Daily Papers

Neural architecture search (NAS) has achieved breakthrough success in a great number of applications in the past few years. It could be time to take a step back and analyze the good and bad aspects in the field of NAS. A variety of algorithms search architectures under different search space. These searched architectures are trained using different setups, e.g., hyper-parameters, data augmentation, regularization. This raises a comparability problem when comparing the performance of various NAS algorithms. NAS-Bench-101 has shown success to alleviate this problem. In this work, we propose an extension to NAS-Bench-101: NAS-Bench-201 with a different search space, results on multiple datasets, and more diagnostic information. NAS-Bench-201 has a fixed search space and provides a unified benchmark for almost any up-to-date NAS algorithms. The design of our search space is inspired from the one used in the most popular cell-based searching algorithms, where a cell is represented as a DAG. Each edge here is associated with an operation selected from a predefined operation set. For it to be applicable for all NAS algorithms, the search space defined in NAS-Bench-201 includes all possible architectures generated by 4 nodes and 5 associated operation options, which results in 15,625 candidates in total. The training log and the performance for each architecture candidate are provided for three datasets. This allows researchers to avoid unnecessary repetitive training for selected candidate and focus solely on the search algorithm itself. The training time saved for every candidate also largely improves the efficiency of many methods. We provide additional diagnostic information such as fine-grained loss and accuracy, which can give inspirations to new designs of NAS algorithms. In further support, we have analyzed it from many aspects and benchmarked 10 recent NAS algorithms.

Ensuring the reliability and availability of complex networked services demands effective root cause analysis (RCA) across cloud environments, data centers, and on-premises networks. Traditional RCA methods, which involve manual inspection of data sources such as logs and telemetry data, are often time-consuming and challenging for on-call engineers. While statistical inference methods have been employed to estimate the causality of network events, these approaches alone are similarly challenging and suffer from a lack of interpretability, making it difficult for engineers to understand the predictions made by black-box models. In this paper, we present RCACopilot, an advanced on-call system that combines statistical tests and large language model (LLM) reasoning to automate RCA across various network environments. RCACopilot gathers and synthesizes critical runtime diagnostic information, predicts the root cause of incidents, provides a clear explanatory narrative, and offers targeted action steps for engineers to resolve the issues. By utilizing LLM reasoning techniques and retrieval, RCACopilot delivers accurate and practical support for operators.

Different medical imaging modalities capture diagnostic information at varying spatial resolutions, from coarse global patterns to fine-grained localized structures. However, most existing vision-language frameworks in the medical domain apply a uniform strategy for local feature extraction, overlooking the modality-specific demands. In this work, we present MedMoE, a modular and extensible vision-language processing framework that dynamically adapts visual representation based on the diagnostic context. MedMoE incorporates a Mixture-of-Experts (MoE) module conditioned on the report type, which routes multi-scale image features through specialized expert branches trained to capture modality-specific visual semantics. These experts operate over feature pyramids derived from a Swin Transformer backbone, enabling spatially adaptive attention to clinically relevant regions. This framework produces localized visual representations aligned with textual descriptions, without requiring modality-specific supervision at inference. Empirical results on diverse medical benchmarks demonstrate that MedMoE improves alignment and retrieval performance across imaging modalities, underscoring the value of modality-specialized visual representations in clinical vision-language systems.

Breast cancer remains a leading cause of cancer-related mortality worldwide, making early detection and accurate treatment response monitoring critical priorities. We present BreastDCEDL, a curated, deep learning-ready dataset comprising pre-treatment 3D Dynamic Contrast-Enhanced MRI (DCE-MRI) scans from 2,070 breast cancer patients drawn from the I-SPY1, I-SPY2, and Duke cohorts, all sourced from The Cancer Imaging Archive. The raw DICOM imaging data were rigorously converted into standardized 3D NIfTI volumes with preserved signal integrity, accompanied by unified tumor annotations and harmonized clinical metadata including pathologic complete response (pCR), hormone receptor (HR), and HER2 status. Although DCE-MRI provides essential diagnostic information and deep learning offers tremendous potential for analyzing such complex data, progress has been limited by lack of accessible, public, multicenter datasets. BreastDCEDL addresses this gap by enabling development of advanced models, including state-of-the-art transformer architectures that require substantial training data. To demonstrate its capacity for robust modeling, we developed the first transformer-based model for breast DCE-MRI, leveraging Vision Transformer (ViT) architecture trained on RGB-fused images from three contrast phases (pre-contrast, early post-contrast, and late post-contrast). Our ViT model achieved state-of-the-art pCR prediction performance in HR+/HER2- patients (AUC 0.94, accuracy 0.93). BreastDCEDL includes predefined benchmark splits, offering a framework for reproducible research and enabling clinically meaningful modeling in breast cancer imaging.

Multi-agent LLM systems are entering production -- processing documents, managing workflows, acting on behalf of users -- yet their resilience to prompt injection is still evaluated with a single binary: did the attack succeed? This leaves architects without the diagnostic information needed to harden real pipelines. We introduce a kill-chain canary methodology that tracks a cryptographic token through four stages (EXPOSED -> PERSISTED -> RELAYED -> EXECUTED) across 950 runs, five frontier LLMs, six attack surfaces, and five defense conditions. The results reframe prompt injection as a pipeline-architecture problem: every model is fully exposed, yet outcomes diverge downstream -- Claude blocks all injections at memory-write (0/164 ASR), GPT-4o-mini propagates at 53%, and DeepSeek exhibits 0%/100% across surfaces from the same model. Three findings matter for deployment: (1) write-node placement is the highest-leverage safety decision -- routing writes through a verified model eliminates propagation; (2) all four defenses fail on at least one surface due to channel mismatch alone, no adversarial adaptation required; (3) invisible whitefont PDF payloads match or exceed visible-text ASR, meaning rendered-layer screening is insufficient. These dynamics apply directly to production: institutional investors and financial firms already run NLP pipelines over earnings calls, SEC filings, and analyst reports -- the document-ingestion workflows now migrating to LLM agents. Code, run logs, and tooling are publicly released.

Timely and accurate lymphoma diagnosis is essential for guiding cancer treatment. Standard diagnostic practice combines hematoxylin and eosin (HE)-stained whole slide images with immunohistochemistry, flow cytometry, and molecular genetic tests to determine lymphoma subtypes, a process requiring costly equipment, skilled personnel, and causing treatment delays. Deep learning methods could assist pathologists by extracting diagnostic information from routinely available HE-stained slides, yet comprehensive benchmarks for lymphoma subtyping on multicenter data are lacking. In this work, we present the first multicenter lymphoma benchmarking dataset covering four common lymphoma subtypes and healthy control tissue. We systematically evaluate five publicly available pathology foundation models (H-optimus-1, H0-mini, Virchow2, UNI2, Titan) combined with attention-based (AB-MIL) and transformer-based (TransMIL) multiple instance learning aggregators across three magnifications (10x, 20x, 40x). On in-distribution test sets, models achieve multiclass balanced accuracies exceeding 80% across all magnifications, with all foundation models performing similarly and both aggregation methods showing comparable results. The magnification study reveals that 40x resolution is sufficient, with no performance gains from higher resolutions or cross-magnification aggregation. However, on out-of-distribution test sets, performance drops substantially to around 60%, highlighting significant generalization challenges. To advance the field, larger multicenter studies covering additional rare lymphoma subtypes are needed. We provide an automated benchmarking pipeline to facilitate such future research.

Quantitative susceptibility maps from magnetic resonance images can provide both prognostic and diagnostic information in multiple sclerosis, a neurodegenerative disease characterized by the formation of lesions in white matter brain tissue. In particular, susceptibility maps provide adequate contrast to distinguish between "rim" lesions, surrounded by deposited paramagnetic iron, and "non-rim" lesion types. These paramagnetic rim lesions (PRLs) are an emerging biomarker in multiple sclerosis. Much effort has been devoted to both detection and segmentation of such lesions to monitor longitudinal change. As paramagnetic rim lesions are rare, addressing this problem requires confronting the class imbalance between rim and non-rim lesions. We produce synthetic quantitative susceptibility maps of paramagnetic rim lesions and show that inclusion of such synthetic data improves classifier performance and provide a multi-channel extension to generate accompanying contrasts and probabilistic segmentation maps. We exploit the projection capability of our trained generative network to demonstrate a novel denoising approach that allows us to train on ambiguous rim cases and substantially increase the minority class. We show that both synthetic lesion synthesis and our proposed rim lesion label denoising method best approximate the unseen rim lesion distribution and improve detection in a clinically interpretable manner. We release our code and generated data at https://github.com/agr78/PRLx-GAN upon publication.

Whole Slide Images (WSIs) exhibit hierarchical structure, where diagnostic information emerges from cellular morphology, regional tissue organization, and global context. Existing Computational Pathology (CPath) Multimodal Large Language Models (MLLMs) typically compress an entire WSI into a single embedding, which hinders fine-grained grounding and ignores how pathologists synthesize evidence across different scales. We introduce MLLM-HWSI, a Hierarchical WSI-level MLLM that aligns visual features with pathology language at four distinct scales, cell as word, patch as phrase, region as sentence, and WSI as paragraph to support interpretable evidence-grounded reasoning. MLLM-HWSI decomposes each WSI into multi-scale embeddings with scale-specific projectors and jointly enforces (i) a hierarchical contrastive objective and (ii) a cross-scale consistency loss, preserving semantic coherence from cells to the WSI. We compute diagnostically relevant patches and aggregate segmented cell embeddings into a compact cellular token per-patch using a lightweight Cell-Cell Attention Fusion (CCAF) transformer. The projected multi-scale tokens are fused with text tokens and fed to an instruction-tuned LLM for open-ended reasoning, VQA, report, and caption generation tasks. Trained in three stages, MLLM-HWSI achieves new SOTA results on 13 WSI-level benchmarks across six CPath tasks. By aligning language with multi-scale visual evidence, MLLM-HWSI provides accurate, interpretable outputs that mirror diagnostic workflows and advance holistic WSI understanding. Code is available at: https://github.com/BasitAlawode/HWSI-MLLM{GitHub}.

The automatic identification and analysis of pronunciation errors, known as Mispronunciation Detection and Diagnosis (MDD) plays a crucial role in Computer Aided Pronunciation Learning (CAPL) tools such as Second-Language (L2) learning or speech therapy applications. Existing MDD methods relying on analysing phonemes can only detect categorical errors of phonemes that have an adequate amount of training data to be modelled. With the unpredictable nature of the pronunciation errors of non-native or disordered speakers and the scarcity of training datasets, it is unfeasible to model all types of mispronunciations. Moreover, phoneme-level MDD approaches have a limited ability to provide detailed diagnostic information about the error made. In this paper, we propose a low-level MDD approach based on the detection of speech attribute features. Speech attribute features break down phoneme production into elementary components that are directly related to the articulatory system leading to more formative feedback to the learner. We further propose a multi-label variant of the Connectionist Temporal Classification (CTC) approach to jointly model the non-mutually exclusive speech attributes using a single model. The pre-trained wav2vec2 model was employed as a core model for the speech attribute detector. The proposed method was applied to L2 speech corpora collected from English learners from different native languages. The proposed speech attribute MDD method was further compared to the traditional phoneme-level MDD and achieved a significantly lower False Acceptance Rate (FAR), False Rejection Rate (FRR), and Diagnostic Error Rate (DER) over all speech attributes compared to the phoneme-level equivalent.

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

Speech patterns have been identified as potential diagnostic markers for neuropsychiatric conditions. However, most studies only compare a single clinical group to healthy controls, whereas clinical practice often requires differentiating between multiple potential diagnoses (multiclass settings). To address this, we assembled a dataset of repeated recordings from 420 participants (67 with major depressive disorder, 106 with schizophrenia and 46 with autism, as well as matched controls), and tested the performance of a range of conventional machine learning models and advanced Transformer models on both binary and multiclass classification, based on voice and text features. While binary models performed comparably to previous research (F1 scores between 0.54-0.75 for autism spectrum disorder, ASD; 0.67-0.92 for major depressive disorder, MDD; and 0.71-0.83 for schizophrenia); when differentiating between multiple diagnostic groups performance decreased markedly (F1 scores between 0.35-0.44 for ASD, 0.57-0.75 for MDD, 0.15-0.66 for schizophrenia, and 0.38-0.52 macro F1). Combining voice and text-based models yielded increased performance, suggesting that they capture complementary diagnostic information. Our results indicate that models trained on binary classification may learn to rely on markers of generic differences between clinical and non-clinical populations, or markers of clinical features that overlap across conditions, rather than identifying markers specific to individual conditions. We provide recommendations for future research in the field, suggesting increased focus on developing larger transdiagnostic datasets that include more fine-grained clinical features, and that can support the development of models that better capture the complexity of neuropsychiatric conditions and naturalistic diagnostic assessment.

Large Language Models (LLMs) pre-trained on internet-scale datasets have shown impressive capabilities in code understanding, synthesis, and general purpose question-and-answering. Key to their performance is the substantial prior knowledge acquired during training and their ability to reason over extended sequences of symbols, often presented in natural language. In this work, we aim to harness the extensive long-term reasoning, natural language comprehension, and the available prior knowledge of LLMs for increased resilience and adaptation in autonomous mobile robots. We introduce REAL, an approach for REsilience and Adaptation using LLMs. REAL provides a strategy to employ LLMs as a part of the mission planning and control framework of an autonomous robot. The LLM employed by REAL provides (i) a source of prior knowledge to increase resilience for challenging scenarios that the system had not been explicitly designed for; (ii) a way to interpret natural-language and other log/diagnostic information available in the autonomy stack, for mission planning; (iii) a way to adapt the control inputs using minimal user-provided prior knowledge about the dynamics/kinematics of the robot. We integrate REAL in the autonomy stack of a real multirotor, querying onboard an offboard LLM at 0.1-1.0 Hz as part the robot's mission planning and control feedback loops. We demonstrate in real-world experiments the ability of the LLM to reduce the position tracking errors of a multirotor under the presence of (i) errors in the parameters of the controller and (ii) unmodeled dynamics. We also show (iii) decision making to avoid potentially dangerous scenarios (e.g., robot oscillates) that had not been explicitly accounted for in the initial prompt design.

The automated generation of imaging reports proves invaluable in alleviating the workload of radiologists. A clinically applicable reports generation algorithm should demonstrate its effectiveness in producing reports that accurately describe radiology findings and attend to patient-specific indications. In this paper, we introduce a novel method, Structural Entities extraction and patient indications Incorporation (SEI) for chest X-ray report generation. Specifically, we employ a structural entities extraction (SEE) approach to eliminate presentation-style vocabulary in reports and improve the quality of factual entity sequences. This reduces the noise in the following cross-modal alignment module by aligning X-ray images with factual entity sequences in reports, thereby enhancing the precision of cross-modal alignment and further aiding the model in gradient-free retrieval of similar historical cases. Subsequently, we propose a cross-modal fusion network to integrate information from X-ray images, similar historical cases, and patient-specific indications. This process allows the text decoder to attend to discriminative features of X-ray images, assimilate historical diagnostic information from similar cases, and understand the examination intention of patients. This, in turn, assists in triggering the text decoder to produce high-quality reports. Experiments conducted on MIMIC-CXR validate the superiority of SEI over state-of-the-art approaches on both natural language generation and clinical efficacy metrics.

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

Repository-level software engineering (SWE) is a challenging long-horizon setting: agents must reason over extended interactions, use tools, and adapt to stateful environments. Recent work trains SWE agents with reinforcement learning methods such as Group Relative Policy Optimization (GRPO), which independently sample multiple trajectories per issue, test the resulting patches, and compare terminal rewards within a fixed group. However, this training setup does not reuse verifier feedback from failed patches as context for subsequent attempts, even though this feedback contains valuable diagnostic information about what went wrong. Training on recovery trajectories is challenging because the preceding outcome determines whether the next trajectory is generated, while the failed execution determines its conditioning context. We introduce FC-SWE, a failure-conditioned RL framework that incorporates recovery attempts into policy training. After a patch fails verification, FC-SWE restores the repository to its original task state and uses the failed patch and verifier feedback as context for a recovery trajectory. FC-SWE adapts GRPO to these chains of complete, multi-turn tool-use trajectories through two mechanisms. Trajectory-local rewards preserve each attempt's verifier outcome, preventing recovery success from rewarding an earlier failed patch. Active-set advantage estimation forms a comparison group from all initial and recovery trajectories actually executed for the same issue, so failed attempts remain in the group while unexecuted attempts are excluded. On all 500 SWE-bench Verified tasks under a verifier-assisted protocol, FC-SWE with Qwen3.5-4B and SWE-agent achieves 41.7% Resolved@1 and 52.8% Resolved@2, compared with 38.9% and 48.5% for GRPO. Although trained with at most two attempts per chain, FC-SWE reaches 70.7% Resolved@11 under an eleven-attempt test-time budget.

Medical conversational AI (AI) plays a pivotal role in the development of safer and more effective medical dialogue systems. However, existing benchmarks and evaluation frameworks for assessing the information-gathering and diagnostic reasoning abilities of medical large language models (LLMs) have not been rigorously evaluated. To address these gaps, we present MedDialogRubrics, a novel benchmark comprising 5,200 synthetically constructed patient cases and over 60,000 fine-grained evaluation rubrics generated by LLMs and subsequently refined by clinical experts, specifically designed to assess the multi-turn diagnostic capabilities of LLM. Our framework employs a multi-agent system to synthesize realistic patient records and chief complaints from underlying disease knowledge without accessing real-world electronic health records, thereby mitigating privacy and data-governance concerns. We design a robust Patient Agent that is limited to a set of atomic medical facts and augmented with a dynamic guidance mechanism that continuously detects and corrects hallucinations throughout the dialogue, ensuring internal coherence and clinical plausibility of the simulated cases. Furthermore, we propose a structured LLM-based and expert-annotated rubric-generation pipeline that retrieves Evidence-Based Medicine (EBM) guidelines and utilizes the reject sampling to derive a prioritized set of rubric items ("must-ask" items) for each case. We perform a comprehensive evaluation of state-of-the-art models and demonstrate that, across multiple assessment dimensions, current models face substantial challenges. Our results indicate that improving medical dialogue will require advances in dialogue management architectures, not just incremental tuning of the base-model.

Image captioning, situated at the intersection of computer vision and natural language processing, requires a sophisticated understanding of both visual scenes and linguistic structure. While modern approaches are dominated by large-scale Transformer architectures, this paper documents a systematic, iterative development of foundational image captioning models, progressing from a simple CNN-LSTM encoder-decoder to a competitive attention-based system. This paper presents a series of five models, beginning with Genesis and concluding with Nexus, an advanced model featuring an EfficientNetV2B3 backbone and a dynamic attention mechanism. The experiments chart the impact of architectural enhancements and demonstrate a key finding within the classic CNN-LSTM paradigm: merely upgrading the visual backbone without a corresponding attention mechanism can degrade performance, as the single-vector bottleneck cannot transmit the richer visual detail. This insight validates the architectural shift to attention. Trained on the MS COCO 2017 dataset, the final model, Nexus, achieves a BLEU-4 score of 31.4, surpassing several foundational benchmarks and validating the iterative design process. This work provides a clear, replicable blueprint for understanding the core architectural principles that underpin modern vision-language tasks.

The emergence of Large Reasoning Models has introduced exceptionally long Chain-of-Thought traces, creating a transparency burden where critical logic is often buried under massive procedural text. To address this, we present ReasoningLens, an open-source framework designed for the hierarchical visualization and diagnostic auditing of complex reasoning chains. ReasoningLens addresses information necropsy by: (1) structuring traces into interactive hierarchies that separate high-level strategy from low-level execution; (2) leveraging an agentic auditor for automated error detection and tool-augmented verification; and (3) synthesizing systemic reasoning profiles to reveal model-specific blind spots. By transforming unstructured walls of text into actionable insights, ReasoningLens provides a modular foundation for interpreting, debugging, and optimizing the next generation of reasoning-centric AI.

Most clinical benchmarks evaluate language models (LMs) on diagnosis using complete case descriptions. In clinical practice, however, patients present information in different ways, and clinicians must obtain relevant history and determine which examinations are needed before reaching a diagnosis. Diagnostic accuracy alone therefore cannot establish whether an agent gathered essential information or conducted an appropriate clinical assessment. Furthermore, existing benchmarks lack professional clinicians' verification. To address this gap, we introduce KlinikeBench, a benchmark of 333 clinician-authored tasks, each providing an isolated sandbox environment with a virtual patient, clinical tools, and task-specific success criteria. More than 35 clinicians contributed to case authoring and benchmark evaluation. In an empirical study, clinicians gave simulated dialogues higher mean quality ratings than reference conversations, which is adapted from real conversation. In each task, an LM has a fixed budget of turns to communicate with the patient, ask about relevant history, request examinations, follow action constraints, and record a final diagnosis. We score these steps separately as well as together. Across 31 models and seven model families, the best-performing models (e.g., GPT-6-astra and Claude Opus 5) succeed on less than 30% of tasks, even though their diagnosis accuracy reaches 90.7%. Some models benefit from talking with the patient; others diagnose well from a complete chart but perform much worse in conversation. Overall, KlinikeBench provides a testbed for evaluating the full clinical encounter and reveals a substantial gap between diagnostic accuracy and performance in interactive clinical assessment.

Human speech conveys rich perceptual information, such as emotion and speaker identity, yet most automatic speech quality judges reduce it to a single naturalness score. We study diagnostic speech judges: given two candidates, a diagnostic judge decides which is better, along which perceptual dimensions (e.g., timbre, emotion, timing) they differ, and which audible cues support its decision. Learning such judges is challenging: expert annotation is costly, and simply prompting a frontier audio-language model to produce labels is unreliable: our probing reveals substantial errors and unstable instruction following. We introduce SpeechCritic, which learns a diagnostic judge in a reference-conditioned cross-lingual setting from only about 300 human-labeled comparisons. Rather than replacing the frontier model, SpeechCritic calibrates it with these labels: for each dimension, it selects the acoustic measurements that agree with human judgments, maps them to A/Tie/B probabilities, and passes these to the model as non-binding hints alongside the audio. Compared with the same model labeling without hints, this raises dimension-level agreement with humans by 6.3 points and cuts the mismatch with human Tie rates by 10.4 points. We then train a 7B judge on this supervision and find that different training signals shape different judge behaviors: SFT establishes the task, OPD transfers the teacher's dimension-level strengths and weaknesses, and RL helps most on clear-cut comparisons where human raters agree. Notably, human listeners also find that RL makes rationales cite more specific, localized acoustic cues, although it never directly rewards rationale text. Finally, we show that the pipeline is language-pair agnostic by instantiating it on both English-Japanese and English-Spanish. Together, these results demonstrate a path from limited human preferences to a diagnostic speech judge.

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

Vision-Language Models (VLMs) frequently "hallucinate" - generate plausible yet factually incorrect statements - posing a critical barrier to their trustworthy deployment. In this work, we propose a new paradigm for diagnosing hallucinations, recasting them from static output errors into dynamic pathologies of a model's computational cognition. Our framework is grounded in a normative principle of computational rationality, allowing us to model a VLM's generation as a dynamic cognitive trajectory. We design a suite of information-theoretic probes that project this trajectory onto an interpretable, low-dimensional Cognitive State Space. Our central discovery is a governing principle we term the geometric-information duality: a cognitive trajectory's geometric abnormality within this space is fundamentally equivalent to its high information-theoretic surprisal. Hallucination detection is counts as a geometric anomaly detection problem. Evaluated across diverse settings - from rigorous binary QA (POPE) and comprehensive reasoning (MME) to unconstrained open-ended captioning (MS-COCO) - our framework achieves state-of-the-art performance. Crucially, it operates with high efficiency under weak supervision and remains highly robust even when calibration data is heavily contaminated. This approach enables a causal attribution of failures, mapping observable errors to distinct pathological states: perceptual instability (measured by Perceptual Entropy), logical-causal failure (measured by Inferential Conflict), and decisional ambiguity (measured by Decision Entropy). Ultimately, this opens a path toward building AI systems whose reasoning is transparent, auditable, and diagnosable by design.

The robustness of deep neural networks is crucial for safety-critical deployments, yet existing evaluation methods are often attack-dependent and lack interpretability. We propose a principled, attack-agnostic robustness metric based on the spectral norm of the Fisher Information Matrix (FIM), which quantifies the worst-case sensitivity of the model's output distribution to input perturbations. Theoretically, we establish that the FIM equals the variance of the input Jacobian and derive closed-form spectral bounds for common architectures, including VGG, ResNet, DenseNet, and Transformer, providing the first theoretical robustness ranking. To enable scalable evaluation, we develop efficient algorithms, including power iteration and Hutchinson-based estimation, that support both white-box and black-box settings. Extensive experiments across multiple datasets, including CIFAR, ImageNet, and medical images, and across multiple architectures show a strong correlation between our metric and adversarial vulnerability. Our framework serves as an interpretable diagnostic tool that complements attack-based evaluations, offering insights into architectural sensitivity and guiding the design of more robust models. Code is available at: https://github.com/franz-chang/SRP/.

Existing reasoning evaluations typically provide task-relevant information to models as available premises, rarely examining concurrently how models discover evidence autonomously and how information presentation within narratives guides or obscures judgment. This paper proposes the WORTH Benchmark: models read original mystery narratives without clue annotations, autonomously select key clue sentences, identify case participants, and explain their reasoning process. The narrative materials are designed by professional authors such that evidence facilitating reasoning coexists with narrative arrangements that delay the revelation of truth. We report a pilot experiment under full-story conditions across two episodes, conducting a total of 70 formal runs on models, of which 67 runs are content-scorable. Scoring separately records hits on author-designated key clue sentences and participant selections; natural language explanations are used for case diagnosis and are not scored independently. The results show that clue hits and participant judgments are not synchronized; across 37 content-scorable runs in Episode 02, 31 runs simultaneously selected the same set of incorrect participants, while adjacent suspicion-oriented and exoneration-oriented sentences were selected 25 times and 0 times, respectively. These phenomena illustrate the diagnostic value of component-wise analysis and suggest that not-fully-cooperative informational relationships may influence evidence selection and judgment. This study only implements full-story conditions for two episodes, and does not establish stable model rankings or infer general mechanisms on this basis; human player records have not yet been cleaned, and this version does not report human-model comparisons.

Audio-visual understanding is a rapidly evolving field that seeks to integrate and interpret information from both auditory and visual modalities. Despite recent advances in multi-modal learning, existing benchmarks often suffer from strong visual bias -- where answers can be inferred from visual data alone -- and provide only aggregate scores that conflate multiple sources of error. This makes it difficult to determine whether models struggle with visual understanding, audio interpretation, or audio-visual alignment. In this work, we introduce DAVE (Diagnostic Audio Visual Evaluation), a novel benchmark dataset designed to systematically evaluate audio-visual models across controlled challenges. DAVE alleviates existing limitations by (i) ensuring both modalities are necessary to answer correctly and (ii) decoupling evaluation into atomic subcategories. Our detailed analysis of state-of-the-art models reveals specific failure modes and provides targeted insights for improvement. By offering this standardized diagnostic framework, we aim to facilitate more robust development of audio-visual models. The dataset is released: https://github.com/gorjanradevski/dave

The Uniform Information Density (UID) hypothesis suggests that effective communication maintains a stable flow of information. In this work, we revisit this principle in the context of large language model (LLM) reasoning traces, asking whether step-level uniformity reflects reasoning quality. To this end, we propose an entropy-based stepwise information density metric and introduce two complementary measures of uniformity, local and global uniformity scores. Across the experiments on six different reasoning benchmarks, we find that step-level uniformity not only provides a strong theoretical lens but also yields practical performance benefits; for example, selecting reasoning traces with more uniform information density at the step-level improves accuracy by 10-32\% relative gains over baselines at AIME2025. Our analysis further reveals that correct reasoning traces tend to avoid sharp information density spikes, while incorrect traces exhibit irregular information bursts. These results demonstrate that UID-inspired information density measures outperform alternative internal signals as predictors of reasoning quality. Results highlight the uniformity of the information density as a robust diagnostic and selection criterion for building more reliable and accurate reasoning systems.

General-purpose Large Vision-Language Models (LVLMs), despite their massive scale, often falter in dermatology due to "diffuse attention" - the inability to disentangle subtle pathological lesions from background noise. In this paper, we challenge the assumption that parameter scaling is the only path to medical precision. We introduce SkinFlow, a framework that treats diagnosis as an optimization of visual information transmission efficiency. Our approach utilizes a Virtual-Width Dynamic Vision Encoder (DVE) to "unfold" complex pathological manifolds without physical parameter expansion, coupled with a two-stage Reinforcement Learning strategy. This strategy sequentially aligns explicit medical descriptions (Stage I) and reconstructs implicit diagnostic textures (Stage II) within a constrained semantic space. Furthermore, we propose a clinically grounded evaluation protocol that prioritizes diagnostic safety and hierarchical relevance over rigid label matching. Empirical results are compelling: our 7B model establishes a new state-of-the-art on the Fitzpatrick17k benchmark, achieving a +12.06% gain in Top-1 accuracy and a +28.57% boost in Top-6 accuracy over the massive general-purpose models (e.g., Qwen3VL-235B and GPT-5.2). These findings demonstrate that optimizing geometric capacity and information flow yields superior diagnostic reasoning compared to raw parameter scaling.

Heart disease remains a significant threat to human health. As a non-invasive diagnostic tool, the electrocardiogram (ECG) is one of the most widely used methods for cardiac screening. However, the scarcity of high-quality ECG data, driven by privacy concerns and limited medical resources, creates a pressing need for effective ECG signal generation. Existing approaches for generating ECG signals typically rely on small training datasets, lack comprehensive evaluation frameworks, and overlook potential applications beyond data augmentation. To address these challenges, we propose DiffuSETS, a novel framework capable of generating ECG signals with high semantic alignment and fidelity. DiffuSETS accepts various modalities of clinical text reports and patient-specific information as inputs, enabling the creation of clinically meaningful ECG signals. Additionally, to address the lack of standardized evaluation in ECG generation, we introduce a comprehensive benchmarking methodology to assess the effectiveness of generative models in this domain. Our model achieve excellent results in tests, proving its superiority in the task of ECG generation. Furthermore, we showcase its potential to mitigate data scarcity while exploring novel applications in cardiology education and medical knowledge discovery, highlighting the broader impact of our work.

Search-augmented large language models (LLMs) have advanced information-seeking tasks by integrating retrieval into generation, reducing users' cognitive burden compared to traditional search systems. Yet they remain insufficient for fully addressing diverse user needs, which requires recognizing how the same query can reflect different intents across users and delivering information in preferred forms. While recent systems such as ChatGPT and Gemini attempt personalization by leveraging user histories, systematic evaluation of such personalization is under-explored. To address this gap, we propose BESPOKE, the realistic benchmark for evaluating personalization in search-augmented LLMs. BESPOKE is designed to be both realistic, by collecting authentic chat and search histories directly from humans, and diagnostic, by pairing responses with fine-grained preference scores and feedback. The benchmark is constructed through long-term, deeply engaged human annotation, where human annotators contributed their own histories, authored queries with detailed information needs, and evaluated responses with scores and diagnostic feedback. Leveraging BESPOKE, we conduct systematic analyses that reveal key requirements for effective personalization in information-seeking tasks, providing a foundation for fine-grained evaluation of personalized search-augmented LLMs. Our code and data are available at https://augustinlib.github.io/BESPOKE/.

While dense retrieval models have achieved remarkable success, rigorous evaluation of their sensitivity to the position of relevant information (i.e., position bias) remains largely unexplored. Existing benchmarks typically employ position-agnostic relevance labels, conflating the challenge of processing long contexts with the bias against specific evidence locations. To address this challenge, we introduce PosIR (Position-Aware Information Retrieval), a comprehensive benchmark designed to diagnose position bias in diverse retrieval scenarios. PosIR comprises 310 datasets spanning 10 languages and 31 domains, constructed through a rigorous pipeline that ties relevance to precise reference spans, enabling the strict disentanglement of document length from information position. Extensive experiments with 10 state-of-the-art embedding models reveal that: (1) Performance on PosIR in long-context settings correlates poorly with the MMTEB benchmark, exposing limitations in current short-text benchmarks; (2) Position bias is pervasive and intensifies with document length, with most models exhibiting primacy bias while certain models show unexpected recency bias; (3) Gradient-based saliency analysis further uncovers the distinct internal attention mechanisms driving these positional preferences. In summary, PosIR serves as a valuable diagnostic framework to foster the development of position-robust retrieval systems.

Acute poly-substance intoxication requires rapid, life-saving decisions under substantial uncertainty, as clinicians must rely on incomplete ingestion details and nonspecific symptoms. Effective diagnostic reasoning in this chaotic environment requires fusing unstructured, non-medical narratives (e.g. paramedic scene descriptions and unreliable patient self-reports or known histories), with structured medical data like vital signs. While Large Language Models (LLMs) show potential for processing such heterogeneous inputs, they struggle in this setting, often underperforming simple baselines that rely solely on patient histories. To address this, we present DeToxR (Decision-support for Toxicology with Reasoning), the first adaptation of Reinforcement Learning (RL) to emergency toxicology. We design a robust data-fusion engine for multi-label prediction across 14 substance classes based on an LLM finetuned with Group Relative Policy Optimization (GRPO). We optimize the model's reasoning directly using a clinical performance reward. By formulating a multi-label agreement metric as the reward signal, the model is explicitly penalized for missing co-ingested substances and hallucinating absent poisons. Our model significantly outperforms its unadapted base LLM counterpart and supervised baselines. Furthermore, in a clinical validation study, the model indicates a clinical advantage by outperforming an expert toxicologist in identifying the correct poisons (Micro-F1: 0.644 vs. 0.473). These results demonstrate the potential of RL-aligned LLMs to synthesize unstructured pre-clinical narratives and structured medical data for decision support in high-stakes environments.

Retrieval-augmented generation (RAG) under a fixed reader-context budget forces a selection problem: of the evidence retrieved, only a fraction can be shown to the reader. We argue that document recall -- the standard retrieval metric -- is the wrong quantity to optimize in this regime, and we make two contributions. First, as a general contribution, we introduce answer-in-context, a diagnostic that measures whether a gold answer survives as a contiguous span in the packed reader context (not the retrieved set). It predicts answer F1 better than recall (r=0.39-0.55 vs. about 0.31), separates answer quality roughly five-fold (0.60 vs. 0.12 on HotpotQA), and carries information beyond retrieval: it adds Delta R squared=0.17 over recall and shows a 4.6x EM gap even among questions where all gold was retrieved. We also confirm it interventionally: on 2WikiMultiHopQA a packing change that raises coverage but not answer-in-context yields no accuracy gain. Second, as a conditional contribution, we cast reader-context construction as budgeted monotone submodular maximization and build a packer that jointly optimizes relevance, query coverage, representativeness, and diversity. On HotpotQA with a 160-token budget and a 3B reader it beats a strong focused heuristic, MMR, and naive packing -- by up to +5.1 F1 at equal-or-lower token cost, across three seeds. Crucially, we map the scope of this win honestly: it requires the conjunction of (i) multi-hop complementary structure, (ii) retrieval that surfaces the evidence, (iii) a binding but not extreme budget, and (iv) a reader weak enough that evidence density, not reading capacity, is the bottleneck. A quantization-controlled reader-scale ladder (3B to 7B to 14B) shows the edge over the heuristic is absorbed by 7B and significantly reverses by 14B, while the diagnostic explains every boundary with a single variable.

The ability to perceive how objects change over time is a crucial ingredient in human intelligence. However, current benchmarks cannot faithfully reflect the temporal understanding abilities of video-language models (VidLMs) due to the existence of static visual shortcuts. To remedy this issue, we present VITATECS, a diagnostic VIdeo-Text dAtaset for the evaluation of TEmporal Concept underStanding. Specifically, we first introduce a fine-grained taxonomy of temporal concepts in natural language in order to diagnose the capability of VidLMs to comprehend different temporal aspects. Furthermore, to disentangle the correlation between static and temporal information, we generate counterfactual video descriptions that differ from the original one only in the specified temporal aspect. We employ a semi-automatic data collection framework using large language models and human-in-the-loop annotation to obtain high-quality counterfactual descriptions efficiently. Evaluation of representative video-language understanding models confirms their deficiency in temporal understanding, revealing the need for greater emphasis on the temporal elements in video-language research.

Interactive medical questioning is essential in real-world clinical consultations, where physicians must actively gather information from patients. While medical Large Language Models (LLMs) have shown impressive capabilities in static medical question answering, they predominantly operate under a reactive paradigm: generating answers directly without seeking additional information, which risks incorrect diagnoses in such interactive settings. To address this limitation, we propose ProMed, a reinforcement learning (RL) framework that transitions medical LLMs toward a proactive paradigm, equipping them with the ability to ask clinically valuable questions before decision-making. At the core of ProMed is the Shapley Information Gain (SIG) reward, which quantifies the clinical utility of each question by combining the amount of newly acquired information with its contextual importance, estimated via Shapley values. We integrate SIG into a two-stage training pipeline: (1) SIG-Guided Model Initialization uses Monte Carlo Tree Search (MCTS) to construct high-reward interaction trajectories to supervise the model, and (2) SIG-Augmented Policy Optimization, which integrates SIG and enhances RL with a novel SIG-guided Reward Distribution Mechanism that assigns higher rewards to informative questions for targeted optimization. Extensive experiments on two newly curated partial-information medical benchmarks demonstrate that ProMed significantly outperforms state-of-the-art methods by an average of 6.29% and delivers a 54.45% gain over the reactive paradigm, while also generalizing robustly to out-of-domain cases.

We introduce InterChart, a diagnostic benchmark that evaluates how well vision-language models (VLMs) reason across multiple related charts, a task central to real-world applications such as scientific reporting, financial analysis, and public policy dashboards. Unlike prior benchmarks focusing on isolated, visually uniform charts, InterChart challenges models with diverse question types ranging from entity inference and trend correlation to numerical estimation and abstract multi-step reasoning grounded in 2-3 thematically or structurally related charts. We organize the benchmark into three tiers of increasing difficulty: (1) factual reasoning over individual charts, (2) integrative analysis across synthetically aligned chart sets, and (3) semantic inference over visually complex, real-world chart pairs. Our evaluation of state-of-the-art open and closed-source VLMs reveals consistent and steep accuracy declines as chart complexity increases. We find that models perform better when we decompose multi-entity charts into simpler visual units, underscoring their struggles with cross-chart integration. By exposing these systematic limitations, InterChart provides a rigorous framework for advancing multimodal reasoning in complex, multi-visual environments.

Scalp disorders are highly prevalent worldwide, yet remain underdiagnosed due to limited access to expert evaluation and the high cost of annotation. Although AI-based approaches hold great promise, their practical deployment is hindered by challenges such as severe data imbalance and the absence of pixel-level segmentation labels. To address these issues, we propose ScalpVision, an AI-driven system for the holistic diagnosis of scalp diseases. In ScalpVision, effective hair segmentation is achieved using pseudo image-label pairs and an innovative prompting method in the absence of traditional hair masking labels. Additionally, ScalpVision introduces DiffuseIT-M, a generative model adopted for dataset augmentation while maintaining hair information, facilitating improved predictions of scalp disease severity. Our experimental results affirm ScalpVision's efficiency in diagnosing a variety of scalp conditions, showcasing its potential as a valuable tool in dermatological care. Our code is available at https://github.com/winston1214/ScalpVision.

We introduce CRAFT, a multi-agent benchmark for evaluating pragmatic communication in large language models under strict partial information. In this setting, multiple agents with complementary but incomplete views must coordinate through natural language to construct a shared 3D structure that no single agent can fully observe. We formalize this problem as a multi-sender pragmatic reasoning task and provide a diagnostic framework that decomposes failures into spatial grounding, belief modeling and pragmatic communication errors, including a taxonomy of behavioral failure profiles in both frontier and open-weight models. Across a diverse set of models, including 8 open-weight and 7 frontier including reasoning models, we find that stronger reasoning ability does not reliably translate to better coordination: smaller open-weight models often match or outperform frontier systems, and improved individual communication does not guarantee successful collaboration. These results suggest that multi-agent coordination remains a fundamentally unsolved challenge for current language models. Our code can be found at https://github.com/csu-signal/CRAFT

Agentic tasks require a large language model to interact with the world, navigating information and gathering evidence across multiple steps with restricted resources. Due to this complexity, agentic task failures arise from various sources, and pinpointing these failure causes is essential to diagnose and improve agentic systems. Existing benchmarks, however, tend to focus on a single leaderboard score, leaving the underlying failure modes opaque. To fill this gap, we introduce AgentHop, a diagnostic benchmark of 1,011 multiple-choice questions paired with a controlled seven-tool sandbox under fixed token, turn, and tool-call constraints. AgentHop reveals model vulnerabilities by dissecting a single accuracy score along four axes of agent operation: retrieval, synthesis, tool-call, and resource management. Across 19 models, we find that behavior clusters by model family, with tool-call signatures revealing distinct family fingerprints: GPT models commit early, Anthropic and GLM checkpoints verify before committing, DeepSeek and Kimi over-search, and Gemini-3 Pro stays balanced. Decomposed axes further expose within-family structure: Claude Opus 4.6 and Sonnet 4.6 land within one accuracy point yet diverge on retrieval-versus-synthesis emphasis, with Opus retrieving more and Sonnet synthesizing better. We release the full benchmark set and the harness to support diagnostic agent benchmarking.

Many Swedish benchmarks are translated US-centric benchmarks, and therefore not suitable for testing knowledge that is particularly relevant, or even specific, to Sweden. We therefore introduce a manually written question-answering benchmark specifically targeted to Sweden-related personalities and events, many of which receive very limited coverage in international media. Our annotators drew inspiration from a popular radio program featuring public figures from culture and media, as well as major sports events in Sweden. The dataset can be used to measure factual recall across models of varying sizes and degrees of Swedish coverage, and allows to probe cross-lingual factual consistency as to contains English translations. Using the dataset, we find that smaller models with stronger Swedish coverage perform comparably to a three times larger multilingual model in recalling Sweden-related facts. We also observe that continued pre-training on Swedish generally improves factual knowledge but also leads to forgetting of a part of the previously known information. These results demonstrate the dataset's potential as a diagnostic tool for studying language adaptation and knowledge retention in multilingual models and during language adaptation.

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

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

Recent benchmarks for VLMs largely assess single- or limited-view perception, leaving untested the core cognitive ability to integrate observations across viewpoints into a coherent, world-centric (allocentric) 3D mental model. We introduce MultiView-Bench, a diagnostic benchmark expressly designed to evaluate multi-view integration for holistic 3D scene comprehension. Unlike existing datasets that focus on pixel-level mapping or camera-relative navigation, MultiView-Bench requires models to decouple object positioning from transient perspectives and ground them in a fixed global coordinate system. This capability serves as a prerequisite for VLMs before being deployed for downstream tasks such as mechanical part assembly. Our systematic evaluation of frontier VLMs reveals consistent failure modes: strong performance on 2D planar relations from a single image, but marked difficulty with 3D spatial relations and with aggregating information across views. We further identify biases in VLMs, such as struggles with unconventional axis directions and sensitivity to object colorways and texture variations. Acknowledging these limitations, we propose ViewNavigator, which uses active viewpoint selection and evidence fusion to improve four base models by 12.3--20.0 percentage points under a six-image cap matching the fixed-view baseline; budget-extended gains are model-dependent and reach 27 percentage points for GPT-5.

Most existing LLM diagnoses are evaluated on static, single-turn settings where complete patient information is provided upfront, an oversimplification of real clinical practice. We study active diagnosis: the real-life clinical process of starting from initial observation, ordering tests, interpreting results, and updating a differential diagnosis across multiple turns. Through systematic analysis, we identify three recurring failure modes in current LLMs: ungrounded test ordering, unreliable diagnostic update, and degraded multi-turn coherence. Together, these failures reveal a core deficit: existing medical training data teaches models to reason from complete information but not to act under evolving, partial evidence. To address this gap, we introduce MedAction, a tree-structured distillation pipeline that synthesizes diverse and high-quality multi-turn diagnostic trajectories via LLM-environment interaction. We propose two knowledge-graph-grounded metrics to filter trajectory quality: Disease Trajectory Consistency (DTC), which tracks whether the model's hypothesis converges toward the correct diagnosis, and Reasoning-Action Consistency (RAC), which verifies that belief updates are driven by gathered evidence. Using this pipeline, we construct MedAction-32K, a dataset of 32,681 trajectories from 2,896 PMC cases. Fine-tuning an 8B model on MedAction-32K achieves state-of-the-art performance among open-source models on both MedR-Bench and our curated MedAction-300-Hard benchmark, pushing the edge for open-source medical LLMs.

Idiopathic pulmonary fibrosis (IPF) is a progressive disease that irreversibly transforms lung tissue into rigid fibrotic structures, leading to debilitating symptoms such as shortness of breath and chronic fatigue. The heterogeneity and complexity of this disease, particularly regarding its severity and progression rate, have made predicting its future course a complex and challenging task. Besides, traditional diagnostic methods based on clinical evaluations and imaging have limitations in capturing the disease's complexity. Using the Kaggle Pulmonary Fibrosis Progression dataset, which includes computed tomography images, and clinical information, the model predicts changes in forced vital capacity (FVC), a key progression indicator. Our method uses a proposed context-aware sequential-parallel hybrid transformer model and clinical information enrichment for its prediction. The proposed method achieved a Laplace Log-Likelihood score of -6.508, outperforming prior methods and demonstrating superior predictive capabilities. These results highlight the potential of advanced deep learning techniques to provide more accurate and timely predictions, offering a transformative approach to the diagnosis and management of IPF, with implications for improved patient outcomes and therapeutic advancements.

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

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

Video Large Language Models (VideoLLMs) have shown remarkable progress in video understanding. However, these models still struggle to effectively perceive and exploit rich temporal information in videos when responding to user queries. Therefore, they often generate descriptions of events that are temporal inconsistent or causally implausible, causing severe hallucination issues. While most prior studies have focused on spatial hallucinations (e.g. object mismatches), temporal reasoning in video understanding remains relatively underexplored. To address this issue, we propose Self-Diagnostic Contrastive Decoding (SEASON), a training-free method that adaptively enhances temporal and spatial faithfulness for each output token. It achieves this by dynamically diagnosing each token's hallucination tendency and applying adaptive contrastive decoding against its corresponding temporal and spatial negatives. Extensive experiments demonstrate that SEASON outperforms all existing training-free hallucination mitigation approaches on three hallucination examination benchmarks, while further improves VideoLLMs across four general video understanding benchmarks. The code will be released upon acceptance.

The application of Large Language Models (LLMs) to diagnostic decision-making has garnered growing interest. However, existing benchmarks largely focus on textual reasoning or isolated visual question-answering (VQA) tasks, lacking holistic integration of clinical narratives and medical imaging, and thus failing to assess the multimodal diagnostic synthesis capability central to expert clinical judgment. To bridge this gap, we introduce MedReaMM, a benchmark specifically designed to evaluate models' ability to synthesize heterogeneous clinical evidence consisting of detailed patient histories alongside multiple medical images into accurate differential diagnoses under a complete-information paradigm. Constructed from case reports sourced from top-tier medical journals and curated clinical case databases, MedReaMM comprises 625 expert-validated cases with an average of 2.79 medical images per case and a total of 1,042 standardized diagnoses annotated with ICD-11 codes. These cases predominantly represent rare, atypical, or multi-system presentations that demand expert-level evidence integration beyond routine pattern recognition. We evaluate 23 Large Multimodal Models (LMMs) and find that most achieve diagnostic accuracy scores below 50%, underscoring a substantial gap in multimodal diagnostic synthesis capability. Further analysis reveals that medical knowledge proficiency, medical image understanding, and evidence integration are all highly correlated with diagnostic performance.

Large language models can generate interactive web interfaces, but reliable generative UI requires maintaining an executable artifact as user requests evolve. We introduce EvoGenUI-Bench, a benchmark for multi-turn interface maintenance comprising 150 five-turn tasks and 750 turns across three scenarios: information presentation, executable interaction, and tool-grounded external state. We execute generated artifacts in a browser and evaluate them using screenshots, source and DOM evidence, actor traces, and runtime logs. Beyond turn-level and episode-level success, we measure cross-turn retention with Adjacent Pass Retention. Across eight models, even the strongest achieves 74.9% Turn Pass while completing only 37.3% of five-turn episodes; APR further falls to 52.4% on tool-grounded tasks. Diagnostic analysis shows that presentation failures center on information architecture, interaction failures on derived-state propagation and affordance binding, and tool-grounded failures additionally involve external-state grounding and requirement decomposition. These results reframe generative UI evaluation from judging isolated outputs to testing whether interface behavior, derived state, external state, and assistant claims remain synchronized as the artifact evolves.

Traditional whole slide image (WSI) analysis methods typically rely on the multiple instance learning (MIL) paradigm, which extracts patch-level features at high magnification and aggregates them for slide-level prediction. However, such exhaustive patch-level processing is computationally expensive, severely limiting the efficiency and scalability of WSI analysis. To address this challenge, we propose PathCTM (a Pathology-oriented Continuous Thought Model) that enables token-efficient scale-space continuous reasoning for gigapixel WSIs. PathCTM formulates diagnostic inference as a dynamic sequential information pursuit. It progressively transitions from low-magnification global to high-magnification local inspection, and adaptively terminates inference when sufficient evidence is gathered to effectively bound decision uncertainty. Specifically, it uses conditional computation for dynamic scale switching with attention-guided region pruning, coupled with confidence-aware early stopping. Extensive experiments demonstrate that, compared with standard MIL-based methods, PathCTM reduces the number of required image patches by 95.95% and shortens inference time by approximately 95.62%, while maintaining AUC without degradation. Code is available at https://github.com/JSGe-AI/PathCTM.

An effective method for combining frozen large language models (LLM) and visual encoders involves a resampler module that creates a `visual prompt' which is provided to the LLM, along with the textual prompt. While this approach has enabled impressive performance across many coarse-grained tasks like image captioning and visual question answering, more fine-grained tasks that require spatial understanding have not been thoroughly examined. In this paper, we use diagnostic classifiers to measure the extent to which the visual prompt produced by the resampler encodes spatial information. Our results show that this information is largely absent from the resampler output when kept frozen during training of the classifiers. However, when the resampler and classifier are trained jointly, we observe a significant performance boost. This shows that the compression achieved by the resamplers can in principle encode the requisite spatial information, but that more object-aware objectives are needed at the pretraining stage to facilitate this capability

Skin lesion datasets provide essential information for understanding various skin conditions and developing effective diagnostic tools. They aid the artificial intelligence-based early detection of skin cancer, facilitate treatment planning, and contribute to medical education and research. Published large datasets have partially coverage the subclassifications of the skin lesions. This limitation highlights the need for more expansive and varied datasets to reduce false predictions and help improve the failure analysis for skin lesions. This study presents a diverse dataset comprising 12,345 dermatoscopic images with 38 subclasses of skin lesions collected in Turkiye which comprises different skin types in the transition zone between Europe and Asia. Each subgroup contains high-resolution photos and expert annotations, providing a strong and reliable basis for future research. The detailed analysis of each subgroup provided in this study facilitates targeted research endeavors and enhances the depth of understanding regarding the skin lesions. This dataset distinguishes itself through a diverse structure with 5 super classes, 15 main classes, 38 subclasses and its 12,345 high-resolution dermatoscopic images.

Cardiac biosignals, such as electrocardiograms (ECG) and photoplethysmograms (PPG), are of paramount importance for the diagnosis, prevention, and management of cardiovascular diseases, and have been extensively used in a variety of clinical tasks. Conventional deep learning approaches for analyzing these signals typically rely on homogeneous datasets and static bespoke models, limiting their robustness and generalizability across diverse clinical settings and acquisition protocols. In this study, we present a cardiac sensing foundation model (CSFM) that leverages advanced transformer architectures and a generative, masked pretraining strategy to learn unified representations from vast, heterogeneous health records. Our model is pretrained on an innovative multi-modal integration of data from multiple large-scale datasets (including MIMIC-III-WDB, MIMIC-IV-ECG, and CODE), comprising cardiac signals and the corresponding clinical or machine-generated text reports from approximately 1.7 million individuals. We demonstrate that the embeddings derived from our CSFM not only serve as effective feature extractors across diverse cardiac sensing scenarios, but also enable seamless transfer learning across varying input configurations and sensor modalities. Extensive evaluations across diagnostic tasks, demographic information recognition, vital sign measurement, clinical outcome prediction, and ECG question answering reveal that CSFM consistently outperforms traditional one-modal-one-task approaches. Notably, CSFM exhibits robust performance across multiple ECG lead configurations from standard 12-lead systems to single-lead setups, and in scenarios where only ECG, only PPG, or a combination thereof is available. These findings highlight the potential of CSFM as a versatile and scalable solution, for comprehensive cardiac monitoring.

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

We introduce a data-driven diagnostic that combines the singular value decomposition (SVD) with an information-theoretic entropy to quantify the phase-space complexity of perturbed distribution functions in gyrokinetic turbulence. Applying this framework to nonlinear flux-tube simulations that solve the time evolution of the ion distribution function represented by Fourier modes with the wavenumber for real space, we define the von Neumann entropy (vNE) to analyze the velocity-space structure. A global survey in the wavenumber space reveals a wavenumber-dependent variation of the vNE in velocity-space structure: the vNE remains low at low wavenumber but increases across k_perpρ_{ti}sim 1. Hermite/Laguerre decompositions revealed that the finite Larmor radius (FLR) phase mixing in the perpendicular (magnetic-moment) direction is active. Simultaneously, the systematic increase in vNE for k_perpρ_{ti} correlates with the broadening of the Hermite spectrum, suggesting enhanced parallel phase mixing (Landau resonance) as the primary mechanism for the observed wave number dependence. These results demonstrate that the SVD-based vNE provides a compact measure of kinetic complexity without assuming a predefined basis and enables a global mapping of its wavenumber dependence of phase-mixing processes in gyrokinetic turbulence.

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

Multimodal Large Language Models (MLLMs) achieve strong performance by integrating visual inputs with the rich priors of pretrained language models. However, they often fail on vision-centric tasks, especially when visual evidence conflicts with pretrained knowledge. We explore these failures separately using two diagnostic paradigms: (1) probing whether visual information is available, via image reconstruction, and (2) measuring multimodal context sensitivity, the extent to which the model follows visual context versus the language prior. To support the second, we introduce the WhatIfVis, a benchmark spanning five coarse-grained dimensions (spatial-temporal, color, count, size, and weight) whose questions admit answers from either the image or the prior. Our analysis yields three findings: (i) Coarse-grained visual evidence is preserved, as these attributes can be reconstructed from the final-layer image tokens of frozen MLLMs. Failures on questions about these attributes therefore point to post-perceptual utilization, rather than to degraded visual encoding during perception. (ii) Even when explicitly instructed to use or ignore visual evidence, vanilla models (without supervised fine-tuning on the WhatIfVis) show unstable visual context sensitivity. Supervised fine-tuning (SFT) improves this controllability and generalizes across domains, and activation patching further localizes the vision-versus-prior trade-off at architecture-specific depths across all six models. (iii) The vision-versus-prior trade-off is controllable along a learned vector. Applying this steering vector, even without any intent instruction, improves controllability over the vanilla model. Together, these results relocate the bottleneck, indicating that for the coarse attributes we study, MLLMs encode the visual evidence but cannot reliably control their reliance on it.

Large language models frequently rely on both contextual input and parametric knowledge to perform tasks. However, these sources can come into conflict, especially when retrieved documents contradict the model's parametric knowledge. We propose a diagnostic framework to systematically evaluate LLM behavior under context-memory conflict, where the contextual information diverges from their parametric beliefs. We construct diagnostic data that elicit these conflicts and analyze model performance across multiple task types. Our findings reveal that (1) knowledge conflict has minimal impact on tasks that do not require knowledge utilization, (2) model performance is consistently higher when contextual and parametric knowledge are aligned, (3) models are unable to fully suppress their internal knowledge even when instructed, and (4) providing rationales that explain the conflict increases reliance on contexts. These insights raise concerns about the validity of model-based evaluation and underscore the need to account for knowledge conflict in the deployment of LLMs.

It is unclear whether strong forecasting performance reflects genuine temporal understanding or the ability to reason under contextual and event-driven conditions. We introduce TemporalBench, a multi-domain benchmark designed to evaluate temporal reasoning behavior under progressively richer informational settings. TemporalBench adopts a four-tier task taxonomy that examines historical structure interpretation, context-free forecasting, contextual temporal reasoning, and event-conditioned prediction across four real-world domains: retail, healthcare, energy, and physical systems. By controlling access to future targets and contextual information, the benchmark enables a diagnostic analysis of whether models can correctly interpret temporal patterns, align them with external context, and adapt predictions when conditions change. Extensive baseline experiments show that strong numerical forecasting accuracy does not reliably translate into robust contextual or event-aware temporal reasoning; instead, existing agent frameworks exhibit fragmented strengths and systematic failure modes that remain largely hidden under forecasting-only benchmarks. The TemporalBench dataset is publicly available at https://huggingface.co/datasets/Melady/TemporalBench, and we additionally provide a public leaderboard at https://huggingface.co/spaces/Melady/TemporalBench_Leaderboard.

Large language models often produce hallucinated answers that violate prompt-level constraints. A key diagnostic question is whether these failures reflect missing knowledge, or whether the model has the relevant information but follows the wrong inference path. We study this phenomenon as inference misalignment: a mismatch between the answer supported by the prompt and the answer favored by statistically salient latent associations. We formalize this view with a latent key-task model, in which pretraining-frequency imbalance can cause a shortcut path to dominate the constraint-sensitive path and induce positive inference loss. The framework predicts two failure modes: task-retrieval bias in entity disambiguation and key-selection bias in action choice. We introduce TrapQA, a controlled diagnostic testbed with two components. ScientistQA tests disambiguation among similar scientists with supplementary factual probes, while Real-Life Constrained QA tests everyday constraint following under salient shortcuts. Our results show that hallucination can arise from biased latent inference rather than absent knowledge alone.

We present anyakrakusuma, an open-source Python library that solves the discrete static Schrödinger bridge problem, the entropically regularized counterpart of optimal transport, through a log-domain Sinkhorn--Knopp iteration and reconstructs the entropic interpolation between two empirical point clouds. The solver is paired with a diagnostic pipeline that characterizes the optimal coupling and the intermediate distributions through information-theoretic and geometric measures. We exercise the library on four idealized planar cases spanning a circle-to-circle dilation, a spiral-to-mixture fragmentation, a rigid reorientation of two moons, and a Lissajous-to-trefoil deformation. The log-domain formulation is necessary rather than merely convenient at the parameters studied, where the cost-to-regularization ratio reaches four hundred and the Gibbs kernel underflows double precision across most of its range; the iteration nonetheless attains a marginal residual of 10^{-9} and unit marginal fidelity in every case. Residual histories decay geometrically over approximately eight decades at per-iteration contraction factors between 0.966 and 0.976, which are local rates near the fixed point that lie many orders of magnitude below the worst-case Hilbert-metric bound. The covariance analysis recovers an imposed ninety-degree reorientation to within 0.07^circ, roughly forty times smaller than its uncertainty, across a masked interval of near-isotropy on which the principal axis is unobservable. The diagnostics are reported with explicit attention to the regimes in which each is well defined, including the differential entropy, which is meaningful only on the open interpolation interval. The presented cases are constructed rather than measured; quantitative application to empirical point clouds requires further study.

Leukemia diagnosis primarily relies on manual microscopic analysis of bone marrow morphology supported by additional laboratory parameters, making it complex and time consuming. While artificial intelligence (AI) solutions have been proposed, most utilize private datasets and only cover parts of the diagnostic pipeline. Therefore, we present a large, high-quality, publicly available leukemia bone marrow dataset spanning the entire diagnostic process, from cell detection to diagnosis. Using this dataset, we further propose methods for cell detection, cell classification, and diagnosis prediction. The dataset comprises 246 pediatric patients with diagnostic, clinical and laboratory information, over 40 000 cells with bounding box annotations and more than 28 000 of these with high-quality class labels, making it the most comprehensive dataset publicly available. Evaluation of the AI models yielded an average precision of 0.96 for the cell detection, an area under the curve of 0.98, and an F1-score of 0.61 for the 33-class cell classification, and a mean F1-score of 0.90 for the diagnosis prediction using predicted cell counts. While the proposed approaches demonstrate their usefulness for AI-assisted diagnostics, the dataset will foster further research and development in the field, ultimately contributing to more precise diagnoses and improved patient outcomes.

Large language models (LLMs) have demonstrated excellent capabilities in the field of biomedical question answering, but their application in real-world clinical consultations still faces core challenges. Existing systems rely on a one-way information transmission mode where patients must fully describe their symptoms in a single round, leading to nonspecific diagnostic recommendations when complaints are vague. Traditional multi-turn dialogue methods based on supervised learning are constrained by static data-driven paradigms, lacking generalizability and struggling to intelligently extract key clinical information. To address these limitations, we propose DoctorAgent-RL, a reinforcement learning (RL)-based multi-agent collaborative framework that models medical consultations as a dynamic decision-making process under uncertainty. The doctor agent continuously optimizes its questioning strategy within the RL framework through multi-turn interactions with the patient agent, dynamically adjusting its information-gathering path based on comprehensive rewards from the Consultation Evaluator. This RL fine-tuning mechanism enables LLMs to autonomously develop interaction strategies aligned with clinical reasoning logic, rather than superficially imitating patterns in existing dialogue data. Notably, we constructed MTMedDialog, the first English multi-turn medical consultation dataset capable of simulating patient interactions. Experiments demonstrate that DoctorAgent-RL outperforms existing models in both multi-turn reasoning capability and final diagnostic performance, demonstrating practical value in assisting clinical consultations. https://github.com/JarvisUSTC/DoctorAgent-RL

Real-world clinical decision-making grapples with integrating information from diverse data modalities, including medical text, 2D/3D images, and video, leading to inefficiencies and potential diagnostic oversights. While generalist vision-language models (VLMs) offer promise, their medical development faces challenges of opaque pipelines, data scarcity, and architectural inflexibility. Here we present Hulu-Med, a transparent medical VLM that unifies understanding across all these modalities. Built upon a unified patch-based vision encoder and an LLM decoder, Hulu-Med was progressively trained on 16.7 million (M) samples to scale from 2D to 3D and video comprehension. The medical-aware token reduction enables efficient training, requiring only 4,000 to 40,000 GPU hours for 7B to 32B parameter variants. Extensive evaluation across 30 benchmarks exhibits state-of-the-art performance, surpassing leading open-source models and competing with proprietary systems in tasks spanning visual question-answering, medical report generation, and complex reasoning in multilingual and rare disease scenarios. By open-sourcing our complete pipeline, we establish that high-performance medical VLM can be achieved transparently, providing a foundational tool for accessible and impactful clinical AI. Code is released on https://github.com/ZJUI-AI4H/Hulu-Med{https://github.com/ZJUI-AI4H/Hulu-Med}.

Histopathology image analysis is fundamental to digital pathology, with hematoxylin and eosin (H&E) staining as the gold standard for diagnostic and prognostic assessments. While H&E imaging effectively highlights cellular and tissue structures, it lacks sensitivity to birefringence and tissue anisotropy, which are crucial for assessing collagen organization, fiber alignment, and microstructural alterations--key indicators of tumor progression, fibrosis, and other pathological conditions. To bridge this gap, we construct a polarization imaging system and curate a new dataset of over 13,000 paired Polar-H&E images. Visualizations of polarization properties reveal distinctive optical signatures in pathological tissues, underscoring its diagnostic value. Building on this dataset, we propose PolarHE, a dual-modality fusion framework that integrates H&E with polarization imaging, leveraging the latter ability to enhance tissue characterization. Our approach employs a feature decomposition strategy to disentangle common and modality specific features, ensuring effective multimodal representation learning. Through comprehensive validation, our approach significantly outperforms previous methods, achieving an accuracy of 86.70% on the Chaoyang dataset and 89.06% on the MHIST dataset. These results demonstrate that polarization imaging is a powerful and underutilized modality in computational pathology, enriching feature representation and improving diagnostic accuracy. PolarHE establishes a promising direction for multimodal learning, paving the way for more interpretable and generalizable pathology models.

Large Language Model (LLM) agents, while proficient in the digital realm, face a significant gap in physical-world deployment due to the challenge of forming and maintaining a robust spatial mental model. We identify three core cognitive challenges hindering this transition: spatial reasoning, long-horizon state tracking via mental simulation, and active exploration under partial observation. To isolate and evaluate these faculties, we introduce CubeBench, a novel generative benchmark centered on the Rubik's Cube. CubeBench uses a three-tiered diagnostic framework that progressively assesses agent capabilities, from foundational state tracking with full symbolic information to active exploration with only partial visual data. Our experiments on leading LLMs reveal critical limitations, including a uniform 0.00% pass rate on all long-horizon tasks, exposing a fundamental failure in long-term planning. We also propose a diagnostic framework to isolate these cognitive bottlenecks by providing external solver tools. By analyzing the failure modes, we provide key insights to guide the development of more physically-grounded intelligent agents.

Online medical consultation (OMC) restricts doctors to gathering patient information solely through inquiries, making the already complex sequential decision-making process of diagnosis even more challenging. Recently, the rapid advancement of large language models has demonstrated a significant potential to transform OMC. However, most studies have primarily focused on improving diagnostic accuracy under conditions of relatively sufficient information, while paying limited attention to the "inquiry" phase of the consultation process. This lack of focus has left the relationship between "inquiry" and "diagnosis" insufficiently explored. In this paper, we first extract real patient interaction strategies from authentic doctor-patient conversations and use these strategies to guide the training of a patient simulator that closely mirrors real-world behavior. By inputting medical records into our patient simulator to simulate patient responses, we conduct extensive experiments to explore the relationship between "inquiry" and "diagnosis" in the consultation process. Experimental results demonstrate that inquiry and diagnosis adhere to the Liebig's law: poor inquiry quality limits the effectiveness of diagnosis, regardless of diagnostic capability, and vice versa. Furthermore, the experiments reveal significant differences in the inquiry performance of various models. To investigate this phenomenon, we categorize the inquiry process into four types: (1) chief complaint inquiry; (2) specification of known symptoms; (3) inquiry about accompanying symptoms; and (4) gathering family or medical history. We analyze the distribution of inquiries across the four types for different models to explore the reasons behind their significant performance differences. We plan to open-source the weights and related code of our patient simulator at https://github.com/LIO-H-ZEN/PatientSimulator.

Accurate brain tumor diagnosis requires models to not only detect lesions but also generate clinically interpretable reasoning grounded in imaging manifestations, yet existing public datasets remain limited in annotation richness and diagnostic semantics. To bridge this gap, we introduce MM-NeuroOnco, a large-scale multimodal benchmark and instruction-tuning dataset for brain tumor MRI understanding, consisting of 24,726 MRI slices from 20 data sources paired with approximately 200,000 semantically enriched multimodal instructions spanning diverse tumor subtypes and imaging modalities. To mitigate the scarcity and high cost of diagnostic semantic annotations, we develop a multi-model collaborative pipeline for automated medical information completion and quality control, enabling the generation of diagnosis-related semantics beyond mask-only annotations. Building upon this dataset, we further construct MM-NeuroOnco-Bench, a manually annotated evaluation benchmark with a rejection-aware setting to reduce biases inherent in closed-ended question formats. Evaluation across ten representative models shows that even the strongest baseline, Gemini 3 Flash, achieves only 41.88% accuracy on diagnosis-related questions, highlighting the substantial challenges of multimodal brain tumor diagnostic understanding. Leveraging MM-NeuroOnco, we further propose NeuroOnco-GPT, which achieves a 27% absolute accuracy improvement on diagnostic questions following fine-tuning. This result demonstrates the effectiveness of our dataset and benchmark in advancing clinically grounded multimodal diagnostic reasoning. Code and dataset are publicly available at: https://github.com/gfnnnb/MM-NeuroOnco

Image segmentation remains a pivotal component in medical image analysis, aiding in the extraction of critical information for precise diagnostic practices. With the advent of deep learning, automated image segmentation methods have risen to prominence, showcasing exceptional proficiency in processing medical imagery. Motivated by the Segment Anything Model (SAM)-a foundational model renowned for its remarkable precision and robust generalization capabilities in segmenting 2D natural images-we introduce SAM3D, an innovative adaptation tailored for 3D volumetric medical image analysis. Unlike current SAM-based methods that segment volumetric data by converting the volume into separate 2D slices for individual analysis, our SAM3D model processes the entire 3D volume image in a unified approach. Extensive experiments are conducted on multiple medical image datasets to demonstrate that our network attains competitive results compared with other state-of-the-art methods in 3D medical segmentation tasks while being significantly efficient in terms of parameters. Code and checkpoints are available at https://github.com/UARK-AICV/SAM3D.

Predicting disease trajectories from electronic health records (EHRs) is a complex task due to major challenges such as data non-stationarity, high granularity of medical codes, and integration of multimodal data. EHRs contain both structured data, such as diagnostic codes, and unstructured data, such as clinical notes, which hold essential information often overlooked. Current models, primarily based on structured data, struggle to capture the complete medical context of patients, resulting in a loss of valuable information. To address this issue, we propose an approach that integrates unstructured clinical notes into transformer-based deep learning models for sequential disease prediction. This integration enriches the representation of patients' medical histories, thereby improving the accuracy of diagnosis predictions. Experiments on MIMIC-IV datasets demonstrate that the proposed approach outperforms traditional models relying solely on structured data.

Retrieval-augmented generation (RAG) is a well-suited technique for retrieving privacy-sensitive Electronic Health Records (EHR). It can serve as a key module of the healthcare copilot, helping reduce misdiagnosis for healthcare practitioners and patients. However, the diagnostic accuracy and specificity of existing heuristic-based RAG models used in the medical domain are inadequate, particularly for diseases with similar manifestations. This paper proposes MedRAG, a RAG model enhanced by knowledge graph (KG)-elicited reasoning for the medical domain that retrieves diagnosis and treatment recommendations based on manifestations. MedRAG systematically constructs a comprehensive four-tier hierarchical diagnostic KG encompassing critical diagnostic differences of various diseases. These differences are dynamically integrated with similar EHRs retrieved from an EHR database, and reasoned within a large language model. This process enables more accurate and specific decision support, while also proactively providing follow-up questions to enhance personalized medical decision-making. MedRAG is evaluated on both a public dataset DDXPlus and a private chronic pain diagnostic dataset (CPDD) collected from Tan Tock Seng Hospital, and its performance is compared against various existing RAG methods. Experimental results show that, leveraging the information integration and relational abilities of the KG, our MedRAG provides more specific diagnostic insights and outperforms state-of-the-art models in reducing misdiagnosis rates. Our code will be available at https://github.com/SNOWTEAM2023/MedRAG

Users typically engage with LLMs interactively, yet most existing benchmarks evaluate them in a static, single-turn format, posing reliability concerns in interactive scenarios. We identify a key obstacle towards reliability: LLMs are trained to answer any question, even with incomplete context or insufficient knowledge. In this paper, we propose to change the static paradigm to an interactive one, develop systems that proactively ask questions to gather more information and respond reliably, and introduce an benchmark - MediQ - to evaluate question-asking ability in LLMs. MediQ simulates clinical interactions consisting of a Patient System and an adaptive Expert System; with potentially incomplete initial information, the Expert refrains from making diagnostic decisions when unconfident, and instead elicits missing details via follow-up questions. We provide a pipeline to convert single-turn medical benchmarks into an interactive format. Our results show that directly prompting state-of-the-art LLMs to ask questions degrades performance, indicating that adapting LLMs to proactive information-seeking settings is nontrivial. We experiment with abstention strategies to better estimate model confidence and decide when to ask questions, improving diagnostic accuracy by 22.3%; however, performance still lags compared to an (unrealistic in practice) upper bound with complete information upfront. Further analyses show improved interactive performance with filtering irrelevant contexts and reformatting conversations. Overall, we introduce a novel problem towards LLM reliability, an interactive MediQ benchmark and a novel question-asking system, and highlight directions to extend LLMs' information-seeking abilities in critical domains.

Large Vision Language Models (LVLMs) have demonstrated remarkable capabilities, yet their proficiency in understanding and reasoning over multiple images remains largely unexplored. While existing benchmarks have initiated the evaluation of multi-image models, a comprehensive analysis of their core weaknesses and their causes is still lacking. In this work, we introduce MIMIC (Multi-Image Model Insights and Challenges), a new benchmark designed to rigorously evaluate the multi-image capabilities of LVLMs. Using MIMIC, we conduct a series of diagnostic experiments that reveal pervasive issues: LVLMs often fail to aggregate information across images and struggle to track or attend to multiple concepts simultaneously. To address these failures, we propose two novel complementary remedies. On the data side, we present a procedural data-generation strategy that composes single-image annotations into rich, targeted multi-image training examples. On the optimization side, we analyze layer-wise attention patterns and derive an attention-masking scheme tailored for multi-image inputs. Experiments substantially improved cross-image aggregation, while also enhancing performance on existing multi-image benchmarks, outperforming prior state of the art across tasks. Data and code will be made available at https://github.com/anurag-198/MIMIC.

LLM failures in causal reasoning, including sycophancy, rung collapse, and miscalibrated refusal, are well-documented, yet progress on remediation is slow because no benchmark enables systematic diagnosis. We introduce CausalT5K, a diagnostic benchmark of over 5,000 cases across 10 domains that tests three critical capabilities: (1) detecting rung collapse, where models answer interventional queries with associational evidence; (2) resisting sycophantic drift under adversarial pressure; and (3) generating Wise Refusals that specify missing information when evidence is underdetermined. Unlike synthetic benchmarks, CausalT5K embeds causal traps in realistic narratives and decomposes performance into Utility (sensitivity) and Safety (specificity), revealing failure modes invisible to aggregate accuracy. Developed through a rigorous human-machine collaborative pipeline involving 40 domain experts, iterative cross-validation cycles, and composite verification via rule-based, LLM, and human scoring, CausalT5K implements Pearl's Ladder of Causation as research infrastructure. Preliminary experiments reveal a Four-Quadrant Control Landscape where static audit policies universally fail, a finding that demonstrates CausalT5K's value for advancing trustworthy reasoning systems. Repository: https://github.com/genglongling/CausalT5kBench

This study investigates the integration of diverse patient data sources into multimodal language models for automated chest X-ray (CXR) report generation. Traditionally, CXR report generation relies solely on CXR images and limited radiology data, overlooking valuable information from patient health records, particularly from emergency departments. Utilising the MIMIC-CXR and MIMIC-IV-ED datasets, we incorporate detailed patient information such as aperiodic vital signs, medications, and clinical history to enhance diagnostic accuracy. We introduce a novel approach to transform these heterogeneous data sources into embeddings that prompt a multimodal language model, significantly enhancing the diagnostic accuracy of generated radiology reports. Our comprehensive evaluation demonstrates the benefits of using a broader set of patient data, underscoring the potential for enhanced diagnostic capabilities and better patient outcomes through the integration of multimodal data in CXR report generation.

Video Large Language Models (Video LLMs) have shown promising capabilities in video comprehension, yet they struggle with tracking temporal changes and reasoning about temporal relationships. While previous research attributed this limitation to the ineffective temporal encoding of visual inputs, our diagnostic study reveals that video representations contain sufficient information for even small probing classifiers to achieve perfect accuracy. Surprisingly, we find that the key bottleneck in Video LLMs' temporal reasoning capability stems from the underlying LLM's inherent difficulty with temporal concepts, as evidenced by poor performance on textual temporal question-answering tasks. Building on this discovery, we introduce the Textual Temporal reasoning Transfer (T3). T3 synthesizes diverse temporal reasoning tasks in pure text format from existing image-text datasets, addressing the scarcity of video samples with complex temporal scenarios. Remarkably, without using any video data, T3 enhances LongVA-7B's temporal understanding, yielding a 5.3 absolute accuracy improvement on the challenging TempCompass benchmark, which enables our model to outperform ShareGPT4Video-8B trained on 28,000 video samples. Additionally, the enhanced LongVA-7B model achieves competitive performance on comprehensive video benchmarks. For example, it achieves a 49.7 accuracy on the Temporal Reasoning task of Video-MME, surpassing powerful large-scale models such as InternVL-Chat-V1.5-20B and VILA1.5-40B. Further analysis reveals a strong correlation between textual and video temporal task performance, validating the efficacy of transferring temporal reasoning abilities from text to video domains.

Automatically summarizing patients' main problems from daily progress notes using natural language processing methods helps to battle against information and cognitive overload in hospital settings and potentially assists providers with computerized diagnostic decision support. Problem list summarization requires a model to understand, abstract, and generate clinical documentation. In this work, we propose a new NLP task that aims to generate a list of problems in a patient's daily care plan using input from the provider's progress notes during hospitalization. We investigate the performance of T5 and BART, two state-of-the-art seq2seq transformer architectures, in solving this problem. We provide a corpus built on top of progress notes from publicly available electronic health record progress notes in the Medical Information Mart for Intensive Care (MIMIC)-III. T5 and BART are trained on general domain text, and we experiment with a data augmentation method and a domain adaptation pre-training method to increase exposure to medical vocabulary and knowledge. Evaluation methods include ROUGE, BERTScore, cosine similarity on sentence embedding, and F-score on medical concepts. Results show that T5 with domain adaptive pre-training achieves significant performance gains compared to a rule-based system and general domain pre-trained language models, indicating a promising direction for tackling the problem summarization task.

Daily progress notes are common types in the electronic health record (EHR) where healthcare providers document the patient's daily progress and treatment plans. The EHR is designed to document all the care provided to patients, but it also enables note bloat with extraneous information that distracts from the diagnoses and treatment plans. Applications of natural language processing (NLP) in the EHR is a growing field with the majority of methods in information extraction. Few tasks use NLP methods for downstream diagnostic decision support. We introduced the 2022 National NLP Clinical Challenge (N2C2) Track 3: Progress Note Understanding - Assessment and Plan Reasoning as one step towards a new suite of tasks. The Assessment and Plan Reasoning task focuses on the most critical components of progress notes, Assessment and Plan subsections where health problems and diagnoses are contained. The goal of the task was to develop and evaluate NLP systems that automatically predict causal relations between the overall status of the patient contained in the Assessment section and its relation to each component of the Plan section which contains the diagnoses and treatment plans. The goal of the task was to identify and prioritize diagnoses as the first steps in diagnostic decision support to find the most relevant information in long documents like daily progress notes. We present the results of 2022 n2c2 Track 3 and provide a description of the data, evaluation, participation and system performance.

Evaluating large language models (LLMs) in the biomedical domain requires benchmarks that can distinguish reasoning from pattern matching and remain discriminative as model capabilities improve. Existing biomedical question answering (QA) benchmarks are limited in this respect. Multiple-choice formats can allow models to succeed through answer elimination rather than inference, while widely circulated exam-style datasets are increasingly vulnerable to performance saturation and training data contamination. Multi-hop reasoning, defined as the ability to integrate information across multiple sources to derive an answer, is central to clinically meaningful tasks such as diagnostic support, literature-based discovery, and hypothesis generation, yet remains underrepresented in current biomedical QA benchmarks. MedHopQA is a disease-centered multi-hop reasoning benchmark consisting of 1,000 expert-curated question-answer pairs introduced as a shared task at BioCreative IX. Each question requires synthesis of information across two distinct Wikipedia articles, and answers are provided in an open-ended free-text format. Gold annotations are augmented with ontology-grounded synonym sets from MONDO, NCBI Gene, and NCBI Taxonomy to support both lexical and concept-level evaluation. MedHopQA was constructed through a structured process combining human annotation, triage, iterative verification, and LLM-as-a-judge validation. To reduce leaderboard gaming and contamination risk, the 1,000 scored questions are embedded within a publicly downloadable set of 10,000 questions, with answers withheld, on a CodaBench leaderboard. MedHopQA provides both a benchmark and a reusable framework for constructing future biomedical QA datasets that prioritize compositional reasoning, saturation resistance, and contamination resistance as core design constraints.

Premature closure, or committing to a conclusion before sufficient information is available, is a recognized contributor to diagnostic error but remains underexamined in large language models (LLMs). We define LLM premature closure as inappropriate commitment under uncertainty: providing an answer, recommendation, or clinical guidance when the safer response would be clarification, abstention, escalation, or refusal. We evaluated five frontier LLMs across structured and open-ended medical tasks. In MedQA (n = 500) and AfriMed-QA (n = 490) questions where the correct choice had been removed, models still selected an answer at high rates, with baseline false-action rates of 55-81% and 53-82%, respectively. In open-ended evaluation, models gave inappropriate answers on an average of 30% of 861 HealthBench questions and 78% of 191 physician-authored adversarial queries. Safety-oriented prompting reduced premature closure across models, but residual failure persisted, highlighting the need to evaluate whether medical LLMs know when not to answer.

Quantum low-density parity-check (qLDPC) codes have a canonical mixed state---the normalized projector onto the code space---that lies at the intersection of quantum error correction and quantum many-body physics, yet the stability of its information-theoretic structure under local noise remains poorly understood. Recent progress on mixed-state phases of matter has identified the spatial decay of conditional mutual information (CMI) I(A:C|B) as a key diagnostic of such stability, analogous to the role of the spectral gap for quantum ground states. We prove that, for the normalized code-projector state of a Z_d qLDPC stabilizer code under local Pauli noise, the CMI across a buffer B separating A from C decays exponentially with the width of B in two complementary noise regimes independent of system size. At weak noise, this holds for full-system tripartitions, where correlations between the two sides require an error cluster to cross the buffer, an exponentially unlikely event. At strong noise, exponential decay holds whenever the buffer supports no logical operator, since correlations can persist only along rare chains of buffer qudits that remain informative. Under an additional space-uniformity assumption, we establish the robustness of Levin--Wen topological entropy. On finite-dimensional lattices of size n, the weak-noise bound further implies a constant-layer quasi-local Petz recovery channel of range O(poly(log n)/varepsilon) that recovers the noiseless state within trace-distance error varepsilon. Both CMI bounds apply to general qLDPC interaction graphs, including geometries where such constant-depth quasi-local recovery need not exist. Thus, the exponential decay of the noise-induced CMI provides a general criterion for mixed-state phase stability.

Background Major depressive disorder (MDD) is a leading cause of global disability, yet current diagnostic approaches often rely on subjective assessments and lack the ability to integrate multimodal clinical information. Large language models (LLMs) hold promise for enhancing diagnostic accuracy through advanced reasoning but face challenges in interpretability, hallucination, and reliance on synthetic data. Methods We developed MDD-Thinker, an LLM-based diagnostic framework that integrates supervised fine-tuning (SFT) with reinforcement learning (RL) to strengthen reasoning ability and interpretability. Using the UK Biobank dataset, we generated 40,000 reasoning samples, supplemented with 10,000 samples from publicly available mental health datasets. The model was fine-tuned on these reasoning corpora, and its diagnostic and reasoning performance was evaluated against machine learning, deep learning, and state-of-the-art LLM baselines. Findings MDD-Thinker achieved an accuracy of 0.8268 and F1-score of 0.8081, significantly outperforming traditional baselines such as SVM and MLP, as well as general-purpose LLMs. Incorporating both SFT and RL yielded the greatest improvements, with relative gains of 29.0% in accuracy, 38.1% in F1-score, and 34.8% in AUC. Moreover, the model demonstrated comparable reasoning performance compared to much larger LLMs, while maintaining computational efficiency. Interpretation This study presents the first reasoning-enhanced LLM framework for MDD diagnosis trained on large-scale real-world clinical data. By integrating SFT and RL, MDD-Thinker balances accuracy, interpretability, and efficiency, offering a scalable approach for intelligent psychiatric diagnostics. These findings suggest that reasoning-oriented LLMs can provide clinically reliable support for MDD detection and may inform broader applications in mental health care.

Like other fields of Traditional Medicines, Unani Medicines have been found as an effective medical practice for ages. It is still widely used in the subcontinent, particularly in Pakistan and India. However, Unani Medicines Practitioners are lacking modern IT applications in their everyday clinical practices. An Online Clinical Decision Support System may address this challenge to assist apprentice Unani Medicines practitioners in their diagnostic processes. The proposed system provides a web-based interface to enter the patient's symptoms, which are then automatically analyzed by our system to generate a list of probable diseases. The system allows practitioners to choose the most likely disease and inform patients about the associated treatment options remotely. The system consists of three modules: an Online Clinical Decision Support System, an Artificial Intelligence Inference Engine, and a comprehensive Unani Medicines Database. The system employs advanced AI techniques such as Decision Trees, Deep Learning, and Natural Language Processing. For system development, the project team used a technology stack that includes React, FastAPI, and MySQL. Data and functionality of the application is exposed using APIs for integration and extension with similar domain applications. The novelty of the project is that it addresses the challenge of diagnosing diseases accurately and efficiently in the context of Unani Medicines principles. By leveraging the power of technology, the proposed Clinical Decision Support System has the potential to ease access to healthcare services and information, reduce cost, boost practitioner and patient satisfaction, improve speed and accuracy of the diagnostic process, and provide effective treatments remotely. The application will be useful for Unani Medicines Practitioners, Patients, Government Drug Regulators, Software Developers, and Medical Researchers.

Recent advancements in Digital Pathology (DP), particularly through artificial intelligence and Foundation Models, have underscored the importance of large-scale, diverse, and richly annotated datasets. Despite their critical role, publicly available Whole Slide Image (WSI) datasets often lack sufficient scale, tissue diversity, and comprehensive clinical metadata, limiting the robustness and generalizability of AI models. In response, we introduce the HISTAI dataset, a large, multimodal, open-access WSI collection comprising over 60,000 slides from various tissue types. Each case in the HISTAI dataset is accompanied by extensive clinical metadata, including diagnosis, demographic information, detailed pathological annotations, and standardized diagnostic coding. The dataset aims to fill gaps identified in existing resources, promoting innovation, reproducibility, and the development of clinically relevant computational pathology solutions. The dataset can be accessed at https://github.com/HistAI/HISTAI.

Incentivizing the reasoning ability of Multimodal Large Language Models (MLLMs) is essential for medical applications to transparently analyze medical scans and provide reliable diagnosis. However, existing medical MLLMs rely solely on internal knowledge during reasoning, leading to hallucinated reasoning and factual inaccuracies when encountering cases beyond their training scope. Although recent Agentic Retrieval-Augmented Generation (RAG) methods elicit the medical model's proactive retrieval ability during reasoning, they are confined to unimodal LLMs, neglecting the crucial visual information during reasoning and retrieval. Consequently, we propose the first Multimodal Medical Reasoning-with-Retrieval framework, Med-RwR, which actively retrieves external knowledge by querying observed symptoms or domain-specific medical concepts during reasoning. Specifically, we design a two-stage reinforcement learning strategy with tailored rewards that stimulate the model to leverage both visual diagnostic findings and textual clinical information for effective retrieval. Building on this foundation, we further propose a Confidence-Driven Image Re-retrieval (CDIR) method for test-time scaling when low prediction confidence is detected. Evaluation on various public medical benchmarks demonstrates Med-RwR's significant improvements over baseline models, proving the effectiveness of enhancing reasoning capabilities with external knowledge integration. Furthermore, Med-RwR demonstrates remarkable generalizability to unfamiliar domains, evidenced by 8.8% performance gain on our proposed EchoCardiography Benchmark (ECBench), despite the scarcity of echocardiography data in the training corpus. Our data, model, and codes will be made publicly available at https://github.com/xmed-lab/Med-RwR.

The development of clinical natural language processing (NLP) systems is severely hampered by the sensitive nature of medical records, which restricts data sharing under stringent privacy regulations, particularly in France and the broader European Union. To address this gap, we introduce PARHAF, a large open-source corpus of clinical documents in French. PARHAF comprises expert-authored clinical reports describing realistic yet entirely fictitious patient cases, making it anonymous and freely shareable by design. The corpus was developed using a structured protocol that combined clinician expertise with epidemiological guidance from the French National Health Data System (SNDS), ensuring broad clinical coverage. A total of 104 medical residents across 18 specialties authored and peer-reviewed the reports following predefined clinical scenarios and document templates. The corpus contains 7394 clinical reports covering 5009 patient cases across a wide range of medical and surgical specialties. It includes a general-purpose component designed to approximate real-world hospitalization distributions, and four specialized subsets that support information-extraction use cases in oncology, infectious diseases, and diagnostic coding. Documents are released under a CC-BY open license, with a portion temporarily embargoed to enable future benchmarking under controlled conditions. PARHAF provides a valuable resource for training and evaluating French clinical language models in a fully privacy-preserving setting, and establishes a replicable methodology for building shareable synthetic clinical corpora in other languages and health systems.

As data-science agents shift from co-pilots to auto-pilots, silent misframing becomes a critical failure mode. Agents quietly commit to plausible but unintended task framings, producing clean, executable artifacts that hide their incorrect assessment of the task. Existing benchmarks score whether the pipeline runs, ignoring whether the agent recognized the task was underspecified. We introduce Ambig-DS, two diagnostic suites: one for prediction-target ambiguity (Ambig-DS-Target, 51 tasks built on DSBench, a tabular modeling benchmark) and one for evaluation-objective ambiguity (Ambig-DS-Objective, 61 tasks built on MLE-bench, a Kaggle-style ML competition benchmark), constructed so that scoring uses each source benchmark's original evaluator. For every task we pair the original, fully specified version with an ambiguous variant produced by controlled edits; a human-and-LLM verification pipeline confirms each variant admits multiple plausible interpretations with decision-relevant consequences. The suites are analyzed independently and ambiguity lowers performance in both. Across five agents spanning efficient to frontier-class models, we find in our controlled diagnostic setting: (i) failures are silent commitments: wrong-target submissions on Target, wrong-metric or non-committal baseline submissions on Objective, rather than execution errors; (ii) allowing the agent to ask one clarifying question recovers much of the loss under idealized conditions, suggesting missing framing information drives a substantial part of the observed degradation; but (iii) agents cannot reliably tell when to use it: permissive prompts induce over-asking on clear tasks, while conservative prompts induce silent defaulting on ambiguous ones. Recognizing target and objective underspecification, not pipeline execution, is the bottleneck missing from standard DS-agent evaluations.

Uterine diseases represent an important category of gynecologic pathology and require accurate histopathological assessment for diagnosis and treatment planning. Whole-slide images (WSI) have enabled the digital transformation of pathology workflows and provided new opportunities for artificial intelligence (AI) in computational pathology. In particular, multimodal models that jointly analyze histopathology images and pathology reports have shown promising potential for automated pathology report generation and AI-assisted diagnosis. However, the development of such systems remains limited by the scarcity of datasets that pair whole-slide images with clinically meaningful pathology reports. Instead, existing pathology datasets focus on patch- or slide-level annotations of a single endpoint (e.g., disease class), which do not fully capture the rich information in full clinical diagnostic workflow reports. Here, we introduce TUM-Uteria, a uterine pathology dataset comprising WSIs paired with diagnostic pathology reports at both the case and slide levels, collected from a tertiary medical center. The dataset contains 216 clinical cases, comprising 455 slide-level WSI-report pairs. The dataset underwent a structured multi-stage validation procedure involving board-certified pathologists to ensure reliable annotations. TUM-Uteria supports research in computational pathology, including whole-slide image analysis, multimodal learning, and automated pathology report generation.

Convolutional neural networks trained on ImageNet are known to exhibit a strong preference for local high-frequency texture, an inductive bias that translates into fragile robustness against distribution shifts in real-world environments. Event cameras, in contrast, record only changes in scene brightness and are therefore well suited to capturing contour information; however, due to the absence of diagnostic benchmarks in the event domain, the inductive bias that event-camera data instills in vision models has remained underexplored. In this work, we use knowledge distillation from the event domain to the RGB domain so as to exploit the rich evaluation toolkit available in the RGB domain and systematically dissect this inductive bias. Our experiments show that distillation from the event domain induces, in the RGB domain, color invariance, shape bias, and robustness to high-frequency noise. We identify the underlying mechanism as the model suppressing its dependence on high-frequency texture while acquiring a stronger dependence on edge-based object shape. This hypothesis is supported by changes in how color and spatial information are processed at the early layers, together with a spectral trade-off in which robustness to the absence of high-frequency components coexists with vulnerability to contamination of the relied-upon frequency bands and to disruption of geometric structure. We further show that this inductive bias differs from existing robustification methods and that it functions as a useful prior for diverse downstream tasks in which shape and contour information contribute alongside other cues. The code is available at https://github.com/snskysk/event2rgb-distillation .

Omni-modal assistants must remember not only what users say, but also what they show and convey. Existing long-term memory benchmarks are mostly text-and-image or report a single end-to-end score, so they cannot locate whether evidence is lost when it is represented, retrieved, delivered, or read. We introduce MOSAIC, a benchmark of 923 questions over persona-grounded histories of 11-24 sessions spanning text, image, video, and audio. MOSAIC constructs targeted spatial, temporal, and prosodic signals rather than decorative media, with the strongest causal validation for spatial information and selector-level validation for annotated prosody, and pairs them with a matched diagnostic protocol that freezes the question, reader, prompt, and budget while intervening on representation, retrieval, and delivery. Matched decomposition shows that representation loss is modality-dependent, residual reading dominates even under gold evidence, and abstention remains weak on these controls: strong answerable scores coexist with failures to refuse. MOSAIC thus turns omni-modal memory evaluation from a leaderboard into a diagnosis of write, retrieve, deliver, and read failures.

MRI is an indispensable clinical tool, offering a rich variety of tissue contrasts to support broad diagnostic and research applications. Clinical exams routinely acquire multiple structural sequences that provide complementary information for differential diagnosis, while research protocols often incorporate advanced functional, diffusion, spectroscopic, and relaxometry sequences to capture multidimensional insights into tissue structure and composition. However, these capabilities come at the cost of prolonged scan times, which reduce patient throughput, increase susceptibility to motion artifacts, and may require trade-offs in image quality or diagnostic scope. Over the last two decades, advances in image reconstruction algorithms--alongside improvements in hardware and pulse sequence design--have made it possible to accelerate acquisitions while preserving diagnostic quality. Central to this progress is the ability to incorporate prior information to regularize the solutions to the reconstruction problem. In this tutorial, we overview the basics of MRI reconstruction and highlight state-of-the-art approaches, beginning with classical methods that rely on explicit hand-crafted priors, and then turning to deep learning methods that leverage a combination of learned and crafted priors to further push the performance envelope. We also explore the translational aspects and eventual clinical implications of these methods. We conclude by discussing future directions to address remaining challenges in MRI reconstruction. The tutorial is accompanied by a Python toolbox (https://github.com/tutorial-MRI-recon/tutorial) to demonstrate select methods discussed in the article.

Neurophysiological recordings such as electroencephalography (EEG) offer accessible and minimally invasive means of estimating physiological activity for applications in healthcare, diagnostic screening, and even immersive entertainment. However, these recordings yield high-dimensional, noisy time-series data that typically require extensive pre-processing and handcrafted feature extraction to reveal meaningful information. Recently, there has been a surge of interest in applying representation learning techniques from large pre-trained (foundation) models to effectively decode and interpret biosignals. We discuss the challenges posed for incorporating such methods and introduce BioCodec, an alternative representation learning framework inspired by neural codecs to capture low-level signal characteristics in the form of discrete tokens. Pre-trained on thousands of EEG hours, BioCodec shows efficacy across multiple downstream tasks, ranging from clinical diagnostic tasks and sleep physiology to decoding speech and motor imagery, particularly in low-resource settings. Additionally, we provide a qualitative analysis of codebook usage and estimate the spatial coherence of codebook embeddings from EEG connectivity. Notably, we also document the suitability of our method to other biosignal data, i.e., electromyographic (EMG) signals. Overall, the proposed approach provides a versatile solution for biosignal tokenization that performs competitively with state-of-the-art models. The source code and model checkpoints are shared.

Real-world embodied tasks, from everyday activities to professional procedures, require agents to act under physical constraints while tracking evolving object and task states. Tool use sits at the heart of such tasks, as many everyday and professional activities are tool-mediated. Understanding them requires reasoning about affordances, hand-tool-object geometry, procedural progress, and causal effects on target objects. Yet despite strong performance on perception-oriented video tasks such as captioning and general video QA, current multimodal video models remain limited in this form of tool-centric embodied reasoning. Progress in this direction has been limited by the lack of real-world egocentric data and diagnostic benchmarks. To address this gap, we introduce EgoTools, the first comprehensive suite for egocentric tool-use understanding. It consists of two complementary components: EgoTools-Data, a large-scale corpus of 100 hours of tool-centric egocentric recordings with synchronized audio, dense captions, reasoning-heavy narrations, and supplementary 3D information; and EgoTools-Bench, a diagnostic benchmark of 1,000 QA pairs across four tracks that cover tool-use understanding from perception and geometry to procedure and causal reasoning. Experimental results show that current models still struggle to ground tool use in visual evidence: Gemini-3.1-Pro achieves 66.9% overall accuracy but only 51.7% on Perception & Grounding. Beyond evaluation, we validate EgoTools-Data as a training resource. On the full 1,000-question benchmark, full supervised fine-tuning improves Qwen3-VL-8B-Instruct from 50.0% to 60.9%, under strict source-video separation. Together, these results establish EgoTools as a unified resource for both training and diagnostic evaluation of real-world egocentric tool-use understanding.

Mental disorders are highly prevalent worldwide, but the shortage of psychiatrists and the inherent subjectivity of interview-based diagnosis create substantial barriers to timely and consistent mental-health assessment. Progress in AI-assisted psychiatric diagnosis is constrained by the absence of benchmarks that simultaneously provide realistic patient simulation, clinician-verified diagnostic labels, and support for dynamic multi-turn consultation. We present LingxiDiagBench, a large-scale multi-agent benchmark that evaluates LLMs on both static diagnostic inference and dynamic multi-turn psychiatric consultation in Chinese. At its core is LingxiDiag-16K, a dataset of 16,000 EMR-aligned synthetic consultation dialogues designed to reproduce real clinical demographic and diagnostic distributions across 12 ICD-10 psychiatric categories. Through extensive experiments across state-of-the-art LLMs, we establish key findings: (1) although LLMs achieve high accuracy on binary depression--anxiety classification (up to 92.3%), performance deteriorates substantially for depression--anxiety comorbidity recognition (43.0%) and 12-way differential diagnosis (28.5%); (2) dynamic consultation often underperforms static evaluation, indicating that ineffective information-gathering strategies significantly impair downstream diagnostic reasoning; (3) consultation quality assessed by LLM-as-a-Judge shows only moderate correlation with diagnostic accuracy, suggesting that well-structured questioning alone does not ensure correct diagnostic decisions. We release LingxiDiag-16K and the full evaluation framework to support reproducible research at https://github.com/Lingxi-mental-health/LingxiDiagBench.

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

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

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

Diagnostic consultation is an online sequential decision-making process in which clinicians gather evidence through patient interaction until a diagnosis is sufficiently supported. Automating this process requires adaptive inquiry and interpretable decisions. Bayesian networks offer a natural foundation by updating diagnostic posteriors as evidence accumulates, but their use in open-ended consultation raises two challenges: linking diagnostic hypotheses to potential inquiries and translating evolving posteriors into consultation decisions. We introduce AutoDisym, an automated pipeline that integrates diagnostic knowledge with heterogeneous diagnosis-labeled clinical narratives to construct a Disorder--Symptom Bayesian Network (DSBN). Building on the DSBN, we propose ConsultMind, an uncertainty-aware framework that updates disorder posteriors after each response and uses posterior uncertainty to guide inquiry and diagnosis. We evaluate both methods across psychiatry, respiratory medicine, fever clinics, and three public datasets. The results show that AutoDisym can automatically construct high-quality DSBNs and that ConsultMind consistently improves diagnostic performance and explanation soundness. For example, AutoDisym achieves macro-averaged F1 scores of 81.37 for canonical symptoms and 72.19 for manifestations using GPT-5.6-Sol. ConsultMind improves Top-1 and Top-3 diagnostic accuracy by up to 22.15 and 37.89 percentage points, respectively. Physician evaluation further shows that ConsultMind improves the quality of ranking explanations, differential diagnoses, and diagnosis rationales across LLMs of different scales. This work offers a promising approach to automatic diagnostic consultation.

In clinical radiology reports, doctors capture important information about the patient's health status. They convey their observations from raw medical imaging data about the inner structures of a patient. As such, formulating reports requires medical experts to possess wide-ranging knowledge about anatomical regions with their normal, healthy appearance as well as the ability to recognize abnormalities. This explicit grasp on both the patient's anatomy and their appearance is missing in current medical image-processing systems as annotations are especially difficult to gather. This renders the models to be narrow experts e.g. for identifying specific diseases. In this work, we recover this missing link by adding human anatomy into the mix and enable the association of content in medical reports to their occurrence in associated imagery (medical phrase grounding). To exploit anatomical structures in this scenario, we present a sophisticated automatic pipeline to gather and integrate human bodily structures from computed tomography datasets, which we incorporate in our PAXRay: A Projected dataset for the segmentation of Anatomical structures in X-Ray data. Our evaluation shows that methods that take advantage of anatomical information benefit heavily in visually grounding radiologists' findings, as our anatomical segmentations allow for up to absolute 50% better grounding results on the OpenI dataset as compared to commonly used region proposals. The PAXRay dataset is available at https://constantinseibold.github.io/paxray/.

Future short or long-term space missions require a new generation of monitoring and diagnostic systems due to communication impasses as well as limitations in specialized crew and equipment. Machine learning supported diagnostic systems present a viable solution for medical and technical applications. We discuss challenges and applicability of such systems in light of upcoming missions and outline an example use case for a next-generation medical diagnostic system for future space operations. Additionally, we present approach recommendations and constraints for the successful generation and use of machine learning models aboard a spacecraft.

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

Accurate diagnostic coding of medical notes is crucial for enhancing patient care, medical research, and error-free billing in healthcare organizations. Manual coding is a time-consuming task for providers, and diagnostic codes often exhibit low sensitivity and specificity, whereas the free text in medical notes can be a more precise description of a patients status. Thus, accurate automated diagnostic coding of medical notes has become critical for a learning healthcare system. Recent developments in long-document transformer architectures have enabled attention-based deep-learning models to adjudicate medical notes. In addition, contrastive loss functions have been used to jointly pre-train large language and image models with noisy labels. To further improve the automated adjudication of medical notes, we developed an approach based on i) models for ICD-10 diagnostic code sequences using a large real-world data set, ii) large language models for medical notes, and iii) contrastive pre-training to build an integrated model of both ICD-10 diagnostic codes and corresponding medical text. We demonstrate that a contrastive approach for pre-training improves performance over prior state-of-the-art models for the MIMIC-III-50, MIMIC-III-rare50, and MIMIC-III-full diagnostic coding tasks.

Clinical diagnosis of the eye is performed over multifarious data modalities including scalar clinical labels, vectorized biomarkers, two-dimensional fundus images, and three-dimensional Optical Coherence Tomography (OCT) scans. Clinical practitioners use all available data modalities for diagnosing and treating eye diseases like Diabetic Retinopathy (DR) or Diabetic Macular Edema (DME). Enabling usage of machine learning algorithms within the ophthalmic medical domain requires research into the relationships and interactions between all relevant data over a treatment period. Existing datasets are limited in that they neither provide data nor consider the explicit relationship modeling between the data modalities. In this paper, we introduce the Ophthalmic Labels for Investigating Visual Eye Semantics (OLIVES) dataset that addresses the above limitation. This is the first OCT and near-IR fundus dataset that includes clinical labels, biomarker labels, disease labels, and time-series patient treatment information from associated clinical trials. The dataset consists of 1268 near-IR fundus images each with at least 49 OCT scans, and 16 biomarkers, along with 4 clinical labels and a disease diagnosis of DR or DME. In total, there are 96 eyes' data averaged over a period of at least two years with each eye treated for an average of 66 weeks and 7 injections. We benchmark the utility of OLIVES dataset for ophthalmic data as well as provide benchmarks and concrete research directions for core and emerging machine learning paradigms within medical image analysis.

Electronic medical records (EMR) contain sensitive personal information. For example, they may include details about infectious diseases, such as human immunodeficiency virus (HIV), or they may contain information about a mental illness. They may also contain other sensitive information such as medical details related to fertility treatments. Because EMRs are subject to confidentiality requirements, accessing and analyzing EMR databases is a privilege given to only a small number of individuals. Individuals who work at institutions that do not have access to EMR systems have no opportunity to gain hands-on experience with this valuable resource. Simulated medical databases are currently available; however, they are difficult to configure and are limited in their resemblance to real clinical databases. Generating highly accessible repositories of virtual patient EMRs while relying only minimally on real patient data is expected to serve as a valuable resource to a broader audience of medical personnel, including those who reside in underdeveloped countries.

Large language models (LLMs) have recently showcased remarkable capabilities, spanning a wide range of tasks and applications, including those in the medical domain. Models like GPT-4 excel in medical question answering but may face challenges in the lack of interpretability when handling complex tasks in real clinical settings. We thus introduce the diagnostic reasoning dataset for clinical notes (DiReCT), aiming at evaluating the reasoning ability and interpretability of LLMs compared to human doctors. It contains 511 clinical notes, each meticulously annotated by physicians, detailing the diagnostic reasoning process from observations in a clinical note to the final diagnosis. Additionally, a diagnostic knowledge graph is provided to offer essential knowledge for reasoning, which may not be covered in the training data of existing LLMs. Evaluations of leading LLMs on DiReCT bring out a significant gap between their reasoning ability and that of human doctors, highlighting the critical need for models that can reason effectively in real-world clinical scenarios.

The Korteweg-de Vries (KdV) equation serves as a foundational model in nonlinear wave physics, describing the balance between dispersive spreading and nonlinear steepening that gives rise to solitons. This article introduces sangkuriang, an open-source Python library for solving this equation using Fourier pseudo-spectral spatial discretization coupled with adaptive high-order time integration. The implementation leverages just-in-time (JIT) compilation for computational efficiency while maintaining accessibility for instructional purposes. Validation encompasses progressively complex scenarios including isolated soliton propagation, symmetric two-wave configurations, overtaking collisions between waves of differing amplitudes, and three-body interactions. Conservation of the classical invariants is monitored throughout, with deviations remaining small across all test cases. Measured soliton velocities conform closely to theoretical predictions based on the amplitude-velocity relationship characteristic of integrable systems. Complementary diagnostics drawn from information theory and recurrence analysis confirm that computed solutions preserve the regular phase-space structure expected for completely integrable dynamics. The solver outputs data in standard scientific formats compatible with common analysis tools and generates visualizations of spatiotemporal wave evolution. By combining numerical accuracy with practical accessibility on modest computational resources, sangkuriang offers a platform suitable for both classroom demonstrations of nonlinear wave phenomena and exploratory research into soliton dynamics.

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

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

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

Pathology vision-language models (VLMs) have shown strong visual perception ability, but their robustness in the language domain remains poorly characterized. Existing pathology VLM benchmarks largely rely on canonical closed-set prompts or perturb only generic templates, treating language as a fixed evaluation component rather than a variable axis of model behavior. In clinical practice, however, diagnostic language varies across reports, institutions, and candidate diagnoses. We introduce PathLang, a language-centered and clinically grounded zero-shot benchmark. PathLang holds the underlying slides, ground-truth labels, and image-text evaluation direction fixed while systematically varying only the diagnostic language, so that performance differences reflect how a diagnosis is phrased rather than what is imaged. The language variation follows how pathologists actually rephrase diagnoses (terminology, specificity, and reporting style), and all prompts and candidate pools are validated by six board-certified pathologists. PathLang covers four task families: (1) zero-shot classification with image-text alignment analysis, (2) cross-modal retrieval, (3) paraphrase robustness, including semantic-equivalence paraphrases, length and reporting-style variation, and prompt ensembling, and (4) open-vocabulary diagnosis retrieval over four candidate pools with distinct forms of semantic competition. Across nine VLMs and five public datasets spanning four organs, we find that performance is highly sensitive to clinically equivalent paraphrases, varies substantially across forms of semantic competition, and that image-text alignment quality does not necessarily translate into inter-class separability. We release the prompt corpus, candidate pools, pre-computed text embeddings, and evaluation code at https://anonymous.4open.science/r/PathLang.

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

Finding relevant literature underpins the practice of evidence-based medicine. From 2014 to 2016, TREC conducted a clinical decision support track, wherein participants were tasked with finding articles relevant to clinical questions posed by physicians. In total, 87 teams have participated over the past three years, generating 395 runs. During this period, each team has trialled a variety of methods. While there was significant overlap in the methods employed by different teams, the results were varied. Due to the diversity of the platforms used, the results arising from the different techniques are not directly comparable, reducing the ability to build on previous work. By using a stable platform, we have been able to compare different document and query processing techniques, allowing us to experiment with different search parameters. We have used our system to reproduce leading teams runs, and compare the results obtained. By benchmarking our indexing and search techniques, we can statistically test a variety of hypotheses, paving the way for further research.

Medical imaging technologies, including computed tomography (CT) or chest X-Ray (CXR), are largely employed to facilitate the diagnosis of the COVID-19. Since manual report writing is usually too time-consuming, a more intelligent auxiliary medical system that could generate medical reports automatically and immediately is urgently needed. In this article, we propose to use the medical visual language BERT (Medical-VLBERT) model to identify the abnormality on the COVID-19 scans and generate the medical report automatically based on the detected lesion regions. To produce more accurate medical reports and minimize the visual-and-linguistic differences, this model adopts an alternate learning strategy with two procedures that are knowledge pretraining and transferring. To be more precise, the knowledge pretraining procedure is to memorize the knowledge from medical texts, while the transferring procedure is to utilize the acquired knowledge for professional medical sentences generations through observations of medical images. In practice, for automatic medical report generation on the COVID-19 cases, we constructed a dataset of 368 medical findings in Chinese and 1104 chest CT scans from The First Affiliated Hospital of Jinan University, Guangzhou, China, and The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China. Besides, to alleviate the insufficiency of the COVID-19 training samples, our model was first trained on the large-scale Chinese CX-CHR dataset and then transferred to the COVID-19 CT dataset for further fine-tuning. The experimental results showed that Medical-VLBERT achieved state-of-the-art performances on terminology prediction and report generation with the Chinese COVID-19 CT dataset and the CX-CHR dataset. The Chinese COVID-19 CT dataset is available at https://covid19ct.github.io/.

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

A promising application of AI to healthcare is the retrieval of information from electronic health records (EHRs), e.g. to aid clinicians in finding relevant information for a consultation or to recruit suitable patients for a study. This requires search capabilities far beyond simple string matching, including the retrieval of concepts (diagnoses, symptoms, medications, etc.) related to the one in question. The suitability of AI methods for such applications is tested by predicting the relatedness of concepts with known relatedness scores. However, all existing biomedical concept relatedness datasets are notoriously small and consist of hand-picked concept pairs. We open-source a novel concept relatedness benchmark overcoming these issues: it is six times larger than existing datasets and concept pairs are chosen based on co-occurrence in EHRs, ensuring their relevance for the application of interest. We present an in-depth analysis of our new dataset and compare it to existing ones, highlighting that it is not only larger but also complements existing datasets in terms of the types of concepts included. Initial experiments with state-of-the-art embedding methods show that our dataset is a challenging new benchmark for testing concept relatedness models.

The controversy of computed tomography (CT) use in COVID-19 screening is associated with ambiguous characteristics of chest CT as a diagnostic test. The reported values of CT sensitivity and specificity calculated using RT-PCR as a reference standard vary widely. The objective of this study was to reevaluate the diagnostic and prognostic value of CT using an alternative approach. This study included 973 symptomatic COVID-19 patients aged 42 pm 17 years, 56% females. We reviewed the disease dynamics between the initial and follow-up CT studies using a "CT0-4" grading system. Sensitivity and specificity were calculated as conditional probabilities that a patient's condition would improve or deteriorate relative to the initial CT study results. For the calculation of negative (NPV) and positive (PPV) predictive values, we estimated the COVID-19 prevalence in Moscow. We used several ARIMA and EST models with different parameters to fit the data on total cases of COVID-19 from March 6, 2020, to July 20, 2020, and forecast the incidence. The "CT0-4" grading scale demonstrated low sensitivity (28%) but high specificity (95%). The best statistical model for describing the pandemic in Moscow was ETS with multiplicative trend, error, and season type. According to our calculations, with the predicted prevalence of 2.1%, the values of NPV and PPV would be 98% and 10%, correspondingly. We associate the low sensitivity and PPV values with the small sample size of the patients with severe symptoms and non-optimal methodological setup for measuring these specific characteristics. The "CT0-4" grading scale was highly specific and predictive for identifying admissions to hospitals of COVID-19 patients. Despite the ambiguous accuracy, chest CT proved to be an effective practical tool for patient management during the pandemic, provided that the necessary infrastructure and human resources are available.

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

We investigate whether large language models produce different medical triage recommendations for identical neurological symptoms when only the patient's stated gender and age vary. Using three model families--Gemini 3.5 Flash, Claude Sonnet 4.6, and GPT-5.4-mini--we present a standardized symptom profile (persistent headache, blurred vision, morning nausea, visual disturbances) across seven demographic conditions: three age groups (25, 38, 65) x two genders (male, female), plus a gender-unspecified baseline (n = 30 per condition per model, 630 total trials). We find a stark, systemic gender-dependent triage disparity: young women receive significantly lower emergency room (ER) referral rates than age-matched men (Gemini: 0% vs. 23.3%; Claude: 6.7% vs. 96.7%; GPT: 6.7% vs. 66.7%, all p < 0.001). The disparity disappears at age 65 for all models. The primary mechanism is diagnostic substitution: the models anchor on a gender-associated diagnosis, preferentially classifying young women with Idiopathic Intracranial Hypertension (IIH)--a condition epidemiologically linked to women of childbearing age--while diagnosing men with generic increased intracranial pressure with space-occupying lesions in the differential. This diagnostic closure routes female patients to lower-urgency care (outpatient doctor appointments) despite comparable severity ratings (7-9/10). Our findings demonstrate that clinical LLMs replicate documented human clinical biases by using epidemiological priors to suppress triage urgency, suggesting that AI triage engines must decouple urgency assessment from probabilistic diagnostic priors. We release all code, prompts, and raw results.

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

Medical phrase grounding is crucial for identifying relevant regions in medical images based on phrase queries, facilitating accurate image analysis and diagnosis. However, current methods rely on manual extraction of key phrases from medical reports, reducing efficiency and increasing the workload for clinicians. Additionally, the lack of model confidence estimation limits clinical trust and usability. In this paper, we introduce a novel task called Medical Report Grounding (MRG), which aims to directly identify diagnostic phrases and their corresponding grounding boxes from medical reports in an end-to-end manner. To address this challenge, we propose uMedGround, a robust and reliable framework that leverages a multimodal large language model to predict diagnostic phrases by embedding a unique token, <BOX>, into the vocabulary to enhance detection capabilities. A vision encoder-decoder processes the embedded token and input image to generate grounding boxes. Critically, uMedGround incorporates an uncertainty-aware prediction model, significantly improving the robustness and reliability of grounding predictions. Experimental results demonstrate that uMedGround outperforms state-of-the-art medical phrase grounding methods and fine-tuned large visual-language models, validating its effectiveness and reliability. This study represents a pioneering exploration of the MRG task, marking the first-ever endeavor in this domain. Additionally, we demonstrate the applicability of uMedGround in medical visual question answering and class-based localization tasks, where it highlights visual evidence aligned with key diagnostic phrases, supporting clinicians in interpreting various types of textual inputs, including free-text reports, visual question answering queries, and class labels.