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Aug 10

Seeing or Knowing? Visual Context Sensitivity in Multimodal Large Language Models

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.

  • 7 authors
·
Jul 27 3

Perturbation Probing: A Two-Pass-per-Prompt Diagnostic for FFN Behavioral Circuits in Aligned LLMs

Perturbation probing generates task-specific causal hypotheses for FFN neurons in large language models using two forward passes per prompt and no backpropagation, followed by a one-time intervention sweep of about 150 passes amortized across all identified neurons. Across eight behavioral circuits, 13 models, and four architecture families, we identify two circuit structures that organize LLM behavior. Opposition circuits appear when RLHF suppresses a pre-training tendency. In safety refusal, about 50 neurons, or 0.014 percent of all neurons, control the refusal template; ablating them changes 80 percent of response formats on 520 AdvBench prompts while producing near-zero harmful compliance, 3 of 520 cases, all with disclaimers. Routing circuits appear for pre-training behaviors distributed through attention. For language selection, residual-stream direction injection switches English to Chinese output on 99.1 percent of 580 benchmark prompts in the 3 of 19 tested models that satisfy three observed conditions: bilingual training, FFN-to-skip signal ratio between 0.3 and 1.1, and linear representability. The same intervention fails on the other 16 models and on math, code, and factual circuits, defining the limits of directional steering. The FFN-to-skip signal ratio, computed from the same two forward passes, distinguishes the two structures and predicts the appropriate intervention. Circuit topology varies by architecture, from Qwen's concentrated FFN bottleneck to Gemma's normalization-shielded circuit. In Qwen3.5-2B, ablating 20 neurons eliminates multi-turn sycophantic capitulation, while amplifying 10 related neurons improves factual correction from 52 percent to 88 percent on 200 TruthfulQA prompts. These results show that perturbation probing offers mechanistic insight into RLHF-organized behavior and a practical toolkit for precision template-layer editing.

  • 3 authors
·
Apr 29

MemeReaCon: Probing Contextual Meme Understanding in Large Vision-Language Models

Memes have emerged as a popular form of multimodal online communication, where their interpretation heavily depends on the specific context in which they appear. Current approaches predominantly focus on isolated meme analysis, either for harmful content detection or standalone interpretation, overlooking a fundamental challenge: the same meme can express different intents depending on its conversational context. This oversight creates an evaluation gap: although humans intuitively recognize how context shapes meme interpretation, Large Vision Language Models (LVLMs) can hardly understand context-dependent meme intent. To address this critical limitation, we introduce MemeReaCon, a novel benchmark specifically designed to evaluate how LVLMs understand memes in their original context. We collected memes from five different Reddit communities, keeping each meme's image, the post text, and user comments together. We carefully labeled how the text and meme work together, what the poster intended, how the meme is structured, and how the community responded. Our tests with leading LVLMs show a clear weakness: models either fail to interpret critical information in the contexts, or overly focus on visual details while overlooking communicative purpose. MemeReaCon thus serves both as a diagnostic tool exposing current limitations and as a challenging benchmark to drive development toward more sophisticated LVLMs of the context-aware understanding.

  • 13 authors
·
May 22, 2025

Hidden in Plain Sight: Probing Implicit Reasoning in Multimodal Language Models

Multimodal large language models (MLLMs) are increasingly deployed in open-ended, real-world environments where inputs are messy, underspecified, and not always trustworthy. Unlike curated benchmarks, these settings frequently involve instructions that refer to missing objects or contradictory facts, rely on ambiguous references, or request infeasible actions. In such cases, success hinges not on task execution alone, but on a model's ability to detect when something is silently wrong. This paper presents a systematic analysis of how current MLLMs handle such implicit reasoning scenarios: cases where the flaw is not explicitly stated but must be inferred from context. Using a curated diagnostic suite spanning four categories of real-world failure modes, we evaluate six MLLMs, including o3 and GPT-4o, and find that models frequently fail to surface hidden issues, even when they possess the necessary perceptual and reasoning skills. Explicit prompting reveals that the underlying capabilities exist but are often suppressed in favor of user compliance. We further show that simple inference-time interventions, such as cautious persona prompting and, in particular, requiring a clarifying question, can dramatically recover performance. Our findings highlight a persistent gap between reasoning competence and behavioral compliance in current MLLMs and suggest practical strategies for making these models more trustworthy in underconstrained environments.

  • 7 authors
·
May 30, 2025 1

Probing the Robustness of Large Language Models Safety to Latent Perturbations

Safety alignment is a key requirement for building reliable Artificial General Intelligence. Despite significant advances in safety alignment, we observe that minor latent shifts can still trigger unsafe responses in aligned models. We argue that this stems from the shallow nature of existing alignment methods, which focus on surface-level refusal behaviors without sufficiently altering internal representations. Consequently, small shifts in hidden activations can re-trigger harmful behaviors embedded in the latent space. To explore the robustness of safety alignment to latent perturbations, we introduce a probing method that measures the Negative Log-Likelihood of the original response generated by the model. This probe quantifies local sensitivity in the latent space, serving as a diagnostic tool for identifying vulnerable directions. Based on this signal, we construct effective jailbreak trajectories, giving rise to the Activation Steering Attack (ASA). More importantly, these insights offer a principled foundation for improving alignment robustness. To this end, we introduce Layer-wise Adversarial Patch Training~(LAPT), a fine-tuning strategy that inject controlled perturbations into hidden representations during training. Experimental results highlight that LAPT strengthen alignment robustness without compromising general capabilities. Our findings reveal fundamental flaws in current alignment paradigms and call for representation-level training strategies that move beyond surface-level behavior supervision. Codes and results are available at https://github.com/Carol-gutianle/LatentSafety.

  • 10 authors
·
Jun 18, 2025

DALL-Eval: Probing the Reasoning Skills and Social Biases of Text-to-Image Generative Models

Recently, DALL-E, a multimodal transformer language model, and its variants (including diffusion models) have shown high-quality text-to-image generation capabilities. However, despite the interesting image generation results, there has not been a detailed analysis on how to evaluate such models. In this work, we investigate the visual reasoning capabilities and social biases of different text-to-image models, covering both multimodal transformer language models and diffusion models. First, we measure three visual reasoning skills: object recognition, object counting, and spatial relation understanding. For this, we propose PaintSkills, a compositional diagnostic dataset and evaluation toolkit that measures these skills. In our experiments, there exists a large gap between the performance of recent text-to-image models and the upper bound accuracy in object counting and spatial relation understanding skills. Second, we assess gender and skin tone biases by measuring the variance of the gender/skin tone distribution based on automated and human evaluation. We demonstrate that recent text-to-image models learn specific gender/skin tone biases from web image-text pairs. We hope that our work will help guide future progress in improving text-to-image generation models on visual reasoning skills and learning socially unbiased representations. Code and data: https://github.com/j-min/DallEval

  • 3 authors
·
Feb 8, 2022

Can Image Models Imagine Time? ImageTime: A Novel Benchmark for Probing Visual World Modeling Through Spatiotemporal Consistency

Image generation models now produce high-quality static images, yet their ability to represent how a visual world changes over time remains poorly understood. Practical workflows such as storyboarding, step-by-step illustration, reference-guided editing, and video previsualization require models to preserve identities, objects, spatial relations, and causal order across multiple visual states. Existing evaluations largely measure single-image correctness, compositional alignment, or video quality, leaving open whether an image model can coherently imagine a temporally ordered process. We introduce ImageTime, a diagnostic benchmark that uses spatiotemporal consistency as a behavioral probe of visual world modeling in image generation. Given an action instruction, and optionally a reference image specifying the initial state, a model must generate one image containing four ordered key states: initial state, action onset, transition state, and final state. This four-keyframe protocol is more temporally demanding than single-image generation while avoiding the confounds of dense video dynamics. ImageTime organizes tasks with a progressive capability hierarchy and decomposes each scenario into stage-wise state predicates, cross-frame temporal constraints, and forbidden causal violations. GPT-5.5 scores all generated images under a structured VLM-as-judge protocol, producing interpretable capability scores, diagnostic subscores, and failure labels. Through multi-family benchmarking, ImageTime reveals where current image generation systems succeed, fail, and drift when asked to maintain coherent visual world states over time.

  • 2 authors
·
Jun 9

ToolSense: A Diagnostic Framework for Auditing Parametric Tool Knowledge in LLMs

Large language models deployed as agents over large tool catalogs face a critical tool-retrieval bottleneck. As embedding-based retrieval approaches rely on compact encoders that may under-capture specialized tool semantics, parametric tool retrieval addresses this by encoding each tool as a virtual token appended to the LLM vocabulary, fine-tuned in two stages (memorization then retrieval SFT) to use the LLM as a retriever, achieving strong performance on standard ToolBench retrieval benchmarks. Yet these benchmarks use verbose, fully-specified queries, and their evaluation applies constrained decoding that restricts outputs to valid token paths, neither reveals whether the model actually understands its tools. We introduce ToolSense, an open-source LLM-powered diagnostic framework that takes any tool catalog as input and automatically generates three benchmarks: a Realistic Retrieval Benchmark (RRB) with queries at three ambiguity tiers, an MCQ probing benchmark, and a QA probing benchmark. Applying ToolSense to ToolBench (~47k tools) and evaluating five parametric model training configurations reveals a knowledge-retrieval dissociation: on RRB queries, several configurations collapse by ~50-64 percentage points compared to fully-specified ToolBench benchmarks, falling below the embedding-model baseline. Additionally, despite strong retrieval performance, some models score near-random on factual probes, suggesting a knowledge-retrieval dissociation. We open-source the ToolSense framework and the ToolBench diagnostic benchmarks at https://github.com/SAP/toolsense.

SAP SAP
·
Jun 3 2

Worse than Random? An Embarrassingly Simple Probing Evaluation of Large Multimodal Models in Medical VQA

Large Multimodal Models (LMMs) have shown remarkable progress in the field of medical Visual Question Answering (Med-VQA), achieving high accuracy on existing benchmarks. However, their reliability under robust evaluation is questionable. This study reveals that state-of-the-art models, when subjected to simple probing evaluation, perform worse than random guessing on medical diagnosis questions. To address this critical evaluation problem, we introduce the Probing Evaluation for Medical Diagnosis (ProbMed) dataset to rigorously assess LMM performance in medical imaging through probing evaluation and procedural diagnosis. Particularly, probing evaluation features pairing original questions with negation questions with hallucinated attributes, while procedural diagnosis requires reasoning across various diagnostic dimensions for each image, including modality recognition, organ identification, clinical findings, abnormalities, and positional grounding. Our evaluation reveals that top-performing models like GPT-4V and Gemini Pro perform worse than random guessing on specialized diagnostic questions, indicating significant limitations in handling fine-grained medical inquiries. Besides, models like LLaVA-Med struggle even with more general questions, and results from CheXagent demonstrate the transferability of expertise across different modalities of the same organ, showing that specialized domain knowledge is still crucial for improving performance. This study underscores the urgent need for more robust evaluation to ensure the reliability of LMMs in critical fields like medical diagnosis, and current LMMs are still far from applicable to those fields.

  • 4 authors
·
May 30, 2024

PRM-as-a-Judge: A Dense Evaluation Paradigm for Fine-Grained Robotic Auditing

Current robotic evaluation is still largely dominated by binary success rates, which collapse rich execution processes into a single outcome and obscure critical qualities such as progress, efficiency, and stability. To address this limitation, we propose PRM-as-a-Judge, a dense evaluation paradigm that leverages Process Reward Models (PRMs) to audit policy execution directly from trajectory videos by estimating task progress from observation sequences. Central to this paradigm is the OPD (Outcome-Process-Diagnosis) metric system, which explicitly formalizes execution quality via a task-aligned progress potential. We characterize dense robotic evaluation through two axiomatic properties: macro-consistency, which requires additive and path-consistent aggregation, and micro-resolution, which requires sensitivity to fine-grained physical evolution. Under this formulation, potential-based PRM judges provide a natural instantiation of dense evaluation, with macro-consistency following directly from the induced scalar potential. We empirically validate the micro-resolution property using RoboPulse, a diagnostic benchmark specifically designed for probing micro-scale progress discrimination, where several trajectory-trained PRM judges outperform discriminative similarity-based methods and general-purpose foundation-model judges. Finally, leveraging PRM-as-a-Judge and the OPD metric system, we conduct a structured audit of mainstream policy paradigms across long-horizon tasks, revealing behavioral signatures and failure modes that are invisible to outcome-only metrics.

  • 18 authors
·
Mar 23

Temporal Reasoning Transfer from Text to Video

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.

  • 9 authors
·
Oct 8, 2024 4

Attention, Please! Revisiting Attentive Probing for Masked Image Modeling

As fine-tuning (FT) becomes increasingly impractical at scale, probing is emerging as the preferred evaluation protocol for self-supervised learning (SSL). Yet, the standard linear probing (LP) fails to adequately reflect the potential of models trained with Masked Image Modeling (MIM), due to the distributed nature of patch tokens. This motivates the need for attentive probing, an alternative that uses attention to selectively aggregate patch-level features. Despite its growing adoption, attentive probing remains under-explored, with existing methods suffering from excessive parameterization and poor computational efficiency. In this work, we revisit attentive probing through the lens of the accuracy-efficiency trade-off. We conduct a systematic study of existing methods, analyzing their mechanisms and benchmarking their performance. We introduce efficient probing (EP), a multi-query cross-attention mechanism that eliminates redundant projections, reduces the number of trainable parameters, and achieves up to a 10times speed-up over conventional multi-head attention. Despite its simplicity, EP outperforms LP and prior attentive probing approaches across seven benchmarks, generalizes well beyond MIM to diverse pre-training paradigms, produces interpretable attention maps, and achieves strong gains in low-shot and layer-wise settings. Code available at https://github.com/billpsomas/efficient-probing.

  • 9 authors
·
Jun 11, 2025 2

RAPTOR: Ridge-Adaptive Logistic Probes

Probing studies what information is encoded in a frozen LLM's layer representations by training a lightweight predictor on top of them. Beyond analysis, probes are often used operationally in probe-then-steer pipelines: a learned concept vector is extracted from a probe and injected via additive activation steering by adding it to a layer representation during the forward pass. The effectiveness of this pipeline hinges on estimating concept vectors that are accurate, directionally stable under ablation, and inexpensive to obtain. Motivated by these desiderata, we propose RAPTOR (Ridge-Adaptive Logistic Probe), a simple L2-regularized logistic probe whose validation-tuned ridge strength yields concept vectors from normalized weights. Across extensive experiments on instruction-tuned LLMs and human-written concept datasets, RAPTOR matches or exceeds strong baselines in accuracy while achieving competitive directional stability and substantially lower training cost; these quantitative results are supported by qualitative downstream steering demonstrations. Finally, using the Convex Gaussian Min-max Theorem (CGMT), we provide a mechanistic characterization of ridge logistic regression in an idealized Gaussian teacher-student model in the high-dimensional few-shot regime, explaining how penalty strength mediates probe accuracy and concept-vector stability and yielding structural predictions that qualitatively align with trends observed on real LLM embeddings.

Evolving Diagnostic Agents in a Virtual Clinical Environment

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.

Learning on Model Weights using Tree Experts

The number of publicly available models is rapidly increasing, yet most remain undocumented. Users looking for suitable models for their tasks must first determine what each model does. Training machine learning models to infer missing documentation directly from model weights is challenging, as these weights often contain significant variation unrelated to model functionality (denoted nuisance). Here, we identify a key property of real-world models: most public models belong to a small set of Model Trees, where all models within a tree are fine-tuned from a common ancestor (e.g., a foundation model). Importantly, we find that within each tree there is less nuisance variation between models. Concretely, while learning across Model Trees requires complex architectures, even a linear classifier trained on a single model layer often works within trees. While effective, these linear classifiers are computationally expensive, especially when dealing with larger models that have many parameters. To address this, we introduce Probing Experts (ProbeX), a theoretically motivated and lightweight method. Notably, ProbeX is the first probing method specifically designed to learn from the weights of a single hidden model layer. We demonstrate the effectiveness of ProbeX by predicting the categories in a model's training dataset based only on its weights. Excitingly, ProbeX can map the weights of Stable Diffusion into a weight-language embedding space, enabling model search via text, i.e., zero-shot model classification.

  • 4 authors
·
Oct 17, 2024

Exploring the Inquiry-Diagnosis Relationship with Advanced Patient Simulators

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.

  • 10 authors
·
Jan 16, 2025 4

Pressure-Testing Deception Probes in LLMs: Scaling, Robustness, and the Geometry of Deceptive Representations

Linear probes trained on LLM activations are increasingly proposed as deception-detection metrics, yet report AUROC exceeding 0.96 on clean benchmarks while collapsing under distributional shift. This paper systematically pressure-tests probe-based metrics across the Gemma 3 model family (1B-27B parameters), diagnosing why they fail rather than merely documenting that they fail. We test four hypotheses about deception encoding: (1) single linear direction, (2) multi-dimensional subspace, (3) convex conic hull, (4) entropy proxy. Our design includes cross-domain transfer matrices, multi-dimensional probe analysis with permutation null baselines, entropy-residualization tests, and distractor evaluations across 8 stylistic shifts. We find that: (a) probes achieve near-perfect AUROC (>=0.998) on clean data but collapse under stylistic shifts; style-augmented probes recover near-perfect detection (mean AUROC 0.979-0.983) on unseen styles; (b) the single-direction hypothesis is rejected (k=1 captures only 0.61-0.80 AUROC), with cross-domain transfer failure confirmed as geometric rather than layer-mismatch-driven; (c) the entropy-proxy hypothesis is rejected (max |rho|=0.454, max Delta-AUROC after residualization=0.004); and (d) deception does not form a significant linear subspace (per-domain k*=0), yet multi-dimensional probes (k>=5) recover the signal through distributed sub-threshold features. Probe fragility reflects distributional narrowness rather than an architectural limitation: style-augmented probes recover near-perfect detection at both 4B and 27B, establishing that the inverse scaling pattern is a training-distribution artifact rather than a genuine scale-dependent phenomenon.

  • 1 authors
·
May 27 2

Thinking Like a Botanist: Challenging Multimodal Language Models with Intent-Driven Chain-of-Inquiry

Vision evaluations are typically done through multi-step processes. In most contemporary fields, experts analyze images using structured, evidence-based adaptive questioning. In plant pathology, botanists inspect leaf images, identify visual cues, infer diagnostic intent, and probe further with targeted questions that adapt to species, symptoms, and severity. This structured probing is crucial for accurate disease diagnosis and treatment formulation. Yet current vision-language models are evaluated on single-turn question answering. To address this gap, we introduce PlantInquiryVQA, a benchmark for studying multi-step, intent-driven visual reasoning in botanical diagnosis. We formalize a Chain of Inquiry framework modeling diagnostic trajectories as ordered question-answer sequences conditioned on grounded visual cues and explicit epistemic intent. We release a dataset of 24,950 expert-curated plant images and 138,068 question-answer pairs annotated with visual grounding, severity labels, and domain-specific reasoning templates. Evaluations on top-tier Multimodal Large Language Models reveal that while they describe visual symptoms adequately, they struggle with safe clinical reasoning and accurate diagnosis. Importantly, structured question-guided inquiry significantly improves diagnostic correctness, reduces hallucination, and increases reasoning efficiency. We hope PlantInquiryVQA serves as a foundational benchmark in advancing research to train diagnostic agents to reason like expert botanists rather than static classifiers.

  • 7 authors
·
Apr 21

RAD: Towards Trustworthy Retrieval-Augmented Multi-modal Clinical Diagnosis

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.

Fudan-University Fudan University
·
Sep 24, 2025

DDXPlus: A New Dataset For Automatic Medical Diagnosis

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.

  • 5 authors
·
May 18, 2022

Building Production-Ready Probes For Gemini

Frontier language model capabilities are improving rapidly. We thus need stronger mitigations against bad actors misusing increasingly powerful systems. Prior work has shown that activation probes may be a promising misuse mitigation technique, but we identify a key remaining challenge: probes fail to generalize under important production distribution shifts. In particular, we find that the shift from short-context to long-context inputs is difficult for existing probe architectures. We propose several new probe architecture that handle this long-context distribution shift. We evaluate these probes in the cyber-offensive domain, testing their robustness against various production-relevant shifts, including multi-turn conversations, static jailbreaks, and adaptive red teaming. Our results demonstrate that while multimax addresses context length, a combination of architecture choice and training on diverse distributions is required for broad generalization. Additionally, we show that pairing probes with prompted classifiers achieves optimal accuracy at a low cost due to the computational efficiency of probes. These findings have informed the successful deployment of misuse mitigation probes in user-facing instances of Gemini, Google's frontier language model. Finally, we find early positive results using AlphaEvolve to automate improvements in both probe architecture search and adaptive red teaming, showing that automating some AI safety research is already possible.

  • 7 authors
·
Jan 16 3

Automatic Differential Diagnosis using Transformer-Based Multi-Label Sequence Classification

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.

  • 3 authors
·
Aug 28, 2024 1

LungNoduleAgent: A Collaborative Multi-Agent System for Precision Diagnosis of Lung Nodules

Diagnosing lung cancer typically involves physicians identifying lung nodules in Computed tomography (CT) scans and generating diagnostic reports based on their morphological features and medical expertise. Although advancements have been made in using multimodal large language models for analyzing lung CT scans, challenges remain in accurately describing nodule morphology and incorporating medical expertise. These limitations affect the reliability and effectiveness of these models in clinical settings. Collaborative multi-agent systems offer a promising strategy for achieving a balance between generality and precision in medical applications, yet their potential in pathology has not been thoroughly explored. To bridge these gaps, we introduce LungNoduleAgent, an innovative collaborative multi-agent system specifically designed for analyzing lung CT scans. LungNoduleAgent streamlines the diagnostic process into sequential components, improving precision in describing nodules and grading malignancy through three primary modules. The first module, the Nodule Spotter, coordinates clinical detection models to accurately identify nodules. The second module, the Radiologist, integrates localized image description techniques to produce comprehensive CT reports. Finally, the Doctor Agent System performs malignancy reasoning by using images and CT reports, supported by a pathology knowledge base and a multi-agent system framework. Extensive testing on two private datasets and the public LIDC-IDRI dataset indicates that LungNoduleAgent surpasses mainstream vision-language models, agent systems, and advanced expert models. These results highlight the importance of region-level semantic alignment and multi-agent collaboration in diagnosing nodules. LungNoduleAgent stands out as a promising foundational tool for supporting clinical analyses of lung nodules.

  • 10 authors
·
Nov 25, 2025

Neural Probe-Based Hallucination Detection for Large Language Models

Large language models(LLMs) excel at text generation and knowledge question-answering tasks, but they are prone to generating hallucinated content, severely limiting their application in high-risk domains. Current hallucination detection methods based on uncertainty estimation and external knowledge retrieval suffer from the limitation that they still produce erroneous content at high confidence levels and rely heavily on retrieval efficiency and knowledge coverage. In contrast, probe methods that leverage the model's hidden-layer states offer real-time and lightweight advantages. However, traditional linear probes struggle to capture nonlinear structures in deep semantic spaces.To overcome these limitations, we propose a neural network-based framework for token-level hallucination detection. By freezing language model parameters, we employ lightweight MLP probes to perform nonlinear modeling of high-level hidden states. A multi-objective joint loss function is designed to enhance detection stability and semantic disambiguity. Additionally, we establish a layer position-probe performance response model, using Bayesian optimization to automatically search for optimal probe insertion layers and achieve superior training results.Experimental results on LongFact, HealthBench, and TriviaQA demonstrate that MLP probes significantly outperform state-of-the-art methods in accuracy, recall, and detection capability under low false-positive conditions.

  • 2 authors
·
Dec 24, 2025

MedExAgent: Training LLM Agents to Ask, Examine, and Diagnose in Noisy Clinical Environments

Real-world clinical diagnosis is a complex process in which the doctor is required to obtain information from both interaction with the patient and conducting medical exams. Additionally, the doctor needs to adapt to different patient personas, as well as noisy and incomplete information that can happen at any time during the process. However, existing benchmarks for medical LLMs and methods for automatic diagnosis largely simplify this process by reducing it to single-turn question answering, noise-free conversations, or sequential exam making, etc., ignoring the interactive and uncertain nature of clinical diagnosis. In this paper, we aim to address this gap by formalizing clinical diagnosis as a Partially Observable Markov Decision Process (POMDP) with three action types: questioning the patient, ordering medical exams as tool calls, and issuing a diagnosis. We also introduce a systematic noise model comprising seven patient noise types and three exam noise types. Using our proposed environment, we train an effective diagnosis agent, MedExAgent, through a two-stage pipeline that first performs supervised finetuning on synthetic conversations structured after the Calgary-Cambridge model for clinical interviews, and then applies DAPO to optimize a composite reward capturing diagnostic accuracy, tool call quality, and exam cost including financial cost and patient discomfort. Through extensive experiments and ablation studies, we demonstrate that MedExAgent achieves diagnostic performance comparable to larger models while maintaining cost-efficient examination strategies.

  • 5 authors
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May 7

Stop Early, Spend Less: Hidden-State Probes as a Practical Recipe for Streaming Moderation of LLM Outputs

Deploying large language models in user-facing systems requires efficient output safety filtering. Existing approaches typically rely on a separate moderation model applied after generation, which doubles inference cost and only detects violations after generation completes. We observe that the signal needed for moderation is already present in the model hidden states. Based on this, we train lightweight token-level probes that operate directly on internal activations, producing per-token safety scores that can be aggregated for both offline evaluation and online intervention. The probe reuses activations from the generator and requires no additional forward pass, enabling sub millisecond per-token safety checks inside the decoding loop. A probe applied to a single mid layer recovers most decisions of a strong guard model, acting as a low cost surrogate optimized for latency rather than accuracy. In streaming settings, it can halt or modify unsafe outputs before they are fully generated, replacing end of sequence moderation with continuous token level monitoring. Compared to post hoc and streaming guard models, our method achieves orders of magnitude lower compute overhead with minimal latency cost. We also provide a practical deployment recipe, including layer selection, aggregation strategy, probing frequency, and triggering thresholds. Finally, we show that the probe linear component corresponds to a direction in residual space, enabling both detection and activation steering at negligible cost.

  • 3 authors
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Jun 8

End-to-End Agentic RAG System Training for Traceable Diagnostic Reasoning

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

  • 10 authors
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Aug 21, 2025 2

Plans Don't Persist: Why Context Management Is Load Bearing for LLM Agents

Long-horizon agents depend on context management: systems compress, summarize, and evict old tokens so tasks can continue beyond finite windows. That is safe only when dropped information is no longer needed or has been internalized. Plans are the stress case: they are written early, used for many steps, and first to be evicted. We introduce replay pairing, a diagnostic that runs the same trajectory with and without the plan in history and measures hidden-state cosine distance. On Llama-3.1-70B, plan signal spikes to 0.453 one step after the plan, then falls 4.1x in a single action-observation step; HotpotQA falls 12.4x. This is evidence that standard LLM agents do not carry plans forward as persistent state, and instead depend on the plan remaining in context. A layer-L32 probe detects this decay as a diagnostic, not as proof that it reads plan content itself. Reasoning models add a measurement confound: their `<think>` traces re-derive plan content, so standard stripping leaves plan evidence in the stripped condition. We name this the reasoning-trace confound and fix it with strict stripping, which removes prior `<think>` blocks from the stripped run only. It recovers +163% of the step+1 signal in-sample and +153% held out, while not meaningfully changing non-reasoning Llama (+4.8%). On DeepSeek-R1-Distill-Llama-70B, a Llama-trained probe transfers at AUROC 0.748 (p=6e-4), while R1-specific probes reach 1.000, suggesting R1 encodes plan signal in a different hidden-state direction. Finally, a compression stress test shows the practical cost: naive plan eviction cuts ALFWorld success by 34.7pp, while probe-gated re-surfacing does not recover it. The contribution is a measurement and stress-test framework showing that agent-critical information can be context-resident rather than persistent. Context management is load bearing, but plan protection alone is not enough.

Snowflake Snowflake
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Jun 21 1

Tuning Pre-trained Model via Moment Probing

Recently, efficient fine-tuning of large-scale pre-trained models has attracted increasing research interests, where linear probing (LP) as a fundamental module is involved in exploiting the final representations for task-dependent classification. However, most of the existing methods focus on how to effectively introduce a few of learnable parameters, and little work pays attention to the commonly used LP module. In this paper, we propose a novel Moment Probing (MP) method to further explore the potential of LP. Distinguished from LP which builds a linear classification head based on the mean of final features (e.g., word tokens for ViT) or classification tokens, our MP performs a linear classifier on feature distribution, which provides the stronger representation ability by exploiting richer statistical information inherent in features. Specifically, we represent feature distribution by its characteristic function, which is efficiently approximated by using first- and second-order moments of features. Furthermore, we propose a multi-head convolutional cross-covariance (MHC^3) to compute second-order moments in an efficient and effective manner. By considering that MP could affect feature learning, we introduce a partially shared module to learn two recalibrating parameters (PSRP) for backbones based on MP, namely MP_{+}. Extensive experiments on ten benchmarks using various models show that our MP significantly outperforms LP and is competitive with counterparts at less training cost, while our MP_{+} achieves state-of-the-art performance.

  • 6 authors
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Jul 21, 2023

Pathology-CoT: Learning Visual Chain-of-Thought Agent from Expert Whole Slide Image Diagnosis Behavior

Diagnosing a whole-slide image is an interactive, multi-stage process involving changes in magnification and movement between fields. Although recent pathology foundation models are strong, practical agentic systems that decide what field to examine next, adjust magnification, and deliver explainable diagnoses are still lacking. The blocker is data: scalable, clinically aligned supervision of expert viewing behavior that is tacit and experience-based, not written in textbooks or online, and therefore absent from large language model training. We introduce the AI Session Recorder, which works with standard WSI viewers to unobtrusively record routine navigation and convert the viewer logs into standardized behavioral commands (inspect or peek at discrete magnifications) and bounding boxes. A lightweight human-in-the-loop review turns AI-drafted rationales into the Pathology-CoT dataset, a form of paired "where to look" and "why it matters" supervision produced at roughly six times lower labeling time. Using this behavioral data, we build Pathologist-o3, a two-stage agent that first proposes regions of interest and then performs behavior-guided reasoning. On gastrointestinal lymph-node metastasis detection, it achieved 84.5% precision, 100.0% recall, and 75.4% accuracy, exceeding the state-of-the-art OpenAI o3 model and generalizing across backbones. To our knowledge, this constitutes one of the first behavior-grounded agentic systems in pathology. Turning everyday viewer logs into scalable, expert-validated supervision, our framework makes agentic pathology practical and establishes a path to human-aligned, upgradeable clinical AI.

zhihuanglab Zhi Huang Lab
·
Oct 6, 2025 2

Automated Circuit Interpretation via Probe Prompting

Mechanistic interpretability aims to understand neural networks by identifying which learned features mediate specific behaviors. Attribution graphs reveal these feature pathways, but interpreting them requires extensive manual analysis -- a single prompt can take approximately 2 hours for an experienced circuit tracer. We present probe prompting, an automated pipeline that transforms attribution graphs into compact, interpretable subgraphs built from concept-aligned supernodes. Starting from a seed prompt and target logit, we select high-influence features, generate concept-targeted yet context-varying probes, and group features by cross-prompt activation signatures into Semantic, Relationship, and Say-X categories using transparent decision rules. Across five prompts including classic "capitals" circuits, probe-prompted subgraphs preserve high explanatory coverage while compressing complexity (Completeness 0.83, mean across circuits; Replacement 0.54). Compared to geometric clustering baselines, concept-aligned groups exhibit higher behavioral coherence: 2.3x higher peak-token consistency (0.425 vs 0.183) and 5.8x higher activation-pattern similarity (0.762 vs 0.130), despite lower geometric compactness. Entity-swap tests reveal a layerwise hierarchy: early-layer features transfer robustly (64% transfer rate, mean layer 6.3), while late-layer Say-X features specialize for output promotion (mean layer 16.4), supporting a backbone-and-specialization view of transformer computation. We release code (https://github.com/peppinob-ol/attribution-graph-probing), an interactive demo (https://huggingface.co/spaces/Peppinob/attribution-graph-probing), and minimal artifacts enabling immediate reproduction and community adoption.

  • 1 authors
·
Nov 10, 2025

Potential of Multimodal Large Language Models for Data Mining of Medical Images and Free-text Reports

Medical images and radiology reports are crucial for diagnosing medical conditions, highlighting the importance of quantitative analysis for clinical decision-making. However, the diversity and cross-source heterogeneity of these data challenge the generalizability of current data-mining methods. Multimodal large language models (MLLMs) have recently transformed many domains, significantly affecting the medical field. Notably, Gemini-Vision-series (Gemini) and GPT-4-series (GPT-4) models have epitomized a paradigm shift in Artificial General Intelligence (AGI) for computer vision, showcasing their potential in the biomedical domain. In this study, we evaluated the performance of the Gemini, GPT-4, and 4 popular large models for an exhaustive evaluation across 14 medical imaging datasets, including 5 medical imaging categories (dermatology, radiology, dentistry, ophthalmology, and endoscopy), and 3 radiology report datasets. The investigated tasks encompass disease classification, lesion segmentation, anatomical localization, disease diagnosis, report generation, and lesion detection. Our experimental results demonstrated that Gemini-series models excelled in report generation and lesion detection but faces challenges in disease classification and anatomical localization. Conversely, GPT-series models exhibited proficiency in lesion segmentation and anatomical localization but encountered difficulties in disease diagnosis and lesion detection. Additionally, both the Gemini series and GPT series contain models that have demonstrated commendable generation efficiency. While both models hold promise in reducing physician workload, alleviating pressure on limited healthcare resources, and fostering collaboration between clinical practitioners and artificial intelligence technologies, substantial enhancements and comprehensive validations remain imperative before clinical deployment.

  • 14 authors
·
Jul 8, 2024

Site-Level Fine-Tuning with Progressive Layer Freezing: Towards Robust Prediction of Bronchopulmonary Dysplasia from Day-1 Chest Radiographs in Extremely Preterm Infants

Bronchopulmonary dysplasia (BPD) is a chronic lung disease affecting 35% of extremely low birth weight infants. Defined by oxygen dependence at 36 weeks postmenstrual age, it causes lifelong respiratory complications. However, preventive interventions carry severe risks, including neurodevelopmental impairment, ventilator-induced lung injury, and systemic complications. Therefore, early BPD prognosis and prediction of BPD outcome is crucial to avoid unnecessary toxicity in low risk infants. Admission radiographs of extremely preterm infants are routinely acquired within 24h of life and could serve as a non-invasive prognostic tool. In this work, we developed and investigated a deep learning approach using chest X-rays from 163 extremely low-birth-weight infants (leq32 weeks gestation, 401-999g) obtained within 24 hours of birth. We fine-tuned a ResNet-50 pretrained specifically on adult chest radiographs, employing progressive layer freezing with discriminative learning rates to prevent overfitting and evaluated a CutMix augmentation and linear probing. For moderate/severe BPD outcome prediction, our best performing model with progressive freezing, linear probing and CutMix achieved an AUROC of 0.78 pm 0.10, balanced accuracy of 0.69 pm 0.10, and an F1-score of 0.67 pm 0.11. In-domain pre-training significantly outperformed ImageNet initialization (p = 0.031) which confirms domain-specific pretraining to be important for BPD outcome prediction. Routine IRDS grades showed limited prognostic value (AUROC 0.57 pm 0.11), confirming the need of learned markers. Our approach demonstrates that domain-specific pretraining enables accurate BPD prediction from routine day-1 radiographs. Through progressive freezing and linear probing, the method remains computationally feasible for site-level implementation and future federated learning deployments.

  • 16 authors
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Jul 16, 2025

Hyperdimensional Probe: Decoding LLM Representations via Vector Symbolic Architectures

Despite their capabilities, Large Language Models (LLMs) remain opaque with limited understanding of their internal representations. Current interpretability methods, such as direct logit attribution (DLA) and sparse autoencoders (SAEs), provide restricted insight due to limitations such as the model's output vocabulary or unclear feature names. This work introduces Hyperdimensional Probe, a novel paradigm for decoding information from the LLM vector space. It combines ideas from symbolic representations and neural probing to project the model's residual stream into interpretable concepts via Vector Symbolic Architectures (VSAs). This probe combines the strengths of SAEs and conventional probes while overcoming their key limitations. We validate our decoding paradigm with controlled input-completion tasks, probing the model's final state before next-token prediction on inputs spanning syntactic pattern recognition, key-value associations, and abstract inference. We further assess it in a question-answering setting, examining the state of the model both before and after text generation. Our experiments show that our probe reliably extracts meaningful concepts across varied LLMs, embedding sizes, and input domains, also helping identify LLM failures. Our work advances information decoding in LLM vector space, enabling extracting more informative, interpretable, and structured features from neural representations.

  • 5 authors
·
Sep 29, 2025 2

A Tutorial on MRI Reconstruction: From Modern Methods to Clinical Implications

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.

  • 7 authors
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Jul 22, 2025

Can Generalist Foundation Models Outcompete Special-Purpose Tuning? Case Study in Medicine

Generalist foundation models such as GPT-4 have displayed surprising capabilities in a wide variety of domains and tasks. Yet, there is a prevalent assumption that they cannot match specialist capabilities of fine-tuned models. For example, most explorations to date on medical competency benchmarks have leveraged domain-specific training, as exemplified by efforts on BioGPT and Med-PaLM. We build on a prior study of GPT-4's capabilities on medical challenge benchmarks in the absence of special training. Rather than using simple prompting to highlight the model's out-of-the-box capabilities, we perform a systematic exploration of prompt engineering. We find that prompting innovation can unlock deeper specialist capabilities and show that GPT-4 easily tops prior leading results for medical benchmarks. The prompting methods we explore are general purpose, and make no specific use of domain expertise, removing the need for expert-curated content. Our experimental design carefully controls for overfitting during the prompt engineering process. We introduce Medprompt, based on a composition of several prompting strategies. With Medprompt, GPT-4 achieves state-of-the-art results on all nine of the benchmark datasets in the MultiMedQA suite. The method outperforms leading specialist models such as Med-PaLM 2 by a significant margin with an order of magnitude fewer calls to the model. Steering GPT-4 with Medprompt achieves a 27% reduction in error rate on the MedQA dataset over the best methods to date achieved with specialist models and surpasses a score of 90% for the first time. Beyond medical problems, we show the power of Medprompt to generalize to other domains and provide evidence for the broad applicability of the approach via studies of the strategy on exams in electrical engineering, machine learning, philosophy, accounting, law, nursing, and clinical psychology.

  • 18 authors
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Nov 27, 2023

Sequential Diagnosis with Language Models

Artificial intelligence holds great promise for expanding access to expert medical knowledge and reasoning. However, most evaluations of language models rely on static vignettes and multiple-choice questions that fail to reflect the complexity and nuance of evidence-based medicine in real-world settings. In clinical practice, physicians iteratively formulate and revise diagnostic hypotheses, adapting each subsequent question and test to what they've just learned, and weigh the evolving evidence before committing to a final diagnosis. To emulate this iterative process, we introduce the Sequential Diagnosis Benchmark, which transforms 304 diagnostically challenging New England Journal of Medicine clinicopathological conference (NEJM-CPC) cases into stepwise diagnostic encounters. A physician or AI begins with a short case abstract and must iteratively request additional details from a gatekeeper model that reveals findings only when explicitly queried. Performance is assessed not just by diagnostic accuracy but also by the cost of physician visits and tests performed. We also present the MAI Diagnostic Orchestrator (MAI-DxO), a model-agnostic orchestrator that simulates a panel of physicians, proposes likely differential diagnoses and strategically selects high-value, cost-effective tests. When paired with OpenAI's o3 model, MAI-DxO achieves 80% diagnostic accuracy--four times higher than the 20% average of generalist physicians. MAI-DxO also reduces diagnostic costs by 20% compared to physicians, and 70% compared to off-the-shelf o3. When configured for maximum accuracy, MAI-DxO achieves 85.5% accuracy. These performance gains with MAI-DxO generalize across models from the OpenAI, Gemini, Claude, Grok, DeepSeek, and Llama families. We highlight how AI systems, when guided to think iteratively and act judiciously, can advance diagnostic precision and cost-effectiveness in clinical care.

  • 15 authors
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Jun 27, 2025

EchoWorld: Learning Motion-Aware World Models for Echocardiography Probe Guidance

Echocardiography is crucial for cardiovascular disease detection but relies heavily on experienced sonographers. Echocardiography probe guidance systems, which provide real-time movement instructions for acquiring standard plane images, offer a promising solution for AI-assisted or fully autonomous scanning. However, developing effective machine learning models for this task remains challenging, as they must grasp heart anatomy and the intricate interplay between probe motion and visual signals. To address this, we present EchoWorld, a motion-aware world modeling framework for probe guidance that encodes anatomical knowledge and motion-induced visual dynamics, while effectively leveraging past visual-motion sequences to enhance guidance precision. EchoWorld employs a pre-training strategy inspired by world modeling principles, where the model predicts masked anatomical regions and simulates the visual outcomes of probe adjustments. Built upon this pre-trained model, we introduce a motion-aware attention mechanism in the fine-tuning stage that effectively integrates historical visual-motion data, enabling precise and adaptive probe guidance. Trained on more than one million ultrasound images from over 200 routine scans, EchoWorld effectively captures key echocardiographic knowledge, as validated by qualitative analysis. Moreover, our method significantly reduces guidance errors compared to existing visual backbones and guidance frameworks, excelling in both single-frame and sequential evaluation protocols. Code is available at https://github.com/LeapLabTHU/EchoWorld.

  • 6 authors
·
Apr 17, 2025

Probe-Geometry Alignment: Erasing the Cross-Sequence Memorization Signature Below Chance

Recent attacks show that behavioural unlearning of large language models leaves internal traces recoverable by adversarial probes. We characterise where this retention lives and show it can be surgically removed without measurable capability cost. Our central protocol is a leave-one-out cross-sequence probe that tests whether a memorisation signature generalises across held-out sequences. The signature is real and consistent across scale: memorisation-specific gaps of +0.32, +0.19, +0.30 on Pythia-70M, GPT-2 medium, and Mistral-7B; on Pythia-70M, the random-initialisation control collapses to -0.04 at the deepest layer where the pretrained signature peaks. The probe direction is causally separable from recall -- projecting it out collapses the signature locally (+0.44 -> -0.19) while behavioural recall barely changes -- and a probe trained on naturally memorised content does not classify fine-tuning-injected secrets, marking two representationally distinct regimes. We then introduce probe-geometry alignment (PGA), a surgical erasure that aligns activations along the probe's live readout direction at each depth. PGA drives the cross-sequence probe below random chance at all four scales tested (toy depth-4: 0.17; Pythia-70M: 0.07; Mistral-7B: 0.45; GPT-2 medium: 0.06 via MD-PGA k=2) and remains robust to six adversarial probe variants. Against a re-fitting attacker who trains a fresh probe on PGA-treated activations, we extend PGA adversarially, defeating the re-fit probe at every memorisation-relevant depth while preserving five zero-shot capability benchmarks within 2.8 percentage points per task (mean Δacc = +0.2pp). The cross-sequence signature is a real, causally separable, regime-specific property of pretrained representations -- removable below chance with a single rank-one intervention per depth at no measurable capability cost.

  • 2 authors
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May 5

VeriLLMed: Interactive Visual Debugging of Medical Large Language Models with Knowledge Graphs

Large language models (LLMs) show promise in medical diagnosis, but real-world deployment remains challenging due to high-stakes clinical decisions and imperfect reasoning reliability. As a result, careful inspection of model behavior is essential for assessing whether diagnostic reasoning is reliable and clinically grounded. However, debugging medical LLMs remains difficult. First, developers often lack sufficient medical domain expertise to interpret model errors in clinically meaningful terms. Second, models can fail across a large and diverse set of instances involving different input types, tasks, and reasoning steps, making it challenging for developers to prioritize which errors deserve focused inspection. Third, developers struggle to identify recurring error patterns across cases, as existing debugging practices are largely instance-centric and rely on manual inspection of isolated failures. To address these challenges, we present VeriLLMed, a visual analytics system that integrates external biomedical knowledge to audit and debug medical LLM diagnostic reasoning. VeriLLMed transforms model outputs into comparable reasoning paths, constructs knowledge graph-grounded reference paths, and identifies three recurring classes of diagnosis errors: relation errors, branch errors, and missing errors. Case studies and expert evaluation demonstrate that VeriLLMed helps developers identify clinically implausible reasoning and generate actionable insights that can inform the improvement of medical LLMs.

  • 10 authors
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Apr 24

Towards Accurate Differential Diagnosis with Large Language Models

An accurate differential diagnosis (DDx) is a cornerstone of medical care, often reached through an iterative process of interpretation that combines clinical history, physical examination, investigations and procedures. Interactive interfaces powered by Large Language Models (LLMs) present new opportunities to both assist and automate aspects of this process. In this study, we introduce an LLM optimized for diagnostic reasoning, and evaluate its ability to generate a DDx alone or as an aid to clinicians. 20 clinicians evaluated 302 challenging, real-world medical cases sourced from the New England Journal of Medicine (NEJM) case reports. Each case report was read by two clinicians, who were randomized to one of two assistive conditions: either assistance from search engines and standard medical resources, or LLM assistance in addition to these tools. All clinicians provided a baseline, unassisted DDx prior to using the respective assistive tools. Our LLM for DDx exhibited standalone performance that exceeded that of unassisted clinicians (top-10 accuracy 59.1% vs 33.6%, [p = 0.04]). Comparing the two assisted study arms, the DDx quality score was higher for clinicians assisted by our LLM (top-10 accuracy 51.7%) compared to clinicians without its assistance (36.1%) (McNemar's Test: 45.7, p < 0.01) and clinicians with search (44.4%) (4.75, p = 0.03). Further, clinicians assisted by our LLM arrived at more comprehensive differential lists than those without its assistance. Our study suggests that our LLM for DDx has potential to improve clinicians' diagnostic reasoning and accuracy in challenging cases, meriting further real-world evaluation for its ability to empower physicians and widen patients' access to specialist-level expertise.

  • 28 authors
·
Nov 30, 2023 1

SymptomAI: Towards a Conversational AI Agent for Everyday Symptom Assessment

Language models excel at diagnostic assessments on currated medical case-studies and vignettes, performing on par with, or better than, clinical professionals. However, existing studies focus on complex scenarios with rich context making it difficult to draw conclusions about how these systems perform for patients reporting symptoms in everyday life. We deployed SymptomAI, a set of conversational AI agents for end-to-end patient interviewing and differential diagnosis (DDx), via the Fitbit app in a study that randomized participants (N=13,917) to interact with five AI agents. This corpus captures diverse communication and a realistic distribution of illnesses from a real world population. A subset of 1,228 participants reported a clinician-provided diagnosis, and 517 of these were further evaluated by a panel of clinicians during over 250 hours of annotation. SymptomAI DDx were significantly more accurate (OR = 2.47, p < 0.001) than those from independent clinicians given the same dialogue in a blinded randomized comparison. Moreover, agentic strategies which conduct a dedicated symptom interview that elicit additional symptom information before providing a diagnosis, perform substantially better than baseline, user-guided conversations (p < 0.001). An auxiliary analysis on 1,509 conversations from a general US population panel validated that these results generalize beyond wearable device users. We used SymptomAI diagnoses as labels for all 13,917 participants to analyze over 500,000 days of wearable metrics across nearly 400 unique conditions. We identified strong associations between acute infections and physiological shifts (e.g., OR > 7 for influenza). While limited by self-reported ground truth, these results demonstrate the benefits of a dedicated and complete symptom interview compared to a user-guided symptom discussion, which is the default of most consumer LLMs.

  • 33 authors
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May 4 1

Towards Conversational Diagnostic AI

At the heart of medicine lies the physician-patient dialogue, where skillful history-taking paves the way for accurate diagnosis, effective management, and enduring trust. Artificial Intelligence (AI) systems capable of diagnostic dialogue could increase accessibility, consistency, and quality of care. However, approximating clinicians' expertise is an outstanding grand challenge. Here, we introduce AMIE (Articulate Medical Intelligence Explorer), a Large Language Model (LLM) based AI system optimized for diagnostic dialogue. AMIE uses a novel self-play based simulated environment with automated feedback mechanisms for scaling learning across diverse disease conditions, specialties, and contexts. We designed a framework for evaluating clinically-meaningful axes of performance including history-taking, diagnostic accuracy, management reasoning, communication skills, and empathy. We compared AMIE's performance to that of primary care physicians (PCPs) in a randomized, double-blind crossover study of text-based consultations with validated patient actors in the style of an Objective Structured Clinical Examination (OSCE). The study included 149 case scenarios from clinical providers in Canada, the UK, and India, 20 PCPs for comparison with AMIE, and evaluations by specialist physicians and patient actors. AMIE demonstrated greater diagnostic accuracy and superior performance on 28 of 32 axes according to specialist physicians and 24 of 26 axes according to patient actors. Our research has several limitations and should be interpreted with appropriate caution. Clinicians were limited to unfamiliar synchronous text-chat which permits large-scale LLM-patient interactions but is not representative of usual clinical practice. While further research is required before AMIE could be translated to real-world settings, the results represent a milestone towards conversational diagnostic AI.

  • 25 authors
·
Jan 10, 2024

Non-Holomorphic Impact on t-b-τ Yukawa Unification in minimal GMSB

We study and explore the low scale implications of Yukawa unification in the minimal gauge mediated supersymmetry breaking models. We also assume non-zero non-holomorphic terms, with which the YU solutions can be accommodated in the cases with μ> 0. These results can be considered a direct effect from the non-holomorphic terms, but they also lead to testable low scale implications compatible with YU. We observe abundant solutions consistent with the Higgs boson mass. This constraint leads to heavy strongly interacting supersymmetric particles, while the electroweak sector can be realized relatively lighter and they can be probed by several experiments. We find that the chargino can be lighter than 1 TeV and it is degenerate with the lightest neutralino in most of such solutions. Consistent solutions in this region can accommodate charginos as light as about 120 GeV, and they will be tested more likely soon by the analyses over the compressed spectra. These solutions are also be subjected in the lifetime analyses. Our analyses identify such light charginos decaying in about 10^{-2} ns. Probing such points may need a slight improvement in sensitivity of the analyses, and one can expect them to be tested very soon. In the same region, stau is realized to be another light supersymmetric particle, and some of the solutions can be inconsistently lighter. We find that it can weigh as light as about 600 GeV consistently, and it can be tested also soon over its lifetime. We summarize and also exemplify our findings with five benchmark scenarios. Most of the benchmark solutions also reveal that the solutions can be tested in heavy Higgs boson searches, which shape the whole Higgs boson spectrum in models.

  • 3 authors
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May 2

X-RAY: Mapping LLM Reasoning Capability via Formalized and Calibrated Probes

Large language models (LLMs) achieve promising performance, yet their ability to reason remains poorly understood. Existing evaluations largely emphasize task-level accuracy, often conflating pattern matching with reasoning capability. We present X-RAY, an explainable reasoning analysis system that maps the LLM reasoning capability using calibrated, formally verified probes. We model reasoning capability as a function of extractable structure, operationalized through formal properties such as constraint interaction, reasoning depth, and solution-space geometry. X-Ray generates probes via formal tools with controlled structural variations, enabling precise isolation of incremental structural information through formal calibration and verification. We evaluate state-of-the-art LLMs on problems ranging from junior-level to advanced in mathematics, physics, and chemistry. Our analysis reveals a systematic asymmetry in LLM reasoning: models are relatively robust to constraint refinement, where additional conditions shrink an existing solution space, but degrade sharply under solution-space restructuring, where modifications alter the underlying structural form of the solution manifold. Moreover, calibrated formal probes differentiate models that appear indistinguishable on standard benchmarks and reveal failure modes that are structurally interpretable rather than opaque. Beyond evaluation, our framework is contamination-free and supports the training and testing of reasoning models.

  • 4 authors
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Mar 4

What Does My QA Model Know? Devising Controlled Probes using Expert Knowledge

Open-domain question answering (QA) is known to involve several underlying knowledge and reasoning challenges, but are models actually learning such knowledge when trained on benchmark tasks? To investigate this, we introduce several new challenge tasks that probe whether state-of-the-art QA models have general knowledge about word definitions and general taxonomic reasoning, both of which are fundamental to more complex forms of reasoning and are widespread in benchmark datasets. As an alternative to expensive crowd-sourcing, we introduce a methodology for automatically building datasets from various types of expert knowledge (e.g., knowledge graphs and lexical taxonomies), allowing for systematic control over the resulting probes and for a more comprehensive evaluation. We find automatically constructing probes to be vulnerable to annotation artifacts, which we carefully control for. Our evaluation confirms that transformer-based QA models are already predisposed to recognize certain types of structural lexical knowledge. However, it also reveals a more nuanced picture: their performance degrades substantially with even a slight increase in the number of hops in the underlying taxonomic hierarchy, or as more challenging distractor candidate answers are introduced. Further, even when these models succeed at the standard instance-level evaluation, they leave much room for improvement when assessed at the level of clusters of semantically connected probes (e.g., all Isa questions about a concept).

  • 2 authors
·
Dec 31, 2019

MEDDxAgent: A Unified Modular Agent Framework for Explainable Automatic Differential Diagnosis

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

  • 6 authors
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Feb 26, 2025

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

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

  • 5 authors
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Jan 19

RareBench: Can LLMs Serve as Rare Diseases Specialists?

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

  • 6 authors
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Feb 9, 2024

ReGround: Restoring Visual Grounding in Multi-Step Reasoning through Self-Diagnosis and Visual Re-Examination

Vision-Language Models (VLMs) often lose visual grounding during multi-step reasoning: as reasoning chains grow longer, later inference steps rely increasingly on language priors rather than image evidence. We identify a consistent benchmark-level signature associated with this degradation: across 2,510 re-examined samples from four benchmarks, attention entropy over image tokens typically decreases during Round 1 and rises again after image re-injection. However, we find that effective visual re-examination requires two complementary ingredients: image re-injection and targeted self-diagnosis. Without targeted diagnosis, re-examination can even hurt performance, whereas accurate self-diagnosis yields substantial gains -- a swing of several points on key benchmarks, indicating that diagnostic quality is a key factor in whether re-examination helps or hurts in our setting. We present ReGround, a two-stage framework that teaches VLMs to self-diagnose grounding failures and selectively re-examine visual evidence, without architectural modifications or external tools. Through capability bootstrapping, a stronger variant from the same model family provides diagnostic scaffolding only during data construction, while the policy model learns to diagnose autonomously at inference time and retains most of the assisted gains. Experiments on eight benchmarks across two VLM backbones demonstrate consistent gains, especially on visually intensive multi-step reasoning tasks, while incurring only modest inference overhead relative to tool-augmented baselines. Project page: https://sespoir.github.io/reground-page/ . Code: https://github.com/sespoir/ReGround .

  • 3 authors
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Aug 4

DiagnosisArena: Benchmarking Diagnostic Reasoning for Large Language Models

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.

  • 8 authors
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May 20, 2025

AEGIS: A Backup Reflex for Physical AI

Long-horizon robot manipulation tends to fail gradually: one bad step degrades the state, and the policy spirals into a basin from which it cannot recover. The failure is often visible before it happens. We introduce AEGIS (Activation-probe Early-warning, Gated Inference Switching), a selective escalation method that uses a lightweight probe on a weak policy's frozen activations to detect high-risk steps while there is still time to act. When the probe flags a step, control switches to a stronger separate policy, but only for the steps that need it. On LIBERO-Spatial, AEGIS recovers 10.1% of the trajectories the weak policy alone loses, versus 4.6% for budget-matched blind escalation and 5.1% for a random-trigger placebo. These gains are significant under one-sided exact paired McNemar tests with Holm-Bonferroni adjustment over three pre-registered contrasts: +5.4pp over blind escalation, p=8.5e-6; +5.0pp over random triggering, p=1.0e-4; paired-trajectory bootstrap CIs exclude zero. AEGIS activates the stronger policy on only 38% of steps, so the lever is timing rather than compute. The probe clears its precondition with an early-window AUROC of 0.764, 95% CI [0.70, 0.84], read from the weak-policy path over the first 30% of trajectory steps before any handoff. We pre-register the full analysis plan, including a conditional recovered-task-rate estimand and explicit kill criteria, and confirm the result on 700 common-random-number episodes per arm, with nA-fail=646.

  • 1 authors
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Jun 3

SHOVIR: A Benchmark for Evaluating Vision Shortcut Learning in Radiology Report Generation

Current evaluation protocols for Vision-Language Models (VLMs) in Radiology Report Generation (RRG) rely on report-level metrics that measure lexical overlap or aggregate clinical correctness. However, such metrics do not test whether individual diagnostic statements stem from the actual pathological evidence visible in the image. This allows models to achieve competitive scores by exploiting learned priors or spurious correlations, a failure mode we refer to as vision shortcut. We introduce SHOVIR, a benchmark for evaluating vision shortcut behavior in RRG. SHOVIR extends two spatially annotated chest X-ray datasets, MIMIC-CXR and PadChest-GR, with per-box CheXpert labels, and defines image-level and disease-level occlusion experiments that contrast baseline performance on clean images against localized, region-specific perturbations. Comparing predictions across these conditions isolates two failure modes at the disease-class level: direct shortcuts, where a finding persists after its visual evidence is removed, and contextual shortcuts, where detection degrades once co-occurring pathologies are occluded despite the target region remaining intact. Benchmarking eight state-of-the-art VLMs, we find that shortcut behavior varies substantially across architectures and datasets. Models achieving the highest baseline report quality do not necessarily rank highest in spatial grounding, revealing that clinically fluent generation can coexist with shallow reliance on visual evidence. These findings expose a blind spot in current RRG evaluation and motivate region-aware assessment protocols.

  • 5 authors
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Jun 28

Curiosity-driven Red-teaming for Large Language Models

Large language models (LLMs) hold great potential for many natural language applications but risk generating incorrect or toxic content. To probe when an LLM generates unwanted content, the current paradigm is to recruit a red team of human testers to design input prompts (i.e., test cases) that elicit undesirable responses from LLMs. However, relying solely on human testers is expensive and time-consuming. Recent works automate red teaming by training a separate red team LLM with reinforcement learning (RL) to generate test cases that maximize the chance of eliciting undesirable responses from the target LLM. However, current RL methods are only able to generate a small number of effective test cases resulting in a low coverage of the span of prompts that elicit undesirable responses from the target LLM. To overcome this limitation, we draw a connection between the problem of increasing the coverage of generated test cases and the well-studied approach of curiosity-driven exploration that optimizes for novelty. Our method of curiosity-driven red teaming (CRT) achieves greater coverage of test cases while mantaining or increasing their effectiveness compared to existing methods. Our method, CRT successfully provokes toxic responses from LLaMA2 model that has been heavily fine-tuned using human preferences to avoid toxic outputs. Code is available at https://github.com/Improbable-AI/curiosity_redteam

  • 8 authors
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Feb 29, 2024

VERITAS: A Multi-Agent Co-Scientist for Verifiable Image-Derived Hypothesis Testing

Scientific research based on multimodal clinical data (including medical imaging) requires coordinating clinical, radiological, programming, and biostatistical expertise, a fragmented process that bottlenecks discovery. We present VERITAS (Verifiable Epistemic Reasoning for Image-Derived Hypothesis Testing via Agentic Systems), a clinical co-scientist: a multi-agent system that autonomously tests natural-language hypotheses and produces a fully auditable evidence trail, tracing every conclusion through executable outputs from analysis plan to segmentation masks to statistical code to final verdict. Unlike prior AI-scientist systems, which mainly operate on tabular or text data, VERITAS grounds autonomous discovery directly in medical images. It decomposes the workflow into four phases handled by role-specialized agents, and introduces an epistemic evidence label framework that mechanically classifies outcomes as Supported, Refuted, Underpowered, or Invalid by jointly evaluating significance, effect direction, and study power. This distinction is critical in medical imaging, where non-significant results often reflect insufficient sample size rather than absent effects. We construct a tiered benchmark of 64 hypotheses spanning six complexity levels across cardiac and brain glioma MRI datasets. VERITAS reaches 81.4% verdict accuracy with frontier models and 71.2% with locally-hosted open-weight models (8-30B), outperforming all single-model baselines in both classes. It also produces the highest rate of independently verifiable statistical outputs (86.6%), so even its failures remain diagnosable through artifact inspection. Structured multi-agent decomposition thus substitutes for model scale while preserving the verifiability that scientific discovery demands. We release code, hypothesis bank, and evaluation pipeline at https://github.com/LucZot/veritas.

  • 3 authors
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Jun 30

Closing the Activation-Cone Blind Spot: Response-Time Probing and Unified Defense

Inference-time safety methods for large language models have proliferated, yet no systematic comparison exists. We evaluate five defense paradigms (no defense, static steering, CAST, AlphaSteer, probe-gated) across seven instruction-tuned models (7-31B) and five attack types (GCG, AutoDAN, DeepInception, prefilling, intent laundering). Our central finding: prompt-time activation defenses are structurally blind to prefilling attacks. AlphaSteer achieves 0% attack success on GCG, AutoDAN, and intent laundering but 50% on prefilling. We prove a corollary: any defense that gates intervention on a single layer's activation alignment with a benign reference (cone, subspace, or null-space) is blind to attacks that craft activations to lie inside that reference, whether checked at prompt time or per token. As its constructive contrapositive we introduce response-time probing: a linear probe on the model's hidden state at the first generated tokens, with AUROC 0.97-1.00 across all seven models. Combined with a halt, it cuts prefilling attack success to 0/40 on every model with 0% benign false positives, outperforming Llama Guard 3. Cross-template generalisation depends on probe depth, so we scope the claim to the canonical prefilling-template family. Composing the response-halt with AlphaSteer's null-space steering gives an orthogonal split (the halt catches prefilling, AlphaSteer catches semantic attacks), reaching defense success 0.983 on Mistral and 0.994 on Llama and dominating both components. We further show MMLU fails to capture steering's true utility cost, which appears as behavioral hedging rather than factual loss, and that diverse negative training sets cut probe false positives from 80-100% to near zero. Code, attacks, per-sample results, and the judge prompt are released.

  • 1 authors
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Jun 27

MedAgent-Pro: Towards Multi-modal Evidence-based Medical Diagnosis via Reasoning Agentic Workflow

Developing reliable AI systems to assist human clinicians in multi-modal medical diagnosis has long been a key objective for researchers. Recently, Multi-modal Large Language Models (MLLMs) have gained significant attention and achieved success across various domains. With strong reasoning capabilities and the ability to perform diverse tasks based on user instructions, they hold great potential for enhancing medical diagnosis. However, directly applying MLLMs to the medical domain still presents challenges. They lack detailed perception of visual inputs, limiting their ability to perform quantitative image analysis, which is crucial for medical diagnostics. Additionally, MLLMs often exhibit hallucinations and inconsistencies in reasoning, whereas clinical diagnoses must adhere strictly to established criteria. To address these challenges, we propose MedAgent-Pro, an evidence-based reasoning agentic system designed to achieve reliable, explainable, and precise medical diagnoses. This is accomplished through a hierarchical workflow: at the task level, knowledge-based reasoning generate reliable diagnostic plans for specific diseases following retrieved clinical criteria. While at the case level, multiple tool agents process multi-modal inputs, analyze different indicators according to the plan, and provide a final diagnosis based on both quantitative and qualitative evidence. Comprehensive experiments on both 2D and 3D medical diagnosis tasks demonstrate the superiority and effectiveness of MedAgent-Pro, while case studies further highlight its reliability and interpretability. The code is available at https://github.com/jinlab-imvr/MedAgent-Pro.

  • 4 authors
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Mar 21, 2025 2

Do uHear? Validation of uHear App for Preliminary Screening of Hearing Ability in Soundscape Studies

Studies involving soundscape perception often exclude participants with hearing loss to prevent impaired perception from affecting experimental results. Participants are typically screened with pure tone audiometry, the "gold standard" for identifying and quantifying hearing loss at specific frequencies, and excluded if a study-dependent threshold is not met. However, procuring professional audiometric equipment for soundscape studies may be cost-ineffective, and manually performing audiometric tests is labour-intensive. Moreover, testing requirements for soundscape studies may not require sensitivities and specificities as high as that in a medical diagnosis setting. Hence, in this study, we investigate the effectiveness of the uHear app, an iOS application, as an affordable and automatic alternative to a conventional audiometer in screening participants for hearing loss for the purpose of soundscape studies or listening tests in general. Based on audiometric comparisons with the audiometer of 163 participants, the uHear app was found to have high precision (98.04%) when using the World Health Organization (WHO) grading scheme for assessing normal hearing. Precision is further improved (98.69%) when all frequencies assessed with the uHear app is considered in the grading, which lends further support to this cost-effective, automated alternative to screen for normal hearing.

  • 6 authors
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Jul 16, 2022