Daily Papers

Large language models (LLMs) often fail to ask effective questions under uncertainty, making them unreliable in domains where proactive information-gathering is essential for decisionmaking. We present ALFA, a framework that improves LLM question-asking by (i) decomposing the notion of a "good" question into a set of theory-grounded attributes (e.g., clarity, relevance), (ii) controllably synthesizing attribute-specific question variations, and (iii) aligning models via preference-based optimization to explicitly learn to ask better questions along these fine-grained attributes. Focusing on clinical reasoning as a case study, we introduce the MediQ-AskDocs dataset, composed of 17k real-world clinical interactions augmented with 80k attribute-specific preference pairs of follow-up questions, as well as a novel expert-annotated interactive healthcare QA task to evaluate question-asking abilities. Models aligned with ALFA reduce diagnostic errors by 56.6% on MediQ-AskDocs compared to SOTA instruction-tuned LLMs, with a question-level win-rate of 64.4% and strong generalizability. Our findings suggest that explicitly guiding question-asking with structured, fine-grained attributes offers a scalable path to improve LLMs, especially in expert application domains.

Unstructured clinical notes contain essential patient information but are challenging for physicians to search and interpret efficiently. Although large language models (LLMs) have shown promise in question answering (QA), most existing systems lack transparency, usability, and alignment with clinical workflows. This work introduces an interactive QA system that enables physicians to query clinical notes via text or voice and receive extractive answers highlighted directly in the note for traceability. The system was built using OpenAI models with zero-shot prompting and evaluated across multiple metrics, including exact string match, word overlap, SentenceTransformer similarity, and BERTScore. Results show that while exact match scores ranged from 47 to 62 percent, semantic similarity scores exceeded 87 percent, indicating strong contextual alignment even when wording varied. To assess usability, the system was also evaluated using simulated clinical personas. Seven diverse physician and nurse personas interacted with the system across scenario-based tasks and provided structured feedback. The evaluations highlighted strengths in intuitive design and answer accessibility, alongside opportunities for enhancing explanation clarity.

Ensuring the accuracy of responses provided by large language models (LLMs) is crucial, particularly in clinical settings where incorrect information may directly impact patient health. To address this challenge, we construct K-QA, a dataset containing 1,212 patient questions originating from real-world conversations held on K Health (an AI-driven clinical platform). We employ a panel of in-house physicians to answer and manually decompose a subset of K-QA into self-contained statements. Additionally, we formulate two NLI-based evaluation metrics approximating recall and precision: (1) comprehensiveness, measuring the percentage of essential clinical information in the generated answer and (2) hallucination rate, measuring the number of statements from the physician-curated response contradicted by the LLM answer. Finally, we use K-QA along with these metrics to evaluate several state-of-the-art models, as well as the effect of in-context learning and medically-oriented augmented retrieval schemes developed by the authors. Our findings indicate that in-context learning improves the comprehensiveness of the models, and augmented retrieval is effective in reducing hallucinations. We make K-QA available to to the community to spur research into medically accurate NLP applications.

Multimodal systems have great potential to assist humans in procedural activities, where people follow instructions to achieve their goals. Despite diverse application scenarios, systems are typically evaluated on traditional classification tasks, e.g., action recognition or temporal action segmentation. In this paper, we present a novel evaluation dataset, ProMQA, to measure system advancements in application-oriented scenarios. ProMQA consists of 401 multimodal procedural QA pairs on user recording of procedural activities coupled with their corresponding instruction. For QA annotation, we take a cost-effective human-LLM collaborative approach, where the existing annotation is augmented with LLM-generated QA pairs that are later verified by humans. We then provide the benchmark results to set the baseline performance on ProMQA. Our experiment reveals a significant gap between human performance and that of current systems, including competitive proprietary multimodal models. We hope our dataset sheds light on new aspects of models' multimodal understanding capabilities.

Clinical Question Answering (QA) systems enable doctors to quickly access patient information from electronic health records (EHRs). However, training these systems requires significant annotated data, which is limited due to the expertise needed and the privacy concerns associated with clinical data. This paper explores generating Clinical QA data using large language models (LLMs) in a zero-shot setting. We find that naive prompting often results in easy questions that do not reflect the complexity of clinical scenarios. To address this, we propose two prompting strategies: 1) instructing the model to generate questions that do not overlap with the input context, and 2) summarizing the input record using a predefined schema to scaffold question generation. Experiments on two Clinical QA datasets demonstrate that our method generates more challenging questions, significantly improving fine-tuning performance over baselines. We compare synthetic and gold data and find a gap between their training efficacy resulting from the quality of synthetically generated answers.

We present HEAD-QA, a multi-choice question answering testbed to encourage research on complex reasoning. The questions come from exams to access a specialized position in the Spanish healthcare system, and are challenging even for highly specialized humans. We then consider monolingual (Spanish) and cross-lingual (to English) experiments with information retrieval and neural techniques. We show that: (i) HEAD-QA challenges current methods, and (ii) the results lag well behind human performance, demonstrating its usefulness as a benchmark for future work.

Clinical question answering systems have the potential to provide clinicians with relevant and timely answers to their questions. Nonetheless, despite the advances that have been made, adoption of these systems in clinical settings has been slow. One issue is a lack of question-answering datasets which reflect the real-world needs of health professionals. In this work, we present RealMedQA, a dataset of realistic clinical questions generated by humans and an LLM. We describe the process for generating and verifying the QA pairs and assess several QA models on BioASQ and RealMedQA to assess the relative difficulty of matching answers to questions. We show that the LLM is more cost-efficient for generating "ideal" QA pairs. Additionally, we achieve a lower lexical similarity between questions and answers than BioASQ which provides an additional challenge to the top two QA models, as per the results. We release our code and our dataset publicly to encourage further research.

The problem of answering questions using knowledge from pre-trained language models (LMs) and knowledge graphs (KGs) presents two challenges: given a QA context (question and answer choice), methods need to (i) identify relevant knowledge from large KGs, and (ii) perform joint reasoning over the QA context and KG. In this work, we propose a new model, QA-GNN, which addresses the above challenges through two key innovations: (i) relevance scoring, where we use LMs to estimate the importance of KG nodes relative to the given QA context, and (ii) joint reasoning, where we connect the QA context and KG to form a joint graph, and mutually update their representations through graph neural networks. We evaluate our model on QA benchmarks in the commonsense (CommonsenseQA, OpenBookQA) and biomedical (MedQA-USMLE) domains. QA-GNN outperforms existing LM and LM+KG models, and exhibits capabilities to perform interpretable and structured reasoning, e.g., correctly handling negation in questions.

We present a corpus of 5,000 richly annotated abstracts of medical articles describing clinical randomized controlled trials. Annotations include demarcations of text spans that describe the Patient population enrolled, the Interventions studied and to what they were Compared, and the Outcomes measured (the `PICO' elements). These spans are further annotated at a more granular level, e.g., individual interventions within them are marked and mapped onto a structured medical vocabulary. We acquired annotations from a diverse set of workers with varying levels of expertise and cost. We describe our data collection process and the corpus itself in detail. We then outline a set of challenging NLP tasks that would aid searching of the medical literature and the practice of evidence-based medicine.

In response to the pressing need for advanced clinical problem-solving tools in healthcare, we introduce BooksMed, a novel framework based on a Large Language Model (LLM). BooksMed uniquely emulates human cognitive processes to deliver evidence-based and reliable responses, utilizing the GRADE (Grading of Recommendations, Assessment, Development, and Evaluations) framework to effectively quantify evidence strength. For clinical decision-making to be appropriately assessed, an evaluation metric that is clinically aligned and validated is required. As a solution, we present ExpertMedQA, a multispecialty clinical benchmark comprised of open-ended, expert-level clinical questions, and validated by a diverse group of medical professionals. By demanding an in-depth understanding and critical appraisal of up-to-date clinical literature, ExpertMedQA rigorously evaluates LLM performance. BooksMed outperforms existing state-of-the-art models Med-PaLM 2, Almanac, and ChatGPT in a variety of medical scenarios. Therefore, a framework that mimics human cognitive stages could be a useful tool for providing reliable and evidence-based responses to clinical inquiries.

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

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

Large 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.

Curated datasets for healthcare are often limited due to the need of human annotations from experts. In this paper, we present MedEval, a multi-level, multi-task, and multi-domain medical benchmark to facilitate the development of language models for healthcare. MedEval is comprehensive and consists of data from several healthcare systems and spans 35 human body regions from 8 examination modalities. With 22,779 collected sentences and 21,228 reports, we provide expert annotations at multiple levels, offering a granular potential usage of the data and supporting a wide range of tasks. Moreover, we systematically evaluated 10 generic and domain-specific language models under zero-shot and finetuning settings, from domain-adapted baselines in healthcare to general-purposed state-of-the-art large language models (e.g., ChatGPT). Our evaluations reveal varying effectiveness of the two categories of language models across different tasks, from which we notice the importance of instruction tuning for few-shot usage of large language models. Our investigation paves the way toward benchmarking language models for healthcare and provides valuable insights into the strengths and limitations of adopting large language models in medical domains, informing their practical applications and future advancements.

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

LLMs are bound to transform healthcare with advanced decision support and flexible chat assistants. However, LLMs are prone to generate inaccurate medical content. To ground LLMs in high-quality medical knowledge, LLMs have been equipped with external knowledge via RAG, where unstructured medical knowledge is split into small text chunks that can be selectively retrieved and integrated into the LLMs context. Yet, existing RAG pipelines rely on raw, unstructured medical text, which can be noisy, uncurated and difficult for LLMs to effectively leverage. Systematic approaches to organize medical knowledge to best surface it to LLMs are generally lacking. To address these challenges, we introduce MIRIAD, a large-scale, curated corpus of 5,821,948 medical QA pairs, each rephrased from and grounded in a passage from peer-reviewed medical literature using a semi-automated pipeline combining LLM generation, filtering, grounding, and human annotation. Unlike prior medical corpora, which rely on unstructured text, MIRIAD encapsulates web-scale medical knowledge in an operationalized query-response format, which enables more targeted retrieval. Experiments on challenging medical QA benchmarks show that augmenting LLMs with MIRIAD improves accuracy up to 6.7% compared to unstructured RAG baselines with the same source corpus and with the same amount of retrieved text. Moreover, MIRIAD improved the ability of LLMs to detect medical hallucinations by 22.5 to 37% (increase in F1 score). We further introduce MIRIAD-Atlas, an interactive map of MIRIAD spanning 56 medical disciplines, enabling clinical users to visually explore, search, and refine medical knowledge. MIRIAD promises to unlock a wealth of down-stream applications, including medical information retrievers, enhanced RAG applications, and knowledge-grounded chat interfaces, which ultimately enables more reliable LLM applications in healthcare.

Although large language models (LLMs) often produce impressive outputs, it remains unclear how they perform in real-world scenarios requiring strong reasoning skills and expert domain knowledge. We set out to investigate whether close- and open-source models (GPT-3.5, LLama-2, etc.) can be applied to answer and reason about difficult real-world-based questions. We focus on three popular medical benchmarks (MedQA-USMLE, MedMCQA, and PubMedQA) and multiple prompting scenarios: Chain-of-Thought (CoT, think step-by-step), few-shot and retrieval augmentation. Based on an expert annotation of the generated CoTs, we found that InstructGPT can often read, reason and recall expert knowledge. Last, by leveraging advances in prompt engineering (few-shot and ensemble methods), we demonstrated that GPT-3.5 not only yields calibrated predictive distributions, but also reaches the passing score on three datasets: MedQA-USMLE 60.2%, MedMCQA 62.7% and PubMedQA 78.2%. Open-source models are closing the gap: Llama-2 70B also passed the MedQA-USMLE with 62.5% accuracy.

The advancement in healthcare has shifted focus toward patient-centric approaches, particularly in self-care and patient education, facilitated by access to Electronic Health Records (EHR). However, medical jargon in EHRs poses significant challenges in patient comprehension. To address this, we introduce a new task of automatically generating lay definitions, aiming to simplify complex medical terms into patient-friendly lay language. We first created the README dataset, an extensive collection of over 50,000 unique (medical term, lay definition) pairs and 300,000 mentions, each offering context-aware lay definitions manually annotated by domain experts. We have also engineered a data-centric Human-AI pipeline that synergizes data filtering, augmentation, and selection to improve data quality. We then used README as the training data for models and leveraged a Retrieval-Augmented Generation method to reduce hallucinations and improve the quality of model outputs. Our extensive automatic and human evaluations demonstrate that open-source mobile-friendly models, when fine-tuned with high-quality data, are capable of matching or even surpassing the performance of state-of-the-art closed-source large language models like ChatGPT. This research represents a significant stride in closing the knowledge gap in patient education and advancing patient-centric healthcare solutions.

Developing the required technology to assist medical experts in their everyday activities is currently a hot topic in the Artificial Intelligence research field. Thus, a number of large language models (LLMs) and automated benchmarks have recently been proposed with the aim of facilitating information extraction in Evidence-Based Medicine (EBM) using natural language as a tool for mediating in human-AI interaction. The most representative benchmarks are limited to either multiple-choice or long-form answers and are available only in English. In order to address these shortcomings, in this paper we present a new dataset which, unlike previous work: (i) includes not only explanatory arguments for the correct answer, but also arguments to reason why the incorrect answers are not correct; (ii) the explanations are written originally by medical doctors to answer questions from the Spanish Residency Medical Exams. Furthermore, this new benchmark allows us to setup a novel extractive task which consists of identifying the explanation of the correct answer written by medical doctors. An additional benefit of our setting is that we can leverage the extractive QA paradigm to automatically evaluate performance of LLMs without resorting to costly manual evaluation by medical experts. Comprehensive experimentation with language models for Spanish shows that sometimes multilingual models fare better than monolingual ones, even outperforming models which have been adapted to the medical domain. Furthermore, results across the monolingual models are mixed, with supposedly smaller and inferior models performing competitively. In any case, the obtained results show that our novel dataset and approach can be an effective technique to help medical practitioners in identifying relevant evidence-based explanations for medical questions.

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.

In large organisations, identifying experts on a given topic is crucial in leveraging the internal knowledge spread across teams and departments. So-called enterprise expert retrieval systems automatically discover and structure employees' expertise based on the vast amount of heterogeneous data available about them and the work they perform. Evaluating these systems requires comprehensive ground truth expert annotations, which are hard to obtain. Therefore, the annotation process typically relies on automated recommendations of knowledge areas to validate. This case study provides an analysis of how these recommendations can impact the evaluation of expert finding systems. We demonstrate on a popular benchmark that system-validated annotations lead to overestimated performance of traditional term-based retrieval models and even invalidate comparisons with more recent neural methods. We also augment knowledge areas with synonyms to uncover a strong bias towards literal mentions of their constituent words. Finally, we propose constraints to the annotation process to prevent these biased evaluations, and show that this still allows annotation suggestions of high utility. These findings should inform benchmark creation or selection for expert finding, to guarantee meaningful comparison of methods.

Electronic Health Records (EHRs), which contain patients' medical histories in various multi-modal formats, often overlook the potential for joint reasoning across imaging and table modalities underexplored in current EHR Question Answering (QA) systems. In this paper, we introduce EHRXQA, a novel multi-modal question answering dataset combining structured EHRs and chest X-ray images. To develop our dataset, we first construct two uni-modal resources: 1) The MIMIC- CXR-VQA dataset, our newly created medical visual question answering (VQA) benchmark, specifically designed to augment the imaging modality in EHR QA, and 2) EHRSQL (MIMIC-IV), a refashioned version of a previously established table-based EHR QA dataset. By integrating these two uni-modal resources, we successfully construct a multi-modal EHR QA dataset that necessitates both uni-modal and cross-modal reasoning. To address the unique challenges of multi-modal questions within EHRs, we propose a NeuralSQL-based strategy equipped with an external VQA API. This pioneering endeavor enhances engagement with multi-modal EHR sources and we believe that our dataset can catalyze advances in real-world medical scenarios such as clinical decision-making and research. EHRXQA is available at https://github.com/baeseongsu/ehrxqa.

Biomedical knowledge is uniquely complex and structured, requiring distinct reasoning strategies compared to other scientific disciplines like physics or chemistry. Biomedical scientists do not rely on a single approach to reasoning; instead, they use various strategies, including rule-based, prototype-based, and case-based reasoning. This diversity calls for flexible approaches that accommodate multiple reasoning strategies while leveraging in-domain knowledge. We introduce KGARevion, a knowledge graph (KG) based agent designed to address the complexity of knowledge-intensive medical queries. Upon receiving a query, KGARevion generates relevant triplets by using the knowledge base of the LLM. These triplets are then verified against a grounded KG to filter out erroneous information and ensure that only accurate, relevant data contribute to the final answer. Unlike RAG-based models, this multi-step process ensures robustness in reasoning while adapting to different models of medical reasoning. Evaluations on four gold-standard medical QA datasets show that KGARevion improves accuracy by over 5.2%, outperforming 15 models in handling complex medical questions. To test its capabilities, we curated three new medical QA datasets with varying levels of semantic complexity, where KGARevion achieved a 10.4% improvement in accuracy.

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

This paper proposes a chatbot framework that adopts a hybrid model which consists of a knowledge graph and a text similarity model. Based on this chatbot framework, we build HHH, an online question-and-answer (QA) Healthcare Helper system for answering complex medical questions. HHH maintains a knowledge graph constructed from medical data collected from the Internet. HHH also implements a novel text representation and similarity deep learning model, Hierarchical BiLSTM Attention Model (HBAM), to find the most similar question from a large QA dataset. We compare HBAM with other state-of-the-art language models such as bidirectional encoder representation from transformers (BERT) and Manhattan LSTM Model (MaLSTM). We train and test the models with a subset of the Quora duplicate questions dataset in the medical area. The experimental results show that our model is able to achieve a superior performance than these existing methods.

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

In recent years, there is strong emphasis on mining medical data using machine learning techniques. A common problem is to obtain a noiseless set of textual documents, with a relevant content for the research question, and developing a Question Answering (QA) model for a specific medical field. The purpose of this paper is to present a new methodology for building a medical dataset and obtain a QA model for analysis of symptoms and impact on daily life for a specific disease domain. The ``Mental Health'' forum was used, a forum dedicated to people suffering from schizophrenia and different mental disorders. Relevant posts of active users, who regularly participate, were extrapolated providing a new method of obtaining low-bias content and without privacy issues. Furthermore, it is shown how to pre-process the dataset to convert it into a QA dataset. The Bidirectional Encoder Representations from Transformers (BERT), DistilBERT, RoBERTa, and BioBERT models were fine-tuned and evaluated via F1-Score, Exact Match, Precision and Recall. Accurate empirical experiments demonstrated the effectiveness of the proposed method for obtaining an accurate dataset for QA model implementation. By fine-tuning the BioBERT QA model, we achieved an F1 score of 0.885, showing a considerable improvement and outperforming the state-of-the-art model for mental disorders domain.

Current Large Language Models (LLMs) benchmarks are often based on open-ended or close-ended QA evaluations, avoiding the requirement of human labor. Close-ended measurements evaluate the factuality of responses but lack expressiveness. Open-ended capture the model's capacity to produce discourse responses but are harder to assess for correctness. These two approaches are commonly used, either independently or together, though their relationship remains poorly understood. This work is focused on the healthcare domain, where both factuality and discourse matter greatly. It introduces a comprehensive, multi-axis suite for healthcare LLM evaluation, exploring correlations between open and close benchmarks and metrics. Findings include blind spots and overlaps in current methodologies. As an updated sanity check, we release a new medical benchmark--CareQA--, with both open and closed variants. Finally, we propose a novel metric for open-ended evaluations --Relaxed Perplexity-- to mitigate the identified limitations.

Multimodal retrieval-augmented generation (MM-RAG) is a key approach for applying large language models (LLMs) and agents to real-world knowledge bases, yet current evaluations are fragmented, focusing on either text or images in isolation or on simplified multimodal setups that fail to capture document-centric multimodal use cases. In this paper, we introduce UniDoc-Bench, the first large-scale, realistic benchmark for MM-RAG built from 70k real-world PDF pages across eight domains. Our pipeline extracts and links evidence from text, tables, and figures, then generates 1,600 multimodal QA pairs spanning factual retrieval, comparison, summarization, and logical reasoning queries. To ensure reliability, 20% of QA pairs are validated by multiple annotators and expert adjudication. UniDoc-Bench supports apples-to-apples comparison across four paradigms: (1) text-only, (2) image-only, (3) multimodal text-image fusion, and (4) multimodal joint retrieval -- under a unified protocol with standardized candidate pools, prompts, and evaluation metrics. Our experiments show that multimodal text-image fusion RAG systems consistently outperform both unimodal and jointly multimodal embedding-based retrieval, indicating that neither text nor images alone are sufficient and that current multimodal embeddings remain inadequate. Beyond benchmarking, our analysis reveals when and how visual context complements textual evidence, uncovers systematic failure modes, and offers actionable guidance for developing more robust MM-RAG pipelines.

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.

Generating high-quality question-answer pairs for specialized technical domains remains challenging, with existing approaches facing a tradeoff between leveraging expert examples and achieving topical diversity. We present ExpertGenQA, a protocol that combines few-shot learning with structured topic and style categorization to generate comprehensive domain-specific QA pairs. Using U.S. Federal Railroad Administration documents as a test bed, we demonstrate that ExpertGenQA achieves twice the efficiency of baseline few-shot approaches while maintaining 94.4% topic coverage. Through systematic evaluation, we show that current LLM-based judges and reward models exhibit strong bias toward superficial writing styles rather than content quality. Our analysis using Bloom's Taxonomy reveals that ExpertGenQA better preserves the cognitive complexity distribution of expert-written questions compared to template-based approaches. When used to train retrieval models, our generated queries improve top-1 accuracy by 13.02% over baseline performance, demonstrating their effectiveness for downstream applications in technical domains.

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.

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.

The emergence of advanced reasoning capabilities in Large Language Models (LLMs) marks a transformative development in healthcare applications. Beyond merely expanding functional capabilities, these reasoning mechanisms enhance decision transparency and explainability-critical requirements in medical contexts. This survey examines the transformation of medical LLMs from basic information retrieval tools to sophisticated clinical reasoning systems capable of supporting complex healthcare decisions. We provide a thorough analysis of the enabling technological foundations, with a particular focus on specialized prompting techniques like Chain-of-Thought and recent breakthroughs in Reinforcement Learning exemplified by DeepSeek-R1. Our investigation evaluates purpose-built medical frameworks while also examining emerging paradigms such as multi-agent collaborative systems and innovative prompting architectures. The survey critically assesses current evaluation methodologies for medical validation and addresses persistent challenges in field interpretation limitations, bias mitigation strategies, patient safety frameworks, and integration of multimodal clinical data. Through this survey, we seek to establish a roadmap for developing reliable LLMs that can serve as effective partners in clinical practice and medical research.

While text-to-image (T2I) generative models have become ubiquitous, they do not necessarily generate images that align with a given prompt. While previous work has evaluated T2I alignment by proposing metrics, benchmarks, and templates for collecting human judgements, the quality of these components is not systematically measured. Human-rated prompt sets are generally small and the reliability of the ratings -- and thereby the prompt set used to compare models -- is not evaluated. We address this gap by performing an extensive study evaluating auto-eval metrics and human templates. We provide three main contributions: (1) We introduce a comprehensive skills-based benchmark that can discriminate models across different human templates. This skills-based benchmark categorises prompts into sub-skills, allowing a practitioner to pinpoint not only which skills are challenging, but at what level of complexity a skill becomes challenging. (2) We gather human ratings across four templates and four T2I models for a total of >100K annotations. This allows us to understand where differences arise due to inherent ambiguity in the prompt and where they arise due to differences in metric and model quality. (3) Finally, we introduce a new QA-based auto-eval metric that is better correlated with human ratings than existing metrics for our new dataset, across different human templates, and on TIFA160.

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.

Retrieval-Augmented Generation (RAG) is a cornerstone of modern question answering (QA) systems, enabling grounded answers based on external knowledge. Although recent progress has been driven by open-domain datasets, enterprise QA systems need datasets that mirror the concrete, domain-specific issues users raise in day-to-day support scenarios. Critically, evaluating end-to-end RAG systems requires benchmarks comprising not only question--answer pairs but also the specific knowledge base (KB) snapshot from which answers were derived. To address this need, we introduce WixQA, a benchmark suite featuring QA datasets precisely grounded in the released KB corpus, enabling holistic evaluation of retrieval and generation components. WixQA includes three distinct QA datasets derived from Wix.com customer support interactions and grounded in a snapshot of the public Wix Help Center KB: (i) WixQA-ExpertWritten, 200 real user queries with expert-authored, multi-step answers; (ii) WixQA-Simulated, 200 expert-validated QA pairs distilled from user dialogues; and (iii) WixQA-Synthetic, 6,222 LLM-generated QA pairs, with one pair systematically derived from each article in the knowledge base. We release the KB snapshot alongside the datasets under MIT license and provide comprehensive baseline results, forming a unique benchmark for evaluating enterprise RAG systems in realistic enterprise environments.

To evaluate Large Language Models (LLMs) for question answering (QA), traditional methods typically focus on directly assessing the immediate responses generated by the models based on the given question and context. In the common use case of humans seeking AI assistant's help in finding information, these non-interactive evaluations do not account for the dynamic nature of human-model conversations, and interaction-aware evaluations have shown that accurate QA models are preferred by humans (Lee et al., 2023). Recent works in human-computer interaction (HCI) have employed human evaluators to conduct interactions and evaluations, but they are often prohibitively expensive and time-consuming to scale. In this work, we introduce an automatic evaluation framework IQA-EVAL to Interactive Question Answering Evaluation. More specifically, we introduce LLM-based Evaluation Agent (LEA) that can: (1) simulate human behaviors to generate interactions with IQA models; (2) automatically evaluate the generated interactions. Moreover, we propose assigning personas to LEAs to better simulate groups of real human evaluators. We show that: (1) our evaluation framework with GPT-4 (or Claude) as the backbone model achieves a high correlation with human evaluations on the IQA task; (2) assigning personas to LEA to better represent the crowd further significantly improves correlations. Finally, we use our automatic metric to evaluate five recent representative LLMs with over 1000 questions from complex and ambiguous question answering tasks, which comes with a substantial cost of $5k if evaluated by humans.

LLMs have demonstrated impressive performance in answering medical questions, such as passing scores on medical licensing examinations. However, medical board exam questions or general clinical questions do not capture the complexity of realistic clinical cases. Moreover, the lack of reference explanations means we cannot easily evaluate the reasoning of model decisions, a crucial component of supporting doctors in making complex medical decisions. To address these challenges, we construct two new datasets: JAMA Clinical Challenge and Medbullets. JAMA Clinical Challenge consists of questions based on challenging clinical cases, while Medbullets comprises USMLE Step 2&3 style clinical questions. Both datasets are structured as multiple-choice question-answering tasks, where each question is accompanied by an expert-written explanation. We evaluate four LLMs on the two datasets using various prompts. Experiments demonstrate that our datasets are harder than previous benchmarks. The inconsistency between automatic and human evaluations of model-generated explanations highlights the need to develop new metrics to support future research on explainable medical QA.

With the growing use of language models (LMs) in clinical environments, there is an immediate need to evaluate the accuracy and safety of LM-generated medical text. Currently, such evaluation relies solely on manual physician review. However, detecting errors in LM-generated text is challenging because 1) manual review is costly and 2) expert-composed reference outputs are often unavailable in real-world settings. While the "LM-as-judge" paradigm (a LM evaluating another LM) offers scalable evaluation, even frontier LMs can miss subtle but clinically significant errors. To address these challenges, we propose MedVAL, a self-supervised framework that leverages synthetic data to train evaluator LMs to assess whether LM-generated medical outputs are factually consistent with inputs, without requiring physician labels or reference outputs. To evaluate LM performance, we introduce MedVAL-Bench, a dataset containing 840 outputs annotated by physicians, following a physician-defined taxonomy of risk levels and error categories. Across 6 diverse medical tasks and 10 state-of-the-art LMs spanning open-source, proprietary, and medically adapted models, MedVAL fine-tuning significantly improves (p < 0.001) alignment with physicians on both seen and unseen tasks, increasing average F1 scores from 66% to 83%, with per-sample safety classification scores up to 86%. MedVAL improves the performance of even the best-performing proprietary LM (GPT-4o) by 8%. To support a scalable, risk-aware pathway towards clinical integration, we open-source the 1) codebase ( https://github.com/StanfordMIMI/MedVAL ), 2) MedVAL-Bench ( https://huggingface.co/datasets/stanfordmimi/MedVAL-Bench ), and 3) MedVAL-4B ( https://huggingface.co/stanfordmimi/MedVAL-4B ), the best-performing open-source LM. Our research provides the first evidence of LMs approaching expert-level validation ability for medical text.

Understanding causal narratives communicated in clinical notes can help make strides towards personalized healthcare. Extracted causal information from clinical notes can be combined with structured EHR data such as patients' demographics, diagnoses, and medications. This will enhance healthcare providers' ability to identify aspects of a patient's story communicated in the clinical notes and help make more informed decisions. In this work, we propose annotation guidelines, develop an annotated corpus and provide baseline scores to identify types and direction of causal relations between a pair of biomedical concepts in clinical notes; communicated implicitly or explicitly, identified either in a single sentence or across multiple sentences. We annotate a total of 2714 de-identified examples sampled from the 2018 n2c2 shared task dataset and train four different language model based architectures. Annotation based on our guidelines achieved a high inter-annotator agreement i.e. Fleiss' kappa (kappa) score of 0.72, and our model for identification of causal relations achieved a macro F1 score of 0.56 on the test data. The high inter-annotator agreement for clinical text shows the quality of our annotation guidelines while the provided baseline F1 score sets the direction for future research towards understanding narratives in clinical texts.

Question answering (QA) in the field of healthcare has received much attention due to significant advancements in natural language processing. However, existing healthcare QA datasets primarily focus on medical images, clinical notes, or structured electronic health record tables. This leaves the vast potential of combining electrocardiogram (ECG) data with these systems largely untapped. To address this gap, we present ECG-QA, the first QA dataset specifically designed for ECG analysis. The dataset comprises a total of 70 question templates that cover a wide range of clinically relevant ECG topics, each validated by an ECG expert to ensure their clinical utility. As a result, our dataset includes diverse ECG interpretation questions, including those that require a comparative analysis of two different ECGs. In addition, we have conducted numerous experiments to provide valuable insights for future research directions. We believe that ECG-QA will serve as a valuable resource for the development of intelligent QA systems capable of assisting clinicians in ECG interpretations. Dataset URL: https://github.com/Jwoo5/ecg-qa

As practitioners increasingly deploy machine learning models in critical domains such as health care, finance, and policy, it becomes vital to ensure that domain experts function effectively alongside these models. Explainability is one way to bridge the gap between human decision-makers and machine learning models. However, most of the existing work on explainability focuses on one-off, static explanations like feature importances or rule lists. These sorts of explanations may not be sufficient for many use cases that require dynamic, continuous discovery from stakeholders. In the literature, few works ask decision-makers about the utility of existing explanations and other desiderata they would like to see in an explanation going forward. In this work, we address this gap and carry out a study where we interview doctors, healthcare professionals, and policymakers about their needs and desires for explanations. Our study indicates that decision-makers would strongly prefer interactive explanations in the form of natural language dialogues. Domain experts wish to treat machine learning models as "another colleague", i.e., one who can be held accountable by asking why they made a particular decision through expressive and accessible natural language interactions. Considering these needs, we outline a set of five principles researchers should follow when designing interactive explanations as a starting place for future work. Further, we show why natural language dialogues satisfy these principles and are a desirable way to build interactive explanations. Next, we provide a design of a dialogue system for explainability and discuss the risks, trade-offs, and research opportunities of building these systems. Overall, we hope our work serves as a starting place for researchers and engineers to design interactive explainability systems.

The proliferation of Large Language Models (LLMs) in medicine has enabled impressive capabilities, yet a critical gap remains in their ability to perform systematic, transparent, and verifiable reasoning, a cornerstone of clinical practice. This has catalyzed a shift from single-step answer generation to the development of LLMs explicitly designed for medical reasoning. This paper provides the first systematic review of this emerging field. We propose a taxonomy of reasoning enhancement techniques, categorized into training-time strategies (e.g., supervised fine-tuning, reinforcement learning) and test-time mechanisms (e.g., prompt engineering, multi-agent systems). We analyze how these techniques are applied across different data modalities (text, image, code) and in key clinical applications such as diagnosis, education, and treatment planning. Furthermore, we survey the evolution of evaluation benchmarks from simple accuracy metrics to sophisticated assessments of reasoning quality and visual interpretability. Based on an analysis of 60 seminal studies from 2022-2025, we conclude by identifying critical challenges, including the faithfulness-plausibility gap and the need for native multimodal reasoning, and outlining future directions toward building efficient, robust, and sociotechnically responsible medical AI.

We introduce MedXpertQA, a highly challenging and comprehensive benchmark to evaluate expert-level medical knowledge and advanced reasoning. MedXpertQA includes 4,460 questions spanning 17 specialties and 11 body systems. It includes two subsets, Text for text evaluation and MM for multimodal evaluation. Notably, MM introduces expert-level exam questions with diverse images and rich clinical information, including patient records and examination results, setting it apart from traditional medical multimodal benchmarks with simple QA pairs generated from image captions. MedXpertQA applies rigorous filtering and augmentation to address the insufficient difficulty of existing benchmarks like MedQA, and incorporates specialty board questions to improve clinical relevance and comprehensiveness. We perform data synthesis to mitigate data leakage risk and conduct multiple rounds of expert reviews to ensure accuracy and reliability. We evaluate 16 leading models on MedXpertQA. Moreover, medicine is deeply connected to real-world decision-making, providing a rich and representative setting for assessing reasoning abilities beyond mathematics and code. To this end, we develop a reasoning-oriented subset to facilitate the assessment of o1-like models.

Medical visual question answering (Med-VQA) has tremendous potential in healthcare. However, the development of this technology is hindered by the lacking of publicly-available and high-quality labeled datasets for training and evaluation. In this paper, we present a large bilingual dataset, SLAKE, with comprehensive semantic labels annotated by experienced physicians and a new structural medical knowledge base for Med-VQA. Besides, SLAKE includes richer modalities and covers more human body parts than the currently available dataset. We show that SLAKE can be used to facilitate the development and evaluation of Med-VQA systems. The dataset can be downloaded from http://www.med-vqa.com/slake.

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

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.

The Interactive Knowledge Assistant Track (iKAT) 2024 focuses on advancing conversational assistants, able to adapt their interaction and responses from personalized user knowledge. The track incorporates a Personal Textual Knowledge Base (PTKB) alongside Conversational AI tasks, such as passage ranking and response generation. Query Rewrite being an effective approach for resolving conversational context, we explore Large Language Models (LLMs), as query rewriters. Specifically, our submitted runs explore multi-aspect query generation using the MQ4CS framework, which we further enhance with Learned Sparse Retrieval via the SPLADE architecture, coupled with robust cross-encoder models. We also propose an alternative to the previous interleaving strategy, aggregating multiple aspects during the reranking phase. Our findings indicate that multi-aspect query generation is effective in enhancing performance when integrated with advanced retrieval and reranking models. Our results also lead the way for better personalization in Conversational Search, relying on LLMs to integrate personalization within query rewrite, and outperforming human rewrite performance.

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

Large language models (LLMs) have shown promise for generative and knowledge-intensive tasks including question-answering (QA) tasks. However, the practical deployment still faces challenges, notably the issue of "hallucination", where models generate plausible-sounding but unfaithful or nonsensical information. This issue becomes particularly critical in the medical domain due to the uncommon professional concepts and potential social risks involved. This paper analyses the phenomenon of hallucination in medical generative QA systems using widely adopted LLMs and datasets. Our investigation centers on the identification and comprehension of common problematic answers, with a specific emphasis on hallucination. To tackle this challenge, we present an interactive self-reflection methodology that incorporates knowledge acquisition and answer generation. Through this feedback process, our approach steadily enhances the factuality, consistency, and entailment of the generated answers. Consequently, we harness the interactivity and multitasking ability of LLMs and produce progressively more precise and accurate answers. Experimental results on both automatic and human evaluation demonstrate the superiority of our approach in hallucination reduction compared to baselines.

Skin carcinoma is the most prevalent form of cancer globally, accounting for over $8 billion in annual healthcare expenditures. In clinical settings, physicians document patient visits using detailed SOAP (Subjective, Objective, Assessment, and Plan) notes. However, manually generating these notes is labor-intensive and contributes to clinician burnout. In this work, we propose a weakly supervised multimodal framework to generate clinically structured SOAP notes from limited inputs, including lesion images and sparse clinical text. Our approach reduces reliance on manual annotations, enabling scalable, clinically grounded documentation while alleviating clinician burden and reducing the need for large annotated data. Our method achieves performance comparable to GPT-4o, Claude, and DeepSeek Janus Pro across key clinical relevance metrics. To evaluate clinical quality, we introduce two novel metrics MedConceptEval and Clinical Coherence Score (CCS) which assess semantic alignment with expert medical concepts and input features, respectively.

As language models are adapted by a more sophisticated and diverse set of users, the importance of guaranteeing that they provide factually correct information supported by verifiable sources is critical across fields of study & professions. This is especially the case for high-stakes fields, such as medicine and law, where the risk of propagating false information is high and can lead to undesirable societal consequences. Previous work studying factuality and attribution has not focused on analyzing these characteristics of language model outputs in domain-specific scenarios. In this work, we present an evaluation study analyzing various axes of factuality and attribution provided in responses from a few systems, by bringing domain experts in the loop. Specifically, we first collect expert-curated questions from 484 participants across 32 fields of study, and then ask the same experts to evaluate generated responses to their own questions. We also ask experts to revise answers produced by language models, which leads to ExpertQA, a high-quality long-form QA dataset with 2177 questions spanning 32 fields, along with verified answers and attributions for claims in the answers.

The lack of standardized evaluation benchmarks in the medical domain for text inputs can be a barrier to widely adopting and leveraging the potential of natural language models for health-related downstream tasks. This paper revisited an openly available MIMIC-IV benchmark for electronic health records (EHRs) to address this issue. First, we integrate the MIMIC-IV data within the Hugging Face datasets library to allow an easy share and use of this collection. Second, we investigate the application of templates to convert EHR tabular data to text. Experiments using fine-tuned and zero-shot LLMs on the mortality of patients task show that fine-tuned text-based models are competitive against robust tabular classifiers. In contrast, zero-shot LLMs struggle to leverage EHR representations. This study underlines the potential of text-based approaches in the medical field and highlights areas for further improvement.

We introduce RJUA-QA, a novel medical dataset for question answering (QA) and reasoning with clinical evidence, contributing to bridge the gap between general large language models (LLMs) and medical-specific LLM applications. RJUA-QA is derived from realistic clinical scenarios and aims to facilitate LLMs in generating reliable diagnostic and advice. The dataset contains 2,132 curated Question-Context-Answer pairs, corresponding about 25,000 diagnostic records and clinical cases. The dataset covers 67 common urological disease categories, where the disease coverage exceeds 97.6\% of the population seeking medical services in urology. Each data instance in RJUA-QA comprises: (1) a question mirroring real patient to inquiry about clinical symptoms and medical conditions, (2) a context including comprehensive expert knowledge, serving as a reference for medical examination and diagnosis, (3) a doctor response offering the diagnostic conclusion and suggested examination guidance, (4) a diagnosed clinical disease as the recommended diagnostic outcome, and (5) clinical advice providing recommendations for medical examination. RJUA-QA is the first medical QA dataset for clinical reasoning over the patient inquiries, where expert-level knowledge and experience are required for yielding diagnostic conclusions and medical examination advice. A comprehensive evaluation is conducted to evaluate the performance of both medical-specific and general LLMs on the RJUA-QA dataset.

Language model heavily depends on high-quality data for optimal performance. Existing approaches rely on manually designed heuristics, the perplexity of existing models, training classifiers, or careful prompt engineering, which require significant expert experience and human annotation effort while introduce biases. We introduce CritiQ, a novel data selection method that automatically mines criteria from human preferences for data quality with only sim30 human-annotated pairs and performs efficient data selection. The main component, CritiQ Flow, employs a manager agent to evolve quality criteria and worker agents to make pairwise judgments. We build a knowledge base that extracts quality criteria from previous work to boost CritiQ Flow. Compared to perplexity- and classifier- based methods, verbal criteria are more interpretable and possess reusable value. After deriving the criteria, we train the CritiQ Scorer to give quality scores and perform efficient data selection. We demonstrate the effectiveness of our method in the code, math, and logic domains, achieving high accuracy on human-annotated test sets. To validate the quality of the selected data, we continually train Llama 3.1 models and observe improved performance on downstream tasks compared to uniform sampling. Ablation studies validate the benefits of the knowledge base and the reflection process. We analyze how criteria evolve and the effectiveness of majority voting.

Large language models (LLMs) have demonstrated remarkable performance on question-answering (QA) tasks because of their superior capabilities in natural language understanding and generation. However, LLM-based QA struggles with complex QA tasks due to poor reasoning capacity, outdated knowledge, and hallucinations. Several recent works synthesize LLMs and knowledge graphs (KGs) for QA to address the above challenges. In this survey, we propose a new structured taxonomy that categorizes the methodology of synthesizing LLMs and KGs for QA according to the categories of QA and the KG's role when integrating with LLMs. We systematically survey state-of-the-art advances in synthesizing LLMs and KGs for QA and compare and analyze these approaches in terms of strength, limitations, and KG requirements. We then align the approaches with QA and discuss how these approaches address the main challenges of different complex QA. Finally, we summarize the advancements, evaluation metrics, and benchmark datasets and highlight open challenges and opportunities.

Medical consumer question answering (CQA) is crucial for empowering patients by providing personalized and reliable health information. Despite recent advances in large language models (LLMs) for medical QA, consumer-oriented and multilingual resources, particularly in low-resource languages like Persian, remain sparse. To bridge this gap, we present PerMedCQA, the first Persian-language benchmark for evaluating LLMs on real-world, consumer-generated medical questions. Curated from a large medical QA forum, PerMedCQA contains 68,138 question-answer pairs, refined through careful data cleaning from an initial set of 87,780 raw entries. We evaluate several state-of-the-art multilingual and instruction-tuned LLMs, utilizing MedJudge, a novel rubric-based evaluation framework driven by an LLM grader, validated against expert human annotators. Our results highlight key challenges in multilingual medical QA and provide valuable insights for developing more accurate and context-aware medical assistance systems. The data is publicly available on https://huggingface.co/datasets/NaghmehAI/PerMedCQA

Scholastic trivia competitions test knowledge and intelligence through mastery of question answering. Modern question answering benchmarks are one variant of the Turing test. Specifically, answering a set of questions as well as a human is a minimum bar towards demonstrating human-like intelligence. This paper makes the case that the format of one competition -- where participants can answer in the middle of hearing a question (incremental) -- better differentiates the skill between (human or machine) players. Additionally, merging a sequential decision-making sub-task with question answering (QA) provides a good setting for research in model calibration and opponent modeling. Thus, embedded in this task are three machine learning challenges: (1) factoid QA over thousands of Wikipedia-like answers, (2) calibration of the QA model's confidence scores, and (3) sequential decision-making that incorporates knowledge of the QA model, its calibration, and what the opponent may do. We make two contributions: (1) collecting and curating a large factoid QA dataset and an accompanying gameplay dataset, and (2) developing a model that addresses these three machine learning challenges. In addition to offline evaluation, we pitted our model against some of the most accomplished trivia players in the world in a series of exhibition matches spanning several years. Throughout this paper, we show that collaborations with the vibrant trivia community have contributed to the quality of our dataset, spawned new research directions, and doubled as an exciting way to engage the public with research in machine learning and natural language processing.

Large language models (LLMs) have shown impressive results while requiring little or no direct supervision. Further, there is mounting evidence that LLMs may have potential in information-seeking scenarios. We believe the ability of an LLM to attribute the text that it generates is likely to be crucial in this setting. We formulate and study Attributed QA as a key first step in the development of attributed LLMs. We propose a reproducible evaluation framework for the task and benchmark a broad set of architectures. We take human annotations as a gold standard and show that a correlated automatic metric is suitable for development. Our experimental work gives concrete answers to two key questions (How to measure attribution?, and How well do current state-of-the-art methods perform on attribution?), and give some hints as to how to address a third (How to build LLMs with attribution?).

As one promising way to inquire about any particular information through a dialog with the bot, question answering dialog systems have gained increasing research interests recently. Designing interactive QA systems has always been a challenging task in natural language processing and used as a benchmark to evaluate a machine's ability of natural language understanding. However, such systems often struggle when the question answering is carried out in multiple turns by the users to seek more information based on what they have already learned, thus, giving rise to another complicated form called Conversational Question Answering (CQA). CQA systems are often criticized for not understanding or utilizing the previous context of the conversation when answering the questions. To address the research gap, in this paper, we explore how to integrate conversational history into the neural machine comprehension system. On one hand, we introduce a framework based on a publically available pre-trained language model called BERT for incorporating history turns into the system. On the other hand, we propose a history selection mechanism that selects the turns that are relevant and contributes the most to answer the current question. Experimentation results revealed that our framework is comparable in performance with the state-of-the-art models on the QuAC leader board. We also conduct a number of experiments to show the side effects of using entire context information which brings unnecessary information and noise signals resulting in a decline in the model's performance.

Question answering (QA) systems have gained explosive attention in recent years. However, QA tasks in Vietnamese do not have many datasets. Significantly, there is mostly no dataset in the medical domain. Therefore, we built a Vietnamese Healthcare Question Answering dataset (ViHealthQA), including 10,015 question-answer passage pairs for this task, in which questions from health-interested users were asked on prestigious health websites and answers from highly qualified experts. This paper proposes a two-stage QA system based on Sentence-BERT (SBERT) using multiple negatives ranking (MNR) loss combined with BM25. Then, we conduct diverse experiments with many bag-of-words models to assess our system's performance. With the obtained results, this system achieves better performance than traditional methods.

We present WebGLM, a web-enhanced question-answering system based on the General Language Model (GLM). Its goal is to augment a pre-trained large language model (LLM) with web search and retrieval capabilities while being efficient for real-world deployments. To achieve this, we develop WebGLM with strategies for the LLM-augmented retriever, bootstrapped generator, and human preference-aware scorer. Specifically, we identify and address the limitations of WebGPT (OpenAI), through which WebGLM is enabled with accuracy, efficiency, and cost-effectiveness advantages. In addition, we propose systematic criteria for evaluating web-enhanced QA systems. We conduct multi-dimensional human evaluation and quantitative ablation studies, which suggest the outperformance of the proposed WebGLM designs over existing systems. WebGLM with the 10-billion-parameter GLM (10B) is shown to perform better than the similar-sized WebGPT (13B) and even comparably to WebGPT (175B) in human evaluation. The code, demo, and data are at https://github.com/THUDM/WebGLM.

Existing multimodal conversation agents have shown impressive abilities to locate absolute positions or retrieve attributes in simple scenarios, but they fail to perform well when complex relative positions and information alignments are involved, which poses a bottleneck in response quality. In this paper, we propose a Situated Conversation Agent Petrained with Multimodal Questions from INcremental Layout Graph (SPRING) with abilities of reasoning multi-hops spatial relations and connecting them with visual attributes in crowded situated scenarios. Specifically, we design two types of Multimodal Question Answering (MQA) tasks to pretrain the agent. All QA pairs utilized during pretraining are generated from novel Incremental Layout Graphs (ILG). QA pair difficulty labels automatically annotated by ILG are used to promote MQA-based Curriculum Learning. Experimental results verify the SPRING's effectiveness, showing that it significantly outperforms state-of-the-art approaches on both SIMMC 1.0 and SIMMC 2.0 datasets.

Evaluation of QA systems is very challenging and expensive, with the most reliable approach being human annotations of correctness of answers for questions. Recent works (AVA, BEM) have shown that transformer LM encoder based similarity metrics transfer well for QA evaluation, but they are limited by the usage of a single correct reference answer. We propose a new evaluation metric: SQuArE (Sentence-level QUestion AnsweRing Evaluation), using multiple reference answers (combining multiple correct and incorrect references) for sentence-form QA. We evaluate SQuArE on both sentence-level extractive (Answer Selection) and generative (GenQA) QA systems, across multiple academic and industrial datasets, and show that it outperforms previous baselines and obtains the highest correlation with human annotations.

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.

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.

We present a new text-to-SQL dataset for electronic health records (EHRs). The utterances were collected from 222 hospital staff members, including physicians, nurses, and insurance review and health records teams. To construct the QA dataset on structured EHR data, we conducted a poll at a university hospital and used the responses to create seed questions. We then manually linked these questions to two open-source EHR databases, MIMIC-III and eICU, and included various time expressions and held-out unanswerable questions in the dataset, which were also collected from the poll. Our dataset poses a unique set of challenges: the model needs to 1) generate SQL queries that reflect a wide range of needs in the hospital, including simple retrieval and complex operations such as calculating survival rate, 2) understand various time expressions to answer time-sensitive questions in healthcare, and 3) distinguish whether a given question is answerable or unanswerable. We believe our dataset, EHRSQL, can serve as a practical benchmark for developing and assessing QA models on structured EHR data and take a step further towards bridging the gap between text-to-SQL research and its real-life deployment in healthcare. EHRSQL is available at https://github.com/glee4810/EHRSQL.

The paper describes the open Russian medical language understanding benchmark covering several task types (classification, question answering, natural language inference, named entity recognition) on a number of novel text sets. Given the sensitive nature of the data in healthcare, such a benchmark partially closes the problem of Russian medical dataset absence. We prepare the unified format labeling, data split, and evaluation metrics for new tasks. The remaining tasks are from existing datasets with a few modifications. A single-number metric expresses a model's ability to cope with the benchmark. Moreover, we implement several baseline models, from simple ones to neural networks with transformer architecture, and release the code. Expectedly, the more advanced models yield better performance, but even a simple model is enough for a decent result in some tasks. Furthermore, for all tasks, we provide a human evaluation. Interestingly the models outperform humans in the large-scale classification tasks. However, the advantage of natural intelligence remains in the tasks requiring more knowledge and reasoning.

Medical Dialogue Generation serves a critical role in telemedicine by facilitating the dissemination of medical expertise to patients. Existing studies focus on incorporating textual representations, which have limited their ability to represent the semantics of text, such as ignoring important medical entities. To enhance the model's understanding of the textual semantics and the medical knowledge including entities and relations, we introduce the use of Abstract Meaning Representations (AMR) to construct graphical representations that delineate the roles of language constituents and medical entities within the dialogues. In this paper, We propose a novel framework that models dialogues between patients and healthcare professionals using AMR graphs, where the neural networks incorporate textual and graphical knowledge with a dual attention mechanism. Experimental results show that our framework outperforms strong baseline models in medical dialogue generation, demonstrating the effectiveness of AMR graphs in enhancing the representations of medical knowledge and logical relationships. Furthermore, to support future research in this domain, we provide the corresponding source code at https://github.com/Bernard-Yang/MedDiaAMR.

As frontier language models increasingly saturate standard QA benchmarks, concerns about data contamination, memorization, and escalating dataset creation costs persist. We propose a debate-driven evaluation paradigm that transforms any existing QA dataset into structured adversarial debates--where one model is given the official answer to defend, and another constructs and defends an alternative answer--adjudicated by a judge model blind to the correct solution. By forcing multi-round argumentation, this approach substantially increases difficulty while penalizing shallow memorization, yet reuses QA items to reduce curation overhead. We make two main contributions: (1) an evaluation pipeline to systematically convert QA tasks into debate-based assessments, and (2) a public benchmark that demonstrates our paradigm's effectiveness on a subset of MMLU-Pro questions, complete with standardized protocols and reference models. Empirical results validate the robustness of the method and its effectiveness against data contamination--a Llama 3.1 model fine-tuned on test questions showed dramatic accuracy improvements (50% -> 82%) but performed worse in debates. Results also show that even weaker judges can reliably differentiate stronger debaters, highlighting how debate-based evaluation can scale to future, more capable systems while maintaining a fraction of the cost of creating new benchmarks. Overall, our framework underscores that "pretraining on the test set is no longer all you need," offering a sustainable path for measuring the genuine reasoning ability of advanced language models.

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.

Recent advancements in open-domain question answering (ODQA), i.e., finding answers from large open-domain corpus like Wikipedia, have led to human-level performance on many datasets. However, progress in QA over book stories (Book QA) lags behind despite its similar task formulation to ODQA. This work provides a comprehensive and quantitative analysis about the difficulty of Book QA: (1) We benchmark the research on the NarrativeQA dataset with extensive experiments with cutting-edge ODQA techniques. This quantifies the challenges Book QA poses, as well as advances the published state-of-the-art with a sim7\% absolute improvement on Rouge-L. (2) We further analyze the detailed challenges in Book QA through human studies.\url{https://github.com/gorov/BookQA.} Our findings indicate that the event-centric questions dominate this task, which exemplifies the inability of existing QA models to handle event-oriented scenarios.

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

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.

The progress introduced by pre-trained language models and their fine-tuning has resulted in significant improvements in most downstream NLP tasks. The unsupervised training of a language model combined with further target task fine-tuning has become the standard QA fine-tuning procedure. In this work, we demonstrate that this strategy is sub-optimal for fine-tuning QA models, especially under a low QA annotation budget, which is a usual setting in practice due to the extractive QA labeling cost. We draw our conclusions by conducting an exhaustive analysis of the performance of the alternatives of the sequential fine-tuning strategy on different QA datasets. Based on the experiments performed, we observed that the best strategy to fine-tune the QA model in low-budget settings is taking a pre-trained language model (PLM) and then fine-tuning PLM with a dataset composed of the target dataset and SQuAD dataset. With zero extra annotation effort, the best strategy outperforms the standard strategy by 2.28% to 6.48%. Our experiments provide one of the first investigations on how to best fine-tune a QA system under a low budget and are therefore of the utmost practical interest to the QA practitioners.

The problem of Question Answering (QA) has attracted significant research interest for long. Its relevance to language understanding and knowledge retrieval tasks, along with the simple setting makes the task of QA crucial for strong AI systems. Recent success on simple QA tasks has shifted the focus to more complex settings. Among these, Multi-Hop QA (MHQA) is one of the most researched tasks over the recent years. The ability to answer multi-hop questions and perform multi step reasoning can significantly improve the utility of NLP systems. Consequently, the field has seen a sudden surge with high quality datasets, models and evaluation strategies. The notion of `multiple hops' is somewhat abstract which results in a large variety of tasks that require multi-hop reasoning. This implies that different datasets and models differ significantly which makes the field challenging to generalize and survey. This work aims to provide a general and formal definition of MHQA task, and organize and summarize existing MHQA frameworks. We also outline the best methods to create MHQA datasets. The paper provides a systematic and thorough introduction as well as the structuring of the existing attempts to this highly interesting, yet quite challenging task.

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

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

As medical datasets rapidly expand, creating detailed annotations of different body structures becomes increasingly expensive and time-consuming. We consider that requesting radiologists to create detailed annotations is unnecessarily burdensome and that pre-existing AI models can largely automate this process. Following the spirit don't use a sledgehammer on a nut, we find that, rather than creating annotations from scratch, radiologists only have to review and edit errors if the Best-AI Labels have mistakes. To obtain the Best-AI Labels among multiple AI Labels, we developed an automatic tool, called Label Critic, that can assess label quality through tireless pairwise comparisons. Extensive experiments demonstrate that, when incorporated with our developed Image-Prompt pairs, pre-existing Large Vision-Language Models (LVLM), trained on natural images and texts, achieve 96.5% accuracy when choosing the best label in a pair-wise comparison, without extra fine-tuning. By transforming the manual annotation task (30-60 min/scan) into an automatic comparison task (15 sec/scan), we effectively reduce the manual efforts required from radiologists by an order of magnitude. When the Best-AI Labels are sufficiently accurate (81% depending on body structures), they will be directly adopted as the gold-standard annotations for the dataset, with lower-quality AI Labels automatically discarded. Label Critic can also check the label quality of a single AI Label with 71.8% accuracy when no alternatives are available for comparison, prompting radiologists to review and edit if the estimated quality is low (19% depending on body structures).

This paper introduces MISS-QA, the first benchmark specifically designed to evaluate the ability of models to interpret schematic diagrams within scientific literature. MISS-QA comprises 1,500 expert-annotated examples over 465 scientific papers. In this benchmark, models are tasked with interpreting schematic diagrams that illustrate research overviews and answering corresponding information-seeking questions based on the broader context of the paper. We assess the performance of 18 frontier multimodal foundation models, including o4-mini, Gemini-2.5-Flash, and Qwen2.5-VL. We reveal a significant performance gap between these models and human experts on MISS-QA. Our analysis of model performance on unanswerable questions and our detailed error analysis further highlight the strengths and limitations of current models, offering key insights to enhance models in comprehending multimodal scientific literature.

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

Most research on question answering focuses on the pre-deployment stage; i.e., building an accurate model for deployment. In this paper, we ask the question: Can we improve QA systems further post-deployment based on user interactions? We focus on two kinds of improvements: 1) improving the QA system's performance itself, and 2) providing the model with the ability to explain the correctness or incorrectness of an answer. We collect a retrieval-based QA dataset, FeedbackQA, which contains interactive feedback from users. We collect this dataset by deploying a base QA system to crowdworkers who then engage with the system and provide feedback on the quality of its answers. The feedback contains both structured ratings and unstructured natural language explanations. We train a neural model with this feedback data that can generate explanations and re-score answer candidates. We show that feedback data not only improves the accuracy of the deployed QA system but also other stronger non-deployed systems. The generated explanations also help users make informed decisions about the correctness of answers. Project page: https://mcgill-nlp.github.io/feedbackqa/

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.

Electronic Health Records (EHRs) contain rich yet complex information, and their automated analysis is critical for clinical decision-making. Despite recent advances of large language models (LLMs) in clinical workflows, their ability to analyze EHRs remains limited due to narrow task coverage and lack of EHR-oriented reasoning capabilities. This paper aims to bridge the gap, specifically, we present EHR-Ins, a large-scale, comprehensive EHR reasoning instruction dataset, comprising 300k high-quality reasoning cases and 4M non-reasoning cases across 42 distinct EHR tasks. Its core innovation is a thinking-graph-driven framework that enables to generate high-quality reasoning data at scale. Based on it, we develop EHR-R1, a series of reasoning-enhanced LLMs with up to 72B parameters tailored for EHR analysis. Through a multi-stage training paradigm, including domain adaptation, reasoning enhancement, and reinforcement learning, EHR-R1 systematically acquires domain knowledge and diverse reasoning capabilities, enabling accurate and robust EHR analysis. Lastly, we introduce EHR-Bench, a new benchmark curated from MIMIC-IV, spanning 42 tasks, to comprehensively assess reasoning and prediction across EHR scenarios. In experiments, we show that the resulting EHR-R1 consistently outperforms state-of-the-art commercial and open-source LLMs (including DeepSeek-V3 and GPT-4o), surpassing GPT-4o by over 30 points on MIMIC-Bench and achieving a 10\% higher zero-shot AUROC on EHRSHOT. Collectively, EHR-Ins, EHR-R1, and EHR-Bench have significantly advanced the development for more reliable and clinically relevant EHR analysis.

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.

Modern operating room is becoming increasingly complex, requiring innovative intra-operative support systems. While the focus of surgical data science has largely been on video analysis, integrating surgical computer vision with language capabilities is emerging as a necessity. Our work aims to advance Visual Question Answering (VQA) in the surgical context with scene graph knowledge, addressing two main challenges in the current surgical VQA systems: removing question-condition bias in the surgical VQA dataset and incorporating scene-aware reasoning in the surgical VQA model design. First, we propose a Surgical Scene Graph-based dataset, SSG-QA, generated by employing segmentation and detection models on publicly available datasets. We build surgical scene graphs using spatial and action information of instruments and anatomies. These graphs are fed into a question engine, generating diverse QA pairs. Our SSG-QA dataset provides a more complex, diverse, geometrically grounded, unbiased, and surgical action-oriented dataset compared to existing surgical VQA datasets. We then propose SSG-QA-Net, a novel surgical VQA model incorporating a lightweight Scene-embedded Interaction Module (SIM), which integrates geometric scene knowledge in the VQA model design by employing cross-attention between the textual and the scene features. Our comprehensive analysis of the SSG-QA dataset shows that SSG-QA-Net outperforms existing methods across different question types and complexities. We highlight that the primary limitation in the current surgical VQA systems is the lack of scene knowledge to answer complex queries. We present a novel surgical VQA dataset and model and show that results can be significantly improved by incorporating geometric scene features in the VQA model design. The source code and the dataset will be made publicly available at: https://github.com/CAMMA-public/SSG-QA

Large reasoning models have recently made significant strides in mathematical and code reasoning, yet their success has not transferred smoothly to the medical domain. While multiple factors contribute to this disparity, a critical issue is the inadequate focus on the quality of intermediate reflection steps, which is particularly crucial in high-stakes medical scenarios. To address this challenge, we propose Med-REFL, a \textbf{Med}ical \textbf{R}easoning \textbf{E}nhancement via self-corrected \textbf{F}ine-grained ref\textbf{L}ection. Our method leverages a tree-of-thought approach to decompose medical questions into fine-grained reasoning paths, quantitatively evaluating each step and its subsequent reflections. These assessments enable automatic construction of direct preference optimization data, reducing reliance on expensive expert annotations while guiding models to identify and correct reasoning errors. Experimental results on the MedQA-USMLE benchmark demonstrate Med-REFL achieves consistent improvements, with average gains up to 4.11\%. Notably, it further boosts the state-of-the-art performance of 7B/8B models by an additional 4.13\%. Furthermore, Med-REFL exhibits strong generalization capabilities and robustness across several challenging medical question-answering datasets. Our work illustrates that prioritizing reflection quality leads to more accurate and trustworthy reasoning in medical AI applications. Checkpoints, code, and data can be found https://github.com/TianYin123/Med-REFL{here}.

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

Question Answering on Electronic Health Records (EHR-QA) has a significant impact on the healthcare domain, and it is being actively studied. Previous research on structured EHR-QA focuses on converting natural language queries into query language such as SQL or SPARQL (NLQ2Query), so the problem scope is limited to pre-defined data types by the specific query language. In order to expand the EHR-QA task beyond this limitation to handle multi-modal medical data and solve complex inference in the future, more primitive systemic language is needed. In this paper, we design the program-based model (NLQ2Program) for EHR-QA as the first step towards the future direction. We tackle MIMICSPARQL*, the graph-based EHR-QA dataset, via a program-based approach in a semi-supervised manner in order to overcome the absence of gold programs. Without the gold program, our proposed model shows comparable performance to the previous state-of-the-art model, which is an NLQ2Query model (0.9% gain). In addition, for a reliable EHR-QA model, we apply the uncertainty decomposition method to measure the ambiguity in the input question. We empirically confirmed data uncertainty is most indicative of the ambiguity in the input question.

Building high-quality datasets for specialized tasks is a time-consuming and resource-intensive process that often requires specialized domain knowledge. We propose Corpus Retrieval and Augmentation for Fine-Tuning (CRAFT), a method for generating synthetic datasets, given a small number of user-written few-shots that demonstrate the task to be performed. Given the few-shot examples, we use large-scale public web-crawled corpora and similarity-based document retrieval to find other relevant human-written documents. Lastly, instruction-tuned large language models (LLMs) augment the retrieved documents into custom-formatted task samples, which then can be used for fine-tuning. We demonstrate that CRAFT can efficiently generate large-scale task-specific training datasets for four diverse tasks: biology question-answering (QA), medicine QA and commonsense QA as well as summarization. Our experiments show that CRAFT-based models outperform or achieve comparable performance to general LLMs for QA tasks, while CRAFT-based summarization models outperform models trained on human-curated data by 46 preference points.

Domain-specific QA systems require not just generative fluency but high factual accuracy grounded in structured expert knowledge. While recent Retrieval-Augmented Generation (RAG) frameworks improve context recall, they struggle with integrating heterogeneous data and maintaining reasoning consistency. To address these challenges, we propose DO-RAG, a scalable and customizable hybrid QA framework that integrates multi-level knowledge graph construction with semantic vector retrieval. Our system employs a novel agentic chain-of-thought architecture to extract structured relationships from unstructured, multimodal documents, constructing dynamic knowledge graphs that enhance retrieval precision. At query time, DO-RAG fuses graph and vector retrieval results to generate context-aware responses, followed by hallucination mitigation via grounded refinement. Experimental evaluations in the database and electrical domains show near-perfect recall and over 94% answer relevancy, with DO-RAG outperforming baseline frameworks by up to 33.38%. By combining traceability, adaptability, and performance efficiency, DO-RAG offers a reliable foundation for multi-domain, high-precision QA at scale.

Seeking dietary guidance often requires navigating complex professional knowledge while accommodating individual health conditions. Knowledge Graphs (KGs) offer structured and interpretable nutritional information, whereas Large Language Models (LLMs) naturally facilitate conversational recommendation delivery. In this paper, we present HealthGenie, an interactive system that combines the strengths of LLMs and KGs to provide personalized dietary recommendations along with hierarchical information visualization for a quick and intuitive overview. Upon receiving a user query, HealthGenie performs query refinement and retrieves relevant information from a pre-built KG. The system then visualizes and highlights pertinent information, organized by defined categories, while offering detailed, explainable recommendation rationales. Users can further tailor these recommendations by adjusting preferences interactively. Our evaluation, comprising a within-subject comparative experiment and an open-ended discussion, demonstrates that HealthGenie effectively supports users in obtaining personalized dietary guidance based on their health conditions while reducing interaction effort and cognitive load. These findings highlight the potential of LLM-KG integration in supporting decision-making through explainable and visualized information. We examine the system's usefulness and effectiveness with an N=12 within-subject study and provide design considerations for future systems that integrate conversational LLM and KG.

Clinical predictive models often rely on patients' electronic health records (EHR), but integrating medical knowledge to enhance predictions and decision-making is challenging. This is because personalized predictions require personalized knowledge graphs (KGs), which are difficult to generate from patient EHR data. To address this, we propose GraphCare, an open-world framework that uses external KGs to improve EHR-based predictions. Our method extracts knowledge from large language models (LLMs) and external biomedical KGs to build patient-specific KGs, which are then used to train our proposed Bi-attention AugmenTed (BAT) graph neural network (GNN) for healthcare predictions. On two public datasets, MIMIC-III and MIMIC-IV, GraphCare surpasses baselines in four vital healthcare prediction tasks: mortality, readmission, length of stay (LOS), and drug recommendation. On MIMIC-III, it boosts AUROC by 17.6\% and 6.6\% for mortality and readmission, and F1-score by 7.9\% and 10.8\% for LOS and drug recommendation, respectively. Notably, GraphCare demonstrates a substantial edge in scenarios with limited data availability. Our findings highlight the potential of using external KGs in healthcare prediction tasks and demonstrate the promise of GraphCare in generating personalized KGs for promoting personalized medicine.

Large language models (LLMs) adapted to follow user instructions are now widely deployed as conversational agents. In this work, we examine one increasingly common instruction-following task: providing writing assistance to compose a long-form answer. To evaluate the capabilities of current LLMs on this task, we construct KIWI, a dataset of knowledge-intensive writing instructions in the scientific domain. Given a research question, an initial model-generated answer and a set of relevant papers, an expert annotator iteratively issues instructions for the model to revise and improve its answer. We collect 1,260 interaction turns from 234 interaction sessions with three state-of-the-art LLMs. Each turn includes a user instruction, a model response, and a human evaluation of the model response. Through a detailed analysis of the collected responses, we find that all models struggle to incorporate new information into an existing answer, and to perform precise and unambiguous edits. Further, we find that models struggle to judge whether their outputs successfully followed user instructions, with accuracy at least 10 points short of human agreement. Our findings indicate that KIWI will be a valuable resource to measure progress and improve LLMs' instruction-following capabilities for knowledge intensive writing tasks.

The rapid evolution of Natural Language Processing (NLP) has favored major languages such as English, leaving a significant gap for many others due to limited resources. This is especially evident in the context of data annotation, a task whose importance cannot be underestimated, but which is time-consuming and costly. Thus, any dataset for resource-poor languages is precious, in particular when it is task-specific. Here, we explore the feasibility of repurposing existing datasets for a new NLP task: we repurposed the Belebele dataset (Bandarkar et al., 2023), which was designed for multiple-choice question answering (MCQA), to enable extractive QA (EQA) in the style of machine reading comprehension. We present annotation guidelines and a parallel EQA dataset for English and Modern Standard Arabic (MSA). We also present QA evaluation results for several monolingual and cross-lingual QA pairs including English, MSA, and five Arabic dialects. Our aim is to enable others to adapt our approach for the 120+ other language variants in Belebele, many of which are deemed under-resourced. We also conduct a thorough analysis and share our insights from the process, which we hope will contribute to a deeper understanding of the challenges and the opportunities associated with task reformulation in NLP research.

Readers of academic research papers often read with the goal of answering specific questions. Question Answering systems that can answer those questions can make consumption of the content much more efficient. However, building such tools requires data that reflect the difficulty of the task arising from complex reasoning about claims made in multiple parts of a paper. In contrast, existing information-seeking question answering datasets usually contain questions about generic factoid-type information. We therefore present QASPER, a dataset of 5,049 questions over 1,585 Natural Language Processing papers. Each question is written by an NLP practitioner who read only the title and abstract of the corresponding paper, and the question seeks information present in the full text. The questions are then answered by a separate set of NLP practitioners who also provide supporting evidence to answers. We find that existing models that do well on other QA tasks do not perform well on answering these questions, underperforming humans by at least 27 F1 points when answering them from entire papers, motivating further research in document-grounded, information-seeking QA, which our dataset is designed to facilitate.

The rapid expansion of medical literature presents growing challenges for structuring and integrating domain knowledge at scale. Knowledge Graphs (KGs) offer a promising solution by enabling efficient retrieval, automated reasoning, and knowledge discovery. However, current KG construction methods often rely on supervised pipelines with limited generalizability or naively aggregate outputs from Large Language Models (LLMs), treating biomedical corpora as static and ignoring the temporal dynamics and contextual uncertainty of evolving knowledge. To address these limitations, we introduce MedKGent, a LLM agent framework for constructing temporally evolving medical KGs. Leveraging over 10 million PubMed abstracts published between 1975 and 2023, we simulate the emergence of biomedical knowledge via a fine-grained daily time series. MedKGent incrementally builds the KG in a day-by-day manner using two specialized agents powered by the Qwen2.5-32B-Instruct model. The Extractor Agent identifies knowledge triples and assigns confidence scores via sampling-based estimation, which are used to filter low-confidence extractions and inform downstream processing. The Constructor Agent incrementally integrates the retained triples into a temporally evolving graph, guided by confidence scores and timestamps to reinforce recurring knowledge and resolve conflicts. The resulting KG contains 156,275 entities and 2,971,384 relational triples. Quality assessments by two SOTA LLMs and three domain experts demonstrate an accuracy approaching 90%, with strong inter-rater agreement. To evaluate downstream utility, we conduct RAG across seven medical question answering benchmarks using five leading LLMs, consistently observing significant improvements over non-augmented baselines. Case studies further demonstrate the KG's value in literature-based drug repurposing via confidence-aware causal inference.

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

Automatic medical text simplification can assist providers with patient-friendly communication and make medical texts more accessible, thereby improving health literacy. But curating a quality corpus for this task requires the supervision of medical experts. In this work, we present Med-EASi (textbf{Med}ical dataset for textbf{E}laborative and textbf{A}bstractive textbf{Si}mplification), a uniquely crowdsourced and finely annotated dataset for supervised simplification of short medical texts. Its expert-layman-AI collaborative annotations facilitate controllability over text simplification by marking four kinds of textual transformations: elaboration, replacement, deletion, and insertion. To learn medical text simplification, we fine-tune T5-large with four different styles of input-output combinations, leading to two control-free and two controllable versions of the model. We add two types of controllability into text simplification, by using a multi-angle training approach: position-aware, which uses in-place annotated inputs and outputs, and position-agnostic, where the model only knows the contents to be edited, but not their positions. Our results show that our fine-grained annotations improve learning compared to the unannotated baseline. Furthermore, position-aware control generates better simplification than the position-agnostic one. The data and code are available at https://github.com/Chandrayee/CTRL-SIMP.

Large Language Models (LLMs) have demonstrated considerable success in open-book question answering (QA), where the task requires generating answers grounded in a provided external context. A critical challenge in open-book QA is to ensure that model responses are based on the provided context rather than its parametric knowledge, which can be outdated, incomplete, or incorrect. Existing evaluation methods, primarily based on the LLM-as-a-judge approach, face significant limitations, including biases, scalability issues, and dependence on costly external systems. To address these challenges, we propose a novel metric that contrasts the perplexity of the model response under two conditions: when the context is provided and when it is not. The resulting score quantifies the extent to which the model's answer relies on the provided context. The validity of this metric is demonstrated through a series of experiments that show its effectiveness in identifying whether a given answer is grounded in the provided context. Unlike existing approaches, this metric is computationally efficient, interpretable, and adaptable to various use cases, offering a scalable and practical solution to assess context utilization in open-book QA systems.

Recent advances in large language models (LLMs) have demonstrated notable performance in medical licensing exams. However, comprehensive evaluation of LLMs across various healthcare roles, particularly in high-stakes clinical scenarios, remains a challenge. Existing benchmarks are typically text-based, English-centric, and focus primarily on medicines, which limits their ability to assess broader healthcare knowledge and multimodal reasoning. To address these gaps, we introduce KokushiMD-10, the first multimodal benchmark constructed from ten Japanese national healthcare licensing exams. This benchmark spans multiple fields, including Medicine, Dentistry, Nursing, Pharmacy, and allied health professions. It contains over 11588 real exam questions, incorporating clinical images and expert-annotated rationales to evaluate both textual and visual reasoning. We benchmark over 30 state-of-the-art LLMs, including GPT-4o, Claude 3.5, and Gemini, across both text and image-based settings. Despite promising results, no model consistently meets passing thresholds across domains, highlighting the ongoing challenges in medical AI. KokushiMD-10 provides a comprehensive and linguistically grounded resource for evaluating and advancing reasoning-centric medical AI across multilingual and multimodal clinical tasks.

Recent artificial intelligence (AI) systems have reached milestones in "grand challenges" ranging from Go to protein-folding. The capability to retrieve medical knowledge, reason over it, and answer medical questions comparably to physicians has long been viewed as one such grand challenge. Large language models (LLMs) have catalyzed significant progress in medical question answering; Med-PaLM was the first model to exceed a "passing" score in US Medical Licensing Examination (USMLE) style questions with a score of 67.2% on the MedQA dataset. However, this and other prior work suggested significant room for improvement, especially when models' answers were compared to clinicians' answers. Here we present Med-PaLM 2, which bridges these gaps by leveraging a combination of base LLM improvements (PaLM 2), medical domain finetuning, and prompting strategies including a novel ensemble refinement approach. Med-PaLM 2 scored up to 86.5% on the MedQA dataset, improving upon Med-PaLM by over 19% and setting a new state-of-the-art. We also observed performance approaching or exceeding state-of-the-art across MedMCQA, PubMedQA, and MMLU clinical topics datasets. We performed detailed human evaluations on long-form questions along multiple axes relevant to clinical applications. In pairwise comparative ranking of 1066 consumer medical questions, physicians preferred Med-PaLM 2 answers to those produced by physicians on eight of nine axes pertaining to clinical utility (p < 0.001). We also observed significant improvements compared to Med-PaLM on every evaluation axis (p < 0.001) on newly introduced datasets of 240 long-form "adversarial" questions to probe LLM limitations. While further studies are necessary to validate the efficacy of these models in real-world settings, these results highlight rapid progress towards physician-level performance in medical question answering.

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 paper, we release a largest ever medical Question Answering (QA) dataset with 26 million QA pairs. We benchmark many existing approaches in our dataset in terms of both retrieval and generation. Experimental results show that the existing models perform far lower than expected and the released dataset is still challenging in the pre-trained language model era. Moreover, we also experimentally show the benefit of the proposed dataset in many aspects: (i) trained models for other QA datasets in a zero-shot fashion; and (ii) as external knowledge for retrieval-augmented generation (RAG); and (iii) improving existing pre-trained language models by using the QA pairs as a pre-training corpus in continued training manner. We believe that this dataset will not only contribute to medical research but also facilitate both the patients and clinical doctors. See https://github.com/FreedomIntelligence/Huatuo-26M.

The integration of Computer-Assisted Diagnosis (CAD) with Large Language Models (LLMs) holds great potential in clinical applications, specifically in the roles of virtual family doctors and clinic assistants. However, current works in this field are plagued by limitations, specifically a restricted scope of applicable image domains and the provision of unreliable medical advice. This restricts their overall processing capabilities. Furthermore, the mismatch in writing style between LLMs and radiologists undermines their practical usefulness. To tackle these challenges, we introduce ChatCAD+, which is designed to be universal and reliable. It is capable of handling medical images from diverse domains and leveraging up-to-date information from reputable medical websites to provide reliable medical advice. Additionally, it incorporates a template retrieval system that improves report generation performance via exemplar reports. This approach ensures greater consistency with the expertise of human professionals. The source code is available at https://github.com/zhaozh10/ChatCAD.

We present PeerQA, a real-world, scientific, document-level Question Answering (QA) dataset. PeerQA questions have been sourced from peer reviews, which contain questions that reviewers raised while thoroughly examining the scientific article. Answers have been annotated by the original authors of each paper. The dataset contains 579 QA pairs from 208 academic articles, with a majority from ML and NLP, as well as a subset of other scientific communities like Geoscience and Public Health. PeerQA supports three critical tasks for developing practical QA systems: Evidence retrieval, unanswerable question classification, and answer generation. We provide a detailed analysis of the collected dataset and conduct experiments establishing baseline systems for all three tasks. Our experiments and analyses reveal the need for decontextualization in document-level retrieval, where we find that even simple decontextualization approaches consistently improve retrieval performance across architectures. On answer generation, PeerQA serves as a challenging benchmark for long-context modeling, as the papers have an average size of 12k tokens. Our code and data is available at https://github.com/UKPLab/peerqa.

Keeping track of scientific challenges, advances and emerging directions is a fundamental part of research. However, researchers face a flood of papers that hinders discovery of important knowledge. In biomedicine, this directly impacts human lives. To address this problem, we present a novel task of extraction and search of scientific challenges and directions, to facilitate rapid knowledge discovery. We construct and release an expert-annotated corpus of texts sampled from full-length papers, labeled with novel semantic categories that generalize across many types of challenges and directions. We focus on a large corpus of interdisciplinary work relating to the COVID-19 pandemic, ranging from biomedicine to areas such as AI and economics. We apply a model trained on our data to identify challenges and directions across the corpus and build a dedicated search engine. In experiments with 19 researchers and clinicians using our system, we outperform a popular scientific search engine in assisting knowledge discovery. Finally, we show that models trained on our resource generalize to the wider biomedical domain and to AI papers, highlighting its broad utility. We make our data, model and search engine publicly available. https://challenges.apps.allenai.org/

Textual health records of cancer patients are usually protracted and highly unstructured, making it very time-consuming for health professionals to get a complete overview of the patient's therapeutic course. As such limitations can lead to suboptimal and/or inefficient treatment procedures, healthcare providers would greatly benefit from a system that effectively summarizes the information of those records. With the advent of deep neural models, this objective has been partially attained for English clinical texts, however, the research community still lacks an effective solution for languages with limited resources. In this paper, we present the approach we developed to extract procedures, drugs, and diseases from oncology health records written in European Portuguese. This project was conducted in collaboration with the Portuguese Institute for Oncology which, besides holding over 10 years of duly protected medical records, also provided oncologist expertise throughout the development of the project. Since there is no annotated corpus for biomedical entity extraction in Portuguese, we also present the strategy we followed in annotating the corpus for the development of the models. The final models, which combined a neural architecture with entity linking, achieved F_1 scores of 88.6, 95.0, and 55.8 per cent in the mention extraction of procedures, drugs, and diseases, respectively.

Recent large language models often answer factual questions correctly. But users can't trust any given claim a model makes without fact-checking, because language models can hallucinate convincing nonsense. In this work we use reinforcement learning from human preferences (RLHP) to train "open-book" QA models that generate answers whilst also citing specific evidence for their claims, which aids in the appraisal of correctness. Supporting evidence is drawn from multiple documents found via a search engine, or from a single user-provided document. Our 280 billion parameter model, GopherCite, is able to produce answers with high quality supporting evidence and abstain from answering when unsure. We measure the performance of GopherCite by conducting human evaluation of answers to questions in a subset of the NaturalQuestions and ELI5 datasets. The model's response is found to be high-quality 80\% of the time on this Natural Questions subset, and 67\% of the time on the ELI5 subset. Abstaining from the third of questions for which it is most unsure improves performance to 90\% and 80\% respectively, approaching human baselines. However, analysis on the adversarial TruthfulQA dataset shows why citation is only one part of an overall strategy for safety and trustworthiness: not all claims supported by evidence are true.

The goal of this work is to build conversational Question Answering (QA) interfaces for the large body of domain-specific information available in FAQ sites. We present DoQA, a dataset with 2,437 dialogues and 10,917 QA pairs. The dialogues are collected from three Stack Exchange sites using the Wizard of Oz method with crowdsourcing. Compared to previous work, DoQA comprises well-defined information needs, leading to more coherent and natural conversations with less factoid questions and is multi-domain. In addition, we introduce a more realistic information retrieval(IR) scenario where the system needs to find the answer in any of the FAQ documents. The results of an existing, strong, system show that, thanks to transfer learning from a Wikipedia QA dataset and fine tuning on a single FAQ domain, it is possible to build high quality conversational QA systems for FAQs without in-domain training data. The good results carry over into the more challenging IR scenario. In both cases, there is still ample room for improvement, as indicated by the higher human upperbound.

Improving performance on complex tasks and enabling interpretable decision making in large language models (LLMs), especially for clinical applications, requires effective reasoning. Yet this remains challenging without supervised fine-tuning (SFT) on costly chain-of-thought (CoT) data distilled from closed-source models (e.g., GPT-4o). In this work, we present AlphaMed, the first medical LLM to show that reasoning capability can emerge purely through reinforcement learning (RL), using minimalist rule-based rewards on public multiple-choice QA datasets, without relying on SFT or distilled CoT data. AlphaMed achieves state-of-the-art results on six medical QA benchmarks, outperforming models trained with conventional SFT+RL pipelines. On challenging benchmarks (e.g., MedXpert), AlphaMed even surpasses larger or closed-source models such as DeepSeek-V3-671B and Claude-3.5-Sonnet. To understand the factors behind this success, we conduct a comprehensive data-centric analysis guided by three questions: (i) Can minimalist rule-based RL incentivize reasoning without distilled CoT supervision? (ii) How do dataset quantity and diversity impact reasoning? (iii) How does question difficulty shape the emergence and generalization of reasoning? Our findings show that dataset informativeness is a key driver of reasoning performance, and that minimalist RL on informative, multiple-choice QA data is effective at inducing reasoning without CoT supervision. We also observe divergent trends across benchmarks, underscoring limitations in current evaluation and the need for more challenging, reasoning-oriented medical QA benchmarks.

Despite recent advances in large language models (LLMs), most QA benchmarks are still confined to single-paragraph or single-document settings, failing to capture the complexity of real-world information-seeking tasks. Practical QA often requires multi-hop reasoning over information distributed across multiple documents, modalities, and structural formats. Although prior datasets made progress in this area, they rely heavily on Wikipedia-based content and unimodal plain text, with shallow reasoning paths that typically produce brief phrase-level or single-sentence answers, thus limiting their realism and generalizability. We propose DocHop-QA, a large-scale benchmark comprising 11,379 QA instances for multimodal, multi-document, multi-hop question answering. Constructed from publicly available scientific documents sourced from PubMed, DocHop-QA is domain-agnostic and incorporates diverse information formats, including textual passages, tables, and structural layout cues. Unlike existing datasets, DocHop-QA does not rely on explicitly hyperlinked documents; instead, it supports open-ended reasoning through semantic similarity and layout-aware evidence synthesis. To scale realistic QA construction, we designed an LLM-driven pipeline grounded in 11 high-frequency scientific question concepts. We evaluated DocHop-QA through four tasks spanning structured index prediction, generative answering, and multimodal integration, reflecting both discriminative and generative paradigms. These tasks demonstrate DocHop-QA's capacity to support complex, multimodal reasoning across multiple documents.

Retriever-augmented instruction-following models are attractive alternatives to fine-tuned approaches for information-seeking tasks such as question answering (QA). By simply prepending retrieved documents in its input along with an instruction, these models can be adapted to various information domains and tasks without additional fine-tuning. While the model responses tend to be natural and fluent, the additional verbosity makes traditional QA evaluation metrics such as exact match (EM) and F1 unreliable for accurately quantifying model performance. In this work, we investigate the performance of instruction-following models across three information-seeking QA tasks. We use both automatic and human evaluation to evaluate these models along two dimensions: 1) how well they satisfy the user's information need (correctness), and 2) whether they produce a response based on the provided knowledge (faithfulness). Guided by human evaluation and analysis, we highlight the shortcomings of traditional metrics for both correctness and faithfulness. We then propose simple token-overlap based and model-based metrics that reflect the true performance of these models. Our analysis reveals that instruction-following models are competitive, and sometimes even outperform fine-tuned models for correctness. However, these models struggle to stick to the provided knowledge and often hallucinate in their responses. We hope our work encourages a more holistic evaluation of instruction-following models for QA. Our code and data is available at https://github.com/McGill-NLP/instruct-qa

The widespread consumer-grade 3D printers and learning resources online enable novices to self-train in remote settings. While troubleshooting plays an essential part of 3D printing, the process remains challenging for many remote novices even with the help of well-developed online sources, such as online troubleshooting archives and online community help. We conducted a formative study with 76 active 3D printing users to learn how remote novices leverage online resources in troubleshooting and their challenges. We found that remote novices cannot fully utilize online resources. For example, the online archives statically provide general information, making it hard to search and relate their unique cases with existing descriptions. Online communities can potentially ease their struggles by providing more targeted suggestions, but a helper who can provide custom help is rather scarce, making it hard to obtain timely assistance. We propose 3DPFIX, an interactive 3D troubleshooting system powered by the pipeline to facilitate Human-AI Collaboration, designed to improve novices' 3D printing experiences and thus help them easily accumulate their domain knowledge. We built 3DPFIX that supports automated diagnosis and solution-seeking. 3DPFIX was built upon shared dialogues about failure cases from Q&A discourses accumulated in online communities. We leverage social annotations (i.e., comments) to build an annotated failure image dataset for AI classifiers and extract a solution pool. Our summative study revealed that using 3DPFIX helped participants spend significantly less effort in diagnosing failures and finding a more accurate solution than relying on their common practice. We also found that 3DPFIX users learn about 3D printing domain-specific knowledge. We discuss the implications of leveraging community-driven data in developing future Human-AI Collaboration designs.

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.

Many computer scientists use the aggregated answers of online workers to represent ground truth. Prior work has shown that aggregation methods such as majority voting are effective for measuring relatively objective features. For subjective features such as semantic connotation, online workers, known for optimizing their hourly earnings, tend to deteriorate in the quality of their responses as they work longer. In this paper, we aim to address this issue by proposing a quality-aware semantic data annotation system. We observe that with timely feedback on workers' performance quantified by quality scores, better informed online workers can maintain the quality of their labeling throughout an extended period of time. We validate the effectiveness of the proposed annotation system through i) evaluating performance based on an expert-labeled dataset, and ii) demonstrating machine learning tasks that can lead to consistent learning behavior with 70%-80% accuracy. Our results suggest that with our system, researchers can collect high-quality answers of subjective semantic features at a large scale.

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.

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

Large language models (LLMs) have shown remarkable progress in encoding clinical knowledge and responding to complex medical queries with appropriate clinical reasoning. However, their applicability in subspecialist or complex medical settings remains underexplored. In this work, we probe the performance of AMIE, a research conversational diagnostic AI system, in the subspecialist domain of breast oncology care without specific fine-tuning to this challenging domain. To perform this evaluation, we curated a set of 50 synthetic breast cancer vignettes representing a range of treatment-naive and treatment-refractory cases and mirroring the key information available to a multidisciplinary tumor board for decision-making (openly released with this work). We developed a detailed clinical rubric for evaluating management plans, including axes such as the quality of case summarization, safety of the proposed care plan, and recommendations for chemotherapy, radiotherapy, surgery and hormonal therapy. To improve performance, we enhanced AMIE with the inference-time ability to perform web search retrieval to gather relevant and up-to-date clinical knowledge and refine its responses with a multi-stage self-critique pipeline. We compare response quality of AMIE with internal medicine trainees, oncology fellows, and general oncology attendings under both automated and specialist clinician evaluations. In our evaluations, AMIE outperformed trainees and fellows demonstrating the potential of the system in this challenging and important domain. We further demonstrate through qualitative examples, how systems such as AMIE might facilitate conversational interactions to assist clinicians in their decision making. However, AMIE's performance was overall inferior to attending oncologists suggesting that further research is needed prior to consideration of prospective uses.

Limited access to mental healthcare, extended wait times, and increasing capabilities of Large Language Models (LLMs) has led individuals to turn to LLMs for fulfilling their mental health needs. However, examining the multi-turn mental health conversation capabilities of LLMs remains under-explored. Existing evaluation frameworks typically focus on diagnostic accuracy and win-rates and often overlook alignment with patient-specific goals, values, and personalities required for meaningful conversations. To address this, we introduce MedAgent, a novel framework for synthetically generating realistic, multi-turn mental health sensemaking conversations and use it to create the Mental Health Sensemaking Dialogue (MHSD) dataset, comprising over 2,200 patient-LLM conversations. Additionally, we present MultiSenseEval, a holistic framework to evaluate the multi-turn conversation abilities of LLMs in healthcare settings using human-centric criteria. Our findings reveal that frontier reasoning models yield below-par performance for patient-centric communication and struggle at advanced diagnostic capabilities with average score of 31%. Additionally, we observed variation in model performance based on patient's persona and performance drop with increasing turns in the conversation. Our work provides a comprehensive synthetic data generation framework, a dataset and evaluation framework for assessing LLMs in multi-turn mental health conversations.

Accurate and interpretable multi-disease diagnosis remains a critical challenge in medical research, particularly when leveraging heterogeneous multimodal medical data. Current approaches often rely on single-modal data, limiting their ability to comprehensively understand complex diseases. To address this, we propose MedTVT-R1, a novel Multimodal Large Language Model (MLLM) framework designed to integrate clinical multimodal data for reasoning and diagnosing multiple diseases. We construct MedTVT-QA, a curated instruction dataset that provides question-answer pairs for physiological-level interpretations and disease-level diagnoses with a Chain of Evidence approach. MedTVT-R1 incorporates a modality perception layer to capture inter-modal dependencies and adaptively weight modality contributions. Additionally, we employ Group Relative Policy Optimization (GRPO)-based Reinforcement Fine-Tuning with a Jaccard Reward function to enhance diagnostic reasoning. Experimental results demonstrate MedTVT-R1's superiority in multimodal feature utilization and multi-disease diagnosis, offering significant potential for clinical applications such as diagnostic report generation and comorbidity reasoning. The dataset and code are available at https://github.com/keke-nice/MedTVT-R1.

The accelerating development of general medical artificial intelligence (GMAI), powered by multimodal large language models (MLLMs), offers transformative potential for addressing persistent healthcare challenges, including workforce deficits and escalating costs. The parallel development of systematic evaluation benchmarks emerges as a critical imperative to enable performance assessment and provide technological guidance. Meanwhile, as an invaluable knowledge source, the potential of medical textbooks for benchmark development remains underexploited. Here, we present MedBookVQA, a systematic and comprehensive multimodal benchmark derived from open-access medical textbooks. To curate this benchmark, we propose a standardized pipeline for automated extraction of medical figures while contextually aligning them with corresponding medical narratives. Based on this curated data, we generate 5,000 clinically relevant questions spanning modality recognition, disease classification, anatomical identification, symptom diagnosis, and surgical procedures. A multi-tier annotation system categorizes queries through hierarchical taxonomies encompassing medical imaging modalities (42 categories), body anatomies (125 structures), and clinical specialties (31 departments), enabling nuanced analysis across medical subdomains. We evaluate a wide array of MLLMs, including proprietary, open-sourced, medical, and reasoning models, revealing significant performance disparities across task types and model categories. Our findings highlight critical capability gaps in current GMAI systems while establishing textbook-derived multimodal benchmarks as essential evaluation tools. MedBookVQA establishes textbook-derived benchmarking as a critical paradigm for advancing clinical AI, exposing limitations in GMAI systems while providing anatomically structured performance metrics across specialties.

Users of social platforms often perceive these sites as supportive spaces to post about their mental health issues. Those conversations contain important traces about individuals' health risks. Recently, researchers have exploited this online information to construct mental health detection models, which aim to identify users at risk on platforms like Twitter, Reddit or Facebook. Most of these models are centred on achieving good classification results, ignoring the explainability and interpretability of the decisions. Recent research has pointed out the importance of using clinical markers, such as the use of symptoms, to improve trust in the computational models by health professionals. In this paper, we propose using transformer-based architectures to detect and explain the appearance of depressive symptom markers in the users' writings. We present two approaches: i) train a model to classify, and another one to explain the classifier's decision separately and ii) unify the two tasks simultaneously using a single model. Additionally, for this latter manner, we also investigated the performance of recent conversational LLMs when using in-context learning. Our natural language explanations enable clinicians to interpret the models' decisions based on validated symptoms, enhancing trust in the automated process. We evaluate our approach using recent symptom-based datasets, employing both offline and expert-in-the-loop metrics to assess the quality of the explanations generated by our models. The experimental results show that it is possible to achieve good classification results while generating interpretable symptom-based explanations.

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 reasoning models (LRMs) have shown significant progress in test-time scaling through chain-of-thought prompting. Current approaches like search-o1 integrate retrieval augmented generation (RAG) into multi-step reasoning processes but rely on a single, linear reasoning chain while incorporating unstructured textual information in a flat, context-agnostic manner. As a result, these approaches can lead to error accumulation throughout the reasoning chain, which significantly limits its effectiveness in medical question-answering (QA) tasks where both accuracy and traceability are critical requirements. To address these challenges, we propose MIRAGE (Multi-chain Inference with Retrieval-Augmented Graph Exploration), a novel test-time scalable reasoning framework that performs dynamic multi-chain inference over structured medical knowledge graphs. Specifically, MIRAGE 1) decomposes complex queries into entity-grounded sub-questions, 2) executes parallel inference chains, 3) retrieves evidence adaptively via neighbor expansion and multi-hop traversal, and 4) integrates answers using cross-chain verification to resolve contradictions. Experiments on three medical QA benchmarks (GenMedGPT-5k, CMCQA, and ExplainCPE) show that MIRAGE consistently outperforms GPT-4o, Tree-of-Thought variants, and other retrieval-augmented baselines in both automatic and human evaluations. Additionally, MIRAGE improves interpretability by generating explicit reasoning chains that trace each factual claim to concrete chains within the knowledge graph, making it well-suited for complex medical reasoning scenarios. The code will be available for further research.

Large language models (LLMs) such as GPT-4o and o1 have demonstrated strong performance on clinical natural language processing (NLP) tasks across multiple medical benchmarks. Nonetheless, two high-impact NLP tasks - structured tabular reporting from nurse dictations and medical order extraction from doctor-patient consultations - remain underexplored due to data scarcity and sensitivity, despite active industry efforts. Practical solutions to these real-world clinical tasks can significantly reduce the documentation burden on healthcare providers, allowing greater focus on patient care. In this paper, we investigate these two challenging tasks using private and open-source clinical datasets, evaluating the performance of both open- and closed-weight LLMs, and analyzing their respective strengths and limitations. Furthermore, we propose an agentic pipeline for generating realistic, non-sensitive nurse dictations, enabling structured extraction of clinical observations. To support further research in both areas, we release SYNUR and SIMORD, the first open-source datasets for nurse observation extraction and medical order extraction.

One of the most challenging problems facing NLP today is evaluation. Some of the most pressing issues pertain to benchmark saturation, data contamination, and diversity in the quality of test examples. To address these concerns, we propose Selection Methodology for Accurate, Reduced, and Targeted (SMART) filtering, a novel approach to select a high-quality subset of examples from existing benchmark datasets by systematically removing less informative and less challenging examples. Our approach applies three filtering criteria, removing (i) easy examples, (ii) data-contaminated examples, and (iii) examples that are similar to each other based on distance in an embedding space. We demonstrate the effectiveness of SMART on three multiple choice QA datasets, where our methodology increases efficiency by reducing dataset size by 48\% on average, while increasing Pearson correlation with rankings from ChatBot Arena, a more open-ended human evaluation setting. Our method enables us to be more efficient, whether using SMART to make new benchmarks more challenging or to revitalize older datasets, while still preserving the relative model rankings.

Recent immense breakthroughs in generative models such as in GPT4 have precipitated re-imagined ubiquitous usage of these models in all applications. One area that can benefit by improvements in artificial intelligence (AI) is healthcare. The note generation task from doctor-patient encounters, and its associated electronic medical record documentation, is one of the most arduous time-consuming tasks for physicians. It is also a natural prime potential beneficiary to advances in generative models. However with such advances, benchmarking is more critical than ever. Whether studying model weaknesses or developing new evaluation metrics, shared open datasets are an imperative part of understanding the current state-of-the-art. Unfortunately as clinic encounter conversations are not routinely recorded and are difficult to ethically share due to patient confidentiality, there are no sufficiently large clinic dialogue-note datasets to benchmark this task. Here we present the Ambient Clinical Intelligence Benchmark (ACI-BENCH) corpus, the largest dataset to date tackling the problem of AI-assisted note generation from visit dialogue. We also present the benchmark performances of several common state-of-the-art approaches.

Large language models (LLMs), particularly those with reasoning capabilities, have rapidly advanced in recent years, demonstrating significant potential across a wide range of applications. However, their deployment in healthcare, especially in disease reasoning tasks, is hindered by the challenge of acquiring expert-level cognitive data. In this paper, we introduce Citrus, a medical language model that bridges the gap between clinical expertise and AI reasoning by emulating the cognitive processes of medical experts. The model is trained on a large corpus of simulated expert disease reasoning data, synthesized using a novel approach that accurately captures the decision-making pathways of clinicians. This approach enables Citrus to better simulate the complex reasoning processes involved in diagnosing and treating medical conditions.To further address the lack of publicly available datasets for medical reasoning tasks, we release the last-stage training data, including a custom-built medical diagnostic dialogue dataset. This open-source contribution aims to support further research and development in the field. Evaluations using authoritative benchmarks such as MedQA, covering tasks in medical reasoning and language understanding, show that Citrus achieves superior performance compared to other models of similar size. These results highlight Citrus potential to significantly enhance medical decision support systems, providing a more accurate and efficient tool for clinical decision-making.

People increasingly search online for answers to their medical questions but the rate at which medical questions are asked online significantly exceeds the capacity of qualified people to answer them. This leaves many questions unanswered or inadequately answered. Many of these questions are not unique, and reliable identification of similar questions would enable more efficient and effective question answering schema. COVID-19 has only exacerbated this problem. Almost every government agency and healthcare organization has tried to meet the informational need of users by building online FAQs, but there is no way for people to ask their question and know if it is answered on one of these pages. While many research efforts have focused on the problem of general question similarity, these approaches do not generalize well to domains that require expert knowledge to determine semantic similarity, such as the medical domain. In this paper, we show how a double fine-tuning approach of pretraining a neural network on medical question-answer pairs followed by fine-tuning on medical question-question pairs is a particularly useful intermediate task for the ultimate goal of determining medical question similarity. While other pretraining tasks yield an accuracy below 78.7% on this task, our model achieves an accuracy of 82.6% with the same number of training examples, an accuracy of 80.0% with a much smaller training set, and an accuracy of 84.5% when the full corpus of medical question-answer data is used. We also describe a currently live system that uses the trained model to match user questions to COVID-related FAQs.

This paper investigates the capabilities of Large Language Models (LLMs) in the context of understanding their own knowledge and measuring their uncertainty. We argue this is an important feature for mitigating hallucinations. Specifically, we focus on addressing known-unknown questions, characterized by high uncertainty due to the absence of definitive answers. To facilitate our study, we collect a dataset with new Known-Unknown Questions (KUQ) and propose a novel categorization scheme to elucidate the sources of uncertainty. Subsequently, we assess the LLMs' ability to differentiate between known and unknown questions and classify them accordingly. Moreover, we evaluate the quality of their answers in an Open-Ended QA setting. To quantify the uncertainty expressed in the answers, we create a semantic evaluation method that measures the model's accuracy in expressing uncertainty between known vs unknown questions.

Large Language Models (LLMs), although powerful in general domains, often perform poorly on domain-specific tasks like medical question answering (QA). Moreover, they tend to function as "black-boxes," making it challenging to modify their behavior. Addressing this, our study delves into model editing utilizing in-context learning, aiming to improve LLM responses without the need for fine-tuning or retraining. Specifically, we propose a comprehensive retrieval strategy to extract medical facts from an external knowledge base, and then we incorporate them into the query prompt for the LLM. Focusing on medical QA using the MedQA-SMILE dataset, we evaluate the impact of different retrieval models and the number of facts provided to the LLM. Notably, our edited Vicuna model exhibited an accuracy improvement from 44.46% to 48.54%. This work underscores the potential of model editing to enhance LLM performance, offering a practical approach to mitigate the challenges of black-box LLMs.

AI-driven medical history-taking is an important component in symptom checking, automated patient intake, triage, and other AI virtual care applications. As history-taking is extremely varied, machine learning models require a significant amount of data to train. To overcome this challenge, existing systems are developed using indirect data or expert knowledge. This leads to a training-inference gap as models are trained on different kinds of data than what they observe at inference time. In this work, we present a two-stage re-ranking approach that helps close the training-inference gap by re-ranking the first-stage question candidates using a dialogue-contextualized model. For this, we propose a new model, global re-ranker, which cross-encodes the dialogue with all questions simultaneously, and compare it with several existing neural baselines. We test both transformer and S4-based language model backbones. We find that relative to the expert system, the best performance is achieved by our proposed global re-ranker with a transformer backbone, resulting in a 30% higher normalized discount cumulative gain (nDCG) and a 77% higher mean average precision (mAP).

We introduce GODEL (Grounded Open Dialogue Language Model), a large pre-trained language model for dialog. In contrast with earlier models such as DialoGPT, GODEL leverages a new phase of grounded pre-training designed to better support adapting GODEL to a wide range of downstream dialog tasks that require information external to the current conversation (e.g., a database or document) to produce good responses. Experiments against an array of benchmarks that encompass task-oriented dialog, conversational QA, and grounded open-domain dialog show that GODEL outperforms state-of-the-art pre-trained dialog models in few-shot fine-tuning setups, in terms of both human and automatic evaluation. A novel feature of our evaluation methodology is the introduction of a notion of utility that assesses the usefulness of responses (extrinsic evaluation) in addition to their communicative features (intrinsic evaluation). We show that extrinsic evaluation offers improved inter-annotator agreement and correlation with automated metrics. Code and data processing scripts are publicly available.

We present DocPuzzle, a rigorously constructed benchmark for evaluating long-context reasoning capabilities in large language models (LLMs). This benchmark comprises 100 expert-level QA problems requiring multi-step reasoning over long real-world documents. To ensure the task quality and complexity, we implement a human-AI collaborative annotation-validation pipeline. DocPuzzle introduces an innovative evaluation framework that mitigates guessing bias through checklist-guided process analysis, establishing new standards for assessing reasoning capacities in LLMs. Our evaluation results show that: 1)Advanced slow-thinking reasoning models like o1-preview(69.7%) and DeepSeek-R1(66.3%) significantly outperform best general instruct models like Claude 3.5 Sonnet(57.7%); 2)Distilled reasoning models like DeepSeek-R1-Distill-Qwen-32B(41.3%) falls far behind the teacher model, suggesting challenges to maintain the generalization of reasoning capabilities relying solely on distillation.

Large language models (LLMs) have demonstrated impressive generative capabilities with the potential to innovate in medicine. However, the application of LLMs in real clinical settings remains challenging due to the lack of factual consistency in the generated content. In this work, we develop an augmented LLM framework, KG-Rank, which leverages a medical knowledge graph (KG) along with ranking and re-ranking techniques, to improve the factuality of long-form question answering (QA) in the medical domain. Specifically, when receiving a question, KG-Rank automatically identifies medical entities within the question and retrieves the related triples from the medical KG to gather factual information. Subsequently, KG-Rank innovatively applies multiple ranking techniques to refine the ordering of these triples, providing more relevant and precise information for LLM inference. To the best of our knowledge, KG-Rank is the first application of KG combined with ranking models in medical QA specifically for generating long answers. Evaluation on four selected medical QA datasets demonstrates that KG-Rank achieves an improvement of over 18% in ROUGE-L score. Additionally, we extend KG-Rank to open domains, including law, business, music, and history, where it realizes a 14% improvement in ROUGE-L score, indicating the effectiveness and great potential of KG-Rank.

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.

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

Dialogue assessment plays a critical role in the development of open-domain dialogue systems. Existing work are uncapable of providing an end-to-end and human-epistemic assessment dataset, while they only provide sub-metrics like coherence or the dialogues are conversed between annotators far from real user settings. In this paper, we release a large-scale dialogue quality assessment dataset (DiQAD), for automatically assessing open-domain dialogue quality. Specifically, we (1) establish the assessment criteria based on the dimensions conforming to human judgements on dialogue qualities, and (2) annotate large-scale dialogues that conversed between real users based on these annotation criteria, which contains around 100,000 dialogues. We conduct several experiments and report the performances of the baselines as the benchmark on DiQAD. The dataset is openly accessible at https://github.com/yukunZhao/Dataset_Dialogue_quality_evaluation.

Integrating Large Language Models (LLMs) with Knowledge Graphs (KGs) results in complex systems with numerous hyperparameters that directly affect performance. While such systems are increasingly common in retrieval-augmented generation, the role of systematic hyperparameter optimization remains underexplored. In this paper, we study this problem in the context of Cognee, a modular framework for end-to-end KG construction and retrieval. Using three multi-hop QA benchmarks (HotPotQA, TwoWikiMultiHop, and MuSiQue) we optimize parameters related to chunking, graph construction, retrieval, and prompting. Each configuration is scored using established metrics (exact match, F1, and DeepEval's LLM-based correctness metric). Our results demonstrate that meaningful gains can be achieved through targeted tuning. While the gains are consistent, they are not uniform, with performance varying across datasets and metrics. This variability highlights both the value of tuning and the limitations of standard evaluation measures. While demonstrating the immediate potential of hyperparameter tuning, we argue that future progress will depend not only on architectural advances but also on clearer frameworks for optimization and evaluation in complex, modular systems.

We introduce KorMedMCQA, the first Korean multiple-choice question answering (MCQA) benchmark derived from Korean healthcare professional licensing examinations, covering from the year 2012 to year 2023. This dataset consists of a selection of questions from the license examinations for doctors, nurses, and pharmacists, featuring a diverse array of subjects. We conduct baseline experiments on various large language models, including proprietary/open-source, multilingual/Korean-additional pretrained, and clinical context pretrained models, highlighting the potential for further enhancements. We make our data publicly available on HuggingFace and provide a evaluation script via LM-Harness, inviting further exploration and advancement in Korean healthcare environments.

Recent advances in NLP and information retrieval have given rise to a diverse set of question answering tasks that are of different formats (e.g., extractive, abstractive), require different model architectures (e.g., generative, discriminative), and setups (e.g., with or without retrieval). Despite having a large number of powerful, specialized QA pipelines (which we refer to as Skills) that consider a single domain, model or setup, there exists no framework where users can easily explore and compare such pipelines and can extend them according to their needs. To address this issue, we present UKP-SQUARE, an extensible online QA platform for researchers which allows users to query and analyze a large collection of modern Skills via a user-friendly web interface and integrated behavioural tests. In addition, QA researchers can develop, manage, and share their custom Skills using our microservices that support a wide range of models (Transformers, Adapters, ONNX), datastores and retrieval techniques (e.g., sparse and dense). UKP-SQUARE is available on https://square.ukp-lab.de.

Researchers have long recognized the socio-technical gaps in personal tracking research, where machines can never fully model the complexity of human behavior, making it only able to produce basic rule-based outputs or "black-box" results that lack clear explanations. Real-world deployments rely on experts for this complex translation from sparse data to meaningful insights. In this study, we consider this translation process from data to insights by experts as "sensemaking" and explore how HCI researchers can support it through Vital Insight, an evidence-based 'sensemaking' system that combines direct representation and indirect inference through visualization and Large Language Models. We evaluate Vital Insight in user testing sessions with 14 experts in multi-modal tracking, synthesize design implications, and develop an expert sensemaking model where they iteratively move between direct data representations and AI-supported inferences to explore, retrieve, question, and validate insights.

This paper describes the KnowledgeHub tool, a scientific literature Information Extraction (IE) and Question Answering (QA) pipeline. This is achieved by supporting the ingestion of PDF documents that are converted to text and structured representations. An ontology can then be constructed where a user defines the types of entities and relationships they want to capture. A browser-based annotation tool enables annotating the contents of the PDF documents according to the ontology. Named Entity Recognition (NER) and Relation Classification (RC) models can be trained on the resulting annotations and can be used to annotate the unannotated portion of the documents. A knowledge graph is constructed from these entity and relation triples which can be queried to obtain insights from the data. Furthermore, we integrate a suite of Large Language Models (LLMs) that can be used for QA and summarisation that is grounded in the included documents via a retrieval component. KnowledgeHub is a unique tool that supports annotation, IE and QA, which gives the user full insight into the knowledge discovery pipeline.

In this work, we present a manually annotated corpus for Adverse Event (AE) extraction from discharge summaries of elderly patients, a population often underrepresented in clinical NLP resources. The dataset includes 14 clinically significant AEs-such as falls, delirium, and intracranial haemorrhage, along with contextual attributes like negation, diagnosis type, and in-hospital occurrence. Uniquely, the annotation schema supports both discontinuous and overlapping entities, addressing challenges rarely tackled in prior work. We evaluate multiple models using FlairNLP across three annotation granularities: fine-grained, coarse-grained, and coarse-grained with negation. While transformer-based models (e.g., BERT-cased) achieve strong performance on document-level coarse-grained extraction (F1 = 0.943), performance drops notably for fine-grained entity-level tasks (e.g., F1 = 0.675), particularly for rare events and complex attributes. These results demonstrate that despite high-level scores, significant challenges remain in detecting underrepresented AEs and capturing nuanced clinical language. Developed within a Trusted Research Environment (TRE), the dataset is available upon request via DataLoch and serves as a robust benchmark for evaluating AE extraction methods and supporting future cross-dataset generalisation.

Question answering systems should help users to access knowledge on a broad range of topics and to answer a wide array of different questions. Most systems fall short of this expectation as they are only specialized in one particular setting, e.g., answering factual questions with Wikipedia data. To overcome this limitation, we propose composing multiple QA agents within a meta-QA system. We argue that there exist a wide range of specialized QA agents in literature. Thus, we address the central research question of how to effectively and efficiently identify suitable QA agents for any given question. We study both supervised and unsupervised approaches to address this challenge, showing that TWEAC -- Transformer with Extendable Agent Classifiers -- achieves the best performance overall with 94% accuracy. We provide extensive insights on the scalability of TWEAC, demonstrating that it scales robustly to over 100 QA agents with each providing just 1000 examples of questions they can answer. Our code and data is available: https://github.com/UKPLab/TWEAC-qa-agent-selection

A key limitation in current datasets for multi-hop reasoning is that the required steps for answering the question are mentioned in it explicitly. In this work, we introduce StrategyQA, a question answering (QA) benchmark where the required reasoning steps are implicit in the question, and should be inferred using a strategy. A fundamental challenge in this setup is how to elicit such creative questions from crowdsourcing workers, while covering a broad range of potential strategies. We propose a data collection procedure that combines term-based priming to inspire annotators, careful control over the annotator population, and adversarial filtering for eliminating reasoning shortcuts. Moreover, we annotate each question with (1) a decomposition into reasoning steps for answering it, and (2) Wikipedia paragraphs that contain the answers to each step. Overall, StrategyQA includes 2,780 examples, each consisting of a strategy question, its decomposition, and evidence paragraphs. Analysis shows that questions in StrategyQA are short, topic-diverse, and cover a wide range of strategies. Empirically, we show that humans perform well (87%) on this task, while our best baseline reaches an accuracy of sim66%.

We present NovaCOMET, an open commonsense knowledge model, that combines the best aspects of knowledge and general task models. Compared to previous knowledge models, NovaCOMET allows open-format relations enabling direct application to reasoning tasks; compared to general task models like Flan-T5, it explicitly centers knowledge, enabling superior performance for commonsense reasoning. NovaCOMET leverages the knowledge of opaque proprietary models to create an open knowledge pipeline. First, knowledge is symbolically distilled into NovATOMIC, a publicly-released discrete knowledge graph which can be audited, critiqued, and filtered. Next, we train NovaCOMET on NovATOMIC by fine-tuning an open-source pretrained model. NovaCOMET uses an open-format training objective, replacing the fixed relation sets of past knowledge models, enabling arbitrary structures within the data to serve as inputs or outputs. The resulting generation model, optionally augmented with human annotation, matches or exceeds comparable open task models like Flan-T5 on a range of commonsense generation tasks. NovaCOMET serves as a counterexample to the contemporary focus on instruction tuning only, demonstrating a distinct advantage to explicitly modeling commonsense knowledge as well.

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.

Motivated by suggested question generation in conversational news recommendation systems, we propose a model for generating question-answer pairs (QA pairs) with self-contained, summary-centric questions and length-constrained, article-summarizing answers. We begin by collecting a new dataset of news articles with questions as titles and pairing them with summaries of varying length. This dataset is used to learn a QA pair generation model producing summaries as answers that balance brevity with sufficiency jointly with their corresponding questions. We then reinforce the QA pair generation process with a differentiable reward function to mitigate exposure bias, a common problem in natural language generation. Both automatic metrics and human evaluation demonstrate these QA pairs successfully capture the central gists of the articles and achieve high answer accuracy.

Experts in various fields routinely perform methodical writing tasks to plan, organize, and report their work. From a clinician writing a differential diagnosis for a patient, to a teacher writing a lesson plan for students, these tasks are pervasive, requiring to methodically generate structured long-form output for a given input. We develop a typology of methodical tasks structured in the form of a task objective, procedure, input, and output, and introduce DoLoMiTes, a novel benchmark with specifications for 519 such tasks elicited from hundreds of experts from across 25 fields. Our benchmark further contains specific instantiations of methodical tasks with concrete input and output examples (1,857 in total) which we obtain by collecting expert revisions of up to 10 model-generated examples of each task. We use these examples to evaluate contemporary language models highlighting that automating methodical tasks is a challenging long-form generation problem, as it requires performing complex inferences, while drawing upon the given context as well as domain knowledge.

As large language models (LLMs) advance in conversational and reasoning capabilities, their practical application in healthcare has become a critical research focus. However, there is a notable gap between the performance of medical LLMs on static benchmarks such as USMLE and their utility in real-world clinical decision-making. This discrepancy arises because traditional exams fail to capture the dynamic, interactive nature of medical consultations. To address this challenge, we introduce a novel dynamic verification framework that moves beyond static answer verifier, establishing a large-scale, high-fidelity interactive reinforcement learning system. Our framework comprises two key components: a Patient Simulator that creates realistic clinical environments using de-identified medical records, and a Clinical Rubrics Generator that dynamically produces multi-dimensional evaluation metrics. Building on this foundation, we develop Baichuan-M2, a 32B-parameter medical augmented reasoning model trained through a multi-stage reinforcement learning strategy with an improved Group Relative Policy Optimization (GRPO) algorithm. Evaluated on HealthBench, Baichuan-M2 outperforms all other open-source models and most advanced closed-source counterparts, achieving a score above 32 on the challenging HealthBench Hard benchmark-previously exceeded only by GPT-5. Our work demonstrates that robust dynamic verifier system is essential for aligning LLM capabilities with practical clinical applications, establishing a new Pareto front in the performance-parameter trade-off for medical AI deployment.

Improving large language models (LLMs) for electronic health record (EHR) reasoning is essential for enabling accurate and generalizable clinical predictions. While LLMs excel at medical text understanding, they underperform on EHR-based prediction tasks due to challenges in modeling temporally structured, high-dimensional data. Existing approaches often rely on hybrid paradigms, where LLMs serve merely as frozen prior retrievers while downstream deep learning (DL) models handle prediction, failing to improve the LLM's intrinsic reasoning capacity and inheriting the generalization limitations of DL models. To this end, we propose EAG-RL, a novel two-stage training framework designed to intrinsically enhance LLMs' EHR reasoning ability through expert attention guidance, where expert EHR models refer to task-specific DL models trained on EHR data. Concretely, EAG-RL first constructs high-quality, stepwise reasoning trajectories using expert-guided Monte Carlo Tree Search to effectively initialize the LLM's policy. Then, EAG-RL further optimizes the policy via reinforcement learning by aligning the LLM's attention with clinically salient features identified by expert EHR models. Extensive experiments on two real-world EHR datasets show that EAG-RL improves the intrinsic EHR reasoning ability of LLMs by an average of 14.62%, while also enhancing robustness to feature perturbations and generalization to unseen clinical domains. These results demonstrate the practical potential of EAG-RL for real-world deployment in clinical prediction tasks. Our code have been available at https://github.com/devilran6/EAG-RL.

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.

Recently proposed systems for open-domain question answering (OpenQA) require large amounts of training data to achieve state-of-the-art performance. However, data annotation is known to be time-consuming and therefore expensive to acquire. As a result, the appropriate datasets are available only for a handful of languages (mainly English and Chinese). In this work, we introduce and publicly release PolQA, the first Polish dataset for OpenQA. It consists of 7,000 questions, 87,525 manually labeled evidence passages, and a corpus of over 7,097,322 candidate passages. Each question is classified according to its formulation, type, as well as entity type of the answer. This resource allows us to evaluate the impact of different annotation choices on the performance of the QA system and propose an efficient annotation strategy that increases the passage retrieval performance by 10.55 p.p. while reducing the annotation cost by 82%.

Accessing medical literature is difficult for laypeople as the content is written for specialists and contains medical jargon. Automated text simplification methods offer a potential means to address this issue. In this work, we propose a summarize-then-simplify two-stage strategy, which we call NapSS, identifying the relevant content to simplify while ensuring that the original narrative flow is preserved. In this approach, we first generate reference summaries via sentence matching between the original and the simplified abstracts. These summaries are then used to train an extractive summarizer, learning the most relevant content to be simplified. Then, to ensure the narrative consistency of the simplified text, we synthesize auxiliary narrative prompts combining key phrases derived from the syntactical analyses of the original text. Our model achieves results significantly better than the seq2seq baseline on an English medical corpus, yielding 3%~4% absolute improvements in terms of lexical similarity, and providing a further 1.1% improvement of SARI score when combined with the baseline. We also highlight shortcomings of existing evaluation methods, and introduce new metrics that take into account both lexical and high-level semantic similarity. A human evaluation conducted on a random sample of the test set further establishes the effectiveness of the proposed approach. Codes and models are released here: https://github.com/LuJunru/NapSS.

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.

We introduce Vibe-Eval: a new open benchmark and framework for evaluating multimodal chat models. Vibe-Eval consists of 269 visual understanding prompts, including 100 of hard difficulty, complete with gold-standard responses authored by experts. Vibe-Eval is open-ended and challenging with dual objectives: (i) vibe checking multimodal chat models for day-to-day tasks and (ii) rigorously testing and probing the capabilities of present frontier models. Notably, our hard set contains >50% questions that all frontier models answer incorrectly. We explore the nuances of designing, evaluating, and ranking models on ultra challenging prompts. We also discuss trade-offs between human and automatic evaluation, and show that automatic model evaluation using Reka Core roughly correlates to human judgment. We offer free API access for the purpose of lightweight evaluation and plan to conduct formal human evaluations for public models that perform well on the Vibe-Eval's automatic scores. We release the evaluation code and data, see https://github.com/reka-ai/reka-vibe-eval

People are increasingly seeking healthcare information from large language models (LLMs) via interactive chatbots, yet the nature and inherent risks of these conversations remain largely unexplored. In this paper, we filter large-scale conversational AI datasets to achieve HealthChat-11K, a curated dataset of 11K real-world conversations composed of 25K user messages. We use HealthChat-11K and a clinician-driven taxonomy for how users interact with LLMs when seeking healthcare information in order to systematically study user interactions across 21 distinct health specialties. Our analysis reveals insights into the nature of how and why users seek health information, such as common interactions, instances of incomplete context, affective behaviors, and interactions (e.g., leading questions) that can induce sycophancy, underscoring the need for improvements in the healthcare support capabilities of LLMs deployed as conversational AI. Code and artifacts to retrieve our analyses and combine them into a curated dataset can be found here: https://github.com/yahskapar/HealthChat

Retrieval-augmented generation (RAG) has emerged as a promising approach to enhance the performance of large language models (LLMs) in knowledge-intensive tasks such as those from medical domain. However, the sensitive nature of the medical domain necessitates a completely accurate and trustworthy system. While existing RAG benchmarks primarily focus on the standard retrieve-answer setting, they overlook many practical scenarios that measure crucial aspects of a reliable medical system. This paper addresses this gap by providing a comprehensive evaluation framework for medical question-answering (QA) systems in a RAG setting for these situations, including sufficiency, integration, and robustness. We introduce Medical Retrieval-Augmented Generation Benchmark (MedRGB) that provides various supplementary elements to four medical QA datasets for testing LLMs' ability to handle these specific scenarios. Utilizing MedRGB, we conduct extensive evaluations of both state-of-the-art commercial LLMs and open-source models across multiple retrieval conditions. Our experimental results reveals current models' limited ability to handle noise and misinformation in the retrieved documents. We further analyze the LLMs' reasoning processes to provides valuable insights and future directions for developing RAG systems in this critical medical domain.

This paper introduces ExpertLongBench, an expert-level benchmark containing 11 tasks from 9 domains that reflect realistic expert workflows and applications. Beyond question answering, the application-driven tasks in ExpertLongBench demand long-form outputs that can exceed 5,000 tokens and strict adherence to domain-specific requirements. Notably, each task in ExpertLongBench includes a rubric, designed or validated by domain experts, to specify task requirements and guide output evaluation. Furthermore, we propose CLEAR, an evaluation framework that supports accurate evaluation of long-form model outputs in our benchmark. To achieve fine-grained, expert-aligned evaluation, CLEAR derives checklists from both model outputs and references by extracting information corresponding to items in the task-specific rubric. Checklist items for model outputs are then compared with corresponding items for reference outputs to assess their correctness, enabling grounded evaluation. We benchmark 11 large language models (LLMs) and analyze components in CLEAR, showing that (1) existing LLMs, with the top performer achieving only a 26.8% F1 score, require significant improvement for expert-level tasks; (2) models can generate content corresponding to the required aspects, though often not accurately; and (3) accurate checklist extraction and comparison in CLEAR can be achieved by open-weight models for more scalable and low-cost usage.

Retrieval augmented language models have recently become the standard for knowledge intensive tasks. Rather than relying purely on latent semantics within the parameters of large neural models, these methods enlist a semi-parametric memory to encode an index of knowledge for the model to retrieve over. Most prior work has employed text passages as the unit of knowledge, which has high coverage at the cost of interpretability, controllability, and efficiency. The opposite properties arise in other methods which have instead relied on knowledge base (KB) facts. At the same time, more recent work has demonstrated the effectiveness of storing and retrieving from an index of Q-A pairs derived from text lewis2021paq. This approach yields a high coverage knowledge representation that maintains KB-like properties due to its representations being more atomic units of information. In this work we push this line of research further by proposing a question-answer augmented encoder-decoder model and accompanying pretraining strategy. This yields an end-to-end system that not only outperforms prior QA retrieval methods on single-hop QA tasks but also enables compositional reasoning, as demonstrated by strong performance on two multi-hop QA datasets. Together, these methods improve the ability to interpret and control the model while narrowing the performance gap with passage retrieval systems.

Uncertainty Quantification (UQ) research has primarily focused on closed-book factual question answering (QA), while contextual QA remains unexplored, despite its importance in real-world applications. In this work, we focus on UQ for the contextual QA task and propose a theoretically grounded approach to quantify epistemic uncertainty. We begin by introducing a task-agnostic, token-level uncertainty measure defined as the cross-entropy between the predictive distribution of the given model and the unknown true distribution. By decomposing this measure, we isolate the epistemic component and approximate the true distribution by a perfectly prompted, idealized model. We then derive an upper bound for epistemic uncertainty and show that it can be interpreted as semantic feature gaps in the given model's hidden representations relative to the ideal model. We further apply this generic framework to the contextual QA task and hypothesize that three features approximate this gap: context-reliance (using the provided context rather than parametric knowledge), context comprehension (extracting relevant information from context), and honesty (avoiding intentional lies). Using a top-down interpretability approach, we extract these features by using only a small number of labeled samples and ensemble them to form a robust uncertainty score. Experiments on multiple QA benchmarks in both in-distribution and out-of-distribution settings show that our method substantially outperforms state-of-the-art unsupervised (sampling-free and sampling-based) and supervised UQ methods, achieving up to a 13-point PRR improvement while incurring a negligible inference overhead.

Customizing LLMs for a specific task involves separating high-quality responses from lower-quality ones. This skill can be developed using supervised fine-tuning with extensive human preference data. However, obtaining a large volume of expert-annotated data is costly for most tasks. In this paper, we explore a novel method to optimize LLMs using ranking metrics. This method trains the model to prioritize the best responses from a pool of candidates created for a particular task. Rather than a traditional full ordering, we advocate for a partial ordering, as achieving consensus on the perfect order of candidate responses can be challenging. Our partial ordering is more robust, less sensitive to noise, and can be achieved with limited human annotations or through heuristic methods. We test our system's improved response generation ability using benchmark datasets, including textual entailment and multi-document question answering. We conduct ablation studies to understand crucial factors, such as how to gather candidate responses for a specific task, determine their most suitable order, and balance supervised fine-tuning with ranking metrics. Our approach, named Rescue, offers a promising avenue for enhancing the response generation and task accuracy of LLMs.

The answering quality of an aligned large language model (LLM) can be drastically improved if treated with proper crafting of prompts. In this paper, we propose ExpertPrompting to elicit the potential of LLMs to answer as distinguished experts. We first utilize In-Context Learning to automatically synthesize detailed and customized descriptions of the expert identity for each specific instruction, and then ask LLMs to provide answer conditioned on such agent background. Based on this augmented prompting strategy, we produce a new set of instruction-following data using GPT-3.5, and train a competitive open-source chat assistant called ExpertLLaMA. We employ GPT4-based evaluation to show that 1) the expert data is of significantly higher quality than vanilla answers, and 2) ExpertLLaMA outperforms existing open-source opponents and achieves 96\% of the original ChatGPT's capability. All data and the ExpertLLaMA model will be made publicly available at https://github.com/OFA-Sys/ExpertLLaMA.

Open-domain complex Question Answering (QA) is a difficult task with challenges in evidence retrieval and reasoning. The complexity of such questions could stem from questions being compositional, hybrid evidence, or ambiguity in questions. While retrieval performance for classical QA tasks is well explored, their capabilities for heterogeneous complex retrieval tasks, especially in an open-domain setting, and the impact on downstream QA performance, are relatively unexplored. To address this, in this work, we propose a benchmark composing diverse complex QA tasks and provide a toolkit to evaluate state-of-the-art pre-trained dense and sparse retrieval models in an open-domain setting. We observe that late interaction models and surprisingly lexical models like BM25 perform well compared to other pre-trained dense retrieval models. In addition, since context-based reasoning is critical for solving complex QA tasks, we also evaluate the reasoning capabilities of LLMs and the impact of retrieval performance on their reasoning capabilities. Through experiments, we observe that much progress is to be made in retrieval for complex QA to improve downstream QA performance. Our software and related data can be accessed at https://github.com/VenkteshV/DEXTER

Medical Visual Question Answering (MedVQA), which offers language responses to image-based medical inquiries, represents a challenging task and significant advancement in healthcare. It assists medical experts to swiftly interpret medical images, thereby enabling faster and more accurate diagnoses. However, the model interpretability and transparency of existing MedVQA solutions are often limited, posing challenges in understanding their decision-making processes. To address this issue, we devise a semi-automated annotation process to streamline data preparation and build new benchmark MedVQA datasets R-RAD, R-SLAKE and R-Path. These datasets provide intermediate medical decision-making rationales generated by multimodal large language models and human annotations for question-answering pairs in existing MedVQA datasets, i.e., VQA-RAD, SLAKE and PathVQA. Moreover, we design a novel framework, MedThink, which finetunes lightweight pretrained generative models by incorporating medical decision-making rationales. MedThink includes three distinct strategies to generate decision outcomes and corresponding rationales, thereby clearly showcasing the medical decision-making process during reasoning. Our comprehensive experiments show that our method achieves an accuracy of 83.5% on R-RAD, 86.3% on R-SLAKE and 87.2% on R-Path. These results significantly exceed those of existing state-of-the-art models with comparable parameters. Datasets and code will be released.

This position paper emphasizes the critical gap in the evaluation of Explainable AI (XAI) due to the lack of standardized and reliable metrics, which diminishes its practical value, trustworthiness, and ability to meet regulatory requirements. Current evaluation methods are often fragmented, subjective, and biased, making them prone to manipulation and complicating the assessment of complex models. A central issue is the absence of a ground truth for explanations, complicating comparisons across various XAI approaches. To address these challenges, we advocate for widespread research into developing robust, context-sensitive evaluation metrics. These metrics should be resistant to manipulation, relevant to each use case, and based on human judgment and real-world applicability. We also recommend creating domain-specific evaluation benchmarks that align with the user and regulatory needs of sectors such as healthcare and finance. By encouraging collaboration among academia, industry, and regulators, we can create standards that balance flexibility and consistency, ensuring XAI explanations are meaningful, trustworthy, and compliant with evolving regulations.

This document presents a detailed description of the challenge on clarifying questions for dialogue systems (ClariQ). The challenge is organized as part of the Conversational AI challenge series (ConvAI3) at Search Oriented Conversational AI (SCAI) EMNLP workshop in 2020. The main aim of the conversational systems is to return an appropriate answer in response to the user requests. However, some user requests might be ambiguous. In IR settings such a situation is handled mainly thought the diversification of the search result page. It is however much more challenging in dialogue settings with limited bandwidth. Therefore, in this challenge, we provide a common evaluation framework to evaluate mixed-initiative conversations. Participants are asked to rank clarifying questions in an information-seeking conversations. The challenge is organized in two stages where in Stage 1 we evaluate the submissions in an offline setting and single-turn conversations. Top participants of Stage 1 get the chance to have their model tested by human annotators.

Large language models like ChatGPT have shown substantial progress in natural language understanding and generation, proving valuable across various disciplines, including the medical field. Despite advancements, challenges persist due to the complexity and diversity inherent in medical tasks which often require multi-task learning capabilities. Previous approaches, although beneficial, fall short in real-world applications because they necessitate task-specific annotations at inference time, limiting broader generalization. This paper introduces MING-MOE, a novel Mixture-of-Expert~(MOE)-based medical large language model designed to manage diverse and complex medical tasks without requiring task-specific annotations, thus enhancing its usability across extensive datasets. MING-MOE employs a Mixture of Low-Rank Adaptation (MoLoRA) technique, allowing for efficient parameter usage by maintaining base model parameters static while adapting through a minimal set of trainable parameters. We demonstrate that MING-MOE achieves state-of-the-art (SOTA) performance on over 20 medical tasks, illustrating a significant improvement over existing models. This approach not only extends the capabilities of medical language models but also improves inference efficiency.

Large language models (LLMs) have shown substantial progress in natural language understanding and generation, proving valuable especially in the medical field. Despite advancements, challenges persist due to the complexity and diversity inherent in medical tasks, which can be categorized as knowledge-intensive tasks and alignment-required tasks. Previous approaches either ignore the latter task or focus on a minority of tasks and hence lose generalization. To address these drawbacks, we propose a progressive fine-tuning pipeline. This pipeline employs a Knowledge Aggregator and a Noise aggregator to encode diverse knowledge in the first stage and filter out detrimental information. In the second stage, we drop the Noise Aggregator to avoid the interference of suboptimal representation and leverage an additional alignment module optimized towards an orthogonal direction to the knowledge space to mitigate knowledge forgetting. Based on this two-stage paradigm, we proposed a Medical LLM through decoupling Clinical Alignment and Knowledge Aggregation (MedCare), which is designed to achieve state-of-the-art (SOTA) performance on over 20 medical tasks, as well as SOTA results on specific medical alignment tasks. Various model sizes of MedCare (1.8B, 7B, 14B) all demonstrate significant improvements over existing models with similar model sizes.

Question answering biases in video QA datasets can mislead multimodal model to overfit to QA artifacts and jeopardize the model's ability to generalize. Understanding how strong these QA biases are and where they come from helps the community measure progress more accurately and provide researchers insights to debug their models. In this paper, we analyze QA biases in popular video question answering datasets and discover pretrained language models can answer 37-48% questions correctly without using any multimodal context information, far exceeding the 20% random guess baseline for 5-choose-1 multiple-choice questions. Our ablation study shows biases can come from annotators and type of questions. Specifically, annotators that have been seen during training are better predicted by the model and reasoning, abstract questions incur more biases than factual, direct questions. We also show empirically that using annotator-non-overlapping train-test splits can reduce QA biases for video QA datasets.

The information in tables can be an important complement to text, making table-based question answering (QA) systems of great value. The intrinsic complexity of handling tables often adds an extra burden to both model design and data annotation. In this paper, we aim to develop a simple table-based QA model with minimal annotation effort. Motivated by the fact that table-based QA requires both alignment between questions and tables and the ability to perform complicated reasoning over multiple table elements, we propose an omnivorous pretraining approach that consumes both natural and synthetic data to endow models with these respective abilities. Specifically, given freely available tables, we leverage retrieval to pair them with relevant natural sentences for mask-based pretraining, and synthesize NL questions by converting SQL sampled from tables for pretraining with a QA loss. We perform extensive experiments in both few-shot and full settings, and the results clearly demonstrate the superiority of our model OmniTab, with the best multitasking approach achieving an absolute gain of 16.2% and 2.7% in 128-shot and full settings respectively, also establishing a new state-of-the-art on WikiTableQuestions. Detailed ablations and analyses reveal different characteristics of natural and synthetic data, shedding light on future directions in omnivorous pretraining. Code, pretraining data, and pretrained models are available at https://github.com/jzbjyb/OmniTab.

Question Answering (QA) in NLP is the task of finding answers to a query within a relevant context retrieved by a retrieval system. Yet, the mix of relevant and irrelevant information in these contexts can hinder performance enhancements in QA tasks. To address this, we introduce a context filtering approach that removes non-essential details, summarizing crucial content through Reward Modeling. This method emphasizes keeping vital data while omitting the extraneous during summarization model training. We offer a framework for developing efficient QA models by discerning useful information from dataset pairs, bypassing the need for costly human evaluation. Furthermore, we show that our approach can significantly outperform the baseline, as evidenced by a 6.8-fold increase in the EM Per Token (EPT) metric, which we propose as a measure of token efficiency, indicating a notable token-efficiency boost for low-resource settings.

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.

Hallucinated outputs from language models pose risks in the medical domain, especially for lay audiences making health-related decisions. Existing factuality evaluation methods, such as entailment- and question-answering-based (QA), struggle with plain language summary (PLS) generation due to elaborative explanation phenomenon, which introduces external content (e.g., definitions, background, examples) absent from the source document to enhance comprehension. To address this, we introduce PlainQAFact, a framework trained on a fine-grained, human-annotated dataset PlainFact, to evaluate the factuality of both source-simplified and elaboratively explained sentences. PlainQAFact first classifies factuality type and then assesses factuality using a retrieval-augmented QA-based scoring method. Our approach is lightweight and computationally efficient. Empirical results show that existing factuality metrics fail to effectively evaluate factuality in PLS, especially for elaborative explanations, whereas PlainQAFact achieves state-of-the-art performance. We further analyze its effectiveness across external knowledge sources, answer extraction strategies, overlap measures, and document granularity levels, refining its overall factuality assessment.

Question-answering for domain-specific applications has recently attracted much interest due to the latest advancements in large language models (LLMs). However, accurately assessing the performance of these applications remains a challenge, mainly due to the lack of suitable benchmarks that effectively simulate real-world scenarios. To address this challenge, we introduce two product question-answering (QA) datasets focused on Adobe Acrobat and Photoshop products to help evaluate the performance of existing models on domain-specific product QA tasks. Additionally, we propose a novel knowledge-driven RAG-QA framework to enhance the performance of the models in the product QA task. Our experiments demonstrated that inducing domain knowledge through query reformulation allowed for increased retrieval and generative performance when compared to standard RAG-QA methods. This improvement, however, is slight, and thus illustrates the challenge posed by the datasets introduced.

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

With increasing demand for and adoption of virtual assistants, recent work has investigated ways to accelerate bot schema design through the automatic induction of intents or the induction of slots and dialogue states. However, a lack of dedicated benchmarks and standardized evaluation has made progress difficult to track and comparisons between systems difficult to make. This challenge track, held as part of the Eleventh Dialog Systems Technology Challenge, introduces a benchmark that aims to evaluate methods for the automatic induction of customer intents in a realistic setting of customer service interactions between human agents and customers. We propose two subtasks for progressively tackling the automatic induction of intents and corresponding evaluation methodologies. We then present three datasets suitable for evaluating the tasks and propose simple baselines. Finally, we summarize the submissions and results of the challenge track, for which we received submissions from 34 teams.

We present a new kind of question answering dataset, OpenBookQA, modeled after open book exams for assessing human understanding of a subject. The open book that comes with our questions is a set of 1329 elementary level science facts. Roughly 6000 questions probe an understanding of these facts and their application to novel situations. This requires combining an open book fact (e.g., metals conduct electricity) with broad common knowledge (e.g., a suit of armor is made of metal) obtained from other sources. While existing QA datasets over documents or knowledge bases, being generally self-contained, focus on linguistic understanding, OpenBookQA probes a deeper understanding of both the topic---in the context of common knowledge---and the language it is expressed in. Human performance on OpenBookQA is close to 92%, but many state-of-the-art pre-trained QA methods perform surprisingly poorly, worse than several simple neural baselines we develop. Our oracle experiments designed to circumvent the knowledge retrieval bottleneck demonstrate the value of both the open book and additional facts. We leave it as a challenge to solve the retrieval problem in this multi-hop setting and to close the large gap to human performance.

Electrocardiograms (ECGs) are non-invasive diagnostic tools crucial for detecting cardiac arrhythmic diseases in clinical practice. While ECG Self-supervised Learning (eSSL) methods show promise in representation learning from unannotated ECG data, they often overlook the clinical knowledge that can be found in reports. This oversight and the requirement for annotated samples for downstream tasks limit eSSL's versatility. In this work, we address these issues with the Multimodal ECG Representation Learning (MERL}) framework. Through multimodal learning on ECG records and associated reports, MERL is capable of performing zero-shot ECG classification with text prompts, eliminating the need for training data in downstream tasks. At test time, we propose the Clinical Knowledge Enhanced Prompt Engineering (CKEPE) approach, which uses Large Language Models (LLMs) to exploit external expert-verified clinical knowledge databases, generating more descriptive prompts and reducing hallucinations in LLM-generated content to boost zero-shot classification. Based on MERL, we perform the first benchmark across six public ECG datasets, showing the superior performance of MERL compared against eSSL methods. Notably, MERL achieves an average AUC score of 75.2% in zero-shot classification (without training data), 3.2% higher than linear probed eSSL methods with 10\% annotated training data, averaged across all six datasets. Code and models are available at https://github.com/cheliu-computation/MERL

Large language models (LLMs) have demonstrated remarkable performance on single-turn text-to-SQL tasks, but real-world database applications predominantly require multi-turn interactions to handle ambiguous queries, execution errors, and evolving user requirements. Existing multi-turn benchmarks fall short by treating conversation histories as static context or limiting evaluation to read-only operations, failing to reflect production-grade database assistant challenges. We introduce BIRD-INTERACT, a benchmark that restores this realism through: (1) a comprehensive interaction environment coupling each database with a hierarchical knowledge base, metadata files, and a function-driven user simulator, enabling models to solicit clarifications, retrieve knowledge, and recover from errors without human supervision; (2) two evaluation settings consisting of a pre-defined conversational protocol (c-Interact) and an open-ended agentic setting (a-Interact) where models autonomously decide when to query the user simulator or explore the environment; (3) a challenging task suite covering the full CRUD spectrum for business-intelligence and operational use cases, guarded by executable test cases. Each task features ambiguous and follow-up sub-tasks requiring dynamic interaction. The suite comprises BIRD-INTERACT-FULL (600 tasks, up to 11,796 interactions) for comprehensive performance assessment, and BIRD-INTERACT-LITE (300 tasks with simplified databases) for detailed behavioral analysis and rapid method development. Our empirical results highlight BIRD-INTERACT's difficulty: GPT-5 completes only 8.67% of tasks in c-Interact and 17.00% in a-Interact. Analysis via memory grafting and Interaction Test-time Scaling validates the importance of effective interaction for complex, dynamic text-to-SQL tasks.

Multimodal in-context learning (ICL) remains underexplored despite significant potential for domains such as medicine. Clinicians routinely encounter diverse, specialized tasks requiring adaptation from limited examples, such as drawing insights from a few relevant prior cases or considering a constrained set of differential diagnoses. While multimodal large language models (MLLMs) have shown advances in medical visual question answering (VQA), their ability to learn multimodal tasks from context is largely unknown. We introduce SMMILE, the first expert-driven multimodal ICL benchmark for medical tasks. Eleven medical experts curated problems, each including a multimodal query and multimodal in-context examples as task demonstrations. SMMILE encompasses 111 problems (517 question-image-answer triplets) covering 6 medical specialties and 13 imaging modalities. We further introduce SMMILE++, an augmented variant with 1038 permuted problems. A comprehensive evaluation of 15 MLLMs demonstrates that most models exhibit moderate to poor multimodal ICL ability in medical tasks. In open-ended evaluations, ICL contributes only 8% average improvement over zero-shot on SMMILE and 9.4% on SMMILE++. We observe a susceptibility for irrelevant in-context examples: even a single noisy or irrelevant example can degrade performance by up to 9.5%. Moreover, example ordering exhibits a recency bias, i.e., placing the most relevant example last can lead to substantial performance improvements by up to 71%. Our findings highlight critical limitations and biases in current MLLMs when learning multimodal medical tasks from context.

Recent advances in inference time scaling with extended long chain-of thought have significantly improved the reasoning capabilities of both general and medical large language models (LLMs). However, these models tend to engage in lengthy reasoning processes regardless of the difficulty of the input question, leading to increased inference costs in real-world applications. Therefore, enabling adaptive thinking where models think less for simpler questions and think more for complex ones is critical for the effective use of medical LLMs in practice. Despite its importance, there is a lack of end-to-end approaches designed to enhance the adaptive thinking capabilities of medical LLMs while providing a comprehensive examination of the trade-off between performance and computational cost. To bridge this gap, we propose AdaThink-Med, the first end-to-end framework designed to enhance adaptive thinking ability in medical reasoning models with uncertainty-guided length calibration. AdaThink-Med first generates multiple candidate outputs for each question, evaluates the correctness and uncertainty of each candidate, and then estimates problem difficulty via an uncertainty-guided length calibration module. For outputs with low difficulty and correct answers, the framework penalizes longer reasoning paths; whereas for those with high difficulty and incorrect answers, it encourages extending the chain of thought to explore alternative solutions. On six public medical QA benchmarks, AdaThink-Med achieves up to 6.4x length reduction on average while retaining performance with only minimal degradation. Intriguingly, we observe that AdaThink-Med spontaneously develops two distinct reasoning modes, which we characterize as "non-thinking" and "thinking", demonstrating the model's ability to suppress redundant reasoning processes dynamically.

Large language models (LLMs) demonstrate remarkable performance on knowledge-intensive tasks, suggesting that real-world knowledge is encoded in their model parameters. However, besides explorations on a few probing tasks in limited knowledge domains, it is not well understood how to evaluate LLMs' knowledge systematically and how well their knowledge abilities generalize, across a spectrum of knowledge domains and progressively complex task formats. To this end, we propose KGQuiz, a knowledge-intensive benchmark to comprehensively investigate the knowledge generalization abilities of LLMs. KGQuiz is a scalable framework constructed from triplet-based knowledge, which covers three knowledge domains and consists of five tasks with increasing complexity: true-or-false, multiple-choice QA, blank filling, factual editing, and open-ended knowledge generation. To gain a better understanding of LLMs' knowledge abilities and their generalization, we evaluate 10 open-source and black-box LLMs on the KGQuiz benchmark across the five knowledge-intensive tasks and knowledge domains. Extensive experiments demonstrate that LLMs achieve impressive performance in straightforward knowledge QA tasks, while settings and contexts requiring more complex reasoning or employing domain-specific facts still present significant challenges. We envision KGQuiz as a testbed to analyze such nuanced variations in performance across domains and task formats, and ultimately to understand, evaluate, and improve LLMs' knowledge abilities across a wide spectrum of knowledge domains and tasks.

Objectives: While Large Language Models (LLMs) have been widely used to assist clinicians and support patients, no existing work has explored dialogue systems for standard diagnostic interviews and assessments. This study aims to bridge the gap in mental healthcare accessibility by developing an LLM-powered dialogue system that replicates clinician behavior. Materials and Methods: We introduce TRUST, a framework of cooperative LLM modules capable of conducting formal diagnostic interviews and assessments for Post-Traumatic Stress Disorder (PTSD). To guide the generation of appropriate clinical responses, we propose a Dialogue Acts schema specifically designed for clinical interviews. Additionally, we develop a patient simulation approach based on real-life interview transcripts to replace time-consuming and costly manual testing by clinicians. Results: A comprehensive set of evaluation metrics is designed to assess the dialogue system from both the agent and patient simulation perspectives. Expert evaluations by conversation and clinical specialists show that TRUST performs comparably to real-life clinical interviews. Discussion: Our system performs at the level of average clinicians, with room for future enhancements in communication styles and response appropriateness. Conclusions: Our TRUST framework shows its potential to facilitate mental healthcare availability.

We introduce RadEval, a unified, open-source framework for evaluating radiology texts. RadEval consolidates a diverse range of metrics, from classic n-gram overlap (BLEU, ROUGE) and contextual measures (BERTScore) to clinical concept-based scores (F1CheXbert, F1RadGraph, RaTEScore, SRR-BERT, TemporalEntityF1) and advanced LLM-based evaluators (GREEN). We refine and standardize implementations, extend GREEN to support multiple imaging modalities with a more lightweight model, and pretrain a domain-specific radiology encoder, demonstrating strong zero-shot retrieval performance. We also release a richly annotated expert dataset with over 450 clinically significant error labels and show how different metrics correlate with radiologist judgment. Finally, RadEval provides statistical testing tools and baseline model evaluations across multiple publicly available datasets, facilitating reproducibility and robust benchmarking in radiology report generation.

Safe and trustworthy use of Large Language Models (LLM) in the processing of healthcare documents and scientific papers could substantially help clinicians, scientists and policymakers in overcoming information overload and focusing on the most relevant information at a given moment. Retrieval Augmented Generation (RAG) is a promising method to leverage the potential of LLMs while enhancing the accuracy of their outcomes. This report assesses the potentials and shortcomings of such approaches in the automatic knowledge synthesis of different types of documents in the health domain. To this end, it describes: (1) an internally developed proof of concept pipeline that employs state-of-the-art practices to deliver safe and trustable analysis for healthcare documents and scientific papers called RAGEv (Retrieval Augmented Generation Evaluation); (2) a set of evaluation tools for LLM-based document retrieval and generation; (3) a benchmark dataset to verify the accuracy and veracity of the results called RAGEv-Bench. It concludes that careful implementations of RAG techniques could minimize most of the common problems in the use of LLMs for document processing in the health domain, obtaining very high scores both on short yes/no answers and long answers. There is a high potential for incorporating it into the day-to-day work of policy support tasks, but additional efforts are required to obtain a consistent and trustworthy tool.

In this paper, we propose the task of consecutive question generation (CQG), which generates a set of logically related question-answer pairs to understand a whole passage, with a comprehensive consideration of the aspects including accuracy, coverage, and informativeness. To achieve this, we first examine the four key elements of CQG, i.e., question, answer, rationale, and context history, and propose a novel dynamic multitask framework with one main task generating a question-answer pair, and four auxiliary tasks generating other elements. It directly helps the model generate good questions through both joint training and self-reranking. At the same time, to fully explore the worth-asking information in a given passage, we make use of the reranking losses to sample the rationales and search for the best question series globally. Finally, we measure our strategy by QA data augmentation and manual evaluation, as well as a novel application of generated question-answer pairs on DocNLI. We prove that our strategy can improve question generation significantly and benefit multiple related NLP tasks.

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