time, enabling efficient optimization of antibody binding affinity toward specific antigens.

Large language models (LLMs) have recently become the leading source of answers for users' questions online. Despite their ability to offer eloquent answers, their accuracy and reliability can pose a significant challenge. This is especially true for sensitive domains such as biomedicine, where there is a higher need for factually correct answers. This paper introduces a biomedical retrieval-augmented generation (RAG) system designed to enhance the reliability of generated responses. The system is based on a fine-tuned LLM for the referenced question-answering, where retrieved relevant abstracts from PubMed are passed to LLM's context as input through a prompt. Its output is an answer based on PubMed abstracts, where each statement is referenced accordingly, allowing the users to verify the answer. Our retrieval system achieves an absolute improvement of 23% compared to the PubMed search engine. Based on the manual evaluation on a small sample, our fine-tuned LLM component achieves comparable results to GPT-4 Turbo in referencing relevant abstracts. We make the dataset used to fine-tune the models and the fine-tuned models based on Mistral-7B-instruct-v0.1 and v0.2 publicly available.

Large language models (LLMs) are increasingly essential in processing natural languages, yet their application is frequently compromised by biases and inaccuracies originating in their training data. In this study, we introduce Cross-Care, the first benchmark framework dedicated to assessing biases and real world knowledge in LLMs, specifically focusing on the representation of disease prevalence across diverse demographic groups. We systematically evaluate how demographic biases embedded in pre-training corpora like ThePile influence the outputs of LLMs. We expose and quantify discrepancies by juxtaposing these biases against actual disease prevalences in various U.S. demographic groups. Our results highlight substantial misalignment between LLM representation of disease prevalence and real disease prevalence rates across demographic subgroups, indicating a pronounced risk of bias propagation and a lack of real-world grounding for medical applications of LLMs. Furthermore, we observe that various alignment methods minimally resolve inconsistencies in the models' representation of disease prevalence across different languages. For further exploration and analysis, we make all data and a data visualization tool available at: www.crosscare.net.

To build effective therapeutics, biologists iteratively mutate antibody sequences to improve binding and stability. Proposed mutations can be informed by previous measurements or by learning from large antibody databases to predict only typical antibodies. Unfortunately, the space of typical antibodies is enormous to search, and experiments often fail to find suitable antibodies on a budget. We introduce Clone-informed Bayesian Optimization (CloneBO), a Bayesian optimization procedure that efficiently optimizes antibodies in the lab by teaching a generative model how our immune system optimizes antibodies. Our immune system makes antibodies by iteratively evolving specific portions of their sequences to bind their target strongly and stably, resulting in a set of related, evolving sequences known as a clonal family. We train a large language model, CloneLM, on hundreds of thousands of clonal families and use it to design sequences with mutations that are most likely to optimize an antibody within the human immune system. We propose to guide our designs to fit previous measurements with a twisted sequential Monte Carlo procedure. We show that CloneBO optimizes antibodies substantially more efficiently than previous methods in realistic in silico experiments and designs stronger and more stable binders in in vitro wet lab experiments.

Ensuring that generative AI systems align with human values is essential but challenging, especially when considering multiple human values and their potential trade-offs. Since human values can be personalized and dynamically change over time, the desirable levels of value alignment vary across different ethnic groups, industry sectors, and user cohorts. Within existing frameworks, it is hard to define human values and align AI systems accordingly across different directions simultaneously, such as harmlessness, helpfulness, and positiveness. To address this, we develop a novel, first-principle approach called Multi-Human-Value Alignment Palette (MAP), which navigates the alignment across multiple human values in a structured and reliable way. MAP formulates the alignment problem as an optimization task with user-defined constraints, which define human value targets. It can be efficiently solved via a primal-dual approach, which determines whether a user-defined alignment target is achievable and how to achieve it. We conduct a detailed theoretical analysis of MAP by quantifying the trade-offs between values, the sensitivity to constraints, the fundamental connection between multi-value alignment and sequential alignment, and proving that linear weighted rewards are sufficient for multi-value alignment. Extensive experiments demonstrate MAP's ability to align multiple values in a principled manner while delivering strong empirical performance across various tasks.

Large language models (LLMs) are increasingly evaluated in clinical settings using multi-dimensional rubrics which quantify reasoning quality, safety, and patient-centeredness. Yet, replicating specific mistakes in other LLM models is not straightforward and often requires manual effort. We introduce MedMistake, an automatic pipeline that extracts mistakes LLMs make in patient-doctor conversations and converts them into a benchmark of single-shot QA pairs. Our pipeline (1) creates complex, conversational data between an LLM patient and LLM doctor, (2) runs an evaluation with a committee of 2 LLM judges across a variety of dimensions and (3) creates simplified single-shot QA scenarios from those mistakes. We release MedMistake-All, a dataset of 3,390 single-shot QA pairs where GPT-5 and Gemini 2.5 Pro are currently failing to answer correctly, as judged by two LLM judges. We used medical experts to validate a subset of 211/3390 questions (MedMistake-Bench), which we used to run a final evaluation of 12 frontier LLMs: Claude Opus 4.5, Claude Sonnet 4.5, DeepSeek-Chat, Gemini 2.5 Pro, Gemini 3 Pro, GPT-4o, GPT-5, GPT-5.1, GPT-5.2, Grok 4, Grok 4.1, Mistral Large. We found that GPT models, Claude and Grok obtained the best performance on MedMistake-Bench. We release both the doctor-validated benchmark (MedMistake-Bench), as well as the full dataset (MedMistake-All) at https://huggingface.co/datasets/TheLumos/MedicalMistakeBenchmark.

Systematic literature reviews are essential for synthesizing scientific evidence but are costly, difficult to scale and time-intensive, creating bottlenecks for evidence-based policy. We study whether large language models can automate the complete systematic review workflow, from article retrieval, article screening, data extraction to report synthesis. Applied to epidemiological reviews of nine WHO-designated priority pathogens and validated against expert-curated ground truth, our open-source agentic pipeline (AgentSLR) achieves performance comparable to human researchers while reducing review time from approximately 7 weeks to 20 hours (a 58x speed-up). Our comparison of five frontier models reveals that performance on SLR is driven less by model size or inference cost than by each model's distinctive capabilities. Through human-in-the-loop validation, we identify key failure modes. Our results demonstrate that agentic AI can substantially accelerate scientific evidence synthesis in specialised domains.

Recent advances in large language models (LLMs) have introduced the novel paradigm of using LLMs as judges, where an LLM evaluates and scores the outputs of another LLM, which often correlates highly with human preferences. However, the use of LLM-as-a-judge has been primarily studied in English. In this paper, we evaluate this framework in Russian by introducing the Russian Error tyPes Annotation dataset (REPA), a dataset of 1k user queries and 2k LLM-generated responses. Human annotators labeled each response pair expressing their preferences across ten specific error types, as well as selecting an overall preference. We rank six generative LLMs across the error types using three rating systems based on human preferences. We also evaluate responses using eight LLM judges in zero-shot and few-shot settings. We describe the results of analyzing the judges and position and length biases. Our findings reveal a notable gap between LLM judge performance in Russian and English. However, rankings based on human and LLM preferences show partial alignment, suggesting that while current LLM judges struggle with fine-grained evaluation in Russian, there is potential for improvement.