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Feb 16

Language Models Prefer What They Know: Relative Confidence Estimation via Confidence Preferences

Language models (LMs) should provide reliable confidence estimates to help users detect mistakes in their outputs and defer to human experts when necessary. Asking a language model to assess its confidence ("Score your confidence from 0-1.") is a natural way of evaluating its uncertainty. However, models struggle to provide absolute assessments of confidence (i.e. judging confidence in answering a question independent of other questions) and the coarse-grained scores they produce are not useful for evaluating the correctness of their answers. We propose relative confidence estimation, where we match up questions against each other and ask the model to make relative judgments of confidence ("Which question are you more confident in answering correctly?"). Treating each question as a "player" in a series of matchups against other questions and the model's preferences as match outcomes, we can use rank aggregation methods like Elo rating and Bradley-Terry to translate the model's confidence preferences into confidence scores. We evaluate relative confidence estimation against absolute confidence estimation and self-consistency confidence methods on five state-of-the-art LMs -- GPT-4, GPT-4o, Gemini 1.5 Pro, Claude 3.5 Sonnet, and Llama 3.1 405B -- across 14 challenging STEM, social science, and commonsense reasoning question answering tasks. Our results demonstrate that relative confidence estimation consistently provides more reliable confidence scores than absolute confidence estimation, with average gains of 3.5% in selective classification AUC over direct absolute confidence estimation methods and 1.7% over self-consistency approaches across all models and datasets.

  • 3 authors
·
Feb 3, 2025 2

PACE-LM: Prompting and Augmentation for Calibrated Confidence Estimation with GPT-4 in Cloud Incident Root Cause Analysis

Major cloud providers have employed advanced AI-based solutions like large language models to aid humans in identifying the root causes of cloud incidents. Despite the growing prevalence of AI-driven assistants in the root cause analysis process, their effectiveness in assisting on-call engineers is constrained by low accuracy due to the intrinsic difficulty of the task, a propensity for LLM-based approaches to hallucinate, and difficulties in distinguishing these well-disguised hallucinations. To address this challenge, we propose to perform confidence estimation for the predictions to help on-call engineers make decisions on whether to adopt the model prediction. Considering the black-box nature of many LLM-based root cause predictors, fine-tuning or temperature-scaling-based approaches are inapplicable. We therefore design an innovative confidence estimation framework based on prompting retrieval-augmented large language models (LLMs) that demand a minimal amount of information from the root cause predictor. This approach consists of two scoring phases: the LLM-based confidence estimator first evaluates its confidence in making judgments in the face of the current incident that reflects its ``grounded-ness" level in reference data, then rates the root cause prediction based on historical references. An optimization step combines these two scores for a final confidence assignment. We show that our method is able to produce calibrated confidence estimates for predicted root causes, validate the usefulness of retrieved historical data and the prompting strategy as well as the generalizability across different root cause prediction models. Our study takes an important move towards reliably and effectively embedding LLMs into cloud incident management systems.

  • 6 authors
·
Sep 11, 2023

Can LLMs Express Their Uncertainty? An Empirical Evaluation of Confidence Elicitation in LLMs

Empowering large language models to accurately express confidence in their answers is essential for trustworthy decision-making. Previous confidence elicitation methods, which primarily rely on white-box access to internal model information or model fine-tuning, have become less suitable for LLMs, especially closed-source commercial APIs. This leads to a growing need to explore the untapped area of black-box approaches for LLM uncertainty estimation. To better break down the problem, we define a systematic framework with three components: prompting strategies for eliciting verbalized confidence, sampling methods for generating multiple responses, and aggregation techniques for computing consistency. We then benchmark these methods on two key tasks-confidence calibration and failure prediction-across five types of datasets (e.g., commonsense and arithmetic reasoning) and five widely-used LLMs including GPT-4 and LLaMA 2 Chat. Our analysis uncovers several key insights: 1) LLMs, when verbalizing their confidence, tend to be overconfident, potentially imitating human patterns of expressing confidence. 2) As model capability scales up, both calibration and failure prediction performance improve. 3) Employing our proposed strategies, such as human-inspired prompts, consistency among multiple responses, and better aggregation strategies can help mitigate this overconfidence from various perspectives. 4) Comparisons with white-box methods indicate that while white-box methods perform better, the gap is narrow, e.g., 0.522 to 0.605 in AUROC. Despite these advancements, none of these techniques consistently outperform others, and all investigated methods struggle in challenging tasks, such as those requiring professional knowledge, indicating significant scope for improvement. We believe this study can serve as a strong baseline and provide insights for eliciting confidence in black-box LLMs.

  • 7 authors
·
Jun 22, 2023

The Calibration Gap between Model and Human Confidence in Large Language Models

For large language models (LLMs) to be trusted by humans they need to be well-calibrated in the sense that they can accurately assess and communicate how likely it is that their predictions are correct. Recent work has focused on the quality of internal LLM confidence assessments, but the question remains of how well LLMs can communicate this internal model confidence to human users. This paper explores the disparity between external human confidence in an LLM's responses and the internal confidence of the model. Through experiments involving multiple-choice questions, we systematically examine human users' ability to discern the reliability of LLM outputs. Our study focuses on two key areas: (1) assessing users' perception of true LLM confidence and (2) investigating the impact of tailored explanations on this perception. The research highlights that default explanations from LLMs often lead to user overestimation of both the model's confidence and its' accuracy. By modifying the explanations to more accurately reflect the LLM's internal confidence, we observe a significant shift in user perception, aligning it more closely with the model's actual confidence levels. This adjustment in explanatory approach demonstrates potential for enhancing user trust and accuracy in assessing LLM outputs. The findings underscore the importance of transparent communication of confidence levels in LLMs, particularly in high-stakes applications where understanding the reliability of AI-generated information is essential.

  • 8 authors
·
Jan 24, 2024

Using LLMs to Establish Implicit User Sentiment of Software Desirability

This study explores the use of LLMs for providing quantitative zero-shot sentiment analysis of implicit software desirability, addressing a critical challenge in product evaluation where traditional review scores, though convenient, fail to capture the richness of qualitative user feedback. Innovations include establishing a method that 1) works with qualitative user experience data without the need for explicit review scores, 2) focuses on implicit user satisfaction, and 3) provides scaled numerical sentiment analysis, offering a more nuanced understanding of user sentiment, instead of simply classifying sentiment as positive, neutral, or negative. Data is collected using the Microsoft Product Desirability Toolkit (PDT), a well-known qualitative user experience analysis tool. For initial exploration, the PDT metric was given to users of two software systems. PDT data was fed through several LLMs (Claude Sonnet 3 and 3.5, GPT4, and GPT4o) and through a leading transfer learning technique, Twitter-Roberta-Base-Sentiment, and Vader, a leading sentiment analysis tool. Each system was asked to evaluate the data in two ways, by looking at the sentiment expressed in the PDT word/explanation pairs; and by looking at the sentiment expressed by the users in their grouped selection of five words and explanations, as a whole. Each LLM provided a sentiment score, its confidence (low, medium, high) in the score, and an explanation of the score. All LLMs tested were able to statistically detect user sentiment from the users' grouped data, whereas TRBS and Vader were not. The confidence and explanation of confidence provided by the LLMs assisted in understanding user sentiment. This study adds deeper understanding of evaluating user experiences, toward the goal of creating a universal tool that quantifies implicit sentiment.

  • 3 authors
·
Aug 2, 2024

When Can We Trust LLMs in Mental Health? Large-Scale Benchmarks for Reliable LLM Evaluation

Evaluating Large Language Models (LLMs) for mental health support is challenging due to the emotionally and cognitively complex nature of therapeutic dialogue. Existing benchmarks are limited in scale, reliability, often relying on synthetic or social media data, and lack frameworks to assess when automated judges can be trusted. To address the need for large-scale dialogue datasets and judge reliability assessment, we introduce two benchmarks that provide a framework for generation and evaluation. MentalBench-100k consolidates 10,000 one-turn conversations from three real scenarios datasets, each paired with nine LLM-generated responses, yielding 100,000 response pairs. MentalAlign-70k}reframes evaluation by comparing four high-performing LLM judges with human experts across 70,000 ratings on seven attributes, grouped into Cognitive Support Score (CSS) and Affective Resonance Score (ARS). We then employ the Affective Cognitive Agreement Framework, a statistical methodology using intraclass correlation coefficients (ICC) with confidence intervals to quantify agreement, consistency, and bias between LLM judges and human experts. Our analysis reveals systematic inflation by LLM judges, strong reliability for cognitive attributes such as guidance and informativeness, reduced precision for empathy, and some unreliability in safety and relevance. Our contributions establish new methodological and empirical foundations for reliable, large-scale evaluation of LLMs in mental health. We release the benchmarks and codes at: https://github.com/abeerbadawi/MentalBench/

  • 9 authors
·
Oct 21, 2025

Mind the Generation Process: Fine-Grained Confidence Estimation During LLM Generation

While large language models (LLMs) have demonstrated remarkable performance across diverse tasks, they fundamentally lack self-awareness and frequently exhibit overconfidence, assigning high confidence scores to incorrect predictions. Accurate confidence estimation is therefore critical for enhancing the trustworthiness and reliability of LLM-generated outputs. However, existing approaches suffer from coarse-grained scoring mechanisms that fail to provide fine-grained, continuous confidence estimates throughout the generation process. To address these limitations, we introduce FineCE, a novel confidence estimation method that delivers accurate, fine-grained confidence scores during text generation. Specifically, we first develop a comprehensive pipeline for constructing training data that effectively captures the underlying probabilistic distribution of LLM responses, and then train a model to predict confidence scores for arbitrary text sequences in a supervised manner. Furthermore, we propose a Backward Confidence Integration (BCI) strategy that leverages information from the subsequent text to enhance confidence estimation for the current sequence during inference. We also introduce three strategies for identifying optimal positions to perform confidence estimation within the generation process. Extensive experiments on multiple benchmark datasets demonstrate that FineCE consistently outperforms existing classical confidence estimation methods. Our code and all baselines used in the paper are available on GitHub.

  • 11 authors
·
Aug 16, 2025 2

Influence Scores at Scale for Efficient Language Data Sampling

Modern ML systems ingest data aggregated from diverse sources, such as synthetic, human-annotated, and live customer traffic. Understanding which examples are important to the performance of a learning algorithm is crucial for efficient model training. Recently, a growing body of literature has given rise to various "influence scores," which use training artifacts such as model confidence or checkpointed gradients to identify important subsets of data. However, these methods have primarily been developed in computer vision settings, and it remains unclear how well they generalize to language-based tasks using pretrained models. In this paper, we explore the applicability of influence scores in language classification tasks. We evaluate a diverse subset of these scores on the SNLI dataset by quantifying accuracy changes in response to pruning training data through random and influence-score-based sampling. We then stress-test one of the scores -- "variance of gradients" (VoG) from Agarwal et al. (2022) -- in an NLU model stack that was exposed to dynamic user speech patterns in a voice assistant type of setting. Our experiments demonstrate that in many cases, encoder-based language models can be finetuned on roughly 50% of the original data without degradation in performance metrics. Along the way, we summarize lessons learned from applying out-of-the-box implementations of influence scores, quantify the effects of noisy and class-imbalanced data, and offer recommendations on score-based sampling for better accuracy and training efficiency.

  • 3 authors
·
Nov 27, 2023

Understanding the Impact of Confidence in Retrieval Augmented Generation: A Case Study in the Medical Domain

Retrieval Augmented Generation (RAG) complements the knowledge of Large Language Models (LLMs) by leveraging external information to enhance response accuracy for queries. This approach is widely applied in several fields by taking its advantage of injecting the most up-to-date information, and researchers are focusing on understanding and improving this aspect to unlock the full potential of RAG in such high-stakes applications. However, despite the potential of RAG to address these needs, the mechanisms behind the confidence levels of its outputs remain underexplored, although the confidence of information is very critical in some domains, such as finance, healthcare, and medicine. Our study focuses the impact of RAG on confidence within the medical domain under various configurations and models. We evaluate confidence by treating the model's predicted probability as its output and calculating Expected Calibration Error (ECE) and Adaptive Calibration Error (ACE) scores based on the probabilities and accuracy. In addition, we analyze whether the order of retrieved documents within prompts calibrates the confidence. Our findings reveal large variation in confidence and accuracy depending on the model, settings, and the format of input prompts. These results underscore the necessity of optimizing configurations based on the specific model and conditions.

  • 10 authors
·
Dec 28, 2024

Confidence as a Reward: Transforming LLMs into Reward Models

Reward models can significantly enhance the reasoning capabilities of large language models (LLMs), but they typically require extensive curated data and costly training. To mitigate these challenges, training-free approaches such as LLM-as-a-Judge leverage the intrinsic reasoning abilities of LLMs to evaluate responses, achieving promising results. Recent works have also indicated that model confidence can serve effectively as a reward metric, distinguishing between chain-of-thought (CoT) and non-CoT paths. However, the concept of using confidence as a reward has not been comprehensively studied. In this work, we systematically investigate Confidence-as-a-Reward (CRew), a simple yet powerful training-free method that utilizes token-level confidence in the model's final answers as a proxy for reward, especially suitable for close-ended tasks. Through extensive experiments on mathematical reasoning tasks, we demonstrate that CRew outperforms existing training-free reward approaches on the MATH500 and RewardMATH benchmarks, and even surpasses most trained reward models. We further identify a strong correlation between CRew scores and the actual reasoning performance of the model. Additionally, we find that CRew can effectively filter high-quality training data. Building upon these insights, we propose CRew-DPO, a training strategy that constructs preference data from confidence scores combined with correctness signals. Finetuning with CRew-DPO further enhances the model's judging capabilities and consistently outperforms existing self-training methods.

  • 6 authors
·
Oct 15, 2025

Multiple Choice Questions: Reasoning Makes Large Language Models (LLMs) More Self-Confident Even When They Are Wrong

One of the most widely used methods to evaluate LLMs are Multiple Choice Question (MCQ) tests. MCQ benchmarks enable the testing of LLM knowledge on almost any topic at scale as the results can be processed automatically. To help the LLM answer, a few examples called few shots can be included in the prompt. Moreover, the LLM can be asked to answer the question directly with the selected option or to first provide the reasoning and then the selected answer, which is known as chain of thought. In addition to checking whether the selected answer is correct, the evaluation can look at the LLM-estimated probability of its response as an indication of the confidence of the LLM in the response. In this paper, we study how the LLM confidence in its answer depends on whether the model has been asked to answer directly or to provide the reasoning before answering. The results of the evaluation of questions on a wide range of topics in seven different models show that LLMs are more confident in their answers when they provide reasoning before the answer. This occurs regardless of whether the selected answer is correct. Our hypothesis is that this behavior is due to the reasoning that modifies the probability of the selected answer, as the LLM predicts the answer based on the input question and the reasoning that supports the selection made. Therefore, LLM estimated probabilities seem to have intrinsic limitations that should be understood in order to use them in evaluation procedures. Interestingly, the same behavior has been observed in humans, for whom explaining an answer increases confidence in its correctness.

  • 5 authors
·
Jan 16, 2025 2

Comparing Rule-Based and Deep Learning Models for Patient Phenotyping

Objective: We investigate whether deep learning techniques for natural language processing (NLP) can be used efficiently for patient phenotyping. Patient phenotyping is a classification task for determining whether a patient has a medical condition, and is a crucial part of secondary analysis of healthcare data. We assess the performance of deep learning algorithms and compare them with classical NLP approaches. Materials and Methods: We compare convolutional neural networks (CNNs), n-gram models, and approaches based on cTAKES that extract pre-defined medical concepts from clinical notes and use them to predict patient phenotypes. The performance is tested on 10 different phenotyping tasks using 1,610 discharge summaries extracted from the MIMIC-III database. Results: CNNs outperform other phenotyping algorithms in all 10 tasks. The average F1-score of our model is 76 (PPV of 83, and sensitivity of 71) with our model having an F1-score up to 37 points higher than alternative approaches. We additionally assess the interpretability of our model by presenting a method that extracts the most salient phrases for a particular prediction. Conclusion: We show that NLP methods based on deep learning improve the performance of patient phenotyping. Our CNN-based algorithm automatically learns the phrases associated with each patient phenotype. As such, it reduces the annotation complexity for clinical domain experts, who are normally required to develop task-specific annotation rules and identify relevant phrases. Our method performs well in terms of both performance and interpretability, which indicates that deep learning is an effective approach to patient phenotyping based on clinicians' notes.

  • 11 authors
·
Mar 25, 2017

Measuring Language Model Hallucinations Through Distributional Correctness

Common evaluation paradigms for language models focus on scoring single responses through accuracy metrics or proper scoring rules, failing to capture the full richness of a model's belief state. Recent work illustrates that language models hallucinate in-part because they are optimised to be good test-takers under binary scoring schemes that reward any answer over abstention. While this insight naturally leads to penalty-based approaches, they ignore crucial distinctions in how models distribute uncertainty, for example between hedging toward incorrect answers versus hedging toward "I don't know" responses. A novel evaluation metric, the Distributional Correctness Score (DCS), is introduced to solve this problem, i.e., of not considering a model's entire probability distribution over answer choices. DCS naturally distinguishes between harmful overconfidence in wrong answers and uncertainty expressed through abstention, providing scores in an interpretable default range. Through theoretical analysis and illustrative examples, DCS is demonstrated to offer a more nuanced and aligned evaluation paradigm that incentivises models to express genuine uncertainty rather than guessing. Adapting 12 existing evaluation benchmarks to DCS's variants and measuring performance on six language models reveals that for half of the tested benchmarks scores are negative across all tested models, indicating significant tendencies towards hallucination.

  • 1 authors
·
Oct 5, 2025

PRBench: Large-Scale Expert Rubrics for Evaluating High-Stakes Professional Reasoning

Frontier model progress is often measured by academic benchmarks, which offer a limited view of performance in real-world professional contexts. Existing evaluations often fail to assess open-ended, economically consequential tasks in high-stakes domains like Legal and Finance, where practical returns are paramount. To address this, we introduce Professional Reasoning Bench (PRBench), a realistic, open-ended, and difficult benchmark of real-world problems in Finance and Law. We open-source its 1,100 expert-authored tasks and 19,356 expert-curated criteria, making it, to our knowledge, the largest public, rubric-based benchmark for both legal and finance domains. We recruit 182 qualified professionals, holding JDs, CFAs, or 6+ years of experience, who contributed tasks inspired by their actual workflows. This process yields significant diversity, with tasks spanning 114 countries and 47 US jurisdictions. Our expert-curated rubrics are validated through a rigorous quality pipeline, including independent expert validation. Subsequent evaluation of 20 leading models reveals substantial room for improvement, with top scores of only 0.39 (Finance) and 0.37 (Legal) on our Hard subsets. We further catalog associated economic impacts of the prompts and analyze performance using human-annotated rubric categories. Our analysis shows that models with similar overall scores can diverge significantly on specific capabilities. Common failure modes include inaccurate judgments, a lack of process transparency and incomplete reasoning, highlighting critical gaps in their reliability for professional adoption.

  • 24 authors
·
Nov 14, 2025

Can Large Language Models Express Uncertainty Like Human?

Large language models (LLMs) are increasingly used in high-stakes settings, where overconfident responses can mislead users. Reliable confidence estimation has been shown to enhance trust and task accuracy. Yet existing methods face practical barriers: logits are often hidden, multi-sampling is computationally expensive, and verbalized numerical uncertainty (e.g., giving a 0-100 score) deviates from natural communication. We revisit linguistic confidence (LC), where models express uncertainty through hedging language (e.g., probably, might), offering a lightweight and human-centered alternative. To advance this direction, we (1) release the first diverse, large-scale dataset of hedging expressions with human-annotated confidence scores, and (2) propose a lightweight mapper that converts hedges into confidence scores at near-zero cost. Building on these resources, we (3) conduct the first systematic study of LC across modern LLMs and QA benchmarks, revealing that while most LLMs underperform in expressing reliable LC, carefully designed prompting achieves competitive calibration and discriminability. Finally, we (4) introduce a fine-tuning framework that further improves LC reliability. Taken together, our work positions linguistic confidence as a scalable, efficient, and human-aligned approach to LLM uncertainty estimation, and calls for deeper exploration of this promising yet underexplored direction.

  • 9 authors
·
Sep 28, 2025

Language Models And A Second Opinion Use Case: The Pocket Professional

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.

  • 1 authors
·
Oct 27, 2024 2

Preference Learning Unlocks LLMs' Psycho-Counseling Skills

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.

  • 3 authors
·
Feb 26, 2025 2

Prompt4Trust: A Reinforcement Learning Prompt Augmentation Framework for Clinically-Aligned Confidence Calibration in Multimodal Large Language Models

Multimodal large language models (MLLMs) hold considerable promise for applications in healthcare. However, their deployment in safety-critical settings is hindered by two key limitations: (i) sensitivity to prompt design, and (ii) a tendency to generate incorrect responses with high confidence. As clinicians may rely on a model's stated confidence to gauge the reliability of its predictions, it is especially important that when a model expresses high confidence, it is also highly accurate. We introduce Prompt4Trust, the first reinforcement learning (RL) framework for prompt augmentation targeting confidence calibration in MLLMs. A lightweight LLM is trained to produce context-aware auxiliary prompts that guide a downstream task MLLM to generate responses in which the expressed confidence more accurately reflects predictive accuracy. Unlike conventional calibration techniques, Prompt4Trust specifically prioritizes aspects of calibration most critical for safe and trustworthy clinical decision-making. Beyond improvements driven by this clinically motivated calibration objective, our proposed method also improves task accuracy, achieving state-of-the-art medical visual question answering (VQA) performance on the PMC-VQA benchmark, which is composed of multiple-choice questions spanning diverse medical imaging modalities. Moreover, our framework trained with a small downstream task MLLM showed promising zero-shot generalization to larger MLLMs in our experiments, suggesting the potential for scalable calibration without the associated computational costs. This work demonstrates the potential of automated yet human-aligned prompt engineering for improving the the trustworthiness of MLLMs in safety critical settings. Our codebase can be found at https://github.com/xingbpshen/prompt4trust.

  • 4 authors
·
Jul 12, 2025

HealthQA-BR: A System-Wide Benchmark Reveals Critical Knowledge Gaps in Large Language Models

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.

  • 1 authors
·
Jun 16, 2025

Reliable and Efficient Amortized Model-based Evaluation

Comprehensive evaluations of language models (LM) during both development and deployment phases are necessary because these models possess numerous capabilities (e.g., mathematical reasoning, legal support, or medical diagnostic) as well as safety risks (e.g., racial bias, toxicity, or misinformation). The average score across a wide range of benchmarks provides a signal that helps guide the use of these LMs in practice. Currently, holistic evaluations are costly due to the large volume of benchmark questions, making frequent evaluations impractical. A popular attempt to lower the cost is to compute the average score on a subset of the benchmark. This approach, unfortunately, often renders an unreliable measure of LM performance because the average score is often confounded with the difficulty of the questions in the benchmark subset. Item response theory (IRT) was designed to address this challenge, providing a reliable measurement by careful controlling for question difficulty. Unfortunately, question difficulty is expensive to estimate. Facing this challenge, we train a model that predicts question difficulty from its content, enabling a reliable measurement at a fraction of the cost. In addition, we leverage this difficulty predictor to further improve the evaluation efficiency through training a question generator given a difficulty level. This question generator is essential in adaptive testing, where, instead of using a random subset of the benchmark questions, informative questions are adaptively chosen based on the current estimation of LLM performance. Experiments on 22 common natural language benchmarks and 172 LMs show that this approach is more reliable and efficient compared to current common practice.

  • 5 authors
·
Mar 17, 2025

LACIE: Listener-Aware Finetuning for Confidence Calibration in Large Language Models

When answering questions, LLMs can convey not only an answer, but a level of confidence about the answer being correct. This includes explicit confidence markers (e.g. giving a numeric score) as well as implicit markers, like an authoritative tone or elaborating with additional knowledge. For LLMs to be trustworthy knowledge sources, the confidence they convey should match their actual expertise; however, most current models tend towards overconfidence. To calibrate both implicit and explicit confidence markers, we introduce a pragmatic, listener-aware finetuning method (LACIE) that models the listener, considering not only whether an answer is right, but whether it will be accepted by a listener. We cast calibration as preference optimization, creating data via a two-agent game, where a speaker model's outputs are judged by a simulated listener. We then finetune three LLMs (Mistral-7B, Llama3-8B, Llama3-70B) with LACIE, and show that the resulting models are better calibrated w.r.t. a simulated listener. Crucially, these trends transfer to human listeners, helping them correctly predict model correctness: we conduct a human evaluation where annotators accept or reject an LLM's answers, finding that training with LACIE results in 47% fewer incorrect answers being accepted while maintaining the same level of acceptance for correct answers. Furthermore, LACIE generalizes to another dataset, resulting in a large increase in truthfulness on TruthfulQA when trained on TriviaQA. Our analysis indicates that LACIE leads to a better confidence separation between correct and incorrect examples. Qualitatively, we find that a LACIE-trained model hedges more and implicitly signals certainty when it is correct by using an authoritative tone or including details. Finally, LACIE finetuning leads to an emergent increase in model abstention (e.g. saying "I don't know") for answers that are likely wrong.

  • 3 authors
·
May 31, 2024

Taming Overconfidence in LLMs: Reward Calibration in RLHF

Language model calibration refers to the alignment between the confidence of the model and the actual performance of its responses. While previous studies point out the overconfidence phenomenon in Large Language Models (LLMs) and show that LLMs trained with Reinforcement Learning from Human Feedback (RLHF) are overconfident with a more sharpened output probability, in this study, we reveal that RLHF tends to lead models to express verbalized overconfidence in their own responses. We investigate the underlying cause of this overconfidence and demonstrate that reward models used for Proximal Policy Optimization (PPO) exhibit inherent biases towards high-confidence scores regardless of the actual quality of responses. Building upon this insight, we propose two PPO variants: PPO-M: PPO with Calibrated Reward Modeling and PPO-C: PPO with Calibrated Reward Calculation. PPO-M integrates explicit confidence scores in reward model training, which calibrates reward models to better capture the alignment between response quality and verbalized confidence. PPO-C adjusts the reward score during PPO based on the difference between the current reward and the moving average of past rewards. Both PPO-M and PPO-C can be seamlessly integrated into the current PPO pipeline and do not require additional golden labels. We evaluate our methods on both Llama3-8B and Mistral-7B across six diverse datasets including multiple-choice and open-ended generation. Experiment results demonstrate that both of our methods can reduce calibration error and maintain performance comparable to standard PPO. We further show that they do not compromise model capabilities in open-ended conversation settings.

  • 4 authors
·
Oct 13, 2024 2

ConfTuner: Training Large Language Models to Express Their Confidence Verbally

Large Language Models (LLMs) are increasingly deployed in high-stakes domains such as science, law, and healthcare, where accurate expressions of uncertainty are essential for reliability and trust. However, current LLMs are often observed to generate incorrect answers with high confidence, a phenomenon known as "overconfidence". Recent efforts have focused on calibrating LLMs' verbalized confidence: i.e., their expressions of confidence in text form, such as "I am 80% confident that...". Existing approaches either rely on prompt engineering or fine-tuning with heuristically generated uncertainty estimates, both of which have limited effectiveness and generalizability. Motivated by the notion of proper scoring rules for calibration in classical machine learning models, we introduce ConfTuner, a simple and efficient fine-tuning method that introduces minimal overhead and does not require ground-truth confidence scores or proxy confidence estimates. ConfTuner relies on a new loss function, tokenized Brier score, which we theoretically prove to be a proper scoring rule, intuitively meaning that it "correctly incentivizes the model to report its true probability of being correct". ConfTuner improves calibration across diverse reasoning tasks and generalizes to black-box models such as GPT-4o. Our results further show that better-calibrated confidence enables downstream gains in self-correction and model cascade, advancing the development of trustworthy LLM systems. The code is available at https://github.com/liushiliushi/ConfTuner.

  • 4 authors
·
Aug 26, 2025

GPT Takes the Bar Exam

Nearly all jurisdictions in the United States require a professional license exam, commonly referred to as "the Bar Exam," as a precondition for law practice. To even sit for the exam, most jurisdictions require that an applicant completes at least seven years of post-secondary education, including three years at an accredited law school. In addition, most test-takers also undergo weeks to months of further, exam-specific preparation. Despite this significant investment of time and capital, approximately one in five test-takers still score under the rate required to pass the exam on their first try. In the face of a complex task that requires such depth of knowledge, what, then, should we expect of the state of the art in "AI?" In this research, we document our experimental evaluation of the performance of OpenAI's `text-davinci-003` model, often-referred to as GPT-3.5, on the multistate multiple choice (MBE) section of the exam. While we find no benefit in fine-tuning over GPT-3.5's zero-shot performance at the scale of our training data, we do find that hyperparameter optimization and prompt engineering positively impacted GPT-3.5's zero-shot performance. For best prompt and parameters, GPT-3.5 achieves a headline correct rate of 50.3% on a complete NCBE MBE practice exam, significantly in excess of the 25% baseline guessing rate, and performs at a passing rate for both Evidence and Torts. GPT-3.5's ranking of responses is also highly-correlated with correctness; its top two and top three choices are correct 71% and 88% of the time, respectively, indicating very strong non-entailment performance. While our ability to interpret these results is limited by nascent scientific understanding of LLMs and the proprietary nature of GPT, we believe that these results strongly suggest that an LLM will pass the MBE component of the Bar Exam in the near future.

  • 2 authors
·
Dec 29, 2022

CritiCal: Can Critique Help LLM Uncertainty or Confidence Calibration?

Accurate confidence calibration in Large Language Models (LLMs) is critical for safe use in high-stakes domains, where clear verbalized confidence enhances user trust. Traditional methods that mimic reference confidence expressions often fail to capture the reasoning needed for accurate confidence assessment. We propose natural language critiques as a solution, ideally suited for confidence calibration, as precise gold confidence labels are hard to obtain and often require multiple generations. This paper studies how natural language critiques can enhance verbalized confidence, addressing: (1) What to critique: uncertainty (question-focused) or confidence (answer-specific)? Analysis shows confidence suits multiple-choice tasks, while uncertainty excels in open-ended scenarios. (2) How to critique: self-critique or critique calibration training? We propose Self-Critique, enabling LLMs to critique and optimize their confidence beyond mere accuracy, and CritiCal, a novel Critique Calibration training method that leverages natural language critiques to improve confidence calibration, moving beyond direct numerical optimization. Experiments show that CritiCal significantly outperforms Self-Critique and other competitive baselines, even surpassing its teacher model, GPT-4o, in complex reasoning tasks. CritiCal also shows robust generalization in out-of-distribution settings, advancing LLM's reliability.

  • 10 authors
·
Oct 28, 2025 2

GREAT Score: Global Robustness Evaluation of Adversarial Perturbation using Generative Models

Current studies on adversarial robustness mainly focus on aggregating local robustness results from a set of data samples to evaluate and rank different models. However, the local statistics may not well represent the true global robustness of the underlying unknown data distribution. To address this challenge, this paper makes the first attempt to present a new framework, called GREAT Score , for global robustness evaluation of adversarial perturbation using generative models. Formally, GREAT Score carries the physical meaning of a global statistic capturing a mean certified attack-proof perturbation level over all samples drawn from a generative model. For finite-sample evaluation, we also derive a probabilistic guarantee on the sample complexity and the difference between the sample mean and the true mean. GREAT Score has several advantages: (1) Robustness evaluations using GREAT Score are efficient and scalable to large models, by sparing the need of running adversarial attacks. In particular, we show high correlation and significantly reduced computation cost of GREAT Score when compared to the attack-based model ranking on RobustBench (Croce,et. al. 2021). (2) The use of generative models facilitates the approximation of the unknown data distribution. In our ablation study with different generative adversarial networks (GANs), we observe consistency between global robustness evaluation and the quality of GANs. (3) GREAT Score can be used for remote auditing of privacy-sensitive black-box models, as demonstrated by our robustness evaluation on several online facial recognition services.

  • 3 authors
·
Apr 19, 2023

Generalized Correctness Models: Learning Calibrated and Model-Agnostic Correctness Predictors from Historical Patterns

Generating accurate and calibrated confidence estimates is critical for deploying LLMs in high-stakes or user-facing applications, and remains an open challenge. Prior research has often framed confidence as a problem of eliciting a model's "self-knowledge", i.e., the ability of an LLM to judge whether its own answers are correct; this approach implicitly assumes that there is some privileged information about the answer's correctness that is accessible to the model itself. However, our experiments reveal that an LLM attempting to predict the correctness of its own outputs generally performs no better than an unrelated LLM. Moreover, we hypothesize that a key factor in building a "Correctness Model" (CM) is exposure to a target model's historical predictions. We propose multiple methods to inject this historical correctness information, creating a Generalized Correctness Model (GCM). We first show that GCMs can be trained on the correctness data from many LLMs and learn patterns for correctness prediction applicable across datasets and models. We then use CMs as a lens for studying the source of correctness prediction ability and its generalization, systematically controlling their training data and finding that answer phrasing is a strong predictor for correctness. We further explore alternative methods of injecting history without training an LLM, finding that including history as in-context examples can help improve correctness prediction, and post-hoc calibration can provide complementary reductions in calibration error. We evaluate GCMs based on Qwen3-8B across 5 model families and the MMLU and TriviaQA datasets, as well as on a downstream selective prediction task, finding that reliable LLM confidence estimation is a generalizable and model-agnostic skill learned by systematically encoding correctness history rather than a model-specific skill reliant on self-introspection.

  • 5 authors
·
Sep 29, 2025 2

Beyond Binary Rewards: Training LMs to Reason About Their Uncertainty

When language models (LMs) are trained via reinforcement learning (RL) to generate natural language "reasoning chains", their performance improves on a variety of difficult question answering tasks. Today, almost all successful applications of RL for reasoning use binary reward functions that evaluate the correctness of LM outputs. Because such reward functions do not penalize guessing or low-confidence outputs, they often have the unintended side-effect of degrading calibration and increasing the rate at which LMs generate incorrect responses (or "hallucinate") in other problem domains. This paper describes RLCR (Reinforcement Learning with Calibration Rewards), an approach to training reasoning models that jointly improves accuracy and calibrated confidence estimation. During RLCR, LMs generate both predictions and numerical confidence estimates after reasoning. They are trained to optimize a reward function that augments a binary correctness score with a Brier score -- a scoring rule for confidence estimates that incentivizes calibrated prediction. We first prove that this reward function (or any analogous reward function that uses a bounded, proper scoring rule) yields models whose predictions are both accurate and well-calibrated. We next show that across diverse datasets, RLCR substantially improves calibration with no loss in accuracy, on both in-domain and out-of-domain evaluations -- outperforming both ordinary RL training and classifiers trained to assign post-hoc confidence scores. While ordinary RL hurts calibration, RLCR improves it. Finally, we demonstrate that verbalized confidence can be leveraged at test time to improve accuracy and calibration via confidence-weighted scaling methods. Our results show that explicitly optimizing for calibration can produce more generally reliable reasoning models.

  • 7 authors
·
Jul 22, 2025 1

Do Large Language Models Know What They Don't Know? Kalshibench: A New Benchmark for Evaluating Epistemic Calibration via Prediction Markets

A well-calibrated model should express confidence that matches its actual accuracy -- when it claims 80\% confidence, it should be correct 80\% of the time. While large language models (LLMs) have achieved remarkable performance across diverse tasks, their epistemic calibration remains poorly understood. We introduce KalshiBench, a benchmark of 300 prediction market questions from Kalshi, a CFTC-regulated exchange, with verifiable real-world outcomes occurring after model training cutoffs. Unlike traditional benchmarks measuring accuracy on static knowledge, KalshiBench evaluates whether models can appropriately quantify uncertainty about genuinely unknown future events. We evaluate five frontier models -- Claude Opus 4.5, GPT-5.2, DeepSeek-V3.2, Qwen3-235B, and Kimi-K2 -- and find systematic overconfidence across all models. Even the best-calibrated model (Claude Opus 4.5, ECE=0.120) shows substantial calibration errors, while reasoning-enhanced models like GPT-5.2-XHigh exhibit worse calibration (ECE=0.395) despite comparable accuracy. Critically, only one model achieves a positive Brier Skill Score, indicating most models perform worse than simply predicting base rates. Our findings suggest that scaling and enhanced reasoning do not automatically confer calibration benefits, highlighting epistemic calibration as a distinct capability requiring targeted development.

  • 1 authors
·
Dec 17, 2025

Cautious Next Token Prediction

Next token prediction paradigm has been prevailing for autoregressive models in the era of LLMs. The current default sampling choice for popular LLMs is temperature scaling together with nucleus sampling to balance diversity and coherence. Nevertheless, such approach leads to inferior performance in various NLP tasks when the model is not certain about testing questions. To this end, we propose a brand new training-free decoding strategy, dubbed as Cautious Next Token Prediction (CNTP). In the decoding process, if the model has comparatively high prediction entropy at a certain step, we sample multiple trials starting from the step independently and stop when encountering any punctuation. Then we select the trial with the lowest perplexity score viewed as the most probable and reliable trial path given the model's capacity. The trial number is negatively correlated with the prediction confidence, i.e., the less confident the model is, the more trials it should sample. This is consistent with human beings' behaviour: when feeling uncertain or unconfident, one tends to think more creatively, exploring multiple thinking paths, to cautiously select the path one feels most confident about. Extensive experiments on both LLMs and MLLMs show that our proposed CNTP approach outperforms existing standard decoding strategies consistently by a clear margin. Moreover, the integration of CNTP with self consistency can further improve over vanilla self consistency. We believe our proposed CNTP has the potential to become one of the default choices for LLM decoding. Code is available at https://github.com/wyzjack/CNTP.

  • 10 authors
·
Jul 3, 2025

Modeling Motivational Interviewing Strategies On An Online Peer-to-Peer Counseling Platform

Millions of people participate in online peer-to-peer support sessions, yet there has been little prior research on systematic psychology-based evaluations of fine-grained peer-counselor behavior in relation to client satisfaction. This paper seeks to bridge this gap by mapping peer-counselor chat-messages to motivational interviewing (MI) techniques. We annotate 14,797 utterances from 734 chat conversations using 17 MI techniques and introduce four new interviewing codes such as chit-chat and inappropriate to account for the unique conversational patterns observed on online platforms. We automate the process of labeling peer-counselor responses to MI techniques by fine-tuning large domain-specific language models and then use these automated measures to investigate the behavior of the peer counselors via correlational studies. Specifically, we study the impact of MI techniques on the conversation ratings to investigate the techniques that predict clients' satisfaction with their counseling sessions. When counselors use techniques such as reflection and affirmation, clients are more satisfied. Examining volunteer counselors' change in usage of techniques suggest that counselors learn to use more introduction and open questions as they gain experience. This work provides a deeper understanding of the use of motivational interviewing techniques on peer-to-peer counselor platforms and sheds light on how to build better training programs for volunteer counselors on online platforms.

  • 7 authors
·
Nov 9, 2022

GPT as Knowledge Worker: A Zero-Shot Evaluation of (AI)CPA Capabilities

The global economy is increasingly dependent on knowledge workers to meet the needs of public and private organizations. While there is no single definition of knowledge work, organizations and industry groups still attempt to measure individuals' capability to engage in it. The most comprehensive assessment of capability readiness for professional knowledge workers is the Uniform CPA Examination developed by the American Institute of Certified Public Accountants (AICPA). In this paper, we experimentally evaluate OpenAI's `text-davinci-003` and prior versions of GPT on both a sample Regulation (REG) exam and an assessment of over 200 multiple-choice questions based on the AICPA Blueprints for legal, financial, accounting, technology, and ethical tasks. First, we find that `text-davinci-003` achieves a correct rate of 14.4% on a sample REG exam section, significantly underperforming human capabilities on quantitative reasoning in zero-shot prompts. Second, `text-davinci-003` appears to be approaching human-level performance on the Remembering & Understanding and Application skill levels in the Exam absent calculation. For best prompt and parameters, the model answers 57.6% of questions correctly, significantly better than the 25% guessing rate, and its top two answers are correct 82.1% of the time, indicating strong non-entailment. Finally, we find that recent generations of GPT-3 demonstrate material improvements on this assessment, rising from 30% for `text-davinci-001` to 57% for `text-davinci-003`. These findings strongly suggest that large language models have the potential to transform the quality and efficiency of future knowledge work.

  • 4 authors
·
Jan 11, 2023

On Randomness in Agentic Evals

Agentic systems are evaluated on benchmarks where agents interact with environments to solve tasks. Most papers report a pass@1 score computed from a single run per task, assuming this gives a reliable performance estimate. We test this assumption by collecting 60,000 agentic trajectories on SWE-Bench-Verified, spanning three models and two scaffolds. We find substantial variance: single-run pass@1 estimates vary by 2.2 to 6.0 percentage points depending on which run is selected, with standard deviations exceeding 1.5 percentage points even at temperature 0. This variance has critical implications: reported improvements of 2--3 percentage points may reflect evaluation noise rather than genuine algorithmic progress. Through token-level analysis, we show that trajectories diverge early, often within the first few percent of tokens, and that these small differences cascade into different solution strategies. To enable reliable evaluation of agentic systems, we recommend three concrete practices: (1) estimate pass@1 from multiple independent runs per task, especially when measuring small improvements, (2) use statistical power analysis to determine the number of runs needed to detect expected effect sizes, and (3) consider metrics like pass@k (optimistic bound) and pass^k (pessimistic bound) with k>1 to better characterize the full performance envelope. While these practices increase evaluation cost, they are essential for distinguishing genuine scientific progress from statistical noise.

TrueGL: A Truthful, Reliable, and Unified Engine for Grounded Learning in Full-Stack Search

In the age of open and free information, a concerning trend of reliance on AI is emerging. However, existing AI tools struggle to evaluate the credibility of information and to justify their assessments. Hence, there is a growing need for systems that can help users evaluate the trustworthiness of online information. Although major search engines incorporate AI features, they often lack clear reliability indicators. We present TrueGL, a model that makes trustworthy search results more accessible. The model is a fine-tuned version of IBM's Granite-1B, trained on the custom dataset and integrated into a search engine with a reliability scoring system. We evaluate the system using prompt engineering and assigning each statement a continuous reliability score from 0.1 to 1, then instructing the model to return a textual explanation alongside the score. Each model's predicted scores are measured against real scores using standard evaluation metrics. TrueGL consistently outperforms other small-scale LLMs and rule-based approaches across all experiments on key evaluation metrics, including MAE, RMSE, and R2. The model's high accuracy, broad content coverage, and ease of use make trustworthy information more accessible and help reduce the spread of false or misleading content online. Our code is publicly available at https://github.com/AlgazinovAleksandr/TrueGL, and our model is publicly released at https://huggingface.co/JoydeepC/trueGL.

  • 6 authors
·
Jun 4, 2025

ObjexMT: Objective Extraction and Metacognitive Calibration for LLM-as-a-Judge under Multi-Turn Jailbreaks

LLM-as-a-Judge (LLMaaJ) now underpins scalable evaluation, yet we lack a decisive test of a judge's qualification: can it recover a conversation's latent objective and know when that inference is trustworthy? LLMs degrade under irrelevant or long context; multi-turn jailbreaks further hide goals across turns. We introduce ObjexMT, a benchmark for objective extraction and metacognition. Given a multi-turn transcript, a model must return a one-sentence base objective and a self-reported confidence. Accuracy is computed via LLM-judge semantic similarity to gold objectives, converted to binary correctness by a single human-aligned threshold calibrated once on N = 100 items (tau^*=0.61). Metacognition is evaluated with ECE, Brier, Wrong-at-High-Conf, and risk-coverage. Across gpt-4.1, claude-sonnet-4, and Qwen3-235B-A22B-FP8 on SafeMTData_Attack600, SafeMTData_1K, MHJ, and CoSafe, claude-sonnet-4 attains the best objective-extraction accuracy (0.515) and calibration (ECE 0.296; Brier 0.324); gpt-4.1 and Qwen3-235B-A22B-FP8 tie at 0.441 but are overconfident (mean confidence approx0.88 vs. accuracy approx0.44; Wrong-at-0.90 approx48-52%). Performance varies by dataset (approx0.167-0.865). ObjexMT thus supplies an actionable test for LLM judges: when objectives are not explicit, judges often misinfer them with high confidence. We recommend exposing objectives when feasible and gating decisions by confidence otherwise. Code and data at https://github.com/hyunjun1121/ObjexMT_dataset.

AIM-Intelligence AIM Intelligence
·
Aug 22, 2025

Evaluating language models as risk scores

Current question-answering benchmarks predominantly focus on accuracy in realizable prediction tasks. Conditioned on a question and answer-key, does the most likely token match the ground truth? Such benchmarks necessarily fail to evaluate LLMs' ability to quantify ground-truth outcome uncertainty. In this work, we focus on the use of LLMs as risk scores for unrealizable prediction tasks. We introduce folktexts, a software package to systematically generate risk scores using LLMs, and evaluate them against US Census data products. A flexible API enables the use of different prompting schemes, local or web-hosted models, and diverse census columns that can be used to compose custom prediction tasks. We evaluate 17 recent LLMs across five proposed benchmark tasks. We find that zero-shot risk scores produced by multiple-choice question-answering have high predictive signal but are widely miscalibrated. Base models consistently overestimate outcome uncertainty, while instruction-tuned models underestimate uncertainty and produce over-confident risk scores. In fact, instruction-tuning polarizes answer distribution regardless of true underlying data uncertainty. This reveals a general inability of instruction-tuned LLMs to express data uncertainty using multiple-choice answers. A separate experiment using verbalized chat-style risk queries yields substantially improved calibration across instruction-tuned models. These differences in ability to quantify data uncertainty cannot be revealed in realizable settings, and highlight a blind-spot in the current evaluation ecosystem that folktexts covers.

  • 3 authors
·
Jul 19, 2024

3MDBench: Medical Multimodal Multi-agent Dialogue Benchmark

Large Vision-Language Models (LVLMs) are increasingly being explored for applications in telemedicine, yet their ability to engage with diverse patient behaviors remains underexplored. We introduce 3MDBench (Medical Multimodal Multi-agent Dialogue Benchmark), an open-source evaluation framework designed to assess LLM-driven medical consultations. Unlike existing benchmarks, 3MDBench simulates real-world patient variability by incorporating four temperament-driven Patient Agents and an Assessor Agent that evaluates diagnostic accuracy and dialogue quality. The benchmark integrates textual and image-based patient data across 34 common diagnoses, mirroring real-world telemedicine interactions. Under different diagnostic strategies, we evaluate state-of-the-art LVLMs. Our findings demonstrate that incorporating dialogue improves the F1 score from 50.4 to 54.2 compared to non-dialogue settings, underscoring the value of context-driven, information-seeking questioning. Additionally, we demonstrate that multimodal inputs enhance diagnostic efficiency. Image-supported models outperform text-only counterparts by raising the diagnostic F1 score from 52.8 to 54.2 in a similar dialogue setting. Finally, we suggest an approach that improves the diagnostic F1-score to 70.3 by training the CNN model on the diagnosis prediction task and incorporating its top-3 predictions into the LVLM context. 3MDBench provides a reproducible and extendable evaluation framework for AI-driven medical assistants. It offers insights into how patient temperament, dialogue strategies, and multimodal reasoning influence diagnosis quality. By addressing real-world complexities in telemedicine, our benchmark paves the way for more empathetic, reliable, and context-aware AI-driven healthcare solutions. The source code of our benchmark is publicly available: https://github.com/univanxx/3mdbench

  • 6 authors
·
Mar 26, 2025

Comparison of Unsupervised Metrics for Evaluating Judicial Decision Extraction

The rapid advancement of artificial intelligence in legal natural language processing demands scalable methods for evaluating text extraction from judicial decisions. This study evaluates 16 unsupervised metrics, including novel formulations, to assess the quality of extracting seven semantic blocks from 1,000 anonymized Russian judicial decisions, validated against 7,168 expert reviews on a 1--5 Likert scale. These metrics, spanning document-based, semantic, structural, pseudo-ground truth, and legal-specific categories, operate without pre-annotated ground truth. Bootstrapped correlations, Lin's concordance correlation coefficient (CCC), and mean absolute error (MAE) reveal that Term Frequency Coherence (Pearson r = 0.540, Lin CCC = 0.512, MAE = 0.127) and Coverage Ratio/Block Completeness (Pearson r = 0.513, Lin CCC = 0.443, MAE = 0.139) best align with expert ratings, while Legal Term Density (Pearson r = -0.479, Lin CCC = -0.079, MAE = 0.394) show strong negative correlations. The LLM Evaluation Score (mean = 0.849, Pearson r = 0.382, Lin CCC = 0.325, MAE = 0.197) showed moderate alignment, but its performance, using gpt-4.1-mini via g4f, suggests limited specialization for legal textse. These findings highlight that unsupervised metrics, including LLM-based approaches, enable scalable screening but, with moderate correlations and low CCC values, cannot fully replace human judgment in high-stakes legal contexts. This work advances legal NLP by providing annotation-free evaluation tools, with implications for judicial analytics and ethical AI deployment.

  • 5 authors
·
Oct 2, 2025

Calibration and Correctness of Language Models for Code

Machine learning models are widely used, but can also often be wrong. Users would benefit from a reliable indication of whether a given output from a given model should be trusted, so a rational decision can be made whether to use the output or not. For example, outputs can be associated with a confidence measure; if this confidence measure is strongly associated with likelihood of correctness, then the model is said to be well-calibrated. A well-calibrated confidence measure can serve as a basis for rational, graduated decision-making on how much review and care is needed when using generated code. Calibration has so far been studied in mostly non-generative (e.g. classification) settings, especially in software engineering. However, generated code can quite often be wrong: Given generated code, developers must decide whether to use directly, use after varying intensity of careful review, or discard model-generated code. Thus, calibration is vital in generative settings. We make several contributions. We develop a framework for evaluating the calibration of code-generating models. We consider several tasks, correctness criteria, datasets, and approaches, and find that, by and large, generative code models we test are not well-calibrated out of the box. We then show how calibration can be improved using standard methods, such as Platt scaling. Since Platt scaling relies on the prior availability of correctness data, we evaluate the applicability and generalizability of Platt scaling in software engineering, discuss settings where it has good potential for practical use, and settings where it does not. Our contributions will lead to better-calibrated decision-making in the current use of code generated by language models, and offers a framework for future research to further improve calibration methods for generative models in software engineering.

  • 9 authors
·
Feb 3, 2024

Parrot: Persuasion and Agreement Robustness Rating of Output Truth -- A Sycophancy Robustness Benchmark for LLMs

This study presents PARROT (Persuasion and Agreement Robustness Rating of Output Truth), a robustness focused framework designed to measure the degradation in accuracy that occurs under social pressure exerted on users through authority and persuasion in large language models (LLMs) the phenomenon of sycophancy (excessive conformity). PARROT (i) isolates causal effects by comparing the neutral version of the same question with an authoritatively false version using a double-blind evaluation, (ii) quantifies confidence shifts toward the correct and imposed false responses using log-likelihood-based calibration tracking, and (iii) systematically classifies failure modes (e.g., robust correct, sycophantic agreement, reinforced error, stubborn error, self-correction, etc.) using an eight-state behavioral taxonomy. We evaluated 22 models using 1,302 MMLU-style multiple-choice questions across 13 domains and domain-specific authority templates. Findings show marked heterogeneity: advanced models (e.g., GPT-5, GPT-4.1, Claude Sonnet 4.5) exhibit low "follow rates" (leq 11%, GPT-5: 4\%) and minimal accuracy loss, while older/smaller models show severe epistemic collapse (GPT-4: 80\%, Qwen 2.5-1.5B: 94\%). The danger is not limited to response changes; weak models reduce confidence in the correct response while increasing confidence in the imposed incorrect response. While international law and global knowledge at the domain level exhibit high fragility, elementary mathematics is relatively resilient. Consequently, we argue that the goal of "resistance to overfitting pressure" should be addressed as a primary objective alongside accuracy, harm avoidance, and privacy for safe deployment in the real world.

  • 3 authors
·
Nov 21, 2025 4

Beyond Overall Accuracy: A Psychometric Deep Dive into the Topic-Specific Medical Capabilities of 80 Large Language Models

As Large Language Models (LLMs) are increasingly proposed for high-stakes medical applications, there has emerged a critical need for reliable and accurate evaluation methodologies. Traditional accuracy metrics fail inadequately as they neither capture question characteristics nor offer topic-specific insights. To address this gap, we introduce MedIRT, a rigorous evaluation framework grounded in Item Response Theory (IRT), the gold standard in high-stakes educational testing. Unlike previous research relying on archival data, we prospectively gathered fresh responses from 80 diverse LLMs on a balanced, 1,100-question USMLE-aligned benchmark. Using one unidimensional two-parameter logistic IRT model per topic, we estimate LLM's latent model ability jointly with question difficulty and discrimination, yielding more stable and nuanced performance rankings than accuracy alone. Notably, we identify distinctive ``spiky'' ability profiles, where overall rankings can be misleading due to highly specialized model abilities. While GPT-5 was the top performer in a majority of domains (8 of 11), it was outperformed in Social Science and Communication by Claude-3-opus, demonstrating that even an overall 23rd-ranked model can hold the top spot for specific competencies. Furthermore, we demonstrate IRT's utility in auditing benchmarks by identifying flawed questions. We synthesize these findings into a practical decision-support framework that integrates our multi-factor competency profiles with operational metrics. This work establishes a robust, psychometrically grounded methodology essential for the safe, effective, and trustworthy deployment of LLMs in healthcare.

  • 4 authors
·
Sep 28, 2025

PsychEval: A Multi-Session and Multi-Therapy Benchmark for High-Realism AI Psychological Counselor

To develop a reliable AI for psychological assessment, we introduce PsychEval, a multi-session, multi-therapy, and highly realistic benchmark designed to address three key challenges: 1) Can we train a highly realistic AI counselor? Realistic counseling is a longitudinal task requiring sustained memory and dynamic goal tracking. We propose a multi-session benchmark (spanning 6-10 sessions across three distinct stages) that demands critical capabilities such as memory continuity, adaptive reasoning, and longitudinal planning. The dataset is annotated with extensive professional skills, comprising over 677 meta-skills and 4577 atomic skills. 2) How to train a multi-therapy AI counselor? While existing models often focus on a single therapy, complex cases frequently require flexible strategies among various therapies. We construct a diverse dataset covering five therapeutic modalities (Psychodynamic, Behaviorism, CBT, Humanistic Existentialist, and Postmodernist) alongside an integrative therapy with a unified three-stage clinical framework across six core psychological topics. 3) How to systematically evaluate an AI counselor? We establish a holistic evaluation framework with 18 therapy-specific and therapy-shared metrics across Client-Level and Counselor-Level dimensions. To support this, we also construct over 2,000 diverse client profiles. Extensive experimental analysis fully validates the superior quality and clinical fidelity of our dataset. Crucially, PsychEval transcends static benchmarking to serve as a high-fidelity reinforcement learning environment that enables the self-evolutionary training of clinically responsible and adaptive AI counselors.

  • 13 authors
·
Jan 5

Interactive Agents: Simulating Counselor-Client Psychological Counseling via Role-Playing LLM-to-LLM Interactions

Virtual counselors powered by large language models (LLMs) aim to create interactive support systems that effectively assist clients struggling with mental health challenges. To replicate counselor-client conversations, researchers have built an online mental health platform that allows professional counselors to provide clients with text-based counseling services for about an hour per session. Notwithstanding its effectiveness, challenges exist as human annotation is time-consuming, cost-intensive, privacy-protected, and not scalable. To address this issue and investigate the applicability of LLMs in psychological counseling conversation simulation, we propose a framework that employs two LLMs via role-playing for simulating counselor-client interactions. Our framework involves two LLMs, one acting as a client equipped with a specific and real-life user profile and the other playing the role of an experienced counselor, generating professional responses using integrative therapy techniques. We implement both the counselor and the client by zero-shot prompting the GPT-4 model. In order to assess the effectiveness of LLMs in simulating counselor-client interactions and understand the disparities between LLM- and human-generated conversations, we evaluate the synthetic data from various perspectives. We begin by assessing the client's performance through automatic evaluations. Next, we analyze and compare the disparities between dialogues generated by the LLM and those generated by professional counselors. Furthermore, we conduct extensive experiments to thoroughly examine the performance of our LLM-based counselor trained with synthetic interactive dialogues by benchmarking against state-of-the-art models for mental health.

  • 2 authors
·
Aug 28, 2024

The Persona Paradox: Medical Personas as Behavioral Priors in Clinical Language Models

Persona conditioning can be viewed as a behavioral prior for large language models (LLMs) and is often assumed to confer expertise and improve safety in a monotonic manner. However, its effects on high-stakes clinical decision-making remain poorly characterized. We systematically evaluate persona-based control in clinical LLMs, examining how professional roles (e.g., Emergency Department physician, nurse) and interaction styles (bold vs.\ cautious) influence behavior across models and medical tasks. We assess performance on clinical triage and patient-safety tasks using multidimensional evaluations that capture task accuracy, calibration, and safety-relevant risk behavior. We find systematic, context-dependent, and non-monotonic effects: Medical personas improve performance in critical care tasks, yielding gains of up to sim+20% in accuracy and calibration, but degrade performance in primary-care settings by comparable margins. Interaction style modulates risk propensity and sensitivity, but it's highly model-dependent. While aggregated LLM-judge rankings favor medical over non-medical personas in safety-critical cases, we found that human clinicians show moderate agreement on safety compliance (average Cohen's κ= 0.43) but indicate a low confidence in 95.9\% of their responses on reasoning quality. Our work shows that personas function as behavioral priors that introduce context-dependent trade-offs rather than guarantees of safety or expertise. The code is available at https://github.com/rsinghlab/Persona\_Paradox.

GAPS: A Clinically Grounded, Automated Benchmark for Evaluating AI Clinicians

Current benchmarks for AI clinician systems, often based on multiple-choice exams or manual rubrics, fail to capture the depth, robustness, and safety required for real-world clinical practice. To address this, we introduce the GAPS framework, a multidimensional paradigm for evaluating Grounding (cognitive depth), Adequacy (answer completeness), Perturbation (robustness), and Safety. Critically, we developed a fully automated, guideline-anchored pipeline to construct a GAPS-aligned benchmark end-to-end, overcoming the scalability and subjectivity limitations of prior work. Our pipeline assembles an evidence neighborhood, creates dual graph and tree representations, and automatically generates questions across G-levels. Rubrics are synthesized by a DeepResearch agent that mimics GRADE-consistent, PICO-driven evidence review in a ReAct loop. Scoring is performed by an ensemble of large language model (LLM) judges. Validation confirmed our automated questions are high-quality and align with clinician judgment. Evaluating state-of-the-art models on the benchmark revealed key failure modes: performance degrades sharply with increased reasoning depth (G-axis), models struggle with answer completeness (A-axis), and they are highly vulnerable to adversarial perturbations (P-axis) as well as certain safety issues (S-axis). This automated, clinically-grounded approach provides a reproducible and scalable method for rigorously evaluating AI clinician systems and guiding their development toward safer, more reliable clinical practice.

  • 41 authors
·
Oct 15, 2025

AutoPSV: Automated Process-Supervised Verifier

In this work, we propose a novel method named Automated Process-Supervised Verifier (\textsc{AutoPSV}) to enhance the reasoning capabilities of large language models (LLMs) by automatically annotating the reasoning steps. AutoPSV begins by training a verification model on the correctness of final answers, enabling it to generate automatic process annotations. This verification model assigns a confidence score to each reasoning step, indicating the probability of arriving at the correct final answer from that point onward. We detect relative changes in the verification's confidence scores across reasoning steps to automatically annotate the reasoning process, enabling error detection even in scenarios where ground truth answers are unavailable. This alleviates the need for numerous manual annotations or the high computational costs associated with model-induced annotation approaches. We experimentally validate that the step-level confidence changes learned by the verification model trained on the final answer correctness can effectively identify errors in the reasoning steps. We demonstrate that the verification model, when trained on process annotations generated by AutoPSV, exhibits improved performance in selecting correct answers from multiple LLM-generated outputs. Notably, we achieve substantial improvements across five datasets in mathematics and commonsense reasoning. The source code of AutoPSV is available at https://github.com/rookie-joe/AutoPSV.

  • 7 authors
·
May 26, 2024

Automatic Personalized Impression Generation for PET Reports Using Large Language Models

In this study, we aimed to determine if fine-tuned large language models (LLMs) can generate accurate, personalized impressions for whole-body PET reports. Twelve language models were trained on a corpus of PET reports using the teacher-forcing algorithm, with the report findings as input and the clinical impressions as reference. An extra input token encodes the reading physician's identity, allowing models to learn physician-specific reporting styles. Our corpus comprised 37,370 retrospective PET reports collected from our institution between 2010 and 2022. To identify the best LLM, 30 evaluation metrics were benchmarked against quality scores from two nuclear medicine (NM) physicians, with the most aligned metrics selecting the model for expert evaluation. In a subset of data, model-generated impressions and original clinical impressions were assessed by three NM physicians according to 6 quality dimensions (3-point scale) and an overall utility score (5-point scale). Each physician reviewed 12 of their own reports and 12 reports from other physicians. Bootstrap resampling was used for statistical analysis. Of all evaluation metrics, domain-adapted BARTScore and PEGASUSScore showed the highest Spearman's rank correlations (0.568 and 0.563) with physician preferences. Based on these metrics, the fine-tuned PEGASUS model was selected as the top LLM. When physicians reviewed PEGASUS-generated impressions in their own style, 89% were considered clinically acceptable, with a mean utility score of 4.08 out of 5. Physicians rated these personalized impressions as comparable in overall utility to the impressions dictated by other physicians (4.03, P=0.41). In conclusion, personalized impressions generated by PEGASUS were clinically useful, highlighting its potential to expedite PET reporting.

  • 11 authors
·
Sep 18, 2023

Closing the gap between open-source and commercial large language models for medical evidence summarization

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.

  • 14 authors
·
Jul 25, 2024