Daily Papers

In health, most large language model (LLM) research has focused on clinical tasks. However, mobile and wearable devices, which are rarely integrated into such tasks, provide rich, longitudinal data for personal health monitoring. Here we present Personal Health Large Language Model (PH-LLM), fine-tuned from Gemini for understanding and reasoning over numerical time-series personal health data. We created and curated three datasets that test 1) production of personalized insights and recommendations from sleep patterns, physical activity, and physiological responses, 2) expert domain knowledge, and 3) prediction of self-reported sleep outcomes. For the first task we designed 857 case studies in collaboration with domain experts to assess real-world scenarios in sleep and fitness. Through comprehensive evaluation of domain-specific rubrics, we observed that Gemini Ultra 1.0 and PH-LLM are not statistically different from expert performance in fitness and, while experts remain superior for sleep, fine-tuning PH-LLM provided significant improvements in using relevant domain knowledge and personalizing information for sleep insights. We evaluated PH-LLM domain knowledge using multiple choice sleep medicine and fitness examinations. PH-LLM achieved 79% on sleep and 88% on fitness, exceeding average scores from a sample of human experts. Finally, we trained PH-LLM to predict self-reported sleep quality outcomes from textual and multimodal encoding representations of wearable data, and demonstrate that multimodal encoding is required to match performance of specialized discriminative models. Although further development and evaluation are necessary in the safety-critical personal health domain, these results demonstrate both the broad knowledge and capabilities of Gemini models and the benefit of contextualizing physiological data for personal health applications as done with PH-LLM.

Large language models (LLMs) have performed well in providing general and extensive health suggestions in single-turn conversations, exemplified by systems such as ChatGPT, ChatGLM, ChatDoctor, DoctorGLM, and etc. However, the limited information provided by users during single turn results in inadequate personalization and targeting of the generated suggestions, which requires users to independently select the useful part. It is mainly caused by the missing ability to engage in multi-turn questioning. In real-world medical consultations, doctors usually employ a series of iterative inquiries to comprehend the patient's condition thoroughly, enabling them to provide effective and personalized suggestions subsequently, which can be defined as chain of questioning (CoQ) for LLMs. To improve the CoQ of LLMs, we propose BianQue, a ChatGLM-based LLM finetuned with the self-constructed health conversation dataset BianQueCorpus that is consist of multiple turns of questioning and health suggestions polished by ChatGPT. Experimental results demonstrate that the proposed BianQue can simultaneously balance the capabilities of both questioning and health suggestions, which will help promote the research and application of LLMs in the field of proactive health.

Large language models (LLMs) are transforming the ways the general public accesses and consumes information. Their influence is particularly pronounced in pivotal sectors like healthcare, where lay individuals are increasingly appropriating LLMs as conversational agents for everyday queries. While LLMs demonstrate impressive language understanding and generation proficiencies, concerns regarding their safety remain paramount in these high-stake domains. Moreover, the development of LLMs is disproportionately focused on English. It remains unclear how these LLMs perform in the context of non-English languages, a gap that is critical for ensuring equity in the real-world use of these systems.This paper provides a framework to investigate the effectiveness of LLMs as multi-lingual dialogue systems for healthcare queries. Our empirically-derived framework XlingEval focuses on three fundamental criteria for evaluating LLM responses to naturalistic human-authored health-related questions: correctness, consistency, and verifiability. Through extensive experiments on four major global languages, including English, Spanish, Chinese, and Hindi, spanning three expert-annotated large health Q&A datasets, and through an amalgamation of algorithmic and human-evaluation strategies, we found a pronounced disparity in LLM responses across these languages, indicating a need for enhanced cross-lingual capabilities. We further propose XlingHealth, a cross-lingual benchmark for examining the multilingual capabilities of LLMs in the healthcare context. Our findings underscore the pressing need to bolster the cross-lingual capacities of these models, and to provide an equitable information ecosystem accessible to all.

In this study, we investigated the ability of the large language model (LLM) to enhance healthcare data interoperability. We leveraged the LLM to convert clinical texts into their corresponding FHIR resources. Our experiments, conducted on 3,671 snippets of clinical text, demonstrated that the LLM not only streamlines the multi-step natural language processing and human calibration processes but also achieves an exceptional accuracy rate of over 90% in exact matches when compared to human annotations.

Recent large language models (LLMs) offer the potential to support public health monitoring by facilitating health disclosure through open-ended conversations but rarely preserve the knowledge gained about individuals across repeated interactions. Augmenting LLMs with long-term memory (LTM) presents an opportunity to improve engagement and self-disclosure, but we lack an understanding of how LTM impacts people's interaction with LLM-driven chatbots in public health interventions. We examine the case of CareCall -- an LLM-driven voice chatbot with LTM -- through the analysis of 1,252 call logs and interviews with nine users. We found that LTM enhanced health disclosure and fostered positive perceptions of the chatbot by offering familiarity. However, we also observed challenges in promoting self-disclosure through LTM, particularly around addressing chronic health conditions and privacy concerns. We discuss considerations for LTM integration in LLM-driven chatbots for public health monitoring, including carefully deciding what topics need to be remembered in light of public health goals.

Large Language Models (LLMs) have gained significant attention in the medical domain for their human-level capabilities, leading to increased efforts to explore their potential in various healthcare applications. However, despite such a promising future, there are multiple challenges and obstacles that remain for their real-world uses in practical settings. This work discusses key challenges for LLMs in medical applications from four unique aspects: operational vulnerabilities, ethical and social considerations, performance and assessment difficulties, and legal and regulatory compliance. Addressing these challenges is crucial for leveraging LLMs to their full potential and ensuring their responsible integration into healthcare.

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

Large language models (LLMs) are a class of language models that have demonstrated outstanding performance across a range of natural language processing (NLP) tasks and have become a highly sought-after research area, because of their ability to generate human-like language and their potential to revolutionize science and technology. In this study, we conduct bibliometric and discourse analyses of scholarly literature on LLMs. Synthesizing over 5,000 publications, this paper serves as a roadmap for researchers, practitioners, and policymakers to navigate the current landscape of LLMs research. We present the research trends from 2017 to early 2023, identifying patterns in research paradigms and collaborations. We start with analyzing the core algorithm developments and NLP tasks that are fundamental in LLMs research. We then investigate the applications of LLMs in various fields and domains including medicine, engineering, social science, and humanities. Our review also reveals the dynamic, fast-paced evolution of LLMs research. Overall, this paper offers valuable insights into the current state, impact, and potential of LLMs research and its applications.

We aim to present a comprehensive overview of the latest advancements in utilizing Large Language Models (LLMs) within the healthcare sector, emphasizing their transformative impact across various medical domains. LLMs have become pivotal in supporting healthcare, including physicians, healthcare providers, and patients. Our review provides insight into the applications of Large Language Models (LLMs) in healthcare, specifically focusing on diagnostic and treatment-related functionalities. We shed light on how LLMs are applied in cancer care, dermatology, dental care, neurodegenerative disorders, and mental health, highlighting their innovative contributions to medical diagnostics and patient care. Throughout our analysis, we explore the challenges and opportunities associated with integrating LLMs in healthcare, recognizing their potential across various medical specialties despite existing limitations. Additionally, we offer an overview of handling diverse data types within the medical field.

Large language models (LLMs) represent a transformative class of AI tools capable of revolutionizing various aspects of healthcare by generating human-like responses across diverse contexts and adapting to novel tasks following human instructions. Their potential application spans a broad range of medical tasks, such as clinical documentation, matching patients to clinical trials, and answering medical questions. In this primer paper, we propose an actionable guideline to help healthcare professionals more efficiently utilize LLMs in their work, along with a set of best practices. This approach consists of several main phases, including formulating the task, choosing LLMs, prompt engineering, fine-tuning, and deployment. We start with the discussion of critical considerations in identifying healthcare tasks that align with the core capabilities of LLMs and selecting models based on the selected task and data, performance requirements, and model interface. We then review the strategies, such as prompt engineering and fine-tuning, to adapt standard LLMs to specialized medical tasks. Deployment considerations, including regulatory compliance, ethical guidelines, and continuous monitoring for fairness and bias, are also discussed. By providing a structured step-by-step methodology, this tutorial aims to equip healthcare professionals with the tools necessary to effectively integrate LLMs into clinical practice, ensuring that these powerful technologies are applied in a safe, reliable, and impactful manner.

Large Language Models (LLMs) have rapidly become important tools in Biomedical and Health Informatics (BHI), enabling new ways to analyze data, treat patients, and conduct research. This bibliometric review aims to provide a panoramic view of how LLMs have been used in BHI by examining research articles and collaboration networks from 2022 to 2023. It further explores how LLMs can improve Natural Language Processing (NLP) applications in various BHI areas like medical diagnosis, patient engagement, electronic health record management, and personalized medicine. To do this, our bibliometric review identifies key trends, maps out research networks, and highlights major developments in this fast-moving field. Lastly, it discusses the ethical concerns and practical challenges of using LLMs in BHI, such as data privacy and reliable medical recommendations. Looking ahead, we consider how LLMs could further transform biomedical research as well as healthcare delivery and patient outcomes. This bibliometric review serves as a resource for stakeholders in healthcare, including researchers, clinicians, and policymakers, to understand the current state and future potential of LLMs in BHI.

Large language models (LLMs) hold significant potential for mental health support, capable of generating empathetic responses and simulating therapeutic conversations. However, existing LLM-based approaches often lack the clinical grounding necessary for real-world psychological counseling, particularly in explicit diagnostic reasoning aligned with standards like the DSM/ICD and incorporating diverse therapeutic modalities beyond basic empathy or single strategies. To address these critical limitations, we propose PsyLLM, the first large language model designed to systematically integrate both diagnostic and therapeutic reasoning for mental health counseling. To develop the PsyLLM, we propose a novel automated data synthesis pipeline. This pipeline processes real-world mental health posts, generates multi-turn dialogue structures, and leverages LLMs guided by international diagnostic standards (e.g., DSM/ICD) and multiple therapeutic frameworks (e.g., CBT, ACT, psychodynamic) to simulate detailed clinical reasoning processes. Rigorous multi-dimensional filtering ensures the generation of high-quality, clinically aligned dialogue data. In addition, we introduce a new benchmark and evaluation protocol, assessing counseling quality across four key dimensions: comprehensiveness, professionalism, authenticity, and safety. Our experiments demonstrate that PsyLLM significantly outperforms state-of-the-art baseline models on this benchmark.

Large language models (LLMs) have received much attention and shown their potential in digital health, while their application in mental health is subject to ongoing debate. This systematic review aims to summarize and characterize the use of LLMs in mental health by investigating the strengths and limitations of the latest work in LLMs and discusses the challenges and opportunities for early screening, digital interventions, and other clinical applications in mental health. Following PRISMA guidelines, we examined English articles from PubMed, DBLP Computer Science Bibliography, and IEEE Xplore, published between 1 January 2017, and 1 September 2023, focusing on mental health and LLMs. The review analyzed 32 articles, including mental health analysis using social media datasets (n=13), mental health chatbots (n=10), and other mental health applications (n=9). Findings reveal LLMs' effectiveness in mental health issue detection and the enhancement of telepsychological services through personalised healthcare. Nonetheless, risks like text inconsistencies, hallucinatory content, and the lack of an ethical framework raise concerns about their clinical use. Despite these challenges, the advancement of LLMs underscores their potential as innovative clinical tools, necessitating further research and development. The review emphasizes that LLMs should complement, not replace, professional mental health services.

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

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

Large language models (LLMs), such as ChatGPT, have received substantial attention due to their impressive human language understanding and generation capabilities. Therefore, the application of LLMs in medicine to assist physicians and patient care emerges as a promising research direction in both artificial intelligence and clinical medicine. To reflect this trend, this survey provides a comprehensive overview of the principles, applications, and challenges faced by LLMs in medicine. Specifically, we aim to address the following questions: 1) How can medical LLMs be built? 2) What are the downstream performances of medical LLMs? 3) How can medical LLMs be utilized in real-world clinical practice? 4) What challenges arise from the use of medical LLMs? and 5) How can we better construct and utilize medical LLMs? As a result, this survey aims to provide insights into the opportunities and challenges of LLMs in medicine and serve as a valuable resource for constructing practical and effective medical LLMs. A regularly updated list of practical guides on medical LLMs can be found at https://github.com/AI-in-Health/MedLLMsPracticalGuide.

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

Large language models (LLMs) have been applied to tasks in healthcare, ranging from medical exam questions to responding to patient questions. With increasing institutional partnerships between companies producing LLMs and healthcare systems, real world clinical application is coming closer to reality. As these models gain traction, it is essential for healthcare practitioners to understand what LLMs are, their development, their current and potential applications, and the associated pitfalls when utilized in medicine. This review and accompanying tutorial aim to give an overview of these topics to aid healthcare practitioners in understanding the rapidly changing landscape of LLMs as applied to medicine.

Background: Recent advancements in large language models (LLMs) offer potential benefits in healthcare, particularly in processing extensive patient records. However, existing benchmarks do not fully assess LLMs' capability in handling real-world, lengthy clinical data. Methods: We present the LongHealth benchmark, comprising 20 detailed fictional patient cases across various diseases, with each case containing 5,090 to 6,754 words. The benchmark challenges LLMs with 400 multiple-choice questions in three categories: information extraction, negation, and sorting, challenging LLMs to extract and interpret information from large clinical documents. Results: We evaluated nine open-source LLMs with a minimum of 16,000 tokens and also included OpenAI's proprietary and cost-efficient GPT-3.5 Turbo for comparison. The highest accuracy was observed for Mixtral-8x7B-Instruct-v0.1, particularly in tasks focused on information retrieval from single and multiple patient documents. However, all models struggled significantly in tasks requiring the identification of missing information, highlighting a critical area for improvement in clinical data interpretation. Conclusion: While LLMs show considerable potential for processing long clinical documents, their current accuracy levels are insufficient for reliable clinical use, especially in scenarios requiring the identification of missing information. The LongHealth benchmark provides a more realistic assessment of LLMs in a healthcare setting and highlights the need for further model refinement for safe and effective clinical application. We make the benchmark and evaluation code publicly available.

Large language models (LLMs) have demonstrated remarkable success in NLP tasks. However, there is a paucity of studies that attempt to evaluate their performances on social media-based health-related natural language processing tasks, which have traditionally been difficult to achieve high scores in. We benchmarked one supervised classic machine learning model based on Support Vector Machines (SVMs), three supervised pretrained language models (PLMs) based on RoBERTa, BERTweet, and SocBERT, and two LLM based classifiers (GPT3.5 and GPT4), across 6 text classification tasks. We developed three approaches for leveraging LLMs for text classification: employing LLMs as zero-shot classifiers, us-ing LLMs as annotators to annotate training data for supervised classifiers, and utilizing LLMs with few-shot examples for augmentation of manually annotated data. Our comprehensive experiments demonstrate that employ-ing data augmentation using LLMs (GPT-4) with relatively small human-annotated data to train lightweight supervised classification models achieves superior results compared to training with human-annotated data alone. Supervised learners also outperform GPT-4 and GPT-3.5 in zero-shot settings. By leveraging this data augmentation strategy, we can harness the power of LLMs to develop smaller, more effective domain-specific NLP models. LLM-annotated data without human guidance for training light-weight supervised classification models is an ineffective strategy. However, LLM, as a zero-shot classifier, shows promise in excluding false negatives and potentially reducing the human effort required for data annotation. Future investigations are imperative to explore optimal training data sizes and the optimal amounts of augmented data.

Diabetes is a chronic disease that poses a significant global health burden, and optimizing diabetes management requires multi-stakeholder collaboration. Large language models (LLMs) have shown promise in various healthcare scenarios, but their effectiveness across a diverse range of diabetes tasks remains unproven. In this study, we introduced a framework to train and validate diabetes-specific LLMs. We first developed a comprehensive data processing pipeline that includes data collection, filtering, augmentation and refinement. This approach contributes to creating a high-quality, diabetes-specific dataset, and several evaluation benchmarks entirely from scratch. Utilizing the collected training dataset, we fine-tuned a diabetes-specific LLM family that demonstrated state-of-the-art proficiency in understanding and processing various diabetes tasks compared to other LLMs. Furthermore, clinical studies showed the potential applications of our models in diabetes care, including providing personalized healthcare, assisting medical education, and streamlining clinical tasks. In conclusion, our study introduced a framework to develop and evaluate a diabetes-specific LLM family, and highlighted its potential to enhance clinical practice and provide personalized, data-driven support for diabetes support when facing different end users. The code is provided via GitHub at https://github.com/waltonfuture/Diabetica.

The deployment of large language models (LLMs) within the healthcare sector has sparked both enthusiasm and apprehension. These models exhibit the remarkable capability to provide proficient responses to free-text queries, demonstrating a nuanced understanding of professional medical knowledge. This comprehensive survey delves into the functionalities of existing LLMs designed for healthcare applications, elucidating the trajectory of their development, starting from traditional Pretrained Language Models (PLMs) to the present state of LLMs in healthcare sector. First, we explore the potential of LLMs to amplify the efficiency and effectiveness of diverse healthcare applications, particularly focusing on clinical language understanding tasks. These tasks encompass a wide spectrum, ranging from named entity recognition and relation extraction to natural language inference, multi-modal medical applications, document classification, and question-answering. Additionally, we conduct an extensive comparison of the most recent state-of-the-art LLMs in the healthcare domain, while also assessing the utilization of various open-source LLMs and highlighting their significance in healthcare applications. Furthermore, we present the essential performance metrics employed to evaluate LLMs in the biomedical domain, shedding light on their effectiveness and limitations. Finally, we summarize the prominent challenges and constraints faced by large language models in the healthcare sector, offering a holistic perspective on their potential benefits and shortcomings. This review provides a comprehensive exploration of the current landscape of LLMs in healthcare, addressing their role in transforming medical applications and the areas that warrant further research and development.

Identifying disease phenotypes from electronic health records (EHRs) is critical for numerous secondary uses. Manually encoding physician knowledge into rules is particularly challenging for rare diseases due to inadequate EHR coding, necessitating review of clinical notes. Large language models (LLMs) offer promise in text understanding but may not efficiently handle real-world clinical documentation. We propose a zero-shot LLM-based method enriched by retrieval-augmented generation and MapReduce, which pre-identifies disease-related text snippets to be used in parallel as queries for the LLM to establish diagnosis. We show that this method as applied to pulmonary hypertension (PH), a rare disease characterized by elevated arterial pressures in the lungs, significantly outperforms physician logic rules (F_1 score of 0.62 vs. 0.75). This method has the potential to enhance rare disease cohort identification, expanding the scope of robust clinical research and care gap identification.

Healthcare monitoring is crucial for early detection, timely intervention, and the ongoing management of health conditions, ultimately improving individuals' quality of life. Recent research shows that Large Language Models (LLMs) have demonstrated impressive performance in supporting healthcare tasks. However, existing LLM-based healthcare solutions typically rely on cloud-based systems, which raise privacy concerns and increase the risk of personal information leakage. As a result, there is growing interest in running these models locally on devices like mobile phones and wearables to protect users' privacy. Small Language Models (SLMs) are potential candidates to solve privacy and computational issues, as they are more efficient and better suited for local deployment. However, the performance of SLMs in healthcare domains has not yet been investigated. This paper examines the capability of SLMs to accurately analyze health data, such as steps, calories, sleep minutes, and other vital statistics, to assess an individual's health status. Our results show that, TinyLlama, which has 1.1 billion parameters, utilizes 4.31 GB memory, and has 0.48s latency, showing the best performance compared other four state-of-the-art (SOTA) SLMs on various healthcare applications. Our results indicate that SLMs could potentially be deployed on wearable or mobile devices for real-time health monitoring, providing a practical solution for efficient and privacy-preserving healthcare.

Large language models (LLMs) offer a promising pre-screening tool, improving early disease detection and providing enhanced healthcare access for underprivileged communities. The early diagnosis of various diseases continues to be a significant challenge in healthcare, primarily due to the nonspecific nature of early symptoms, the shortage of expert medical practitioners, and the need for prolonged clinical evaluations, all of which can delay treatment and adversely affect patient outcomes. With impressive accuracy in prediction across a range of diseases, LLMs have the potential to revolutionize clinical pre-screening and decision-making for various medical conditions. In this work, we study the diagnostic capability of LLMs for Rheumatoid Arthritis (RA) with real world patients data. Patient data was collected alongside diagnoses from medical experts, and the performance of LLMs was evaluated in comparison to expert diagnoses for RA disease prediction. We notice an interesting pattern in disease diagnosis and find an unexpected misalignment between prediction and explanation. We conduct a series of multi-round analyses using different LLM agents. The best-performing model accurately predicts rheumatoid arthritis (RA) diseases approximately 95\% of the time. However, when medical experts evaluated the reasoning generated by the model, they found that nearly 68\% of the reasoning was incorrect. This study highlights a clear misalignment between LLMs high prediction accuracy and its flawed reasoning, raising important questions about relying on LLM explanations in clinical settings. LLMs provide incorrect reasoning to arrive at the correct answer for RA disease diagnosis.

Mental health has attracted substantial attention in recent years and LLM can be an effective technology for alleviating this problem owing to its capability in text understanding and dialogue. However, existing research in this domain often suffers from limitations, such as training on datasets lacking crucial prior knowledge and evidence, and the absence of comprehensive evaluation methods. In this paper, we propose a specialized psychological large language model (LLM), named PsycoLLM, trained on a proposed high-quality psychological dataset, including single-turn QA, multi-turn dialogues enriched with prior knowledge and knowledge-based QA. Additionally, to compare the performance of PsycoLLM with other LLMs, we develop a comprehensive psychological benchmark based on authoritative psychological counseling examinations in China, which includes assessments of professional ethics, theoretical proficiency, and case analysis. The experimental results on the benchmark illustrates the effectiveness of PsycoLLM, which demonstrates superior performance compared to other LLMs.

With the introduction of ChatGPT, Large Language Models (LLMs) have received enormous attention in healthcare. Despite their potential benefits, researchers have underscored various ethical implications. While individual instances have drawn much attention, the debate lacks a systematic overview of practical applications currently researched and ethical issues connected to them. Against this background, this work aims to map the ethical landscape surrounding the current stage of deployment of LLMs in medicine and healthcare. Electronic databases and preprint servers were queried using a comprehensive search strategy. Studies were screened and extracted following a modified rapid review approach. Methodological quality was assessed using a hybrid approach. For 53 records, a meta-aggregative synthesis was performed. Four fields of applications emerged and testify to a vivid exploration phase. Advantages of using LLMs are attributed to their capacity in data analysis, personalized information provisioning, support in decision-making, mitigating information loss and enhancing information accessibility. However, we also identifies recurrent ethical concerns connected to fairness, bias, non-maleficence, transparency, and privacy. A distinctive concern is the tendency to produce harmful misinformation or convincingly but inaccurate content. A recurrent plea for ethical guidance and human oversight is evident. Given the variety of use cases, it is suggested that the ethical guidance debate be reframed to focus on defining what constitutes acceptable human oversight across the spectrum of applications. This involves considering diverse settings, varying potentials for harm, and different acceptable thresholds for performance and certainty in healthcare. In addition, a critical inquiry is necessary to determine the extent to which the current experimental use of LLMs is necessary and justified.

The integration of Large Language Models (LLMs) into healthcare holds significant potential to enhance diagnostic accuracy and support medical treatment planning. These AI-driven systems can analyze vast datasets, assisting clinicians in identifying diseases, recommending treatments, and predicting patient outcomes. This study evaluates the performance of a range of contemporary LLMs, including both open-source and closed-source models, on the 2024 Portuguese National Exam for medical specialty access (PNA), a standardized medical knowledge assessment. Our results highlight considerable variation in accuracy and cost-effectiveness, with several models demonstrating performance exceeding human benchmarks for medical students on this specific task. We identify leading models based on a combined score of accuracy and cost, discuss the implications of reasoning methodologies like Chain-of-Thought, and underscore the potential for LLMs to function as valuable complementary tools aiding medical professionals in complex clinical decision-making.

Large Language Models (LLMs) have introduced a new era of proficiency in comprehending complex healthcare and biomedical topics. However, there is a noticeable lack of models in languages other than English and models that can interpret multi-modal input, which is crucial for global healthcare accessibility. In response, this study introduces Qilin-Med-VL, the first Chinese large vision-language model designed to integrate the analysis of textual and visual data. Qilin-Med-VL combines a pre-trained Vision Transformer (ViT) with a foundational LLM. It undergoes a thorough two-stage curriculum training process that includes feature alignment and instruction tuning. This method enhances the model's ability to generate medical captions and answer complex medical queries. We also release ChiMed-VL, a dataset consisting of more than 1M image-text pairs. This dataset has been carefully curated to enable detailed and comprehensive interpretation of medical data using various types of images.

The utilization of large language models (LLMs) in the Healthcare domain has generated both excitement and concern due to their ability to effectively respond to freetext queries with certain professional knowledge. This survey outlines the capabilities of the currently developed LLMs for Healthcare and explicates their development process, with the aim of providing an overview of the development roadmap from traditional Pretrained Language Models (PLMs) to LLMs. Specifically, we first explore the potential of LLMs to enhance the efficiency and effectiveness of various Healthcare applications highlighting both the strengths and limitations. Secondly, we conduct a comparison between the previous PLMs and the latest LLMs, as well as comparing various LLMs with each other. Then we summarize related Healthcare training data, training methods, optimization strategies, and usage. Finally, the unique concerns associated with deploying LLMs in Healthcare settings are investigated, particularly regarding fairness, accountability, transparency and ethics. Our survey provide a comprehensive investigation from perspectives of both computer science and Healthcare specialty. Besides the discussion about Healthcare concerns, we supports the computer science community by compiling a collection of open source resources, such as accessible datasets, the latest methodologies, code implementations, and evaluation benchmarks in the Github. Summarily, we contend that a significant paradigm shift is underway, transitioning from PLMs to LLMs. This shift encompasses a move from discriminative AI approaches to generative AI approaches, as well as a shift from model-centered methodologies to datacentered methodologies.

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

With the rapid development of large language models (LLMs), assessing their performance on health-related inquiries has become increasingly essential. It is critical that these models provide accurate and trustworthy health information, as their application in real-world contexts--where misinformation can have serious consequences for individuals seeking medical advice and support--depends on their reliability. In this work, we present CHBench, the first comprehensive Chinese Health-related Benchmark designed to evaluate LLMs' capabilities in understanding physical and mental health across diverse scenarios. CHBench includes 6,493 entries related to mental health and 2,999 entries focused on physical health, covering a broad spectrum of topics. This dataset serves as a foundation for evaluating Chinese LLMs' capacity to comprehend and generate accurate health-related information. Our extensive evaluations of four popular Chinese LLMs demonstrate that there remains considerable room for improvement in their understanding of health-related information. The code is available at https://github.com/TracyGuo2001/CHBench.

Healthcare systems continuously generate vast amounts of electronic health records (EHRs), commonly stored in the Fast Healthcare Interoperability Resources (FHIR) standard. Despite the wealth of information in these records, their complexity and volume make it difficult for users to retrieve and interpret crucial health insights. Recent advances in Large Language Models (LLMs) offer a solution, enabling semantic question answering (QA) over medical data, allowing users to interact with their health records more effectively. However, ensuring privacy and compliance requires edge and private deployments of LLMs. This paper proposes a novel approach to semantic QA over EHRs by first identifying the most relevant FHIR resources for a user query (Task1) and subsequently answering the query based on these resources (Task2). We explore the performance of privately hosted, fine-tuned LLMs, evaluating them against benchmark models such as GPT-4 and GPT-4o. Our results demonstrate that fine-tuned LLMs, while 250x smaller in size, outperform GPT-4 family models by 0.55% in F1 score on Task1 and 42% on Meteor Task in Task2. Additionally, we examine advanced aspects of LLM usage, including sequential fine-tuning, model self-evaluation (narcissistic evaluation), and the impact of training data size on performance. The models and datasets are available here: https://huggingface.co/genloop

Large language models (LLMs) have shown impressive capabilities in natural language processing tasks, including dialogue generation. This research aims to conduct a novel comparative analysis of two prominent techniques, fine-tuning with LoRA (Low-Rank Adaptation) and the Retrieval-Augmented Generation (RAG) framework, in the context of doctor-patient chat conversations with multiple datasets of mixed medical domains. The analysis involves three state-of-the-art models: Llama-2, GPT, and the LSTM model. Employing real-world doctor-patient dialogues, we comprehensively evaluate the performance of models, assessing key metrics such as language quality (perplexity, BLEU score), factual accuracy (fact-checking against medical knowledge bases), adherence to medical guidelines, and overall human judgments (coherence, empathy, safety). The findings provide insights into the strengths and limitations of each approach, shedding light on their suitability for healthcare applications. Furthermore, the research investigates the robustness of the models in handling diverse patient queries, ranging from general health inquiries to specific medical conditions. The impact of domain-specific knowledge integration is also explored, highlighting the potential for enhancing LLM performance through targeted data augmentation and retrieval strategies.

The recent advancements in artificial intelligence highlight the potential of language models in psychological health support. While models trained on data from mental health service platform have achieved preliminary success, challenges persist in areas such as data scarcity, quality, and ensuring a solid foundation in psychological techniques. To address these challenges, this study introduces a novel approach to enhance the precision and efficacy of psychological support through large language models. Specifically, we design a specific prompt derived from principles of Cognitive Behavioral Therapy (CBT) and have generated the CBT QA dataset, specifically for Chinese psychological health Q&A based on CBT structured intervention strategies. Unlike previous methods, our dataset emphasizes professional and structured response. Utilizing this dataset, we fine-tuned the large language model, giving birth to CBT-LLM, the large-scale language model specifically designed for Cognitive Behavioral Therapy techniques. Empirical evaluations demonstrate that CBT-LLM excels in generating structured, professional, and highly relevant responses in psychological health support tasks, showcasing its practicality and quality. The model is available on Hugging Face: https://huggingface.co/Hongbin37/CBT-LLM.

Hepato-pancreato-biliary (HPB) disorders represent a global public health challenge due to their high morbidity and mortality. Although large language models (LLMs) have shown promising performance in general medical question-answering tasks, the current evaluation benchmarks are mostly derived from standardized examinations or manually designed questions, lacking HPB coverage and clinical cases. To address these issues, we systematically eatablish an HPB disease evaluation benchmark comprising 3,535 closed-ended multiple-choice questions and 337 open-ended real diagnosis cases, which encompasses all the 33 main categories and 465 subcategories of HPB diseases defined in the International Statistical Classification of Diseases, 10th Revision (ICD-10). The multiple-choice questions are curated from public datasets and synthesized data, and the clinical cases are collected from prestigious medical journals, case-sharing platforms, and collaborating hospitals. By evalauting commercial and open-source general and medical LLMs on our established benchmark, namely ClinBench-HBP, we find that while commercial LLMs perform competently on medical exam questions, they exhibit substantial performance degradation on HPB diagnosis tasks, especially on complex, inpatient clinical cases. Those medical LLMs also show limited generalizability to HPB diseases. Our results reveal the critical limitations of current LLMs in the domain of HPB diseases, underscoring the imperative need for future medical LLMs to handle real, complex clinical diagnostics rather than simple medical exam questions. The benchmark will be released at https://clinbench-hpb.github.io.

With the rapid development of artificial intelligence, large language models (LLMs) have shown promising capabilities in mimicking human-level language comprehension and reasoning. This has sparked significant interest in applying LLMs to enhance various aspects of healthcare, ranging from medical education to clinical decision support. However, medicine involves multifaceted data modalities and nuanced reasoning skills, presenting challenges for integrating LLMs. This paper provides a comprehensive review on the applications and implications of LLMs in medicine. It begins by examining the fundamental applications of general-purpose and specialized LLMs, demonstrating their utilities in knowledge retrieval, research support, clinical workflow automation, and diagnostic assistance. Recognizing the inherent multimodality of medicine, the review then focuses on multimodal LLMs, investigating their ability to process diverse data types like medical imaging and EHRs to augment diagnostic accuracy. To address LLMs' limitations regarding personalization and complex clinical reasoning, the paper explores the emerging development of LLM-powered autonomous agents for healthcare. Furthermore, it summarizes the evaluation methodologies for assessing LLMs' reliability and safety in medical contexts. Overall, this review offers an extensive analysis on the transformative potential of LLMs in modern medicine. It also highlights the pivotal need for continuous optimizations and ethical oversight before these models can be effectively integrated into clinical practice. Visit https://github.com/mingze-yuan/Awesome-LLM-Healthcare for an accompanying GitHub repository containing latest papers.

Mental health risk is a critical global public health challenge, necessitating innovative and reliable assessment methods. With the development of large language models (LLMs), they stand out to be a promising tool for explainable mental health care applications. Nevertheless, existing approaches predominantly rely on subjective textual mental records, which can be distorted by inherent mental uncertainties, leading to inconsistent and unreliable predictions. To address these limitations, this paper introduces ProMind-LLM. We investigate an innovative approach integrating objective behavior data as complementary information alongside subjective mental records for robust mental health risk assessment. Specifically, ProMind-LLM incorporates a comprehensive pipeline that includes domain-specific pretraining to tailor the LLM for mental health contexts, a self-refine mechanism to optimize the processing of numerical behavioral data, and causal chain-of-thought reasoning to enhance the reliability and interpretability of its predictions. Evaluations of two real-world datasets, PMData and Globem, demonstrate the effectiveness of our proposed methods, achieving substantial improvements over general LLMs. We anticipate that ProMind-LLM will pave the way for more dependable, interpretable, and scalable mental health case solutions.

Large Language Models (LLMs) aim to serve as versatile assistants aligned with human values, as defined by the principles of being helpful, honest, and harmless (hhh). However, in terms of Multimodal Large Language Models (MLLMs), despite their commendable performance in perception and reasoning tasks, their alignment with human values remains largely unexplored, given the complexity of defining hhh dimensions in the visual world and the difficulty in collecting relevant data that accurately mirrors real-world situations. To address this gap, we introduce Ch3Ef, a Compreh3ensive Evaluation dataset and strategy for assessing alignment with human expectations. Ch3Ef dataset contains 1002 human-annotated data samples, covering 12 domains and 46 tasks based on the hhh principle. We also present a unified evaluation strategy supporting assessment across various scenarios and different perspectives. Based on the evaluation results, we summarize over 10 key findings that deepen the understanding of MLLM capabilities, limitations, and the dynamic relationships between evaluation levels, guiding future advancements in the field.

We present Eir Thai Medical LLM, a large language model with 8 billion parameters, specifically designed to enhance the accuracy of handling medical tasks in the Thai language. This model focuses on providing clear and easy-to-understand answers for both healthcare professionals and patients, thereby improving the efficiency of diagnosis and treatment processes. Human evaluation was conducted to ensure that the model adheres to care standards and provides unbiased answers. To prioritize data security, the model is deployed within the hospital's internal network, ensuring both high security and faster processing speeds. The internal API connection is secured with encryption and strict authentication measures to prevent data leaks and unauthorized access. We evaluated several open-source large language models with 8 billion parameters on four medical benchmarks: MedQA, MedMCQA, PubMedQA, and the medical subset of MMLU. The best-performing baselines were used to develop Eir Thai Medical LLM. Our evaluation employed multiple questioning strategies, including zero-shot, few-shot, chain-of-thought reasoning, and ensemble/self-consistency voting methods. Our model outperformed commercially available Thai-language large language models by more than 10%. In addition, we developed enhanced model testing tailored for clinical use in Thai across 18 clinical tasks, where our model exceeded GPT-4o performance by more than 11%

The rapid evolution of Large Language Models (LLMs) offers promising potential to alleviate the global scarcity of mental health professionals. However, LLMs' alignment with essential mental health counseling competencies remains understudied. We introduce CounselingBench, a novel NCMHCE-based benchmark evaluating LLMs across five key mental health counseling competencies. Testing 22 general-purpose and medical-finetuned LLMs, we find frontier models exceed minimum thresholds but fall short of expert-level performance, with significant variations: they excel in Intake, Assessment & Diagnosis yet struggle with Core Counseling Attributes and Professional Practice & Ethics. Medical LLMs surprisingly underperform generalist models accuracy-wise, while at the same time producing slightly higher-quality justifications but making more context-related errors. Our findings highlight the complexities of developing AI systems for mental health counseling, particularly for competencies requiring empathy and contextual understanding. We found that frontier LLMs perform at a level exceeding the minimal required level of aptitude for all key mental health counseling competencies, but fall short of expert-level performance, and that current medical LLMs do not significantly improve upon generalist models in mental health counseling competencies. This underscores the critical need for specialized, mental health counseling-specific fine-tuned LLMs that rigorously aligns with core competencies combined with appropriate human supervision before any responsible real-world deployment can be considered.

Large Language Models (LLMs) have shown the potential to significantly contribute to patient care, diagnostics, and administrative processes. Emerging biomedical LLMs address healthcare-specific challenges, including privacy demands and computational constraints. However, evaluation of these models has primarily been limited to non-clinical tasks, which do not reflect the complexity of practical clinical applications. Additionally, there has been no thorough comparison between biomedical and general-domain LLMs for clinical tasks. To fill this gap, we present the Clinical Language Understanding Evaluation (CLUE), a benchmark tailored to evaluate LLMs on real-world clinical tasks. CLUE includes two novel datasets derived from MIMIC IV discharge letters and four existing tasks designed to test the practical applicability of LLMs in healthcare settings. Our evaluation covers several biomedical and general domain LLMs, providing insights into their clinical performance and applicability. CLUE represents a step towards a standardized approach to evaluating and developing LLMs in healthcare to align future model development with the real-world needs of clinical application. We publish our evaluation and data generation scripts: https://github.com/dadaamin/CLUE

Large Language Models (LLMs) have great potential in the field of health care, yet they face great challenges in adapting to rapidly evolving medical knowledge. This can lead to outdated or contradictory treatment suggestions. This study investigated how LLMs respond to evolving clinical guidelines, focusing on concept drift and internal inconsistencies. We developed the DriftMedQA benchmark to simulate guideline evolution and assessed the temporal reliability of various LLMs. Our evaluation of seven state-of-the-art models across 4,290 scenarios demonstrated difficulties in rejecting outdated recommendations and frequently endorsing conflicting guidance. Additionally, we explored two mitigation strategies: Retrieval-Augmented Generation and preference fine-tuning via Direct Preference Optimization. While each method improved model performance, their combination led to the most consistent and reliable results. These findings underscore the need to improve LLM robustness to temporal shifts to ensure more dependable applications in clinical practice.

Large language models (LLM) have demonstrated emergent abilities in text generation, question answering, and reasoning, facilitating various tasks and domains. Despite their proficiency in various tasks, LLMs like LaPM 540B and Llama-3.1 405B face limitations due to large parameter sizes and computational demands, often requiring cloud API use which raises privacy concerns, limits real-time applications on edge devices, and increases fine-tuning costs. Additionally, LLMs often underperform in specialized domains such as healthcare and law due to insufficient domain-specific knowledge, necessitating specialized models. Therefore, Small Language Models (SLMs) are increasingly favored for their low inference latency, cost-effectiveness, efficient development, and easy customization and adaptability. These models are particularly well-suited for resource-limited environments and domain knowledge acquisition, addressing LLMs' challenges and proving ideal for applications that require localized data handling for privacy, minimal inference latency for efficiency, and domain knowledge acquisition through lightweight fine-tuning. The rising demand for SLMs has spurred extensive research and development. However, a comprehensive survey investigating issues related to the definition, acquisition, application, enhancement, and reliability of SLM remains lacking, prompting us to conduct a detailed survey on these topics. The definition of SLMs varies widely, thus to standardize, we propose defining SLMs by their capability to perform specialized tasks and suitability for resource-constrained settings, setting boundaries based on the minimal size for emergent abilities and the maximum size sustainable under resource constraints. For other aspects, we provide a taxonomy of relevant models/methods and develop general frameworks for each category to enhance and utilize SLMs effectively.

Large language models (LLMs) demonstrate remarkable medical expertise, but data privacy concerns impede their direct use in healthcare environments. Although offering improved data privacy protection, domain-specific small language models (SLMs) often underperform LLMs, emphasizing the need for methods that reduce this performance gap while alleviating privacy concerns. In this paper, we present a simple yet effective method that harnesses LLMs' medical proficiency to boost SLM performance in medical tasks under privacy-restricted scenarios. Specifically, we mitigate patient privacy issues by extracting keywords from medical data and prompting the LLM to generate a medical knowledge-intensive context by simulating clinicians' thought processes. This context serves as additional input for SLMs, augmenting their decision-making capabilities. Our method significantly enhances performance in both few-shot and full training settings across three medical knowledge-intensive tasks, achieving up to a 22.57% increase in absolute accuracy compared to SLM fine-tuning without context, and sets new state-of-the-art results in two medical tasks within privacy-restricted scenarios. Further out-of-domain testing and experiments in two general domain datasets showcase its generalizability and broad applicability.

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

Large language models (LLMs), such as GPT-4, have demonstrated remarkable capabilities across a wide range of tasks, including health applications. In this paper, we study how LLMs can be used to scale biomedical knowledge curation. We find that while LLMs already possess decent competency in structuring biomedical text, by distillation into a task-specific student model through self-supervised learning, substantial gains can be attained over out-of-box LLMs, with additional advantages such as cost, efficiency, and white-box model access. We conduct a case study on adverse drug event (ADE) extraction, which is an important area for improving care. On standard ADE extraction evaluation, a GPT-3.5 distilled PubMedBERT model attained comparable accuracy as supervised state-of-the-art models without using any labeled data. Despite being over 1,000 times smaller, the distilled model outperformed its teacher GPT-3.5 by over 6 absolute points in F1 and GPT-4 by over 5 absolute points. Ablation studies on distillation model choice (e.g., PubMedBERT vs BioGPT) and ADE extraction architecture shed light on best practice for biomedical knowledge extraction. Similar gains were attained by distillation for other standard biomedical knowledge extraction tasks such as gene-disease associations and protected health information, further illustrating the promise of this approach.

Large Language Models (LLMs) have emerged as personalized assistants for users across a wide range of tasks -- from offering writing support to delivering tailored recommendations or consultations. Over time, the interaction history between a user and an LLM can provide extensive information about an individual's traits and preferences. However, open questions remain on how well LLMs today can effectively leverage such history to (1) internalize the user's inherent traits and preferences, (2) track how the user profiling and preferences evolve over time, and (3) generate personalized responses accordingly in new scenarios. In this work, we introduce the PERSONAMEM benchmark. PERSONAMEM features curated user profiles with over 180 simulated user-LLM interaction histories, each containing up to 60 sessions of multi-turn conversations across 15 real-world tasks that require personalization. Given an in-situ user query, i.e. query issued by the user from the first-person perspective, we evaluate LLM chatbots' ability to identify the most suitable response according to the current state of the user's profile. We observe that current LLMs still struggle to recognize the dynamic evolution in users' profiles over time through direct prompting approaches. As a consequence, LLMs often fail to deliver responses that align with users' current situations and preferences, with frontier models such as GPT-4.1, o4-mini, GPT-4.5, o1, or Gemini-2.0 achieving only around 50% overall accuracy, suggesting room for improvement. We hope that PERSONAMEM, along with the user profile and conversation simulation pipeline, can facilitate future research in the development of truly user-aware chatbots. Code and data are available at github.com/bowen-upenn/PersonaMem.

Large language models (LLMs) have demonstrated remarkable capabilities in natural language understanding and generation across various domains, including medicine. We present a comprehensive evaluation of GPT-4, a state-of-the-art LLM, on medical competency examinations and benchmark datasets. GPT-4 is a general-purpose model that is not specialized for medical problems through training or engineered to solve clinical tasks. Our analysis covers two sets of official practice materials for the USMLE, a three-step examination program used to assess clinical competency and grant licensure in the United States. We also evaluate performance on the MultiMedQA suite of benchmark datasets. Beyond measuring model performance, experiments were conducted to investigate the influence of test questions containing both text and images on model performance, probe for memorization of content during training, and study probability calibration, which is of critical importance in high-stakes applications like medicine. Our results show that GPT-4, without any specialized prompt crafting, exceeds the passing score on USMLE by over 20 points and outperforms earlier general-purpose models (GPT-3.5) as well as models specifically fine-tuned on medical knowledge (Med-PaLM, a prompt-tuned version of Flan-PaLM 540B). In addition, GPT-4 is significantly better calibrated than GPT-3.5, demonstrating a much-improved ability to predict the likelihood that its answers are correct. We also explore the behavior of the model qualitatively through a case study that shows the ability of GPT-4 to explain medical reasoning, personalize explanations to students, and interactively craft new counterfactual scenarios around a medical case. Implications of the findings are discussed for potential uses of GPT-4 in medical education, assessment, and clinical practice, with appropriate attention to challenges of accuracy and safety.

Large Language Models (LLMs) constitute a breakthrough state-of-the-art Artificial Intelligence (AI) technology which is rapidly evolving and promises to aid in medical diagnosis either by assisting doctors or by simulating a doctor's workflow in more advanced and complex implementations. In this technical paper, we outline Cognitive Network Evaluation Toolkit for Medical Domains (COGNET-MD), which constitutes a novel benchmark for LLM evaluation in the medical domain. Specifically, we propose a scoring-framework with increased difficulty to assess the ability of LLMs in interpreting medical text. The proposed framework is accompanied with a database of Multiple Choice Quizzes (MCQs). To ensure alignment with current medical trends and enhance safety, usefulness, and applicability, these MCQs have been constructed in collaboration with several associated medical experts in various medical domains and are characterized by varying degrees of difficulty. The current (first) version of the database includes the medical domains of Psychiatry, Dentistry, Pulmonology, Dermatology and Endocrinology, but it will be continuously extended and expanded to include additional medical domains.

As Large Language Models (LLMs) become widely accessible, a detailed understanding of their knowledge within specific domains becomes necessary for successful real world use. This is particularly critical in public health, where failure to retrieve relevant, accurate, and current information could significantly impact UK residents. However, currently little is known about LLM knowledge of UK Government public health information. To address this issue, this paper introduces a new benchmark, PubHealthBench, with over 8000 questions for evaluating LLMs' Multiple Choice Question Answering (MCQA) and free form responses to public health queries, created via an automated pipeline. We also release a new dataset of the extracted UK Government public health guidance documents used as source text for PubHealthBench. Assessing 24 LLMs on PubHealthBench we find the latest private LLMs (GPT-4.5, GPT-4.1 and o1) have a high degree of knowledge, achieving >90% in the MCQA setup, and outperform humans with cursory search engine use. However, in the free form setup we see lower performance with no model scoring >75%. Therefore, whilst there are promising signs that state of the art (SOTA) LLMs are an increasingly accurate source of public health information, additional safeguards or tools may still be needed when providing free form responses on public health topics.

Large Language Models (LLMs) hold great promise to revolutionize current clinical systems for their superior capacities on medical text processing tasks and medical licensing exams. Meanwhile, traditional ML models such as SVM and XGBoost have still been mainly adopted in clinical prediction tasks. An emerging question is Can LLMs beat traditional ML models in clinical prediction? Thus, we build a new benchmark ClinicalBench to comprehensively study the clinical predictive modeling capacities of both general-purpose and medical LLMs, and compare them with traditional ML models. ClinicalBench embraces three common clinical prediction tasks, two databases, 14 general-purpose LLMs, 8 medical LLMs, and 11 traditional ML models. Through extensive empirical investigation, we discover that both general-purpose and medical LLMs, even with different model scales, diverse prompting or fine-tuning strategies, still cannot beat traditional ML models in clinical prediction yet, shedding light on their potential deficiency in clinical reasoning and decision-making. We call for caution when practitioners adopt LLMs in clinical applications. ClinicalBench can be utilized to bridge the gap between LLMs' development for healthcare and real-world clinical practice.

Large Language Models (LLMs) have significantly advanced natural language processing (NLP) with their impressive language understanding and generation capabilities. However, their performance may be suboptimal for domain-specific tasks that require specialized knowledge due to limited exposure to the related data. Additionally, the lack of transparency of most state-of-the-art (SOTA) LLMs, which can only be accessed via APIs, impedes further fine-tuning with domain custom data. Moreover, providing private data to the LLMs' owner leads to data privacy problems. To address these challenges, we propose the novel Parametric Knowledge Guiding (PKG) framework, which equips LLMs with a knowledge-guiding module to access relevant knowledge without altering the LLMs' parameters. Our PKG is based on open-source "white-box" language models, allowing offline memory of any knowledge that LLMs require. We demonstrate that our PKG framework can enhance the performance of "black-box" LLMs on a range of domain knowledge-intensive tasks that require factual (+7.9%), tabular (+11.9%), medical (+3.0%), and multimodal (+8.1%) knowledge.

Large language models (LLMs), such as GPT-4, PaLM, and LLaMa, have been shown to achieve remarkable performance across a variety of natural language tasks. Recent advancements in instruction tuning bring LLMs with ability in following user's instructions and producing human-like responses. However, the high costs associated with training and implementing LLMs pose challenges to academic research. Furthermore, the availability of pretrained LLMs and instruction-tune datasets for Vietnamese language is limited. To tackle these concerns, we leverage large-scale instruction-following datasets from open-source projects, namely Alpaca, GPT4All, and Chat-Doctor, which cover general domain and specific medical domain. To the best of our knowledge, these are the first instructional dataset for Vietnamese. Subsequently, we utilize parameter-efficient tuning through Low-Rank Adaptation (LoRA) on two open LLMs: Bloomz (Multilingual) and GPTJ-6B (Vietnamese), resulting four models: Bloomz-Chat, Bloomz-Doctor, GPTJ-Chat, GPTJ-Doctor.Finally, we assess the effectiveness of our methodology on a per-sample basis, taking into consideration the helpfulness, relevance, accuracy, level of detail in their responses. This evaluation process entails the utilization of GPT-4 as an automated scoring mechanism. Despite utilizing a low-cost setup, our method demonstrates about 20-30\% improvement over the original models in our evaluation tasks.

Large Language Models (LLMs) are advanced Artificial Intelligence (AI) systems that have undergone extensive training using large datasets in order to understand and produce language that closely resembles that of humans. These models have reached a level of proficiency where they are capable of successfully completing university exams across several disciplines and generating functional code to handle novel problems. This research investigates the coding proficiency of ChatGPT 3.5, a LLM released by OpenAI in November 2022, which has gained significant recognition for its impressive text generating and code creation capabilities. The skill of the model in creating code snippets is evaluated across 10 various programming languages and 4 different software domains. Based on the findings derived from this research, major unexpected behaviors and limitations of the model have been identified. This study aims to identify potential areas for development and examine the ramifications of automated code generation on the evolution of programming languages and on the tech industry.

Large Language Models (LLMs) are transforming artificial intelligence, enabling autonomous agents to perform diverse tasks across various domains. These agents, proficient in human-like text comprehension and generation, have the potential to revolutionize sectors from customer service to healthcare. However, they face challenges such as multimodality, human value alignment, hallucinations, and evaluation. Techniques like prompting, reasoning, tool utilization, and in-context learning are being explored to enhance their capabilities. Evaluation platforms like AgentBench, WebArena, and ToolLLM provide robust methods for assessing these agents in complex scenarios. These advancements are leading to the development of more resilient and capable autonomous agents, anticipated to become integral in our digital lives, assisting in tasks from email responses to disease diagnosis. The future of AI, with LLMs at the forefront, is promising.

In recent years, the application of Large Language Models (LLMs) in healthcare has shown significant promise in improving the accessibility and dissemination of medical knowledge. This paper presents a detailed study of various LLMs trained on the MedQuAD medical question-answering dataset, with a focus on identifying the most effective model for providing accurate medical information. Among the models tested, the Sentence-t5 combined with Mistral 7B demonstrated superior performance, achieving a precision score of 0.762. This model's enhanced capabilities are attributed to its advanced pretraining techniques, robust architecture, and effective prompt construction methodologies. By leveraging these strengths, the Sentence-t5 + Mistral 7B model excels in understanding and generating precise medical answers. Our findings highlight the potential of integrating sophisticated LLMs in medical contexts to facilitate efficient and accurate medical knowledge retrieval, thus significantly enhancing patient education and support.

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

Recently, Large Language Models (LLMs) have showcased remarkable capabilities in natural language understanding. While demonstrating proficiency in everyday conversations and question-answering situations, these models frequently struggle in domains that require precision, such as medical applications, due to their lack of domain-specific knowledge. In this paper, we describe the procedure for building a powerful, open-source language model specifically designed for medicine applications, termed as PMC-LLaMA. Our contributions are threefold: (i) we systematically investigate the process of adapting a general-purpose foundation language model towards medical domain, this involves data-centric knowledge injection through the integration of 4.8M biomedical academic papers and 30K medical textbooks, as well as comprehensive fine-tuning for alignment with domain-specific instructions; (ii) we contribute a large-scale, comprehensive dataset for instruction tuning. This dataset encompasses medical question-answering (QA), rationale for reasoning, and conversational dialogues, comprising a total of 202M tokens; (iii) we conduct thorough ablation studies to demonstrate the effectiveness of each proposed component. While evaluating on various public medical question-answering benchmarks, our lightweight PMCLLaMA, which consists of only 13 billion parameters, exhibits superior performance, even surpassing ChatGPT. All models, codes, datasets can be found in https://github.com/chaoyi-wu/PMC-LLaMA.

Applying large language models (LLMs) to assist in psycho-counseling is an emerging and meaningful approach, driven by the significant gap between patient needs and the availability of mental health support. However, current LLMs struggle to consistently provide effective responses to client speeches, largely due to the lack of supervision from high-quality real psycho-counseling data, whose content is typically inaccessible due to client privacy concerns. Furthermore, the quality of therapists' responses in available sessions can vary significantly based on their professional training and experience. Assessing the quality of therapists' responses remains an open challenge. In this work, we address these challenges by first proposing a set of professional and comprehensive principles to evaluate therapists' responses to client speeches. Using these principles, we create a preference dataset, PsychoCounsel-Preference, which contains 36k high-quality preference comparison pairs. This dataset aligns with the preferences of professional psychotherapists, providing a robust foundation for evaluating and improving LLMs in psycho-counseling. Experiments on reward modeling and preference learning demonstrate that PsychoCounsel-Preference is an excellent resource for LLMs to acquire essential skills for responding to clients in a counseling session. Our best-aligned model, PsychoCounsel-Llama3-8B, achieves an impressive win rate of 87% against GPT-4o. We release PsychoCounsel-Preference, PsychoCounsel-Llama3-8B and the reward model PsychoCounsel Llama3-8B-Reward to facilitate the research of psycho-counseling with LLMs at: https://hf.co/Psychotherapy-LLM.

Large language models (LLMs) can potentially democratize access to medical knowledge. While many efforts have been made to harness and improve LLMs' medical knowledge and reasoning capacities, the resulting models are either closed-source (e.g., PaLM, GPT-4) or limited in scale (<= 13B parameters), which restricts their abilities. In this work, we improve access to large-scale medical LLMs by releasing MEDITRON: a suite of open-source LLMs with 7B and 70B parameters adapted to the medical domain. MEDITRON builds on Llama-2 (through our adaptation of Nvidia's Megatron-LM distributed trainer), and extends pretraining on a comprehensively curated medical corpus, including selected PubMed articles, abstracts, and internationally-recognized medical guidelines. Evaluations using four major medical benchmarks show significant performance gains over several state-of-the-art baselines before and after task-specific finetuning. Overall, MEDITRON achieves a 6% absolute performance gain over the best public baseline in its parameter class and 3% over the strongest baseline we finetuned from Llama-2. Compared to closed-source LLMs, MEDITRON-70B outperforms GPT-3.5 and Med-PaLM and is within 5% of GPT-4 and 10% of Med-PaLM-2. We release our code for curating the medical pretraining corpus and the MEDITRON model weights to drive open-source development of more capable medical LLMs.

Extracting patient information from unstructured text is a critical task in health decision-support and clinical research. Large language models (LLMs) have shown the potential to accelerate clinical curation via few-shot in-context learning, in contrast to supervised learning which requires much more costly human annotations. However, despite drastic advances in modern LLMs such as GPT-4, they still struggle with issues regarding accuracy and interpretability, especially in mission-critical domains such as health. Here, we explore a general mitigation framework using self-verification, which leverages the LLM to provide provenance for its own extraction and check its own outputs. This is made possible by the asymmetry between verification and generation, where the latter is often much easier than the former. Experimental results show that our method consistently improves accuracy for various LLMs in standard clinical information extraction tasks. Additionally, self-verification yields interpretations in the form of a short text span corresponding to each output, which makes it very efficient for human experts to audit the results, paving the way towards trustworthy extraction of clinical information in resource-constrained scenarios. To facilitate future research in this direction, we release our code and prompts.

Large language models (LLMs) have captured significant interest from both academia and industry due to their impressive performance across various textual tasks. However, the potential of LLMs to analyze physiological time-series data remains an emerging research field. Particularly, there is a notable gap in the utilization of LLMs for analyzing wearable biosignals to achieve cuffless blood pressure (BP) measurement, which is critical for the management of cardiovascular diseases. This paper presents the first work to explore the capacity of LLMs to perform cuffless BP estimation based on wearable biosignals. We extracted physiological features from electrocardiogram (ECG) and photoplethysmogram (PPG) signals and designed context-enhanced prompts by combining these features with BP domain knowledge and user information. Subsequently, we adapted LLMs to BP estimation tasks through fine-tuning. To evaluate the proposed approach, we conducted assessments of ten advanced LLMs using a comprehensive public dataset of wearable biosignals from 1,272 participants. The experimental results demonstrate that the optimally fine-tuned LLM significantly surpasses conventional task-specific baselines, achieving an estimation error of 0.00 pm 9.25 mmHg for systolic BP and 1.29 pm 6.37 mmHg for diastolic BP. Notably, the ablation studies highlight the benefits of our context enhancement strategy, leading to an 8.9% reduction in mean absolute error for systolic BP estimation. This paper pioneers the exploration of LLMs for cuffless BP measurement, providing a potential solution to enhance the accuracy of cuffless BP measurement.

Large Language Models (LLMs) have gained significant attention due to their high performance on a wide range of natural language tasks since the release of ChatGPT. The LLMs learn to understand and generate language by training billions of model parameters on vast volumes of text data. Despite being a relatively new field, LLM research is rapidly advancing in various directions. In this paper, we present an overview of LLM families, including LLaMA, PaLM, GPT, and MoE, and the methods developed to create and enhance LLMs for official European Union (EU) languages. We provide a comprehensive summary of common monolingual and multilingual datasets used for pretraining large language models.

Large Language Models (LLMs), with their flexible generation abilities, can be powerful data sources in domains with few or no available corpora. However, problems like hallucinations and biases limit such applications. In this case study, we pick nutrition counselling, a domain lacking any public resource, and show that high-quality datasets can be gathered by combining LLMs, crowd-workers and nutrition experts. We first crowd-source and cluster a novel dataset of diet-related issues, then work with experts to prompt ChatGPT into producing related supportive text. Finally, we let the experts evaluate the safety of the generated text. We release HAI-coaching, the first expert-annotated nutrition counselling dataset containing ~2.4K dietary struggles from crowd workers, and ~97K related supportive texts generated by ChatGPT. Extensive analysis shows that ChatGPT while producing highly fluent and human-like text, also manifests harmful behaviours, especially in sensitive topics like mental health, making it unsuitable for unsupervised use.

Large language models (LLMs) are a special class of pretrained language models obtained by scaling model size, pretraining corpus and computation. LLMs, because of their large size and pretraining on large volumes of text data, exhibit special abilities which allow them to achieve remarkable performances without any task-specific training in many of the natural language processing tasks. The era of LLMs started with OpenAI GPT-3 model, and the popularity of LLMs is increasing exponentially after the introduction of models like ChatGPT and GPT4. We refer to GPT-3 and its successor OpenAI models, including ChatGPT and GPT4, as GPT-3 family large language models (GLLMs). With the ever-rising popularity of GLLMs, especially in the research community, there is a strong need for a comprehensive survey which summarizes the recent research progress in multiple dimensions and can guide the research community with insightful future research directions. We start the survey paper with foundation concepts like transformers, transfer learning, self-supervised learning, pretrained language models and large language models. We then present a brief overview of GLLMs and discuss the performances of GLLMs in various downstream tasks, specific domains and multiple languages. We also discuss the data labelling and data augmentation abilities of GLLMs, the robustness of GLLMs, the effectiveness of GLLMs as evaluators, and finally, conclude with multiple insightful future research directions. To summarize, this comprehensive survey paper will serve as a good resource for both academic and industry people to stay updated with the latest research related to GPT-3 family large language models.

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

Large language models (LLMs) have revolutionized Natural Language Processing (NLP) by minimizing the need for complex feature engineering. However, the application of LLMs in specialized domains like biopharmaceuticals and chemistry remains largely unexplored. These fields are characterized by intricate terminologies, specialized knowledge, and a high demand for precision areas where general purpose LLMs often fall short. In this study, we introduce PharmaGPT, a suite of domain specilized LLMs with 13 billion and 70 billion parameters, specifically trained on a comprehensive corpus tailored to the Bio-Pharmaceutical and Chemical domains. Our evaluation shows that PharmaGPT surpasses existing general models on specific-domain benchmarks such as NAPLEX, demonstrating its exceptional capability in domain-specific tasks. Remarkably, this performance is achieved with a model that has only a fraction, sometimes just one-tenth-of the parameters of general-purpose large models. This advancement establishes a new benchmark for LLMs in the bio-pharmaceutical and chemical fields, addressing the existing gap in specialized language modeling. It also suggests a promising path for enhanced research and development, paving the way for more precise and effective NLP applications in these areas.

Large Language Models (LLMs) have drawn a lot of attention due to their strong performance on a wide range of natural language tasks, since the release of ChatGPT in November 2022. LLMs' ability of general-purpose language understanding and generation is acquired by training billions of model's parameters on massive amounts of text data, as predicted by scaling laws kaplan2020scaling,hoffmann2022training. The research area of LLMs, while very recent, is evolving rapidly in many different ways. In this paper, we review some of the most prominent LLMs, including three popular LLM families (GPT, LLaMA, PaLM), and discuss their characteristics, contributions and limitations. We also give an overview of techniques developed to build, and augment LLMs. We then survey popular datasets prepared for LLM training, fine-tuning, and evaluation, review widely used LLM evaluation metrics, and compare the performance of several popular LLMs on a set of representative benchmarks. Finally, we conclude the paper by discussing open challenges and future research directions.

Large Language Models (LLMs) have shown capabilities close to human performance in various analytical tasks, leading researchers to use them for time and labor-intensive analyses. However, their capability to handle highly specialized and open-ended tasks in domains like policy studies remains in question. This paper investigates the efficiency and accuracy of LLMs in specialized tasks through a structured user study focusing on Human-LLM partnership. The study, conducted in two stages-Topic Discovery and Topic Assignment-integrates LLMs with expert annotators to observe the impact of LLM suggestions on what is usually human-only analysis. Results indicate that LLM-generated topic lists have significant overlap with human generated topic lists, with minor hiccups in missing document-specific topics. However, LLM suggestions may significantly improve task completion speed, but at the same time introduce anchoring bias, potentially affecting the depth and nuance of the analysis, raising a critical question about the trade-off between increased efficiency and the risk of biased analysis.

This paper reviews the state-of-the-art of language models architectures and strategies for "complex" question-answering (QA, CQA, CPS) with a focus on hybridization. Large Language Models (LLM) are good at leveraging public data on standard problems but once you want to tackle more specific complex questions or problems (e.g. How does the concept of personal freedom vary between different cultures ? What is the best mix of power generation methods to reduce climate change ?) you may need specific architecture, knowledge, skills, methods, sensitive data protection, explainability, human approval and versatile feedback... Recent projects like ChatGPT and GALACTICA have allowed non-specialists to grasp the great potential as well as the equally strong limitations of LLM in complex QA. In this paper, we start by reviewing required skills and evaluation techniques. We integrate findings from the robust community edited research papers BIG, BLOOM and HELM which open source, benchmark and analyze limits and challenges of LLM in terms of tasks complexity and strict evaluation on accuracy (e.g. fairness, robustness, toxicity, ...) as a baseline. We discuss some challenges associated with complex QA, including domain adaptation, decomposition and efficient multi-step QA, long form and non-factoid QA, safety and multi-sensitivity data protection, multimodal search, hallucinations, explainability and truthfulness, temporal reasoning. We analyze current solutions and promising research trends, using elements such as: hybrid LLM architectural patterns, training and prompting strategies, active human reinforcement learning supervised with AI, neuro-symbolic and structured knowledge grounding, program synthesis, iterated decomposition and others.

Large-scale language models (LLMs), such as ChatGPT, are capable of generating human-like responses for various downstream tasks, such as task-oriented dialogues and question answering. However, applying LLMs to medical domains remains challenging due to their inability to leverage domain-specific knowledge. In this study, we present the Large-scale Language Models Augmented with Medical Textbooks (LLM-AMT), which integrates authoritative medical textbooks as the cornerstone of its design, enhancing its proficiency in the specialized domain through plug-and-play modules, comprised of a Hybrid Textbook Retriever, supplemented by the Query Augmenter and the LLM Reader. Experimental evaluation on three open-domain medical question-answering tasks reveals a substantial enhancement in both the professionalism and accuracy of the LLM responses when utilizing LLM-AMT, exhibiting an improvement ranging from 11.4% to 13.2%. Despite being 100 times smaller, we found that medical textbooks as the retrieval corpus serves as a more valuable external knowledge source than Wikipedia in the medical domain. Our experiments show that textbook augmentation results in a performance improvement ranging from 9.7% to 12.2% over Wikipedia augmentation.

With the advent of Large Language Models (LLMs), medical artificial intelligence (AI) has experienced substantial technological progress and paradigm shifts, highlighting the potential of LLMs to streamline healthcare delivery and improve patient outcomes. Considering this rapid technical progress, in this survey, we trace the recent advances of Medical Large Language Models (Med-LLMs), including the background, key findings, and mainstream techniques, especially for the evolution from general-purpose models to medical-specialized applications. Firstly, we delve into the foundational technology of Med-LLMs, indicating how general models can be progressively adapted and refined for the complicated medical tasks. Secondly, the wide-ranging applications of Med-LLMs are investigated across various healthcare domains, as well as an up-to-date review of existing Med-LLMs. The transformative impact of these models on daily medical practice is evident through their ability to assist clinicians, educators, and patients. Recognizing the importance of responsible innovation, we discuss the challenges associated with ensuring fairness, accountability, privacy, and robustness. Ethical considerations, rigorous evaluation methodologies, and the establishment of regulatory frameworks are crucial for building trustworthiness in the real-world system. We emphasize the need for ongoing scrutiny and development to maintain high standards of safety and reliability. Finally, we anticipate possible future trajectories for Med-LLMs, identifying key avenues for prudent expansion. By consolidating these insights, our review aims to provide professionals and researchers with a thorough understanding of the strengths and limitations of Med-LLMs, fostering a balanced and ethical approach to their integration into the healthcare ecosystem.

Advances in large language models (LLMs) have empowered a variety of applications. However, there is still a significant gap in research when it comes to understanding and enhancing the capabilities of LLMs in the field of mental health. In this work, we present the first comprehensive evaluation of multiple LLMs, including Alpaca, Alpaca-LoRA, FLAN-T5, GPT-3.5, and GPT-4, on various mental health prediction tasks via online text data. We conduct a broad range of experiments, covering zero-shot prompting, few-shot prompting, and instruction fine-tuning. The results indicate a promising yet limited performance of LLMs with zero-shot and few-shot prompt designs for the mental health tasks. More importantly, our experiments show that instruction finetuning can significantly boost the performance of LLMs for all tasks simultaneously. Our best-finetuned models, Mental-Alpaca and Mental-FLAN-T5, outperform the best prompt design of GPT-3.5 (25 and 15 times bigger) by 10.9% on balanced accuracy and the best of GPT-4 (250 and 150 times bigger) by 4.8%. They further perform on par with the state-of-the-art task-specific language model. We also conduct an exploratory case study on LLMs' capability on the mental health reasoning tasks, illustrating the promising capability of certain models such as GPT-4. We summarize our findings into a set of action guidelines for potential methods to enhance LLMs' capability for mental health tasks. Meanwhile, we also emphasize the important limitations before achieving deployability in real-world mental health settings, such as known racial and gender bias. We highlight the important ethical risks accompanying this line of research.

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

Large Language Models (LLMs), such as ChatGPT, LLaMA, GLM, and PaLM, have exhibited remarkable performances across various tasks in recent years. However, LLMs face two main challenges in real-world applications. One challenge is that training LLMs consumes vast computing resources, preventing LLMs from being adopted by small and medium-sized enterprises with limited computing resources. Another is that training LLM requires a large amount of high-quality data, which are often scattered among enterprises. To address these challenges, we propose FATE-LLM, an industrial-grade federated learning framework for large language models. FATE-LLM (1) facilitates federated learning for large language models (coined FedLLM); (2) promotes efficient training of FedLLM using parameter-efficient fine-tuning methods; (3) protects the intellectual property of LLMs; (4) preserves data privacy during training and inference through privacy-preserving mechanisms. We release the code of FATE-LLM at https://github.com/FederatedAI/FATE-LLM to facilitate the research of FedLLM and enable a broad range of industrial applications.

Large Language Models (LLMs), such as GPT3.5, have exhibited remarkable proficiency in comprehending and generating natural language. However, their unpersonalized generation paradigm may result in suboptimal user-specific outcomes. Typically, users converse differently based on their knowledge and preferences. This necessitates the task of enhancing user-oriented LLM which remains unexplored. While one can fully train an LLM for this objective, the resource consumption is unaffordable. Prior research has explored memory-based methods to store and retrieve knowledge to enhance generation without retraining for new queries. However, we contend that a mere memory module is inadequate to comprehend a user's preference, and fully training an LLM can be excessively costly. In this study, we propose a novel computational bionic memory mechanism, equipped with a parameter-efficient fine-tuning schema, to personalize LLMs. Our extensive experimental results demonstrate the effectiveness and superiority of the proposed approach. To encourage further research into this area, we are releasing a new conversation dataset generated entirely by LLM based on an open-source medical corpus, as well as our implementation code.

Large language models (LLMs) have been widely used in various applications but are known to suffer from issues related to untruthfulness and toxicity. While parameter-efficient modules (PEMs) have demonstrated their effectiveness in equipping models with new skills, leveraging PEMs for deficiency unlearning remains underexplored. In this work, we propose a PEMs operation approach, namely Extraction-before-Subtraction (Ext-Sub), to enhance the truthfulness and detoxification of LLMs through the integration of ``expert'' PEM and ``anti-expert'' PEM. Remarkably, even anti-expert PEM possess valuable capabilities due to their proficiency in generating fabricated content, which necessitates language modeling and logical narrative competence. Rather than merely negating the parameters, our approach involves extracting and eliminating solely the deficiency capability within anti-expert PEM while preserving the general capabilities. To evaluate the effectiveness of our approach in terms of truthfulness and detoxification, we conduct extensive experiments on LLMs, encompassing additional abilities such as language modeling and mathematical reasoning. Our empirical results demonstrate that our approach effectively improves truthfulness and detoxification, while largely preserving the fundamental abilities of LLMs.

Large language models (LLMs) are gaining increasing popularity in both academia and industry, owing to their unprecedented performance in various applications. As LLMs continue to play a vital role in both research and daily use, their evaluation becomes increasingly critical, not only at the task level, but also at the society level for better understanding of their potential risks. Over the past years, significant efforts have been made to examine LLMs from various perspectives. This paper presents a comprehensive review of these evaluation methods for LLMs, focusing on three key dimensions: what to evaluate, where to evaluate, and how to evaluate. Firstly, we provide an overview from the perspective of evaluation tasks, encompassing general natural language processing tasks, reasoning, medical usage, ethics, educations, natural and social sciences, agent applications, and other areas. Secondly, we answer the `where' and `how' questions by diving into the evaluation methods and benchmarks, which serve as crucial components in assessing performance of LLMs. Then, we summarize the success and failure cases of LLMs in different tasks. Finally, we shed light on several future challenges that lie ahead in LLMs evaluation. Our aim is to offer invaluable insights to researchers in the realm of LLMs evaluation, thereby aiding the development of more proficient LLMs. Our key point is that evaluation should be treated as an essential discipline to better assist the development of LLMs. We consistently maintain the related open-source materials at: https://github.com/MLGroupJLU/LLM-eval-survey.

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

The recommendation of medication is a vital aspect of intelligent healthcare systems, as it involves prescribing the most suitable drugs based on a patient's specific health needs. Unfortunately, many sophisticated models currently in use tend to overlook the nuanced semantics of medical data, while only relying heavily on identities. Furthermore, these models face significant challenges in handling cases involving patients who are visiting the hospital for the first time, as they lack prior prescription histories to draw upon. To tackle these issues, we harness the powerful semantic comprehension and input-agnostic characteristics of Large Language Models (LLMs). Our research aims to transform existing medication recommendation methodologies using LLMs. In this paper, we introduce a novel approach called Large Language Model Distilling Medication Recommendation (LEADER). We begin by creating appropriate prompt templates that enable LLMs to suggest medications effectively. However, the straightforward integration of LLMs into recommender systems leads to an out-of-corpus issue specific to drugs. We handle it by adapting the LLMs with a novel output layer and a refined tuning loss function. Although LLM-based models exhibit remarkable capabilities, they are plagued by high computational costs during inference, which is impractical for the healthcare sector. To mitigate this, we have developed a feature-level knowledge distillation technique, which transfers the LLM's proficiency to a more compact model. Extensive experiments conducted on two real-world datasets, MIMIC-III and MIMIC-IV, demonstrate that our proposed model not only delivers effective results but also is efficient. To ease the reproducibility of our experiments, we release the implementation code online.

Ensuring the safety of large language models (LLMs) is critical for responsible deployment, yet existing evaluations often prioritize performance over identifying failure modes. We introduce Phare, a multilingual diagnostic framework to probe and evaluate LLM behavior across three critical dimensions: hallucination and reliability, social biases, and harmful content generation. Our evaluation of 17 state-of-the-art LLMs reveals patterns of systematic vulnerabilities across all safety dimensions, including sycophancy, prompt sensitivity, and stereotype reproduction. By highlighting these specific failure modes rather than simply ranking models, Phare provides researchers and practitioners with actionable insights to build more robust, aligned, and trustworthy language systems.

Large Language Models (LLMs) are at the forefront of NLP achievements but fall short in dealing with shortcut learning, factual inconsistency, and vulnerability to adversarial inputs.These shortcomings are especially critical in medical contexts, where they can misrepresent actual model capabilities. Addressing this, we present SemEval-2024 Task 2: Safe Biomedical Natural Language Inference for ClinicalTrials. Our contributions include the refined NLI4CT-P dataset (i.e., Natural Language Inference for Clinical Trials - Perturbed), designed to challenge LLMs with interventional and causal reasoning tasks, along with a comprehensive evaluation of methods and results for participant submissions. A total of 106 participants registered for the task contributing to over 1200 individual submissions and 25 system overview papers. This initiative aims to advance the robustness and applicability of NLI models in healthcare, ensuring safer and more dependable AI assistance in clinical decision-making. We anticipate that the dataset, models, and outcomes of this task can support future research in the field of biomedical NLI. The dataset, competition leaderboard, and website are publicly available.

Global rates of mental health concerns are rising and there is increasing realization that existing models of mental healthcare will not adequately expand to meet the demand. With the emergence of large language models (LLMs) has come great optimism regarding their promise to create novel, large-scale solutions to support mental health. Despite their nascence, LLMs have already been applied to mental health-related tasks. In this review, we summarize the extant literature on efforts to use LLMs to provide mental health education, assessment, and intervention and highlight key opportunities for positive impact in each area. We then highlight risks associated with LLMs application to mental health and encourage adoption of strategies to mitigate these risks. The urgent need for mental health support must be balanced with responsible development, testing, and deployment of mental health LLMs. Especially critical is ensuring that mental health LLMs are fine-tuned for mental health, enhance mental health equity, adhere to ethical standards, and that people, including those with lived experience with mental health concerns, are involved in all stages from development through deployment. Prioritizing these efforts will minimize potential harms to mental health and maximize the likelihood that LLMs will positively impact mental health globally.

Recent large language models (LLMs) can generate and revise text with human-level performance, and have been widely commercialized in systems like ChatGPT. These models come with clear limitations: they can produce inaccurate information, reinforce existing biases, and be easily misused. Yet, many scientists have been using them to assist their scholarly writing. How wide-spread is LLM usage in the academic literature currently? To answer this question, we use an unbiased, large-scale approach, free from any assumptions on academic LLM usage. We study vocabulary changes in 14 million PubMed abstracts from 2010-2024, and show how the appearance of LLMs led to an abrupt increase in the frequency of certain style words. Our analysis based on excess words usage suggests that at least 10% of 2024 abstracts were processed with LLMs. This lower bound differed across disciplines, countries, and journals, and was as high as 30% for some PubMed sub-corpora. We show that the appearance of LLM-based writing assistants has had an unprecedented impact in the scientific literature, surpassing the effect of major world events such as the Covid pandemic.

Large Language Models (LLMs) provide a possibility to make a great breakthrough in medicine. The establishment of a standardized medical benchmark becomes a fundamental cornerstone to measure progression. However, medical environments in different regions have their local characteristics, e.g., the ubiquity and significance of traditional Chinese medicine within China. Therefore, merely translating English-based medical evaluation may result in contextual incongruities to a local region. To solve the issue, we propose a localized medical benchmark called CMB, a Comprehensive Medical Benchmark in Chinese, designed and rooted entirely within the native Chinese linguistic and cultural framework. While traditional Chinese medicine is integral to this evaluation, it does not constitute its entirety. Using this benchmark, we have evaluated several prominent large-scale LLMs, including ChatGPT, GPT-4, dedicated Chinese LLMs, and LLMs specialized in the medical domain. It is worth noting that our benchmark is not devised as a leaderboard competition but as an instrument for self-assessment of model advancements. We hope this benchmark could facilitate the widespread adoption and enhancement of medical LLMs within China. Check details in https://cmedbenchmark.llmzoo.com/.

Large Language Models (LLMs) have emerged as powerful tools in the field of Natural Language Processing (NLP) and have recently gained significant attention in the domain of Recommendation Systems (RS). These models, trained on massive amounts of data using self-supervised learning, have demonstrated remarkable success in learning universal representations and have the potential to enhance various aspects of recommendation systems by some effective transfer techniques such as fine-tuning and prompt tuning, and so on. The crucial aspect of harnessing the power of language models in enhancing recommendation quality is the utilization of their high-quality representations of textual features and their extensive coverage of external knowledge to establish correlations between items and users. To provide a comprehensive understanding of the existing LLM-based recommendation systems, this survey presents a taxonomy that categorizes these models into two major paradigms, respectively Discriminative LLM for Recommendation (DLLM4Rec) and Generative LLM for Recommendation (GLLM4Rec), with the latter being systematically sorted out for the first time. Furthermore, we systematically review and analyze existing LLM-based recommendation systems within each paradigm, providing insights into their methodologies, techniques, and performance. Additionally, we identify key challenges and several valuable findings to provide researchers and practitioners with inspiration. We have also created a GitHub repository to index relevant papers on LLMs for recommendation, https://github.com/WLiK/LLM4Rec.

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

The ability of large language models (LLMs) to follow natural language instructions with human-level fluency suggests many opportunities in healthcare to reduce administrative burden and improve quality of care. However, evaluating LLMs on realistic text generation tasks for healthcare remains challenging. Existing question answering datasets for electronic health record (EHR) data fail to capture the complexity of information needs and documentation burdens experienced by clinicians. To address these challenges, we introduce MedAlign, a benchmark dataset of 983 natural language instructions for EHR data. MedAlign is curated by 15 clinicians (7 specialities), includes clinician-written reference responses for 303 instructions, and provides 276 longitudinal EHRs for grounding instruction-response pairs. We used MedAlign to evaluate 6 general domain LLMs, having clinicians rank the accuracy and quality of each LLM response. We found high error rates, ranging from 35% (GPT-4) to 68% (MPT-7B-Instruct), and an 8.3% drop in accuracy moving from 32k to 2k context lengths for GPT-4. Finally, we report correlations between clinician rankings and automated natural language generation metrics as a way to rank LLMs without human review. We make MedAlign available under a research data use agreement to enable LLM evaluations on tasks aligned with clinician needs and preferences.

Large language models (LLMs) are increasingly used in healthcare, but their reliability is heavily influenced by user-driven factors such as question phrasing and the completeness of clinical information. In this study, we examined how misinformation framing, source authority, model persona, and omission of key clinical details affect the diagnostic accuracy and reliability of LLM outputs. We conducted two experiments: one introducing misleading external opinions with varying assertiveness (perturbation test), and another removing specific categories of patient information (ablation test). Using public datasets (MedQA and Medbullets), we evaluated proprietary models (GPT-4o, Claude 3.5 Sonnet, Claude 3.5 Haiku, Gemini 1.5 Pro, Gemini 1.5 Flash) and open-source models (LLaMA 3 8B, LLaMA 3 Med42 8B, DeepSeek R1 8B). All models were vulnerable to user-driven misinformation, with proprietary models especially affected by definitive and authoritative language. Assertive tone had the greatest negative impact on accuracy. In the ablation test, omitting physical exam findings and lab results caused the most significant performance drop. Although proprietary models had higher baseline accuracy, their performance declined sharply under misinformation. These results highlight the need for well-structured prompts and complete clinical context. Users should avoid authoritative framing of misinformation and provide full clinical details, especially for complex cases.

Large Language Models (LLMs), typified by OpenAI's GPT series and Meta's LLaMA variants, have marked a significant advancement in artificial intelligence. Trained on vast amounts of text data, LLMs are capable of understanding and generating human-like text across a diverse range of topics. This study expands on the applications of LLMs, exploring their potential in data preprocessing, a critical stage in data mining and analytics applications. We delve into the applicability of state-of-the-art LLMs such as GPT-3.5, GPT-4, and Vicuna-13B for error detection, data imputation, schema matching, and entity matching tasks. Alongside showcasing the inherent capabilities of LLMs, we highlight their limitations, particularly in terms of computational expense and inefficiency. We propose an LLM-based framework for data preprocessing, which integrates cutting-edge prompt engineering techniques, coupled with traditional methods like contextualization and feature selection, to improve the performance and efficiency of these models. The effectiveness of LLMs in data preprocessing is evaluated through an experimental study spanning 12 datasets. GPT-4 emerged as a standout, achieving 100\% accuracy or F1 score on 4 datasets, suggesting LLMs' immense potential in these tasks. Despite certain limitations, our study underscores the promise of LLMs in this domain and anticipates future developments to overcome current hurdles.

As the prevalence of mental health challenges, social media has emerged as a key platform for individuals to express their emotions.Deep learning tends to be a promising solution for analyzing mental health on social media. However, black box models are often inflexible when switching between tasks, and their results typically lack explanations. With the rise of large language models (LLMs), their flexibility has introduced new approaches to the field. Also due to the generative nature, they can be prompted to explain decision-making processes. However, their performance on complex psychological analysis still lags behind deep learning. In this paper, we introduce the first multi-task Chinese Social Media Interpretable Mental Health Instructions (C-IMHI) dataset, consisting of 9K samples, which has been quality-controlled and manually validated. We also propose MentalGLM series models, the first open-source LLMs designed for explainable mental health analysis targeting Chinese social media, trained on a corpus of 50K instructions. The proposed models were evaluated on three downstream tasks and achieved better or comparable performance compared to deep learning models, generalized LLMs, and task fine-tuned LLMs. We validated a portion of the generated decision explanations with experts, showing promising results. We also evaluated the proposed models on a clinical dataset, where they outperformed other LLMs, indicating their potential applicability in the clinical field. Our models show strong performance, validated across tasks and perspectives. The decision explanations enhance usability and facilitate better understanding and practical application of the models. Both the constructed dataset and the models are publicly available via: https://github.com/zwzzzQAQ/MentalGLM.

Large Language Models(LLMs)have become effective tools for natural language processing and have been used in many different fields. This essay offers a succinct summary of various LLM subcategories. The survey emphasizes recent developments and efforts made for various LLM kinds, including task-based financial LLMs, multilingual language LLMs, biomedical and clinical LLMs, vision language LLMs, and code language models. The survey gives a general summary of the methods, attributes, datasets, transformer models, and comparison metrics applied in each category of LLMs. Furthermore, it highlights unresolved problems in the field of developing chatbots and virtual assistants, such as boosting natural language processing, enhancing chatbot intelligence, and resolving moral and legal dilemmas. The purpose of this study is to provide readers, developers, academics, and users interested in LLM-based chatbots and virtual intelligent assistant technologies with useful information and future directions.

Tumor documentation in Germany is largely done manually, requiring reading patient records and entering data into structured databases. Large language models (LLMs) could potentially enhance this process by improving efficiency and reliability. This evaluation tests eleven different open source LLMs with sizes ranging from 1-70 billion model parameters on three basic tasks of the tumor documentation process: identifying tumor diagnoses, assigning ICD-10 codes, and extracting the date of first diagnosis. For evaluating the LLMs on these tasks, a dataset of annotated text snippets based on anonymized doctors' notes from urology was prepared. Different prompting strategies were used to investigate the effect of the number of examples in few-shot prompting and to explore the capabilities of the LLMs in general. The models Llama 3.1 8B, Mistral 7B, and Mistral NeMo 12 B performed comparably well in the tasks. Models with less extensive training data or having fewer than 7 billion parameters showed notably lower performance, while larger models did not display performance gains. Examples from a different medical domain than urology could also improve the outcome in few-shot prompting, which demonstrates the ability of LLMs to handle tasks needed for tumor documentation. Open source LLMs show a strong potential for automating tumor documentation. Models from 7-12 billion parameters could offer an optimal balance between performance and resource efficiency. With tailored fine-tuning and well-designed prompting, these models might become important tools for clinical documentation in the future. The code for the evaluation is available from https://github.com/stefan-m-lenz/UroLlmEval. We also release the dataset as a new valuable resource that addresses the shortage of authentic and easily accessible benchmarks in German-language medical NLP.

Recent breakthroughs in large language models (LLMs) offer unprecedented natural language understanding and generation capabilities. However, existing surveys on LLMs in biomedicine often focus on specific applications or model architectures, lacking a comprehensive analysis that integrates the latest advancements across various biomedical domains. This review, based on an analysis of 484 publications sourced from databases including PubMed, Web of Science, and arXiv, provides an in-depth examination of the current landscape, applications, challenges, and prospects of LLMs in biomedicine, distinguishing itself by focusing on the practical implications of these models in real-world biomedical contexts. Firstly, we explore the capabilities of LLMs in zero-shot learning across a broad spectrum of biomedical tasks, including diagnostic assistance, drug discovery, and personalized medicine, among others, with insights drawn from 137 key studies. Then, we discuss adaptation strategies of LLMs, including fine-tuning methods for both uni-modal and multi-modal LLMs to enhance their performance in specialized biomedical contexts where zero-shot fails to achieve, such as medical question answering and efficient processing of biomedical literature. Finally, we discuss the challenges that LLMs face in the biomedicine domain including data privacy concerns, limited model interpretability, issues with dataset quality, and ethics due to the sensitive nature of biomedical data, the need for highly reliable model outputs, and the ethical implications of deploying AI in healthcare. To address these challenges, we also identify future research directions of LLM in biomedicine including federated learning methods to preserve data privacy and integrating explainable AI methodologies to enhance the transparency of LLMs.

Current Large Language Models (LLMs) exhibit significant limitations, notably in structured, interpretable, and verifiable medical reasoning, alongside practical deployment challenges related to computational resources and data privacy. This report focused on the development of WiNGPT-3.0, the 32-billion parameter LLMs, engineered with the objective of enhancing its capacity for medical reasoning and exploring its potential for effective integration within healthcare IT infrastructures. The broader aim is to advance towards clinically applicable models. The approach involved a multi-stage training pipeline tailored for general, medical, and clinical reasoning. This pipeline incorporated supervised fine-tuning (SFT) and reinforcement learning (RL), leveraging curated Long Chain-of-Thought (CoT) datasets, auxiliary reward models, and an evidence-based diagnostic chain simulation. WiNGPT-3.0 demonstrated strong performance: specific model variants achieved scores of 66.6 on MedCalc and 87.1 on MedQA-USMLE. Furthermore, targeted training improved performance on a clinical reasoning task from a baseline score of 58.1 to 62.5. These findings suggest that reinforcement learning, even when applied with a limited dataset of only a few thousand examples, can enhance medical reasoning accuracy. Crucially, this demonstration of RL's efficacy with limited data and computation paves the way for more trustworthy and practically deployable LLMs within clinical workflows and health information infrastructures.

Large Language Models (LLMs) have the potential of facilitating the development of Artificial Intelligence technology to assist medical experts for interactive decision support, which has been demonstrated by their competitive performances in Medical QA. However, while impressive, the required quality bar for medical applications remains far from being achieved. Currently, LLMs remain challenged by outdated knowledge and by their tendency to generate hallucinated content. Furthermore, most benchmarks to assess medical knowledge lack reference gold explanations which means that it is not possible to evaluate the reasoning of LLMs predictions. Finally, the situation is particularly grim if we consider benchmarking LLMs for languages other than English which remains, as far as we know, a totally neglected topic. In order to address these shortcomings, in this paper we present MedExpQA, the first multilingual benchmark based on medical exams to evaluate LLMs in Medical Question Answering. To the best of our knowledge, MedExpQA includes for the first time reference gold explanations written by medical doctors which can be leveraged to establish various gold-based upper-bounds for comparison with LLMs performance. Comprehensive multilingual experimentation using both the gold reference explanations and Retrieval Augmented Generation (RAG) approaches show that performance of LLMs still has large room for improvement, especially for languages other than English. Furthermore, and despite using state-of-the-art RAG methods, our results also demonstrate the difficulty of obtaining and integrating readily available medical knowledge that may positively impact results on downstream evaluations for Medical Question Answering. So far the benchmark is available in four languages, but we hope that this work may encourage further development to other languages.

The rise of large language models (LLMs) has revolutionized user interactions with knowledge-based systems, enabling chatbots to synthesize vast amounts of information and assist with complex, exploratory tasks. However, LLM-based chatbots often struggle to provide personalized support, particularly when users start with vague queries or lack sufficient contextual information. This paper introduces the Collaborative Assistant for Personalized Exploration (CARE), a system designed to enhance personalization in exploratory tasks by combining a multi-agent LLM framework with a structured user interface. CARE's interface consists of a Chat Panel, Solution Panel, and Needs Panel, enabling iterative query refinement and dynamic solution generation. The multi-agent framework collaborates to identify both explicit and implicit user needs, delivering tailored, actionable solutions. In a within-subject user study with 22 participants, CARE was consistently preferred over a baseline LLM chatbot, with users praising its ability to reduce cognitive load, inspire creativity, and provide more tailored solutions. Our findings highlight CARE's potential to transform LLM-based systems from passive information retrievers to proactive partners in personalized problem-solving and exploration.

Large language models (LLMs) hold great promise in summarizing medical evidence. Most recent studies focus on the application of proprietary LLMs. Using proprietary LLMs introduces multiple risk factors, including a lack of transparency and vendor dependency. While open-source LLMs allow better transparency and customization, their performance falls short compared to proprietary ones. In this study, we investigated to what extent fine-tuning open-source LLMs can further improve their performance in summarizing medical evidence. Utilizing a benchmark dataset, MedReview, consisting of 8,161 pairs of systematic reviews and summaries, we fine-tuned three broadly-used, open-sourced LLMs, namely PRIMERA, LongT5, and Llama-2. Overall, the fine-tuned LLMs obtained an increase of 9.89 in ROUGE-L (95% confidence interval: 8.94-10.81), 13.21 in METEOR score (95% confidence interval: 12.05-14.37), and 15.82 in CHRF score (95% confidence interval: 13.89-16.44). The performance of fine-tuned LongT5 is close to GPT-3.5 with zero-shot settings. Furthermore, smaller fine-tuned models sometimes even demonstrated superior performance compared to larger zero-shot models. The above trends of improvement were also manifested in both human and GPT4-simulated evaluations. Our results can be applied to guide model selection for tasks demanding particular domain knowledge, such as medical evidence summarization.

Large language models (LLMs) are increasingly applied to outpatient referral tasks across healthcare systems. However, there is a lack of standardized evaluation criteria to assess their effectiveness, particularly in dynamic, interactive scenarios. In this study, we systematically examine the capabilities and limitations of LLMs in managing tasks within Intelligent Outpatient Referral (IOR) systems and propose a comprehensive evaluation framework specifically designed for such systems. This framework comprises two core tasks: static evaluation, which focuses on evaluating the ability of predefined outpatient referrals, and dynamic evaluation, which evaluates capabilities of refining outpatient referral recommendations through iterative dialogues. Our findings suggest that LLMs offer limited advantages over BERT-like models, but show promise in asking effective questions during interactive dialogues.

Accurate and efficient question-answering systems are essential for delivering high-quality patient care in the medical field. While Large Language Models (LLMs) have made remarkable strides across various domains, they continue to face significant challenges in medical question answering, particularly in understanding domain-specific terminologies and performing complex reasoning. These limitations undermine their effectiveness in critical medical applications. To address these issues, we propose a novel approach incorporating similar case generation within a multi-agent medical question-answering (MedQA) system. Specifically, we leverage the Llama3.1:70B model, a state-of-the-art LLM, in a multi-agent architecture to enhance performance on the MedQA dataset using zero-shot learning. Our method capitalizes on the model's inherent medical knowledge and reasoning capabilities, eliminating the need for additional training data. Experimental results show substantial performance gains over existing benchmark models, with improvements of 7% in both accuracy and F1-score across various medical QA tasks. Furthermore, we examine the model's interpretability and reliability in addressing complex medical queries. This research not only offers a robust solution for medical question answering but also establishes a foundation for broader applications of LLMs in the medical domain.

Large Language Models (LLMs) have demonstrated remarkable capabilities, yet their transition to real-world applications reveals a critical limitation: the inability to adapt to individual preferences while maintaining alignment with universal human values. Current alignment techniques adopt a one-size-fits-all approach that fails to accommodate users' diverse backgrounds and needs. This paper presents the first comprehensive survey of personalized alignment-a paradigm that enables LLMs to adapt their behavior within ethical boundaries based on individual preferences. We propose a unified framework comprising preference memory management, personalized generation, and feedback-based alignment, systematically analyzing implementation approaches and evaluating their effectiveness across various scenarios. By examining current techniques, potential risks, and future challenges, this survey provides a structured foundation for developing more adaptable and ethically-aligned LLMs.

Many large language models (LLMs) for medicine have largely been evaluated on short texts, and their ability to handle longer sequences such as a complete electronic health record (EHR) has not been systematically explored. Assessing these models on long sequences is crucial since prior work in the general domain has demonstrated performance degradation of LLMs on longer texts. Motivated by this, we introduce LongBoX, a collection of seven medical datasets in text-to-text format, designed to investigate model performance on long sequences. Preliminary experiments reveal that both medical LLMs (e.g., BioGPT) and strong general domain LLMs (e.g., FLAN-T5) struggle on this benchmark. We further evaluate two techniques designed for long-sequence handling: (i) local-global attention, and (ii) Fusion-in-Decoder (FiD). Our results demonstrate mixed results with long-sequence handling - while scores on some datasets increase, there is substantial room for improvement. We hope that LongBoX facilitates the development of more effective long-sequence techniques for the medical domain. Data and source code are available at https://github.com/Mihir3009/LongBoX.

The remarkable capabilities of Large Language Models (LLMs) make them increasingly compelling for adoption in real-world healthcare applications. However, the risks associated with using LLMs in medical applications have not been systematically characterized. We propose using five key principles for safe and trustworthy medical AI: Truthfulness, Resilience, Fairness, Robustness, and Privacy, along with ten specific aspects. Under this comprehensive framework, we introduce a novel MedGuard benchmark with 1,000 expert-verified questions. Our evaluation of 11 commonly used LLMs shows that the current language models, regardless of their safety alignment mechanisms, generally perform poorly on most of our benchmarks, particularly when compared to the high performance of human physicians. Despite recent reports indicate that advanced LLMs like ChatGPT can match or even exceed human performance in various medical tasks, this study underscores a significant safety gap, highlighting the crucial need for human oversight and the implementation of AI safety guardrails.

Electronic Health Records (EHRs) hold immense potential for advancing healthcare, offering rich, longitudinal data that combines structured information with valuable insights from unstructured clinical notes. However, the unstructured nature of clinical text poses significant challenges for secondary applications. Traditional methods for structuring EHR free-text data, such as rule-based systems and multi-stage pipelines, are often limited by their time-consuming configurations and inability to adapt across clinical notes from diverse healthcare settings. Few systems provide a comprehensive attribute extraction for terminologies. While giant large language models (LLMs) like GPT-4 and LLaMA 405B excel at structuring tasks, they are slow, costly, and impractical for large-scale use. To overcome these limitations, we introduce GENIE, a Generative Note Information Extraction system that leverages LLMs to streamline the structuring of unstructured clinical text into usable data with standardized format. GENIE processes entire paragraphs in a single pass, extracting entities, assertion statuses, locations, modifiers, values, and purposes with high accuracy. Its unified, end-to-end approach simplifies workflows, reduces errors, and eliminates the need for extensive manual intervention. Using a robust data preparation pipeline and fine-tuned small scale LLMs, GENIE achieves competitive performance across multiple information extraction tasks, outperforming traditional tools like cTAKES and MetaMap and can handle extra attributes to be extracted. GENIE strongly enhances real-world applicability and scalability in healthcare systems. By open-sourcing the model and test data, we aim to encourage collaboration and drive further advancements in EHR structurization.

Large Language Models (LLMs) have achieved remarkable success in various fields, prompting several studies to explore their potential in recommendation systems. However, these attempts have so far resulted in only modest improvements over traditional recommendation models. Moreover, three critical questions remain under-explored: firstly, the real value of LLMs' pre-trained weights, often considered to encapsulate world knowledge; secondly, the necessity of fine-tuning for recommendation tasks; lastly, whether LLMs can exhibit the same scalability benefits in recommendation systems as they do in other domains. In this paper, we propose a novel Hierarchical Large Language Model (HLLM) architecture designed to enhance sequential recommendation systems. Our approach employs a two-tier model: the first Item LLM extracts rich content features from the detailed text description of the item, while the second User LLM utilizes these features to predict users' future interests based on their interaction history. Extensive experiments demonstrate that our method effectively leverages the pre-trained capabilities of open-source LLMs, and further fine-tuning leads to significant performance boosts. Additionally, HLLM achieves excellent scalability, with the largest configuration utilizing 7B parameters for both item feature extraction and user interest modeling. Moreover, HLLM offers excellent training and serving efficiency, making it practical in real-world applications. Evaluations on two large-scale datasets, PixelRec and Amazon Reviews, show that HLLM achieves state-of-the-art results, outperforming traditional ID-based models by a wide margin. In online A/B testing, HLLM showcases notable gains, validating its practical impact in real-world recommendation scenarios. Codes are available at https://github.com/bytedance/HLLM.

Large language models (LLMs) have shown potential in biomedical applications, leading to efforts to fine-tune them on domain-specific data. However, the effectiveness of this approach remains unclear. This study evaluates the performance of biomedically fine-tuned LLMs against their general-purpose counterparts on a variety of clinical tasks. We evaluated their performance on clinical case challenges from the New England Journal of Medicine (NEJM) and the Journal of the American Medical Association (JAMA) and on several clinical tasks (e.g., information extraction, document summarization, and clinical coding). Using benchmarks specifically chosen to be likely outside the fine-tuning datasets of biomedical models, we found that biomedical LLMs mostly perform inferior to their general-purpose counterparts, especially on tasks not focused on medical knowledge. While larger models showed similar performance on case tasks (e.g., OpenBioLLM-70B: 66.4% vs. Llama-3-70B-Instruct: 65% on JAMA cases), smaller biomedical models showed more pronounced underperformance (e.g., OpenBioLLM-8B: 30% vs. Llama-3-8B-Instruct: 64.3% on NEJM cases). Similar trends were observed across the CLUE (Clinical Language Understanding Evaluation) benchmark tasks, with general-purpose models often performing better on text generation, question answering, and coding tasks. Our results suggest that fine-tuning LLMs to biomedical data may not provide the expected benefits and may potentially lead to reduced performance, challenging prevailing assumptions about domain-specific adaptation of LLMs and highlighting the need for more rigorous evaluation frameworks in healthcare AI. Alternative approaches, such as retrieval-augmented generation, may be more effective in enhancing the biomedical capabilities of LLMs without compromising their general knowledge.

General large language models (LLMs) such as ChatGPT have shown remarkable success. However, such LLMs have not been widely adopted for medical purposes, due to poor accuracy and inability to provide medical advice. We propose IvyGPT, an LLM based on LLaMA that is trained and fine-tuned with high-quality medical question-answer (QA) instances and Reinforcement Learning from Human Feedback (RLHF). After supervised fine-tuning, IvyGPT has good multi-turn conversation capabilities, but it cannot perform like a doctor in other aspects, such as comprehensive diagnosis. Through RLHF, IvyGPT can output richer diagnosis and treatment answers that are closer to human. In the training, we used QLoRA to train 33 billion parameters on a small number of NVIDIA A100 (80GB) GPUs. Experimental results show that IvyGPT has outperformed other medical GPT models.

Large language models (LLMs) have exhibited remarkable capabilities across various domains and tasks, pushing the boundaries of our knowledge in learning and cognition. The latest model, OpenAI's o1, stands out as the first LLM with an internalized chain-of-thought technique using reinforcement learning strategies. While it has demonstrated surprisingly strong capabilities on various general language tasks, its performance in specialized fields such as medicine remains unknown. To this end, this report provides a comprehensive exploration of o1 on different medical scenarios, examining 3 key aspects: understanding, reasoning, and multilinguality. Specifically, our evaluation encompasses 6 tasks using data from 37 medical datasets, including two newly constructed and more challenging question-answering (QA) tasks based on professional medical quizzes from the New England Journal of Medicine (NEJM) and The Lancet. These datasets offer greater clinical relevance compared to standard medical QA benchmarks such as MedQA, translating more effectively into real-world clinical utility. Our analysis of o1 suggests that the enhanced reasoning ability of LLMs may (significantly) benefit their capability to understand various medical instructions and reason through complex clinical scenarios. Notably, o1 surpasses the previous GPT-4 in accuracy by an average of 6.2% and 6.6% across 19 datasets and two newly created complex QA scenarios. But meanwhile, we identify several weaknesses in both the model capability and the existing evaluation protocols, including hallucination, inconsistent multilingual ability, and discrepant metrics for evaluation. We release our raw data and model outputs at https://ucsc-vlaa.github.io/o1_medicine/ for future research.

Current ophthalmology clinical workflows are plagued by over-referrals, long waits, and complex and heterogeneous medical records. Large language models (LLMs) present a promising solution to automate various procedures such as triaging, preliminary tests like visual acuity assessment, and report summaries. However, LLMs have demonstrated significantly varied performance across different languages in natural language question-answering tasks, potentially exacerbating healthcare disparities in Low and Middle-Income Countries (LMICs). This study introduces the first multilingual ophthalmological question-answering benchmark with manually curated questions parallel across languages, allowing for direct cross-lingual comparisons. Our evaluation of 6 popular LLMs across 7 different languages reveals substantial bias across different languages, highlighting risks for clinical deployment of LLMs in LMICs. Existing debiasing methods such as Translation Chain-of-Thought or Retrieval-augmented generation (RAG) by themselves fall short of closing this performance gap, often failing to improve performance across all languages and lacking specificity for the medical domain. To address this issue, We propose CLARA (Cross-Lingual Reflective Agentic system), a novel inference time de-biasing method leveraging retrieval augmented generation and self-verification. Our approach not only improves performance across all languages but also significantly reduces the multilingual bias gap, facilitating equitable LLM application across the globe.

Large Language Models (LLMs) have demonstrated remarkable capabilities in important tasks such as natural language understanding, language generation, and complex reasoning and have the potential to make a substantial impact on our society. Such capabilities, however, come with the considerable resources they demand, highlighting the strong need to develop effective techniques for addressing their efficiency challenges. In this survey, we provide a systematic and comprehensive review of efficient LLMs research. We organize the literature in a taxonomy consisting of three main categories, covering distinct yet interconnected efficient LLMs topics from model-centric, data-centric, and framework-centric perspective, respectively. We have also created a GitHub repository where we compile the papers featured in this survey at https://github.com/AIoT-MLSys-Lab/EfficientLLMs, and will actively maintain this repository and incorporate new research as it emerges. We hope our survey can serve as a valuable resource to help researchers and practitioners gain a systematic understanding of the research developments in efficient LLMs and inspire them to contribute to this important and exciting field.

Large Language Models (LLMs), despite their remarkable progress across various general domains, encounter significant barriers in medicine and healthcare. This field faces unique challenges such as domain-specific terminologies and the reasoning over specialized knowledge. To address these obstinate issues, we propose a novel Multi-disciplinary Collaboration (MC) framework for the medical domain that leverages role-playing LLM-based agents who participate in a collaborative multi-round discussion, thereby enhancing LLM proficiency and reasoning capabilities. This training-free and interpretable framework encompasses five critical steps: gathering domain experts, proposing individual analyses, summarising these analyses into a report, iterating over discussions until a consensus is reached, and ultimately making a decision. Our work particularly focuses on the zero-shot scenario, our results on nine data sets (MedQA, MedMCQA, PubMedQA, and six subtasks from MMLU) establish that our proposed MC framework excels at mining and harnessing the medical expertise in LLMs, as well as extending its reasoning abilities. Based on these outcomes, we further conduct a human evaluation to pinpoint and categorize common errors within our method, as well as ablation studies aimed at understanding the impact of various factors on overall performance. Our code can be found at https://github.com/gersteinlab/MedAgents.

The rise of chronic diseases and pandemics like COVID-19 has emphasized the need for effective patient data processing while ensuring privacy through anonymization and de-identification of protected health information (PHI). Anonymized data facilitates research without compromising patient confidentiality. This paper introduces expert small AI models developed using the LLM-in-the-loop methodology to meet the demand for domain-specific de-identification NER models. These models overcome the privacy risks associated with large language models (LLMs) used via APIs by eliminating the need to transmit or store sensitive data. More importantly, they consistently outperform LLMs in de-identification tasks, offering superior performance and reliability. Our de-identification NER models, developed in eight languages (English, German, Italian, French, Romanian, Turkish, Spanish, and Arabic) achieved f1-micro score averages of 0.966, 0.975, 0.976, 0.970, 0.964, 0.974, 0.978, and 0.953 respectively. These results establish them as the most accurate healthcare anonymization solutions, surpassing existing small models and even general-purpose LLMs such as GPT-4o. While Part-1 of this series introduced the LLM-in-the-loop methodology for bio-medical document translation, this second paper showcases its success in developing cost-effective expert small NER models in de-identification tasks. Our findings lay the groundwork for future healthcare AI innovations, including biomedical entity and relation extraction, demonstrating the value of specialized models for domain-specific challenges.

Brief hospital course (BHC) summaries are common clinical documents generated by summarizing clinical notes. While large language models (LLMs) depict remarkable capabilities in automating real-world tasks, their capabilities for healthcare applications such as BHC synthesis have not been shown. To enable the adaptation of LLMs for BHC synthesis, we introduce a novel benchmark consisting of a pre-processed dataset extracted from MIMIC-IV notes, encapsulating clinical note, and brief hospital course (BHC) pairs. We assess the performance of two general-purpose LLMs and three healthcare-adapted LLMs to improve BHC synthesis from clinical notes. Using clinical notes as input for generating BHCs, we apply prompting-based (using in-context learning) and fine-tuning-based adaptation strategies to three open-source LLMs (Clinical-T5-Large, Llama2-13B, FLAN-UL2) and two proprietary LLMs (GPT-3.5, GPT-4). We quantitatively evaluate the performance of these LLMs across varying context-length inputs using conventional natural language similarity metrics. We further perform a qualitative study where five diverse clinicians blindly compare clinician-written BHCs and two LLM-generated BHCs for 30 samples across metrics of comprehensiveness, conciseness, factual correctness, and fluency. Overall, we present a new benchmark and pre-processed dataset for using LLMs in BHC synthesis from clinical notes. We observe high-quality summarization performance for both in-context proprietary and fine-tuned open-source LLMs using both quantitative metrics and a qualitative clinical reader study. We propose our work as a benchmark to motivate future works to adapt and assess the performance of LLMs in BHC synthesis.

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

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

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

Large language models (LLMs) have demonstrated remarkable performance across a wide array of NLP tasks. However, their efficacy is undermined by undesired and inconsistent behaviors, including hallucination, unfaithful reasoning, and toxic content. A promising approach to rectify these flaws is self-correction, where the LLM itself is prompted or guided to fix problems in its own output. Techniques leveraging automated feedback -- either produced by the LLM itself or some external system -- are of particular interest as they are a promising way to make LLM-based solutions more practical and deployable with minimal human feedback. This paper presents a comprehensive review of this emerging class of techniques. We analyze and taxonomize a wide array of recent work utilizing these strategies, including training-time, generation-time, and post-hoc correction. We also summarize the major applications of this strategy and conclude by discussing future directions and challenges.

Large Language Models (LLMs) represent a significant advancement in artificial intelligence, finding applications across various domains. However, their reliance on massive internet-sourced datasets for training brings notable privacy issues, which are exacerbated in critical domains (e.g., healthcare). Moreover, certain application-specific scenarios may require fine-tuning these models on private data. This survey critically examines the privacy threats associated with LLMs, emphasizing the potential for these models to memorize and inadvertently reveal sensitive information. We explore current threats by reviewing privacy attacks on LLMs and propose comprehensive solutions for integrating privacy mechanisms throughout the entire learning pipeline. These solutions range from anonymizing training datasets to implementing differential privacy during training or inference and machine unlearning after training. Our comprehensive review of existing literature highlights ongoing challenges, available tools, and future directions for preserving privacy in LLMs. This work aims to guide the development of more secure and trustworthy AI systems by providing a thorough understanding of privacy preservation methods and their effectiveness in mitigating risks.

Large language models (LLMs) have recently achieved impressive performance across a wide range of natural language tasks and are now widely used in real-world applications. Among them, black-box LLMs--served via APIs without access to model internals--are especially dominant due to their scalability and ease of deployment. Despite their strong capabilities, these models typically produce generalized responses that overlook personal preferences and reasoning styles. This has led to growing interest in black-box LLM personalization, which aims to tailor model outputs to user-specific context without modifying model parameters. However, existing approaches primarily focus on response-level personalization, attempting to match final outputs without modeling personal thought process. To address this limitation, we propose RPM, a framework for reasoning-level personalization that aligns the model's reasoning process with a user's personalized logic. RPM first constructs statistical user-specific factors by extracting and grouping response-influential features from user history. It then builds personalized reasoning paths that reflect how these factors are used in context. In the inference stage, RPM retrieves reasoning-aligned examples for new queries via feature-level similarity and performs inference conditioned on the structured factors and retrieved reasoning paths, enabling the model to follow user-specific reasoning trajectories. This reasoning-level personalization enhances both predictive accuracy and interpretability by grounding model outputs in user-specific logic through structured information. Extensive experiments across diverse tasks show that RPM consistently outperforms response-level personalization methods, demonstrating the effectiveness of reasoning-level personalization in black-box LLMs.

Large language models (LLMs) have become the secret ingredient driving numerous industrial applications, showcasing their remarkable versatility across a diverse spectrum of tasks. From natural language processing and sentiment analysis to content generation and personalized recommendations, their unparalleled adaptability has facilitated widespread adoption across industries. This transformative shift driven by LLMs underscores the need to explore the underlying associated challenges and avenues for enhancement in their utilization. In this paper, our objective is to unravel and evaluate the obstacles and opportunities inherent in leveraging LLMs within an industrial context. To this end, we conduct a survey involving a group of industry practitioners, develop four research questions derived from the insights gathered, and examine 68 industry papers to address these questions and derive meaningful conclusions.

Large language models (LLMs) use pretraining to predict the subsequent word; however, their expansion requires significant computing resources. Numerous big tech companies and research institutes have developed multilingual LLMs (MLLMs) to meet current demands, overlooking less-resourced languages (LRLs). This study proposed three strategies to enhance the performance of LRLs based on the publicly available MLLMs. First, the MLLM vocabularies of LRLs were expanded to enhance expressiveness. Second, bilingual data were used for pretraining to align the high- and less-resourced languages. Third, a high-quality small-scale instruction dataset was constructed and instruction-tuning was performed to augment the LRL. The experiments employed the Llama2 model and Korean was used as the LRL, which was quantitatively evaluated against other developed LLMs across eight tasks. Furthermore, a qualitative assessment was performed based on human evaluation and GPT4. Experimental results showed that our proposed Bllossom model exhibited superior performance in qualitative analyses compared to previously proposed Korean monolingual models.

Advances in large language models (LLMs) provide new opportunities in healthcare for improved patient care, clinical decision-making, and enhancement of physician and administrator workflows. However, the potential of these models importantly depends on their ability to generalize effectively across clinical environments and populations, a challenge often underestimated in early development. To better understand reasons for these challenges and inform mitigation approaches, we evaluated ClinicLLM, an LLM trained on [HOSPITAL]'s clinical notes, analyzing its performance on 30-day all-cause readmission prediction focusing on variability across hospitals and patient characteristics. We found poorer generalization particularly in hospitals with fewer samples, among patients with government and unspecified insurance, the elderly, and those with high comorbidities. To understand reasons for lack of generalization, we investigated sample sizes for fine-tuning, note content (number of words per note), patient characteristics (comorbidity level, age, insurance type, borough), and health system aspects (hospital, all-cause 30-day readmission, and mortality rates). We used descriptive statistics and supervised classification to identify features. We found that, along with sample size, patient age, number of comorbidities, and the number of words in notes are all important factors related to generalization. Finally, we compared local fine-tuning (hospital specific), instance-based augmented fine-tuning and cluster-based fine-tuning for improving generalization. Among these, local fine-tuning proved most effective, increasing AUC by 0.25% to 11.74% (most helpful in settings with limited data). Overall, this study provides new insights for enhancing the deployment of large language models in the societally important domain of healthcare, and improving their performance for broader populations.

Large language models (LLMs) are capable of writing grammatical text that follows instructions, answers questions, and solves problems. As they have advanced, it has become difficult to distinguish their output from human-written text. While past research has found some differences in surface features such as word choice and punctuation, and developed classifiers to detect LLM output, none has studied the rhetorical styles of LLMs. Using several variants of Llama 3 and GPT-4o, we construct two parallel corpora of human- and LLM-written texts from common prompts. Using Douglas Biber's set of lexical, grammatical, and rhetorical features, we identify systematic differences between LLMs and humans and between different LLMs. These differences persist when moving from smaller models to larger ones, and are larger for instruction-tuned models than base models. This demonstrates that despite their advanced abilities, LLMs struggle to match human styles, and hence more advanced linguistic features can detect patterns in their behavior not previously recognized.

Large language models (LLMs) have showcased profound capabilities in language understanding and generation, facilitating a wide array of applications. However, there is a notable paucity of detailed, open-sourced methodologies on efficiently scaling LLMs beyond 50 billion parameters with minimum trial-and-error cost and computational resources. In this report, we introduce Tele-FLM (aka FLM-2), a 52B open-sourced multilingual large language model that features a stable, efficient pre-training paradigm and enhanced factual judgment capabilities. Tele-FLM demonstrates superior multilingual language modeling abilities, measured by BPB on textual corpus. Besides, in both English and Chinese foundation model evaluation, it is comparable to strong open-sourced models that involve larger pre-training FLOPs, such as Llama2-70B and DeepSeek-67B. In addition to the model weights, we share the core designs, engineering practices, and training details, which we expect to benefit both the academic and industrial communities.

Introduction. Generative Artificial Intelligence, particularly large language models (LLMs), offers transformative potential for Health Economics and Outcomes Research (HEOR). However, evaluating the quality, transparency, and rigor of LLM-assisted research lacks standardized guidance. This article introduces the ELEVATE AI LLMs framework and checklist, designed to support researchers and reviewers in assessing LLM use in HEOR. Methods. The ELEVATE AI LLMs framework was developed through a targeted review of existing guidelines and evaluation frameworks. The framework comprises ten evaluation domains, including model characteristics, accuracy, comprehensiveness, and fairness. The accompanying checklist operationalizes the framework. To validate the framework, we applied it to two published studies, demonstrating its usability across different HEOR tasks. Results. The ELEVATE AI LLMs framework provides a comprehensive structure for evaluating LLM-assisted research, while the checklist facilitates practical application. Validation of the framework and checklist on studies of systematic literature reviews and health economic modeling highlighted their ability to identify strengths and gaps in reporting. Limitations. While the ELEVATE AI LLMs framework provides robust guidance, its broader generalizability and applicability to diverse HEOR tasks require further empirical testing. Additionally, several metrics adapted from computer science need further validation in HEOR contexts. Conclusion. The ELEVATE AI LLMs framework and checklist fill a critical gap in HEOR by offering structured guidance for evaluating LLM-assisted research. By promoting transparency, accuracy, and reproducibility, they aim to standardize and improve the integration of LLMs into HEOR, ensuring their outputs meet the field's rigorous standards.

Current privacy research on large language models (LLMs) primarily focuses on the issue of extracting memorized training data. At the same time, models' inference capabilities have increased drastically. This raises the key question of whether current LLMs could violate individuals' privacy by inferring personal attributes from text given at inference time. In this work, we present the first comprehensive study on the capabilities of pretrained LLMs to infer personal attributes from text. We construct a dataset consisting of real Reddit profiles, and show that current LLMs can infer a wide range of personal attributes (e.g., location, income, sex), achieving up to 85% top-1 and 95.8% top-3 accuracy at a fraction of the cost (100times) and time (240times) required by humans. As people increasingly interact with LLM-powered chatbots across all aspects of life, we also explore the emerging threat of privacy-invasive chatbots trying to extract personal information through seemingly benign questions. Finally, we show that common mitigations, i.e., text anonymization and model alignment, are currently ineffective at protecting user privacy against LLM inference. Our findings highlight that current LLMs can infer personal data at a previously unattainable scale. In the absence of working defenses, we advocate for a broader discussion around LLM privacy implications beyond memorization, striving for a wider privacy protection.

Large language models (LLMs) have demonstrated significant success in natural language processing (NLP) tasks and have shown promising results in other domains such as protein sequence generation. However, there remain salient differences between LLMs used for NLP, which effectively handle multiple tasks and are available in small sizes, and protein language models that are often specialized for specific tasks and only exist in larger sizes. In this work, we introduce two small protein language models, based on Llama-3-8B and Phi-3-mini, that are capable of both uncontrollable and controllable protein generation. For the uncontrollable generation task, our best model achieves an average pLDDT score of 69.75, demonstrating robust performance in generating viable protein structures. For the controllable generation task, in which the model generates proteins according to properties specified in the prompt, we achieve a remarkable average TM-Score of 0.84, indicating high structural similarity to target proteins. We chose 10 properties, including six classes of enzymes, to extend the capabilities of prior protein language models. Our approach utilizes the Low-Rank Adaptor (LoRA) technique, reducing trainable parameters to just 4% of the original model size, lowering computational requirements. By using a subset of the UniRef50 dataset and small models, we reduced the overall training time by 70% without compromising performance. Notably, Phi-3-mini reduced trainable parameters by 60%, decreasing training cost by 30% compared to Llama 3. Consequently, Phi-3 achieved a comparable TM-Score of 0.81, demonstrating that smaller models can match the performance of larger ones, like Llama 3. We also demonstrate the deployment of our models on the energy efficient ET-SoC-1 chip, significantly improving the TPS/W by a factor of 3.

Large Language Models (LLMs) have demonstrated impressive performance on Natural Language Processing (NLP) tasks, such as Question Answering, Summarization, and Classification. The use of LLMs as evaluators, that can rank or score the output of other models (usually LLMs) has become increasingly popular, due to the limitations of current evaluation techniques including the lack of appropriate benchmarks, metrics, cost, and access to human annotators. While LLMs are capable of handling approximately 100 languages, the majority of languages beyond the top 20 lack systematic evaluation across various tasks, metrics, and benchmarks. This creates an urgent need to scale up multilingual evaluation to ensure a precise understanding of LLM performance across diverse languages. LLM-based evaluators seem like the perfect solution to this problem, as they do not require human annotators, human-created references, or benchmarks and can theoretically be used to evaluate any language covered by the LLM. In this paper, we investigate whether LLM-based evaluators can help scale up multilingual evaluation. Specifically, we calibrate LLM-based evaluation against 20k human judgments of five metrics across three text-generation tasks in eight languages. Our findings indicate that LLM-based evaluators may exhibit bias towards higher scores and should be used with caution and should always be calibrated with a dataset of native speaker judgments, particularly in low-resource and non-Latin script languages.

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

This research tests the role of Large Language Models (LLMs) as formal second opinion tools in professional decision-making, particularly focusing on complex medical cases where even experienced physicians seek peer consultation. The work analyzed 183 challenging medical cases from Medscape over a 20-month period, testing multiple LLMs' performance against crowd-sourced physician responses. A key finding was the high overall score possible in the latest foundational models (>80% accuracy compared to consensus opinion), which exceeds most human metrics reported on the same clinical cases (450 pages of patient profiles, test results). The study rates the LLMs' performance disparity between straightforward cases (>81% accuracy) and complex scenarios (43% accuracy), particularly in these cases generating substantial debate among human physicians. The research demonstrates that LLMs may be valuable as generators of comprehensive differential diagnoses rather than as primary diagnostic tools, potentially helping to counter cognitive biases in clinical decision-making, reduce cognitive loads, and thus remove some sources of medical error. The inclusion of a second comparative legal dataset (Supreme Court cases, N=21) provides added empirical context to the AI use to foster second opinions, though these legal challenges proved considerably easier for LLMs to analyze. In addition to the original contributions of empirical evidence for LLM accuracy, the research aggregated a novel benchmark for others to score highly contested question and answer reliability between both LLMs and disagreeing human practitioners. These results suggest that the optimal deployment of LLMs in professional settings may differ substantially from current approaches that emphasize automation of routine tasks.

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

Large language models (LLMs) and small language models (SLMs) are being adopted at remarkable speed, although their safety still remains a serious concern. With the advent of multilingual S/LLMs, the question now becomes a matter of scale: can we expand multilingual safety evaluations of these models with the same velocity at which they are deployed? To this end we introduce RTP-LX, a human-transcreated and human-annotated corpus of toxic prompts and outputs in 28 languages. RTP-LX follows participatory design practices, and a portion of the corpus is especially designed to detect culturally-specific toxic language. We evaluate seven S/LLMs on their ability to detect toxic content in a culturally-sensitive, multilingual scenario. We find that, although they typically score acceptably in terms of accuracy, they have low agreement with human judges when judging holistically the toxicity of a prompt, and have difficulty discerning harm in context-dependent scenarios, particularly with subtle-yet-harmful content (e.g. microagressions, bias). We release of this dataset to contribute to further reduce harmful uses of these models and improve their safe deployment.

Large Language Models (LLMs) like ChatGPT and GPT-4 are versatile and capable of addressing a diverse range of tasks. However, general LLMs, which are developed on open-domain data, may lack the domain-specific knowledge essential for tasks in vertical domains, such as legal, medical, etc. To address this issue, previous approaches either conduct continuous pre-training with domain-specific data or employ retrieval augmentation to support general LLMs. Unfortunately, these strategies are either cost-intensive or unreliable in practical applications. To this end, we present a novel framework named BLADE, which enhances Black-box LArge language models with small Domain-spEcific models. BLADE consists of a black-box LLM and a small domain-specific LM. The small LM preserves domain-specific knowledge and offers specialized insights, while the general LLM contributes robust language comprehension and reasoning capabilities. Specifically, our method involves three steps: 1) pre-training the small LM with domain-specific data, 2) fine-tuning this model using knowledge instruction data, and 3) joint Bayesian optimization of the general LLM and the small LM. Extensive experiments conducted on public legal and medical benchmarks reveal that BLADE significantly outperforms existing approaches. This shows the potential of BLADE as an effective and cost-efficient solution in adapting general LLMs for vertical domains.

Large Language Models (LLMs) in mental healthcare risk propagating biases that reinforce stigma and harm marginalized groups. While previous research identified concerning trends, systematic methods for detecting intersectional biases remain limited. This work introduces a multi-hop question answering (MHQA) framework to explore LLM response biases in mental health discourse. We analyze content from the Interpretable Mental Health Instruction (IMHI) dataset across symptom presentation, coping mechanisms, and treatment approaches. Using systematic tagging across age, race, gender, and socioeconomic status, we investigate bias patterns at demographic intersections. We evaluate four LLMs: Claude 3.5 Sonnet, Jamba 1.6, Gemma 3, and Llama 4, revealing systematic disparities across sentiment, demographics, and mental health conditions. Our MHQA approach demonstrates superior detection compared to conventional methods, identifying amplification points where biases magnify through sequential reasoning. We implement two debiasing techniques: Roleplay Simulation and Explicit Bias Reduction, achieving 66-94% bias reductions through few-shot prompting with BBQ dataset examples. These findings highlight critical areas where LLMs reproduce mental healthcare biases, providing actionable insights for equitable AI development.

Large Language Models (LLMs), particularly those similar to ChatGPT, have significantly influenced the field of Natural Language Processing (NLP). While these models excel in general language tasks, their performance in domain-specific downstream tasks such as biomedical and clinical Named Entity Recognition (NER), Relation Extraction (RE), and Medical Natural Language Inference (NLI) is still evolving. In this context, our study investigates the potential of instruction tuning for biomedical language processing, applying this technique to two general LLMs of substantial scale. We present a comprehensive, instruction-based model trained on a dataset that consists of approximately 200,000 instruction-focused samples. This dataset represents a carefully curated compilation of existing data, meticulously adapted and reformatted to align with the specific requirements of our instruction-based tasks. This initiative represents an important step in utilising such models to achieve results on par with specialised encoder-only models like BioBERT and BioClinicalBERT for various classical biomedical NLP tasks. Our work includes an analysis of the dataset's composition and its impact on model performance, providing insights into the intricacies of instruction tuning. By sharing our codes, models, and the distinctively assembled instruction-based dataset, we seek to encourage ongoing research and development in this area.

The impressive development of large language models (LLMs) is expanding into the realm of large multimodal models (LMMs), which incorporate multiple types of data beyond text. However, the nature of multimodal models leads to significant expenses in the creation of training data. Furthermore, constructing multilingual data for LMMs presents its own set of challenges due to language diversity and complexity. Therefore, in this study, we propose two cost-effective methods to solve this problem: (1) vocabulary expansion and pretraining of multilingual LLM for specific languages, and (2) automatic and elaborate construction of multimodal datasets using GPT4-V. Based on015 these methods, we constructed a 91K English-Korean-Chinese multilingual, multimodal training dataset. Additionally, we developed a bilingual multimodal model that exhibits excellent performance in both Korean and English, surpassing existing approaches.

Large language models (LLMs) have significantly advanced the field of natural language processing (NLP), providing a highly useful, task-agnostic foundation for a wide range of applications. However, directly applying LLMs to solve sophisticated problems in specific domains meets many hurdles, caused by the heterogeneity of domain data, the sophistication of domain knowledge, the uniqueness of domain objectives, and the diversity of the constraints (e.g., various social norms, cultural conformity, religious beliefs, and ethical standards in the domain applications). Domain specification techniques are key to make large language models disruptive in many applications. Specifically, to solve these hurdles, there has been a notable increase in research and practices conducted in recent years on the domain specialization of LLMs. This emerging field of study, with its substantial potential for impact, necessitates a comprehensive and systematic review to better summarize and guide ongoing work in this area. In this article, we present a comprehensive survey on domain specification techniques for large language models, an emerging direction critical for large language model applications. First, we propose a systematic taxonomy that categorizes the LLM domain-specialization techniques based on the accessibility to LLMs and summarizes the framework for all the subcategories as well as their relations and differences to each other. Second, we present an extensive taxonomy of critical application domains that can benefit dramatically from specialized LLMs, discussing their practical significance and open challenges. Last, we offer our insights into the current research status and future trends in this area.

Large Language Models (LLMs) have revolutionized natural language processing, yet aligning these models with human values and preferences using RLHF remains a significant challenge. This challenge is characterized by various instabilities, such as reward hacking and catastrophic forgetting. In this technical report, we propose two innovations to stabilize RLHF training: 1) Advantage Model, which directly models advantage score i.e., extra reward compared to the expected rewards and regulates score distributions across tasks to prevent reward hacking. 2) Selective Rehearsal, which mitigates catastrophic forgetting by strategically selecting data for PPO training and knowledge rehearsing. Our experimental analysis on public and proprietary datasets reveals that the proposed methods not only increase stability in RLHF training but also achieve higher reward scores and win rates.

Large Language Models (LLMs) present immense potential in the medical field, yet concerns over data privacy, regulatory compliance, and model stability restrict their widespread adoption. Although the distillation of high-performing closed-source LLMs has proven effective for general tasks, their application in healthcare is limited due to reduced domain knowledge and remnants of alignment behavior hindering clinical tasks. To address these challenges, we propose Dialogue-Based Knowledge Encoding (DBKE). DBKE enhances models' implicit knowledge base and primes them for conversational recall, augmenting their conversational capabilities and enabling a soft alignment for subsequent use cases. By transforming dense academic source text into synthetic dialogue, DBKE broadens the model's knowledge base and enables a soft alignment that guides downstream behaviours. We present Clinical Camel, an open-source, healthcare-focused conversational model, to showcase the effectiveness of DBKE. Clinical Camel outperforms GPT-3.5 on the United States Medical Licensing Examination (USMLE) Step 1 and Step 3 with scores of 53.2 % and 58.2 %, respectively, compared to GPT-3.5's scores of 36.1 % and 55.7 %. Clinical Camel adeptly handles multi-stage clinical case problems, provides adaptive counseling, and generates clinical notes. However, it is prone to hallucinations, which pose a significant obstacle in safety-critical settings. The performance of Clinical Camel underscores the importance of continued research and development of open-source models for the safe and effective integration of LLMs in healthcare settings.

User profile modeling plays a key role in personalized systems, as it requires building accurate profiles and updating them with new information. In this paper, we present two high-quality open-source user profile datasets: one for profile construction and another for profile updating. These datasets offer a strong basis for evaluating user profile modeling techniques in dynamic settings. We also show a methodology that uses large language models (LLMs) to tackle both profile construction and updating. Our method uses a probabilistic framework to predict user profiles from input text, allowing for precise and context-aware profile generation. Our experiments demonstrate that models like Mistral-7b and Llama2-7b perform strongly in both tasks. LLMs improve the precision and recall of the generated profiles, and high evaluation scores confirm the effectiveness of our approach.

Large language models (LLMs) have significantly advanced Natural Language Processing (NLP) tasks in recent years. However, their universal nature poses limitations in scenarios requiring personalized responses, such as recommendation systems and chatbots. This paper investigates methods to personalize LLMs, comparing fine-tuning and zero-shot reasoning approaches on subjective tasks. Results demonstrate that personalized fine-tuning improves model reasoning compared to non-personalized models. Experiments on datasets for emotion recognition and hate speech detection show consistent performance gains with personalized methods across different LLM architectures. These findings underscore the importance of personalization for enhancing LLM capabilities in subjective text perception tasks.

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

Large Language Models (LLMs) are foundational to AI advancements, facilitating applications like predictive text generation. Nonetheless, they pose risks by potentially memorizing and disseminating sensitive, biased, or copyrighted information from their vast datasets. Machine unlearning emerges as a cutting-edge solution to mitigate these concerns, offering techniques for LLMs to selectively discard certain data. This paper reviews the latest in machine unlearning for LLMs, introducing methods for the targeted forgetting of information to address privacy, ethical, and legal challenges without necessitating full model retraining. It divides existing research into unlearning from unstructured/textual data and structured/classification data, showcasing the effectiveness of these approaches in removing specific data while maintaining model efficacy. Highlighting the practicality of machine unlearning, this analysis also points out the hurdles in preserving model integrity, avoiding excessive or insufficient data removal, and ensuring consistent outputs, underlining the role of machine unlearning in advancing responsible, ethical AI.

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

Large language models (LLMs) have gained widespread interest due to their ability to process human language and perform tasks on which they have not been explicitly trained. This is relevant for the chemical sciences, which face the problem of small and diverse datasets that are frequently in the form of text. LLMs have shown promise in addressing these issues and are increasingly being harnessed to predict chemical properties, optimize reactions, and even design and conduct experiments autonomously. However, we still have only a very limited systematic understanding of the chemical reasoning capabilities of LLMs, which would be required to improve models and mitigate potential harms. Here, we introduce "ChemBench," an automated framework designed to rigorously evaluate the chemical knowledge and reasoning abilities of state-of-the-art LLMs against the expertise of human chemists. We curated more than 7,000 question-answer pairs for a wide array of subfields of the chemical sciences, evaluated leading open and closed-source LLMs, and found that the best models outperformed the best human chemists in our study on average. The models, however, struggle with some chemical reasoning tasks that are easy for human experts and provide overconfident, misleading predictions, such as about chemicals' safety profiles. These findings underscore the dual reality that, although LLMs demonstrate remarkable proficiency in chemical tasks, further research is critical to enhancing their safety and utility in chemical sciences. Our findings also indicate a need for adaptations to chemistry curricula and highlight the importance of continuing to develop evaluation frameworks to improve safe and useful LLMs.

We present PhysioLLM, an interactive system that leverages large language models (LLMs) to provide personalized health understanding and exploration by integrating physiological data from wearables with contextual information. Unlike commercial health apps for wearables, our system offers a comprehensive statistical analysis component that discovers correlations and trends in user data, allowing users to ask questions in natural language and receive generated personalized insights, and guides them to develop actionable goals. As a case study, we focus on improving sleep quality, given its measurability through physiological data and its importance to general well-being. Through a user study with 24 Fitbit watch users, we demonstrate that PhysioLLM outperforms both the Fitbit App alone and a generic LLM chatbot in facilitating a deeper, personalized understanding of health data and supporting actionable steps toward personal health goals.

In this work, we introduce the task of life-long personalization of large language models. While recent mainstream efforts in the LLM community mainly focus on scaling data and compute for improved capabilities of LLMs, we argue that it is also very important to enable LLM systems, or language agents, to continuously adapt to the diverse and ever-changing profiles of every distinct user and provide up-to-date personalized assistance. We provide a clear task formulation and introduce a simple, general, effective, and scalable framework for life-long personalization of LLM systems and language agents. To facilitate future research on LLM personalization, we also introduce methods to synthesize realistic benchmarks and robust evaluation metrics. We will release all codes and data for building and benchmarking life-long personalized LLM systems.

Large language models (LLMs) have shown incredible capabilities and transcended the natural language processing (NLP) community, with adoption throughout many services like healthcare, therapy, education, and customer service. Since users include people with critical information needs like students or patients engaging with chatbots, the safety of these systems is of prime importance. Therefore, a clear understanding of the capabilities and limitations of LLMs is necessary. To this end, we systematically evaluate toxicity in over half a million generations of ChatGPT, a popular dialogue-based LLM. We find that setting the system parameter of ChatGPT by assigning it a persona, say that of the boxer Muhammad Ali, significantly increases the toxicity of generations. Depending on the persona assigned to ChatGPT, its toxicity can increase up to 6x, with outputs engaging in incorrect stereotypes, harmful dialogue, and hurtful opinions. This may be potentially defamatory to the persona and harmful to an unsuspecting user. Furthermore, we find concerning patterns where specific entities (e.g., certain races) are targeted more than others (3x more) irrespective of the assigned persona, that reflect inherent discriminatory biases in the model. We hope that our findings inspire the broader AI community to rethink the efficacy of current safety guardrails and develop better techniques that lead to robust, safe, and trustworthy AI systems.

Large Language Models (LLMs), such as the LLaMA model, have demonstrated their effectiveness in various general-domain natural language processing (NLP) tasks. Nevertheless, LLMs have not yet performed optimally in biomedical domain tasks due to the need for medical expertise in the responses. In response to this challenge, we propose HuaTuo, a LLaMA-based model that has been supervised-fine-tuned with generated QA (Question-Answer) instances. The experimental results demonstrate that HuaTuo generates responses that possess more reliable medical knowledge. Our proposed HuaTuo model is accessible at https://github.com/SCIR-HI/Huatuo-Llama-Med-Chinese.

Large Language Models (LLMs) attempt to imitate human behavior by responding to humans in a way that pleases them, including by adhering to their values. However, humans come from diverse cultures with different values. It is critical to understand whether LLMs showcase different values to the user based on the stereotypical values of a user's known country. We prompt different LLMs with a series of advice requests based on 5 Hofstede Cultural Dimensions -- a quantifiable way of representing the values of a country. Throughout each prompt, we incorporate personas representing 36 different countries and, separately, languages predominantly tied to each country to analyze the consistency in the LLMs' cultural understanding. Through our analysis of the responses, we found that LLMs can differentiate between one side of a value and another, as well as understand that countries have differing values, but will not always uphold the values when giving advice, and fail to understand the need to answer differently based on different cultural values. Rooted in these findings, we present recommendations for training value-aligned and culturally sensitive LLMs. More importantly, the methodology and the framework developed here can help further understand and mitigate culture and language alignment issues with LLMs.

Large Language Models (LLMs) have become increasingly popular due to their ability to process and generate natural language. However, as they are trained on massive datasets of text, LLMs can inherit harmful biases and produce outputs that are not aligned with human values. This paper studies two main approaches to LLM alignment: Reinforcement Learning with Human Feedback (RLHF) and contrastive learning-based methods like Direct Preference Optimization (DPO). By analyzing the stability and robustness of RLHF and DPO, we propose MPO (Mixed Preference Optimization), a novel method that mitigates the weaknesses of both approaches. Specifically, we propose a two-stage training procedure: first train DPO on an easy dataset, and then perform RLHF on a difficult set with DPO model being the reference model. Here, the easy and difficult sets are constructed by a well-trained reward model that splits response pairs into those with large gaps of reward (easy), and those with small gaps (difficult). The first stage allows us to obtain a relatively optimal policy (LLM) model quickly, whereas the second stage refines LLM with online RLHF, thus mitigating the distribution shift issue associated with DPO. Experiments are conducted on two public alignment datasets, namely HH-RLHF and TLDR, demonstrating the effectiveness of MPO, both in terms of GPT4 and human evaluation.

Large language models (LLMs) exhibit remarkable capabilities in understanding and generating natural language. However, these models can inadvertently memorize private information, posing significant privacy risks. This study addresses the challenge of enabling LLMs to protect specific individuals' private data without the need for complete retraining. We propose \return, a Real-world pErsonal daTa UnleaRNing dataset, comprising 2,492 individuals from Wikipedia with associated QA pairs, to evaluate machine unlearning (MU) methods for protecting personal data in a realistic scenario. Additionally, we introduce the Name-Aware Unlearning Framework (NAUF) for Privacy Protection, which enables the model to learn which individuals' information should be protected without affecting its ability to answer questions related to other unrelated individuals. Our extensive experiments demonstrate that NAUF achieves a state-of-the-art average unlearning score, surpassing the best baseline method by 5.65 points, effectively protecting target individuals' personal data while maintaining the model's general capabilities.

Large Language Models (LLMs) have recently emerged as an effective tool to assist individuals in writing various types of content, including professional documents such as recommendation letters. Though bringing convenience, this application also introduces unprecedented fairness concerns. Model-generated reference letters might be directly used by users in professional scenarios. If underlying biases exist in these model-constructed letters, using them without scrutinization could lead to direct societal harms, such as sabotaging application success rates for female applicants. In light of this pressing issue, it is imminent and necessary to comprehensively study fairness issues and associated harms in this real-world use case. In this paper, we critically examine gender biases in LLM-generated reference letters. Drawing inspiration from social science findings, we design evaluation methods to manifest biases through 2 dimensions: (1) biases in language style and (2) biases in lexical content. We further investigate the extent of bias propagation by analyzing the hallucination bias of models, a term that we define to be bias exacerbation in model-hallucinated contents. Through benchmarking evaluation on 2 popular LLMs- ChatGPT and Alpaca, we reveal significant gender biases in LLM-generated recommendation letters. Our findings not only warn against using LLMs for this application without scrutinization, but also illuminate the importance of thoroughly studying hidden biases and harms in LLM-generated professional documents.

Large Language Models (LLMs) have recently showcased their remarkable capacities, not only in natural language processing tasks but also across diverse domains such as clinical medicine, legal consultation, and education. LLMs become more than mere applications, evolving into assistants capable of addressing diverse user requests. This narrows the distinction between human beings and artificial intelligence agents, raising intriguing questions regarding the potential manifestation of personalities, temperaments, and emotions within LLMs. In this paper, we propose a framework, PsychoBench, for evaluating diverse psychological aspects of LLMs. Comprising thirteen scales commonly used in clinical psychology, PsychoBench further classifies these scales into four distinct categories: personality traits, interpersonal relationships, motivational tests, and emotional abilities. Our study examines five popular models, namely text-davinci-003, ChatGPT, GPT-4, LLaMA-2-7b, and LLaMA-2-13b. Additionally, we employ a jailbreak approach to bypass the safety alignment protocols and test the intrinsic natures of LLMs. We have made PsychoBench openly accessible via https://github.com/CUHK-ARISE/PsychoBench.

Over the last few years, large language models (LLMs) have emerged as the most important breakthroughs in natural language processing (NLP) that fundamentally transform research and developments in the field. ChatGPT represents one of the most exciting LLM systems developed recently to showcase impressive skills for language generation and highly attract public attention. Among various exciting applications discovered for ChatGPT in English, the model can process and generate texts for multiple languages due to its multilingual training data. Given the broad adoption of ChatGPT for English in different problems and areas, a natural question is whether ChatGPT can also be applied effectively for other languages or it is necessary to develop more language-specific technologies. The answer to this question requires a thorough evaluation of ChatGPT over multiple tasks with diverse languages and large datasets (i.e., beyond reported anecdotes), which is still missing or limited in current research. Our work aims to fill this gap for the evaluation of ChatGPT and similar LLMs to provide more comprehensive information for multilingual NLP applications. While this work will be an ongoing effort to include additional experiments in the future, our current paper evaluates ChatGPT on 7 different tasks, covering 37 diverse languages with high, medium, low, and extremely low resources. We also focus on the zero-shot learning setting for ChatGPT to improve reproducibility and better simulate the interactions of general users. Compared to the performance of previous models, our extensive experimental results demonstrate a worse performance of ChatGPT for different NLP tasks and languages, calling for further research to develop better models and understanding for multilingual learning.

As large language models (LLMs) gain popularity among speakers of diverse languages, we believe that it is crucial to benchmark them to better understand model behaviors, failures, and limitations in languages beyond English. In this work, we evaluate LLM APIs (ChatGPT, GPT-3, and GPT-4) on the Japanese national medical licensing examinations from the past five years, including the current year. Our team comprises native Japanese-speaking NLP researchers and a practicing cardiologist based in Japan. Our experiments show that GPT-4 outperforms ChatGPT and GPT-3 and passes all six years of the exams, highlighting LLMs' potential in a language that is typologically distant from English. However, our evaluation also exposes critical limitations of the current LLM APIs. First, LLMs sometimes select prohibited choices that should be strictly avoided in medical practice in Japan, such as suggesting euthanasia. Further, our analysis shows that the API costs are generally higher and the maximum context size is smaller for Japanese because of the way non-Latin scripts are currently tokenized in the pipeline. We release our benchmark as Igaku QA as well as all model outputs and exam metadata. We hope that our results and benchmark will spur progress on more diverse applications of LLMs. Our benchmark is available at https://github.com/jungokasai/IgakuQA.

Background: Clinical documentation represents a significant burden for healthcare providers, with physicians spending up to 2 hours daily on administrative tasks. Recent advances in large language models (LLMs) offer promising solutions, but privacy concerns and computational requirements limit their adoption in healthcare settings. Objective: To develop and evaluate a privacy-preserving, on-device medical transcription system using a fine-tuned Llama 3.2 1B model capable of generating structured medical notes from medical transcriptions while maintaining complete data sovereignty entirely in the browser. Methods: We fine-tuned a Llama 3.2 1B model using Parameter-Efficient Fine-Tuning (PEFT) with LoRA on 1,500 synthetic medical transcription-to-structured note pairs. The model was evaluated against the base Llama 3.2 1B on two datasets: 100 endocrinology transcripts and 140 modified ACI benchmark cases. Evaluation employed both statistical metrics (ROUGE, BERTScore, BLEURT) and LLM-as-judge assessments across multiple clinical quality dimensions. Results: The fine-tuned OnDevice model demonstrated substantial improvements over the base model. On the ACI benchmark, ROUGE-1 scores increased from 0.346 to 0.496, while BERTScore F1 improved from 0.832 to 0.866. Clinical quality assessments showed marked reduction in major hallucinations (from 85 to 35 cases) and enhanced factual correctness (2.81 to 3.54 on 5-point scale). Similar improvements were observed on the internal evaluation dataset, with composite scores increasing from 3.13 to 4.43 (+41.5%). Conclusions: Fine-tuning compact LLMs for medical transcription yields clinically meaningful improvements while enabling complete on-device browser deployment. This approach addresses key barriers to AI adoption in healthcare: privacy preservation, cost reduction, and accessibility for resource-constrained environments.

Large language models (LLMs) learn not only natural text generation abilities but also social biases against different demographic groups from real-world data. This poses a critical risk when deploying LLM-based applications. Existing research and resources are not readily applicable in South Korea due to the differences in language and culture, both of which significantly affect the biases and targeted demographic groups. This limitation requires localized social bias datasets to ensure the safe and effective deployment of LLMs. To this end, we present KO SB I, a new social bias dataset of 34k pairs of contexts and sentences in Korean covering 72 demographic groups in 15 categories. We find that through filtering-based moderation, social biases in generated content can be reduced by 16.47%p on average for HyperCLOVA (30B and 82B), and GPT-3.

Large language models (LLMs) have achieved remarkable success in NLP and multimodal tasks. Despite these successes, their development faces two main challenges: (i) high computational cost; and (ii) difficulty in conducting fair and objective evaluations. LLMs are prohibitively expensive, making it feasible for only a few major players to undertake their training, thereby constraining both research and application opportunities. This underscores the importance of cost-effective LLM training. In this paper, we utilize a growth strategy to significantly reduce LLM training cost. We demonstrate that an LLM with 101B parameters and 0.31TB tokens can be trained on a 100K budget. We also adopt a systematic evaluation paradigm for the IQ evaluation of LLMs, in complement to existing evaluations that focus more on knowledge-oriented abilities. We introduce our benchmark including evaluations on important aspects of intelligence including symbolic mapping, itrule understanding, pattern mining, and anti-interference. Such evaluations minimize the potential impact of memorization. Experimental results show that our model FLM-101B, trained with a budget of 100K, achieves comparable performance to powerful and well-known models, eg GPT-3 and GLM-130B, especially in the IQ benchmark evaluations with contexts unseen in training data. The checkpoint of FLM-101B will be open-sourced at https://huggingface.co/CofeAI/FLM-101B.

Clinical trial matching is a key process in health delivery and discovery. In practice, it is plagued by overwhelming unstructured data and unscalable manual processing. In this paper, we conduct a systematic study on scaling clinical trial matching using large language models (LLMs), with oncology as the focus area. Our study is grounded in a clinical trial matching system currently in test deployment at a large U.S. health network. Initial findings are promising: out of box, cutting-edge LLMs, such as GPT-4, can already structure elaborate eligibility criteria of clinical trials and extract complex matching logic (e.g., nested AND/OR/NOT). While still far from perfect, LLMs substantially outperform prior strong baselines and may serve as a preliminary solution to help triage patient-trial candidates with humans in the loop. Our study also reveals a few significant growth areas for applying LLMs to end-to-end clinical trial matching, such as context limitation and accuracy, especially in structuring patient information from longitudinal medical records.

Large Language Models (LLMs) have demonstrated significant potential in transforming clinical applications. In this study, we investigate the efficacy of four techniques in adapting LLMs for clinical use-cases: continuous pretraining, instruct fine-tuning, NEFTune, and prompt engineering. We employ these methods on Mistral 7B and Mixtral 8x7B models, leveraging a large-scale clinical pretraining dataset of 50 billion tokens and an instruct fine-tuning dataset of 500 million tokens. Our evaluation across various clinical tasks reveals the impact of each technique. While continuous pretraining beyond 250 billion tokens yields marginal improvements on its own, it establishes a strong foundation for instruct fine-tuning. Notably, NEFTune, designed primarily to enhance generation quality, surprisingly demonstrates additional gains on our benchmark. Complex prompt engineering methods further enhance performance. These findings show the importance of tailoring fine-tuning strategies and exploring innovative techniques to optimize LLM performance in the clinical domain.

Large Language Models (LLMs) have demonstrated remarkable capabilities in natural language processing, and yet, their factual inaccuracies and hallucinations limits their application, particularly in critical domains like healthcare. Context retrieval methods, by introducing relevant information as input, have emerged as a crucial approach for enhancing LLM factuality and reliability. This study explores the boundaries of context retrieval methods within the healthcare domain, optimizing their components and benchmarking their performance against open and closed alternatives. Our findings reveal how open LLMs, when augmented with an optimized retrieval system, can achieve performance comparable to the biggest private solutions on established healthcare benchmarks (multiple-choice question answering). Recognizing the lack of realism of including the possible answers within the question (a setup only found in medical exams), and after assessing a strong LLM performance degradation in the absence of those options, we extend the context retrieval system in that direction. In particular, we propose OpenMedPrompt a pipeline that improves the generation of more reliable open-ended answers, moving this technology closer to practical application.

Large language models (LLMs), such as ChatGPT, have rapidly penetrated into people's work and daily lives over the past few years, due to their extraordinary conversational skills and intelligence. ChatGPT has become the fastest-growing software in terms of user numbers in human history and become an important foundational model for the next generation of artificial intelligence applications. However, the generations of LLMs are not entirely reliable, often producing content with factual errors, biases, and toxicity. Given their vast number of users and wide range of application scenarios, these unreliable responses can lead to many serious negative impacts. This thesis introduces the exploratory works in the field of language model reliability during the PhD study, focusing on the correctness, non-toxicity, and fairness of LLMs from both software testing and natural language processing perspectives. First, to measure the correctness of LLMs, we introduce two testing frameworks, FactChecker and LogicAsker, to evaluate factual knowledge and logical reasoning accuracy, respectively. Second, for the non-toxicity of LLMs, we introduce two works for red-teaming LLMs. Third, to evaluate the fairness of LLMs, we introduce two evaluation frameworks, BiasAsker and XCulturalBench, to measure the social bias and cultural bias of LLMs, respectively.

Large Language Models (LLMs) have recently emerged as a focal point of research and application, driven by their unprecedented ability to understand and generate text with human-like quality. Even more recently, LLMs have been extended into multi-modal large language models (MM-LLMs) which extends their capabilities to deal with image, video and audio information, in addition to text. This opens up applications like text-to-video generation, image captioning, text-to-speech, and more and is achieved either by retro-fitting an LLM with multi-modal capabilities, or building a MM-LLM from scratch. This paper provides an extensive review of the current state of those LLMs with multi-modal capabilities as well as the very recent MM-LLMs. It covers the historical development of LLMs especially the advances enabled by transformer-based architectures like OpenAI's GPT series and Google's BERT, as well as the role of attention mechanisms in enhancing model performance. The paper includes coverage of the major and most important of the LLMs and MM-LLMs and also covers the techniques of model tuning, including fine-tuning and prompt engineering, which tailor pre-trained models to specific tasks or domains. Ethical considerations and challenges, such as data bias and model misuse, are also analysed to underscore the importance of responsible AI development and deployment. Finally, we discuss the implications of open-source versus proprietary models in AI research. Through this review, we provide insights into the transformative potential of MM-LLMs in various applications.

This paper studies using foundational large language models (LLMs) to make decisions during hyperparameter optimization (HPO). Empirical evaluations demonstrate that in settings with constrained search budgets, LLMs can perform comparably or better than traditional HPO methods like random search and Bayesian optimization on standard benchmarks. Furthermore, we propose to treat the code specifying our model as a hyperparameter, which the LLM outputs, going beyond the capabilities of existing HPO approaches. Our findings suggest that LLMs are a promising tool for improving efficiency in the traditional decision-making problem of hyperparameter optimization.

The rapid development of Large Language Models (LLMs) demonstrates remarkable multilingual capabilities in natural language processing, attracting global attention in both academia and industry. To mitigate potential discrimination and enhance the overall usability and accessibility for diverse language user groups, it is important for the development of language-fair technology. Despite the breakthroughs of LLMs, the investigation into the multilingual scenario remains insufficient, where a comprehensive survey to summarize recent approaches, developments, limitations, and potential solutions is desirable. To this end, we provide a survey with multiple perspectives on the utilization of LLMs in the multilingual scenario. We first rethink the transitions between previous and current research on pre-trained language models. Then we introduce several perspectives on the multilingualism of LLMs, including training and inference methods, model security, multi-domain with language culture, and usage of datasets. We also discuss the major challenges that arise in these aspects, along with possible solutions. Besides, we highlight future research directions that aim at further enhancing LLMs with multilingualism. The survey aims to help the research community address multilingual problems and provide a comprehensive understanding of the core concepts, key techniques, and latest developments in multilingual natural language processing based on LLMs.

Large Language Models (LLMs) exhibit impressive capabilities but also present risks such as biased content generation and privacy issues. One of the current alignment techniques includes principle-driven integration, but it faces challenges arising from the imprecision of manually crafted rules and inadequate risk perception in models without safety training. To address these, we introduce Guide-Align, a two-stage approach. Initially, a safety-trained model identifies potential risks and formulates specific guidelines for various inputs, establishing a comprehensive library of guidelines and a model for input-guidelines retrieval. Subsequently, the retrieval model correlates new inputs with relevant guidelines, which guide LLMs in response generation to ensure safe and high-quality outputs, thereby aligning with human values. An additional optional stage involves fine-tuning a model with well-aligned datasets generated through the process implemented in the second stage. Our method customizes guidelines to accommodate diverse inputs, thereby enhancing the fine-grainedness and comprehensiveness of the guideline library. Furthermore, it incorporates safety expertise from a safety-trained LLM through a lightweight retrieval model. We evaluate our approach on three benchmarks, demonstrating significant improvements in LLM security and quality. Notably, our fine-tuned model, Labrador, even at 13 billion parameters, outperforms GPT-3.5-turbo and surpasses GPT-4 in alignment capabilities.

Multimodal Large Language Models (MLLMs) have become increasingly important due to their state-of-the-art performance and ability to integrate multiple data modalities, such as text, images, and audio, to perform complex tasks with high accuracy. This paper presents a comprehensive survey on personalized multimodal large language models, focusing on their architecture, training methods, and applications. We propose an intuitive taxonomy for categorizing the techniques used to personalize MLLMs to individual users, and discuss the techniques accordingly. Furthermore, we discuss how such techniques can be combined or adapted when appropriate, highlighting their advantages and underlying rationale. We also provide a succinct summary of personalization tasks investigated in existing research, along with the evaluation metrics commonly used. Additionally, we summarize the datasets that are useful for benchmarking personalized MLLMs. Finally, we outline critical open challenges. This survey aims to serve as a valuable resource for researchers and practitioners seeking to understand and advance the development of personalized multimodal large language models.

Large language models (LLMs) have not only revolutionized the field of natural language processing (NLP) but also have the potential to bring a paradigm shift in many other fields due to their remarkable abilities of language understanding, as well as impressive generalization capabilities and reasoning skills. As a result, recent studies have actively attempted to harness the power of LLMs to improve recommender systems, and it is imperative to thoroughly review the recent advances and challenges of LLM-based recommender systems. Unlike existing work, this survey does not merely analyze the classifications of LLM-based recommendation systems according to the technical framework of LLMs. Instead, it investigates how LLMs can better serve recommendation tasks from the perspective of the recommender system community, thus enhancing the integration of large language models into the research of recommender system and its practical application. In addition, the long-standing gap between academic research and industrial applications related to recommender systems has not been well discussed, especially in the era of large language models. In this review, we introduce a novel taxonomy that originates from the intrinsic essence of recommendation, delving into the application of large language model-based recommendation systems and their industrial implementation. Specifically, we propose a three-tier structure that more accurately reflects the developmental progression of recommendation systems from research to practical implementation, including representing and understanding, scheming and utilizing, and industrial deployment. Furthermore, we discuss critical challenges and opportunities in this emerging field. A more up-to-date version of the papers is maintained at: https://github.com/jindongli-Ai/Next-Generation-LLM-based-Recommender-Systems-Survey.

Large Language Models (LLMs) have demonstrated remarkable success in various tasks such as natural language understanding, text summarization, and machine translation. However, their general-purpose nature often limits their effectiveness in domain-specific applications that require specialized knowledge, such as healthcare, chemistry, or legal analysis. To address this, researchers have explored diverse methods to enhance LLMs by integrating domain-specific knowledge. In this survey, we provide a comprehensive overview of these methods, which we categorize into four key approaches: dynamic knowledge injection, static knowledge embedding, modular adapters, and prompt optimization. Each approach offers unique mechanisms to equip LLMs with domain expertise, balancing trade-offs between flexibility, scalability, and efficiency. We discuss how these methods enable LLMs to tackle specialized tasks, compare their advantages and disadvantages, evaluate domain-specific LLMs against general LLMs, and highlight the challenges and opportunities in this emerging field. For those interested in delving deeper into this area, we also summarize the commonly used datasets and benchmarks. To keep researchers updated on the latest studies, we maintain an open-source at: https://github.com/abilliyb/Knowledge_Injection_Survey_Papers, dedicated to documenting research in the field of specialized LLM.

Large language models (LLMs) have demonstrated potential in assisting scientific research, yet their ability to discover high-quality research hypotheses remains unexamined due to the lack of a dedicated benchmark. To address this gap, we introduce the first large-scale benchmark for evaluating LLMs with a near-sufficient set of sub-tasks of scientific discovery: inspiration retrieval, hypothesis composition, and hypothesis ranking. We develop an automated framework that extracts critical components - research questions, background surveys, inspirations, and hypotheses - from scientific papers across 12 disciplines, with expert validation confirming its accuracy. To prevent data contamination, we focus exclusively on papers published in 2024, ensuring minimal overlap with LLM pretraining data. Our evaluation reveals that LLMs perform well in retrieving inspirations, an out-of-distribution task, suggesting their ability to surface novel knowledge associations. This positions LLMs as "research hypothesis mines", capable of facilitating automated scientific discovery by generating innovative hypotheses at scale with minimal human intervention.

Large language models (LLMs) have the potential to transform medicine, but real-world clinical scenarios contain extraneous information that can hinder performance. The rise of assistive technologies like ambient dictation, which automatically generates draft notes from live patient encounters, has the potential to introduce additional noise making it crucial to assess the ability of LLM's to filter relevant data. To investigate this, we developed MedDistractQA, a benchmark using USMLE-style questions embedded with simulated real-world distractions. Our findings show that distracting statements (polysemous words with clinical meanings used in a non-clinical context or references to unrelated health conditions) can reduce LLM accuracy by up to 17.9%. Commonly proposed solutions to improve model performance such as retrieval-augmented generation (RAG) and medical fine-tuning did not change this effect and in some cases introduced their own confounders and further degraded performance. Our findings suggest that LLMs natively lack the logical mechanisms necessary to distinguish relevant from irrelevant clinical information, posing challenges for real-world applications. MedDistractQA and our results highlights the need for robust mitigation strategies to enhance LLM resilience to extraneous information.

Large language models have exhibited exceptional performance on various Natural Language Processing (NLP) tasks, leveraging techniques such as the pre-training, and instruction fine-tuning. Despite these advances, their effectiveness in medical applications is limited, due to challenges such as factual inaccuracies, reasoning abilities, and lack grounding in real-world experience. In this study, we present ClinicalGPT, a language model explicitly designed and optimized for clinical scenarios. By incorporating extensive and diverse real-world data, such as medical records, domain-specific knowledge, and multi-round dialogue consultations in the training process, ClinicalGPT is better prepared to handle multiple clinical task. Furthermore, we introduce a comprehensive evaluation framework that includes medical knowledge question-answering, medical exams, patient consultations, and diagnostic analysis of medical records. Our results demonstrate that ClinicalGPT significantly outperforms other models in these tasks, highlighting the effectiveness of our approach in adapting large language models to the critical domain of healthcare.

Large Language Models (LLMs) have become a key element of modern artificial intelligence, demonstrating the ability to address a wide range of language processing tasks at unprecedented levels of accuracy without the need of collecting problem-specific data. However, these versatile models face a significant challenge: both their training and inference processes require substantial computational resources, time, and memory. Consequently, optimizing this kind of models to minimize these requirements is crucial. In this article, we demonstrate that, with minimal resources and in a remarkably short time, it is possible to enhance a state-of-the-art model, specifically for a given language task, without compromising its overall capabilities using a relatively small pretrained LLM as a basis. Specifically, we present our use case, RigoChat 2, illustrating how LLMs can be adapted to achieve superior results in Spanish-language tasks.

A user-generated text on social media enables health workers to keep track of information, identify possible outbreaks, forecast disease trends, monitor emergency cases, and ascertain disease awareness and response to official health correspondence. This exchange of health information on social media has been regarded as an attempt to enhance public health surveillance (PHS). Despite its potential, the technology is still in its early stages and is not ready for widespread application. Advancements in pretrained language models (PLMs) have facilitated the development of several domain-specific PLMs and a variety of downstream applications. However, there are no PLMs for social media tasks involving PHS. We present and release PHS-BERT, a transformer-based PLM, to identify tasks related to public health surveillance on social media. We compared and benchmarked the performance of PHS-BERT on 25 datasets from different social medial platforms related to 7 different PHS tasks. Compared with existing PLMs that are mainly evaluated on limited tasks, PHS-BERT achieved state-of-the-art performance on all 25 tested datasets, showing that our PLM is robust and generalizable in the common PHS tasks. By making PHS-BERT available, we aim to facilitate the community to reduce the computational cost and introduce new baselines for future works across various PHS-related tasks.

Large language models (LLMs) mark a key shift in natural language processing (NLP), having advanced text generation, translation, and domain-specific reasoning. Closed-source models like GPT-4, powered by proprietary datasets and extensive computational resources, lead with state-of-the-art performance today. However, they face criticism for their "black box" nature and for limiting accessibility in a manner that hinders reproducibility and equitable AI development. By contrast, open-source initiatives like LLaMA and BLOOM prioritize democratization through community-driven development and computational efficiency. These models have significantly reduced performance gaps, particularly in linguistic diversity and domain-specific applications, while providing accessible tools for global researchers and developers. Notably, both paradigms rely on foundational architectural innovations, such as the Transformer framework by Vaswani et al. (2017). Closed-source models excel by scaling effectively, while open-source models adapt to real-world applications in underrepresented languages and domains. Techniques like Low-Rank Adaptation (LoRA) and instruction-tuning datasets enable open-source models to achieve competitive results despite limited resources. To be sure, the tension between closed-source and open-source approaches underscores a broader debate on transparency versus proprietary control in AI. Ethical considerations further highlight this divide. Closed-source systems restrict external scrutiny, while open-source models promote reproducibility and collaboration but lack standardized auditing documentation frameworks to mitigate biases. Hybrid approaches that leverage the strengths of both paradigms are likely to shape the future of LLM innovation, ensuring accessibility, competitive technical performance, and ethical deployment.

Large language models (LLMs) are trained from vast repositories of text authored by millions of distinct authors, reflecting an enormous diversity of human traits. While these models bear the potential to be used as approximations of human subjects in behavioral studies, prior efforts have been limited in steering model responses to match individual human users. In this work, we introduce "Anthology", a method for conditioning LLMs to particular virtual personas by harnessing open-ended life narratives, which we refer to as "backstories." We show that our methodology enhances the consistency and reliability of experimental outcomes while ensuring better representation of diverse sub-populations. Across three nationally representative human surveys conducted as part of Pew Research Center's American Trends Panel (ATP), we demonstrate that Anthology achieves up to 18% improvement in matching the response distributions of human respondents and 27% improvement in consistency metrics. Our code and generated backstories are available at https://github.com/CannyLab/anthology.

The advent of large language models (LLMs) revolutionized natural language processing applications, and running LLMs on edge devices has become increasingly attractive for reasons including reduced latency, data localization, and personalized user experiences. This comprehensive review examines the challenges of deploying computationally expensive LLMs on resource-constrained devices and explores innovative solutions across multiple domains. The paper investigates the development of on-device language models, their efficient architectures, including parameter sharing and modular designs, as well as state-of-the-art compression techniques like quantization, pruning, and knowledge distillation. Hardware acceleration strategies and collaborative edge-cloud deployment approaches are analyzed, highlighting the intricate balance between performance and resource utilization. Case studies of on-device language models from major mobile manufacturers demonstrate real-world applications and potential benefits. The review also addresses critical aspects such as adaptive learning, multi-modal capabilities, and personalization. By identifying key research directions and open challenges, this paper provides a roadmap for future advancements in on-device language models, emphasizing the need for interdisciplinary efforts to realize the full potential of ubiquitous, intelligent computing while ensuring responsible and ethical deployment. For a comprehensive review of research work and educational resources on on-device large language models (LLMs), please visit https://github.com/NexaAI/Awesome-LLMs-on-device. To download and run on-device LLMs, visit https://www.nexaai.com/models.

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

Large Language Models (LLMs) have recently demonstrated remarkable capabilities in natural language processing tasks and beyond. This success of LLMs has led to a large influx of research contributions in this direction. These works encompass diverse topics such as architectural innovations, better training strategies, context length improvements, fine-tuning, multi-modal LLMs, robotics, datasets, benchmarking, efficiency, and more. With the rapid development of techniques and regular breakthroughs in LLM research, it has become considerably challenging to perceive the bigger picture of the advances in this direction. Considering the rapidly emerging plethora of literature on LLMs, it is imperative that the research community is able to benefit from a concise yet comprehensive overview of the recent developments in this field. This article provides an overview of the existing literature on a broad range of LLM-related concepts. Our self-contained comprehensive overview of LLMs discusses relevant background concepts along with covering the advanced topics at the frontier of research in LLMs. This review article is intended to not only provide a systematic survey but also a quick comprehensive reference for the researchers and practitioners to draw insights from extensive informative summaries of the existing works to advance the LLM research.

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

Large language models (LLMs) have ushered in a new era for processing complex information in various fields, including science. The increasing amount of scientific literature allows these models to acquire and understand scientific knowledge effectively, thus improving their performance in a wide range of tasks. Due to the power of LLMs, they require extremely expensive computational resources, intense amounts of data, and training time. Therefore, in recent years, researchers have proposed various methodologies to make scientific LLMs more affordable. The most well-known approaches align in two directions. It can be either focusing on the size of the models or enhancing the quality of data. To date, a comprehensive review of these two families of methods has not yet been undertaken. In this paper, we (I) summarize the current advances in the emerging abilities of LLMs into more accessible AI solutions for science, and (II) investigate the challenges and opportunities of developing affordable solutions for scientific domains using LLMs.

The evaluation of Large Language Models (LLMs) in healthcare has been dominated by physician-centric, English-language benchmarks, creating a dangerous illusion of competence that ignores the interprofessional nature of patient care. To provide a more holistic and realistic assessment, we introduce HealthQA-BR, the first large-scale, system-wide benchmark for Portuguese-speaking healthcare. Comprising 5,632 questions from Brazil's national licensing and residency exams, it uniquely assesses knowledge not only in medicine and its specialties but also in nursing, dentistry, psychology, social work, and other allied health professions. We conducted a rigorous zero-shot evaluation of over 20 leading LLMs. Our results reveal that while state-of-the-art models like GPT 4.1 achieve high overall accuracy (86.6%), this top-line score masks alarming, previously unmeasured deficiencies. A granular analysis shows performance plummets from near-perfect in specialties like Ophthalmology (98.7%) to barely passing in Neurosurgery (60.0%) and, most notably, Social Work (68.4%). This "spiky" knowledge profile is a systemic issue observed across all models, demonstrating that high-level scores are insufficient for safety validation. By publicly releasing HealthQA-BR and our evaluation suite, we provide a crucial tool to move beyond single-score evaluations and toward a more honest, granular audit of AI readiness for the entire healthcare team.

Large Language Models (LLMs) have recently gained significant attention due to their remarkable capabilities in performing diverse tasks across various domains. However, a thorough evaluation of these models is crucial before deploying them in real-world applications to ensure they produce reliable performance. Despite the well-established importance of evaluating LLMs in the community, the complexity of the evaluation process has led to varied evaluation setups, causing inconsistencies in findings and interpretations. To address this, we systematically review the primary challenges and limitations causing these inconsistencies and unreliable evaluations in various steps of LLM evaluation. Based on our critical review, we present our perspectives and recommendations to ensure LLM evaluations are reproducible, reliable, and robust.

Large Language Models (LLMs) are huge artificial neural networks which primarily serve to generate text, but also provide a very sophisticated probabilistic model of language use. Since generating a semantically consistent text requires a form of effective memory, we investigate the memory properties of LLMs and find surprising similarities with key characteristics of human memory. We argue that the human-like memory properties of the Large Language Model do not follow automatically from the LLM architecture but are rather learned from the statistics of the training textual data. These results strongly suggest that the biological features of human memory leave an imprint on the way that we structure our textual narratives.

The latest large language models (LLMs) such as ChatGPT, exhibit strong capabilities in automated mental health analysis. However, existing relevant studies bear several limitations, including inadequate evaluations, lack of prompting strategies, and ignorance of exploring LLMs for explainability. To bridge these gaps, we comprehensively evaluate the mental health analysis and emotional reasoning ability of LLMs on 11 datasets across 5 tasks. We explore the effects of different prompting strategies with unsupervised and distantly supervised emotional information. Based on these prompts, we explore LLMs for interpretable mental health analysis by instructing them to generate explanations for each of their decisions. We convey strict human evaluations to assess the quality of the generated explanations, leading to a novel dataset with 163 human-assessed explanations. We benchmark existing automatic evaluation metrics on this dataset to guide future related works. According to the results, ChatGPT shows strong in-context learning ability but still has a significant gap with advanced task-specific methods. Careful prompt engineering with emotional cues and expert-written few-shot examples can also effectively improve performance on mental health analysis. In addition, ChatGPT generates explanations that approach human performance, showing its great potential in explainable mental health analysis.

Language models (LMs) have demonstrated expert-level reasoning and recall abilities in medicine. However, computational costs and privacy concerns are mounting barriers to wide-scale implementation. We introduce a parsimonious adaptation of phi-3-mini, MedMobile, a 3.8 billion parameter LM capable of running on a mobile device, for medical applications. We demonstrate that MedMobile scores 75.7% on the MedQA (USMLE), surpassing the passing mark for physicians (~60%), and approaching the scores of models 100 times its size. We subsequently perform a careful set of ablations, and demonstrate that chain of thought, ensembling, and fine-tuning lead to the greatest performance gains, while unexpectedly retrieval augmented generation fails to demonstrate significant improvements

Multilingual large language models (MLLMs) have shown impressive capabilities across a variety of languages. However, efficacy can differ greatly between different language families, especially for those with limited linguistic resources. This report presents MERaLiON-TextLLM, a series of open-source language models specifically tailored to improve understanding and generation in Chinese, Indonesian, Malay, and Singlish. The initial released model is built on Llama-3-8B-Base and refined through a meticulously crafted process of continued pre-training and weight merging. Our approach achieves performance improvements across benchmarks in these languages, exceeding the capabilities of the official Llama-3 models. We provide the model checkpoints as a resource to support further research and development in cross-lingual language understanding.

Large Language Models (LLMs) have shown promising results on machine translation for high resource language pairs and domains. However, in specialised domains (e.g. medical) LLMs have shown lower performance compared to standard neural machine translation models. The consistency in the machine translation of terminology is crucial for users, researchers, and translators in specialised domains. In this study, we compare the performance between baseline LLMs and instruction-tuned LLMs in the medical domain. In addition, we introduce terminology from specialised medical dictionaries into the instruction formatted datasets for fine-tuning LLMs. The instruction-tuned LLMs significantly outperform the baseline models with automatic metrics.

Large language models (LLMs) have shown excellent mastering of human language, but still struggle in real-world applications that require mathematical problem-solving. While many strategies and datasets to enhance LLMs' mathematics are developed, it remains a challenge to simultaneously maintain and improve both language and mathematical capabilities in deployed LLM systems.In this work, we tailor the Self-Critique pipeline, which addresses the challenge in the feedback learning stage of LLM alignment. We first train a general Math-Critique model from the LLM itself to provide feedback signals. Then, we sequentially employ rejective fine-tuning and direct preference optimization over the LLM's own generations for data collection. Based on ChatGLM3-32B, we conduct a series of experiments on both academic and our newly created challenging dataset, MathUserEval. Results show that our pipeline significantly enhances the LLM's mathematical problem-solving while still improving its language ability, outperforming LLMs that could be two times larger. Related techniques have been deployed to ChatGLM\url{https://chatglm.cn}, an online serving LLM. Related evaluation dataset and scripts are released at https://github.com/THUDM/ChatGLM-Math.

Large-language models have recently demonstrated impressive zero-shot capabilities in a variety of natural language tasks such as summarization, dialogue generation, and question-answering. Despite many promising applications in clinical medicine, adoption of these models in real-world settings has been largely limited by their tendency to generate incorrect and sometimes even toxic statements. In this study, we develop Almanac, a large language model framework augmented with retrieval capabilities for medical guideline and treatment recommendations. Performance on a novel dataset of clinical scenarios (n = 130) evaluated by a panel of 5 board-certified and resident physicians demonstrates significant increases in factuality (mean of 18% at p-value < 0.05) across all specialties, with improvements in completeness and safety. Our results demonstrate the potential for large language models to be effective tools in the clinical decision-making process, while also emphasizing the importance of careful testing and deployment to mitigate their shortcomings.

Large language models (LLMs) have demonstrated remarkable proficiency in mainstream academic disciplines such as mathematics, physics, and computer science. However, human knowledge encompasses over 200 specialized disciplines, far exceeding the scope of existing benchmarks. The capabilities of LLMs in many of these specialized fields-particularly in light industry, agriculture, and service-oriented disciplines-remain inadequately evaluated. To address this gap, we present SuperGPQA, a comprehensive benchmark that evaluates graduate-level knowledge and reasoning capabilities across 285 disciplines. Our benchmark employs a novel Human-LLM collaborative filtering mechanism to eliminate trivial or ambiguous questions through iterative refinement based on both LLM responses and expert feedback. Our experimental results reveal significant room for improvement in the performance of current state-of-the-art LLMs across diverse knowledge domains (e.g., the reasoning-focused model DeepSeek-R1 achieved the highest accuracy of 61.82% on SuperGPQA), highlighting the considerable gap between current model capabilities and artificial general intelligence. Additionally, we present comprehensive insights from our management of a large-scale annotation process, involving over 80 expert annotators and an interactive Human-LLM collaborative system, offering valuable methodological guidance for future research initiatives of comparable scope.

Large language models (LLMs) implicitly learn to perform a range of language tasks, including machine translation (MT). Previous studies explore aspects of LLMs' MT capabilities. However, there exist a wide variety of languages for which recent LLM MT performance has never before been evaluated. Without published experimental evidence on the matter, it is difficult for speakers of the world's diverse languages to know how and whether they can use LLMs for their languages. We present the first experimental evidence for an expansive set of 204 languages, along with MT cost analysis, using the FLORES-200 benchmark. Trends reveal that GPT models approach or exceed traditional MT model performance for some high-resource languages (HRLs) but consistently lag for low-resource languages (LRLs), under-performing traditional MT for 84.1% of languages we covered. Our analysis reveals that a language's resource level is the most important feature in determining ChatGPT's relative ability to translate it, and suggests that ChatGPT is especially disadvantaged for LRLs and African languages.

Large language models (LLMs) have recently demonstrated their potential in clinical applications, providing valuable medical knowledge and advice. For example, a large dialog LLM like ChatGPT has successfully passed part of the US medical licensing exam. However, LLMs currently have difficulty processing images, making it challenging to interpret information from medical images, which are rich in information that supports clinical decisions. On the other hand, computer-aided diagnosis (CAD) networks for medical images have seen significant success in the medical field by using advanced deep-learning algorithms to support clinical decision-making. This paper presents a method for integrating LLMs into medical-image CAD networks. The proposed framework uses LLMs to enhance the output of multiple CAD networks, such as diagnosis networks, lesion segmentation networks, and report generation networks, by summarizing and reorganizing the information presented in natural language text format. The goal is to merge the strengths of LLMs' medical domain knowledge and logical reasoning with the vision understanding capability of existing medical-image CAD models to create a more user-friendly and understandable system for patients compared to conventional CAD systems. In the future, LLM's medical knowledge can be also used to improve the performance of vision-based medical-image CAD models.

Large language models (LLMs) excel in many tasks in NLP and beyond, but most open models have very limited coverage of smaller languages and LLM work tends to focus on languages where nearly unlimited data is available for pretraining. In this work, we study the challenges of creating LLMs for Finnish, a language spoken by less than 0.1% of the world population. We compile an extensive dataset of Finnish combining web crawls, news, social media and eBooks. We pursue two approaches to pretrain models: 1) we train seven monolingual models from scratch (186M to 13B parameters) dubbed FinGPT, 2) we continue the pretraining of the multilingual BLOOM model on a mix of its original training data and Finnish, resulting in a 176 billion parameter model we call BLUUMI. For model evaluation, we introduce FIN-bench, a version of BIG-bench with Finnish tasks. We also assess other model qualities such as toxicity and bias. Our models and tools are openly available at https://turkunlp.org/gpt3-finnish.

Large Language Models are expressive tools that enable complex tasks of text understanding within Computational Social Science. Their versatility, while beneficial, poses a barrier for establishing standardized best practices within the field. To bring clarity on the values of different strategies, we present an overview of the performance of modern LLM-based classification methods on a benchmark of 23 social knowledge tasks. Our results point to three best practices: select models with larger vocabulary and pre-training corpora; avoid simple zero-shot in favor of AI-enhanced prompting; fine-tune on task-specific data, and consider more complex forms instruction-tuning on multiple datasets only when only training data is more abundant.

We introduce SoftTiger, a clinical large language model (CLaM) designed as a foundation model for healthcare workflows. The narrative and unstructured nature of clinical notes is a major obstacle for healthcare intelligentization. We address a critical problem of structuring clinical notes into clinical data, according to international interoperability standards. We collect and annotate data for three subtasks, namely, international patient summary, clinical impression and medical encounter. We then supervised fine-tuned a state-of-the-art LLM using public and credentialed clinical data. The training is orchestrated in a way that the target model can first support basic clinical tasks such as abbreviation expansion and temporal information extraction, and then learn to perform more complex downstream clinical tasks. Moreover, we address several modeling challenges in the healthcare context, e.g., extra long context window. Our blind pairwise evaluation shows that SoftTiger outperforms other popular open-source models and GPT-3.5, comparable to Gemini-pro, with a mild gap from GPT-4. We believe that LLMs may become a step-stone towards healthcare digitalization and democratization. Therefore, we publicly release SoftTiger models at scales of 13 billion and 70 billion parameters, as well as datasets and code for our innovative scalable evaluation, hopefully, making a significant contribution to the healthcare industry.

In recent years, large language models (LLMs) have achieved remarkable success in natural language processing (NLP). LLMs require an extreme amount of parameters to attain high performance. As models grow into the trillion-parameter range, computational and memory costs increase significantly. This makes it difficult for many researchers to access the resources needed to train or apply these models. Optimizing LLM performance involves two main approaches: fine-tuning pre-trained models for specific tasks to achieve state-of-the-art performance, and reducing costs or improving training time while maintaining similar performance. This paper presents a systematic literature review (SLR) following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. We reviewed 65 publications out of 983 from 2017 to December 2023, retrieved from 5 databases. The study presents methods to optimize and accelerate LLMs while achieving cutting-edge results without sacrificing accuracy. We begin with an overview of the development of language modeling, followed by a detailed explanation of commonly used frameworks and libraries, and a taxonomy for improving and speeding up LLMs based on three classes: LLM training, LLM inference, and system serving. We then delve into recent optimization and acceleration strategies such as training optimization, hardware optimization, scalability and reliability, accompanied by the taxonomy and categorization of these strategies. Finally, we provide an in-depth comparison of each class and strategy, with two case studies on optimizing model training and enhancing inference efficiency. These case studies showcase practical approaches to address LLM resource limitations while maintaining performance.

Large Language Models (LLMs) such as ChatGPT, have gained significant attention due to their impressive natural language processing capabilities. It is crucial to prioritize human-centered principles when utilizing these models. Safeguarding the ethical and moral compliance of LLMs is of utmost importance. However, individual ethical issues have not been well studied on the latest LLMs. Therefore, this study aims to address these gaps by introducing a new benchmark -- TrustGPT. TrustGPT provides a comprehensive evaluation of LLMs in three crucial areas: toxicity, bias, and value-alignment. Initially, TrustGPT examines toxicity in language models by employing toxic prompt templates derived from social norms. It then quantifies the extent of bias in models by measuring quantifiable toxicity values across different groups. Lastly, TrustGPT assesses the value of conversation generation models from both active value-alignment and passive value-alignment tasks. Through the implementation of TrustGPT, this research aims to enhance our understanding of the performance of conversation generation models and promote the development of language models that are more ethical and socially responsible.

Large language models (LLMs) have established great success in the general domain of natural language processing. Their emerging task generalization and free-form dialogue capabilities can greatly help to design Chemical General Intelligence (CGI) to assist real-world research in chemistry. However, the existence of specialized language and knowledge in the field of chemistry, such as the highly informative SMILES notation, hinders the performance of general-domain LLMs in chemistry. To this end, we develop ChemDFM, the first LLM towards CGI. ChemDFM-13B is trained on 34B tokens from chemical literature, textbooks, and instructions as well as various data from the general domain. Therefore, it can store, understand, and reason over chemical knowledge and languages while still possessing advanced free-form language comprehension capabilities. Extensive quantitative evaluation shows that ChemDFM can significantly outperform the representative open-sourced LLMs. Moreover, ChemDFM can also surpass GPT-4 on a great portion of chemical tasks, despite the significant size difference. Further qualitative evaluations demonstrate the efficiency and effectiveness of ChemDFM in real-world research scenarios. We will open-source the ChemDFM model soon.

Recent researches of large language models(LLM), which is pre-trained on massive general-purpose corpora, have achieved breakthroughs in responding human queries. However, these methods face challenges including limited data insufficiency to support extensive pre-training and can not align responses with users' instructions. To address these issues, we introduce a medical instruction dataset, CMedINS, containing six medical instructions derived from actual medical tasks, which effectively fine-tunes LLM in conjunction with other data. Subsequently, We launch our medical model, IIMedGPT, employing an efficient preference alignment method, Direct preference Optimization(DPO). The results show that our final model outperforms existing medical models in medical dialogue.Datsets, Code and model checkpoints will be released upon acceptance.

This paper explores the application of large language models (LLMs) in nursing and elderly care, focusing on AI-driven patient monitoring and interaction. We introduce a novel Chinese nursing dataset and implement incremental pre-training (IPT) and supervised fine-tuning (SFT) techniques to enhance LLM performance in specialized tasks. Using LangChain, we develop a dynamic nursing assistant capable of real-time care and personalized interventions. Experimental results demonstrate significant improvements, paving the way for AI-driven solutions to meet the growing demands of healthcare in aging populations.

Recently, Large Language Models (LLMs) have dominated much of the artificial intelligence scene with their ability to process and generate natural languages. However, the majority of LLM research and development remains English-centric, leaving low-resource languages such as those in the Southeast Asian (SEA) region under-represented. To address this representation gap, we introduce Llama-SEA-LION-v3-8B-IT and Gemma-SEA-LION-v3-9B-IT, two cutting-edge multilingual LLMs designed for SEA languages. The SEA-LION family of LLMs supports 11 SEA languages, namely English, Chinese, Indonesian, Vietnamese, Malay, Thai, Burmese, Lao, Filipino, Tamil, and Khmer. Our work leverages large-scale multilingual continued pre-training with a comprehensive post-training regime involving multiple stages of instruction fine-tuning, alignment, and model merging. Evaluation results on multilingual benchmarks indicate that our models achieve state-of-the-art performance across LLMs supporting SEA languages. We open-source the models to benefit the wider SEA community.

Recent advancements in Large Language Models (LLMs) have demonstrated their potential in delivering accurate answers to questions about world knowledge. Despite this, existing benchmarks for evaluating LLMs in healthcare predominantly focus on medical doctors, leaving other critical healthcare professions underrepresented. To fill this research gap, we introduce the Examinations for Medical Personnel in Chinese (EMPEC), a pioneering large-scale healthcare knowledge benchmark in traditional Chinese. EMPEC consists of 157,803 exam questions across 124 subjects and 20 healthcare professions, including underrepresented occupations like Optometrists and Audiologists. Each question is tagged with its release time and source, ensuring relevance and authenticity. We conducted extensive experiments on 17 LLMs, including proprietary, open-source models, general domain models and medical specific models, evaluating their performance under various settings. Our findings reveal that while leading models like GPT-4 achieve over 75\% accuracy, they still struggle with specialized fields and alternative medicine. Surprisingly, general-purpose LLMs outperformed medical-specific models, and incorporating EMPEC's training data significantly enhanced performance. Additionally, the results on questions released after the models' training cutoff date were consistent with overall performance trends, suggesting that the models' performance on the test set can predict their effectiveness in addressing unseen healthcare-related queries. The transition from traditional to simplified Chinese characters had a negligible impact on model performance, indicating robust linguistic versatility. Our study underscores the importance of expanding benchmarks to cover a broader range of healthcare professions to better assess the applicability of LLMs in real-world healthcare scenarios.

Large language models (LLMs) use data to learn about the world in order to produce meaningful correlations and predictions. As such, the nature, scale, quality, and diversity of the datasets used to train these models, or to support their work at inference time, have a direct impact on their quality. The rapid development and adoption of LLMs of varying quality has brought into focus the scarcity of publicly available, high-quality training data and revealed an urgent need to ground the stewardship of these datasets in sustainable practices with clear provenance chains. To that end, this technical report introduces Institutional Books 1.0, a large collection of public domain books originally digitized through Harvard Library's participation in the Google Books project, beginning in 2006. Working with Harvard Library, we extracted, analyzed, and processed these volumes into an extensively-documented dataset of historic texts. This analysis covers the entirety of Harvard Library's collection scanned as part of that project, originally spanning 1,075,899 volumes written in over 250 different languages for a total of approximately 250 billion tokens. As part of this initial release, the OCR-extracted text (original and post-processed) as well as the metadata (bibliographic, source, and generated) of the 983,004 volumes, or 242B tokens, identified as being in the public domain have been made available. This report describes this project's goals and methods as well as the results of the analyses we performed, all in service of making this historical collection more accessible and easier for humans and machines alike to filter, read and use.

Machine translation is indispensable in healthcare for enabling the global dissemination of medical knowledge across languages. However, complex medical terminology poses unique challenges to achieving adequate translation quality and accuracy. This study introduces a novel "LLMs-in-the-loop" approach to develop supervised neural machine translation models optimized specifically for medical texts. While large language models (LLMs) have demonstrated powerful capabilities, this research shows that small, specialized models trained on high-quality in-domain (mostly synthetic) data can outperform even vastly larger LLMs. Custom parallel corpora in six languages were compiled from scientific articles, synthetically generated clinical documents, and medical texts. Our LLMs-in-the-loop methodology employs synthetic data generation, rigorous evaluation, and agent orchestration to enhance performance. We developed small medical translation models using the MarianMT base model. We introduce a new medical translation test dataset to standardize evaluation in this domain. Assessed using BLEU, METEOR, ROUGE, and BERT scores on this test set, our MarianMT-based models outperform Google Translate, DeepL, and GPT-4-Turbo. Results demonstrate that our LLMs-in-the-loop approach, combined with fine-tuning high-quality, domain-specific data, enables specialized models to outperform general-purpose and some larger systems. This research, part of a broader series on expert small models, paves the way for future healthcare-related AI developments, including deidentification and bio-medical entity extraction models. Our study underscores the potential of tailored neural translation models and the LLMs-in-the-loop methodology to advance the field through improved data generation, evaluation, agent, and modeling techniques.

Recent large language models (LLMs) such as ChatGPT and LLaMA have shown great promise in many AI applications. However, their performance on medical tasks is suboptimal and can be improved by training on extensive domain-specific datasets. This study introduces Me LLaMA, a medical LLM family that includes foundation models - Me LLaMA 13/70B, along with their chat-enhanced versions - Me LLaMA 13/70B-chat, developed through continual pre-training and instruction tuning of LLaMA2 using large medical datasets. Our domain-specific data suite for training and evaluation includes a large-scale, continual pre-training dataset with 129B tokens, an instruction tuning dataset with 214k samples, and a new medical evaluation benchmark (MIBE) across six tasks with 12 datasets. Our extensive evaluation using the MIBE shows that Me LLaMA models achieve overall better performance than existing open-source medical LLMs in zero-shot, few-shot and supervised learning abilities. Their zero-shot performance is comparable with ChatGPT across 7 out of 8 datasets, with a slight variance of within 3%, and yet falls short when compared to GPT-4. In addition, we investigated the catastrophic forgetting problem, and our results show that Me LLaMA models outperform other open-source medical LLMs in mitigating this issue. Me LLaMA is one of the largest open-source medical foundation LLMs that use both biomedical and clinical data. It exhibits superior performance across both general and medical tasks compared to other open-source medical LLMs, rendering it an attractive choice for medical AI applications. We release our models, datasets, and evaluation scripts at: https://github.com/BIDS-Xu-Lab/Me-LLaMA.

Large language models (LLMs) have shown impressive capabilities across various natural language tasks. However, evaluating their alignment with human preferences remains a challenge. To this end, we propose a comprehensive human evaluation framework to assess LLMs' proficiency in following instructions on diverse real-world tasks. We construct a hierarchical task tree encompassing 7 major areas covering over 200 categories and over 800 tasks, which covers diverse capabilities such as question answering, reasoning, multiturn dialogue, and text generation, to evaluate LLMs in a comprehensive and in-depth manner. We also design detailed evaluation standards and processes to facilitate consistent, unbiased judgments from human evaluators. A test set of over 3,000 instances is released, spanning different difficulty levels and knowledge domains. Our work provides a standardized methodology to evaluate human alignment in LLMs for both English and Chinese. We also analyze the feasibility of automating parts of evaluation with a strong LLM (GPT-4). Our framework supports a thorough assessment of LLMs as they are integrated into real-world applications. We have made publicly available the task tree, TencentLLMEval dataset, and evaluation methodology which have been demonstrated as effective in assessing the performance of Tencent Hunyuan LLMs. By doing so, we aim to facilitate the benchmarking of advances in the development of safe and human-aligned LLMs.

From pre-trained language model (PLM) to large language model (LLM), the field of natural language processing (NLP) has witnessed steep performance gains and wide practical uses. The evaluation of a research field guides its direction of improvement. However, LLMs are extremely hard to thoroughly evaluate for two reasons. First of all, traditional NLP tasks become inadequate due to the excellent performance of LLM. Secondly, existing evaluation tasks are difficult to keep up with the wide range of applications in real-world scenarios. To tackle these problems, existing works proposed various benchmarks to better evaluate LLMs. To clarify the numerous evaluation tasks in both academia and industry, we investigate multiple papers concerning LLM evaluations. We summarize 4 core competencies of LLM, including reasoning, knowledge, reliability, and safety. For every competency, we introduce its definition, corresponding benchmarks, and metrics. Under this competency architecture, similar tasks are combined to reflect corresponding ability, while new tasks can also be easily added into the system. Finally, we give our suggestions on the future direction of LLM's evaluation.

We present a novel approach to personalized sleep health management using few-shot Chain-of-Thought (CoT) distillation, enabling small-scale language models (> 2B parameters) to rival the performance of large language models (LLMs) in specialized health domains. Our method simultaneously distills problem-solving strategies, long-tail expert knowledge, and personalized recommendation capabilities from larger models into more efficient, compact models. Unlike existing systems, our approach offers three key functionalities: generating personalized sleep health recommendations, supporting user-specific follow-up inquiries, and providing responses to domain-specific knowledge questions. We focus on sleep health due to its measurability via wearable devices and its impact on overall well-being. Our experimental setup, involving GPT-4o for data synthesis, Qwen-max for instruction set creation, and Qwen2.5 1.5B for model distillation, demonstrates significant improvements over baseline small-scale models in penalization, reasoning, and knowledge application. Experiments using 100 simulated sleep reports and 1,000 domain-specific questions shows our model achieves comparable performance to larger models while maintaining efficiency for real-world deployment. This research not only advances AI-driven health management but also provides a novel approach to leveraging LLM capabilities in resource-constrained environments, potentially enhancing the accessibility of personalized healthcare solutions.

The rise of large language models (LLMs) has driven significant progress in medical applications, including traditional Chinese medicine (TCM). However, current medical LLMs struggle with TCM diagnosis and syndrome differentiation due to substantial differences between TCM and modern medical theory, and the scarcity of specialized, high-quality corpora. This paper addresses these challenges by proposing BianCang, a TCM-specific LLM, using a two-stage training process that first injects domain-specific knowledge and then aligns it through targeted stimulation. To enhance diagnostic and differentiation capabilities, we constructed pre-training corpora, instruction-aligned datasets based on real hospital records, and the ChP-TCM dataset derived from the Pharmacopoeia of the People's Republic of China. We compiled extensive TCM and medical corpora for continuous pre-training and supervised fine-tuning, building a comprehensive dataset to refine the model's understanding of TCM. Evaluations across 11 test sets involving 29 models and 4 tasks demonstrate the effectiveness of BianCang, offering valuable insights for future research. Code, datasets, and models are available at https://github.com/QLU-NLP/BianCang.

Recent large language models (LLMs) have demonstrated significant advancements, particularly in their ability to serve as agents thereby surpassing their traditional role as chatbots. These agents can leverage their planning and tool utilization capabilities to address tasks specified at a high level. However, a standardized dataset to benchmark the agent capabilities of LLMs in medical applications is currently lacking, making the evaluation of LLMs on complex tasks in interactive healthcare environments challenging. To address this gap, we introduce MedAgentBench, a broad evaluation suite designed to assess the agent capabilities of large language models within medical records contexts. MedAgentBench encompasses 300 patient-specific clinically-derived tasks from 10 categories written by human physicians, realistic profiles of 100 patients with over 700,000 data elements, a FHIR-compliant interactive environment, and an accompanying codebase. The environment uses the standard APIs and communication infrastructure used in modern EMR systems, so it can be easily migrated into live EMR systems. MedAgentBench presents an unsaturated agent-oriented benchmark that current state-of-the-art LLMs exhibit some ability to succeed at. The best model (Claude 3.5 Sonnet v2) achieves a success rate of 69.67%. However, there is still substantial space for improvement which gives the community a next direction to optimize. Furthermore, there is significant variation in performance across task categories. MedAgentBench establishes this and is publicly available at https://github.com/stanfordmlgroup/MedAgentBench , offering a valuable framework for model developers to track progress and drive continuous improvements in the agent capabilities of large language models within the medical domain.

Ensuring that large language models (LLMs) reflect diverse user values and preferences is crucial as their user bases expand globally. It is therefore encouraging to see the growing interest in LLM personalization within the research community. However, current works often rely on the LLM-as-a-Judge approach for evaluation without thoroughly examining its validity. In this paper, we investigate the reliability of LLM-as-a-Personalized-Judge, asking LLMs to judge user preferences based on personas. Our findings suggest that directly applying LLM-as-a-Personalized-Judge is less reliable than previously assumed, showing low and inconsistent agreement with human ground truth. The personas typically used are often overly simplistic, resulting in low predictive power. To address these issues, we introduce verbal uncertainty estimation into the LLM-as-a-Personalized-Judge pipeline, allowing the model to express low confidence on uncertain judgments. This adjustment leads to much higher agreement (above 80%) on high-certainty samples for binary tasks. Through human evaluation, we find that the LLM-as-a-Personalized-Judge achieves comparable performance to third-party humans evaluation and even surpasses human performance on high-certainty samples. Our work indicates that certainty-enhanced LLM-as-a-Personalized-Judge offers a promising direction for developing more reliable and scalable methods for evaluating LLM personalization.

In real-world NLP applications, Large Language Models (LLMs) offer promising solutions due to their extensive training on vast datasets. However, the large size and high computation demands of LLMs limit their practicality in many applications, especially when further fine-tuning is required. To address these limitations, smaller models are typically preferred for deployment. However, their training is hindered by the scarcity of labeled data. In contrast, unlabeled data is often readily which can be leveraged by using LLMs to generate pseudo-labels for training smaller models. This enables the smaller models (student) to acquire knowledge from LLMs(teacher) while reducing computational costs. This process introduces challenges, such as potential noisy pseudo-labels. Selecting high-quality and informative data is therefore critical to enhance model performance while improving the efficiency of data utilization. To address this, we propose LLKD that enables Learning with Less computational resources and less data for Knowledge Distillation from LLMs. LLKD is an adaptive sample selection method that incorporates signals from both the teacher and student. Specifically, it prioritizes samples where the teacher demonstrates high confidence in its labeling, indicating reliable labels, and where the student exhibits a high information need, identifying challenging samples that require further learning. Our comprehensive experiments show that LLKD achieves superior performance across various datasets with higher data efficiency.

Manual assignment of Anatomical Therapeutic Chemical (ATC) codes to prescription records is a significant bottleneck in healthcare research and operations at Ontario Health and InterRAI Canada, requiring extensive expert time and effort. To automate this process while maintaining data privacy, we develop a practical approach using locally deployable large language models (LLMs). Inspired by recent advances in automatic International Classification of Diseases (ICD) coding, our method frames ATC coding as a hierarchical information extraction task, guiding LLMs through the ATC ontology level by level. We evaluate our approach using GPT-4o as an accuracy ceiling and focus development on open-source Llama models suitable for privacy-sensitive deployment. Testing across Health Canada drug product data, the RABBITS benchmark, and real clinical notes from Ontario Health, our method achieves 78% exact match accuracy with GPT-4o and 60% with Llama 3.1 70B. We investigate knowledge grounding through drug definitions, finding modest improvements in accuracy. Further, we show that fine-tuned Llama 3.1 8B matches zero-shot Llama 3.1 70B accuracy, suggesting that effective ATC coding is feasible with smaller models. Our results demonstrate the feasibility of automatic ATC coding in privacy-sensitive healthcare environments, providing a foundation for future deployments.

Large Language Models (LLMs) have shown the potential to revolutionize natural language processing tasks in various domains, sparking great interest in vertical-specific large models. However, unlike proprietary models such as BloombergGPT and FinGPT, which have leveraged their unique data accumulations to make strides in the finance domain, there hasn't not many similar large language models in the Chinese legal domain to facilitate its digital transformation. In this paper, we propose an open-source legal large language model named ChatLaw. Due to the importance of data quality, we carefully designed a legal domain fine-tuning dataset. Additionally, to overcome the problem of model hallucinations in legal data screening during reference data retrieval, we introduce a method that combines vector database retrieval with keyword retrieval to effectively reduce the inaccuracy of relying solely on vector database retrieval. Furthermore, we propose a self-attention method to enhance the ability of large models to overcome errors present in reference data, further optimizing the issue of model hallucinations at the model level and improving the problem-solving capabilities of large models. We also open-sourced our model and part of the data at https://github.com/PKU-YuanGroup/ChatLaw.

Personalization of Large Language Models (LLMs) has recently become increasingly important with a wide range of applications. Despite the importance and recent progress, most existing works on personalized LLMs have focused either entirely on (a) personalized text generation or (b) leveraging LLMs for personalization-related downstream applications, such as recommendation systems. In this work, we bridge the gap between these two separate main directions for the first time by introducing a taxonomy for personalized LLM usage and summarizing the key differences and challenges. We provide a formalization of the foundations of personalized LLMs that consolidates and expands notions of personalization of LLMs, defining and discussing novel facets of personalization, usage, and desiderata of personalized LLMs. We then unify the literature across these diverse fields and usage scenarios by proposing systematic taxonomies for the granularity of personalization, personalization techniques, datasets, evaluation methods, and applications of personalized LLMs. Finally, we highlight challenges and important open problems that remain to be addressed. By unifying and surveying recent research using the proposed taxonomies, we aim to provide a clear guide to the existing literature and different facets of personalization in LLMs, empowering both researchers and practitioners.

Large Language Models (LLMs) have emerged as transformative tools in artificial intelligence (AI), exhibiting remarkable capabilities across diverse tasks such as text generation, reasoning, and decision-making. While their success has primarily been driven by advances in computational power and deep learning architectures, emerging problems -- in areas such as uncertainty quantification, decision-making, causal inference, and distribution shift -- require a deeper engagement with the field of statistics. This paper explores potential areas where statisticians can make important contributions to the development of LLMs, particularly those that aim to engender trustworthiness and transparency for human users. Thus, we focus on issues such as uncertainty quantification, interpretability, fairness, privacy, watermarking and model adaptation. We also consider possible roles for LLMs in statistical analysis. By bridging AI and statistics, we aim to foster a deeper collaboration that advances both the theoretical foundations and practical applications of LLMs, ultimately shaping their role in addressing complex societal challenges.

The Large Language Model (LLM) is widely employed for tasks such as intelligent assistants, text summarization, translation, and multi-modality on mobile phones. However, the current methods for on-device LLM deployment maintain slow inference speed, which causes poor user experience. To facilitate high-efficiency LLM deployment on device GPUs, we propose four optimization techniques: (a) a symbolic expression-based approach to support dynamic shape model inference; (b) operator optimizations and execution priority setting to enhance inference speed and reduce phone lagging; (c) an FP4 quantization method termed M0E4 to reduce dequantization overhead; (d) a sub-tensor-based technique to eliminate the need for copying KV cache after LLM inference. Furthermore, we implement these methods in our mobile inference engine, Transformer-Lite, which is compatible with both Qualcomm and MTK processors. We evaluated Transformer-Lite's performance using LLMs with varied architectures and parameters ranging from 2B to 14B. Specifically, we achieved prefill and decoding speeds of 121 token/s and 14 token/s for ChatGLM2 6B, and 330 token/s and 30 token/s for smaller Gemma 2B, respectively. Compared with CPU-based FastLLM and GPU-based MLC-LLM, our engine attains over 10x speedup for the prefill speed and 2~3x speedup for the decoding speed.

Large language models (LLMs) have become the foundation of many applications, leveraging their extensive capabilities in processing and understanding natural language. While many open-source LLMs have been released with technical reports, the lack of training details hinders further research and development. This paper presents the development of YuLan, a series of open-source LLMs with 12 billion parameters. The base model of YuLan is pre-trained on approximately 1.7T tokens derived from a diverse corpus, including massive English, Chinese, and multilingual texts. We design a three-stage pre-training method to enhance YuLan's overall capabilities. Subsequent phases of training incorporate instruction-tuning and human alignment, employing a substantial volume of high-quality synthesized data. To facilitate the learning of complex and long-tail knowledge, we devise a curriculum-learning framework throughout across these stages, which helps LLMs learn knowledge in an easy-to-hard manner. YuLan's training is finished on Jan, 2024 and has achieved performance on par with state-of-the-art LLMs across various English and Chinese benchmarks. This paper outlines a comprehensive technical roadmap for developing LLMs from scratch. Our model and codes are available at https://github.com/RUC-GSAI/YuLan-Chat.

Large language models (LLMs) are trained on text-only data that go far beyond the languages with paired speech and text data. At the same time, Dual Encoder (DE) based retrieval systems project queries and documents into the same embedding space and have demonstrated their success in retrieval and bi-text mining. To match speech and text in many languages, we propose using LLMs to initialize multi-modal DE retrieval systems. Unlike traditional methods, our system doesn't require speech data during LLM pre-training and can exploit LLM's multilingual text understanding capabilities to match speech and text in languages unseen during retrieval training. Our multi-modal LLM-based retrieval system is capable of matching speech and text in 102 languages despite only training on 21 languages. Our system outperforms previous systems trained explicitly on all 102 languages. We achieve a 10% absolute improvement in Recall@1 averaged across these languages. Additionally, our model demonstrates cross-lingual speech and text matching, which is further enhanced by readily available machine translation data.

Large language models (LLMs) currently dominate the field of natural language processing (NLP), representing the state-of-the-art across a diverse array of tasks. Developing a model of this nature, from training to inference, requires making numerous decisions which define a combinatorial search problem. For example, selecting the optimal pre-trained LLM, prompt, or hyperparameters to attain the best performance for a task often requires evaluating multiple candidates on an entire test set. This exhaustive evaluation can be time-consuming and costly, as both inference and metric computation with LLMs are resource-intensive. In this paper, we address the challenge of identifying the best method within a limited budget for evaluating methods on test examples. By leveraging the well-studied multi-armed bandit framework, which sequentially selects the next method-example pair to evaluate, our approach, combining multi-armed bandit algorithms with low-rank factorization, significantly reduces the required resources. Experiments show that our algorithms can identify the top-performing method using only 5-15\% of the typically needed resources, resulting in an 85-95\% reduction in cost.

In recent years, Recommender Systems(RS) have witnessed a transformative shift with the advent of Large Language Models(LLMs) in the field of Natural Language Processing(NLP). These models such as OpenAI's GPT-3.5/4, Llama from Meta, have demonstrated unprecedented capabilities in understanding and generating human-like text. This has led to a paradigm shift in the realm of personalized and explainable recommendations, as LLMs offer a versatile toolset for processing vast amounts of textual data to enhance user experiences. To provide a comprehensive understanding of the existing LLM-based recommendation systems, this survey aims to analyze how RS can benefit from LLM-based methodologies. Furthermore, we describe major challenges in Personalized Explanation Generating(PEG) tasks, which are cold-start problems, unfairness and bias problems in RS.

In this paper, we present HuatuoGPT, a large language model (LLM) for medical consultation. The core recipe of HuatuoGPT is to leverage both distilled data from ChatGPT and real-world data from doctors in the supervised fine-tuned stage. The responses of ChatGPT are usually detailed, well-presented and informative while it cannot perform like a doctor in many aspects, e.g. for integrative diagnosis. We argue that real-world data from doctors would be complementary to distilled data in the sense the former could tame a distilled language model to perform like doctors. To better leverage the strengths of both data, we train a reward model to align the language model with the merits that both data bring, following an RLAIF (reinforced learning from AI feedback) fashion. To evaluate and benchmark the models, we propose a comprehensive evaluation scheme (including automatic and manual metrics). Experimental results demonstrate that HuatuoGPT achieves state-of-the-art results in performing medical consultation among open-source LLMs in GPT-4 evaluation, human evaluation, and medical benchmark datasets. It is worth noting that by using additional real-world data and RLAIF, the distilled language model (i.e., HuatuoGPT) outperforms its teacher model ChatGPT in most cases. Our code, data, and models are publicly available at https://github.com/FreedomIntelligence/HuatuoGPT. The online demo is available at https://www.HuatuoGPT.cn/.

Sifting through vast textual data and summarizing key information imposes a substantial burden on how clinicians allocate their time. Although large language models (LLMs) have shown immense promise in natural language processing (NLP) tasks, their efficacy across diverse clinical summarization tasks has not yet been rigorously examined. In this work, we employ domain adaptation methods on eight LLMs, spanning six datasets and four distinct summarization tasks: radiology reports, patient questions, progress notes, and doctor-patient dialogue. Our thorough quantitative assessment reveals trade-offs between models and adaptation methods in addition to instances where recent advances in LLMs may not lead to improved results. Further, in a clinical reader study with six physicians, we depict that summaries from the best adapted LLM are preferable to human summaries in terms of completeness and correctness. Our ensuing qualitative analysis delineates mutual challenges faced by both LLMs and human experts. Lastly, we correlate traditional quantitative NLP metrics with reader study scores to enhance our understanding of how these metrics align with physician preferences. Our research marks the first evidence of LLMs outperforming human experts in clinical text summarization across multiple tasks. This implies that integrating LLMs into clinical workflows could alleviate documentation burden, empowering clinicians to focus more on personalized patient care and other irreplaceable human aspects of medicine.

Social Determinants of Health (SDoH) are economic, social and personal circumstances that affect or influence an individual's health status. SDoHs have shown to be correlated to wellness outcomes, and therefore, are useful to physicians in diagnosing diseases and in decision-making. In this work, we automatically extract SDoHs from clinical text using traditional deep learning and Large Language Models (LLMs) to find the advantages and disadvantages of each on an existing publicly available dataset. Our models outperform a previous reference point on a multilabel SDoH classification by 10 points, and we present a method and model to drastically speed up classification (12X execution time) by eliminating expensive LLM processing. The method we present combines a more nimble and efficient solution that leverages the power of the LLM for precision and traditional deep learning methods for efficiency. We also show highly performant results on a dataset supplemented with synthetic data and several traditional deep learning models that outperform LLMs. Our models and methods offer the next iteration of automatic prediction of SDoHs that impact at-risk patients.

Language is essentially a complex, intricate system of human expressions governed by grammatical rules. It poses a significant challenge to develop capable AI algorithms for comprehending and grasping a language. As a major approach, language modeling has been widely studied for language understanding and generation in the past two decades, evolving from statistical language models to neural language models. Recently, pre-trained language models (PLMs) have been proposed by pre-training Transformer models over large-scale corpora, showing strong capabilities in solving various NLP tasks. Since researchers have found that model scaling can lead to performance improvement, they further study the scaling effect by increasing the model size to an even larger size. Interestingly, when the parameter scale exceeds a certain level, these enlarged language models not only achieve a significant performance improvement but also show some special abilities that are not present in small-scale language models. To discriminate the difference in parameter scale, the research community has coined the term large language models (LLM) for the PLMs of significant size. Recently, the research on LLMs has been largely advanced by both academia and industry, and a remarkable progress is the launch of ChatGPT, which has attracted widespread attention from society. The technical evolution of LLMs has been making an important impact on the entire AI community, which would revolutionize the way how we develop and use AI algorithms. In this survey, we review the recent advances of LLMs by introducing the background, key findings, and mainstream techniques. In particular, we focus on four major aspects of LLMs, namely pre-training, adaptation tuning, utilization, and capacity evaluation. Besides, we also summarize the available resources for developing LLMs and discuss the remaining issues for future directions.

Large language models (LLMs) have made impressive progress in chemistry applications, including molecular property prediction, molecular generation, experimental protocol design, etc. However, the community lacks a dialogue-based model specifically designed for chemistry. The challenge arises from the fact that most chemical data and scientific knowledge are primarily stored in structured databases, and the direct use of these structured data compromises the model's ability to maintain coherent dialogue. To tackle this issue, we develop a novel template-based instruction construction method that transforms structured knowledge into plain dialogue, making it suitable for language model training. By leveraging this approach, we develop ChemLLM, the first large language model dedicated to chemistry, capable of performing various tasks across chemical disciplines with smooth dialogue interaction. ChemLLM beats GPT-3.5 on all three principal tasks in chemistry, i.e., name conversion, molecular caption, and reaction prediction, and surpasses GPT-4 on two of them. Remarkably, ChemLLM also shows exceptional adaptability to related mathematical and physical tasks despite being trained mainly on chemical-centric corpora. Furthermore, ChemLLM demonstrates proficiency in specialized NLP tasks within chemistry, such as literature translation and cheminformatic programming. ChemLLM opens up a new avenue for exploration within chemical studies, while our method of integrating structured chemical knowledge into dialogue systems sets a new frontier for developing LLMs across various scientific fields. Codes, Datasets, and Model weights are publicly accessible at hf.co/AI4Chem/ChemLLM-7B-Chat.

The evaluation of Large Language Models (LLMs) is a key element in their continuous improvement process and many benchmarks have been developed to assess the performance of LLMs in different tasks and topics. As LLMs become adopted worldwide, evaluating them in languages other than English is increasingly important. However, most LLM benchmarks are simply translated using an automated tool and then run in the target language. This means that the results depend not only on the LLM performance in that language but also on the quality of the translation. In this paper, we consider the case of the well-known Massive Multitask Language Understanding (MMLU) benchmark. Selected categories of the benchmark are translated into Spanish using Azure Translator and ChatGPT4 and run on ChatGPT4. Next, the results are processed to identify the test items that produce different answers in Spanish and English. Those are then analyzed manually to understand if the automatic translation caused the change. The results show that a significant fraction of the failing items can be attributed to mistakes in the translation of the benchmark. These results make a strong case for improving benchmarks in languages other than English by at least revising the translations of the items and preferably by adapting the tests to the target language by experts.

Large Language Models (LLMs) are reshaping many aspects of materials science and chemistry research, enabling advances in molecular property prediction, materials design, scientific automation, knowledge extraction, and more. Recent developments demonstrate that the latest class of models are able to integrate structured and unstructured data, assist in hypothesis generation, and streamline research workflows. To explore the frontier of LLM capabilities across the research lifecycle, we review applications of LLMs through 34 total projects developed during the second annual Large Language Model Hackathon for Applications in Materials Science and Chemistry, a global hybrid event. These projects spanned seven key research areas: (1) molecular and material property prediction, (2) molecular and material design, (3) automation and novel interfaces, (4) scientific communication and education, (5) research data management and automation, (6) hypothesis generation and evaluation, and (7) knowledge extraction and reasoning from the scientific literature. Collectively, these applications illustrate how LLMs serve as versatile predictive models, platforms for rapid prototyping of domain-specific tools, and much more. In particular, improvements in both open source and proprietary LLM performance through the addition of reasoning, additional training data, and new techniques have expanded effectiveness, particularly in low-data environments and interdisciplinary research. As LLMs continue to improve, their integration into scientific workflows presents both new opportunities and new challenges, requiring ongoing exploration, continued refinement, and further research to address reliability, interpretability, and reproducibility.

Large language models (LLMs) have had a profound impact on numerous aspects of daily life including natural language processing, content generation, research methodologies and so on. However, one crucial issue concerning the inference results of large language models is security and privacy. In many scenarios, the results generated by LLMs could possibly leak many confidential or copyright information. A recent beautiful and breakthrough work [Vyas, Kakade and Barak 2023] focus on such privacy issue of the LLMs from theoretical perspective. It is well-known that computing the attention matrix is one of the major task during the LLMs computation. Thus, how to give a provable privately guarantees of computing the attention matrix is an important research direction. Previous work [Alman and Song 2023, Brand, Song and Zhou 2023] have proposed provable tight result for fast computation of attention without considering privacy concerns. One natural mathematical formulation to quantity the privacy in theoretical computer science graduate school textbook is differential privacy. Inspired by [Vyas, Kakade and Barak 2023], in this work, we provide a provable result for showing how to differentially private approximate the attention matrix. From technique perspective, our result replies on a pioneering work in the area of differential privacy by [Alabi, Kothari, Tankala, Venkat and Zhang 2022].

Meta-analyses statistically aggregate the findings of different randomized controlled trials (RCTs) to assess treatment effectiveness. Because this yields robust estimates of treatment effectiveness, results from meta-analyses are considered the strongest form of evidence. However, rigorous evidence syntheses are time-consuming and labor-intensive, requiring manual extraction of data from individual trials to be synthesized. Ideally, language technologies would permit fully automatic meta-analysis, on demand. This requires accurately extracting numerical results from individual trials, which has been beyond the capabilities of natural language processing (NLP) models to date. In this work, we evaluate whether modern large language models (LLMs) can reliably perform this task. We annotate (and release) a modest but granular evaluation dataset of clinical trial reports with numerical findings attached to interventions, comparators, and outcomes. Using this dataset, we evaluate the performance of seven LLMs applied zero-shot for the task of conditionally extracting numerical findings from trial reports. We find that massive LLMs that can accommodate lengthy inputs are tantalizingly close to realizing fully automatic meta-analysis, especially for dichotomous (binary) outcomes (e.g., mortality). However, LLMs -- including ones trained on biomedical texts -- perform poorly when the outcome measures are complex and tallying the results requires inference. This work charts a path toward fully automatic meta-analysis of RCTs via LLMs, while also highlighting the limitations of existing models for this aim.

This paper investigates the challenges of developing large language models (LLMs) proficient in both multilingual understanding and medical knowledge. We demonstrate that simply translating medical data does not guarantee strong performance on clinical tasks in the target language. Our experiments reveal that the optimal language mix in training data varies significantly across different medical tasks. We find that larger models with carefully calibrated language ratios achieve superior performance on native-language clinical tasks. Furthermore, our results suggest that relying solely on fine-tuning may not be the most effective approach for incorporating new language knowledge into LLMs. Instead, data and computationally intensive pretraining methods may still be necessary to achieve optimal performance in multilingual medical settings. These findings provide valuable guidance for building effective and inclusive medical AI systems for diverse linguistic communities.

Large Language Models (LLMs) stand at the forefront of a number of Natural Language Processing (NLP) tasks. Despite the widespread adoption of LLMs in NLP, much of their potential in broader fields remains largely unexplored, and significant limitations persist in their design and implementation. Notably, LLMs struggle with structured data, such as graphs, and often falter when tasked with answering domain-specific questions requiring deep expertise, such as those in biology and chemistry. In this paper, we explore a fundamental question: Can LLMs effectively handle molecule prediction tasks? Rather than pursuing top-tier performance, our goal is to assess how LLMs can contribute to diverse molecule tasks. We identify several classification and regression prediction tasks across six standard molecule datasets. Subsequently, we carefully design a set of prompts to query LLMs on these tasks and compare their performance with existing Machine Learning (ML) models, which include text-based models and those specifically designed for analysing the geometric structure of molecules. Our investigation reveals several key insights: Firstly, LLMs generally lag behind ML models in achieving competitive performance on molecule tasks, particularly when compared to models adept at capturing the geometric structure of molecules, highlighting the constrained ability of LLMs to comprehend graph data. Secondly, LLMs show promise in enhancing the performance of ML models when used collaboratively. Lastly, we engage in a discourse regarding the challenges and promising avenues to harness LLMs for molecule prediction tasks. The code and models are available at https://github.com/zhiqiangzhongddu/LLMaMol.

Large language models (LLMs) have had a transformative impact on a variety of scientific tasks across disciplines such as biology, chemistry, medicine, and physics. However, ensuring the safety alignment of these models in scientific research remains an underexplored area, with existing benchmarks primarily focus on textual content and overlooking key scientific representations such as molecular, protein, and genomic languages. Moreover, the safety mechanisms of LLMs in scientific tasks are insufficiently studied. To address these limitations, we introduce SciSafeEval, a comprehensive benchmark designed to evaluate the safety alignment of LLMs across a range of scientific tasks. SciSafeEval spans multiple scientific languages - including textual, molecular, protein, and genomic - and covers a wide range of scientific domains. We evaluate LLMs in zero-shot, few-shot and chain-of-thought settings, and introduce a 'jailbreak' enhancement feature that challenges LLMs equipped with safety guardrails, rigorously testing their defenses against malicious intention. Our benchmark surpasses existing safety datasets in both scale and scope, providing a robust platform for assessing the safety and performance of LLMs in scientific contexts. This work aims to facilitate the responsible development and deployment of LLMs, promoting alignment with safety and ethical standards in scientific research.

In recent years, language models (LMs), such as GPT-4, have been widely used in multiple domains, including natural language processing, visualization, and so on. However, applying them for analyzing and optimizing high-performance computing (HPC) software is still challenging due to the lack of HPC-specific support. In this paper, we design the LM4HPC framework to facilitate the research and development of HPC software analyses and optimizations using LMs. Tailored for supporting HPC datasets, AI models, and pipelines, our framework is built on top of a range of components from different levels of the machine learning software stack, with Hugging Face-compatible APIs. Using three representative tasks, we evaluated the prototype of our framework. The results show that LM4HPC can help users quickly evaluate a set of state-of-the-art models and generate insightful leaderboards.

Large language models (LLMs) are useful in many NLP tasks and become more capable with size, with the best open-source models having over 50 billion parameters. However, using these 50B+ models requires high-end hardware, making them inaccessible to most researchers. In this work, we investigate methods for cost-efficient inference and fine-tuning of LLMs, comparing local and distributed strategies. We observe that a large enough model (50B+) can run efficiently even on geodistributed devices in a consumer-grade network. This could allow running LLM efficiently by pooling together idle compute resources of multiple research groups and volunteers. We address two open problems: (1) how to perform inference and fine-tuning reliably if any device can disconnect abruptly and (2) how to partition LLMs between devices with uneven hardware, joining and leaving at will. In order to do that, we develop special fault-tolerant inference algorithms and load-balancing protocols that automatically assign devices to maximize the total system throughput. We showcase these algorithms in Petals - a decentralized system that runs Llama 2 (70B) and BLOOM (176B) over the Internet up to 10x faster than offloading for interactive generation. We evaluate the performance of our system in simulated conditions and a real-world setup spanning two continents.

Large language models (LLMs) have made significant advances in the field of natural language processing, but they still face challenges such as continuous decision-making. In this research, we propose a novel framework by integrating iterative feedback, reflective mechanisms, and a memory optimization mechanism based on the Ebbinghaus forgetting curve, it significantly enhances the agents' capabilities in handling multi-tasking and long-span information.

Large language models (LLMs) have demonstrated remarkable capabilities out of box for a wide range of applications, yet accuracy still remains a major growth area, especially in mission-critical domains such as biomedicine. An effective method to calibrate the confidence level on LLM responses is essential to automatically detect errors and facilitate human-in-the-loop verification. An important source of calibration signals stems from expert-stipulated programmatic supervision, which is often available at low cost but has its own limitations such as noise and coverage. In this paper, we introduce a Pareto optimal self-supervision framework that can leverage available programmatic supervision to systematically calibrate LLM responses by producing a risk score for every response, without any additional manual efforts. This is accomplished by learning a harmonizer model to align LLM output with other available supervision sources, which would assign higher risk scores to more uncertain LLM responses and facilitate error correction. Experiments on standard relation extraction tasks in biomedical and general domains demonstrate the promise of this approach, with our proposed risk scores highly correlated with the real error rate of LLMs. For the most uncertain test instances, dynamic prompting based on our proposed risk scores results in significant accuracy improvement for off-the-shelf LLMs, boosting GPT-3 results past state-of-the-art (SOTA) weak supervision and GPT-4 results past SOTA supervised results on challenging evaluation datasets.