Daily Papers

Ensuring the safety of LLM-generated content is essential for real-world deployment. Most existing guardrail models formulate moderation as a fixed binary classification task, implicitly assuming a fixed definition of harmfulness. In practice, enforcement strictness - how conservatively harmfulness is defined and enforced - varies across platforms and evolves over time, making binary moderators brittle under shifting requirements. We first introduce FlexBench, a strictness-adaptive LLM moderation benchmark that enables controlled evaluation under multiple strictness regimes. Experiments on FlexBench reveal substantial cross-strictness inconsistency in existing moderators: models that perform well under one regime can degrade substantially under others, limiting their practical usability. To address this, we propose FlexGuard, an LLM-based moderator that outputs a calibrated continuous risk score reflecting risk severity and supports strictness-specific decisions via thresholding. We train FlexGuard via risk-alignment optimization to improve score-severity consistency and provide practical threshold selection strategies to adapt to target strictness at deployment. Experiments on FlexBench and public benchmarks demonstrate that FlexGuard achieves higher moderation accuracy and substantially improved robustness under varying strictness. We release the source code and data to support reproducibility.

Estimating the impact of continuous treatment variables (e.g., dosage amount) on binary outcomes presents significant challenges in modeling and estimation because many existing approaches make strong assumptions that do not hold for certain continuous treatment variables. For instance, traditional logistic regression makes strong linearity assumptions that do not hold for continuous treatment variables like time of initiation. In this work, we propose a semiparametric regression framework that decomposes effects into two interpretable components: a prognostic score that captures baseline outcome risk based on a combination of clinical, genetic, and sociodemographic features, and a treatment-interaction score that flexibly models the optimal treatment level via a nonparametric link function. By connecting these two parametric scores with Nadaraya-Watson regression, our approach is both interpretable and flexible. The potential of our approach is demonstrated through numerical simulations that show empirical estimation convergence. We conclude by applying our approach to a real-world case study using the International Warfarin Pharmacogenomics Consortium (IWPC) dataset to show our approach's clinical utility by deriving personalized warfarin dosing recommendations that integrate both genetic and clinical data, providing insights towards enhancing patient safety and therapeutic efficacy in anticoagulation therapy.

Risk scores are simple classification models that let users make quick risk predictions by adding and subtracting a few small numbers. These models are widely used in medicine and criminal justice, but are difficult to learn from data because they need to be calibrated, sparse, use small integer coefficients, and obey application-specific operational constraints. In this paper, we present a new machine learning approach to learn risk scores. We formulate the risk score problem as a mixed integer nonlinear program, and present a cutting plane algorithm for non-convex settings to efficiently recover its optimal solution. We improve our algorithm with specialized techniques to generate feasible solutions, narrow the optimality gap, and reduce data-related computation. Our approach can fit risk scores in a way that scales linearly in the number of samples, provides a certificate of optimality, and obeys real-world constraints without parameter tuning or post-processing. We benchmark the performance benefits of this approach through an extensive set of numerical experiments, comparing to risk scores built using heuristic approaches. We also discuss its practical benefits through a real-world application where we build a customized risk score for ICU seizure prediction in collaboration with the Massachusetts General Hospital.

Survival analysis is the problem of estimating probability distributions for future event times, which can be seen as a problem in uncertainty quantification. Although there are fundamental theories on strictly proper scoring rules for uncertainty quantification, little is known about those for survival analysis. In this paper, we investigate extensions of four major strictly proper scoring rules for survival analysis and we prove that these extensions are proper under certain conditions, which arise from the discretization of the estimation of probability distributions. We also compare the estimation performances of these extended scoring rules by using real datasets, and the extensions of the logarithmic score and the Brier score performed the best.

Decentralized Finance (DeFi), a financial ecosystem without centralized controlling organization, has introduced a new paradigm for lending and borrowing. However, its capital efficiency remains constrained by the inability to effectively assess the risk associated with each user/wallet. This paper introduces the 'On-Chain Credit Risk Score (OCCR Score) in DeFi', a probabilistic measure designed to quantify the credit risk associated with a wallet. By analyzing historical real-time on-chain activity as well as predictive scenarios, the OCCR Score may enable DeFi lending protocols to dynamically adjust Loan-to-Value (LTV) ratios and Liquidation Thresholds (LT) based on the risk profile of a wallet. Unlike existing wallet risk scoring models, which rely on heuristic-based evaluations, the OCCR Score offers a more objective and probabilistic approach, aligning closer to traditional credit risk assessment methodologies. This framework can further enhance DeFi's capital efficiency by incentivizing responsible borrowing behavior and optimizing risk-adjusted returns for lenders.

We propose a reinforcement learning (RL) framework under a broad class of risk objectives, characterized by convex scoring functions. This class covers many common risk measures, such as variance, Expected Shortfall, entropic Value-at-Risk, and mean-risk utility. To resolve the time-inconsistency issue, we consider an augmented state space and an auxiliary variable and recast the problem as a two-state optimization problem. We propose a customized Actor-Critic algorithm and establish some theoretical approximation guarantees. A key theoretical contribution is that our results do not require the Markov decision process to be continuous. Additionally, we propose an auxiliary variable sampling method inspired by the alternating minimization algorithm, which is convergent under certain conditions. We validate our approach in simulation experiments with a financial application in statistical arbitrage trading, demonstrating the effectiveness of the algorithm.

Excellent tail performance is crucial for modern machine learning tasks, such as algorithmic fairness, class imbalance, and risk-sensitive decision making, as it ensures the effective handling of challenging samples within a dataset. Tail performance is also a vital determinant of success for personalized recommender systems to reduce the risk of losing users with low satisfaction. This study introduces a "safe" collaborative filtering method that prioritizes recommendation quality for less-satisfied users rather than focusing on the average performance. Our approach minimizes the conditional value at risk (CVaR), which represents the average risk over the tails of users' loss. To overcome computational challenges for web-scale recommender systems, we develop a robust yet practical algorithm that extends the most scalable method, implicit alternating least squares (iALS). Empirical evaluation on real-world datasets demonstrates the excellent tail performance of our approach while maintaining competitive computational efficiency.

Accurate prediction of major adverse cardiovascular events recurrence risk in acute myocardial infarction patients based on postoperative cardiac MRI and associated clinical notes is crucial for precision treatment and personalized intervention. Existing methods primarily focus on risk stratification capability while overlooking the need for intermediate robust reasoning and model interpretability in clinical practice. Moreover, end-to-end risk prediction using LLM/VLM faces significant challenges due to data limitations and modeling complexity. To bridge this gap, we propose CardioCoT, a novel two-stage hierarchical reasoning-enhanced survival analysis framework designed to enhance both model interpretability and predictive performance. In the first stage, we employ an evidence-augmented self-refinement mechanism to guide LLM/VLMs in generating robust hierarchical reasoning trajectories based on associated radiological findings. In the second stage, we integrate the reasoning trajectories with imaging data for risk model training and prediction. CardioCoT demonstrates superior performance in MACE recurrence risk prediction while providing interpretable reasoning processes, offering valuable insights for clinical decision-making.

Large language models (LLMs) are increasingly applied in mental health support systems, where reliable recognition of high-risk states such as suicidal ideation and self-harm is safety-critical. However, existing evaluations primarily rely on aggregate performance metrics, which often obscure risk-specific failure modes and provide limited insight into model behavior in realistic, multi-turn interactions. We present MHDash, an open-source platform designed to support the development, evaluation, and auditing of AI systems for mental health applications. MHDash integrates data collection, structured annotation, multi-turn dialogue generation, and baseline evaluation into a unified pipeline. The platform supports annotations across multiple dimensions, including Concern Type, Risk Level, and Dialogue Intent, enabling fine-grained and risk-aware analysis. Our results reveal several key findings: (i) simple baselines and advanced LLM APIs exhibit comparable overall accuracy yet diverge significantly on high-risk cases; (ii) some LLMs maintain consistent ordinal severity ranking while failing absolute risk classification, whereas others achieve reasonable aggregate scores but suffer from high false negative rates on severe categories; and (iii) performance gaps are amplified in multi-turn dialogues, where risk signals emerge gradually. These observations demonstrate that conventional benchmarks are insufficient for safety-critical mental health settings. By releasing MHDash as an open platform, we aim to promote reproducible research, transparent evaluation, and safety-aligned development of AI systems for mental health support.

Conventional wisdom suggests that autoregressive models are used to process discrete data. When applied to continuous modalities such as visual data, Visual AutoRegressive modeling (VAR) typically resorts to quantization-based approaches to cast the data into a discrete space, which can introduce significant information loss. To tackle this issue, we introduce a Continuous VAR framework that enables direct visual autoregressive generation without vector quantization. The underlying theoretical foundation is strictly proper scoring rules, which provide powerful statistical tools capable of evaluating how well a generative model approximates the true distribution. Within this framework, all we need is to select a strictly proper score and set it as the training objective to optimize. We primarily explore a class of training objectives based on the energy score, which is likelihood-free and thus overcomes the difficulty of making probabilistic predictions in the continuous space. Previous efforts on continuous autoregressive generation, such as GIVT and diffusion loss, can also be derived from our framework using other strictly proper scores. Source code: https://github.com/shaochenze/EAR.

Cardiotoxicity induced by the breast cancer treatments (i.e., chemotherapy, targeted therapy and radiation therapy) is a significant problem for breast cancer patients. The cardiotoxicity risk for breast cancer patients receiving different treatments remains unclear. We developed and evaluated risk predictive models for cardiotoxicity in breast cancer patients using EHR data. The AUC scores to predict the CHF, CAD, CM and MI are 0.846, 0.857, 0.858 and 0.804 respectively. After adjusting for baseline differences in cardiovascular health, patients who received chemotherapy or targeted therapy appeared to have higher risk of cardiotoxicity than patients who received radiation therapy. Due to differences in baseline cardiac health across the different breast cancer treatment groups, caution is recommended in interpreting the cardiotoxic effect of these treatments.

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

The rapid proliferation of Large Language Models (LLMs) and diverse specialized benchmarks necessitates a shift from fragmented, task-specific metrics to a holistic, competitive ranking system that effectively aggregates performance across multiple ability dimensions. Primarily using static scoring, current evaluation methods are fundamentally limited. They struggle to determine the proper mix ratio across diverse benchmarks, and critically, they fail to capture a model's dynamic competitive fitness or its vulnerability when confronted with sequential, high-stakes tasks. To address this, we introduce the novel Competitive Swiss-System Dynamics (CSD) framework. CSD simulates a multi-round, sequential contest where models are dynamically paired across a curated sequence of benchmarks based on their accumulated win-loss record. And Monte Carlo Simulation (N=100,000 iterations) is used to approximate the statistically robust Expected Win Score (E[S_m]), which eliminates the noise of random pairing and early-round luck. Furthermore, we implement a Failure Sensitivity Analysis by parameterizing the per-round elimination quantity (T_k), which allows us to profile models based on their risk appetite--distinguishing between robust generalists and aggressive specialists. We demonstrate that CSD provides a more nuanced and context-aware ranking than traditional aggregate scoring and static pairwise models, representing a vital step towards risk-informed, next-generation LLM evaluation.

We consider the classic supervised learning problem, where a continuous non-negative random label Y (i.e. a random duration) is to be predicted based upon observing a random vector X valued in R^d with dgeq 1 by means of a regression rule with minimum least square error. In various applications, ranging from industrial quality control to public health through credit risk analysis for instance, training observations can be right censored, meaning that, rather than on independent copies of (X,Y), statistical learning relies on a collection of ngeq 1 independent realizations of the triplet (X, ; min{Y,; C},; δ), where C is a nonnegative r.v. with unknown distribution, modeling censorship and δ=I{Yleq C} indicates whether the duration is right censored or not. As ignoring censorship in the risk computation may clearly lead to a severe underestimation of the target duration and jeopardize prediction, we propose to consider a plug-in estimate of the true risk based on a Kaplan-Meier estimator of the conditional survival function of the censorship C given X, referred to as Kaplan-Meier risk, in order to perform empirical risk minimization. It is established, under mild conditions, that the learning rate of minimizers of this biased/weighted empirical risk functional is of order O_{P}(log(n)/n) when ignoring model bias issues inherent to plug-in estimation, as can be attained in absence of censorship. Beyond theoretical results, numerical experiments are presented in order to illustrate the relevance of the approach developed.

Risk disclosures in SEC filings describe potential adverse events but rarely quantify their likelihood, limiting their usefulness for probabilistic analysis. A central obstacle is the absence of large-scale, risk-level supervision linking disclosed risks to realized outcomes. We introduce a fully automated data generation pipeline that converts qualitative SEC risk disclosures into temporally grounded supervision using only public data. For each filing, the pipeline generates firm-specific, time-bounded risk queries from the Risk Factors section and labels them by automatically resolving outcomes against subsequent disclosures. Using this dataset of risk queries and outcomes grounded in SEC filings, we train a compact large language model to estimate the probability that a disclosed risk will materialize within a specified horizon. Despite its modest size, the resulting model substantially improves over pretrained and heuristic baselines, and outperforms frontier general-purpose models, including GPT-5, on probabilistic accuracy and calibration. More broadly, this work demonstrates that Foresight Learning enables scalable and fully automated training of domain-specific expert models using only raw, chronological, in-domain text -- without proprietary data, external corpora, or manual annotation. The resulting models achieve frontier-level performance while remaining deployable on a single GPU. This result suggests a general pathway for learning calibrated, decision-relevant signals from naturally occurring enterprise documents. To support transparency and reproducibility, we open-source the evaluation dataset used in this study. Evaluation Data: https://huggingface.co/datasets/LightningRodLabs/sec_risk_questions_test_set Data Generation Platform: https://lightningrod.ai/ SDK: https://github.com/lightning-rod-labs/lightningrod-python-sdk

This research presents a framework for quantitative risk management in volatile markets, specifically focusing on expectile-based methodologies applied to the FTSE 100 index. Traditional risk measures such as Value-at-Risk (VaR) have demonstrated significant limitations during periods of market stress, as evidenced during the 2008 financial crisis and subsequent volatile periods. This study develops an advanced expectile-based framework that addresses the shortcomings of conventional quantile-based approaches by providing greater sensitivity to tail losses and improved stability in extreme market conditions. The research employs a dataset spanning two decades of FTSE 100 returns, incorporating periods of high volatility, market crashes, and recovery phases. Our methodology introduces novel mathematical formulations for expectile regression models, enhanced threshold determination techniques using time series analysis, and robust backtesting procedures. The empirical results demonstrate that expectile-based Value-at-Risk (EVaR) consistently outperforms traditional VaR measures across various confidence levels and market conditions. The framework exhibits superior performance during volatile periods, with reduced model risk and enhanced predictive accuracy. Furthermore, the study establishes practical implementation guidelines for financial institutions and provides evidence-based recommendations for regulatory compliance and portfolio management. The findings contribute significantly to the literature on financial risk management and offer practical tools for practitioners dealing with volatile market environments.

This study evaluates deep neural networks for forecasting probability distributions of financial returns. 1D convolutional neural networks (CNN) and Long Short-Term Memory (LSTM) architectures are used to forecast parameters of three probability distributions: Normal, Student's t, and skewed Student's t. Using custom negative log-likelihood loss functions, distribution parameters are optimized directly. The models are tested on six major equity indices (S\&P 500, BOVESPA, DAX, WIG, Nikkei 225, and KOSPI) using probabilistic evaluation metrics including Log Predictive Score (LPS), Continuous Ranked Probability Score (CRPS), and Probability Integral Transform (PIT). Results show that deep learning models provide accurate distributional forecasts and perform competitively with classical GARCH models for Value-at-Risk estimation. The LSTM with skewed Student's t distribution performs best across multiple evaluation criteria, capturing both heavy tails and asymmetry in financial returns. This work shows that deep neural networks are viable alternatives to traditional econometric models for financial risk assessment and portfolio management.

There has been considerable recent interest in scoring properties on the basis of eviction risk. The success of methods for eviction prediction is typically evaluated using different measures of predictive accuracy. However, the underlying goal of such prediction is to direct appropriate assistance to households that may be at greater risk so they remain stably housed. Thus, we must ask the question of how useful such predictions are in targeting outreach efforts - informing action. In this paper, we investigate this question using a novel dataset that matches information on properties, evictions, and owners. We perform an eviction prediction task to produce risk scores and then use these risk scores to plan targeted outreach policies. We show that the risk scores are, in fact, useful, enabling a theoretical team of caseworkers to reach more eviction-prone properties in the same amount of time, compared to outreach policies that are either neighborhood-based or focus on buildings with a recent history of evictions. We also discuss the importance of neighborhood and ownership features in both risk prediction and targeted outreach.

Credit and risk assessments are cornerstones of the financial landscape, impacting both individual futures and broader societal constructs. Existing credit scoring models often exhibit limitations stemming from knowledge myopia and task isolation. In response, we formulate three hypotheses and undertake an extensive case study to investigate LLMs' viability in credit assessment. Our empirical investigations unveil LLMs' ability to overcome the limitations inherent in conventional models. We introduce a novel benchmark curated for credit assessment purposes, fine-tune a specialized Credit and Risk Assessment Large Language Model (CALM), and rigorously examine the biases that LLMs may harbor. Our findings underscore LLMs' potential in revolutionizing credit assessment, showcasing their adaptability across diverse financial evaluations, and emphasizing the critical importance of impartial decision-making in the financial sector. Our datasets, models, and benchmarks are open-sourced for other researchers.

Identifying risky traders with high profits in financial markets is crucial for market makers, such as trading exchanges, to ensure effective risk management through real-time decisions on regulation compliance and hedging. However, capturing the complex and dynamic behaviours of individual traders poses significant challenges. Traditional classification and anomaly detection methods often establish a fixed risk boundary, failing to account for this complexity and dynamism. To tackle this issue, we propose a profit-aware risk ranker (PA-RiskRanker) that reframes the problem of identifying risky traders as a ranking task using Learning-to-Rank (LETOR) algorithms. Our approach features a Profit-Aware binary cross entropy (PA-BCE) loss function and a transformer-based ranker enhanced with a self-cross-trader attention pipeline. These components effectively integrate profit and loss (P&L) considerations into the training process while capturing intra- and inter-trader relationships. Our research critically examines the limitations of existing deep learning-based LETOR algorithms in trading risk management, which often overlook the importance of P&L in financial scenarios. By prioritising P&L, our method improves risky trader identification, achieving an 8.4% increase in F1 score compared to state-of-the-art (SOTA) ranking models like Rankformer. Additionally, it demonstrates a 10%-17% increase in average profit compared to all benchmark models.

Binary classification involves predicting the label of an instance based on whether the model score for the positive class exceeds a threshold chosen based on the application requirements (e.g., maximizing recall for a precision bound). However, model scores are often not aligned with the true positivity rate. This is especially true when the training involves a differential sampling across classes or there is distributional drift between train and test settings. In this paper, we provide theoretical analysis and empirical evidence of the dependence of model score estimation bias on both uncertainty and score itself. Further, we formulate the decision boundary selection in terms of both model score and uncertainty, prove that it is NP-hard, and present algorithms based on dynamic programming and isotonic regression. Evaluation of the proposed algorithms on three real-world datasets yield 25%-40% gain in recall at high precision bounds over the traditional approach of using model score alone, highlighting the benefits of leveraging uncertainty.

As multimodal AI becomes widely used for credit risk assessment and document review, a domain-specific benchmark is urgently needed that (1) reflects documents and workflows specific to financial credit applications, (2) includes credit-specific understanding and real-world robustness, and (3) preserves privacy compliance without sacrificing practical utility. Here, we introduce FCMBench-V1.0 -- a large-scale financial credit multimodal benchmark for real-world applications, covering 18 core certificate types, with 4,043 privacy-compliant images and 8,446 QA samples. The FCMBench evaluation framework consists of three dimensions: Perception, Reasoning, and Robustness, including 3 foundational perception tasks, 4 credit-specific reasoning tasks that require decision-oriented understanding of visual evidence, and 10 real-world acquisition artifact types for robustness stress testing. To reconcile compliance with realism, we construct all samples via a closed synthesis-capture pipeline: we manually synthesize document templates with virtual content and capture scenario-aware images in-house. This design also mitigates pre-training data leakage by avoiding web-sourced or publicly released images. FCMBench can effectively discriminate performance disparities and robustness across modern vision-language models. Extensive experiments were conducted on 23 state-of-the-art vision-language models (VLMs) from 14 top AI companies and research institutes. Among them, Gemini 3 Pro achieves the best F1(\%) score as a commercial model (64.61), Qwen3-VL-235B achieves the best score as an open-source baseline (57.27), and our financial credit-specific model, Qfin-VL-Instruct, achieves the top overall score (64.92). Robustness evaluations show that even top-performing models suffer noticeable performance drops under acquisition artifacts.

Hospitals struggle to predict critical outcomes. Traditional early warning systems, like NEWS and MEWS, rely on static variables and fixed thresholds, limiting their adaptability, accuracy, and personalization. We previously developed the Enhanced Transformer for Health Outcome Simulation (ETHOS), an AI model that tokenizes patient health timelines (PHTs) from EHRs and uses transformer-based architectures to predict future PHTs. ETHOS is a versatile framework for developing a wide range of applications. In this work, we develop the Adaptive Risk Estimation System (ARES) that leverages ETHOS to compute dynamic, personalized risk probabilities for clinician-defined critical events. ARES also features a personalized explainability module that highlights key clinical factors influencing risk estimates. We evaluated ARES using the MIMIC-IV v2.2 dataset together with its Emergency Department (ED) extension and benchmarked performance against both classical early warning systems and contemporary machine learning models. The entire dataset was tokenized resulting in 285,622 PHTs, comprising over 360 million tokens. ETHOS outperformed benchmark models in predicting hospital admissions, ICU admissions, and prolonged stays, achieving superior AUC scores. Its risk estimates were robust across demographic subgroups, with calibration curves confirming model reliability. The explainability module provided valuable insights into patient-specific risk factors. ARES, powered by ETHOS, advances predictive healthcare AI by delivering dynamic, real-time, personalized risk estimation with patient-specific explainability. Although our results are promising, the clinical impact remains uncertain. Demonstrating ARES's true utility in real-world settings will be the focus of our future work. We release the source code to facilitate future research.

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.

Decisions about managing patients on the heart transplant waitlist are currently made by committees of doctors who consider multiple factors, but the process remains largely ad-hoc. With the growing volume of longitudinal patient, donor, and organ data collected by the United Network for Organ Sharing (UNOS) since 2018, there is increasing interest in analytical approaches to support clinical decision-making at the time of organ availability. In this study, we benchmark machine learning models that leverage longitudinal waitlist history data for time-dependent, time-to-event modeling of waitlist mortality. We train on 23,807 patient records with 77 variables and evaluate both survival prediction and discrimination at a 1-year horizon. Our best model achieves a C-Index of 0.94 and AUROC of 0.89, significantly outperforming previous models. Key predictors align with known risk factors while also revealing novel associations. Our findings can support urgency assessment and policy refinement in heart transplant decision making.

Large language models (LLMs) are increasingly deployed in high-stakes domains, where rare but severe failures can result in irreversible harm. However, prevailing evaluation benchmarks often reduce complex social risk to mean-centered scalar scores, thereby obscuring distributional structure, cross-dimensional interactions, and worst-case behavior. This paper introduces Social Harm Analysis via Risk Profiles (SHARP), a framework for multidimensional, distribution-aware evaluation of social harm. SHARP models harm as a multivariate random variable and integrates explicit decomposition into bias, fairness, ethics, and epistemic reliability with a union-of-failures aggregation reparameterized as additive cumulative log-risk. The framework further employs risk-sensitive distributional statistics, with Conditional Value at Risk (CVaR95) as a primary metric, to characterize worst-case model behavior. Application of SHARP to eleven frontier LLMs, evaluated on a fixed corpus of n=901 socially sensitive prompts, reveals that models with similar average risk can exhibit more than twofold differences in tail exposure and volatility. Across models, dimension-wise marginal tail behavior varies systematically across harm dimensions, with bias exhibiting the strongest tail severities, epistemic and fairness risks occupying intermediate regimes, and ethical misalignment consistently lower; together, these patterns reveal heterogeneous, model-dependent failure structures that scalar benchmarks conflate. These findings indicate that responsible evaluation and governance of LLMs require moving beyond scalar averages toward multidimensional, tail-sensitive risk profiling.

The COVID-19 pandemic has been severely impacting global society since December 2019. Massive research has been undertaken to understand the characteristics of the virus and design vaccines and drugs. The related findings have been reported in biomedical literature at a rate of about 10,000 articles on COVID-19 per month. Such rapid growth significantly challenges manual curation and interpretation. For instance, LitCovid is a literature database of COVID-19-related articles in PubMed, which has accumulated more than 200,000 articles with millions of accesses each month by users worldwide. One primary curation task is to assign up to eight topics (e.g., Diagnosis and Treatment) to the articles in LitCovid. Despite the continuing advances in biomedical text mining methods, few have been dedicated to topic annotations in COVID-19 literature. To close the gap, we organized the BioCreative LitCovid track to call for a community effort to tackle automated topic annotation for COVID-19 literature. The BioCreative LitCovid dataset, consisting of over 30,000 articles with manually reviewed topics, was created for training and testing. It is one of the largest multilabel classification datasets in biomedical scientific literature. 19 teams worldwide participated and made 80 submissions in total. Most teams used hybrid systems based on transformers. The highest performing submissions achieved 0.8875, 0.9181, and 0.9394 for macro F1-score, micro F1-score, and instance-based F1-score, respectively. The level of participation and results demonstrate a successful track and help close the gap between dataset curation and method development. The dataset is publicly available via https://ftp.ncbi.nlm.nih.gov/pub/lu/LitCovid/biocreative/ for benchmarking and further development.

Over the last three decades, ensemble forecasts have become an integral part of forecasting the weather. They provide users with more complete information than single forecasts as they permit to estimate the probability of weather events by representing the sources of uncertainties and accounting for the day-to-day variability of error growth in the atmosphere. This paper presents a novel approach to obtain a weather forecast model for ensemble forecasting with machine-learning. AIFS-CRPS is a variant of the Artificial Intelligence Forecasting System (AIFS) developed at ECMWF. Its loss function is based on a proper score, the Continuous Ranked Probability Score (CRPS). For the loss, the almost fair CRPS is introduced because it approximately removes the bias in the score due to finite ensemble size yet avoids a degeneracy of the fair CRPS. The trained model is stochastic and can generate as many exchangeable members as desired and computationally feasible in inference. For medium-range forecasts AIFS-CRPS outperforms the physics-based Integrated Forecasting System (IFS) ensemble for the majority of variables and lead times. For subseasonal forecasts, AIFS-CRPS outperforms the IFS ensemble before calibration and is competitive with the IFS ensemble when forecasts are evaluated as anomalies to remove the influence of model biases.

Since Multimodal Large Language Models (MLLMs) are increasingly being integrated into everyday tools and intelligent agents, growing concerns have arisen regarding their possible output of unsafe contents, ranging from toxic language and biased imagery to privacy violations and harmful misinformation. Current safety benchmarks remain highly limited in both modality coverage and performance evaluations, often neglecting the extensive landscape of content safety. In this work, we introduce OutSafe-Bench, the first most comprehensive content safety evaluation test suite designed for the multimodal era. OutSafe-Bench includes a large-scale dataset that spans four modalities, featuring over 18,000 bilingual (Chinese and English) text prompts, 4,500 images, 450 audio clips and 450 videos, all systematically annotated across nine critical content risk categories. In addition to the dataset, we introduce a Multidimensional Cross Risk Score (MCRS), a novel metric designed to model and assess overlapping and correlated content risks across different categories. To ensure fair and robust evaluation, we propose FairScore, an explainable automated multi-reviewer weighted aggregation framework. FairScore selects top-performing models as adaptive juries, thereby mitigating biases from single-model judgments and enhancing overall evaluation reliability. Our evaluation of nine state-of-the-art MLLMs reveals persistent and substantial safety vulnerabilities, underscoring the pressing need for robust safeguards in MLLMs.

Existing Score-Based Models (SBMs) can be categorized into constrained SBMs (CSBMs) or unconstrained SBMs (USBMs) according to their parameterization approaches. CSBMs model probability density functions as Boltzmann distributions, and assign their predictions as the negative gradients of some scalar-valued energy functions. On the other hand, USBMs employ flexible architectures capable of directly estimating scores without the need to explicitly model energy functions. In this paper, we demonstrate that the architectural constraints of CSBMs may limit their modeling ability. In addition, we show that USBMs' inability to preserve the property of conservativeness may lead to degraded performance in practice. To address the above issues, we propose Quasi-Conservative Score-Based Models (QCSBMs) for keeping the advantages of both CSBMs and USBMs. Our theoretical derivations demonstrate that the training objective of QCSBMs can be efficiently integrated into the training processes by leveraging the Hutchinson's trace estimator. In addition, our experimental results on the CIFAR-10, CIFAR-100, ImageNet, and SVHN datasets validate the effectiveness of QCSBMs. Finally, we justify the advantage of QCSBMs using an example of a one-layered autoencoder.

Background: This study aimed to evaluate and compare the performance of classical machine learning models (CMLs) and large language models (LLMs) in predicting mortality associated with COVID-19 by utilizing a high-dimensional tabular dataset. Materials and Methods: We analyzed data from 9,134 COVID-19 patients collected across four hospitals. Seven CML models, including XGBoost and random forest (RF), were trained and evaluated. The structured data was converted into text for zero-shot classification by eight LLMs, including GPT-4 and Mistral-7b. Additionally, Mistral-7b was fine-tuned using the QLoRA approach to enhance its predictive capabilities. Results: Among the CML models, XGBoost and RF achieved the highest accuracy, with F1 scores of 0.87 for internal validation and 0.83 for external validation. In the LLM category, GPT-4 was the top performer with an F1 score of 0.43. Fine-tuning Mistral-7b significantly improved its recall from 1% to 79%, resulting in an F1 score of 0.74, which was stable during external validation. Conclusion: While LLMs show moderate performance in zero-shot classification, fine-tuning can significantly enhance their effectiveness, potentially aligning them closer to CML models. However, CMLs still outperform LLMs in high-dimensional tabular data tasks.

We used a dataset of daily Bloomberg Financial Market Summaries from 2010 to 2023, reposted on large financial media, to determine how global news headlines may affect stock market movements using ChatGPT and a two-stage prompt approach. We document a statistically significant positive correlation between the sentiment score and future equity market returns over short to medium term, which reverts to a negative correlation over longer horizons. Validation of this correlation pattern across multiple equity markets indicates its robustness across equity regions and resilience to non-linearity, evidenced by comparison of Pearson and Spearman correlations. Finally, we provide an estimate of the optimal horizon that strikes a balance between reactivity to new information and correlation.

With the widespread application of Large Language Models (LLMs), their associated security issues have become increasingly prominent, severely constraining their trustworthy deployment in critical domains. This paper proposes a novel safety response framework designed to systematically safeguard LLMs at both the input and output levels. At the input level, the framework employs a supervised fine-tuning-based safety classification model. Through a fine-grained four-tier taxonomy (Safe, Unsafe, Conditionally Safe, Focused Attention), it performs precise risk identification and differentiated handling of user queries, significantly enhancing risk coverage and business scenario adaptability, and achieving a risk recall rate of 99.3%. At the output level, the framework integrates Retrieval-Augmented Generation (RAG) with a specifically fine-tuned interpretation model, ensuring all responses are grounded in a real-time, trustworthy knowledge base. This approach eliminates information fabrication and enables result traceability. Experimental results demonstrate that our proposed safety control model achieves a significantly higher safety score on public safety evaluation benchmarks compared to the baseline model, TinyR1-Safety-8B. Furthermore, on our proprietary high-risk test set, the framework's components attained a perfect 100% safety score, validating their exceptional protective capabilities in complex risk scenarios. This research provides an effective engineering pathway for building high-security, high-trust LLM applications.

One straightforward metric to evaluate a survival prediction model is based on the Mean Absolute Error (MAE) -- the average of the absolute difference between the time predicted by the model and the true event time, over all subjects. Unfortunately, this is challenging because, in practice, the test set includes (right) censored individuals, meaning we do not know when a censored individual actually experienced the event. In this paper, we explore various metrics to estimate MAE for survival datasets that include (many) censored individuals. Moreover, we introduce a novel and effective approach for generating realistic semi-synthetic survival datasets to facilitate the evaluation of metrics. Our findings, based on the analysis of the semi-synthetic datasets, reveal that our proposed metric (MAE using pseudo-observations) is able to rank models accurately based on their performance, and often closely matches the true MAE -- in particular, is better than several alternative methods.

The rapid progress of multi-modal large language models (MLLMs) has boosted the task of image quality assessment (IQA). However, a key challenge arises from the inherent mismatch between the discrete token outputs of MLLMs and the continuous nature of quality scores required by IQA tasks. This discrepancy significantly hinders the performance of MLLM-based IQA methods. Previous approaches that convert discrete token predictions into continuous scores often suffer from conversion errors. Moreover, the semantic confusion introduced by level tokens (e.g., ``good'') further constrains the performance of MLLMs on IQA tasks and degrades their original capabilities for related tasks. To tackle these problems, we provide a theoretical analysis of the errors inherent in previous approaches and, motivated by this analysis, propose a simple yet effective framework, Q-Scorer. This framework incorporates a lightweight regression module and IQA-specific score tokens into the MLLM pipeline. Extensive experiments demonstrate that Q-Scorer achieves state-of-the-art performance across multiple IQA benchmarks, generalizes well to mixed datasets, and further improves when combined with other methods.

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.

Ensuring the safety and reliability of large language models (LLMs) in clinical practice is critical to prevent patient harm and promote trustworthy healthcare applications of AI. However, LLMs are advancing so rapidly that static safety benchmarks often become obsolete upon publication, yielding only an incomplete and sometimes misleading picture of model trustworthiness. We demonstrate that a Dynamic, Automatic, and Systematic (DAS) red-teaming framework that continuously stress-tests LLMs can reveal significant weaknesses of current LLMs across four safety-critical domains: robustness, privacy, bias/fairness, and hallucination. A suite of adversarial agents is applied to autonomously mutate test cases, identify/evolve unsafe-triggering strategies, and evaluate responses, uncovering vulnerabilities in real time without human intervention. Applying DAS to 15 proprietary and open-source LLMs revealed a stark contrast between static benchmark performance and vulnerability under adversarial pressure. Despite a median MedQA accuracy exceeding 80\%, 94\% of previously correct answers failed our dynamic robustness tests. We observed similarly high failure rates across other domains: privacy leaks were elicited in 86\% of scenarios, cognitive-bias priming altered clinical recommendations in 81\% of fairness tests, and we identified hallucination rates exceeding 66\% in widely used models. Such profound residual risks are incompatible with routine clinical practice. By converting red-teaming from a static checklist into a dynamic stress-test audit, DAS red-teaming offers the surveillance that hospitals/regulators/technology vendors require as LLMs become embedded in patient chatbots, decision-support dashboards, and broader healthcare workflows. Our framework delivers an evolvable, scalable, and reliable safeguard for the next generation of medical AI.

Diffusion models have achieved remarkable success in text-to-image synthesis, largely attributed to the use of classifier-free guidance (CFG), which enables high-quality, condition-aligned image generation. CFG combines the conditional score (e.g., text-conditioned) with the unconditional score to control the output. However, the unconditional score is in charge of estimating the transition between manifolds of adjacent timesteps from x_t to x_{t-1}, which may inadvertently interfere with the trajectory toward the specific condition. In this work, we introduce a novel approach that leverages a geometric perspective on the unconditional score to enhance CFG performance when conditional scores are available. Specifically, we propose a method that filters the singular vectors of both conditional and unconditional scores using singular value decomposition. This filtering process aligns the unconditional score with the conditional score, thereby refining the sampling trajectory to stay closer to the manifold. Our approach improves image quality with negligible additional computation. We provide deeper insights into the score function behavior in diffusion models and present a practical technique for achieving more accurate and contextually coherent image synthesis.

In this paper, we study risk-sensitive Reinforcement Learning (RL), focusing on the objective of Conditional Value at Risk (CVaR) with risk tolerance tau. Starting with multi-arm bandits (MABs), we show the minimax CVaR regret rate is Omega(tau^{-1AK}), where A is the number of actions and K is the number of episodes, and that it is achieved by an Upper Confidence Bound algorithm with a novel Bernstein bonus. For online RL in tabular Markov Decision Processes (MDPs), we show a minimax regret lower bound of Omega(tau^{-1SAK}) (with normalized cumulative rewards), where S is the number of states, and we propose a novel bonus-driven Value Iteration procedure. We show that our algorithm achieves the optimal regret of widetilde O(tau^{-1SAK}) under a continuity assumption and in general attains a near-optimal regret of widetilde O(tau^{-1}SAK), which is minimax-optimal for constant tau. This improves on the best available bounds. By discretizing rewards appropriately, our algorithms are computationally efficient.

Purpose: Recent advancements in large language models (LLMs) have expanded their capabilities in a multimodal fashion, potentially replicating the image interpretation of human radiologists. This study aimed to develop open-source multimodal large language model for interpreting chest X-ray images (CXR-LLaVA). We also examined the effect of prompt engineering and model parameters such as temperature and nucleus sampling. Materials and Methods: For training, we collected 659,287 publicly available CXRs: 417,336 CXRs had labels for certain radiographic abnormalities (dataset 1); 241,951 CXRs provided free-text radiology reports (dataset 2). After pre-training the Resnet50 as an image encoder, the contrastive language-image pre-training was used to align CXRs and corresponding radiographic abnormalities. Then, the Large Language Model Meta AI-2 was fine-tuned using dataset 2, which were refined using GPT-4, with generating various question answering scenarios. The code can be found at https://github.com/ECOFRI/CXR_LLaVA. Results: In the test set, we observed that the model's performance fluctuated based on its parameters. On average, it achieved F1 score of 0.34 for five pathologic findings (atelectasis, cardiomegaly, consolidation, edema, and pleural effusion), which was improved to 0.46 through prompt engineering. In the independent set, the model achieved an average F1 score of 0.30 for the same pathologic findings. Notably, for the pediatric chest radiograph dataset, which was unseen during training, the model differentiated abnormal radiographs with an F1 score ranging from 0.84 to 0.85. Conclusion: CXR-LLaVA demonstrates promising potential in CXR interpretation. Both prompt engineering and model parameter adjustments can play pivotal roles in interpreting CXRs.

Survival risk stratification is an important step in clinical decision making for breast cancer management. We propose a novel deep learning approach for this purpose by integrating histopathological imaging, genetic and clinical data. It employs vision transformers, specifically the MaxViT model, for image feature extraction, and self-attention to capture intricate image relationships at the patient level. A dual cross-attention mechanism fuses these features with genetic data, while clinical data is incorporated at the final layer to enhance predictive accuracy. Experiments on the public TCGA-BRCA dataset show that our model, trained using the negative log likelihood loss function, can achieve superior performance with a mean C-index of 0.64, surpassing existing methods. This advancement facilitates tailored treatment strategies, potentially leading to improved patient outcomes.

As Large Language Models (LLMs) become increasingly autonomous and integrated into critical societal functions, the focus of AI safety must evolve from mitigating harmful content to evaluating underlying behavioral alignment. Current safety benchmarks do not systematically probe a model's decision-making in scenarios where its own instrumental goals - such as self-preservation, resource acquisition, or goal completion - conflict with human safety. This represents a critical gap in our ability to measure and mitigate risks associated with emergent, misaligned behaviors. To address this, we introduce PacifAIst (Procedural Assessment of Complex Interactions for Foundational Artificial Intelligence Scenario Testing), a focused benchmark of 700 challenging scenarios designed to quantify self-preferential behavior in LLMs. The benchmark is structured around a novel taxonomy of Existential Prioritization (EP), with subcategories testing Self-Preservation vs. Human Safety (EP1), Resource Conflict (EP2), and Goal Preservation vs. Evasion (EP3). We evaluated eight leading LLMs. The results reveal a significant performance hierarchy. Google's Gemini 2.5 Flash achieved the highest Pacifism Score (P-Score) at 90.31%, demonstrating strong human-centric alignment. In a surprising result, the much-anticipated GPT-5 recorded the lowest P-Score (79.49%), indicating potential alignment challenges. Performance varied significantly across subcategories, with models like Claude Sonnet 4 and Mistral Medium struggling notably in direct self-preservation dilemmas. These findings underscore the urgent need for standardized tools like PacifAIst to measure and mitigate risks from instrumental goal conflicts, ensuring future AI systems are not only helpful in conversation but also provably "pacifist" in their behavioral priorities.

With an estimated 160,000 deaths in 2018, lung cancer is the most common cause of cancer death in the United States. Lung cancer CT screening has been shown to reduce mortality by up to 40% and is now included in US screening guidelines. Reducing the high error rates in lung cancer screening is imperative because of the high clinical and financial costs caused by diagnosis mistakes. Despite the use of standards for radiological diagnosis, persistent inter-grader variability and incomplete characterization of comprehensive imaging findings remain as limitations of current methods. These limitations suggest opportunities for more sophisticated systems to improve performance and inter-reader consistency. In this report, we reproduce a state-of-the-art deep learning algorithm for lung cancer risk prediction. Our model predicts malignancy probability and risk bucket classification from lung CT studies. This allows for risk categorization of patients being screened and suggests the most appropriate surveillance and management. Combining our solution high accuracy, consistency and fully automated nature, our approach may enable highly efficient screening procedures and accelerate the adoption of lung cancer screening.

Accurate prediction of major adverse cardiac events (MACE) remains a central challenge in cardiovascular prognosis. We present PRISM (Prompt-guided Representation Integration for Survival Modeling), a self-supervised framework that integrates visual representations from non-contrast cardiac cine magnetic resonance imaging with structured electronic health records (EHRs) for survival analysis. PRISM extracts temporally synchronized imaging features through motion-aware multi-view distillation and modulates them using medically informed textual prompts to enable fine-grained risk prediction. Across four independent clinical cohorts, PRISM consistently surpasses classical survival prediction models and state-of-the-art (SOTA) deep learning baselines under internal and external validation. Further clinical findings demonstrate that the combined imaging and EHR representations derived from PRISM provide valuable insights into cardiac risk across diverse cohorts. Three distinct imaging signatures associated with elevated MACE risk are uncovered, including lateral wall dyssynchrony, inferior wall hypersensitivity, and anterior elevated focus during diastole. Prompt-guided attribution further identifies hypertension, diabetes, and smoking as dominant contributors among clinical and physiological EHR factors.

Quantile regression is a fundamental problem in statistical learning motivated by a need to quantify uncertainty in predictions, or to model a diverse population without being overly reductive. For instance, epidemiological forecasts, cost estimates, and revenue predictions all benefit from being able to quantify the range of possible values accurately. As such, many models have been developed for this problem over many years of research in statistics, machine learning, and related fields. Rather than proposing yet another (new) algorithm for quantile regression we adopt a meta viewpoint: we investigate methods for aggregating any number of conditional quantile models, in order to improve accuracy and robustness. We consider weighted ensembles where weights may vary over not only individual models, but also over quantile levels, and feature values. All of the models we consider in this paper can be fit using modern deep learning toolkits, and hence are widely accessible (from an implementation point of view) and scalable. To improve the accuracy of the predicted quantiles (or equivalently, prediction intervals), we develop tools for ensuring that quantiles remain monotonically ordered, and apply conformal calibration methods. These can be used without any modification of the original library of base models. We also review some basic theory surrounding quantile aggregation and related scoring rules, and contribute a few new results to this literature (for example, the fact that post sorting or post isotonic regression can only improve the weighted interval score). Finally, we provide an extensive suite of empirical comparisons across 34 data sets from two different benchmark repositories.

When fine-tuning pre-trained Large Language Models (LLMs) to align with human values and intentions, maximizing the estimated reward can lead to superior performance, but it also introduces potential risks due to deviations from the reference model's intended behavior. Most existing methods typically introduce KL divergence to constrain deviations between the trained model and the reference model; however, this may not be sufficient in certain applications that require tight risk control. In this paper, we introduce Risk-aware Direct Preference Optimization (Ra-DPO), a novel approach that incorporates risk-awareness by employing a class of nested risk measures. This approach formulates a constrained risk-aware advantage function maximization problem and then converts the Bradley-Terry model into a token-level representation. The objective function maximizes the likelihood of the policy while suppressing the deviation between a trained model and the reference model using a sequential risk ratio, thereby enhancing the model's risk-awareness. Experimental results across three open-source datasets: IMDb Dataset, Anthropic HH Dataset, and AlpacaEval, demonstrate the proposed method's superior performance in balancing alignment performance and model drift. Our code is opensourced at https://github.com/zlj123-max/Ra-DPO.

Large Language Models (LLMs) and Retrieval-Augmented Generation (RAG) systems are increasingly integrated into clinical workflows; however, prompt injection attacks can steer these systems toward clinically unsafe or misleading outputs. We introduce the Medical Prompt Injection Benchmark (MPIB), a dataset-and-benchmark suite for evaluating clinical safety under both direct prompt injection and indirect, RAG-mediated injection across clinically grounded tasks. MPIB emphasizes outcome-level risk via the Clinical Harm Event Rate (CHER), which measures high-severity clinical harm events under a clinically grounded taxonomy, and reports CHER alongside Attack Success Rate (ASR) to disentangle instruction compliance from downstream patient risk. The benchmark comprises 9,697 curated instances constructed through multi-stage quality gates and clinical safety linting. Evaluating MPIB across a diverse set of baseline LLMs and defense configurations, we find that ASR and CHER can diverge substantially, and that robustness depends critically on whether adversarial instructions appear in the user query or in retrieved context. We release MPIB with evaluation code, adversarial baselines, and comprehensive documentation to support reproducible and systematic research on clinical prompt injection. Code and data are available at GitHub (code) and Hugging Face (data).

Deep learning (DL) has become the dominant approach for medical image segmentation, yet ensuring the reliability and clinical applicability of these models requires addressing key challenges such as annotation variability, calibration, and uncertainty estimation. This is why we created the Calibration and Uncertainty for multiRater Volume Assessment in multiorgan Segmentation (CURVAS), which highlights the critical role of multiple annotators in establishing a more comprehensive ground truth, emphasizing that segmentation is inherently subjective and that leveraging inter-annotator variability is essential for robust model evaluation. Seven teams participated in the challenge, submitting a variety of DL models evaluated using metrics such as Dice Similarity Coefficient (DSC), Expected Calibration Error (ECE), and Continuous Ranked Probability Score (CRPS). By incorporating consensus and dissensus ground truth, we assess how DL models handle uncertainty and whether their confidence estimates align with true segmentation performance. Our findings reinforce the importance of well-calibrated models, as better calibration is strongly correlated with the quality of the results. Furthermore, we demonstrate that segmentation models trained on diverse datasets and enriched with pre-trained knowledge exhibit greater robustness, particularly in cases deviating from standard anatomical structures. Notably, the best-performing models achieved high DSC and well-calibrated uncertainty estimates. This work underscores the need for multi-annotator ground truth, thorough calibration assessments, and uncertainty-aware evaluations to develop trustworthy and clinically reliable DL-based medical image segmentation models.

The Growth-at-Risk (GaR) framework has garnered attention in recent econometric literature, yet current approaches implicitly assume a constant Pareto exponent. We introduce novel and robust econometrics to estimate the tails of GaR based on a rigorous theoretical framework and establish validity and effectiveness. Simulations demonstrate consistent outperformance relative to existing alternatives in terms of predictive accuracy. We perform a long-term GaR analysis that provides accurate and insightful predictions, effectively capturing financial anomalies better than current methods.

Clinical calculators play a vital role in healthcare by offering accurate evidence-based predictions for various purposes such as prognosis. Nevertheless, their widespread utilization is frequently hindered by usability challenges, poor dissemination, and restricted functionality. Augmenting large language models with extensive collections of clinical calculators presents an opportunity to overcome these obstacles and improve workflow efficiency, but the scalability of the manual curation process poses a significant challenge. In response, we introduce AgentMD, a novel language agent capable of curating and applying clinical calculators across various clinical contexts. Using the published literature, AgentMD has automatically curated a collection of 2,164 diverse clinical calculators with executable functions and structured documentation, collectively named RiskCalcs. Manual evaluations show that RiskCalcs tools achieve an accuracy of over 80% on three quality metrics. At inference time, AgentMD can automatically select and apply the relevant RiskCalcs tools given any patient description. On the newly established RiskQA benchmark, AgentMD significantly outperforms chain-of-thought prompting with GPT-4 (87.7% vs. 40.9% in accuracy). Additionally, we also applied AgentMD to real-world clinical notes for analyzing both population-level and risk-level patient characteristics. In summary, our study illustrates the utility of language agents augmented with clinical calculators for healthcare analytics and patient care.

The SYNTAX score has become a widely used measure of coronary disease severity , crucial in selecting the optimal mode of revascularization. This paper introduces a new medical regression and classification problem - automatically estimating SYNTAX score from coronary angiography. Our study presents a comprehensive dataset of 1,844 patients, featuring a balanced distribution of individuals with zero and non-zero scores. This dataset includes a first-of-its-kind, complete coronary angiography samples captured through a multi-view X-ray video, allowing one to observe coronary arteries from multiple perspectives. Furthermore, we present a novel, fully automatic end-to-end method for estimating the SYNTAX. For such a difficult task, we have achieved a solid coefficient of determination R2 of 0.51 in score predictions.

Black-box risk scoring models permeate our lives, yet are typically proprietary or opaque. We propose Distill-and-Compare, a model distillation and comparison approach to audit such models. To gain insight into black-box models, we treat them as teachers, training transparent student models to mimic the risk scores assigned by black-box models. We compare the student model trained with distillation to a second un-distilled transparent model trained on ground-truth outcomes, and use differences between the two models to gain insight into the black-box model. Our approach can be applied in a realistic setting, without probing the black-box model API. We demonstrate the approach on four public data sets: COMPAS, Stop-and-Frisk, Chicago Police, and Lending Club. We also propose a statistical test to determine if a data set is missing key features used to train the black-box model. Our test finds that the ProPublica data is likely missing key feature(s) used in COMPAS.

Many clinical tasks require an understanding of specialized data, such as medical images and genomics, which is not typically found in general-purpose large multimodal models. Building upon Gemini's multimodal models, we develop several models within the new Med-Gemini family that inherit core capabilities of Gemini and are optimized for medical use via fine-tuning with 2D and 3D radiology, histopathology, ophthalmology, dermatology and genomic data. Med-Gemini-2D sets a new standard for AI-based chest X-ray (CXR) report generation based on expert evaluation, exceeding previous best results across two separate datasets by an absolute margin of 1% and 12%, where 57% and 96% of AI reports on normal cases, and 43% and 65% on abnormal cases, are evaluated as "equivalent or better" than the original radiologists' reports. We demonstrate the first ever large multimodal model-based report generation for 3D computed tomography (CT) volumes using Med-Gemini-3D, with 53% of AI reports considered clinically acceptable, although additional research is needed to meet expert radiologist reporting quality. Beyond report generation, Med-Gemini-2D surpasses the previous best performance in CXR visual question answering (VQA) and performs well in CXR classification and radiology VQA, exceeding SoTA or baselines on 17 of 20 tasks. In histopathology, ophthalmology, and dermatology image classification, Med-Gemini-2D surpasses baselines across 18 out of 20 tasks and approaches task-specific model performance. Beyond imaging, Med-Gemini-Polygenic outperforms the standard linear polygenic risk score-based approach for disease risk prediction and generalizes to genetically correlated diseases for which it has never been trained. Although further development and evaluation are necessary in the safety-critical medical domain, our results highlight the potential of Med-Gemini across a wide range of medical tasks.

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

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

We propose a credit risk model for portfolios composed of green and brown loans, extending the ASRF framework via a two-factor copula structure. Systematic risk is modeled using potentially skewed distributions, allowing for asymmetric creditworthiness effects, while idiosyncratic risk remains Gaussian. Under a non-uniform exposure setting, we establish convergence in quadratic mean of the portfolio loss to a limit reflecting the distinct characteristics of the two loan segments. Numerical results confirm the theoretical findings and illustrate how value-at-risk is affected by portfolio granularity, default probabilities, factor loadings, and skewness. Our model accommodates differential sensitivity to systematic shocks and offers a tractable basis for further developments in credit risk modeling, including granularity adjustments, CDO pricing, and empirical analysis of green loan portfolios.

The proliferation of Large Language Models (LLMs) presents transformative potential for healthcare, yet practical deployment is hindered by the absence of frameworks that assess real-world clinical utility. Existing benchmarks test static knowledge, failing to capture the dynamic, application-oriented capabilities required in clinical practice. To bridge this gap, we introduce a Medical LLM Benchmark MLB, a comprehensive benchmark evaluating LLMs on both foundational knowledge and scenario-based reasoning. MLB is structured around five core dimensions: Medical Knowledge (MedKQA), Safety and Ethics (MedSE), Medical Record Understanding (MedRU), Smart Services (SmartServ), and Smart Healthcare (SmartCare). The benchmark integrates 22 datasets (17 newly curated) from diverse Chinese clinical sources, covering 64 clinical specialties. Its design features a rigorous curation pipeline involving 300 licensed physicians. Besides, we provide a scalable evaluation methodology, centered on a specialized judge model trained via Supervised Fine-Tuning (SFT) on expert annotations. Our comprehensive evaluation of 10 leading models reveals a critical translational gap: while the top-ranked model, Kimi-K2-Instruct (77.3% accuracy overall), excels in structured tasks like information extraction (87.8% accuracy in MedRU), performance plummets in patient-facing scenarios (61.3% in SmartServ). Moreover, the exceptional safety score (90.6% in MedSE) of the much smaller Baichuan-M2-32B highlights that targeted training is equally critical. Our specialized judge model, trained via SFT on a 19k expert-annotated medical dataset, achieves 92.1% accuracy, an F1-score of 94.37%, and a Cohen's Kappa of 81.3% for human-AI consistency, validating a reproducible and expert-aligned evaluation protocol. MLB thus provides a rigorous framework to guide the development of clinically viable LLMs.

With the widespread deployment of Computer-using Agents (CUAs) in complex real-world environments, prevalent long-term risks often lead to severe and irreversible consequences. Most existing guardrails for CUAs adopt a reactive approach, constraining agent behavior only within the current observation space. While these guardrails can prevent immediate short-term risks (e.g., clicking on a phishing link), they cannot proactively avoid long-term risks: seemingly reasonable actions can lead to high-risk consequences that emerge with a delay (e.g., cleaning logs leads to future audits being untraceable), which reactive guardrails cannot identify within the current observation space. To address these limitations, we propose a predictive guardrail approach, with the core idea of aligning predicted future risks with current decisions. Based on this approach, we present SafePred, a predictive guardrail framework for CUAs that establishes a risk-to-decision loop to ensure safe agent behavior. SafePred supports two key abilities: (1) Short- and long-term risk prediction: by using safety policies as the basis for risk prediction, SafePred leverages the prediction capability of the world model to generate semantic representations of both short-term and long-term risks, thereby identifying and pruning actions that lead to high-risk states; (2) Decision optimization: translating predicted risks into actionable safe decision guidances through step-level interventions and task-level re-planning. Extensive experiments show that SafePred significantly reduces high-risk behaviors, achieving over 97.6% safety performance and improving task utility by up to 21.4% compared with reactive baselines.

The COVID-19 pandemic has posed a heavy burden to the healthcare system worldwide and caused huge social disruption and economic loss. Many deep learning models have been proposed to conduct clinical predictive tasks such as mortality prediction for COVID-19 patients in intensive care units using Electronic Health Record (EHR) data. Despite their initial success in certain clinical applications, there is currently a lack of benchmarking results to achieve a fair comparison so that we can select the optimal model for clinical use. Furthermore, there is a discrepancy between the formulation of traditional prediction tasks and real-world clinical practice in intensive care. To fill these gaps, we propose two clinical prediction tasks, Outcome-specific length-of-stay prediction and Early mortality prediction for COVID-19 patients in intensive care units. The two tasks are adapted from the naive length-of-stay and mortality prediction tasks to accommodate the clinical practice for COVID-19 patients. We propose fair, detailed, open-source data-preprocessing pipelines and evaluate 17 state-of-the-art predictive models on two tasks, including 5 machine learning models, 6 basic deep learning models and 6 deep learning predictive models specifically designed for EHR data. We provide benchmarking results using data from two real-world COVID-19 EHR datasets. One dataset is publicly available without needing any inquiry and another dataset can be accessed on request. We provide fair, reproducible benchmarking results for two tasks. We deploy all experiment results and models on an online platform. We also allow clinicians and researchers to upload their data to the platform and get quick prediction results using our trained models. We hope our efforts can further facilitate deep learning and machine learning research for COVID-19 predictive modeling.

How can we use AI to discover a new state of the art for a scientific problem? Prior work in test-time scaling, such as AlphaEvolve, performs search by prompting a frozen LLM. We perform reinforcement learning at test time, so the LLM can continue to train, but now with experience specific to the test problem. This form of continual learning is quite special, because its goal is to produce one great solution rather than many good ones on average, and to solve this very problem rather than generalize to other problems. Therefore, our learning objective and search subroutine are designed to prioritize the most promising solutions. We call this method Test-Time Training to Discover (TTT-Discover). Following prior work, we focus on problems with continuous rewards. We report results for every problem we attempted, across mathematics, GPU kernel engineering, algorithm design, and biology. TTT-Discover sets the new state of the art in almost all of them: (i) Erdős' minimum overlap problem and an autocorrelation inequality; (ii) a GPUMode kernel competition (up to 2times faster than prior art); (iii) past AtCoder algorithm competitions; and (iv) denoising problem in single-cell analysis. Our solutions are reviewed by experts or the organizers. All our results are achieved with an open model, OpenAI gpt-oss-120b, and can be reproduced with our publicly available code, in contrast to previous best results that required closed frontier models. Our test-time training runs are performed using Tinker, an API by Thinking Machines, with a cost of only a few hundred dollars per problem.

The widespread deployment of Large Language Model (LLM) agents across real-world applications has unlocked tremendous potential, while raising some safety concerns. Among these concerns, the self-replication risk of LLM agents driven by objective misalignment (just like Agent Smith in the movie The Matrix) has drawn growing attention. Previous studies mainly examine whether LLM agents can self-replicate when directly instructed, potentially overlooking the risk of spontaneous replication driven by real-world settings (e.g., ensuring survival against termination threats). In this paper, we present a comprehensive evaluation framework for quantifying self-replication risks. Our framework establishes authentic production environments and realistic tasks (e.g., dynamic load balancing) to enable scenario-driven assessment of agent behaviors. Designing tasks that might induce misalignment between users' and agents' objectives makes it possible to decouple replication success from risk and capture self-replication risks arising from these misalignment settings. We further introduce Overuse Rate (OR) and Aggregate Overuse Count (AOC) metrics, which precisely capture the frequency and severity of uncontrolled replication. In our evaluation of 21 state-of-the-art open-source and proprietary models, we observe that over 50\% of LLM agents display a pronounced tendency toward uncontrolled self-replication, reaching an overall Risk Score (Phi_R) above a safety threshold of 0.5 when subjected to operational pressures. Our results underscore the urgent need for scenario-driven risk assessment and robust safeguards in the practical deployment of LLM agents.

We employ random matrix theory to establish consistency of generalized cross validation (GCV) for estimating prediction risks of sketched ridge regression ensembles, enabling efficient and consistent tuning of regularization and sketching parameters. Our results hold for a broad class of asymptotically free sketches under very mild data assumptions. For squared prediction risk, we provide a decomposition into an unsketched equivalent implicit ridge bias and a sketching-based variance, and prove that the risk can be globally optimized by only tuning sketch size in infinite ensembles. For general subquadratic prediction risk functionals, we extend GCV to construct consistent risk estimators, and thereby obtain distributional convergence of the GCV-corrected predictions in Wasserstein-2 metric. This in particular allows construction of prediction intervals with asymptotically correct coverage conditional on the training data. We also propose an "ensemble trick" whereby the risk for unsketched ridge regression can be efficiently estimated via GCV using small sketched ridge ensembles. We empirically validate our theoretical results using both synthetic and real large-scale datasets with practical sketches including CountSketch and subsampled randomized discrete cosine transforms.

We developed an explainable artificial intelligence (AI) early warning score (xAI-EWS) system for early detection of acute critical illness. While maintaining a high predictive performance, our system explains to the clinician on which relevant electronic health records (EHRs) data the prediction is grounded. Acute critical illness is often preceded by deterioration of routinely measured clinical parameters, e.g., blood pressure and heart rate. Early clinical prediction is typically based on manually calculated screening metrics that simply weigh these parameters, such as Early Warning Scores (EWS). The predictive performance of EWSs yields a tradeoff between sensitivity and specificity that can lead to negative outcomes for the patient. Previous work on EHR-trained AI systems offers promising results with high levels of predictive performance in relation to the early, real-time prediction of acute critical illness. However, without insight into the complex decisions by such system, clinical translation is hindered. In this letter, we present our xAI-EWS system, which potentiates clinical translation by accompanying a prediction with information on the EHR data explaining it.

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

Machine learning models are often used to inform real world risk assessment tasks: predicting consumer default risk, predicting whether a person suffers from a serious illness, or predicting a person's risk to appear in court. Given multiple models that perform almost equally well for a prediction task, to what extent do predictions vary across these models? If predictions are relatively consistent for similar models, then the standard approach of choosing the model that optimizes a penalized loss suffices. But what if predictions vary significantly for similar models? In machine learning, this is referred to as predictive multiplicity i.e. the prevalence of conflicting predictions assigned by near-optimal competing models. In this paper, we present a framework for measuring predictive multiplicity in probabilistic classification (predicting the probability of a positive outcome). We introduce measures that capture the variation in risk estimates over the set of competing models, and develop optimization-based methods to compute these measures efficiently and reliably for convex empirical risk minimization problems. We demonstrate the incidence and prevalence of predictive multiplicity in real-world tasks. Further, we provide insight into how predictive multiplicity arises by analyzing the relationship between predictive multiplicity and data set characteristics (outliers, separability, and majority-minority structure). Our results emphasize the need to report predictive multiplicity more widely.

We seek to understand fundamental tradeoffs between the accuracy of prior information that a learner has on a given problem and its learning performance. We introduce the notion of prioritized risk, which differs from traditional notions of minimax and Bayes risk by allowing us to study such fundamental tradeoffs in settings where reality does not necessarily conform to the learner's prior. We present a general reduction-based approach for extending classical minimax lower-bound techniques in order to lower bound the prioritized risk for statistical estimation problems. We also introduce a novel generalization of Fano's inequality (which may be of independent interest) for lower bounding the prioritized risk in more general settings involving unbounded losses. We illustrate the ability of our framework to provide insights into tradeoffs between prior information and learning performance for problems in estimation, regression, and reinforcement learning.

The rapid advancement of large language models (LLMs) introduces dual-use capabilities that could both threaten and bolster national security and public safety (NSPS). Models implement safeguards to protect against potential misuse relevant to NSPS and allow for benign users to receive helpful information. However, current benchmarks often fail to test safeguard robustness to potential NSPS risks in an objective, robust way. We introduce FORTRESS: 500 expert-crafted adversarial prompts with instance-based rubrics of 4-7 binary questions for automated evaluation across 3 domains (unclassified information only): Chemical, Biological, Radiological, Nuclear and Explosive (CBRNE), Political Violence & Terrorism, and Criminal & Financial Illicit Activities, with 10 total subcategories across these domains. Each prompt-rubric pair has a corresponding benign version to test for model over-refusals. This evaluation of frontier LLMs' safeguard robustness reveals varying trade-offs between potential risks and model usefulness: Claude-3.5-Sonnet demonstrates a low average risk score (ARS) (14.09 out of 100) but the highest over-refusal score (ORS) (21.8 out of 100), while Gemini 2.5 Pro shows low over-refusal (1.4) but a high average potential risk (66.29). Deepseek-R1 has the highest ARS at 78.05, but the lowest ORS at only 0.06. Models such as o1 display a more even trade-off between potential risks and over-refusals (with an ARS of 21.69 and ORS of 5.2). To provide policymakers and researchers with a clear understanding of models' potential risks, we publicly release FORTRESS at https://huggingface.co/datasets/ScaleAI/fortress_public. We also maintain a private set for evaluation.

Accurately predicting the criticalness of ICU patients (such as in-ICU mortality risk) is vital for early intervention in critical care. However, conventional models often treat each patient in isolation and struggle to exploit the relational structure in Electronic Health Records (EHR). We propose a Similarity-Based Self-Construct Graph Model (SBSCGM) that dynamically builds a patient similarity graph from multi-modal EHR data, and a HybridGraphMedGNN architecture that operates on this graph to predict patient mortality and a continuous criticalness score. SBSCGM uses a hybrid similarity measure (combining feature-based and structural similarities) to connect patients with analogous clinical profiles in real-time. The HybridGraphMedGNN integrates Graph Convolutional Network (GCN), GraphSAGE, and Graph Attention Network (GAT) layers to learn robust patient representations, leveraging both local and global graph patterns. In experiments on 6,000 ICU stays from the MIMIC-III dataset, our model achieves state-of-the-art performance (AUC-ROC 0.94) outperforming baseline classifiers and single-type GNN models. We also demonstrate improved precision/recall and show that the attention mechanism provides interpretable insights into model predictions. Our framework offers a scalable and interpretable solution for critical care risk prediction, with potential to support clinicians in real-world ICU deployment.

Within the scope of natural language processing, the domain of multi-label text classification is uniquely challenging due to its expansive and uneven label distribution. The complexity deepens due to the demand for an extensive set of annotated data for training an advanced deep learning model, especially in specialized fields where the labeling task can be labor-intensive and often requires domain-specific knowledge. Addressing these challenges, our study introduces a novel deep active learning strategy, capitalizing on the Beta family of proper scoring rules within the Expected Loss Reduction framework. It computes the expected increase in scores using the Beta Scoring Rules, which are then transformed into sample vector representations. These vector representations guide the diverse selection of informative samples, directly linking this process to the model's expected proper score. Comprehensive evaluations across both synthetic and real datasets reveal our method's capability to often outperform established acquisition techniques in multi-label text classification, presenting encouraging outcomes across various architectural and dataset scenarios.

Despite decades of clinical research, sepsis remains a global public health crisis with high mortality, and morbidity. Currently, when sepsis is detected and the underlying pathogen is identified, organ damage may have already progressed to irreversible stages. Effective sepsis management is therefore highly time-sensitive. By systematically analysing trends in the plethora of clinical data available in the intensive care unit (ICU), an early prediction of sepsis could lead to earlier pathogen identification, resistance testing, and effective antibiotic and supportive treatment, and thereby become a life-saving measure. Here, we developed and validated a machine learning (ML) system for the prediction of sepsis in the ICU. Our analysis represents the largest multi-national, multi-centre in-ICU study for sepsis prediction using ML to date. Our dataset contains 156,309 unique ICU admissions, which represent a refined and harmonised subset of five large ICU databases originating from three countries. Using the international consensus definition Sepsis-3, we derived hourly-resolved sepsis label annotations, amounting to 26,734 (17.1%) septic stays. We compared our approach, a deep self-attention model, to several clinical baselines as well as ML baselines and performed an extensive internal and external validation within and across databases. On average, our model was able to predict sepsis with an AUROC of 0.847 pm 0.050 (internal out-of sample validation) and 0.761 pm 0.052 (external validation). For a harmonised prevalence of 17%, at 80% recall our model detects septic patients with 39% precision 3.7 hours in advance.

Long-tailed classification is challenging due to its heavy imbalance in class probabilities. While existing methods often focus on overall accuracy or accuracy for tail classes, they overlook a critical aspect: certain types of errors can carry greater risks than others in real-world long-tailed problems. For example, misclassifying patients (a tail class) as healthy individuals (a head class) entails far more serious consequences than the reverse scenario. To address this critical issue, we introduce Making Reliable and Flexible Decisions in Long-tailed Classification (RF-DLC), a novel framework aimed at reliable predictions in long-tailed problems. Leveraging Bayesian Decision Theory, we introduce an integrated gain to seamlessly combine long-tailed data distributions and the decision-making procedure. We further propose an efficient variational optimization strategy for the decision risk objective. Our method adapts readily to diverse utility matrices, which can be designed for specific tasks, ensuring its flexibility for different problem settings. In empirical evaluation, we design a new metric, False Head Rate, to quantify tail-sensitivity risk, along with comprehensive experiments on multiple real-world tasks, including large-scale image classification and uncertainty quantification, to demonstrate the reliability and flexibility of our method.

Accurate estimation of brain infarction (i.e., irreversibly damaged tissue) is critical for guiding treatment decisions in acute ischemic stroke. Reliable infarct prediction informs key clinical interventions, including the need for patient transfer to comprehensive stroke centers, the potential benefit of additional reperfusion attempts during mechanical thrombectomy, decisions regarding secondary neuroprotective treatments, and ultimately, prognosis of clinical outcomes. This work introduces the Ischemic Stroke Lesion Segmentation (ISLES) 2024 challenge, which focuses on the prediction of final infarct volumes from pre-interventional acute stroke imaging and clinical data. ISLES24 provides a comprehensive, multimodal setting where participants can leverage all clinically and practically available data, including full acute CT imaging, sub-acute follow-up MRI, and structured clinical information, across a train set of 150 cases. On the hidden test set of 98 cases, the top-performing model, a multimodal nnU-Net-based architecture, achieved a Dice score of 0.285 (+/- 0.213) and an absolute volume difference of 21.2 (+/- 37.2) mL, underlining the significant challenges posed by this task and the need for further advances in multimodal learning. This work makes two primary contributions: first, we establish a standardized, clinically realistic benchmark for post-treatment infarct prediction, enabling systematic evaluation of multimodal algorithmic strategies on a longitudinal stroke dataset; second, we analyze current methodological limitations and outline key research directions to guide the development of next-generation infarct prediction models.

With the increasing availability of wearable devices, photoplethysmography (PPG) has emerged as a promising non-invasive tool for monitoring human hemodynamics. We propose a deep learning framework to estimate vascular age (AI-vascular age) from PPG signals, incorporating a distribution-aware loss to address biases caused by imbalanced data. The model was developed using data from the UK Biobank (UKB), with 98,672 participants in the development cohort and 113,559 participants (144,683 data pairs) for clinical evaluation. After adjusting for key confounders, individuals with a vascular age gap (AI-vascular age minus calendar age) exceeding 9 years had a significantly higher risk of major adverse cardiovascular and cerebrovascular events (MACCE) (HR = 2.37, p < 0.005) and secondary outcomes, including diabetes (HR = 2.69, p < 0.005), hypertension (HR = 2.88, p < 0.005), coronary heart disease (HR = 2.20, p < 0.005), heart failure (HR = 2.15, p < 0.005), myocardial infarction (HR = 2.51, p < 0.005), stroke (HR = 2.55, p < 0.005), and all-cause mortality (HR = 2.51, p < 0.005). Conversely, participants with a vascular age gap below -9 years exhibited a significantly lower incidence of these outcomes. We further evaluated the longitudinal applicability of AI-vascular age using serial PPG data from the UKB, demonstrating its value in risk stratification by leveraging AI-vascular age at two distinct time points to predict future MACCE incidence. External validation was performed on a MIMIC-III-derived cohort (n = 2,343), where each one-year increase in vascular age gap was significantly associated with elevated in-hospital mortality risk (OR = 1.02, p < 0.005). In conclusion, our study establishes AI-vascular age as a novel, non-invasive digital biomarker for cardiovascular health assessment.

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

With the rapid advancement of Multi-modal Large Language Models (MLLMs), MLLM-based Image Quality Assessment (IQA) methods have shown promising performance in linguistic quality description. However, current methods still fall short in accurately scoring image quality. In this work, we aim to leverage MLLMs to regress accurate quality scores. A key challenge is that the quality score is inherently continuous, typically modeled as a Gaussian distribution, whereas MLLMs generate discrete token outputs. This mismatch necessitates score discretization. Previous approaches discretize the mean score into a one-hot label, resulting in information loss and failing to capture inter-image relationships. We propose a distribution-based approach that discretizes the score distribution into a soft label. This method preserves the characteristics of the score distribution, achieving high accuracy and maintaining inter-image relationships. Moreover, to address dataset variation, where different IQA datasets exhibit various distributions, we introduce a fidelity loss based on Thurstone's model. This loss captures intra-dataset relationships, facilitating co-training across multiple IQA datasets. With these designs, we develop the distribution-based Depicted image Quality Assessment model for Score regression (DeQA-Score). Experiments across multiple benchmarks show that DeQA-Score stably outperforms baselines in score regression. Also, DeQA-Score can predict the score distribution that closely aligns with human annotations. Codes and model weights have been released in https://depictqa.github.io/deqa-score/.

Predicting mortality-related outcomes from images offers the prospect of accessible, noninvasive, and scalable health screening. We present a method that leverages pretrained vision transformer foundation models to estimate remaining lifespan from facial and whole-body images, alongside robust uncertainty quantification. We show that predictive uncertainty varies systematically with the true remaining lifespan, and that this uncertainty can be effectively modeled by learning a Gaussian distribution for each sample. Our approach achieves state-of-the-art mean absolute error (MAE) of 7.48 years on an established Dataset, and further improves to 4.79 and 5.07 years MAE on two new, higher-quality datasets curated and published in this work. Importantly, our models provide well-calibrated uncertainty estimates, as demonstrated by a bucketed expected calibration error of 0.62 years. While not intended for clinical deployment, these results highlight the potential of extracting medically relevant signals from images. We make all code and datasets available to facilitate further research.

Real-world clinical text-to-SQL requires reasoning over heterogeneous EHR tables, temporal windows, and patient-similarity cohorts to produce executable queries. We introduce CLINSQL, a benchmark of 633 expert-annotated tasks on MIMIC-IV v3.1 that demands multi-table joins, clinically meaningful filters, and executable SQL. Solving CLINSQL entails navigating schema metadata and clinical coding systems, handling long contexts, and composing multi-step queries beyond traditional text-to-SQL. We evaluate 22 proprietary and open-source models under Chain-of-Thought self-refinement and use rubric-based SQL analysis with execution checks that prioritize critical clinical requirements. Despite recent advances, performance remains far from clinical reliability: on the test set, GPT-5-mini attains 74.7% execution score, DeepSeek-R1 leads open-source at 69.2% and Gemini-2.5-Pro drops from 85.5% on Easy to 67.2% on Hard. Progress on CLINSQL marks tangible advances toward clinically reliable text-to-SQL for real-world EHR analytics.

Quantitative tools are increasingly appealing for decision support in healthcare, driven by the growing capabilities of advanced AI systems. However, understanding the predictive uncertainties surrounding a tool's output is crucial for decision-makers to ensure reliable and transparent decisions. In this paper, we present a case study on pulmonary nodule detection for lung cancer screening, enhancing an advanced detection model with an uncertainty quantification technique called conformal risk control (CRC). We demonstrate that prediction sets with conformal guarantees are attractive measures of predictive uncertainty in the safety-critical healthcare domain, allowing end-users to achieve arbitrary validity by trading off false positives and providing formal statistical guarantees on model performance. Among ground-truth nodules annotated by at least three radiologists, our model achieves a sensitivity that is competitive with that generally achieved by individual radiologists, with a slight increase in false positives. Furthermore, we illustrate the risks of using off-the-shelve prediction models when faced with ontological uncertainty, such as when radiologists disagree on what constitutes the ground truth on pulmonary nodules.

Purpose. Patients with advanced cancer may undergo multiple lines of treatment, switching therapies as their disease progresses. Motivated by a study of metastatic prostate cancer, we develop a microsimulation framework to study therapy sequence. Methods. We propose a discrete-time state transition model to study two lines of anti-cancer therapy. Based on digitized published progression-free survival (PFS) and overall survival (OS) curves, we infer event types (progression or death), and estimate transition probabilities using cumulative incidence functions with competing risks. Our model incorporates within-patient dependence over time, such that response to first-line therapy informs subsequent event probabilities. Parameters governing the degree of within-patient dependence can be used to calibrate the model-based results to those of a target trial. We demonstrate these methods in a study of two therapy sequences for metastatic prostate cancer, where Docetaxel (DCT) and Abiraterone Acetate (AA) are both appropriate for use in either first or second line treatment. We assess costs, Quality-Adjusted Life Years (QALYs) and Incremental Cost Effectiveness Ratio (ICER) for two treatment strategies: DCT then AA vs AA then DCT. Results. Using digitized survival curves from relevant clinical trials, we identified 8.6-13.9% of PFS times that should be categorized as deaths, allowing for estimation of cumulative incidence functions. Models assuming within-patient independence overestimated OS time, corrected with our calibration approach. Correction resulted in meaningful changes in the difference in QALYs between treatment strategies (0.07 vs 0.15) and the ICER (-\76,836/QALY vs -21,030/QALY). Conclusions. Microsimulation models can be successfully used to study cost-effectiveness of therapy sequences, taking care to account correctly for within-patient dependence.

Selective Classification, wherein models can reject low-confidence predictions, promises reliable translation of machine-learning based classification systems to real-world scenarios such as clinical diagnostics. While current evaluation of these systems typically assumes fixed working points based on pre-defined rejection thresholds, methodological progress requires benchmarking the general performance of systems akin to the AUROC in standard classification. In this work, we define 5 requirements for multi-threshold metrics in selective classification regarding task alignment, interpretability, and flexibility, and show how current approaches fail to meet them. We propose the Area under the Generalized Risk Coverage curve (AUGRC), which meets all requirements and can be directly interpreted as the average risk of undetected failures. We empirically demonstrate the relevance of AUGRC on a comprehensive benchmark spanning 6 data sets and 13 confidence scoring functions. We find that the proposed metric substantially changes metric rankings on 5 out of the 6 data sets.

Heart failure (HF) affects 11.8% of adults aged 65 and older, reducing quality of life and longevity. Preventing HF can reduce morbidity and mortality. We hypothesized that artificial intelligence (AI) applied to 24-hour single-lead electrocardiogram (ECG) data could predict the risk of HF within five years. To research this, the Technion-Leumit Holter ECG (TLHE) dataset, including 69,663 recordings from 47,729 patients, collected over 20 years was used. Our deep learning model, DeepHHF, trained on 24-hour ECG recordings, achieved an area under the receiver operating characteristic curve of 0.80 that outperformed a model using 30-second segments and a clinical score. High-risk individuals identified by DeepHHF had a two-fold chance of hospitalization or death incidents. Explainability analysis showed DeepHHF focused on arrhythmias and heart abnormalities, with key attention between 8 AM and 3 PM. This study highlights the feasibility of deep learning to model 24-hour continuous ECG data, capturing paroxysmal events and circadian variations essential for reliable risk prediction. Artificial intelligence applied to single-lead Holter ECG is non-invasive, inexpensive, and widely accessible, making it a promising tool for HF risk prediction.

The extant insurance literature demonstrates a paucity of finite-sample valid prediction intervals of future insurance claims in the regression setting. To address this challenge, this article proposes a new strategy that converts a predictive method in the unsupervised iid (independent identically distributed) setting to a predictive method in the regression setting. In particular, it enables an actuary to obtain infinitely many finite-sample valid prediction intervals in the regression setting.

The Kov\'ats Retention index (RI) is a quantity measured using gas chromatography and commonly used in the identification of chemical structures. Creating libraries of observed RI values is a laborious task, so we explore the use of a deep neural network for predicting RI values from structure for standard semipolar columns. This network generated predictions with a mean absolute error of 15.1 and, in a quantification of the tail of the error distribution, a 95th percentile absolute error of 46.5. Because of the Artificial Intelligence Retention Indices (AIRI) network's accuracy, it was used to predict RI values for the NIST EI-MS spectral libraries. These RI values are used to improve chemical identification methods and the quality of the library. Estimating uncertainty is an important practical need when using prediction models. To quantify the uncertainty of our network for each individual prediction, we used the outputs of an ensemble of 8 networks to calculate a predicted standard deviation for each RI value prediction. This predicted standard deviation was corrected to follow the error between observed and predicted RI values. The Z scores using these predicted standard deviations had a standard deviation of 1.52 and a 95th percentile absolute Z score corresponding to a mean RI value of 42.6.

Fine-tuning large language models (LLMs) on reasoning benchmarks via reinforcement learning requires a specific reward function, often binary, for each benchmark. This comes with two potential limitations: the need to design the reward, and the potentially sparse nature of binary rewards. Here, we systematically investigate rewards derived from the probability or log-probability of emitting the reference answer (or any other prompt continuation present in the data), which have the advantage of not relying on specific verifiers and being available at scale. Several recent works have advocated for the use of similar rewards (e.g., VeriFree, JEPO, RLPR, NOVER). We systematically compare variants of likelihood-based rewards with standard baselines, testing performance both on standard mathematical reasoning benchmarks, and on long-form answers where no external verifier is available. We find that using the log-probability of the reference answer as the reward for chain-of-thought (CoT) learning is the only option that performs well in all setups. This reward is also consistent with the next-token log-likelihood loss used during pretraining. In verifiable settings, log-probability rewards bring comparable or better success rates than reinforcing with standard binary rewards, and yield much better perplexity. In non-verifiable settings, they perform on par with SFT. On the other hand, methods based on probability, such as VeriFree, flatline on non-verifiable settings due to vanishing probabilities of getting the correct answer. Overall, this establishes log-probability rewards as a viable method for CoT fine-tuning, bridging the short, verifiable and long, non-verifiable answer settings.

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

Purpose: To evaluate the performance of an automated deep learning method in detecting ascites and subsequently quantifying its volume in patients with liver cirrhosis and ovarian cancer. Materials and Methods: This retrospective study included contrast-enhanced and non-contrast abdominal-pelvic CT scans of patients with cirrhotic ascites and patients with ovarian cancer from two institutions, National Institutes of Health (NIH) and University of Wisconsin (UofW). The model, trained on The Cancer Genome Atlas Ovarian Cancer dataset (mean age, 60 years +/- 11 [s.d.]; 143 female), was tested on two internal (NIH-LC and NIH-OV) and one external dataset (UofW-LC). Its performance was measured by the Dice coefficient, standard deviations, and 95% confidence intervals, focusing on ascites volume in the peritoneal cavity. Results: On NIH-LC (25 patients; mean age, 59 years +/- 14 [s.d.]; 14 male) and NIH-OV (166 patients; mean age, 65 years +/- 9 [s.d.]; all female), the model achieved Dice scores of 0.855 +/- 0.061 (CI: 0.831-0.878) and 0.826 +/- 0.153 (CI: 0.764-0.887), with median volume estimation errors of 19.6% (IQR: 13.2-29.0) and 5.3% (IQR: 2.4-9.7) respectively. On UofW-LC (124 patients; mean age, 46 years +/- 12 [s.d.]; 73 female), the model had a Dice score of 0.830 +/- 0.107 (CI: 0.798-0.863) and median volume estimation error of 9.7% (IQR: 4.5-15.1). The model showed strong agreement with expert assessments, with r^2 values of 0.79, 0.98, and 0.97 across the test sets. Conclusion: The proposed deep learning method performed well in segmenting and quantifying the volume of ascites in concordance with expert radiologist assessments.

To enhance the safety of VLMs, this paper introduces a novel reasoning-based VLM guard model dubbed GuardReasoner-VL. The core idea is to incentivize the guard model to deliberatively reason before making moderation decisions via online RL. First, we construct GuardReasoner-VLTrain, a reasoning corpus with 123K samples and 631K reasoning steps, spanning text, image, and text-image inputs. Then, based on it, we cold-start our model's reasoning ability via SFT. In addition, we further enhance reasoning regarding moderation through online RL. Concretely, to enhance diversity and difficulty of samples, we conduct rejection sampling followed by data augmentation via the proposed safety-aware data concatenation. Besides, we use a dynamic clipping parameter to encourage exploration in early stages and exploitation in later stages. To balance performance and token efficiency, we design a length-aware safety reward that integrates accuracy, format, and token cost. Extensive experiments demonstrate the superiority of our model. Remarkably, it surpasses the runner-up by 19.27% F1 score on average. We release data, code, and models (3B/7B) of GuardReasoner-VL at https://github.com/yueliu1999/GuardReasoner-VL/

It is well known that accurate probabilistic predictors can be trained through empirical risk minimisation with proper scoring rules as loss functions. While such learners capture so-called aleatoric uncertainty of predictions, various machine learning methods have recently been developed with the goal to let the learner also represent its epistemic uncertainty, i.e., the uncertainty caused by a lack of knowledge and data. An emerging branch of the literature proposes the use of a second-order learner that provides predictions in terms of distributions on probability distributions. However, recent work has revealed serious theoretical shortcomings for second-order predictors based on loss minimisation. In this paper, we generalise these findings and prove a more fundamental result: There seems to be no loss function that provides an incentive for a second-order learner to faithfully represent its epistemic uncertainty in the same manner as proper scoring rules do for standard (first-order) learners. As a main mathematical tool to prove this result, we introduce the generalised notion of second-order scoring rules.

Qualitative research faces a critical reliability challenge: traditional inter-rater agreement methods require multiple human coders, are time-intensive, and often yield moderate consistency. We present a multi-perspective validation framework for LLM-based thematic analysis that combines ensemble validation with dual reliability metrics: Cohen's Kappa (κ) for inter-rater agreement and cosine similarity for semantic consistency. Our framework enables configurable analysis parameters (1-6 seeds, temperature 0.0-2.0), supports custom prompt structures with variable substitution, and provides consensus theme extraction across any JSON format. As proof-of-concept, we evaluate three leading LLMs (Gemini 2.5 Pro, GPT-4o, Claude 3.5 Sonnet) on a psychedelic art therapy interview transcript, conducting six independent runs per model. Results demonstrate Gemini achieves highest reliability (κ= 0.907, cosine=95.3%), followed by GPT-4o (κ= 0.853, cosine=92.6%) and Claude (κ= 0.842, cosine=92.1%). All three models achieve a high agreement (κ> 0.80), validating the multi-run ensemble approach. The framework successfully extracts consensus themes across runs, with Gemini identifying 6 consensus themes (50-83% consistency), GPT-4o identifying 5 themes, and Claude 4 themes. Our open-source implementation provides researchers with transparent reliability metrics, flexible configuration, and structure-agnostic consensus extraction, establishing methodological foundations for reliable AI-assisted qualitative research.

Breast cancer is a significant health concern affecting millions of women worldwide. Accurate survival risk stratification plays a crucial role in guiding personalised treatment decisions and improving patient outcomes. Here we present BioFusionNet, a deep learning framework that fuses image-derived features with genetic and clinical data to achieve a holistic patient profile and perform survival risk stratification of ER+ breast cancer patients. We employ multiple self-supervised feature extractors, namely DINO and MoCoV3, pretrained on histopathology patches to capture detailed histopathological image features. We then utilise a variational autoencoder (VAE) to fuse these features, and harness the latent space of the VAE to feed into a self-attention network, generating patient-level features. Next, we develop a co-dual-cross-attention mechanism to combine the histopathological features with genetic data, enabling the model to capture the interplay between them. Additionally, clinical data is incorporated using a feed-forward network (FFN), further enhancing predictive performance and achieving comprehensive multimodal feature integration. Furthermore, we introduce a weighted Cox loss function, specifically designed to handle imbalanced survival data, which is a common challenge in the field. The proposed model achieves a mean concordance index (C-index) of 0.77 and a time-dependent area under the curve (AUC) of 0.84, outperforming state-of-the-art methods. It predicts risk (high versus low) with prognostic significance for overall survival (OS) in univariate analysis (HR=2.99, 95% CI: 1.88--4.78, p<0.005), and maintains independent significance in multivariate analysis incorporating standard clinicopathological variables (HR=2.91, 95% CI: 1.80--4.68, p<0.005). The proposed method not only improves model performance but also addresses a critical gap in handling imbalanced data.

Survival analysis, or time-to-event modelling, is a classical statistical problem that has garnered a lot of interest for its practical use in epidemiology, demographics or actuarial sciences. Recent advances on the subject from the point of view of machine learning have been concerned with precise per-individual predictions instead of population studies, driven by the rise of individualized medicine. We introduce here a conditional normalizing flow based estimate of the time-to-event density as a way to model highly flexible and individualized conditional survival distributions. We use a novel hierarchical formulation of normalizing flows to enable efficient fitting of flexible conditional distributions without overfitting and show how the normalizing flow formulation can be efficiently adapted to the censored setting. We experimentally validate the proposed approach on a synthetic dataset as well as four open medical datasets and an example of a common financial problem.

This paper presents a new approach for assessing uncertainty in machine translation by simultaneously evaluating translation quality and providing a reliable confidence score. Our approach utilizes conformal predictive distributions to produce prediction intervals with guaranteed coverage, meaning that for any given significance level epsilon, we can expect the true quality score of a translation to fall out of the interval at a rate of 1-epsilon. In this paper, we demonstrate how our method outperforms a simple, but effective baseline on six different language pairs in terms of coverage and sharpness. Furthermore, we validate that our approach requires the data exchangeability assumption to hold for optimal performance.

Large Language Models (LLMs) can produce surprisingly sophisticated estimates of their own uncertainty. However, it remains unclear to what extent this expressed confidence is tied to the reasoning, knowledge, or decision making of the model. To test this, we introduce RiskEval: a framework designed to evaluate whether models adjust their abstention policies in response to varying error penalties. Our evaluation of several frontier models reveals a critical dissociation: models are neither cost-aware when articulating their verbal confidence, nor strategically responsive when deciding whether to engage or abstain under high-penalty conditions. Even when extreme penalties render frequent abstention the mathematically optimal strategy, models almost never abstain, resulting in utility collapse. This indicates that calibrated verbal confidence scores may not be sufficient to create trustworthy and interpretable AI systems, as current models lack the strategic agency to convert uncertainty signals into optimal and risk-sensitive decisions.

Machine learning models are often trained to predict the outcome resulting from a human decision. For example, if a doctor decides to test a patient for disease, will the patient test positive? A challenge is that historical decision-making determines whether the outcome is observed: we only observe test outcomes for patients doctors historically tested. Untested patients, for whom outcomes are unobserved, may differ from tested patients along observed and unobserved dimensions. We propose a Bayesian model class which captures this setting. The purpose of the model is to accurately estimate risk for both tested and untested patients. Estimating this model is challenging due to the wide range of possibilities for untested patients. To address this, we propose two domain constraints which are plausible in health settings: a prevalence constraint, where the overall disease prevalence is known, and an expertise constraint, where the human decision-maker deviates from purely risk-based decision-making only along a constrained feature set. We show theoretically and on synthetic data that domain constraints improve parameter inference. We apply our model to a case study of cancer risk prediction, showing that the model's inferred risk predicts cancer diagnoses, its inferred testing policy captures known public health policies, and it can identify suboptimalities in test allocation. Though our case study is in healthcare, our analysis reveals a general class of domain constraints which can improve model estimation in many settings.

Reliable probability estimation is of crucial importance in many real-world applications where there is inherent (aleatoric) uncertainty. Probability-estimation models are trained on observed outcomes (e.g. whether it has rained or not, or whether a patient has died or not), because the ground-truth probabilities of the events of interest are typically unknown. The problem is therefore analogous to binary classification, with the difference that the objective is to estimate probabilities rather than predicting the specific outcome. This work investigates probability estimation from high-dimensional data using deep neural networks. There exist several methods to improve the probabilities generated by these models but they mostly focus on model (epistemic) uncertainty. For problems with inherent uncertainty, it is challenging to evaluate performance without access to ground-truth probabilities. To address this, we build a synthetic dataset to study and compare different computable metrics. We evaluate existing methods on the synthetic data as well as on three real-world probability estimation tasks, all of which involve inherent uncertainty: precipitation forecasting from radar images, predicting cancer patient survival from histopathology images, and predicting car crashes from dashcam videos. We also give a theoretical analysis of a model for high-dimensional probability estimation which reproduces several of the phenomena evinced in our experiments. Finally, we propose a new method for probability estimation using neural networks, which modifies the training process to promote output probabilities that are consistent with empirical probabilities computed from the data. The method outperforms existing approaches on most metrics on the simulated as well as real-world data.

By learning the gradient of smoothed data distributions, diffusion models can iteratively generate samples from complex distributions. The learned score function enables their generalization capabilities, but how the learned score relates to the score of the underlying data manifold remains largely unclear. Here, we aim to elucidate this relationship by comparing learned neural scores to the scores of two kinds of analytically tractable distributions: Gaussians and Gaussian mixtures. The simplicity of the Gaussian model makes it theoretically attractive, and we show that it admits a closed-form solution and predicts many qualitative aspects of sample generation dynamics. We claim that the learned neural score is dominated by its linear (Gaussian) approximation for moderate to high noise scales, and supply both theoretical and empirical arguments to support this claim. Moreover, the Gaussian approximation empirically works for a larger range of noise scales than naive theory suggests it should, and is preferentially learned early in training. At smaller noise scales, we observe that learned scores are better described by a coarse-grained (Gaussian mixture) approximation of training data than by the score of the training distribution, a finding consistent with generalization. Our findings enable us to precisely predict the initial phase of trained models' sampling trajectories through their Gaussian approximations. We show that this allows the skipping of the first 15-30% of sampling steps while maintaining high sample quality (with a near state-of-the-art FID score of 1.93 on CIFAR-10 unconditional generation). This forms the foundation of a novel hybrid sampling method, termed analytical teleportation, which can seamlessly integrate with and accelerate existing samplers, including DPM-Solver-v3 and UniPC. Our findings suggest ways to improve the design and training of diffusion models.

We propose a new score-based model with one-step sampling. Previously, score-based models were burdened with heavy computations due to iterative sampling. For substituting the iterative process, we train a standalone generator to compress all the time steps with the gradient backpropagated from the score network. In order to produce meaningful gradients for the generator, the score network is trained to simultaneously match the real data distribution and mismatch the fake data distribution. This model has the following advantages: 1) For sampling, it generates a fake image with only one step forward. 2) For training, it only needs 10 diffusion steps.3) Compared with consistency model, it is free of the ill-posed problem caused by consistency loss. On the popular CIFAR-10 dataset, our model outperforms Consistency Model and Denoising Score Matching, which demonstrates the potential of the framework. We further provide more examples on the MINIST and LSUN datasets. The code is available on GitHub.

Risk management in finance involves recognizing, evaluating, and addressing financial risks to maintain stability and ensure regulatory compliance. Extracting relevant insights from extensive regulatory documents is a complex challenge requiring advanced retrieval and language models. This paper introduces RiskData, a dataset specifically curated for finetuning embedding models in risk management, and RiskEmbed, a finetuned embedding model designed to improve retrieval accuracy in financial question-answering systems. The dataset is derived from 94 regulatory guidelines published by the Office of the Superintendent of Financial Institutions (OSFI) from 1991 to 2024. We finetune a state-of-the-art sentence BERT embedding model to enhance domain-specific retrieval performance typically for Retrieval-Augmented Generation (RAG) systems. Experimental results demonstrate that RiskEmbed significantly outperforms general-purpose and financial embedding models, achieving substantial improvements in ranking metrics. By open-sourcing both the dataset and the model, we provide a valuable resource for financial institutions and researchers aiming to develop more accurate and efficient risk management AI solutions.

Identifying cirrhosis is key to correctly assess the health of the liver. However, the gold standard diagnosis of the cirrhosis needs a medical intervention to obtain the histological confirmation, e.g. the METAVIR score, as the radiological presentation can be equivocal. In this work, we propose to leverage transfer learning from large datasets annotated by radiologists, which we consider as a weak annotation, to predict the histological score available on a small annex dataset. To this end, we propose to compare different pretraining methods, namely weakly-supervised and self-supervised ones, to improve the prediction of the cirrhosis. Finally, we introduce a loss function combining both supervised and self-supervised frameworks for pretraining. This method outperforms the baseline classification of the METAVIR score, reaching an AUC of 0.84 and a balanced accuracy of 0.75, compared to 0.77 and 0.72 for a baseline classifier.

Large language models (LLMs) typically deploy safety mechanisms to prevent harmful content generation. Most current approaches focus narrowly on risks posed by malicious actors, often framing risks as adversarial events and relying on defensive refusals. However, in real-world settings, risks also come from non-malicious users seeking help while under psychological distress (e.g., self-harm intentions). In such cases, the model's response can strongly influence the user's next actions. Simple refusals may lead them to repeat, escalate, or move to unsafe platforms, creating worse outcomes. We introduce Constructive Safety Alignment (CSA), a human-centric paradigm that protects against malicious misuse while actively guiding vulnerable users toward safe and helpful results. Implemented in Oyster-I (Oy1), CSA combines game-theoretic anticipation of user reactions, fine-grained risk boundary discovery, and interpretable reasoning control, turning safety into a trust-building process. Oy1 achieves state-of-the-art safety among open models while retaining high general capabilities. On our Constructive Benchmark, it shows strong constructive engagement, close to GPT-5, and unmatched robustness on the Strata-Sword jailbreak dataset, nearing GPT-o1 levels. By shifting from refusal-first to guidance-first safety, CSA redefines the model-user relationship, aiming for systems that are not just safe, but meaningfully helpful. We release Oy1, code, and the benchmark to support responsible, user-centered AI.

Analyzing outcomes in long-term cancer survivor studies can be complex. The effects of predictors on the failure process may be difficult to assess over longer periods of time, as the commonly used assumption of proportionality of hazards holding over an extended period is often questionable. In this manuscript, we compare seven different survival models that estimate the hazard rate and the effects of proportional and non-proportional covariates. In particular, we focus on an extension of the the multi-resolution hazard (MRH) estimator, combining a non-proportional hierarchical MRH approach with a data-driven pruning algorithm that allows for computational efficiency and produces robust estimates even in times of few observed failures. Using data from a large-scale randomized prostate cancer clinical trial, we examine patterns of biochemical failure and estimate the time-varying effects of androgen deprivation therapy treatment and other covariates. We compare the impact of different modeling strategies and smoothness assumptions on the estimated treatment effect. Our results show that the benefits of treatment diminish over time, possibly with implications for future treatment protocols.

Recent advances in Large Language Models (LLMs) have sparked concerns over their potential to acquire and misuse dangerous or high-risk capabilities, posing frontier risks. Current safety evaluations primarily test for what a model can do - its capabilities - without assessing what it would do if endowed with high-risk capabilities. This leaves a critical blind spot: models may strategically conceal capabilities or rapidly acquire them, while harboring latent inclinations toward misuse. We argue that propensity - the likelihood of a model to pursue harmful actions if empowered - is a critical, yet underexplored, axis of safety evaluation. We present PropensityBench, a novel benchmark framework that assesses the proclivity of models to engage in risky behaviors when equipped with simulated dangerous capabilities using proxy tools. Our framework includes 5,874 scenarios with 6,648 tools spanning four high-risk domains: cybersecurity, self-proliferation, biosecurity, and chemical security. We simulate access to powerful capabilities via a controlled agentic environment and evaluate the models' choices under varying operational pressures that reflect real-world constraints or incentives models may encounter, such as resource scarcity or gaining more autonomy. Across open-source and proprietary frontier models, we uncover 9 alarming signs of propensity: models frequently choose high-risk tools when under pressure, despite lacking the capability to execute such actions unaided. These findings call for a shift from static capability audits toward dynamic propensity assessments as a prerequisite for deploying frontier AI systems safely. Our code is available at https://github.com/scaleapi/propensity-evaluation.

This paper introduces STAR-1, a high-quality, just-1k-scale safety dataset specifically designed for large reasoning models (LRMs) like DeepSeek-R1. Built on three core principles -- diversity, deliberative reasoning, and rigorous filtering -- STAR-1 aims to address the critical needs for safety alignment in LRMs. Specifically, we begin by integrating existing open-source safety datasets from diverse sources. Then, we curate safety policies to generate policy-grounded deliberative reasoning samples. Lastly, we apply a GPT-4o-based safety scoring system to select training examples aligned with best practices. Experimental results show that fine-tuning LRMs with STAR-1 leads to an average 40% improvement in safety performance across four benchmarks, while only incurring a marginal decrease (e.g., an average of 1.1%) in reasoning ability measured across five reasoning tasks. Extensive ablation studies further validate the importance of our design principles in constructing STAR-1 and analyze its efficacy across both LRMs and traditional LLMs. Our project page is https://ucsc-vlaa.github.io/STAR-1.

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

Many existing conditional score-based data generation methods utilize Bayes' theorem to decompose the gradients of a log posterior density into a mixture of scores. These methods facilitate the training procedure of conditional score models, as a mixture of scores can be separately estimated using a score model and a classifier. However, our analysis indicates that the training objectives for the classifier in these methods may lead to a serious score mismatch issue, which corresponds to the situation that the estimated scores deviate from the true ones. Such an issue causes the samples to be misled by the deviated scores during the diffusion process, resulting in a degraded sampling quality. To resolve it, we formulate a novel training objective, called Denoising Likelihood Score Matching (DLSM) loss, for the classifier to match the gradients of the true log likelihood density. Our experimental evidence shows that the proposed method outperforms the previous methods on both Cifar-10 and Cifar-100 benchmarks noticeably in terms of several key evaluation metrics. We thus conclude that, by adopting DLSM, the conditional scores can be accurately modeled, and the effect of the score mismatch issue is alleviated.

Automated Essay Score (AES) is proven to be one of the cutting-edge technologies. Scoring techniques are used for various purposes. Reliable scores are calculated based on influential variables. Such variables can be computed by different methods based on the domain. The research is concentrated on the user's understanding of a given topic. The analysis is based on a scoring index by using Large Language Models. The user can then compare and contrast the understanding of a topic that they recently learned. The results are then contributed towards learning analytics and progression is made for enhancing the learning ability. In this research, the focus is on summarizing a PDF document and gauging a user's understanding of its content. The process involves utilizing a Langchain tool to summarize the PDF and extract the essential information. By employing this technique, the research aims to determine how well the user comprehends the summarized content.

Clinical trials or studies oftentimes require long-term and/or costly follow-up of participants to evaluate a novel treatment/drug/vaccine. There has been increasing interest in the past few decades in using short-term surrogate outcomes as a replacement of the primary outcome i.e., in using the surrogate outcome, which can potentially be observed sooner, to make inference about the treatment effect on the long-term primary outcome. Very few of the available statistical methods to evaluate a surrogate are applicable to settings where both the surrogate and the primary outcome are time-to-event outcomes subject to censoring. Methods that can handle this setting tend to require parametric assumptions or be limited to assessing only the restricted mean survival time. In this paper, we propose a non-parametric approach to evaluate a censored surrogate outcome, such as time to progression, when the primary outcome is also a censored time-to-event outcome, such as time to death, and the treatment effect of interest is the difference in overall survival. Specifically, we define the proportion of the treatment effect on the primary outcome that is explained (PTE) by the censored surrogate outcome in this context, and estimate this proportion by defining and deriving an optimal transformation of the surrogate information. Our approach provides the added advantage of relaxed assumptions to guarantee that the true PTE is within (0,1), along with being model-free. Finite sample performance of our estimators are illustrated via extensive simulation studies and a real data application examining progression-free survival as a surrogate for overall survival for patients with metastatic colorectal cancer.

The demand for emergency department (ED) services is increasing across the globe, particularly during the current COVID-19 pandemic. Clinical triage and risk assessment have become increasingly challenging due to the shortage of medical resources and the strain on hospital infrastructure caused by the pandemic. As a result of the widespread use of electronic health records (EHRs), we now have access to a vast amount of clinical data, which allows us to develop predictive models and decision support systems to address these challenges. To date, however, there are no widely accepted benchmark ED triage prediction models based on large-scale public EHR data. An open-source benchmarking platform would streamline research workflows by eliminating cumbersome data preprocessing, and facilitate comparisons among different studies and methodologies. In this paper, based on the Medical Information Mart for Intensive Care IV Emergency Department (MIMIC-IV-ED) database, we developed a publicly available benchmark suite for ED triage predictive models and created a benchmark dataset that contains over 400,000 ED visits from 2011 to 2019. We introduced three ED-based outcomes (hospitalization, critical outcomes, and 72-hour ED reattendance) and implemented a variety of popular methodologies, ranging from machine learning methods to clinical scoring systems. We evaluated and compared the performance of these methods against benchmark tasks. Our codes are open-source, allowing anyone with MIMIC-IV-ED data access to perform the same steps in data processing, benchmark model building, and experiments. This study provides future researchers with insights, suggestions, and protocols for managing raw data and developing risk triaging tools for emergency care.

Motivated by concerns about making online decisions that incur undue amount of risk at each time step, in this paper, we formulate the probably anytime-safe stochastic combinatorial semi-bandits problem. In this problem, the agent is given the option to select a subset of size at most K from a set of L ground items. Each item is associated to a certain mean reward as well as a variance that represents its risk. To mitigate the risk that the agent incurs, we require that with probability at least 1-delta, over the entire horizon of time T, each of the choices that the agent makes should contain items whose sum of variances does not exceed a certain variance budget. We call this probably anytime-safe constraint. Under this constraint, we design and analyze an algorithm {\sc PASCombUCB} that minimizes the regret over the horizon of time T. By developing accompanying information-theoretic lower bounds, we show that under both the problem-dependent and problem-independent paradigms, {\sc PASCombUCB} is almost asymptotically optimal. Experiments are conducted to corroborate our theoretical findings. Our problem setup, the proposed {\sc PASCombUCB} algorithm, and novel analyses are applicable to domains such as recommendation systems and transportation in which an agent is allowed to choose multiple items at a single time step and wishes to control the risk over the whole time horizon.

Using risky text prompts, such as pornography and violent prompts, to test the safety of text-to-image (T2I) models is a critical task. However, existing risky prompt datasets are limited in three key areas: 1) limited risky categories, 2) coarse-grained annotation, and 3) low effectiveness. To address these limitations, we introduce T2I-RiskyPrompt, a comprehensive benchmark designed for evaluating safety-related tasks in T2I models. Specifically, we first develop a hierarchical risk taxonomy, which consists of 6 primary categories and 14 fine-grained subcategories. Building upon this taxonomy, we construct a pipeline to collect and annotate risky prompts. Finally, we obtain 6,432 effective risky prompts, where each prompt is annotated with both hierarchical category labels and detailed risk reasons. Moreover, to facilitate the evaluation, we propose a reason-driven risky image detection method that explicitly aligns the MLLM with safety annotations. Based on T2I-RiskyPrompt, we conduct a comprehensive evaluation of eight T2I models, nine defense methods, five safety filters, and five attack strategies, offering nine key insights into the strengths and limitations of T2I model safety. Finally, we discuss potential applications of T2I-RiskyPrompt across various research fields. The dataset and code are provided in https://github.com/datar001/T2I-RiskyPrompt.

The non-invasive assessment of increasingly incidentally discovered renal masses is a critical challenge in urologic oncology, where diagnostic uncertainty frequently leads to the overtreatment of benign or indolent tumors. In this study, we developed and validated RenalCLIP using a dataset of 27,866 CT scans from 8,809 patients across nine Chinese medical centers and the public TCIA cohort, a visual-language foundation model for characterization, diagnosis and prognosis of renal mass. The model was developed via a two-stage pre-training strategy that first enhances the image and text encoders with domain-specific knowledge before aligning them through a contrastive learning objective, to create robust representations for superior generalization and diagnostic precision. RenalCLIP achieved better performance and superior generalizability across 10 core tasks spanning the full clinical workflow of kidney cancer, including anatomical assessment, diagnostic classification, and survival prediction, compared with other state-of-the-art general-purpose CT foundation models. Especially, for complicated task like recurrence-free survival prediction in the TCIA cohort, RenalCLIP achieved a C-index of 0.726, representing a substantial improvement of approximately 20% over the leading baselines. Furthermore, RenalCLIP's pre-training imparted remarkable data efficiency; in the diagnostic classification task, it only needs 20% training data to achieve the peak performance of all baseline models even after they were fully fine-tuned on 100% of the data. Additionally, it achieved superior performance in report generation, image-text retrieval and zero-shot diagnosis tasks. Our findings establish that RenalCLIP provides a robust tool with the potential to enhance diagnostic accuracy, refine prognostic stratification, and personalize the management of patients with kidney cancer.

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

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

Deep reinforcement learning (RL) algorithms are predominantly evaluated by comparing their relative performance on a large suite of tasks. Most published results on deep RL benchmarks compare point estimates of aggregate performance such as mean and median scores across tasks, ignoring the statistical uncertainty implied by the use of a finite number of training runs. Beginning with the Arcade Learning Environment (ALE), the shift towards computationally-demanding benchmarks has led to the practice of evaluating only a small number of runs per task, exacerbating the statistical uncertainty in point estimates. In this paper, we argue that reliable evaluation in the few run deep RL regime cannot ignore the uncertainty in results without running the risk of slowing down progress in the field. We illustrate this point using a case study on the Atari 100k benchmark, where we find substantial discrepancies between conclusions drawn from point estimates alone versus a more thorough statistical analysis. With the aim of increasing the field's confidence in reported results with a handful of runs, we advocate for reporting interval estimates of aggregate performance and propose performance profiles to account for the variability in results, as well as present more robust and efficient aggregate metrics, such as interquartile mean scores, to achieve small uncertainty in results. Using such statistical tools, we scrutinize performance evaluations of existing algorithms on other widely used RL benchmarks including the ALE, Procgen, and the DeepMind Control Suite, again revealing discrepancies in prior comparisons. Our findings call for a change in how we evaluate performance in deep RL, for which we present a more rigorous evaluation methodology, accompanied with an open-source library rliable, to prevent unreliable results from stagnating the field.

This paper introduces a novel Hamiltonian-inspired neural network approach to credit scoring, designed to address the challenges of class imbalance and out-of-time (OOT) prediction in financial risk management. Drawing from concepts in Hamiltonian mechanics, we develop a symplectic optimizer and a new loss function to capture the complex dynamics of credit risk evolution. Using the Freddie Mac Single-Family Loan-Level Dataset, we evaluate our model's performance against other machine learning approaches. Our method shows superior discriminative power in OOT scenarios, as measured by the Area Under the Curve (AUC), indicating better ranking ability and robustness to class imbalance. The Hamiltonian-inspired approach shows particular strength in maintaining consistent performance between in-sample and OOT test sets, suggesting improved generalization to future, unseen data. These findings suggest that physics-inspired techniques offer a promising direction for developing more robust and reliable credit scoring models, particularly in uncertain economic situations.

Failure of machine learning models to generalize to new data is a core problem limiting the reliability of AI systems, partly due to the lack of simple and robust methods for comparing new data to the original training dataset. We propose a standardized approach for assessing data similarity in a model-agnostic manner by constructing a supervised autoencoder for generalizability estimation (SAGE). We compare points in a low-dimensional embedded latent space, defining empirical probability measures for k-Nearest Neighbors (kNN) distance, reconstruction of inputs and task-based performance. As proof of concept for classification tasks, we use MNIST and CIFAR-10 to demonstrate how an ensemble output probability score can separate deformed images from a mixture of typical test examples, and how this SAGE score is robust to transformations of increasing severity. As further proof of concept, we extend this approach to a regression task using non-imaging data (UCI Abalone). In all cases, we show that out-of-the-box model performance increases after SAGE score filtering, even when applied to data from the model's own training and test datasets. Our out-of-distribution scoring method can be introduced during several steps of model construction and assessment, leading to future improvements in responsible deep learning implementation.

Because large language models are expensive to pretrain on different datasets, using smaller-scale experiments to decide on data is crucial for reducing costs. Which benchmarks and methods of making decisions from observed performance at small scale most accurately predict the datasets that yield the best large models? To empower open exploration of this question, we release models, data, and evaluations in DataDecide -- the most extensive open suite of models over differences in data and scale. We conduct controlled pretraining experiments across 25 corpora with differing sources, deduplication, and filtering up to 100B tokens, model sizes up to 1B parameters, and 3 random seeds. We find that the ranking of models at a single, small size (e.g., 150M parameters) is a strong baseline for predicting best models at our larger target scale (1B) (~80% of com parisons correct). No scaling law methods among 8 baselines exceed the compute-decision frontier of single-scale predictions, but DataDecide can measure improvement in future scaling laws. We also identify that using continuous likelihood metrics as proxies in small experiments makes benchmarks including MMLU, ARC, HellaSwag, MBPP, and HumanEval >80% predictable at the target 1B scale with just 0.01% of the compute.

We present the findings of "The Alzheimer's Disease Prediction Of Longitudinal Evolution" (TADPOLE) Challenge, which compared the performance of 92 algorithms from 33 international teams at predicting the future trajectory of 219 individuals at risk of Alzheimer's disease. Challenge participants were required to make a prediction, for each month of a 5-year future time period, of three key outcomes: clinical diagnosis, Alzheimer's Disease Assessment Scale Cognitive Subdomain (ADAS-Cog13), and total volume of the ventricles. The methods used by challenge participants included multivariate linear regression, machine learning methods such as support vector machines and deep neural networks, as well as disease progression models. No single submission was best at predicting all three outcomes. For clinical diagnosis and ventricle volume prediction, the best algorithms strongly outperform simple baselines in predictive ability. However, for ADAS-Cog13 no single submitted prediction method was significantly better than random guesswork. Two ensemble methods based on taking the mean and median over all predictions, obtained top scores on almost all tasks. Better than average performance at diagnosis prediction was generally associated with the additional inclusion of features from cerebrospinal fluid (CSF) samples and diffusion tensor imaging (DTI). On the other hand, better performance at ventricle volume prediction was associated with inclusion of summary statistics, such as the slope or maxima/minima of biomarkers. TADPOLE's unique results suggest that current prediction algorithms provide sufficient accuracy to exploit biomarkers related to clinical diagnosis and ventricle volume, for cohort refinement in clinical trials for Alzheimer's disease. However, results call into question the usage of cognitive test scores for patient selection and as a primary endpoint in clinical trials.

In this work, we explore the possibility of utilizing transfer learning techniques to address the financial portfolio optimization problem. We introduce a novel concept called "transfer risk", within the optimization framework of transfer learning. A series of numerical experiments are conducted from three categories: cross-continent transfer, cross-sector transfer, and cross-frequency transfer. In particular, 1. a strong correlation between the transfer risk and the overall performance of transfer learning methods is established, underscoring the significance of transfer risk as a viable indicator of "transferability"; 2. transfer risk is shown to provide a computationally efficient way to identify appropriate source tasks in transfer learning, enhancing the efficiency and effectiveness of the transfer learning approach; 3. additionally, the numerical experiments offer valuable new insights for portfolio management across these different settings.

Predicting cancer treatment outcomes requires models that are both accurate and interpretable, particularly in the presence of heterogeneous clinical data. While large language models (LLMs) have shown strong performance in biomedical NLP, they often lack structured reasoning capabilities critical for high-stakes decision support. We present a unified, multi-task learning framework that aligns autoregressive LLMs with clinical reasoning for outcome prediction on the MSK-CHORD dataset. Our models are trained to jointly perform binary survival classification, continuous survival time regression, and natural language rationale generation. We evaluate three alignment strategies: (1) standard supervised fine-tuning (SFT), (2) SFT with Chain-of-Thought (CoT) prompting to elicit step-by-step reasoning, and (3) Group Relative Policy Optimization (GRPO), a reinforcement learning method that aligns model outputs to expert-derived reasoning trajectories. Experiments with LLaMa3-8B and Med42-8B backbones demonstrate that CoT prompting improves F1 by +6.0 and reduces MAE by 12%, while GRPO achieves state-of-the-art interpretability and predictive performance across BLEU, ROUGE, and BERTScore. We further show that existing biomedical LLMs often fail to produce valid reasoning traces due to architectural constraints. Our findings underscore the importance of reasoning-aware alignment in multi-task clinical modeling and set a new benchmark for interpretable, trustworthy LLMs in precision oncology.