Daily Papers

Despite recent progress in vision-language models (VLMs), existing approaches often fail to generate personalized responses based on the user's specific experiences, as they lack the ability to associate visual inputs with a user's accumulated visual-textual context. We newly formalize this challenge as contextualized visual personalization, which requires the visual recognition and textual retrieval of personalized visual experiences by VLMs when interpreting new images. To address this issue, we propose CoViP, a unified framework that treats personalized image captioning as a core task for contextualized visual personalization and improves this capability through reinforcement-learning-based post-training and caption-augmented generation. We further introduce diagnostic evaluations that explicitly rule out textual shortcut solutions and verify whether VLMs truly leverage visual context. Extensive experiments demonstrate that existing open-source and proprietary VLMs exhibit substantial limitations, while CoViP not only improves personalized image captioning but also yields holistic gains across downstream personalization tasks. These results highlight CoViP as a crucial stage for enabling robust and generalizable contextualized visual personalization.

Battles, or side-by-side comparisons in so called arenas that elicit human preferences, have emerged as a popular approach to assessing the output quality of LLMs. Recently, this idea has been extended to retrieval-augmented generation (RAG) systems. While undoubtedly representing an advance in evaluation, battles have at least two drawbacks, particularly in the context of complex information-seeking queries: they are neither explanatory nor diagnostic. Recently, the nugget evaluation methodology has emerged as a promising approach to evaluate the quality of RAG answers. Nuggets decompose long-form LLM-generated answers into atomic facts, highlighting important pieces of information necessary in a "good" response. In this work, we apply our AutoNuggetizer framework to analyze data from roughly 7K Search Arena battles provided by LMArena in a fully automatic manner. Our results show a significant correlation between nugget scores and human preferences, showcasing promise in our approach to explainable and diagnostic system evaluations.

We introduce Michelangelo: a minimal, synthetic, and unleaked long-context reasoning evaluation for large language models which is also easy to automatically score. This evaluation is derived via a novel, unifying framework for evaluations over arbitrarily long contexts which measure the model's ability to do more than retrieve a single piece of information from its context. The central idea of the Latent Structure Queries framework (LSQ) is to construct tasks which require a model to ``chisel away'' the irrelevant information in the context, revealing a latent structure in the context. To verify a model's understanding of this latent structure, we query the model for details of the structure. Using LSQ, we produce three diagnostic long-context evaluations across code and natural-language domains intended to provide a stronger signal of long-context language model capabilities. We perform evaluations on several state-of-the-art models and demonstrate both that a) the proposed evaluations are high-signal and b) that there is significant room for improvement in synthesizing long-context information.

Cardiac biosignals, such as electrocardiograms (ECG) and photoplethysmograms (PPG), are of paramount importance for the diagnosis, prevention, and management of cardiovascular diseases, and have been extensively used in a variety of clinical tasks. Conventional deep learning approaches for analyzing these signals typically rely on homogeneous datasets and static bespoke models, limiting their robustness and generalizability across diverse clinical settings and acquisition protocols. In this study, we present a cardiac sensing foundation model (CSFM) that leverages advanced transformer architectures and a generative, masked pretraining strategy to learn unified representations from vast, heterogeneous health records. Our model is pretrained on an innovative multi-modal integration of data from multiple large-scale datasets (including MIMIC-III-WDB, MIMIC-IV-ECG, and CODE), comprising cardiac signals and the corresponding clinical or machine-generated text reports from approximately 1.7 million individuals. We demonstrate that the embeddings derived from our CSFM not only serve as effective feature extractors across diverse cardiac sensing scenarios, but also enable seamless transfer learning across varying input configurations and sensor modalities. Extensive evaluations across diagnostic tasks, demographic information recognition, vital sign measurement, clinical outcome prediction, and ECG question answering reveal that CSFM consistently outperforms traditional one-modal-one-task approaches. Notably, CSFM exhibits robust performance across multiple ECG lead configurations from standard 12-lead systems to single-lead setups, and in scenarios where only ECG, only PPG, or a combination thereof is available. These findings highlight the potential of CSFM as a versatile and scalable solution, for comprehensive cardiac monitoring.

Despite the successes of recent developments in visual AI, different shortcomings still exist; from missing exact logical reasoning, to abstract generalization abilities, to understanding complex and noisy scenes. Unfortunately, existing benchmarks, were not designed to capture more than a few of these aspects. Whereas deep learning datasets focus on visually complex data but simple visual reasoning tasks, inductive logic datasets involve complex logical learning tasks, however, lack the visual component. To address this, we propose the visual logical learning dataset, V-LoL, that seamlessly combines visual and logical challenges. Notably, we introduce the first instantiation of V-LoL, V-LoL-Trains, -- a visual rendition of a classic benchmark in symbolic AI, the Michalski train problem. By incorporating intricate visual scenes and flexible logical reasoning tasks within a versatile framework, V-LoL-Trains provides a platform for investigating a wide range of visual logical learning challenges. We evaluate a variety of AI systems including traditional symbolic AI, neural AI, as well as neuro-symbolic AI. Our evaluations demonstrate that even state-of-the-art AI faces difficulties in dealing with visual logical learning challenges, highlighting unique advantages and limitations specific to each methodology. Overall, V-LoL opens up new avenues for understanding and enhancing current abilities in visual logical learning for AI systems.

While Multimodal Large Language Models (MLLMs) have achieved remarkable progress in visual understanding, they often struggle when faced with the unstructured and ambiguous nature of human-generated sketches. This limitation is particularly pronounced in the underexplored task of visual grading, where models should not only solve a problem but also diagnose errors in hand-drawn diagrams. Such diagnostic capabilities depend on complex structural, semantic, and metacognitive reasoning. To bridge this gap, we introduce SketchJudge, a novel benchmark tailored for evaluating MLLMs as graders of hand-drawn STEM diagrams. SketchJudge encompasses 1,015 hand-drawn student responses across four domains: geometry, physics, charts, and flowcharts, featuring diverse stylistic variations and distinct error types. Evaluations on SketchJudge demonstrate that even advanced MLLMs lag significantly behind humans, validating the benchmark's effectiveness in exposing the fragility of current vision-language alignment in symbolic and noisy contexts. All data, code, and evaluation scripts are publicly available at https://github.com/yuhangsu82/SketchJudge.

Alignment is no longer a luxury, it is a necessity. As large language models (LLMs) enter high-stakes domains like education, healthcare, governance, and law, their behavior must reliably reflect human-aligned values and safety constraints. Yet current evaluations rely heavily on behavioral proxies such as refusal rates, G-Eval scores, and toxicity classifiers, all of which have critical blind spots. Aligned models are often vulnerable to jailbreaking, stochasticity of generation, and alignment faking. To address this issue, we introduce the Alignment Quality Index (AQI). This novel geometric and prompt-invariant metric empirically assesses LLM alignment by analyzing the separation of safe and unsafe activations in latent space. By combining measures such as the Davies-Bouldin Score (DBS), Dunn Index (DI), Xie-Beni Index (XBI), and Calinski-Harabasz Index (CHI) across various formulations, AQI captures clustering quality to detect hidden misalignments and jailbreak risks, even when outputs appear compliant. AQI also serves as an early warning signal for alignment faking, offering a robust, decoding invariant tool for behavior agnostic safety auditing. Additionally, we propose the LITMUS dataset to facilitate robust evaluation under these challenging conditions. Empirical tests on LITMUS across different models trained under DPO, GRPO, and RLHF conditions demonstrate AQI's correlation with external judges and ability to reveal vulnerabilities missed by refusal metrics. We make our implementation publicly available to foster future research in this area.

Medical Visual Question Answering (Med-VQA) holds significant potential for clinical decision support, yet existing efforts primarily focus on 2D imaging with limited task diversity. This paper presents 3D-RAD, a large-scale dataset designed to advance 3D Med-VQA using radiology CT scans. The 3D-RAD dataset encompasses six diverse VQA tasks: anomaly detection, image observation, medical computation, existence detection, static temporal diagnosis, and longitudinal temporal diagnosis. It supports both open- and closed-ended questions while introducing complex reasoning challenges, including computational tasks and multi-stage temporal analysis, to enable comprehensive benchmarking. Extensive evaluations demonstrate that existing vision-language models (VLMs), especially medical VLMs exhibit limited generalization, particularly in multi-temporal tasks, underscoring the challenges of real-world 3D diagnostic reasoning. To drive future advancements, we release a high-quality training set 3D-RAD-T of 136,195 expert-aligned samples, showing that fine-tuning on this dataset could significantly enhance model performance. Our dataset and code, aiming to catalyze multimodal medical AI research and establish a robust foundation for 3D medical visual understanding, are publicly available at https://github.com/Tang-xiaoxiao/3D-RAD.

Digital healthcare infrastructure is crucial for global medical service delivery. Egypt faces EHR adoption barriers: only 314 hospitals had such systems as of Oct 2024. This limits data management and decision-making. This project introduces an EHR system for Egypt's Universal Health Insurance and healthcare ecosystem. It simplifies data management by centralizing medical histories with a scalable micro-services architecture and polyglot persistence for real-time access and provider communication. Clinical workflows are enhanced via patient examination and history tracking. The system uses the Llama3-OpenBioLLM-70B model to generate summaries of medical histories, provide chatbot features, and generate AI-based medical reports, enabling efficient searches during consultations. A Vision Transformer (ViT) aids in pneumonia classification. Evaluations show the AI excels in capturing details (high recall) but needs improvement in concise narratives. With optimization (retrieval-augmented generation, local data fine-tuning, interoperability protocols), this AI-driven EHR could enhance diagnostic support, decision-making, and healthcare delivery in Egypt.

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

We propose a novel multimodal video benchmark - the Perception Test - to evaluate the perception and reasoning skills of pre-trained multimodal models (e.g. Flamingo, BEiT-3, or GPT-4). Compared to existing benchmarks that focus on computational tasks (e.g. classification, detection or tracking), the Perception Test focuses on skills (Memory, Abstraction, Physics, Semantics) and types of reasoning (descriptive, explanatory, predictive, counterfactual) across video, audio, and text modalities, to provide a comprehensive and efficient evaluation tool. The benchmark probes pre-trained models for their transfer capabilities, in a zero-shot / few-shot or limited finetuning regime. For these purposes, the Perception Test introduces 11.6k real-world videos, 23s average length, designed to show perceptually interesting situations, filmed by around 100 participants worldwide. The videos are densely annotated with six types of labels (multiple-choice and grounded video question-answers, object and point tracks, temporal action and sound segments), enabling both language and non-language evaluations. The fine-tuning and validation splits of the benchmark are publicly available (CC-BY license), in addition to a challenge server with a held-out test split. Human baseline results compared to state-of-the-art video QA models show a significant gap in performance (91.4% vs 43.6%), suggesting that there is significant room for improvement in multimodal video understanding. Dataset, baselines code, and challenge server are available at https://github.com/deepmind/perception_test

In this work, we introduce MedAgentSim, an open-source simulated clinical environment with doctor, patient, and measurement agents designed to evaluate and enhance LLM performance in dynamic diagnostic settings. Unlike prior approaches, our framework requires doctor agents to actively engage with patients through multi-turn conversations, requesting relevant medical examinations (e.g., temperature, blood pressure, ECG) and imaging results (e.g., MRI, X-ray) from a measurement agent to mimic the real-world diagnostic process. Additionally, we incorporate self improvement mechanisms that allow models to iteratively refine their diagnostic strategies. We enhance LLM performance in our simulated setting by integrating multi-agent discussions, chain-of-thought reasoning, and experience-based knowledge retrieval, facilitating progressive learning as doctor agents interact with more patients. We also introduce an evaluation benchmark for assessing the LLM's ability to engage in dynamic, context-aware diagnostic interactions. While MedAgentSim is fully automated, it also supports a user-controlled mode, enabling human interaction with either the doctor or patient agent. Comprehensive evaluations in various simulated diagnostic scenarios demonstrate the effectiveness of our approach. Our code, simulation tool, and benchmark are available at https://medagentsim.netlify.app/.

Large language models have shown promise in clinical decision making, but current approaches struggle to localize and correct errors at specific steps of the reasoning process. This limitation is critical in medicine, where identifying and addressing reasoning errors is essential for accurate diagnosis and effective patient care. We introduce Med-PRM, a process reward modeling framework that leverages retrieval-augmented generation to verify each reasoning step against established medical knowledge bases. By verifying intermediate reasoning steps with evidence retrieved from clinical guidelines and literature, our model can precisely assess the reasoning quality in a fine-grained manner. Evaluations on five medical QA benchmarks and two open-ended diagnostic tasks demonstrate that Med-PRM achieves state-of-the-art performance, with improving the performance of base models by up to 13.50% using Med-PRM. Moreover, we demonstrate the generality of Med-PRM by integrating it in a plug-and-play fashion with strong policy models such as Meerkat, achieving over 80\% accuracy on MedQA for the first time using small-scale models of 8 billion parameters. Our code and data are available at: https://med-prm.github.io/

We introduce PRISM-Bench, a benchmark of puzzle-based visual challenges designed to evaluate not only whether models can solve problems, but how their reasoning unfolds. Unlike prior evaluations that measure only final-answer accuracy, PRISM-Bench introduces a diagnostic task: given a visual puzzle and a step-by-step chain-of-thought (CoT) containing exactly one error, models must identify the first incorrect step. This setting enables fine-grained assessment of logical consistency, error detection, and visual reasoning. The puzzles in PRISM-Bench require multi-step symbolic, geometric, and analogical reasoning, resisting shortcuts based on superficial pattern matching. Evaluations across state-of-the-art MLLMs reveal a persistent gap between fluent generation and faithful reasoning: models that produce plausible CoTs often fail to locate simple logical faults. By disentangling answer generation from reasoning verification, PRISM-Bench offers a sharper lens on multimodal reasoning competence and underscores the need for diagnostic evaluation protocols in the development of trustworthy MLLMs.

This study presents Latent Diffusion Autoencoder (LDAE), a novel encoder-decoder diffusion-based framework for efficient and meaningful unsupervised learning in medical imaging, focusing on Alzheimer disease (AD) using brain MR from the ADNI database as a case study. Unlike conventional diffusion autoencoders operating in image space, LDAE applies the diffusion process in a compressed latent representation, improving computational efficiency and making 3D medical imaging representation learning tractable. To validate the proposed approach, we explore two key hypotheses: (i) LDAE effectively captures meaningful semantic representations on 3D brain MR associated with AD and ageing, and (ii) LDAE achieves high-quality image generation and reconstruction while being computationally efficient. Experimental results support both hypotheses: (i) linear-probe evaluations demonstrate promising diagnostic performance for AD (ROC-AUC: 90%, ACC: 84%) and age prediction (MAE: 4.1 years, RMSE: 5.2 years); (ii) the learned semantic representations enable attribute manipulation, yielding anatomically plausible modifications; (iii) semantic interpolation experiments show strong reconstruction of missing scans, with SSIM of 0.969 (MSE: 0.0019) for a 6-month gap. Even for longer gaps (24 months), the model maintains robust performance (SSIM > 0.93, MSE < 0.004), indicating an ability to capture temporal progression trends; (iv) compared to conventional diffusion autoencoders, LDAE significantly increases inference throughput (20x faster) while also enhancing reconstruction quality. These findings position LDAE as a promising framework for scalable medical imaging applications, with the potential to serve as a foundation model for medical image analysis. Code available at https://github.com/GabrieleLozupone/LDAE

The integration of Artificial Intelligence (AI), especially Large Language Models (LLMs), into the clinical diagnosis process offers significant potential to improve the efficiency and accessibility of medical care. While LLMs have shown some promise in the medical domain, their application in clinical diagnosis remains underexplored, especially in real-world clinical practice, where highly sophisticated, patient-specific decisions need to be made. Current evaluations of LLMs in this field are often narrow in scope, focusing on specific diseases or specialties and employing simplified diagnostic tasks. To bridge this gap, we introduce CliBench, a novel benchmark developed from the MIMIC IV dataset, offering a comprehensive and realistic assessment of LLMs' capabilities in clinical diagnosis. This benchmark not only covers diagnoses from a diverse range of medical cases across various specialties but also incorporates tasks of clinical significance: treatment procedure identification, lab test ordering and medication prescriptions. Supported by structured output ontologies, CliBench enables a precise and multi-granular evaluation, offering an in-depth understanding of LLM's capability on diverse clinical tasks of desired granularity. We conduct a zero-shot evaluation of leading LLMs to assess their proficiency in clinical decision-making. Our preliminary results shed light on the potential and limitations of current LLMs in clinical settings, providing valuable insights for future advancements in LLM-powered healthcare.

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

Positional embeddings (PE) play a crucial role in Vision Transformers (ViTs) by providing spatial information otherwise lost due to the permutation invariant nature of self attention. While absolute positional embeddings (APE) have shown theoretical advantages over relative positional embeddings (RPE), particularly due to the ability of sinusoidal functions to preserve spatial inductive biases like monotonicity and shift invariance, a fundamental challenge arises when mapping a 2D grid to a 1D sequence. Existing methods have mostly overlooked or never explored the impact of patch ordering in positional embeddings. To address this, we propose LOOPE, a learnable patch-ordering method that optimizes spatial representation for a given set of frequencies, providing a principled approach to patch order optimization. Empirical results show that our PE significantly improves classification accuracy across various ViT architectures. To rigorously evaluate the effectiveness of positional embeddings, we introduce the "Three Cell Experiment", a novel benchmarking framework that assesses the ability of PEs to retain relative and absolute positional information across different ViT architectures. Unlike standard evaluations, which typically report a performance gap of 4 to 6% between models with and without PE, our method reveals a striking 30 to 35% difference, offering a more sensitive diagnostic tool to measure the efficacy of PEs. Our experimental analysis confirms that the proposed LOOPE demonstrates enhanced effectiveness in retaining both relative and absolute positional information.

Rare diseases collectively affect over 300 million individuals worldwide, yet timely and accurate diagnosis remains a pervasive challenge. This is largely due to their clinical heterogeneity, low individual prevalence, and the limited familiarity most clinicians have with rare conditions. Here, we introduce DeepRare, the first rare disease diagnosis agentic system powered by a large language model (LLM), capable of processing heterogeneous clinical inputs. The system generates ranked diagnostic hypotheses for rare diseases, each accompanied by a transparent chain of reasoning that links intermediate analytic steps to verifiable medical evidence. DeepRare comprises three key components: a central host with a long-term memory module; specialized agent servers responsible for domain-specific analytical tasks integrating over 40 specialized tools and web-scale, up-to-date medical knowledge sources, ensuring access to the most current clinical information. This modular and scalable design enables complex diagnostic reasoning while maintaining traceability and adaptability. We evaluate DeepRare on eight datasets. The system demonstrates exceptional diagnostic performance among 2,919 diseases, achieving 100% accuracy for 1013 diseases. In HPO-based evaluations, DeepRare significantly outperforms other 15 methods, like traditional bioinformatics diagnostic tools, LLMs, and other agentic systems, achieving an average Recall@1 score of 57.18% and surpassing the second-best method (Reasoning LLM) by a substantial margin of 23.79 percentage points. For multi-modal input scenarios, DeepRare achieves 70.60% at Recall@1 compared to Exomiser's 53.20% in 109 cases. Manual verification of reasoning chains by clinical experts achieves 95.40% agreements. Furthermore, the DeepRare system has been implemented as a user-friendly web application http://raredx.cn/doctor.

Language models have shown promising performance on the task of translating natural language questions into SQL queries (Text-to-SQL). However, most of the state-of-the-art (SOTA) approaches rely on powerful yet closed-source large language models (LLMs), such as ChatGPT and GPT-4, which may have the limitations of unclear model architectures, data privacy risks, and expensive inference overheads. To address the limitations, we introduce CodeS, a series of pre-trained language models with parameters ranging from 1B to 15B, specifically designed for the text-to-SQL task. CodeS is a fully open-source language model, which achieves superior accuracy with much smaller parameter sizes. This paper studies the research challenges in building CodeS. To enhance the SQL generation abilities of CodeS, we adopt an incremental pre-training approach using a specifically curated SQL-centric corpus. Based on this, we address the challenges of schema linking and rapid domain adaptation through strategic prompt construction and a bi-directional data augmentation technique. We conduct comprehensive evaluations on multiple datasets, including the widely used Spider benchmark, the newly released BIRD benchmark, robustness-diagnostic benchmarks such as Spider-DK, Spider-Syn, Spider-Realistic, and Dr.Spider, as well as two real-world datasets created for financial and academic applications. The experimental results show that our CodeS achieves new SOTA accuracy and robustness on nearly all challenging text-to-SQL benchmarks.

Idiopathic pulmonary fibrosis (IPF) is a progressive disease that irreversibly transforms lung tissue into rigid fibrotic structures, leading to debilitating symptoms such as shortness of breath and chronic fatigue. The heterogeneity and complexity of this disease, particularly regarding its severity and progression rate, have made predicting its future course a complex and challenging task. Besides, traditional diagnostic methods based on clinical evaluations and imaging have limitations in capturing the disease's complexity. Using the Kaggle Pulmonary Fibrosis Progression dataset, which includes computed tomography images, and clinical information, the model predicts changes in forced vital capacity (FVC), a key progression indicator. Our method uses a proposed context-aware sequential-parallel hybrid transformer model and clinical information enrichment for its prediction. The proposed method achieved a Laplace Log-Likelihood score of -6.508, outperforming prior methods and demonstrating superior predictive capabilities. These results highlight the potential of advanced deep learning techniques to provide more accurate and timely predictions, offering a transformative approach to the diagnosis and management of IPF, with implications for improved patient outcomes and therapeutic advancements.

In clinical practice, electrocardiography (ECG) remains the gold standard for cardiac monitoring, providing crucial insights for diagnosing a wide range of cardiovascular diseases (CVDs). However, its reliance on specialized equipment and trained personnel limits feasibility for continuous routine monitoring. Photoplethysmography (PPG) offers accessible, continuous monitoring but lacks definitive electrophysiological information, preventing conclusive diagnosis. Generative models present a promising approach to translate PPG into clinically valuable ECG signals, yet current methods face substantial challenges, including the misalignment of physiological semantics in generative models and the complexity of modeling in high-dimensional signals. To this end, we propose PPGFlowECG, a two-stage framework that aligns PPG and ECG in a shared latent space via the CardioAlign Encoder and employs latent rectified flow to generate ECGs with high fidelity and interpretability. To the best of our knowledge, this is the first study to experiment on MCMED, a newly released clinical-grade dataset comprising over 10 million paired PPG-ECG samples from more than 118,000 emergency department visits with expert-labeled cardiovascular disease annotations. Results demonstrate the effectiveness of our method for PPG-to-ECG translation and cardiovascular disease detection. Moreover, cardiologist-led evaluations confirm that the synthesized ECGs achieve high fidelity and improve diagnostic reliability, underscoring our method's potential for real-world cardiovascular screening.

The capability of Unified Multimodal Models (UMMs) to apply world knowledge across diverse tasks remains a critical, unresolved challenge. Existing benchmarks fall short, offering only siloed, single-task evaluations with limited diagnostic power. To bridge this gap, we propose AEGIS (i.e., Assessing Editing, Generation, Interpretation-Understanding for Super-intelligence), a comprehensive multi-task benchmark covering visual understanding, generation, editing, and interleaved generation. AEGIS comprises 1,050 challenging, manually-annotated questions spanning 21 topics (including STEM, humanities, daily life, etc.) and 6 reasoning types. To concretely evaluate the performance of UMMs in world knowledge scope without ambiguous metrics, we further propose Deterministic Checklist-based Evaluation (DCE), a protocol that replaces ambiguous prompt-based scoring with atomic ``Y/N'' judgments, to enhance evaluation reliability. Our extensive experiments reveal that most UMMs exhibit severe world knowledge deficits and that performance degrades significantly with complex reasoning. Additionally, simple plug-in reasoning modules can partially mitigate these vulnerabilities, highlighting a promising direction for future research. These results highlight the importance of world-knowledge-based reasoning as a critical frontier for UMMs.

Large language models (LLMs) can pass explicit social bias tests but still harbor implicit biases, similar to humans who endorse egalitarian beliefs yet exhibit subtle biases. Measuring such implicit biases can be a challenge: as LLMs become increasingly proprietary, it may not be possible to access their embeddings and apply existing bias measures; furthermore, implicit biases are primarily a concern if they affect the actual decisions that these systems make. We address both challenges by introducing two new measures of bias: LLM Implicit Bias, a prompt-based method for revealing implicit bias; and LLM Decision Bias, a strategy to detect subtle discrimination in decision-making tasks. Both measures are based on psychological research: LLM Implicit Bias adapts the Implicit Association Test, widely used to study the automatic associations between concepts held in human minds; and LLM Decision Bias operationalizes psychological results indicating that relative evaluations between two candidates, not absolute evaluations assessing each independently, are more diagnostic of implicit biases. Using these measures, we found pervasive stereotype biases mirroring those in society in 8 value-aligned models across 4 social categories (race, gender, religion, health) in 21 stereotypes (such as race and criminality, race and weapons, gender and science, age and negativity). Our prompt-based LLM Implicit Bias measure correlates with existing language model embedding-based bias methods, but better predicts downstream behaviors measured by LLM Decision Bias. These new prompt-based measures draw from psychology's long history of research into measuring stereotype biases based on purely observable behavior; they expose nuanced biases in proprietary value-aligned LLMs that appear unbiased according to standard benchmarks.

Quantitative evaluation has increased dramatically among recent video inpainting work, but the video and mask content used to gauge performance has received relatively little attention. Although attributes such as camera and background scene motion inherently change the difficulty of the task and affect methods differently, existing evaluation schemes fail to control for them, thereby providing minimal insight into inpainting failure modes. To address this gap, we propose the Diagnostic Evaluation of Video Inpainting on Landscapes (DEVIL) benchmark, which consists of two contributions: (i) a novel dataset of videos and masks labeled according to several key inpainting failure modes, and (ii) an evaluation scheme that samples slices of the dataset characterized by a fixed content attribute, and scores performance on each slice according to reconstruction, realism, and temporal consistency quality. By revealing systematic changes in performance induced by particular characteristics of the input content, our challenging benchmark enables more insightful analysis into video inpainting methods and serves as an invaluable diagnostic tool for the field. Our code and data are available at https://github.com/MichiganCOG/devil .

Recent advances in generative foundational models, often termed "world models," have propelled interest in applying them to critical tasks like robotic planning and autonomous system training. For reliable deployment, these models must exhibit high physical fidelity, accurately simulating real-world dynamics. Existing physics-based video benchmarks, however, suffer from entanglement, where a single test simultaneously evaluates multiple physical laws and concepts, fundamentally limiting their diagnostic capability. We introduce WorldBench, a novel video-based benchmark specifically designed for concept-specific, disentangled evaluation, allowing us to rigorously isolate and assess understanding of a single physical concept or law at a time. To make WorldBench comprehensive, we design benchmarks at two different levels: 1) an evaluation of intuitive physical understanding with concepts such as object permanence or scale/perspective, and 2) an evaluation of low-level physical constants and material properties such as friction coefficients or fluid viscosity. When SOTA video-based world models are evaluated on WorldBench, we find specific patterns of failure in particular physics concepts, with all tested models lacking the physical consistency required to generate reliable real-world interactions. Through its concept-specific evaluation, WorldBench offers a more nuanced and scalable framework for rigorously evaluating the physical reasoning capabilities of video generation and world models, paving the way for more robust and generalizable world-model-driven learning.

Retrieval-augmented generation (RAG) enhances large language models by incorporating context retrieved from external knowledge sources. While the effectiveness of the retrieval module is typically evaluated with relevance-based ranking metrics, such metrics may be insufficient to reflect the retrieval's impact on the final RAG result, especially in long-form generation scenarios. We argue that providing a comprehensive retrieval-augmented context is important for long-form RAG tasks like report generation and propose metrics for assessing the context independent of generation. We introduce CRUX, a Controlled Retrieval-aUgmented conteXt evaluation framework designed to directly assess retrieval-augmented contexts. This framework uses human-written summaries to control the information scope of knowledge, enabling us to measure how well the context covers information essential for long-form generation. CRUX uses question-based evaluation to assess RAG's retrieval in a fine-grained manner. Empirical results show that CRUX offers more reflective and diagnostic evaluation. Our findings also reveal substantial room for improvement in current retrieval methods, pointing to promising directions for advancing RAG's retrieval. Our data and code are publicly available to support and advance future research on retrieval.

Reasoning benchmarks have played a crucial role in the progress of language models. Yet rigorous evaluation remains a significant challenge as static question-answer pairs provide only a snapshot of performance, compressing complex behavior into a single accuracy metric. This limitation is especially true in complex, rule-bound domains such as law, where existing benchmarks are costly to build and ill suited for isolating specific failure modes. To address this, we introduce OpenExempt, a framework and benchmark for diagnostic evaluation of legal reasoning. The OpenExempt Framework uses expert-crafted symbolic representations of U.S. Bankruptcy Code statutes to dynamically generate a large space of natural language reasoning tasks and their machine-computable solutions on demand. This gives users fine-grained control over task complexity and scope, allowing individual reasoning skills to be probed in isolation. Using this system, we construct the OpenExempt Benchmark, a diagnostic benchmark for legal reasoning with 9,765 samples across nine evaluation suites designed to carefully probe model capabilities. Experiments on 13 diverse language models reveal sharp performance cliffs that emerge only under longer reasoning paths and in the presence of obfuscating statements. We release the framework and benchmark publicly to support research aimed at understanding and improving the next generation of reasoning systems.

High-resolution image (HRI) understanding aims to process images with a large number of pixels, such as pathological images and agricultural aerial images, both of which can exceed 1 million pixels. Vision Large Language Models (VLMs) can allegedly handle HRIs, however, there is a lack of a comprehensive benchmark for VLMs to evaluate HRI understanding. To address this gap, we introduce HRScene, a novel unified benchmark for HRI understanding with rich scenes. HRScene incorporates 25 real-world datasets and 2 synthetic diagnostic datasets with resolutions ranging from 1,024 times 1,024 to 35,503 times 26,627. HRScene is collected and re-annotated by 10 graduate-level annotators, covering 25 scenarios, ranging from microscopic to radiology images, street views, long-range pictures, and telescope images. It includes HRIs of real-world objects, scanned documents, and composite multi-image. The two diagnostic evaluation datasets are synthesized by combining the target image with the gold answer and distracting images in different orders, assessing how well models utilize regions in HRI. We conduct extensive experiments involving 28 VLMs, including Gemini 2.0 Flash and GPT-4o. Experiments on HRScene show that current VLMs achieve an average accuracy of around 50% on real-world tasks, revealing significant gaps in HRI understanding. Results on synthetic datasets reveal that VLMs struggle to effectively utilize HRI regions, showing significant Regional Divergence and lost-in-middle, shedding light on future research.

The prevailing video retrieval paradigm is structurally misaligned, as narrow benchmarks incentivize correspondingly limited data and single-task training. Therefore, universal capability is suppressed due to the absence of a diagnostic evaluation that defines and demands multi-dimensional generalization. To break this cycle, we introduce a framework built on the co-design of evaluation, data, and modeling. First, we establish the Universal Video Retrieval Benchmark (UVRB), a suite of 16 datasets designed not only to measure performance but also to diagnose critical capability gaps across tasks and domains. Second, guided by UVRB's diagnostics, we introduce a scalable synthesis workflow that generates 1.55 million high-quality pairs to populate the semantic space required for universality. Finally, we devise the Modality Pyramid, a curriculum that trains our General Video Embedder (GVE) by explicitly leveraging the latent interconnections within our diverse data. Extensive experiments show GVE achieves state-of-the-art zero-shot generalization on UVRB. In particular, our analysis reveals that popular benchmarks are poor predictors of general ability and that partially relevant retrieval is a dominant but overlooked scenario. Overall, our co-designed framework provides a practical path to escape the limited scope and advance toward truly universal video retrieval.

We introduce CompareBench, a benchmark for evaluating visual comparison reasoning in vision-language models (VLMs), a fundamental yet understudied skill. CompareBench consists of 1000 QA pairs across four tasks: quantity (600), temporal (100), geometric (200), and spatial (100). It is derived from two auxiliary datasets that we constructed: TallyBench (2000 counting images with QA) and HistCaps (515 historical images with bilingual captions). We evaluate both closed-source APIs (OpenAI, Gemini, Claude) and open-source models (Qwen2.5-VL and Qwen3-VL series). Results show clear scaling trends but also reveal critical limitations: even the strongest models consistently fail at temporal ordering and spatial relations, and they often make mistakes in basic counting and geometric comparisons that are trivial for humans. These findings demonstrate that visual comparison remains a systematic blind spot for current VLMs. By providing controlled, diverse, and diagnostic evaluation, CompareBench establishes a foundation for advancing more reliable multimodal reasoning.

Despite recent progress in 3D-LLMs, they remain limited in accurately grounding language to visual and spatial elements in 3D environments. This limitation stems in part from training data that focuses on language reasoning rather than spatial understanding due to scarce 3D resources, leaving inherent grounding biases unresolved. To address this, we propose 3D scene editing as a key mechanism to generate precise visual counterfactuals that mitigate these biases through fine-grained spatial manipulation, without requiring costly scene reconstruction or large-scale 3D data collection. Furthermore, to make these edits targeted and directly address the specific weaknesses of the model, we introduce DEER-3D, an error-driven framework following a structured "Decompose, Diagnostic Evaluation, Edit, and Re-train" workflow, rather than broadly or randomly augmenting data as in conventional approaches. Specifically, upon identifying a grounding failure of the 3D-LLM, our framework first diagnoses the exact predicate-level error (e.g., attribute or spatial relation). It then executes minimal, predicate-aligned 3D scene edits, such as recoloring or repositioning, to produce targeted counterfactual supervision for iterative model fine-tuning, significantly enhancing grounding accuracy. We evaluate our editing pipeline across multiple benchmarks for 3D grounding and scene understanding tasks, consistently demonstrating improvements across all evaluated datasets through iterative refinement. DEER-3D underscores the effectiveness of targeted, error-driven scene editing in bridging linguistic reasoning capabilities with spatial grounding in 3D LLMs.

Cross-lingual evaluation of large language models (LLMs) typically conflates two sources of variance: genuine model performance differences and measurement instability. We investigate evaluation reliability by holding generation conditions constant while varying target language. Using synthetic customer-support dialogues generated with identical parameters across Estonian, Finnish, and Hungarian, we test whether automatic metrics and LLM-as-a-judge scoring produce stable model rankings across these morphologically rich, related Finno-Ugric languages. With a small set of Estonian native speaker annotations as a reference point, we find systematic ranking instabilities: surface-level metrics (lexical diversity, surface and semantic similarity) maintain cross-language stability, but pragmatic judgments (coherence, instruction-following) exhibit rank inversions and near-zero correlations. Because generation is controlled, these inconsistencies reflect how judge scoring behaves differently across languages rather than true model differences. This controlled design provides a diagnostic probe: evaluation methods that fail to maintain stability under identical generation conditions signal transfer failure before deployment. Our findings suggest that zero-shot judge transfer is unreliable for discourse-level assessment in morphologically rich languages, motivating language-specific calibration against targeted human baselines. We release our controlled generation protocol, synthetic data, and evaluation framework to enable replication across language families at https://github.com/isaac-chung/cross-lingual-stability-judges.

The integration of visual understanding and generation into unified multimodal models represents a significant stride toward general-purpose AI. However, a fundamental question remains unanswered by existing benchmarks: does this architectural unification actually enable synergetic interaction between the constituent capabilities? Existing evaluation paradigms, which primarily assess understanding and generation in isolation, are insufficient for determining whether a unified model can leverage its understanding to enhance its generation, or use generative simulation to facilitate deeper comprehension. To address this critical gap, we introduce RealUnify, a benchmark specifically designed to evaluate bidirectional capability synergy. RealUnify comprises 1,000 meticulously human-annotated instances spanning 10 categories and 32 subtasks. It is structured around two core axes: 1) Understanding Enhances Generation, which requires reasoning (e.g., commonsense, logic) to guide image generation, and 2) Generation Enhances Understanding, which necessitates mental simulation or reconstruction (e.g., of transformed or disordered visual inputs) to solve reasoning tasks. A key contribution is our dual-evaluation protocol, which combines direct end-to-end assessment with a diagnostic stepwise evaluation that decomposes tasks into distinct understanding and generation phases. This protocol allows us to precisely discern whether performance bottlenecks stem from deficiencies in core abilities or from a failure to integrate them. Through large-scale evaluations of 12 leading unified models and 6 specialized baselines, we find that current unified models still struggle to achieve effective synergy, indicating that architectural unification alone is insufficient. These results highlight the need for new training strategies and inductive biases to fully unlock the potential of unified modeling.

Audio-visual understanding is a rapidly evolving field that seeks to integrate and interpret information from both auditory and visual modalities. Despite recent advances in multi-modal learning, existing benchmarks often suffer from strong visual bias -- where answers can be inferred from visual data alone -- and provide only aggregate scores that conflate multiple sources of error. This makes it difficult to determine whether models struggle with visual understanding, audio interpretation, or audio-visual alignment. In this work, we introduce DAVE (Diagnostic Audio Visual Evaluation), a novel benchmark dataset designed to systematically evaluate audio-visual models across controlled challenges. DAVE alleviates existing limitations by (i) ensuring both modalities are necessary to answer correctly and (ii) decoupling evaluation into atomic subcategories. Our detailed analysis of state-of-the-art models reveals specific failure modes and provides targeted insights for improvement. By offering this standardized diagnostic framework, we aim to facilitate more robust development of audio-visual models. The dataset is released: https://github.com/gorjanradevski/dave

Clinical diagnosis is critical in medical practice, typically requiring a continuous and evolving process that includes primary diagnosis, differential diagnosis, and final diagnosis. However, most existing clinical diagnostic tasks are single-step processes, which does not align with the complex multi-step diagnostic procedures found in real-world clinical settings. In this paper, we propose a multi-step diagnostic task and annotate a clinical diagnostic dataset (MSDiagnosis). This dataset includes primary diagnosis, differential diagnosis, and final diagnosis questions. Additionally, we propose a novel and effective framework. This framework combines forward inference, backward inference, reflection, and refinement, enabling the LLM to self-evaluate and adjust its diagnostic results. To assess the effectiveness of our proposed method, we design and conduct extensive experiments. The experimental results demonstrate the effectiveness of the proposed method. We also provide a comprehensive experimental analysis and suggest future research directions for this task.

Large Multimodal Models (LMMs) have shown remarkable progress in the field of medical Visual Question Answering (Med-VQA), achieving high accuracy on existing benchmarks. However, their reliability under robust evaluation is questionable. This study reveals that state-of-the-art models, when subjected to simple probing evaluation, perform worse than random guessing on medical diagnosis questions. To address this critical evaluation problem, we introduce the Probing Evaluation for Medical Diagnosis (ProbMed) dataset to rigorously assess LMM performance in medical imaging through probing evaluation and procedural diagnosis. Particularly, probing evaluation features pairing original questions with negation questions with hallucinated attributes, while procedural diagnosis requires reasoning across various diagnostic dimensions for each image, including modality recognition, organ identification, clinical findings, abnormalities, and positional grounding. Our evaluation reveals that top-performing models like GPT-4V and Gemini Pro perform worse than random guessing on specialized diagnostic questions, indicating significant limitations in handling fine-grained medical inquiries. Besides, models like LLaVA-Med struggle even with more general questions, and results from CheXagent demonstrate the transferability of expertise across different modalities of the same organ, showing that specialized domain knowledge is still crucial for improving performance. This study underscores the urgent need for more robust evaluation to ensure the reliability of LMMs in critical fields like medical diagnosis, and current LMMs are still far from applicable to those fields.

The rapid increase of computed tomography (CT) scans and their time-consuming manual analysis have created an urgent need for robust automated analysis techniques in clinical settings. These aim to assist radiologists and help them managing their growing workload. Existing methods typically generate entire reports directly from 3D CT images, without explicitly focusing on observed abnormalities. This unguided approach often results in repetitive content or incomplete reports, failing to prioritize anomaly-specific descriptions. We propose a new anomaly-guided report generation model, which first predicts abnormalities and then generates targeted descriptions for each. Evaluation on a public dataset demonstrates significant improvements in report quality and clinical relevance. We extend our work by conducting an ablation study to demonstrate its effectiveness.

The emergence of groundbreaking large language models capable of performing complex reasoning tasks holds significant promise for addressing various scientific challenges, including those arising in complex clinical scenarios. To enable their safe and effective deployment in real-world healthcare settings, it is urgently necessary to benchmark the diagnostic capabilities of current models systematically. Given the limitations of existing medical benchmarks in evaluating advanced diagnostic reasoning, we present DiagnosisArena, a comprehensive and challenging benchmark designed to rigorously assess professional-level diagnostic competence. DiagnosisArena consists of 1,113 pairs of segmented patient cases and corresponding diagnoses, spanning 28 medical specialties, deriving from clinical case reports published in 10 top-tier medical journals. The benchmark is developed through a meticulous construction pipeline, involving multiple rounds of screening and review by both AI systems and human experts, with thorough checks conducted to prevent data leakage. Our study reveals that even the most advanced reasoning models, o3-mini, o1, and DeepSeek-R1, achieve only 45.82%, 31.09%, and 17.79% accuracy, respectively. This finding highlights a significant generalization bottleneck in current large language models when faced with clinical diagnostic reasoning challenges. Through DiagnosisArena, we aim to drive further advancements in AIs diagnostic reasoning capabilities, enabling more effective solutions for real-world clinical diagnostic challenges. We provide the benchmark and evaluation tools for further research and development https://github.com/SPIRAL-MED/DiagnosisArena.

Differential diagnosis is crucial for medicine as it helps healthcare providers systematically distinguish between conditions that share similar symptoms. This study assesses the impact of lab test results on differential diagnoses (DDx) made by large language models (LLMs). Clinical vignettes from 50 case reports from PubMed Central were created incorporating patient demographics, symptoms, and lab results. Five LLMs GPT-4, GPT-3.5, Llama-2-70b, Claude-2, and Mixtral-8x7B were tested to generate Top 10, Top 5, and Top 1 DDx with and without lab data. A comprehensive evaluation involving GPT-4, a knowledge graph, and clinicians was conducted. GPT-4 performed best, achieving 55% accuracy for Top 1 diagnoses and 60% for Top 10 with lab data, with lenient accuracy up to 80%. Lab results significantly improved accuracy, with GPT-4 and Mixtral excelling, though exact match rates were low. Lab tests, including liver function, metabolic/toxicology panels, and serology/immune tests, were generally interpreted correctly by LLMs for differential diagnosis.

Artificial intelligence holds great promise for expanding access to expert medical knowledge and reasoning. However, most evaluations of language models rely on static vignettes and multiple-choice questions that fail to reflect the complexity and nuance of evidence-based medicine in real-world settings. In clinical practice, physicians iteratively formulate and revise diagnostic hypotheses, adapting each subsequent question and test to what they've just learned, and weigh the evolving evidence before committing to a final diagnosis. To emulate this iterative process, we introduce the Sequential Diagnosis Benchmark, which transforms 304 diagnostically challenging New England Journal of Medicine clinicopathological conference (NEJM-CPC) cases into stepwise diagnostic encounters. A physician or AI begins with a short case abstract and must iteratively request additional details from a gatekeeper model that reveals findings only when explicitly queried. Performance is assessed not just by diagnostic accuracy but also by the cost of physician visits and tests performed. We also present the MAI Diagnostic Orchestrator (MAI-DxO), a model-agnostic orchestrator that simulates a panel of physicians, proposes likely differential diagnoses and strategically selects high-value, cost-effective tests. When paired with OpenAI's o3 model, MAI-DxO achieves 80% diagnostic accuracy--four times higher than the 20% average of generalist physicians. MAI-DxO also reduces diagnostic costs by 20% compared to physicians, and 70% compared to off-the-shelf o3. When configured for maximum accuracy, MAI-DxO achieves 85.5% accuracy. These performance gains with MAI-DxO generalize across models from the OpenAI, Gemini, Claude, Grok, DeepSeek, and Llama families. We highlight how AI systems, when guided to think iteratively and act judiciously, can advance diagnostic precision and cost-effectiveness in clinical care.

An accurate differential diagnosis (DDx) is a cornerstone of medical care, often reached through an iterative process of interpretation that combines clinical history, physical examination, investigations and procedures. Interactive interfaces powered by Large Language Models (LLMs) present new opportunities to both assist and automate aspects of this process. In this study, we introduce an LLM optimized for diagnostic reasoning, and evaluate its ability to generate a DDx alone or as an aid to clinicians. 20 clinicians evaluated 302 challenging, real-world medical cases sourced from the New England Journal of Medicine (NEJM) case reports. Each case report was read by two clinicians, who were randomized to one of two assistive conditions: either assistance from search engines and standard medical resources, or LLM assistance in addition to these tools. All clinicians provided a baseline, unassisted DDx prior to using the respective assistive tools. Our LLM for DDx exhibited standalone performance that exceeded that of unassisted clinicians (top-10 accuracy 59.1% vs 33.6%, [p = 0.04]). Comparing the two assisted study arms, the DDx quality score was higher for clinicians assisted by our LLM (top-10 accuracy 51.7%) compared to clinicians without its assistance (36.1%) (McNemar's Test: 45.7, p < 0.01) and clinicians with search (44.4%) (4.75, p = 0.03). Further, clinicians assisted by our LLM arrived at more comprehensive differential lists than those without its assistance. Our study suggests that our LLM for DDx has potential to improve clinicians' diagnostic reasoning and accuracy in challenging cases, meriting further real-world evaluation for its ability to empower physicians and widen patients' access to specialist-level expertise.

In this paper, we present a framework for training large language models (LLMs) as diagnostic agents with reinforcement learning, enabling them to manage multi-turn diagnostic processes, adaptively select examinations, and commit to final diagnoses. Unlike instruction-tuned models trained on static case summaries, our method acquires diagnostic strategies through interactive exploration and outcome-based feedback. Our contributions are fourfold: (i) We present DiagGym, a diagnostics world model trained with electronic health records that emits examination outcomes conditioned on patient history and recommended examination, serving as a virtual clinical environment for realistic diagnosis training and evaluation; (ii) We train DiagAgent via end-to-end, multi-turn reinforcement learning to learn diagnostic policies that optimize both information yield and diagnostic accuracy; (iii) We introduce DiagBench, a diagnostic benchmark comprising 750 cases with physician-validated examination recommendations and 99 cases annotated with 973 physician-written rubrics on diagnosis process; (iv) we demonstrate superior performance across diverse diagnostic settings. DiagAgent significantly outperforms 10 state-of-the-art LLMs, including DeepSeek-v3 and GPT-4o, as well as two prompt-engineered agents. In single-turn settings, DiagAgent achieves 9.34% higher diagnostic accuracy and 44.03% improvement in examination recommendation hit ratio. In end-to-end settings, it delivers 15.12% increase in diagnostic accuracy and 23.09% boost in examination recommendation F1 score. In rubric-based evaluation, it surpasses the next-best model, Claude-sonnet-4, by 7.1% in weighted rubric score. These findings indicate that learning policies in interactive clinical environments confers dynamic and clinically meaningful diagnostic management abilities unattainable through passive training alone.

Recently, DALL-E, a multimodal transformer language model, and its variants (including diffusion models) have shown high-quality text-to-image generation capabilities. However, despite the interesting image generation results, there has not been a detailed analysis on how to evaluate such models. In this work, we investigate the visual reasoning capabilities and social biases of different text-to-image models, covering both multimodal transformer language models and diffusion models. First, we measure three visual reasoning skills: object recognition, object counting, and spatial relation understanding. For this, we propose PaintSkills, a compositional diagnostic dataset and evaluation toolkit that measures these skills. In our experiments, there exists a large gap between the performance of recent text-to-image models and the upper bound accuracy in object counting and spatial relation understanding skills. Second, we assess gender and skin tone biases by measuring the variance of the gender/skin tone distribution based on automated and human evaluation. We demonstrate that recent text-to-image models learn specific gender/skin tone biases from web image-text pairs. We hope that our work will help guide future progress in improving text-to-image generation models on visual reasoning skills and learning socially unbiased representations. Code and data: https://github.com/j-min/DallEval

Clinical diagnosis is a highly specialized discipline requiring both domain expertise and strict adherence to rigorous guidelines. While current AI-driven medical research predominantly focuses on knowledge graphs or natural text pretraining paradigms to incorporate medical knowledge, these approaches primarily rely on implicitly encoded knowledge within model parameters, neglecting task-specific knowledge required by diverse downstream tasks. To address this limitation, we propose Retrieval-Augmented Diagnosis (RAD), a novel framework that explicitly injects external knowledge into multimodal models directly on downstream tasks. Specifically, RAD operates through three key mechanisms: retrieval and refinement of disease-centered knowledge from multiple medical sources, a guideline-enhanced contrastive loss that constrains the latent distance between multi-modal features and guideline knowledge, and the dual transformer decoder that employs guidelines as queries to steer cross-modal fusion, aligning the models with clinical diagnostic workflows from guideline acquisition to feature extraction and decision-making. Moreover, recognizing the lack of quantitative evaluation of interpretability for multimodal diagnostic models, we introduce a set of criteria to assess the interpretability from both image and text perspectives. Extensive evaluations across four datasets with different anatomies demonstrate RAD's generalizability, achieving state-of-the-art performance. Furthermore, RAD enables the model to concentrate more precisely on abnormal regions and critical indicators, ensuring evidence-based, trustworthy diagnosis. Our code is available at https://github.com/tdlhl/RAD.

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

Doctors and patients alike increasingly use Large Language Models (LLMs) to diagnose clinical cases. However, unlike domains such as math or coding, where correctness can be objectively defined by the final answer, medical diagnosis requires both the outcome and the reasoning process to be accurate. Currently, widely used medical benchmarks like MedQA and MMLU assess only accuracy in the final answer, overlooking the quality and faithfulness of the clinical reasoning process. To address this limitation, we introduce MedCaseReasoning, the first open-access dataset for evaluating LLMs on their ability to align with clinician-authored diagnostic reasoning. The dataset includes 14,489 diagnostic question-and-answer cases, each paired with detailed reasoning statements derived from open-access medical case reports. We evaluate state-of-the-art reasoning LLMs on MedCaseReasoning and find significant shortcomings in their diagnoses and reasoning: for instance, the top-performing open-source model, DeepSeek-R1, achieves only 48% 10-shot diagnostic accuracy and mentions only 64% of the clinician reasoning statements (recall). However, we demonstrate that fine-tuning LLMs on the reasoning traces derived from MedCaseReasoning significantly improves diagnostic accuracy and clinical reasoning recall by an average relative gain of 29% and 41%, respectively. The open-source dataset, code, and models are available at https://github.com/kevinwu23/Stanford-MedCaseReasoning.

Clinical diagnosis of the eye is performed over multifarious data modalities including scalar clinical labels, vectorized biomarkers, two-dimensional fundus images, and three-dimensional Optical Coherence Tomography (OCT) scans. Clinical practitioners use all available data modalities for diagnosing and treating eye diseases like Diabetic Retinopathy (DR) or Diabetic Macular Edema (DME). Enabling usage of machine learning algorithms within the ophthalmic medical domain requires research into the relationships and interactions between all relevant data over a treatment period. Existing datasets are limited in that they neither provide data nor consider the explicit relationship modeling between the data modalities. In this paper, we introduce the Ophthalmic Labels for Investigating Visual Eye Semantics (OLIVES) dataset that addresses the above limitation. This is the first OCT and near-IR fundus dataset that includes clinical labels, biomarker labels, disease labels, and time-series patient treatment information from associated clinical trials. The dataset consists of 1268 near-IR fundus images each with at least 49 OCT scans, and 16 biomarkers, along with 4 clinical labels and a disease diagnosis of DR or DME. In total, there are 96 eyes' data averaged over a period of at least two years with each eye treated for an average of 66 weeks and 7 injections. We benchmark the utility of OLIVES dataset for ophthalmic data as well as provide benchmarks and concrete research directions for core and emerging machine learning paradigms within medical image analysis.

As the field of artificial intelligence progresses, assistive technologies are becoming more widely used across all industries. The healthcare industry is no different, with numerous studies being done to develop assistive tools for healthcare professionals. Automatic diagnostic systems are one such beneficial tool that can assist with a variety of tasks, including collecting patient information, analyzing test results, and diagnosing patients. However, the idea of developing systems that can provide a differential diagnosis has been largely overlooked in most of these research studies. In this study, we propose a transformer-based approach for providing differential diagnoses based on a patient's age, sex, medical history, and symptoms. We use the DDXPlus dataset, which provides differential diagnosis information for patients based on 49 disease types. Firstly, we propose a method to process the tabular patient data from the dataset and engineer them into patient reports to make them suitable for our research. In addition, we introduce two data modification modules to diversify the training data and consequently improve the robustness of the models. We approach the task as a multi-label classification problem and conduct extensive experiments using four transformer models. All the models displayed promising results by achieving over 97% F1 score on the held-out test set. Moreover, we design additional behavioral tests to get a broader understanding of the models. In particular, for one of our test cases, we prepared a custom test set of 100 samples with the assistance of a doctor. The results on the custom set showed that our proposed data modification modules improved the model's generalization capabilities. We hope our findings will provide future researchers with valuable insights and inspire them to develop reliable systems for automatic differential diagnosis.

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

Clinical diagnosis prediction models, when provided with a patient's medical history, aim to detect potential diseases early, facilitating timely intervention and improving prognostic outcomes. However, the inherent scarcity of patient data and large disease candidate space often pose challenges in developing satisfactory models for this intricate task. The exploration of leveraging Large Language Models (LLMs) for encapsulating clinical decision processes has been limited. We introduce MERA, a clinical diagnosis prediction model that bridges pertaining natural language knowledge with medical practice. We apply hierarchical contrastive learning on a disease candidate ranking list to alleviate the large decision space issue. With concept memorization through fine-tuning, we bridge the natural language clinical knowledge with medical codes. Experimental results on MIMIC-III and IV datasets show that MERA achieves the state-of-the-art diagnosis prediction performance and dramatically elevates the diagnosis prediction capabilities of generative LMs.

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

There has been a rapidly growing interest in Automatic Symptom Detection (ASD) and Automatic Diagnosis (AD) systems in the machine learning research literature, aiming to assist doctors in telemedicine services. These systems are designed to interact with patients, collect evidence about their symptoms and relevant antecedents, and possibly make predictions about the underlying diseases. Doctors would review the interactions, including the evidence and the predictions, collect if necessary additional information from patients, before deciding on next steps. Despite recent progress in this area, an important piece of doctors' interactions with patients is missing in the design of these systems, namely the differential diagnosis. Its absence is largely due to the lack of datasets that include such information for models to train on. In this work, we present a large-scale synthetic dataset of roughly 1.3 million patients that includes a differential diagnosis, along with the ground truth pathology, symptoms and antecedents for each patient. Unlike existing datasets which only contain binary symptoms and antecedents, this dataset also contains categorical and multi-choice symptoms and antecedents useful for efficient data collection. Moreover, some symptoms are organized in a hierarchy, making it possible to design systems able to interact with patients in a logical way. As a proof-of-concept, we extend two existing AD and ASD systems to incorporate the differential diagnosis, and provide empirical evidence that using differentials as training signals is essential for the efficiency of such systems or for helping doctors better understand the reasoning of those systems.

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

Radiological imaging is central to diagnosis, treatment planning, and clinical decision-making. Vision-language foundation models have spurred interest in automated radiology report generation (RRG), but safe deployment requires reliable clinical evaluation of generated reports. Existing metrics often rely on surface-level similarity or behave as black boxes, lacking interpretability. We introduce ICARE (Interpretable and Clinically-grounded Agent-based Report Evaluation), an interpretable evaluation framework leveraging large language model agents and dynamic multiple-choice question answering (MCQA). Two agents, each with either the ground-truth or generated report, generate clinically meaningful questions and quiz each other. Agreement on answers captures preservation and consistency of findings, serving as interpretable proxies for clinical precision and recall. By linking scores to question-answer pairs, ICARE enables transparent, and interpretable assessment. Clinician studies show ICARE aligns significantly more with expert judgment than prior metrics. Perturbation analyses confirm sensitivity to clinical content and reproducibility, while model comparisons reveal interpretable error patterns.

The automated generation of imaging reports proves invaluable in alleviating the workload of radiologists. A clinically applicable reports generation algorithm should demonstrate its effectiveness in producing reports that accurately describe radiology findings and attend to patient-specific indications. In this paper, we introduce a novel method, Structural Entities extraction and patient indications Incorporation (SEI) for chest X-ray report generation. Specifically, we employ a structural entities extraction (SEE) approach to eliminate presentation-style vocabulary in reports and improve the quality of factual entity sequences. This reduces the noise in the following cross-modal alignment module by aligning X-ray images with factual entity sequences in reports, thereby enhancing the precision of cross-modal alignment and further aiding the model in gradient-free retrieval of similar historical cases. Subsequently, we propose a cross-modal fusion network to integrate information from X-ray images, similar historical cases, and patient-specific indications. This process allows the text decoder to attend to discriminative features of X-ray images, assimilate historical diagnostic information from similar cases, and understand the examination intention of patients. This, in turn, assists in triggering the text decoder to produce high-quality reports. Experiments conducted on MIMIC-CXR validate the superiority of SEI over state-of-the-art approaches on both natural language generation and clinical efficacy metrics.

Skin conditions affect an estimated 1.9 billion people worldwide. A shortage of dermatologists causes long wait times and leads patients to seek dermatologic care from general practitioners. However, the diagnostic accuracy of general practitioners has been reported to be only 0.24-0.70 (compared to 0.77-0.96 for dermatologists), resulting in referral errors, delays in care, and errors in diagnosis and treatment. In this paper, we developed a deep learning system (DLS) to provide a differential diagnosis of skin conditions for clinical cases (skin photographs and associated medical histories). The DLS distinguishes between 26 skin conditions that represent roughly 80% of the volume of skin conditions seen in primary care. The DLS was developed and validated using de-identified cases from a teledermatology practice serving 17 clinical sites via a temporal split: the first 14,021 cases for development and the last 3,756 cases for validation. On the validation set, where a panel of three board-certified dermatologists defined the reference standard for every case, the DLS achieved 0.71 and 0.93 top-1 and top-3 accuracies respectively. For a random subset of the validation set (n=963 cases), 18 clinicians reviewed the cases for comparison. On this subset, the DLS achieved a 0.67 top-1 accuracy, non-inferior to board-certified dermatologists (0.63, p<0.001), and higher than primary care physicians (PCPs, 0.45) and nurse practitioners (NPs, 0.41). The top-3 accuracy showed a similar trend: 0.90 DLS, 0.75 dermatologists, 0.60 PCPs, and 0.55 NPs. These results highlight the potential of the DLS to augment general practitioners to accurately diagnose skin conditions by suggesting differential diagnoses that may not have been considered. Future work will be needed to prospectively assess the clinical impact of using this tool in actual clinical workflows.

Spine disorders affect 619 million people globally and are a leading cause of disability, yet AI-assisted diagnosis remains limited by the lack of level-aware, multimodal datasets. Clinical decision-making for spine disorders requires sophisticated reasoning across X-ray, CT, and MRI at specific vertebral levels. However, progress has been constrained by the absence of traceable, clinically-grounded instruction data and standardized, spine-specific benchmarks. To address this, we introduce SpineMed, an ecosystem co-designed with practicing spine surgeons. It features SpineMed-450k, the first large-scale dataset explicitly designed for vertebral-level reasoning across imaging modalities with over 450,000 instruction instances, and SpineBench, a clinically-grounded evaluation framework. SpineMed-450k is curated from diverse sources, including textbooks, guidelines, open datasets, and ~1,000 de-identified hospital cases, using a clinician-in-the-loop pipeline with a two-stage LLM generation method (draft and revision) to ensure high-quality, traceable data for question-answering, multi-turn consultations, and report generation. SpineBench evaluates models on clinically salient axes, including level identification, pathology assessment, and surgical planning. Our comprehensive evaluation of several recently advanced large vision-language models (LVLMs) on SpineBench reveals systematic weaknesses in fine-grained, level-specific reasoning. In contrast, our model fine-tuned on SpineMed-450k demonstrates consistent and significant improvements across all tasks. Clinician assessments confirm the diagnostic clarity and practical utility of our model's outputs.

Rationale and Objectives: To develop and validate PARROT (Polyglottal Annotated Radiology Reports for Open Testing), a large, multicentric, open-access dataset of fictional radiology reports spanning multiple languages for testing natural language processing applications in radiology. Materials and Methods: From May to September 2024, radiologists were invited to contribute fictional radiology reports following their standard reporting practices. Contributors provided at least 20 reports with associated metadata including anatomical region, imaging modality, clinical context, and for non-English reports, English translations. All reports were assigned ICD-10 codes. A human vs. AI report differentiation study was conducted with 154 participants (radiologists, healthcare professionals, and non-healthcare professionals) assessing whether reports were human-authored or AI-generated. Results: The dataset comprises 2,658 radiology reports from 76 authors across 21 countries and 13 languages. Reports cover multiple imaging modalities (CT: 36.1%, MRI: 22.8%, radiography: 19.0%, ultrasound: 16.8%) and anatomical regions, with chest (19.9%), abdomen (18.6%), head (17.3%), and pelvis (14.1%) being most prevalent. In the differentiation study, participants achieved 53.9% accuracy (95% CI: 50.7%-57.1%) in distinguishing between human and AI-generated reports, with radiologists performing significantly better (56.9%, 95% CI: 53.3%-60.6%, p<0.05) than other groups. Conclusion: PARROT represents the largest open multilingual radiology report dataset, enabling development and validation of natural language processing applications across linguistic, geographic, and clinical boundaries without privacy constraints.

We present Voice Evaluation of Reasoning Ability (VERA), a benchmark for evaluating reasoning ability in voice-interactive systems under real-time conversational constraints. VERA comprises 2,931 voice-native episodes derived from established text benchmarks and organized into five tracks (Math, Web, Science, Long-Context, Factual). Each item is adapted for speech interaction while preserving reasoning difficulty. VERA enables direct text-voice comparison within model families and supports analysis of how architectural choices affect reliability. We assess 12 contemporary voice systems alongside strong text baselines and observe large, consistent modality gaps: on competition mathematics a leading text model attains 74.8% accuracy while its voice counterpart reaches 6.1%; macro-averaged across tracks the best text models achieve 54.0% versus 11.3% for voice. Latency-accuracy analyses reveal a low-latency plateau, where fast voice systems cluster around ~10% accuracy, while approaching text performance requires sacrificing real-time interaction. Diagnostic experiments indicate that common mitigations are insufficient. Increasing "thinking time" yields negligible gains; a decoupled cascade that separates reasoning from narration improves accuracy but still falls well short of text and introduces characteristic grounding/consistency errors. Failure analyses further show distinct error signatures across native streaming, end-to-end, and cascade designs. VERA provides a reproducible testbed and targeted diagnostics for architectures that decouple thinking from speaking, offering a principled way to measure progress toward real-time voice assistants that are both fluent and reliably reasoned.

Spatial control is a core capability in controllable image generation. Advancements in layout-guided image generation have shown promising results on in-distribution (ID) datasets with similar spatial configurations. However, it is unclear how these models perform when facing out-of-distribution (OOD) samples with arbitrary, unseen layouts. In this paper, we propose LayoutBench, a diagnostic benchmark for layout-guided image generation that examines four categories of spatial control skills: number, position, size, and shape. We benchmark two recent representative layout-guided image generation methods and observe that the good ID layout control may not generalize well to arbitrary layouts in the wild (e.g., objects at the boundary). Next, we propose IterInpaint, a new baseline that generates foreground and background regions in a step-by-step manner via inpainting, demonstrating stronger generalizability than existing models on OOD layouts in LayoutBench. We perform quantitative and qualitative evaluation and fine-grained analysis on the four LayoutBench skills to pinpoint the weaknesses of existing models. Lastly, we show comprehensive ablation studies on IterInpaint, including training task ratio, crop&paste vs. repaint, and generation order. Project website: https://layoutbench.github.io

Daily progress notes are common types in the electronic health record (EHR) where healthcare providers document the patient's daily progress and treatment plans. The EHR is designed to document all the care provided to patients, but it also enables note bloat with extraneous information that distracts from the diagnoses and treatment plans. Applications of natural language processing (NLP) in the EHR is a growing field with the majority of methods in information extraction. Few tasks use NLP methods for downstream diagnostic decision support. We introduced the 2022 National NLP Clinical Challenge (N2C2) Track 3: Progress Note Understanding - Assessment and Plan Reasoning as one step towards a new suite of tasks. The Assessment and Plan Reasoning task focuses on the most critical components of progress notes, Assessment and Plan subsections where health problems and diagnoses are contained. The goal of the task was to develop and evaluate NLP systems that automatically predict causal relations between the overall status of the patient contained in the Assessment section and its relation to each component of the Plan section which contains the diagnoses and treatment plans. The goal of the task was to identify and prioritize diagnoses as the first steps in diagnostic decision support to find the most relevant information in long documents like daily progress notes. We present the results of 2022 n2c2 Track 3 and provide a description of the data, evaluation, participation and system performance.

Medical report generation has achieved remarkable advancements yet has still been faced with several challenges. First, the inherent imbalance in the distribution of normal and abnormal cases may lead models to exhibit a biased focus on normal samples, resulting in unreliable diagnoses. Second, the frequent occurrence of common template sentences in the reports may overwhelm the critical abnormal information. Moreover, existing works focus on 2D chest X-rays, leaving CT report generation underexplored due to the high-dimensional nature of CT images and the limited availability of CT-report pairs. Recently, LLM has shown a great ability to generate reliable answers with appropriate prompts, which shed light on addressing the aforementioned challenges. In this paper, we propose Dia-LLaMA, a framework to adapt the LLaMA2-7B for CT report generation by incorporating diagnostic information as guidance prompts. Considering the high dimension of CT, we leverage a pre-trained ViT3D with perceiver to extract the visual information. To tailor the LLM for report generation and emphasize abnormality, we extract additional diagnostic information by referring to a disease prototype memory bank, which is updated during training to capture common disease representations. Furthermore, we introduce disease-aware attention to enable the model to adjust attention for different diseases. Experiments on the chest CT dataset demonstrated that our proposed method outperformed previous methods and achieved state-of-the-art on both clinical efficacy performance and natural language generation metrics. The code will be made publically available.

The ability to perceive how objects change over time is a crucial ingredient in human intelligence. However, current benchmarks cannot faithfully reflect the temporal understanding abilities of video-language models (VidLMs) due to the existence of static visual shortcuts. To remedy this issue, we present VITATECS, a diagnostic VIdeo-Text dAtaset for the evaluation of TEmporal Concept underStanding. Specifically, we first introduce a fine-grained taxonomy of temporal concepts in natural language in order to diagnose the capability of VidLMs to comprehend different temporal aspects. Furthermore, to disentangle the correlation between static and temporal information, we generate counterfactual video descriptions that differ from the original one only in the specified temporal aspect. We employ a semi-automatic data collection framework using large language models and human-in-the-loop annotation to obtain high-quality counterfactual descriptions efficiently. Evaluation of representative video-language understanding models confirms their deficiency in temporal understanding, revealing the need for greater emphasis on the temporal elements in video-language research.

Diabetic retinopathy (DR) is a growing health problem worldwide and is a leading cause of visual impairment and blindness, especially among working people aged 20-65. Its incidence is increasing along with the number of diabetes cases, and it is more common in developed countries than in developing countries. Recent research in the field of diabetic retinopathy diagnosis is using advanced technologies, such as analysis of images obtained by ophthalmoscopy. Automatic methods for analyzing eye images based on neural networks, deep learning and image analysis algorithms can improve the efficiency of diagnosis. This paper describes an automatic DR diagnosis method that includes processing and analysis of ophthalmoscopic images of the eye. It uses morphological algorithms to identify the optic disc and lesions characteristic of DR, such as microaneurysms, hemorrhages and exudates. Automated DR diagnosis has the potential to improve the efficiency of early detection of this disease and contribute to reducing the number of cases of diabetes-related visual impairment. The final step was to create an application with a graphical user interface that allowed retinal images taken at cooperating ophthalmology offices to be uploaded to the server. These images were then analyzed using a developed algorithm to make a diagnosis.

To investigate whether the pleurae, airways and vessels surrounding a nodule on non-contrast computed tomography (CT) can discriminate benign and malignant pulmonary nodules. The LIDC-IDRI dataset, one of the largest publicly available CT database, was exploited for study. A total of 1556 nodules from 694 patients were involved in statistical analysis, where nodules with average scorings <3 and >3 were respectively denoted as benign and malignant. Besides, 339 nodules from 113 patients with diagnosis ground-truth were independently evaluated. Computer algorithms were developed to segment pulmonary structures and quantify the distances to pleural surface, airways and vessels, as well as the counting number and normalized volume of airways and vessels near a nodule. Odds ratio (OR) and Chi-square (\chi^2) testing were performed to demonstrate the correlation between features of surrounding structures and nodule malignancy. A non-parametric receiver operating characteristic (ROC) analysis was conducted in logistic regression to evaluate discrimination ability of each structure. For benign and malignant groups, the average distances from nodules to pleural surface, airways and vessels are respectively (6.56, 5.19), (37.08, 26.43) and (1.42, 1.07) mm. The correlation between nodules and the counting number of airways and vessels that contact or project towards nodules are respectively (OR=22.96, \chi^2=105.04) and (OR=7.06, \chi^2=290.11). The correlation between nodules and the volume of airways and vessels are (OR=9.19, \chi^2=159.02) and (OR=2.29, \chi^2=55.89). The areas-under-curves (AUCs) for pleurae, airways and vessels are respectively 0.5202, 0.6943 and 0.6529. Our results show that malignant nodules are often surrounded by more pulmonary structures compared with benign ones, suggesting that features of these structures could be viewed as lung cancer biomarkers.

LLM-as-judge evaluation has become the de facto standard for scaling model assessment, but the practice is statistically unsound: uncalibrated scores can invert preferences, naive confidence intervals on uncalibrated scores achieve near-0% coverage, and importance-weighted estimators collapse under limited overlap despite high effective sample size (ESS). We introduce Causal Judge Evaluation (CJE), a framework that fixes all three failures. On n=4,961 Chatbot Arena prompts (after filtering from 5k), CJE achieves 99% pairwise ranking accuracy at full sample size (94% averaged across configurations), matching oracle quality, at 14x lower cost (for ranking 5 policies) by calibrating a 16x cheaper judge on just 5% oracle labels (~250 labels). CJE combines three components: (i) AutoCal-R, reward calibration via mean-preserving isotonic regression; (ii) SIMCal-W, weight stabilization via stacking of S-monotone candidates; and (iii) Oracle-Uncertainty Aware (OUA) inference that propagates calibration uncertainty into confidence intervals. We formalize the Coverage-Limited Efficiency (CLE) diagnostic, which explains why IPS-style estimators fail even when ESS exceeds 90%: the logger rarely visits regions where target policies concentrate. Key findings: SNIPS inverts rankings even with reward calibration (38% pairwise, negative Kendall's tau) due to weight instability; calibrated IPS remains near-random (47%) despite weight stabilization, consistent with CLE; OUA improves coverage from near-0% to ~86% (Direct) and ~96% (stacked-DR), where naive intervals severely under-cover.

Large Reasoning Models (LRMs) extend large language models with explicit, multi-step reasoning traces to enhance transparency and performance on complex tasks. However, these reasoning traces can be redundant or logically inconsistent, making them a new source of hallucination that is difficult to detect. Existing hallucination detection methods focus primarily on answer-level uncertainty and often fail to detect hallucinations or logical inconsistencies arising from the model's reasoning trace. This oversight is particularly problematic for LRMs, where the explicit thinking trace is not only an important support to the model's decision-making process but also a key source of potential hallucination. To this end, we propose RACE (Reasoning and Answer Consistency Evaluation), a novel framework specifically tailored for hallucination detection in LRMs. RACE operates by extracting essential reasoning steps and computing four diagnostic signals: inter-sample consistency of reasoning traces, entropy-based answer uncertainty, semantic alignment between reasoning and answers, and internal coherence of reasoning. This joint analysis enables fine-grained hallucination detection even when the final answer appears correct. Experiments across datasets and different LLMs demonstrate that RACE outperforms existing hallucination detection baselines, offering a robust and generalizable solution for evaluating LRMs. Our code is available at: https://github.com/bebr2/RACE.

Although large multimodal models (LMMs) have demonstrated remarkable capabilities in visual scene interpretation and reasoning, their capacity for complex and precise 3-dimensional spatial reasoning remains uncertain. Existing benchmarks focus predominantly on 2D spatial understanding and lack a framework to comprehensively evaluate 6D spatial reasoning across varying complexities. To address this limitation, we present PulseCheck457, a scalable and unbiased synthetic dataset designed with 4 key capability for spatial reasoning: multi-object recognition, 2D location, 3D location, and 3D orientation. We develop a cascading evaluation structure, constructing 7 question types across 5 difficulty levels that range from basic single object recognition to our new proposed complex 6D spatial reasoning tasks. We evaluated various large multimodal models (LMMs) on PulseCheck457, observing a general decline in performance as task complexity increases, particularly in 3D reasoning and 6D spatial tasks. To quantify these challenges, we introduce the Relative Performance Dropping Rate (RPDR), highlighting key weaknesses in 3D reasoning capabilities. Leveraging the unbiased attribute design of our dataset, we also uncover prediction biases across different attributes, with similar patterns observed in real-world image settings.

We introduce EgoSchema, a very long-form video question-answering dataset, and benchmark to evaluate long video understanding capabilities of modern vision and language systems. Derived from Ego4D, EgoSchema consists of over 5000 human curated multiple choice question answer pairs, spanning over 250 hours of real video data, covering a very broad range of natural human activity and behavior. For each question, EgoSchema requires the correct answer to be selected between five given options based on a three-minute-long video clip. While some prior works have proposed video datasets with long clip lengths, we posit that merely the length of the video clip does not truly capture the temporal difficulty of the video task that is being considered. To remedy this, we introduce temporal certificate sets, a general notion for capturing the intrinsic temporal understanding length associated with a broad range of video understanding tasks & datasets. Based on this metric, we find EgoSchema to have intrinsic temporal lengths over 5.7x longer than the second closest dataset and 10x to 100x longer than any other video understanding dataset. Further, our evaluation of several current state-of-the-art video and language models shows them to be severely lacking in long-term video understanding capabilities. Even models with several billions of parameters achieve QA accuracy less than 33% (random is 20%) on the EgoSchema multi-choice question answering task, while humans achieve about 76% accuracy. We posit that {}, with its long intrinsic temporal structures and diverse complexity, would serve as a valuable evaluation probe for developing effective long-term video understanding systems in the future. Data and Zero-shot model evaluation code are open-sourced for both public and commercial use under the Ego4D license at http://egoschema.github.io

Evaluating radiology reports is a challenging problem as factual correctness is extremely important due to the need for accurate medical communication about medical images. Existing automatic evaluation metrics either suffer from failing to consider factual correctness (e.g., BLEU and ROUGE) or are limited in their interpretability (e.g., F1CheXpert and F1RadGraph). In this paper, we introduce GREEN (Generative Radiology Report Evaluation and Error Notation), a radiology report generation metric that leverages the natural language understanding of language models to identify and explain clinically significant errors in candidate reports, both quantitatively and qualitatively. Compared to current metrics, GREEN offers: 1) a score aligned with expert preferences, 2) human interpretable explanations of clinically significant errors, enabling feedback loops with end-users, and 3) a lightweight open-source method that reaches the performance of commercial counterparts. We validate our GREEN metric by comparing it to GPT-4, as well as to error counts of 6 experts and preferences of 2 experts. Our method demonstrates not only higher correlation with expert error counts, but simultaneously higher alignment with expert preferences when compared to previous approaches."

RAG (Retrieval-Augmented Generation) systems and web agents are increasingly evaluated on multi-hop deep search tasks, yet current practice suffers from two major limitations. First, most benchmarks leak the reasoning path in the question text, allowing models to follow surface cues rather than discover reasoning chains autonomously. Second, evaluation is typically reduced to a single pass rate, which collapses diverse behaviours into one score and obscures whether failures stem from inadequate search, poor knowledge use, or inappropriate refusal. To address these issues, we present WebDetective, a benchmark of hint-free multi-hop questions paired with a controlled Wikipedia sandbox that ensures full traceability of model actions, and a holistic evaluation framework that separates search sufficiency, knowledge utilisation, and refusal behaviour. Our evaluation of 25 state-of-the-art models reveals systematic weaknesses across all architectures: models struggle with knowledge utilisation despite having sufficient evidence and demonstrate near-absent appropriate refusal when evidence is lacking. These patterns expose a fundamental gap: today's systems excel at executing given reasoning paths but fail when required to discover them. We develop an agentic workflow, EvidenceLoop, that explicitly targets the challenges our benchmark identifies, incorporating verification loops and systematic evidence tracking that improve both search and synthesis capabilities. This baseline demonstrates that WebDetective's diagnostic framework can guide concrete architectural improvements, establishing our benchmark as a critical tool for developing genuinely autonomous reasoning systems rather than pattern-following agents.

We study professional image generation, where a model must synthesize information-dense, scientifically precise illustrations from technical descriptions rather than merely produce visually plausible pictures. To quantify the progress, we introduce ProImage-Bench, a rubric-based benchmark that targets biology schematics, engineering/patent drawings, and general scientific diagrams. For 654 figures collected from real textbooks and technical reports, we construct detailed image instructions and a hierarchy of rubrics that decompose correctness into 6,076 criteria and 44,131 binary checks. Rubrics are derived from surrounding text and reference figures using large multimodal models, and are evaluated by an automated LMM-based judge with a principled penalty scheme that aggregates sub-question outcomes into interpretable criterion scores. We benchmark several representative text-to-image models on ProImage-Bench and find that, despite strong open-domain performance, the best base model reaches only 0.791 rubric accuracy and 0.553 criterion score overall, revealing substantial gaps in fine-grained scientific fidelity. Finally, we show that the same rubrics provide actionable supervision: feeding failed checks back into an editing model for iterative refinement boosts a strong generator from 0.653 to 0.865 in rubric accuracy and from 0.388 to 0.697 in criterion score. ProImage-Bench thus offers both a rigorous diagnostic for professional image generation and a scalable signal for improving specification-faithful scientific illustrations.

Large Language Models (LLMs) have not only exhibited exceptional performance across various tasks, but also demonstrated sparks of intelligence. Recent studies have focused on assessing their capabilities on human exams and revealed their impressive competence in different domains. However, cognitive research on the overall knowledge structure of LLMs is still lacking. In this paper, based on educational diagnostic assessment method, we conduct an evaluation using MoocRadar, a meticulously annotated human test dataset based on Bloom Taxonomy. We aim to reveal the knowledge structures of LLMs and gain insights of their cognitive capabilities. This research emphasizes the significance of investigating LLMs' knowledge and understanding the disparate cognitive patterns of LLMs. By shedding light on models' knowledge, researchers can advance development and utilization of LLMs in a more informed and effective manner.

Automatic medical report generation supports clinical diagnosis, reduces the workload of radiologists, and holds the promise of improving diagnosis consistency. However, existing evaluation metrics primarily assess the accuracy of key medical information coverage in generated reports compared to human-written reports, while overlooking crucial details such as the location and certainty of reported abnormalities. These limitations hinder the comprehensive assessment of the reliability of generated reports and pose risks in their selection for clinical use. Therefore, we propose a Granular Explainable Multi-Agent Score (GEMA-Score) in this paper, which conducts both objective quantification and subjective evaluation through a large language model-based multi-agent workflow. Our GEMA-Score parses structured reports and employs NER-F1 calculations through interactive exchanges of information among agents to assess disease diagnosis, location, severity, and uncertainty. Additionally, an LLM-based scoring agent evaluates completeness, readability, and clinical terminology while providing explanatory feedback. Extensive experiments validate that GEMA-Score achieves the highest correlation with human expert evaluations on a public dataset, demonstrating its effectiveness in clinical scoring (Kendall coefficient = 0.70 for Rexval dataset and Kendall coefficient = 0.54 for RadEvalX dataset). The anonymous project demo is available at: https://github.com/Zhenxuan-Zhang/GEMA_score.

This paper introduces a novel, entity-aware metric, termed as Radiological Report (Text) Evaluation (RaTEScore), to assess the quality of medical reports generated by AI models. RaTEScore emphasizes crucial medical entities such as diagnostic outcomes and anatomical details, and is robust against complex medical synonyms and sensitive to negation expressions. Technically, we developed a comprehensive medical NER dataset, RaTE-NER, and trained an NER model specifically for this purpose. This model enables the decomposition of complex radiological reports into constituent medical entities. The metric itself is derived by comparing the similarity of entity embeddings, obtained from a language model, based on their types and relevance to clinical significance. Our evaluations demonstrate that RaTEScore aligns more closely with human preference than existing metrics, validated both on established public benchmarks and our newly proposed RaTE-Eval benchmark.

Medical conversational AI (AI) plays a pivotal role in the development of safer and more effective medical dialogue systems. However, existing benchmarks and evaluation frameworks for assessing the information-gathering and diagnostic reasoning abilities of medical large language models (LLMs) have not been rigorously evaluated. To address these gaps, we present MedDialogRubrics, a novel benchmark comprising 5,200 synthetically constructed patient cases and over 60,000 fine-grained evaluation rubrics generated by LLMs and subsequently refined by clinical experts, specifically designed to assess the multi-turn diagnostic capabilities of LLM. Our framework employs a multi-agent system to synthesize realistic patient records and chief complaints from underlying disease knowledge without accessing real-world electronic health records, thereby mitigating privacy and data-governance concerns. We design a robust Patient Agent that is limited to a set of atomic medical facts and augmented with a dynamic guidance mechanism that continuously detects and corrects hallucinations throughout the dialogue, ensuring internal coherence and clinical plausibility of the simulated cases. Furthermore, we propose a structured LLM-based and expert-annotated rubric-generation pipeline that retrieves Evidence-Based Medicine (EBM) guidelines and utilizes the reject sampling to derive a prioritized set of rubric items ("must-ask" items) for each case. We perform a comprehensive evaluation of state-of-the-art models and demonstrate that, across multiple assessment dimensions, current models face substantial challenges. Our results indicate that improving medical dialogue will require advances in dialogue management architectures, not just incremental tuning of the base-model.

We present a Japanese domain-specific language model for the pharmaceutical field, developed through continual pretraining on 2 billion Japanese pharmaceutical tokens and 8 billion English biomedical tokens. To enable rigorous evaluation, we introduce three new benchmarks: YakugakuQA, based on national pharmacist licensing exams; NayoseQA, which tests cross-lingual synonym and terminology normalization; and SogoCheck, a novel task designed to assess consistency reasoning between paired statements. We evaluate our model against both open-source medical LLMs and commercial models, including GPT-4o. Results show that our domain-specific model outperforms existing open models and achieves competitive performance with commercial ones, particularly on terminology-heavy and knowledge-based tasks. Interestingly, even GPT-4o performs poorly on SogoCheck, suggesting that cross-sentence consistency reasoning remains an open challenge. Our benchmark suite offers a broader diagnostic lens for pharmaceutical NLP, covering factual recall, lexical variation, and logical consistency. This work demonstrates the feasibility of building practical, secure, and cost-effective language models for Japanese domain-specific applications, and provides reusable evaluation resources for future research in pharmaceutical and healthcare NLP. Our model, codes, and datasets are released at https://github.com/EQUES-Inc/pharma-LLM-eval.

Synthetic datasets have successfully been used to probe visual question-answering datasets for their reasoning abilities. CLEVR (johnson2017clevr), for example, tests a range of visual reasoning abilities. The questions in CLEVR focus on comparisons of shapes, colors, and sizes, numerical reasoning, and existence claims. This paper introduces a minimally biased, diagnostic visual question-answering dataset, QLEVR, that goes beyond existential and numerical quantification and focus on more complex quantifiers and their combinations, e.g., asking whether there are more than two red balls that are smaller than at least three blue balls in an image. We describe how the dataset was created and present a first evaluation of state-of-the-art visual question-answering models, showing that QLEVR presents a formidable challenge to our current models. Code and Dataset are available at https://github.com/zechenli03/QLEVR

Approaches to Grounded Language Learning typically focus on a single task-based final performance measure that may not depend on desirable properties of the learned hidden representations, such as their ability to predict salient attributes or to generalise to unseen situations. To remedy this, we present GROLLA, an evaluation framework for Grounded Language Learning with Attributes with three sub-tasks: 1) Goal-oriented evaluation; 2) Object attribute prediction evaluation; and 3) Zero-shot evaluation. We also propose a new dataset CompGuessWhat?! as an instance of this framework for evaluating the quality of learned neural representations, in particular concerning attribute grounding. To this end, we extend the original GuessWhat?! dataset by including a semantic layer on top of the perceptual one. Specifically, we enrich the VisualGenome scene graphs associated with the GuessWhat?! images with abstract and situated attributes. By using diagnostic classifiers, we show that current models learn representations that are not expressive enough to encode object attributes (average F1 of 44.27). In addition, they do not learn strategies nor representations that are robust enough to perform well when novel scenes or objects are involved in gameplay (zero-shot best accuracy 50.06%).

Differential Diagnosis (DDx) is a fundamental yet complex aspect of clinical decision-making, in which physicians iteratively refine a ranked list of possible diseases based on symptoms, antecedents, and medical knowledge. While recent advances in large language models (LLMs) have shown promise in supporting DDx, existing approaches face key limitations, including single-dataset evaluations, isolated optimization of components, unrealistic assumptions about complete patient profiles, and single-attempt diagnosis. We introduce a Modular Explainable DDx Agent (MEDDxAgent) framework designed for interactive DDx, where diagnostic reasoning evolves through iterative learning, rather than assuming a complete patient profile is accessible. MEDDxAgent integrates three modular components: (1) an orchestrator (DDxDriver), (2) a history taking simulator, and (3) two specialized agents for knowledge retrieval and diagnosis strategy. To ensure robust evaluation, we introduce a comprehensive DDx benchmark covering respiratory, skin, and rare diseases. We analyze single-turn diagnostic approaches and demonstrate the importance of iterative refinement when patient profiles are not available at the outset. Our broad evaluation demonstrates that MEDDxAgent achieves over 10% accuracy improvements in interactive DDx across both large and small LLMs, while offering critical explainability into its diagnostic reasoning process.

Visual grounding, localizing objects from natural language descriptions, represents a critical bridge between language and vision understanding. While multimodal large language models (MLLMs) achieve impressive scores on existing benchmarks, a fundamental question remains: can MLLMs truly ground language in vision with human-like sophistication, or are they merely pattern-matching on simplified datasets? Current benchmarks fail to capture real-world complexity where humans effortlessly navigate ambiguous references and recognize when grounding is impossible. To rigorously assess MLLMs' true capabilities, we introduce GroundingME, a benchmark that systematically challenges models across four critical dimensions: (1) Discriminative, distinguishing highly similar objects, (2) Spatial, understanding complex relational descriptions, (3) Limited, handling occlusions or tiny objects, and (4) Rejection, recognizing ungroundable queries. Through careful curation combining automated generation with human verification, we create 1,005 challenging examples mirroring real-world complexity. Evaluating 25 state-of-the-art MLLMs reveals a profound capability gap: the best model achieves only 45.1% accuracy, while most score 0% on rejection tasks, reflexively hallucinating objects rather than acknowledging their absence, raising critical safety concerns for deployment. We explore two strategies for improvements: (1) test-time scaling selects optimal response by thinking trajectory to improve complex grounding by up to 2.9%, and (2) data-mixture training teaches models to recognize ungroundable queries, boosting rejection accuracy from 0% to 27.9%. GroundingME thus serves as both a diagnostic tool revealing current limitations in MLLMs and a roadmap toward human-level visual grounding.

The ability of language models in RAG systems to selectively refuse to answer based on flawed context is critical for safety, yet remains a significant failure point. Our large-scale study reveals that even frontier models struggle in this setting, with refusal accuracy dropping below 50% on multi-document tasks, while exhibiting either dangerous overconfidence or overcaution. Static benchmarks fail to reliably evaluate this capability, as models exploit dataset-specific artifacts and memorize test instances. We introduce RefusalBench, a generative methodology that programmatically creates diagnostic test cases through controlled linguistic perturbation. Our framework employs 176 distinct perturbation strategies across six categories of informational uncertainty and three intensity levels. Evaluation of over 30 models uncovers systematic failure patterns: refusal comprises separable detection and categorization skills, and neither scale nor extended reasoning improves performance. We find that selective refusal is a trainable, alignment-sensitive capability, offering a clear path for improvement. We release two benchmarks -- RefusalBench-NQ (single document) and RefusalBench-GaRAGe (multi-document) -- and our complete generation framework to enable continued, dynamic evaluation of this critical capability.

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

Synthetic Data Generation (SDG) based on Artificial Intelligence (AI) can transform the way clinical medicine is delivered by overcoming privacy barriers that currently render clinical data sharing difficult. This is the key to accelerating the development of digital tools contributing to enhanced patient safety. Such tools include robust data-driven clinical decision support systems, and example-based digital training tools that will enable healthcare professionals to improve their diagnostic performance for enhanced patient safety. This study focuses on the clinical evaluation of medical SDG, with a proof-of-concept investigation on diagnosing Inflammatory Bowel Disease (IBD) using Wireless Capsule Endoscopy (WCE) images. Its scientific contributions include a) a novel protocol for the systematic Clinical Evaluation of Medical Image Synthesis (CEMIS); b) a novel variational autoencoder-based model for the generation of high-resolution synthetic WCE images; and c) a comprehensive evaluation of the synthetic images using the CEMIS protocol by 10 international WCE specialists, in terms of image quality, diversity, and realism, as well as their utility for clinical decision-making. The results show that TIDE-II generates clinically plausible, very realistic WCE images, of improved quality compared to relevant state-of-the-art generative models. Concludingly, CEMIS can serve as a reference for future research on medical image-generation techniques, while the adaptation/extension of the architecture of TIDE-II to other imaging domains can be promising.

Scalp disorders are highly prevalent worldwide, yet remain underdiagnosed due to limited access to expert evaluation and the high cost of annotation. Although AI-based approaches hold great promise, their practical deployment is hindered by challenges such as severe data imbalance and the absence of pixel-level segmentation labels. To address these issues, we propose ScalpVision, an AI-driven system for the holistic diagnosis of scalp diseases. In ScalpVision, effective hair segmentation is achieved using pseudo image-label pairs and an innovative prompting method in the absence of traditional hair masking labels. Additionally, ScalpVision introduces DiffuseIT-M, a generative model adopted for dataset augmentation while maintaining hair information, facilitating improved predictions of scalp disease severity. Our experimental results affirm ScalpVision's efficiency in diagnosing a variety of scalp conditions, showcasing its potential as a valuable tool in dermatological care. Our code is available at https://github.com/winston1214/ScalpVision.

Text-to-Audio-Video (T2AV) generation aims to synthesize temporally coherent video and semantically synchronized audio from natural language, yet its evaluation remains fragmented, often relying on unimodal metrics or narrowly scoped benchmarks that fail to capture cross-modal alignment, instruction following, and perceptual realism under complex prompts. To address this limitation, we present T2AV-Compass, a unified benchmark for comprehensive evaluation of T2AV systems, consisting of 500 diverse and complex prompts constructed via a taxonomy-driven pipeline to ensure semantic richness and physical plausibility. Besides, T2AV-Compass introduces a dual-level evaluation framework that integrates objective signal-level metrics for video quality, audio quality, and cross-modal alignment with a subjective MLLM-as-a-Judge protocol for instruction following and realism assessment. Extensive evaluation of 11 representative T2AVsystems reveals that even the strongest models fall substantially short of human-level realism and cross-modal consistency, with persistent failures in audio realism, fine-grained synchronization, instruction following, etc. These results indicate significant improvement room for future models and highlight the value of T2AV-Compass as a challenging and diagnostic testbed for advancing text-to-audio-video generation.

Tool-augmented large language models (LLMs) are rapidly being integrated into real-world applications. Due to the lack of benchmarks, the community still needs to fully understand the hallucination issues within these models. To address this challenge, we introduce a comprehensive diagnostic benchmark, ToolBH. Specifically, we assess the LLM's hallucinations through two perspectives: depth and breadth. In terms of depth, we propose a multi-level diagnostic process, including (1) solvability detection, (2) solution planning, and (3) missing-tool analysis. For breadth, we consider three scenarios based on the characteristics of the toolset: missing necessary tools, potential tools, and limited functionality tools. Furthermore, we developed seven tasks and collected 700 evaluation samples through multiple rounds of manual annotation. The results show the significant challenges presented by the ToolBH benchmark. The current advanced models Gemini-1.5-Pro and GPT-4o only achieve a total score of 45.3 and 37.0, respectively, on a scale of 100. In this benchmark, larger model parameters do not guarantee better performance; the training data and response strategies also play a crucial role in tool-enhanced LLM scenarios. Our diagnostic analysis indicates that the primary reason for model errors lies in assessing task solvability. Additionally, open-weight models suffer from performance drops with verbose replies, whereas proprietary models excel with longer reasoning.

Machine learning has brought striking advances in multilingual natural language processing capabilities over the past year. For example, the latest techniques have improved the state-of-the-art performance on the XTREME multilingual benchmark by more than 13 points. While a sizeable gap to human-level performance remains, improvements have been easier to achieve in some tasks than in others. This paper analyzes the current state of cross-lingual transfer learning and summarizes some lessons learned. In order to catalyze meaningful progress, we extend XTREME to XTREME-R, which consists of an improved set of ten natural language understanding tasks, including challenging language-agnostic retrieval tasks, and covers 50 typologically diverse languages. In addition, we provide a massively multilingual diagnostic suite (MultiCheckList) and fine-grained multi-dataset evaluation capabilities through an interactive public leaderboard to gain a better understanding of such models. The leaderboard and code for XTREME-R will be made available at https://sites.research.google/xtreme and https://github.com/google-research/xtreme respectively.

In this paper, we introduce an advanced Russian general language understanding evaluation benchmark -- RussianGLUE. Recent advances in the field of universal language models and transformers require the development of a methodology for their broad diagnostics and testing for general intellectual skills - detection of natural language inference, commonsense reasoning, ability to perform simple logical operations regardless of text subject or lexicon. For the first time, a benchmark of nine tasks, collected and organized analogically to the SuperGLUE methodology, was developed from scratch for the Russian language. We provide baselines, human level evaluation, an open-source framework for evaluating models (https://github.com/RussianNLP/RussianSuperGLUE), and an overall leaderboard of transformer models for the Russian language. Besides, we present the first results of comparing multilingual models in the adapted diagnostic test set and offer the first steps to further expanding or assessing state-of-the-art models independently of language.

Medical domain automated text generation is an active area of research and development; however, evaluating the clinical quality of generated reports remains a challenge, especially in instances where domain-specific metrics are lacking, e.g. histopathology. We propose HARE (Histopathology Automated Report Evaluation), a novel entity and relation centric framework, composed of a benchmark dataset, a named entity recognition (NER) model, a relation extraction (RE) model, and a novel metric, which prioritizes clinically relevant content by aligning critical histopathology entities and relations between reference and generated reports. To develop the HARE benchmark, we annotated 813 de-identified clinical diagnostic histopathology reports and 652 histopathology reports from The Cancer Genome Atlas (TCGA) with domain-specific entities and relations. We fine-tuned GatorTronS, a domain-adapted language model to develop HARE-NER and HARE-RE which achieved the highest overall F1-score (0.915) among the tested models. The proposed HARE metric outperformed traditional metrics including ROUGE and Meteor, as well as radiology metrics such as RadGraph-XL, with the highest correlation and the best regression to expert evaluations (higher than the second best method, GREEN, a large language model based radiology report evaluator, by Pearson r = 0.168, Spearman ρ= 0.161, Kendall τ= 0.123, R^2 = 0.176, RMSE = 0.018). We release HARE, datasets, and the models at https://github.com/knowlab/HARE to foster advancements in histopathology report generation, providing a robust framework for improving the quality of reports.

Endoscopic procedures are essential for diagnosing and treating internal diseases, and multi-modal large language models (MLLMs) are increasingly applied to assist in endoscopy analysis. However, current benchmarks are limited, as they typically cover specific endoscopic scenarios and a small set of clinical tasks, failing to capture the real-world diversity of endoscopic scenarios and the full range of skills needed in clinical workflows. To address these issues, we introduce EndoBench, the first comprehensive benchmark specifically designed to assess MLLMs across the full spectrum of endoscopic practice with multi-dimensional capacities. EndoBench encompasses 4 distinct endoscopic scenarios, 12 specialized clinical tasks with 12 secondary subtasks, and 5 levels of visual prompting granularities, resulting in 6,832 rigorously validated VQA pairs from 21 diverse datasets. Our multi-dimensional evaluation framework mirrors the clinical workflow--spanning anatomical recognition, lesion analysis, spatial localization, and surgical operations--to holistically gauge the perceptual and diagnostic abilities of MLLMs in realistic scenarios. We benchmark 23 state-of-the-art models, including general-purpose, medical-specialized, and proprietary MLLMs, and establish human clinician performance as a reference standard. Our extensive experiments reveal: (1) proprietary MLLMs outperform open-source and medical-specialized models overall, but still trail human experts; (2) medical-domain supervised fine-tuning substantially boosts task-specific accuracy; and (3) model performance remains sensitive to prompt format and clinical task complexity. EndoBench establishes a new standard for evaluating and advancing MLLMs in endoscopy, highlighting both progress and persistent gaps between current models and expert clinical reasoning. We publicly release our benchmark and code.

Lung cancer remains the leading cause of cancer-related mortality worldwide, and early detection through low-dose computed tomography (LDCT) has shown significant promise in reducing death rates. With the growing integration of artificial intelligence (AI) into medical imaging, the development and evaluation of robust AI models require access to large, well-annotated datasets. In this study, we introduce the utility of Duke Lung Cancer Screening (DLCS) Dataset, the largest open-access LDCT dataset with over 2,000 scans and 3,000 expert-verified nodules. We benchmark deep learning models for both 3D nodule detection and lung cancer classification across internal and external datasets including LUNA16, LUNA25, and NLST-3D+. For detection, we develop two MONAI-based RetinaNet models (DLCSDmD and LUNA16-mD), evaluated using the Competition Performance Metric (CPM). For classification, we compare five models, including state-of-the-art pretrained models (Models Genesis, Med3D), a selfsupervised foundation model (FMCB), a randomly initialized ResNet50, and proposed a novel Strategic Warm-Start++ (SWS++) model. SWS++ uses curated candidate patches to pretrain a classification backbone within the same detection pipeline, enabling task-relevant feature learning. Our models demonstrated strong generalizability, with SWS++ achieving comparable or superior performance to existing foundational models across multiple datasets (AUC: 0.71 to 0.90). All code, models, and data are publicly released to promote reproducibility and collaboration. This work establishes a standardized benchmarking resource for lung cancer AI research, supporting future efforts in model development, validation, and clinical translation.

Automatically evaluating the quality of language generation is critical. Although recent learned metrics show high correlation with human judgement, these metrics can not explain their verdict or associate the scores with defects in generated text. To address this limitation, we present InstructScore, an explainable evaluation metric for text generation. By harnessing both explicit human instruction and the implicit knowledge of GPT-4, we fine-tune a text evaluation metric based on LLaMA, producing both a score for generated text and a human readable diagnostic report. We evaluate InstructScore on a variety of generation tasks, including translation, captioning, data-to-text and commonsense generation. Experiments show that our 7B model surpasses all other unsupervised metrics, including those based on 175B GPT-3 and GPT-4. Surprisingly, our InstructScore, even without direct supervision from human-rated data, achieves performance levels on par with state-of-the-art metrics like COMET22, which were fine-tuned on human ratings.

Models like OpenAI-o3 pioneer visual grounded reasoning by dynamically referencing visual regions, just like human "thinking with images". However, no benchmark exists to evaluate these capabilities holistically. To bridge this gap, we propose TreeBench (Traceable Evidence Evaluation Benchmark), a diagnostic benchmark built on three principles: (1) focused visual perception of subtle targets in complex scenes, (2) traceable evidence via bounding box evaluation, and (3) second-order reasoning to test object interactions and spatial hierarchies beyond simple object localization. Prioritizing images with dense objects, we initially sample 1K high-quality images from SA-1B, and incorporate eight LMM experts to manually annotate questions, candidate options, and answers for each image. After three stages of quality control, TreeBench consists of 405 challenging visual question-answering pairs, even the most advanced models struggle with this benchmark, where none of them reach 60% accuracy, e.g., OpenAI-o3 scores only 54.87. Furthermore, we introduce TreeVGR (Traceable Evidence Enhanced Visual Grounded Reasoning), a training paradigm to supervise localization and reasoning jointly with reinforcement learning, enabling accurate localizations and explainable reasoning pathways. Initialized from Qwen2.5-VL-7B, it improves V* Bench (+16.8), MME-RealWorld (+12.6), and TreeBench (+13.4), proving traceability is key to advancing vision-grounded reasoning. The code is available at https://github.com/Haochen-Wang409/TreeVGR.

Search-augmented large language models (LLMs) have advanced information-seeking tasks by integrating retrieval into generation, reducing users' cognitive burden compared to traditional search systems. Yet they remain insufficient for fully addressing diverse user needs, which requires recognizing how the same query can reflect different intents across users and delivering information in preferred forms. While recent systems such as ChatGPT and Gemini attempt personalization by leveraging user histories, systematic evaluation of such personalization is under-explored. To address this gap, we propose BESPOKE, the realistic benchmark for evaluating personalization in search-augmented LLMs. BESPOKE is designed to be both realistic, by collecting authentic chat and search histories directly from humans, and diagnostic, by pairing responses with fine-grained preference scores and feedback. The benchmark is constructed through long-term, deeply engaged human annotation, where human annotators contributed their own histories, authored queries with detailed information needs, and evaluated responses with scores and diagnostic feedback. Leveraging BESPOKE, we conduct systematic analyses that reveal key requirements for effective personalization in information-seeking tasks, providing a foundation for fine-grained evaluation of personalized search-augmented LLMs. Our code and data are available at https://augustinlib.github.io/BESPOKE/.

Recent progress in Large Vision-Language Models (LVLMs) has enabled promising applications in medical tasks, such as report generation and visual question answering. However, existing benchmarks focus mainly on the final diagnostic answer, offering limited insight into whether models engage in clinically meaningful reasoning. To address this, we present CheXStruct and CXReasonBench, a structured pipeline and benchmark built on the publicly available MIMIC-CXR-JPG dataset. CheXStruct automatically derives a sequence of intermediate reasoning steps directly from chest X-rays, such as segmenting anatomical regions, deriving anatomical landmarks and diagnostic measurements, computing diagnostic indices, and applying clinical thresholds. CXReasonBench leverages this pipeline to evaluate whether models can perform clinically valid reasoning steps and to what extent they can learn from structured guidance, enabling fine-grained and transparent assessment of diagnostic reasoning. The benchmark comprises 18,988 QA pairs across 12 diagnostic tasks and 1,200 cases, each paired with up to 4 visual inputs, and supports multi-path, multi-stage evaluation including visual grounding via anatomical region selection and diagnostic measurements. Even the strongest of 10 evaluated LVLMs struggle with structured reasoning and generalization, often failing to link abstract knowledge with anatomically grounded visual interpretation. The code is available at https://github.com/ttumyche/CXReasonBench

Large Language Models (LLMs) and code agents in software development are rapidly evolving from generating isolated code snippets to producing full-fledged software applications with graphical interfaces, interactive logic, and dynamic behaviors. However, current benchmarks fall short in evaluating such production-ready software, as they often rely on static checks or binary pass/fail scripts, failing to capture the interactive behaviors and runtime dynamics that define real-world usability - qualities that only emerge when an application is actively used. This is the blind spot of current evaluation: you don't know if an app works until you click through it, interact with it, and observe how it responds. To bridge this gap, we introduce RealDevWorld, a novel evaluation framework for automated end-to-end assessment of LLMs' ability to generate production-ready repositories from scratch. It features two key components: (1) RealDevBench, a diverse collection of 194 open-ended software engineering tasks across multiple domains, incorporating multimodal elements to reflect real-world complexity; and (2) AppEvalPilot, a new agent-as-a-judge evaluation system that simulates realistic, GUI-based user interactions to automatically and holistically assess software functional correctness, visual fidelity, and runtime behavior. The framework delivers fine-grained, task-specific diagnostic feedback, supporting nuanced evaluation beyond simple success/failure judgments. Empirical results show that RealDevWorld delivers effective, automatic, and human-aligned evaluations, achieving an accuracy of 0.92 and a correlation of 0.85 with expert human assessments, while significantly reducing the reliance on manual review. This enables scalable, human-aligned assessment of production-level software generated by LLMs. Our code is available on GitHub.

The rapid development of Large Language Models (LLMs) and the emergence of novel abilities with scale have necessitated the construction of holistic, diverse and challenging benchmarks such as HELM and BIG-bench. However, at the moment, most of these benchmarks focus only on performance in English and evaluations that include Southeast Asian (SEA) languages are few in number. We therefore propose BHASA, a holistic linguistic and cultural evaluation suite for LLMs in SEA languages. It comprises three components: (1) a NLP benchmark covering eight tasks across Natural Language Understanding (NLU), Generation (NLG) and Reasoning (NLR) tasks, (2) LINDSEA, a linguistic diagnostic toolkit that spans the gamut of linguistic phenomena including syntax, semantics and pragmatics, and (3) a cultural diagnostics dataset that probes for both cultural representation and sensitivity. For this preliminary effort, we implement the NLP benchmark only for Indonesian, Vietnamese, Thai and Tamil, and we only include Indonesian and Tamil for LINDSEA and the cultural diagnostics dataset. As GPT-4 is purportedly one of the best-performing multilingual LLMs at the moment, we use it as a yardstick to gauge the capabilities of LLMs in the context of SEA languages. Our initial experiments on GPT-4 with BHASA find it lacking in various aspects of linguistic capabilities, cultural representation and sensitivity in the targeted SEA languages. BHASA is a work in progress and will continue to be improved and expanded in the future. The repository for this paper can be found at: https://github.com/aisingapore/BHASA

Chest Xray imaging is a widely used diagnostic tool in modern medicine, and its high utilization creates substantial workloads for radiologists. To alleviate this burden, vision language models are increasingly applied to automate Chest Xray radiology report generation (CXRRRG), aiming for clinically accurate descriptions while reducing manual effort. Conventional approaches, however, typically rely on single images, failing to capture the longitudinal context necessary for producing clinically faithful comparison statements. Recently, growing attention has been directed toward incorporating longitudinal data into CXR RRG, enabling models to leverage historical studies in ways that mirror radiologists diagnostic workflows. Nevertheless, existing surveys primarily address single image CXRRRG and offer limited guidance for longitudinal settings, leaving researchers without a systematic framework for model design. To address this gap, this survey provides the first comprehensive review of longitudinal radiology report generation (LRRG). Specifically, we examine dataset construction strategies, report generation architectures alongside longitudinally tailored designs, and evaluation protocols encompassing both longitudinal specific measures and widely used benchmarks. We further summarize LRRG methods performance, alongside analyses of different ablation studies, which collectively highlight the critical role of longitudinal information and architectural design choices in improving model performance. Finally, we summarize five major limitations of current research and outline promising directions for future development, aiming to lay a foundation for advancing this emerging field.

Multimodal large language models (MLLMs) have demonstrated promising prospects in healthcare, particularly for addressing complex medical tasks, supporting multidisciplinary treatment (MDT), and enabling personalized precision medicine. However, their practical deployment faces critical challenges in resource efficiency, diagnostic accuracy, clinical considerations, and ethical privacy. To address these limitations, we propose Infi-Med, a comprehensive framework for medical MLLMs that introduces three key innovations: (1) a resource-efficient approach through curating and constructing high-quality supervised fine-tuning (SFT) datasets with minimal sample requirements, with a forward-looking design that extends to both pretraining and posttraining phases; (2) enhanced multimodal reasoning capabilities for cross-modal integration and clinical task understanding; and (3) a systematic evaluation system that assesses model performance across medical modalities and task types. Our experiments demonstrate that Infi-Med achieves state-of-the-art (SOTA) performance in general medical reasoning while maintaining rapid adaptability to clinical scenarios. The framework establishes a solid foundation for deploying MLLMs in real-world healthcare settings by balancing model effectiveness with operational constraints.

While Multimodal Large Language Models (MLLMs) have demonstrated remarkable proficiency in tasks such as abnormality detection and report generation for anatomical modalities, their capability in functional imaging remains largely unexplored. In this work, we identify and quantify a fundamental functional perception gap: the inability of current vision encoders to decode functional tracer biodistribution independent of morphological priors. Identifying Positron Emission Tomography (PET) as the quintessential modality to investigate this disconnect, we introduce PET-Bench, the first large-scale functional imaging benchmark comprising 52,308 hierarchical QA pairs from 9,732 multi-site, multi-tracer PET studies. Extensive evaluation of 19 state-of-the-art MLLMs reveals a critical safety hazard termed the Chain-of-Thought (CoT) hallucination trap. We observe that standard CoT prompting, widely considered to enhance reasoning, paradoxically decouples linguistic generation from visual evidence in PET, producing clinically fluent but factually ungrounded diagnoses. To resolve this, we propose Atomic Visual Alignment (AVA), a simple fine-tuning strategy that enforces the mastery of low-level functional perception prior to high-level diagnostic reasoning. Our results demonstrate that AVA effectively bridges the perception gap, transforming CoT from a source of hallucination into a robust inference tool and improving diagnostic accuracy by up to 14.83%. Code and data are available at https://github.com/yezanting/PET-Bench.

Artificial intelligence (AI) has demonstrated significant potential in ECG analysis and cardiovascular disease assessment. Recently, foundation models have played a remarkable role in advancing medical AI. The development of an ECG foundation model holds the promise of elevating AI-ECG research to new heights. However, building such a model faces several challenges, including insufficient database sample sizes and inadequate generalization across multiple domains. Additionally, there is a notable performance gap between single-lead and multi-lead ECG analyses. We introduced an ECG Foundation Model (ECGFounder), a general-purpose model that leverages real-world ECG annotations from cardiology experts to broaden the diagnostic capabilities of ECG analysis. ECGFounder was trained on over 10 million ECGs with 150 label categories from the Harvard-Emory ECG Database, enabling comprehensive cardiovascular disease diagnosis through ECG analysis. The model is designed to be both an effective out-of-the-box solution, and a to be fine-tunable for downstream tasks, maximizing usability. Importantly, we extended its application to lower rank ECGs, and arbitrary single-lead ECGs in particular. ECGFounder is applicable to supporting various downstream tasks in mobile monitoring scenarios. Experimental results demonstrate that ECGFounder achieves expert-level performance on internal validation sets, with AUROC exceeding 0.95 for eighty diagnoses. It also shows strong classification performance and generalization across various diagnoses on external validation sets. When fine-tuned, ECGFounder outperforms baseline models in demographic analysis, clinical event detection, and cross-modality cardiac rhythm diagnosis. The trained model and data will be publicly released upon publication through the bdsp.io. Our code is available at https://github.com/bdsp-core/ECGFounder

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

Large language models (LLMs) now perform strongly on many public math suites, yet frontier separation within mathematics increasingly suffers from ceiling effects. We present two complementary benchmarks: SKYLENAGE-ReasoningMATH, a 100-item, structure-aware diagnostic set with per-item metadata on length, numeric density, and symbolic complexity; and SKYLENAGE-MATH, a 150-item contest-style suite spanning four stages from high school to doctoral under a seven-subject taxonomy. We evaluate fifteen contemporary LLM variants under a single setup and analyze subject x model and grade x model performance. On the contest suite, the strongest model reaches 44% while the runner-up reaches 37%; accuracy declines from high school to doctoral, and top systems exhibit a doctoral-to-high-school retention near 79%. On the reasoning set, the best model attains 81% overall, and hardest-slice results reveal clear robustness gaps between leaders and the mid-tier. In summary, we release SKYLENAGE-ReasoningMATH and report aggregate results for SKYLENAGE-MATH; together, SKYLENAGE provides a hard, reasoning-centered and broadly covering math benchmark with calibrated difficulty and rich metadata, serving as a reference benchmark for future evaluations of mathematical reasoning.

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

This paper presents a comprehensive evaluation of GPT-4V's capabilities across diverse medical imaging tasks, including Radiology Report Generation, Medical Visual Question Answering (VQA), and Visual Grounding. While prior efforts have explored GPT-4V's performance in medical image analysis, to the best of our knowledge, our study represents the first quantitative evaluation on publicly available benchmarks. Our findings highlight GPT-4V's potential in generating descriptive reports for chest X-ray images, particularly when guided by well-structured prompts. Meanwhile, its performance on the MIMIC-CXR dataset benchmark reveals areas for improvement in certain evaluation metrics, such as CIDEr. In the domain of Medical VQA, GPT-4V demonstrates proficiency in distinguishing between question types but falls short of the VQA-RAD benchmark in terms of accuracy. Furthermore, our analysis finds the limitations of conventional evaluation metrics like the BLEU scores, advocating for the development of more semantically robust assessment methods. In the field of Visual Grounding, GPT-4V exhibits preliminary promise in recognizing bounding boxes, but its precision is lacking, especially in identifying specific medical organs and signs. Our evaluation underscores the significant potential of GPT-4V in the medical imaging domain, while also emphasizing the need for targeted refinements to fully unlock its capabilities.

Radiology reports convey detailed clinical observations and capture diagnostic reasoning that evolves over time. However, existing evaluation methods are limited to single-report settings and rely on coarse metrics that fail to capture fine-grained clinical semantics and temporal dependencies. We introduce LUNGUAGE,a benchmark dataset for structured radiology report generation that supports both single-report evaluation and longitudinal patient-level assessment across multiple studies. It contains 1,473 annotated chest X-ray reports, each reviewed by experts, and 80 of them contain longitudinal annotations to capture disease progression and inter-study intervals, also reviewed by experts. Using this benchmark, we develop a two-stage framework that transforms generated reports into fine-grained, schema-aligned structured representations, enabling longitudinal interpretation. We also propose LUNGUAGESCORE, an interpretable metric that compares structured outputs at the entity, relation, and attribute level while modeling temporal consistency across patient timelines. These contributions establish the first benchmark dataset, structuring framework, and evaluation metric for sequential radiology reporting, with empirical results demonstrating that LUNGUAGESCORE effectively supports structured report evaluation. The code is available at: https://github.com/SuperSupermoon/Lunguage

Accurate diagnostic coding of medical notes is crucial for enhancing patient care, medical research, and error-free billing in healthcare organizations. Manual coding is a time-consuming task for providers, and diagnostic codes often exhibit low sensitivity and specificity, whereas the free text in medical notes can be a more precise description of a patients status. Thus, accurate automated diagnostic coding of medical notes has become critical for a learning healthcare system. Recent developments in long-document transformer architectures have enabled attention-based deep-learning models to adjudicate medical notes. In addition, contrastive loss functions have been used to jointly pre-train large language and image models with noisy labels. To further improve the automated adjudication of medical notes, we developed an approach based on i) models for ICD-10 diagnostic code sequences using a large real-world data set, ii) large language models for medical notes, and iii) contrastive pre-training to build an integrated model of both ICD-10 diagnostic codes and corresponding medical text. We demonstrate that a contrastive approach for pre-training improves performance over prior state-of-the-art models for the MIMIC-III-50, MIMIC-III-rare50, and MIMIC-III-full diagnostic coding tasks.

Automated radiology report generation from chest X-ray (CXR) images has the potential to improve clinical efficiency and reduce radiologists' workload. However, most datasets, including the publicly available MIMIC-CXR and CheXpert Plus, consist entirely of free-form reports, which are inherently variable and unstructured. This variability poses challenges for both generation and evaluation: existing models struggle to produce consistent, clinically meaningful reports, and standard evaluation metrics fail to capture the nuances of radiological interpretation. To address this, we introduce Structured Radiology Report Generation (SRRG), a new task that reformulates free-text radiology reports into a standardized format, ensuring clarity, consistency, and structured clinical reporting. We create a novel dataset by restructuring reports using large language models (LLMs) following strict structured reporting desiderata. Additionally, we introduce SRR-BERT, a fine-grained disease classification model trained on 55 labels, enabling more precise and clinically informed evaluation of structured reports. To assess report quality, we propose F1-SRR-BERT, a metric that leverages SRR-BERT's hierarchical disease taxonomy to bridge the gap between free-text variability and structured clinical reporting. We validate our dataset through a reader study conducted by five board-certified radiologists and extensive benchmarking experiments.

We introduce MURA, a large dataset of musculoskeletal radiographs containing 40,561 images from 14,863 studies, where each study is manually labeled by radiologists as either normal or abnormal. To evaluate models robustly and to get an estimate of radiologist performance, we collect additional labels from six board-certified Stanford radiologists on the test set, consisting of 207 musculoskeletal studies. On this test set, the majority vote of a group of three radiologists serves as gold standard. We train a 169-layer DenseNet baseline model to detect and localize abnormalities. Our model achieves an AUROC of 0.929, with an operating point of 0.815 sensitivity and 0.887 specificity. We compare our model and radiologists on the Cohen's kappa statistic, which expresses the agreement of our model and of each radiologist with the gold standard. Model performance is comparable to the best radiologist performance in detecting abnormalities on finger and wrist studies. However, model performance is lower than best radiologist performance in detecting abnormalities on elbow, forearm, hand, humerus, and shoulder studies. We believe that the task is a good challenge for future research. To encourage advances, we have made our dataset freely available at https://stanfordmlgroup.github.io/competitions/mura .

Recent advancements in reasoning-enhanced large language models (LLMs), such as DeepSeek-R1 and OpenAI-o3, have demonstrated significant progress. However, their application in professional medical contexts remains underexplored, particularly in evaluating the quality of their reasoning processes alongside final outputs. Here, we introduce MedR-Bench, a benchmarking dataset of 1,453 structured patient cases, annotated with reasoning references derived from clinical case reports. Spanning 13 body systems and 10 specialties, it includes both common and rare diseases. To comprehensively evaluate LLM performance, we propose a framework encompassing three critical examination recommendation, diagnostic decision-making, and treatment planning, simulating the entire patient care journey. To assess reasoning quality, we present the Reasoning Evaluator, a novel automated system that objectively scores free-text reasoning responses based on efficiency, actuality, and completeness using dynamic cross-referencing and evidence checks. Using this benchmark, we evaluate five state-of-the-art reasoning LLMs, including DeepSeek-R1, OpenAI-o3-mini, and Gemini-2.0-Flash Thinking, etc. Our results show that current LLMs achieve over 85% accuracy in relatively simple diagnostic tasks when provided with sufficient examination results. However, performance declines in more complex tasks, such as examination recommendation and treatment planning. While reasoning outputs are generally reliable, with factuality scores exceeding 90%, critical reasoning steps are frequently missed. These findings underscore both the progress and limitations of clinical LLMs. Notably, open-source models like DeepSeek-R1 are narrowing the gap with proprietary systems, highlighting their potential to drive accessible and equitable advancements in healthcare.

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

The field of medical diagnosis has undergone a significant transformation with the advent of large language models (LLMs), yet the challenges of interpretability within these models remain largely unaddressed. This study introduces Chain-of-Diagnosis (CoD) to enhance the interpretability of LLM-based medical diagnostics. CoD transforms the diagnostic process into a diagnostic chain that mirrors a physician's thought process, providing a transparent reasoning pathway. Additionally, CoD outputs the disease confidence distribution to ensure transparency in decision-making. This interpretability makes model diagnostics controllable and aids in identifying critical symptoms for inquiry through the entropy reduction of confidences. With CoD, we developed DiagnosisGPT, capable of diagnosing 9604 diseases. Experimental results demonstrate that DiagnosisGPT outperforms other LLMs on diagnostic benchmarks. Moreover, DiagnosisGPT provides interpretability while ensuring controllability in diagnostic rigor.

This study investigates the integration of diverse patient data sources into multimodal language models for automated chest X-ray (CXR) report generation. Traditionally, CXR report generation relies solely on CXR images and limited radiology data, overlooking valuable information from patient health records, particularly from emergency departments. Utilising the MIMIC-CXR and MIMIC-IV-ED datasets, we incorporate detailed patient information such as aperiodic vital signs, medications, and clinical history to enhance diagnostic accuracy. We introduce a novel approach to transform these heterogeneous data sources into embeddings that prompt a multimodal language model, significantly enhancing the diagnostic accuracy of generated radiology reports. Our comprehensive evaluation demonstrates the benefits of using a broader set of patient data, underscoring the potential for enhanced diagnostic capabilities and better patient outcomes through the integration of multimodal data in CXR report generation.

The rapid advancement of large-scale vision-language models has showcased remarkable capabilities across various tasks. However, the lack of extensive and high-quality image-text data in medicine has greatly hindered the development of large-scale medical vision-language models. In this work, we present a diagnosis-guided bootstrapping strategy that exploits both image and label information to construct vision-language datasets. Based on the constructed dataset, we developed MedDr, a generalist foundation model for healthcare capable of handling diverse medical data modalities, including radiology, pathology, dermatology, retinography, and endoscopy. Moreover, during inference, we propose a simple but effective retrieval-augmented medical diagnosis strategy, which enhances the model's generalization ability. Extensive experiments on visual question answering, medical report generation, and medical image diagnosis demonstrate the superiority of our method.

The use of deep neural models for diagnosis prediction from clinical text has shown promising results. However, in clinical practice such models must not only be accurate, but provide doctors with interpretable and helpful results. We introduce ProtoPatient, a novel method based on prototypical networks and label-wise attention with both of these abilities. ProtoPatient makes predictions based on parts of the text that are similar to prototypical patients - providing justifications that doctors understand. We evaluate the model on two publicly available clinical datasets and show that it outperforms existing baselines. Quantitative and qualitative evaluations with medical doctors further demonstrate that the model provides valuable explanations for clinical decision support.

Motion artefacts in magnetic resonance brain images can have a strong impact on diagnostic confidence. The assessment of MR image quality is fundamental before proceeding with the clinical diagnosis. Motion artefacts can alter the delineation of structures such as the brain, lesions or tumours and may require a repeat scan. Otherwise, an inaccurate (e.g. correct pathology but wrong severity) or incorrect diagnosis (e.g. wrong pathology) may occur. "Image quality assessment" as a fast, automated step right after scanning can assist in deciding if the acquired images are diagnostically sufficient. An automated image quality assessment based on the structural similarity index (SSIM) regression through a residual neural network is proposed in this work. Additionally, a classification into different groups - by subdividing with SSIM ranges - is evaluated. Importantly, this method predicts SSIM values of an input image in the absence of a reference ground truth image. The networks were able to detect motion artefacts, and the best performance for the regression and classification task has always been achieved with ResNet-18 with contrast augmentation. The mean and standard deviation of residuals' distribution were mu=-0.0009 and sigma=0.0139, respectively. Whilst for the classification task in 3, 5 and 10 classes, the best accuracies were 97, 95 and 89\%, respectively. The results show that the proposed method could be a tool for supporting neuro-radiologists and radiographers in evaluating image quality quickly.

Radiology reporting generative AI holds significant potential to alleviate clinical workloads and streamline medical care. However, achieving high clinical accuracy is challenging, as radiological images often feature subtle lesions and intricate structures. Existing systems often fall short, largely due to their reliance on fixed size, patch-level image features and insufficient incorporation of pathological information. This can result in the neglect of such subtle patterns and inconsistent descriptions of crucial pathologies. To address these challenges, we propose an innovative approach that leverages pathology-aware regional prompts to explicitly integrate anatomical and pathological information of various scales, significantly enhancing the precision and clinical relevance of generated reports. We develop an anatomical region detector that extracts features from distinct anatomical areas, coupled with a novel multi-label lesion detector that identifies global pathologies. Our approach emulates the diagnostic process of radiologists, producing clinically accurate reports with comprehensive diagnostic capabilities. Experimental results show that our model outperforms previous state-of-the-art methods on most natural language generation and clinical efficacy metrics, with formal expert evaluations affirming its potential to enhance radiology practice.

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