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Sep 9

CivBench: A Long-Horizon Benchmark for Tool-Mediated Agents in Civilization VI

We present CivBench, an open-source benchmark for evaluating language model agents in long-horizon, tool-mediated environments through the Model Context Protocol (MCP). A single episode spans 300+ turns and produces thousands of tool calls over a large action space, requiring sustained planning, state monitoring, and execution under partial observability. The environment exposes 76 MCP tools and a narration layer that converts visual game state into structured text. We use CivBench to characterise agent behaviour across four model families in 23 admissible runs. The sample is a pilot, not a model ranking: aggregate outcomes do not reliably discriminate models at this scale. Instead, we introduce two interface-level metrics that the environment makes measurable: Proactive Monitoring Rate (PMR), capturing whether agents actively query latent strategic state, and RAG@10, capturing whether commitments stated in structured planning reflections are executed within ten subsequent turns. Across runs we observe two consistent patterns under a shared playbook protocol. Agents under-monitor strategically relevant state that is available but requires explicit querying: despite playbook guidance to query victory progress every 20 turns, agents do so only every 30 to 75 turns, and in 7 of 20 detectable defeats they failed to query within the 20 turn warning window before game end. Agents also frequently fail to execute near-term commitments stated in their own planning reflections (RAG@10 between 48.2% and 65.8% across models). Both patterns arise despite tool access and explicit guidance, and we interpret them as deviations under instruction rather than absences of capability. We release the environment, scenarios, logs, metrics, and analysis pipeline at https://github.com/lmwilki/civ6-mcp

  • 6 authors
·
Sep 1

MedStreamBench: A Time-Aware Benchmark for Streaming and Proactive Medical Video Understanding

Existing medical video benchmarks primarily evaluate whether a model produces the correct answer, but rarely assess whether it answers at the right time. In real clinical settings, AI systems must decide not only what to predict, but also when to answer, defer judgment, or proactively raise alerts. This creates a critical gap between benchmark evaluation and deployment requirements. We present MedStreamBench, a benchmark for time-aware medical video understanding. MedStreamBench integrates 22 medical datasets and 5,419 QA instances across four temporal settings: retrospective, present, future, and proactive. Unlike conventional benchmarks that assume full-video access, MedStreamBench restricts models to temporally bounded evidence windows and supports both single-turn and streaming evaluation. We further introduce a proactive monitoring setting that requires models to determine whether and when clinically relevant alerts should be triggered. Beyond answer correctness, MedStreamBench evaluates temporal behavior through responsiveness and post-evidence stability. Experiments on leading general-purpose and medical vision-language models reveal a substantial gap between offline recognition and temporally grounded decision-making, with performance dropping markedly in streaming and proactive settings. Our benchmark is available at https://huggingface.co/datasets/Venn2024/MedStreamBench.

  • 5 authors
·
Jul 1

Prostate-Specific Foundation Models for Enhanced Detection of Clinically Significant Cancer

Accurate prostate cancer diagnosis remains challenging. Even when using MRI, radiologists exhibit low specificity and significant inter-observer variability, leading to potential delays or inaccuracies in identifying clinically significant cancers. This leads to numerous unnecessary biopsies and risks of missing clinically significant cancers. Here we present prostate vision contrastive network (ProViCNet), prostate organ-specific vision foundation models for Magnetic Resonance Imaging (MRI) and Trans-Rectal Ultrasound imaging (TRUS) for comprehensive cancer detection. ProViCNet was trained and validated using 4,401 patients across six institutions, as a prostate cancer detection model on radiology images relying on patch-level contrastive learning guided by biopsy confirmed radiologist annotations. ProViCNet demonstrated consistent performance across multiple internal and external validation cohorts with area under the receiver operating curve values ranging from 0.875 to 0.966, significantly outperforming radiologists in the reader study (0.907 versus 0.805, p<0.001) for mpMRI, while achieving 0.670 to 0.740 for TRUS. We also integrated ProViCNet with standard PSA to develop a virtual screening test, and we showed that we can maintain the high sensitivity for detecting clinically significant cancers while more than doubling specificity from 15% to 38% (p<0.001), thereby substantially reducing unnecessary biopsies. These findings highlight that ProViCNet's potential for enhancing prostate cancer diagnosis accuracy and reduce unnecessary biopsies, thereby optimizing diagnostic pathways.

  • 17 authors
·
Feb 1, 2025

Medical Triage as Pairwise Ranking: A Benchmark for Urgency in Patient Portal Messages

Medical triage is the task of allocating medical resources and prioritizing patients based on medical need. This paper introduces the first large-scale public dataset for studying medical triage in the context of asynchronous outpatient portal messages. Our novel task formulation views patient message triage as a pairwise inference problem, where we train LLMs to choose `"which message is more medically urgent" in a head-to-head tournament-style re-sort of a physician's inbox. Our novel benchmark PMR-Bench contains 1569 unique messages and 2,000+ high-quality test pairs for pairwise medical urgency assessment alongside a scalable training data generation pipeline. PMR-Bench includes samples that contain both unstructured patient-written messages alongside real electronic health record (EHR) data, emulating a real-world medical triage scenario. We develop a novel automated data annotation strategy to provide LLMs with in-domain guidance on this task. The resulting data is used to train two model classes, UrgentReward and UrgentSFT, leveraging Bradley-Terry and next token prediction objective, respectively to perform pairwise urgency classification. We find that UrgentSFT achieves top performance on PMR-Bench, with UrgentReward showing distinct advantages in low-resource settings. For example, UrgentSFT-8B and UrgentReward-8B provide a 15- and 16-point boost, respectively, on inbox sorting metrics over off-the-shelf 8B models. Paper resources can be found at https://tinyurl.com/Patient-Message-Triage

  • 7 authors
·
Jan 19