Daily Papers

Equipping large language models with explicit skills has emerged as a promising paradigm for enabling autonomous agents to solve complex tasks. Agent skills can be inherently divided into general skills for broad cognitive transfer and task-specific skills for dynamic execution. However, existing skill-based reinforcement learning (RL) methods typically force a rigid choice between full externalization, which incurs prohibitive context overhead, and full internalization, which risks overfitting and knowledge conflicts. To address this dilemma, we propose Skill0.5, a novel agentic RL framework that explicitly differentiates skill treatments by combining general skill internalization with task-specific skill utilization. Driven by a dynamic, difficulty-aware router, Skill0.5 streams tasks into distinct mastery tiers to apply tailored optimization strategies: it internalizes general skills via privileged distillation to build a cognitive foundation for hard tasks, while using diagnostic probing on easy tasks to penalize shortcuts and enforce specific skill utilization. Experiments on ALFWorld and WebShop demonstrate that Skill0.5 outperforms both memory-based and skill-based RL baselines, yielding performance improvements across both in-distribution and out-of-distribution scenarios.

An effective method for combining frozen large language models (LLM) and visual encoders involves a resampler module that creates a `visual prompt' which is provided to the LLM, along with the textual prompt. While this approach has enabled impressive performance across many coarse-grained tasks like image captioning and visual question answering, more fine-grained tasks that require spatial understanding have not been thoroughly examined. In this paper, we use diagnostic classifiers to measure the extent to which the visual prompt produced by the resampler encodes spatial information. Our results show that this information is largely absent from the resampler output when kept frozen during training of the classifiers. However, when the resampler and classifier are trained jointly, we observe a significant performance boost. This shows that the compression achieved by the resamplers can in principle encode the requisite spatial information, but that more object-aware objectives are needed at the pretraining stage to facilitate this capability

Memes have emerged as a popular form of multimodal online communication, where their interpretation heavily depends on the specific context in which they appear. Current approaches predominantly focus on isolated meme analysis, either for harmful content detection or standalone interpretation, overlooking a fundamental challenge: the same meme can express different intents depending on its conversational context. This oversight creates an evaluation gap: although humans intuitively recognize how context shapes meme interpretation, Large Vision Language Models (LVLMs) can hardly understand context-dependent meme intent. To address this critical limitation, we introduce MemeReaCon, a novel benchmark specifically designed to evaluate how LVLMs understand memes in their original context. We collected memes from five different Reddit communities, keeping each meme's image, the post text, and user comments together. We carefully labeled how the text and meme work together, what the poster intended, how the meme is structured, and how the community responded. Our tests with leading LVLMs show a clear weakness: models either fail to interpret critical information in the contexts, or overly focus on visual details while overlooking communicative purpose. MemeReaCon thus serves both as a diagnostic tool exposing current limitations and as a challenging benchmark to drive development toward more sophisticated LVLMs of the context-aware understanding.

Multimodal large language models (MLLMs) are increasingly deployed in open-ended, real-world environments where inputs are messy, underspecified, and not always trustworthy. Unlike curated benchmarks, these settings frequently involve instructions that refer to missing objects or contradictory facts, rely on ambiguous references, or request infeasible actions. In such cases, success hinges not on task execution alone, but on a model's ability to detect when something is silently wrong. This paper presents a systematic analysis of how current MLLMs handle such implicit reasoning scenarios: cases where the flaw is not explicitly stated but must be inferred from context. Using a curated diagnostic suite spanning four categories of real-world failure modes, we evaluate six MLLMs, including o3 and GPT-4o, and find that models frequently fail to surface hidden issues, even when they possess the necessary perceptual and reasoning skills. Explicit prompting reveals that the underlying capabilities exist but are often suppressed in favor of user compliance. We further show that simple inference-time interventions, such as cautious persona prompting and, in particular, requiring a clarifying question, can dramatically recover performance. Our findings highlight a persistent gap between reasoning competence and behavioral compliance in current MLLMs and suggest practical strategies for making these models more trustworthy in underconstrained environments.

Multimodal language models (MLMs) show promise for clinical decision support and diagnostic reasoning, raising the prospect of end-to-end automated medical image interpretation. However, clinicians are highly selective in adopting AI tools; a model that makes errors on seemingly simple perception tasks such as determining image orientation or identifying whether a CT scan is contrast-enhance are unlikely to be adopted for clinical tasks. We introduce Medblink, a benchmark designed to probe these models for such perceptual abilities. Medblink spans eight clinically meaningful tasks across multiple imaging modalities and anatomical regions, totaling 1,429 multiple-choice questions over 1,605 images. We evaluate 19 state-of-the-art MLMs, including general purpose (GPT4o, Claude 3.5 Sonnet) and domain specific (Med Flamingo, LLaVA Med, RadFM) models. While human annotators achieve 96.4% accuracy, the best-performing model reaches only 65%. These results show that current MLMs frequently fail at routine perceptual checks, suggesting the need to strengthen their visual grounding to support clinical adoption. Data is available on our project page.

Transformer-based speech language models (SLMs) have significantly improved neural speech recognition and understanding. While existing research has examined how well SLMs encode shallow acoustic and phonetic features, the extent to which SLMs encode nuanced syntactic and conceptual features remains unclear. By drawing parallels with linguistic competence assessments for large language models, this study is the first to systematically evaluate the presence of contextual syntactic and semantic features across SLMs for self-supervised learning (S3M), automatic speech recognition (ASR), speech compression (codec), and as the encoder for auditory large language models (AudioLLMs). Through minimal pair designs and diagnostic feature analysis across 71 tasks spanning diverse linguistic levels, our layer-wise and time-resolved analysis uncovers that 1) all speech encode grammatical features more robustly than conceptual ones.

Existing large language models (LLMs) evaluations use fixed-difficulty benchmarks that cannot adapt as models improve, and rarely isolate specific cognitive processes. We introduce Working Memory Fidelity-Active Manipulation (WMF-AM), a probe of cumulative state tracking, the ability to maintain and update intermediate results across K sequential operations within a single query, without a scratchpad. Unlike multi-step agent benchmarks that stress task orchestration, WMF-AM isolates within-pass cumulative load by parameterizing depth K. The core probe uses arithmetic accumulation on 28 models from 12 families (0.5B to frontier); a matched non-arithmetic extension (permissions, schedules, inventories) confirms the design generalizes beyond arithmetic. Three construct-isolation ablations confirm that cumulative load, not arithmetic skill or entity tracking, drives difficulty. We release WMF-AM as a lightweight, recalibratable diagnostic for characterizing where models degrade under cumulative load. Code and data can be accessed at https://github.com/dengzhe-hou/WMF-AM

The phenomenon of sound symbolism, the non-arbitrary mapping between word sounds and meanings, has long been demonstrated through anecdotal experiments like Bouba Kiki, but rarely tested at scale. We present the first computational cross-linguistic analysis of sound symbolism in the semantic domain of size. We compile a typologically broad dataset of 810 adjectives (27 languages, 30 words each), each phonemically transcribed and validated with native-speaker audio. Using interpretable classifiers over bag-of-segment features, we find that phonological form predicts size semantics above chance even across unrelated languages, with both vowels and consonants contributing. To probe universality beyond genealogy, we train an adversarial scrubber that suppresses language identity while preserving size signal (also at family granularity). Language prediction averaged across languages and settings falls below chance while size prediction remains significantly above chance, indicating cross-family sound-symbolic bias. We release data, code, and diagnostic tools for future large-scale studies of iconicity.

Safety alignment is a key requirement for building reliable Artificial General Intelligence. Despite significant advances in safety alignment, we observe that minor latent shifts can still trigger unsafe responses in aligned models. We argue that this stems from the shallow nature of existing alignment methods, which focus on surface-level refusal behaviors without sufficiently altering internal representations. Consequently, small shifts in hidden activations can re-trigger harmful behaviors embedded in the latent space. To explore the robustness of safety alignment to latent perturbations, we introduce a probing method that measures the Negative Log-Likelihood of the original response generated by the model. This probe quantifies local sensitivity in the latent space, serving as a diagnostic tool for identifying vulnerable directions. Based on this signal, we construct effective jailbreak trajectories, giving rise to the Activation Steering Attack (ASA). More importantly, these insights offer a principled foundation for improving alignment robustness. To this end, we introduce Layer-wise Adversarial Patch Training~(LAPT), a fine-tuning strategy that inject controlled perturbations into hidden representations during training. Experimental results highlight that LAPT strengthen alignment robustness without compromising general capabilities. Our findings reveal fundamental flaws in current alignment paradigms and call for representation-level training strategies that move beyond surface-level behavior supervision. Codes and results are available at https://github.com/Carol-gutianle/LatentSafety.

In this work, we dive deep into one of the popular knowledge-grounded dialogue benchmarks that focus on faithfulness, FaithDial. We show that a significant portion of the FaithDial data contains annotation artifacts, which may bias models towards completely ignoring the conversation history. We therefore introduce CHARP, a diagnostic test set, designed for an improved evaluation of hallucinations in conversational model. CHARP not only measures hallucination but also the compliance of the models to the conversation task. Our extensive analysis reveals that models primarily exhibit poor performance on CHARP due to their inability to effectively attend to and reason over the conversation history. Furthermore, the evaluation methods of FaithDial fail to capture these shortcomings, neglecting the conversational history. Our findings indicate that there is substantial room for contribution in both dataset creation and hallucination evaluation for knowledge-grounded dialogue, and that CHARP can serve as a tool for monitoring the progress in this particular research area. CHARP is publicly available at https://huggingface.co/datasets/huawei-noah/CHARP

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

We introduce MentalBench, a benchmark for evaluating psychiatric diagnostic decision-making in large language models (LLMs). Existing mental health benchmarks largely rely on social media data, limiting their ability to assess DSM-grounded diagnostic judgments. At the core of MentalBench is MentalKG, a psychiatrist-built and validated knowledge graph encoding DSM-5 diagnostic criteria and differential diagnostic rules for 23 psychiatric disorders. Using MentalKG as a golden-standard logical backbone, we generate 24,750 synthetic clinical cases that systematically vary in information completeness and diagnostic complexity, enabling low-noise and interpretable evaluation. Our experiments show that while state-of-the-art LLMs perform well on structured queries probing DSM-5 knowledge, they struggle to calibrate confidence in diagnostic decision-making when distinguishing between clinically overlapping disorders. These findings reveal evaluation gaps not captured by existing benchmarks.

This work presents LURK (Latent UnleaRned Knowledge), a novel framework that probes for hidden retained knowledge in unlearned LLMs through adversarial suffix prompting. LURK automatically generates adversarial prompt suffixes designed to elicit residual knowledge about the Harry Potter domain, a commonly used benchmark for unlearning. Our experiments reveal that even models deemed successfully unlearned can leak idiosyncratic information under targeted adversarial conditions, highlighting critical limitations of current unlearning evaluation standards. By uncovering latent knowledge through indirect probing, LURK offers a more rigorous and diagnostic tool for assessing the robustness of unlearning algorithms. All code will be publicly available.

Recent works show that pre-trained language models (PTLMs), such as BERT, possess certain commonsense and factual knowledge. They suggest that it is promising to use PTLMs as "neural knowledge bases" via predicting masked words. Surprisingly, we find that this may not work for numerical commonsense knowledge (e.g., a bird usually has two legs). In this paper, we investigate whether and to what extent we can induce numerical commonsense knowledge from PTLMs as well as the robustness of this process. To study this, we introduce a novel probing task with a diagnostic dataset, NumerSense, containing 13.6k masked-word-prediction probes (10.5k for fine-tuning and 3.1k for testing). Our analysis reveals that: (1) BERT and its stronger variant RoBERTa perform poorly on the diagnostic dataset prior to any fine-tuning; (2) fine-tuning with distant supervision brings some improvement; (3) the best supervised model still performs poorly as compared to human performance (54.06% vs 96.3% in accuracy).

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.

Current robotic evaluation is still largely dominated by binary success rates, which collapse rich execution processes into a single outcome and obscure critical qualities such as progress, efficiency, and stability. To address this limitation, we propose PRM-as-a-Judge, a dense evaluation paradigm that leverages Process Reward Models (PRMs) to audit policy execution directly from trajectory videos by estimating task progress from observation sequences. Central to this paradigm is the OPD (Outcome-Process-Diagnosis) metric system, which explicitly formalizes execution quality via a task-aligned progress potential. We characterize dense robotic evaluation through two axiomatic properties: macro-consistency, which requires additive and path-consistent aggregation, and micro-resolution, which requires sensitivity to fine-grained physical evolution. Under this formulation, potential-based PRM judges provide a natural instantiation of dense evaluation, with macro-consistency following directly from the induced scalar potential. We empirically validate the micro-resolution property using RoboPulse, a diagnostic benchmark specifically designed for probing micro-scale progress discrimination, where several trajectory-trained PRM judges outperform discriminative similarity-based methods and general-purpose foundation-model judges. Finally, leveraging PRM-as-a-Judge and the OPD metric system, we conduct a structured audit of mainstream policy paradigms across long-horizon tasks, revealing behavioral signatures and failure modes that are invisible to outcome-only metrics.

Video Large Language Models (Video LLMs) have shown promising capabilities in video comprehension, yet they struggle with tracking temporal changes and reasoning about temporal relationships. While previous research attributed this limitation to the ineffective temporal encoding of visual inputs, our diagnostic study reveals that video representations contain sufficient information for even small probing classifiers to achieve perfect accuracy. Surprisingly, we find that the key bottleneck in Video LLMs' temporal reasoning capability stems from the underlying LLM's inherent difficulty with temporal concepts, as evidenced by poor performance on textual temporal question-answering tasks. Building on this discovery, we introduce the Textual Temporal reasoning Transfer (T3). T3 synthesizes diverse temporal reasoning tasks in pure text format from existing image-text datasets, addressing the scarcity of video samples with complex temporal scenarios. Remarkably, without using any video data, T3 enhances LongVA-7B's temporal understanding, yielding a 5.3 absolute accuracy improvement on the challenging TempCompass benchmark, which enables our model to outperform ShareGPT4Video-8B trained on 28,000 video samples. Additionally, the enhanced LongVA-7B model achieves competitive performance on comprehensive video benchmarks. For example, it achieves a 49.7 accuracy on the Temporal Reasoning task of Video-MME, surpassing powerful large-scale models such as InternVL-Chat-V1.5-20B and VILA1.5-40B. Further analysis reveals a strong correlation between textual and video temporal task performance, validating the efficacy of transferring temporal reasoning abilities from text to video domains.

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.

A growing body of work makes use of probing to investigate the working of neural models, often considered black boxes. Recently, an ongoing debate emerged surrounding the limitations of the probing paradigm. In this work, we point out the inability to infer behavioral conclusions from probing results and offer an alternative method that focuses on how the information is being used, rather than on what information is encoded. Our method, Amnesic Probing, follows the intuition that the utility of a property for a given task can be assessed by measuring the influence of a causal intervention that removes it from the representation. Equipped with this new analysis tool, we can ask questions that were not possible before, e.g. is part-of-speech information important for word prediction? We perform a series of analyses on BERT to answer these types of questions. Our findings demonstrate that conventional probing performance is not correlated to task importance, and we call for increased scrutiny of claims that draw behavioral or causal conclusions from probing results.

In this article, we use probing to investigate phenomena that occur during fine-tuning and knowledge distillation of a BERT-based natural language understanding (NLU) model. Our ultimate purpose was to use probing to better understand practical production problems and consequently to build better NLU models. We designed experiments to see how fine-tuning changes the linguistic capabilities of BERT, what the optimal size of the fine-tuning dataset is, and what amount of information is contained in a distilled NLU based on a tiny Transformer. The results of the experiments show that the probing paradigm in its current form is not well suited to answer such questions. Structural, Edge and Conditional probes do not take into account how easy it is to decode probed information. Consequently, we conclude that quantification of information decodability is critical for many practical applications of the probing paradigm.

Probing classifiers have emerged as one of the prominent methodologies for interpreting and analyzing deep neural network models of natural language processing. The basic idea is simple -- a classifier is trained to predict some linguistic property from a model's representations -- and has been used to examine a wide variety of models and properties. However, recent studies have demonstrated various methodological limitations of this approach. This article critically reviews the probing classifiers framework, highlighting their promises, shortcomings, and advances.

Knowledge probing evaluates the extent to which a language model (LM) has acquired relational knowledge during its pre-training phase. It provides a cost-effective means of comparing LMs of different sizes and training setups and is useful for monitoring knowledge gained or lost during continual learning (CL). In prior work, we presented an improved knowledge probe called BEAR (Wiland et al., 2024), which enables the comparison of LMs trained with different pre-training objectives (causal and masked LMs) and addresses issues of skewed distributions in previous probes to deliver a more unbiased reading of LM knowledge. With this paper, we present LM-PUB- QUIZ, a Python framework and leaderboard built around the BEAR probing mechanism that enables researchers and practitioners to apply it in their work. It provides options for standalone evaluation and direct integration into the widely-used training pipeline of the Hugging Face TRANSFORMERS library. Further, it provides a fine-grained analysis of different knowledge types to assist users in better understanding the knowledge in each evaluated LM. We publicly release LM-PUB-QUIZ as an open-source project.

As fine-tuning (FT) becomes increasingly impractical at scale, probing is emerging as the preferred evaluation protocol for self-supervised learning (SSL). Yet, the standard linear probing (LP) fails to adequately reflect the potential of models trained with Masked Image Modeling (MIM), due to the distributed nature of patch tokens. This motivates the need for attentive probing, an alternative that uses attention to selectively aggregate patch-level features. Despite its growing adoption, attentive probing remains under-explored, with existing methods suffering from excessive parameterization and poor computational efficiency. In this work, we revisit attentive probing through the lens of the accuracy-efficiency trade-off. We conduct a systematic study of existing methods, analyzing their mechanisms and benchmarking their performance. We introduce efficient probing (EP), a multi-query cross-attention mechanism that eliminates redundant projections, reduces the number of trainable parameters, and achieves up to a 10times speed-up over conventional multi-head attention. Despite its simplicity, EP outperforms LP and prior attentive probing approaches across seven benchmarks, generalizes well beyond MIM to diverse pre-training paradigms, produces interpretable attention maps, and achieves strong gains in low-shot and layer-wise settings. Code available at https://github.com/billpsomas/efficient-probing.

Probing studies what information is encoded in a frozen LLM's layer representations by training a lightweight predictor on top of them. Beyond analysis, probes are often used operationally in probe-then-steer pipelines: a learned concept vector is extracted from a probe and injected via additive activation steering by adding it to a layer representation during the forward pass. The effectiveness of this pipeline hinges on estimating concept vectors that are accurate, directionally stable under ablation, and inexpensive to obtain. Motivated by these desiderata, we propose RAPTOR (Ridge-Adaptive Logistic Probe), a simple L2-regularized logistic probe whose validation-tuned ridge strength yields concept vectors from normalized weights. Across extensive experiments on instruction-tuned LLMs and human-written concept datasets, RAPTOR matches or exceeds strong baselines in accuracy while achieving competitive directional stability and substantially lower training cost; these quantitative results are supported by qualitative downstream steering demonstrations. Finally, using the Convex Gaussian Min-max Theorem (CGMT), we provide a mechanistic characterization of ridge logistic regression in an idealized Gaussian teacher-student model in the high-dimensional few-shot regime, explaining how penalty strength mediates probe accuracy and concept-vector stability and yielding structural predictions that qualitatively align with trends observed on real LLM embeddings.

Knowledge probing assesses to which degree a language model (LM) has successfully learned relational knowledge during pre-training. Probing is an inexpensive way to compare LMs of different sizes and training configurations. However, previous approaches rely on the objective function used in pre-training LMs and are thus applicable only to masked or causal LMs. As a result, comparing different types of LMs becomes impossible. To address this, we propose an approach that uses an LM's inherent ability to estimate the log-likelihood of any given textual statement. We carefully design an evaluation dataset of 7,731 instances (40,916 in a larger variant) from which we produce alternative statements for each relational fact, one of which is correct. We then evaluate whether an LM correctly assigns the highest log-likelihood to the correct statement. Our experimental evaluation of 22 common LMs shows that our proposed framework, BEAR, can effectively probe for knowledge across different LM types. We release the BEAR datasets and an open-source framework that implements the probing approach to the research community to facilitate the evaluation and development of LMs.

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.

Monitoring is an important aspect of safely deploying Large Language Models (LLMs). This paper examines activation probes for detecting ``high-stakes'' interactions -- where the text indicates that the interaction might lead to significant harm -- as a critical, yet underexplored, target for such monitoring. We evaluate several probe architectures trained on synthetic data, and find them to exhibit robust generalization to diverse, out-of-distribution, real-world data. Probes' performance is comparable to that of prompted or finetuned medium-sized LLM monitors, while offering computational savings of six orders-of-magnitude. These savings are enabled by reusing activations of the model that is being monitored. Our experiments also highlight the potential of building resource-aware hierarchical monitoring systems, where probes serve as an efficient initial filter and flag cases for more expensive downstream analysis. We release our novel synthetic dataset and the codebase at https://github.com/arrrlex/models-under-pressure.

The number of publicly available models is rapidly increasing, yet most remain undocumented. Users looking for suitable models for their tasks must first determine what each model does. Training machine learning models to infer missing documentation directly from model weights is challenging, as these weights often contain significant variation unrelated to model functionality (denoted nuisance). Here, we identify a key property of real-world models: most public models belong to a small set of Model Trees, where all models within a tree are fine-tuned from a common ancestor (e.g., a foundation model). Importantly, we find that within each tree there is less nuisance variation between models. Concretely, while learning across Model Trees requires complex architectures, even a linear classifier trained on a single model layer often works within trees. While effective, these linear classifiers are computationally expensive, especially when dealing with larger models that have many parameters. To address this, we introduce Probing Experts (ProbeX), a theoretically motivated and lightweight method. Notably, ProbeX is the first probing method specifically designed to learn from the weights of a single hidden model layer. We demonstrate the effectiveness of ProbeX by predicting the categories in a model's training dataset based only on its weights. Excitingly, ProbeX can map the weights of Stable Diffusion into a weight-language embedding space, enabling model search via text, i.e., zero-shot model classification.

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.

Prior work uses linear probes on benchmark prompts as evidence of evaluation awareness in large language models. Because evaluation context is typically entangled with benchmark format and genre, it is unclear whether probe-based signals reflect context or surface structure. We test whether these signals persist under partial control of prompt format using a controlled 2x2 dataset and diagnostic rewrites. We find that probes primarily track benchmark-canonical structure and fail to generalize to free-form prompts independent of linguistic style. Thus, standard probe-based methodologies do not reliably disentangle evaluation context from structural artifacts, limiting the evidential strength of existing results.

Prompt-based probing has been widely used in evaluating the abilities of pretrained language models (PLMs). Unfortunately, recent studies have discovered such an evaluation may be inaccurate, inconsistent and unreliable. Furthermore, the lack of understanding its inner workings, combined with its wide applicability, has the potential to lead to unforeseen risks for evaluating and applying PLMs in real-world applications. To discover, understand and quantify the risks, this paper investigates the prompt-based probing from a causal view, highlights three critical biases which could induce biased results and conclusions, and proposes to conduct debiasing via causal intervention. This paper provides valuable insights for the design of unbiased datasets, better probing frameworks and more reliable evaluations of pretrained language models. Furthermore, our conclusions also echo that we need to rethink the criteria for identifying better pretrained language models. We openly released the source code and data at https://github.com/c-box/causalEval.

Vision evaluations are typically done through multi-step processes. In most contemporary fields, experts analyze images using structured, evidence-based adaptive questioning. In plant pathology, botanists inspect leaf images, identify visual cues, infer diagnostic intent, and probe further with targeted questions that adapt to species, symptoms, and severity. This structured probing is crucial for accurate disease diagnosis and treatment formulation. Yet current vision-language models are evaluated on single-turn question answering. To address this gap, we introduce PlantInquiryVQA, a benchmark for studying multi-step, intent-driven visual reasoning in botanical diagnosis. We formalize a Chain of Inquiry framework modeling diagnostic trajectories as ordered question-answer sequences conditioned on grounded visual cues and explicit epistemic intent. We release a dataset of 24,950 expert-curated plant images and 138,068 question-answer pairs annotated with visual grounding, severity labels, and domain-specific reasoning templates. Evaluations on top-tier Multimodal Large Language Models reveal that while they describe visual symptoms adequately, they struggle with safe clinical reasoning and accurate diagnosis. Importantly, structured question-guided inquiry significantly improves diagnostic correctness, reduces hallucination, and increases reasoning efficiency. We hope PlantInquiryVQA serves as a foundational benchmark in advancing research to train diagnostic agents to reason like expert botanists rather than static classifiers.

Future short or long-term space missions require a new generation of monitoring and diagnostic systems due to communication impasses as well as limitations in specialized crew and equipment. Machine learning supported diagnostic systems present a viable solution for medical and technical applications. We discuss challenges and applicability of such systems in light of upcoming missions and outline an example use case for a next-generation medical diagnostic system for future space operations. Additionally, we present approach recommendations and constraints for the successful generation and use of machine learning models aboard a spacecraft.

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.

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.

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.

Neural network models have a reputation for being black boxes. We propose to monitor the features at every layer of a model and measure how suitable they are for classification. We use linear classifiers, which we refer to as "probes", trained entirely independently of the model itself. This helps us better understand the roles and dynamics of the intermediate layers. We demonstrate how this can be used to develop a better intuition about models and to diagnose potential problems. We apply this technique to the popular models Inception v3 and Resnet-50. Among other things, we observe experimentally that the linear separability of features increase monotonically along the depth of the model.

Frontier language model capabilities are improving rapidly. We thus need stronger mitigations against bad actors misusing increasingly powerful systems. Prior work has shown that activation probes may be a promising misuse mitigation technique, but we identify a key remaining challenge: probes fail to generalize under important production distribution shifts. In particular, we find that the shift from short-context to long-context inputs is difficult for existing probe architectures. We propose several new probe architecture that handle this long-context distribution shift. We evaluate these probes in the cyber-offensive domain, testing their robustness against various production-relevant shifts, including multi-turn conversations, static jailbreaks, and adaptive red teaming. Our results demonstrate that while multimax addresses context length, a combination of architecture choice and training on diverse distributions is required for broad generalization. Additionally, we show that pairing probes with prompted classifiers achieves optimal accuracy at a low cost due to the computational efficiency of probes. These findings have informed the successful deployment of misuse mitigation probes in user-facing instances of Gemini, Google's frontier language model. Finally, we find early positive results using AlphaEvolve to automate improvements in both probe architecture search and adaptive red teaming, showing that automating some AI safety research is already possible.

Large Language Models (LLMs) can comply with harmful instructions, raising serious safety concerns despite their impressive capabilities. Recent work has leveraged probing-based approaches to study the separability of malicious and benign inputs in LLMs' internal representations, and researchers have proposed using such probing methods for safety detection. We systematically re-examine this paradigm. Motivated by poor out-of-distribution performance, we hypothesize that probes learn superficial patterns rather than semantic harmfulness. Through controlled experiments, we confirm this hypothesis and identify the specific patterns learned: instructional patterns and trigger words. Our investigation follows a systematic approach, progressing from demonstrating comparable performance of simple n-gram methods, to controlled experiments with semantically cleaned datasets, to detailed analysis of pattern dependencies. These results reveal a false sense of security around current probing-based approaches and highlight the need to redesign both models and evaluation protocols, for which we provide further discussions in the hope of suggesting responsible further research in this direction. We have open-sourced the project at https://github.com/WangCheng0116/Why-Probe-Fails.

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.

Traditionally, AI research in medical diagnosis has largely centered on image analysis. While this has led to notable advancements, the absence of patient-reported symptoms continues to hinder diagnostic accuracy. To address this, we propose a Pre-Consultation Dialogue Framework (PCDF) that mimics real-world diagnostic procedures, where doctors iteratively query patients before reaching a conclusion. Specifically, we simulate diagnostic dialogues between two vision-language models (VLMs): a DocVLM, which generates follow-up questions based on the image and dialogue history, and a PatientVLM, which responds using a symptom profile derived from the ground-truth diagnosis. We additionally conducted a small-scale clinical validation of the synthetic symptoms generated by our framework, with licensed clinicians confirming their clinical relevance, symptom coverage, and overall realism. These findings indicate that the resulting DocVLM-PatientVLM interactions form coherent, multi-turn consultations paired with images and diagnoses, which we then use to fine-tune the DocVLM. This dialogue-based supervision leads to substantial gains over image-only training, highlighting the value of realistic symptom elicitation for diagnosis.

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.

Models of language trained on very large corpora have been demonstrated useful for NLP. As fixed artifacts, they have become the object of intense study, with many researchers "probing" the extent to which linguistic abstractions, factual and commonsense knowledge, and reasoning abilities they acquire and readily demonstrate. Building on this line of work, we consider a new question: for types of knowledge a language model learns, when during (pre)training are they acquired? We plot probing performance across iterations, using RoBERTa as a case study. Among our findings: linguistic knowledge is acquired fast, stably, and robustly across domains. Facts and commonsense are slower and more domain-sensitive. Reasoning abilities are, in general, not stably acquired. As new datasets, pretraining protocols, and probes emerge, we believe that probing-across-time analyses can help researchers understand the complex, intermingled learning that these models undergo and guide us toward more efficient approaches that accomplish necessary learning faster.

With the increasing numbers of publicly available models, there are probably pretrained, online models for most tasks users require. However, current model search methods are rudimentary, essentially a text-based search in the documentation, thus users cannot find the relevant models. This paper presents ProbeLog, a method for retrieving classification models that can recognize a target concept, such as "Dog", without access to model metadata or training data. Differently from previous probing methods, ProbeLog computes a descriptor for each output dimension (logit) of each model, by observing its responses on a fixed set of inputs (probes). Our method supports both logit-based retrieval ("find more logits like this") and zero-shot, text-based retrieval ("find all logits corresponding to dogs"). As probing-based representations require multiple costly feedforward passes through the model, we develop a method, based on collaborative filtering, that reduces the cost of encoding repositories by 3x. We demonstrate that ProbeLog achieves high retrieval accuracy, both in real-world and fine-grained search tasks and is scalable to full-size repositories.

Large language models(LLMs) excel at text generation and knowledge question-answering tasks, but they are prone to generating hallucinated content, severely limiting their application in high-risk domains. Current hallucination detection methods based on uncertainty estimation and external knowledge retrieval suffer from the limitation that they still produce erroneous content at high confidence levels and rely heavily on retrieval efficiency and knowledge coverage. In contrast, probe methods that leverage the model's hidden-layer states offer real-time and lightweight advantages. However, traditional linear probes struggle to capture nonlinear structures in deep semantic spaces.To overcome these limitations, we propose a neural network-based framework for token-level hallucination detection. By freezing language model parameters, we employ lightweight MLP probes to perform nonlinear modeling of high-level hidden states. A multi-objective joint loss function is designed to enhance detection stability and semantic disambiguity. Additionally, we establish a layer position-probe performance response model, using Bayesian optimization to automatically search for optimal probe insertion layers and achieve superior training results.Experimental results on LongFact, HealthBench, and TriviaQA demonstrate that MLP probes significantly outperform state-of-the-art methods in accuracy, recall, and detection capability under low false-positive conditions.

Real-world clinical diagnosis is a complex process in which the doctor is required to obtain information from both interaction with the patient and conducting medical exams. Additionally, the doctor needs to adapt to different patient personas, as well as noisy and incomplete information that can happen at any time during the process. However, existing benchmarks for medical LLMs and methods for automatic diagnosis largely simplify this process by reducing it to single-turn question answering, noise-free conversations, or sequential exam making, etc., ignoring the interactive and uncertain nature of clinical diagnosis. In this paper, we aim to address this gap by formalizing clinical diagnosis as a Partially Observable Markov Decision Process (POMDP) with three action types: questioning the patient, ordering medical exams as tool calls, and issuing a diagnosis. We also introduce a systematic noise model comprising seven patient noise types and three exam noise types. Using our proposed environment, we train an effective diagnosis agent, MedExAgent, through a two-stage pipeline that first performs supervised finetuning on synthetic conversations structured after the Calgary-Cambridge model for clinical interviews, and then applies DAPO to optimize a composite reward capturing diagnostic accuracy, tool call quality, and exam cost including financial cost and patient discomfort. Through extensive experiments and ablation studies, we demonstrate that MedExAgent achieves diagnostic performance comparable to larger models while maintaining cost-efficient examination strategies.

Most of the recent works on probing representations have focused on BERT, with the presumption that the findings might be similar to the other models. In this work, we extend the probing studies to two other models in the family, namely ELECTRA and XLNet, showing that variations in the pre-training objectives or architectural choices can result in different behaviors in encoding linguistic information in the representations. Most notably, we observe that ELECTRA tends to encode linguistic knowledge in the deeper layers, whereas XLNet instead concentrates that in the earlier layers. Also, the former model undergoes a slight change during fine-tuning, whereas the latter experiences significant adjustments. Moreover, we show that drawing conclusions based on the weight mixing evaluation strategy -- which is widely used in the context of layer-wise probing -- can be misleading given the norm disparity of the representations across different layers. Instead, we adopt an alternative information-theoretic probing with minimum description length, which has recently been proven to provide more reliable and informative results.

Accurate diagnosis with medical large language models is hindered by knowledge gaps and hallucinations. Retrieval and tool-augmented methods help, but their impact is limited by weak use of external knowledge and poor feedback-reasoning traceability. To address these challenges, We introduce Deep-DxSearch, an agentic RAG system trained end-to-end with reinforcement learning (RL) that enables steer tracebale retrieval-augmented reasoning for medical diagnosis. In Deep-DxSearch, we first construct a large-scale medical retrieval corpus comprising patient records and reliable medical knowledge sources to support retrieval-aware reasoning across diagnostic scenarios. More crutially, we frame the LLM as the core agent and the retrieval corpus as its environment, using tailored rewards on format, retrieval, reasoning structure, and diagnostic accuracy, thereby evolving the agentic RAG policy from large-scale data through RL. Experiments demonstrate that our end-to-end agentic RL training framework consistently outperforms prompt-engineering and training-free RAG approaches across multiple data centers. After training, Deep-DxSearch achieves substantial gains in diagnostic accuracy, surpassing strong diagnostic baselines such as GPT-4o, DeepSeek-R1, and other medical-specific frameworks for both common and rare disease diagnosis under in-distribution and out-of-distribution settings. Moreover, ablation studies on reward design and retrieval corpus components confirm their critical roles, underscoring the uniqueness and effectiveness of our approach compared with traditional implementations. Finally, case studies and interpretability analyses highlight improvements in Deep-DxSearch's diagnostic policy, providing deeper insight into its performance gains and supporting clinicians in delivering more reliable and precise preliminary diagnoses. See https://github.com/MAGIC-AI4Med/Deep-DxSearch.

Recently, efficient fine-tuning of large-scale pre-trained models has attracted increasing research interests, where linear probing (LP) as a fundamental module is involved in exploiting the final representations for task-dependent classification. However, most of the existing methods focus on how to effectively introduce a few of learnable parameters, and little work pays attention to the commonly used LP module. In this paper, we propose a novel Moment Probing (MP) method to further explore the potential of LP. Distinguished from LP which builds a linear classification head based on the mean of final features (e.g., word tokens for ViT) or classification tokens, our MP performs a linear classifier on feature distribution, which provides the stronger representation ability by exploiting richer statistical information inherent in features. Specifically, we represent feature distribution by its characteristic function, which is efficiently approximated by using first- and second-order moments of features. Furthermore, we propose a multi-head convolutional cross-covariance (MHC^3) to compute second-order moments in an efficient and effective manner. By considering that MP could affect feature learning, we introduce a partially shared module to learn two recalibrating parameters (PSRP) for backbones based on MP, namely MP_{+}. Extensive experiments on ten benchmarks using various models show that our MP significantly outperforms LP and is competitive with counterparts at less training cost, while our MP_{+} achieves state-of-the-art performance.

As LLM-based judges become integral to industry applications, obtaining well-calibrated uncertainty estimates efficiently has become critical for production deployment. However, existing techniques, such as verbalized confidence and multi-generation methods, are often either poorly calibrated or computationally expensive. We introduce linear probes trained with a Brier score-based loss to provide calibrated uncertainty estimates from reasoning judges' hidden states, requiring no additional model training. We evaluate our approach on both objective tasks (reasoning, mathematics, factuality, coding) and subjective human preference judgments. Our results demonstrate that probes achieve superior calibration compared to existing methods with approx10x computational savings, generalize robustly to unseen evaluation domains, and deliver higher accuracy on high-confidence predictions. However, probes produce conservative estimates that underperform on easier datasets but may benefit safety-critical deployments prioritizing low false-positive rates. Overall, our work demonstrates that interpretability-based uncertainty estimation provides a practical and scalable plug-and-play solution for LLM judges in production.

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 (LLMs) have impressive capabilities, but are prone to outputting falsehoods. Recent work has developed techniques for inferring whether a LLM is telling the truth by training probes on the LLM's internal activations. However, this line of work is controversial, with some authors pointing out failures of these probes to generalize in basic ways, among other conceptual issues. In this work, we use high-quality datasets of simple true/false statements to study in detail the structure of LLM representations of truth, drawing on three lines of evidence: 1. Visualizations of LLM true/false statement representations, which reveal clear linear structure. 2. Transfer experiments in which probes trained on one dataset generalize to different datasets. 3. Causal evidence obtained by surgically intervening in a LLM's forward pass, causing it to treat false statements as true and vice versa. Overall, we present evidence that at sufficient scale, LLMs linearly represent the truth or falsehood of factual statements. We also show that simple difference-in-mean probes generalize as well as other probing techniques while identifying directions which are more causally implicated in model outputs.

This work explores whether language models encode meaningfully grounded representations of sounds of objects. We learn a linear probe that retrieves the correct text representation of an object given a snippet of audio related to that object, where the sound representation is given by a pretrained audio model. This probe is trained via a contrastive loss that pushes the language representations and sound representations of an object to be close to one another. After training, the probe is tested on its ability to generalize to objects that were not seen during training. Across different language models and audio models, we find that the probe generalization is above chance in many cases, indicating that despite being trained only on raw text, language models encode grounded knowledge of sounds for some objects.

Diagnosing a whole-slide image is an interactive, multi-stage process involving changes in magnification and movement between fields. Although recent pathology foundation models are strong, practical agentic systems that decide what field to examine next, adjust magnification, and deliver explainable diagnoses are still lacking. The blocker is data: scalable, clinically aligned supervision of expert viewing behavior that is tacit and experience-based, not written in textbooks or online, and therefore absent from large language model training. We introduce the AI Session Recorder, which works with standard WSI viewers to unobtrusively record routine navigation and convert the viewer logs into standardized behavioral commands (inspect or peek at discrete magnifications) and bounding boxes. A lightweight human-in-the-loop review turns AI-drafted rationales into the Pathology-CoT dataset, a form of paired "where to look" and "why it matters" supervision produced at roughly six times lower labeling time. Using this behavioral data, we build Pathologist-o3, a two-stage agent that first proposes regions of interest and then performs behavior-guided reasoning. On gastrointestinal lymph-node metastasis detection, it achieved 84.5% precision, 100.0% recall, and 75.4% accuracy, exceeding the state-of-the-art OpenAI o3 model and generalizing across backbones. To our knowledge, this constitutes one of the first behavior-grounded agentic systems in pathology. Turning everyday viewer logs into scalable, expert-validated supervision, our framework makes agentic pathology practical and establishes a path to human-aligned, upgradeable clinical AI.

AI models might use deceptive strategies as part of scheming or misaligned behaviour. Monitoring outputs alone is insufficient, since the AI might produce seemingly benign outputs while their internal reasoning is misaligned. We thus evaluate if linear probes can robustly detect deception by monitoring model activations. We test two probe-training datasets, one with contrasting instructions to be honest or deceptive (following Zou et al., 2023) and one of responses to simple roleplaying scenarios. We test whether these probes generalize to realistic settings where Llama-3.3-70B-Instruct behaves deceptively, such as concealing insider trading (Scheurer et al., 2023) and purposely underperforming on safety evaluations (Benton et al., 2024). We find that our probe distinguishes honest and deceptive responses with AUROCs between 0.96 and 0.999 on our evaluation datasets. If we set the decision threshold to have a 1% false positive rate on chat data not related to deception, our probe catches 95-99% of the deceptive responses. Overall we think white-box probes are promising for future monitoring systems, but current performance is insufficient as a robust defence against deception. Our probes' outputs can be viewed at data.apolloresearch.ai/dd and our code at github.com/ApolloResearch/deception-detection.

Mechanistic interpretability aims to understand neural networks by identifying which learned features mediate specific behaviors. Attribution graphs reveal these feature pathways, but interpreting them requires extensive manual analysis -- a single prompt can take approximately 2 hours for an experienced circuit tracer. We present probe prompting, an automated pipeline that transforms attribution graphs into compact, interpretable subgraphs built from concept-aligned supernodes. Starting from a seed prompt and target logit, we select high-influence features, generate concept-targeted yet context-varying probes, and group features by cross-prompt activation signatures into Semantic, Relationship, and Say-X categories using transparent decision rules. Across five prompts including classic "capitals" circuits, probe-prompted subgraphs preserve high explanatory coverage while compressing complexity (Completeness 0.83, mean across circuits; Replacement 0.54). Compared to geometric clustering baselines, concept-aligned groups exhibit higher behavioral coherence: 2.3x higher peak-token consistency (0.425 vs 0.183) and 5.8x higher activation-pattern similarity (0.762 vs 0.130), despite lower geometric compactness. Entity-swap tests reveal a layerwise hierarchy: early-layer features transfer robustly (64% transfer rate, mean layer 6.3), while late-layer Say-X features specialize for output promotion (mean layer 16.4), supporting a backbone-and-specialization view of transformer computation. We release code (https://github.com/peppinob-ol/attribution-graph-probing), an interactive demo (https://huggingface.co/spaces/Peppinob/attribution-graph-probing), and minimal artifacts enabling immediate reproduction and community adoption.

Medical images and radiology reports are crucial for diagnosing medical conditions, highlighting the importance of quantitative analysis for clinical decision-making. However, the diversity and cross-source heterogeneity of these data challenge the generalizability of current data-mining methods. Multimodal large language models (MLLMs) have recently transformed many domains, significantly affecting the medical field. Notably, Gemini-Vision-series (Gemini) and GPT-4-series (GPT-4) models have epitomized a paradigm shift in Artificial General Intelligence (AGI) for computer vision, showcasing their potential in the biomedical domain. In this study, we evaluated the performance of the Gemini, GPT-4, and 4 popular large models for an exhaustive evaluation across 14 medical imaging datasets, including 5 medical imaging categories (dermatology, radiology, dentistry, ophthalmology, and endoscopy), and 3 radiology report datasets. The investigated tasks encompass disease classification, lesion segmentation, anatomical localization, disease diagnosis, report generation, and lesion detection. Our experimental results demonstrated that Gemini-series models excelled in report generation and lesion detection but faces challenges in disease classification and anatomical localization. Conversely, GPT-series models exhibited proficiency in lesion segmentation and anatomical localization but encountered difficulties in disease diagnosis and lesion detection. Additionally, both the Gemini series and GPT series contain models that have demonstrated commendable generation efficiency. While both models hold promise in reducing physician workload, alleviating pressure on limited healthcare resources, and fostering collaboration between clinical practitioners and artificial intelligence technologies, substantial enhancements and comprehensive validations remain imperative before clinical deployment.

Chest X-ray plays a central role in thoracic diagnosis, and its interpretation inherently requires multi-step, evidence-grounded reasoning. However, large vision-language models (LVLMs) often generate plausible responses that are not faithfully grounded in diagnostic evidence and provide limited visual evidence for verification, while also requiring costly retraining to support new diagnostic tasks, limiting their reliability and adaptability in clinical settings. To address these limitations, we present CXReasonAgent, a diagnostic agent that integrates a large language model (LLM) with clinically grounded diagnostic tools to perform evidence-grounded diagnostic reasoning using image-derived diagnostic and visual evidence. To evaluate these capabilities, we introduce CXReasonDial, a multi-turn dialogue benchmark with 1,946 dialogues across 12 diagnostic tasks, and show that CXReasonAgent produces faithfully grounded responses, enabling more reliable and verifiable diagnostic reasoning than LVLMs. These findings highlight the importance of integrating clinically grounded diagnostic tools, particularly in safety-critical clinical settings.

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

Neural language models (LMs) can be used to evaluate the truth of factual statements in two ways: they can be either queried for statement probabilities, or probed for internal representations of truthfulness. Past work has found that these two procedures sometimes disagree, and that probes tend to be more accurate than LM outputs. This has led some researchers to conclude that LMs "lie" or otherwise encode non-cooperative communicative intents. Is this an accurate description of today's LMs, or can query-probe disagreement arise in other ways? We identify three different classes of disagreement, which we term confabulation, deception, and heterogeneity. In many cases, the superiority of probes is simply attributable to better calibration on uncertain answers rather than a greater fraction of correct, high-confidence answers. In some cases, queries and probes perform better on different subsets of inputs, and accuracy can further be improved by ensembling the two. Code is available at github.com/lingo-mit/lm-truthfulness.

While pretrained models such as BERT have shown large gains across natural language understanding tasks, their performance can be improved by further training the model on a data-rich intermediate task, before fine-tuning it on a target task. However, it is still poorly understood when and why intermediate-task training is beneficial for a given target task. To investigate this, we perform a large-scale study on the pretrained RoBERTa model with 110 intermediate-target task combinations. We further evaluate all trained models with 25 probing tasks meant to reveal the specific skills that drive transfer. We observe that intermediate tasks requiring high-level inference and reasoning abilities tend to work best. We also observe that target task performance is strongly correlated with higher-level abilities such as coreference resolution. However, we fail to observe more granular correlations between probing and target task performance, highlighting the need for further work on broad-coverage probing benchmarks. We also observe evidence that the forgetting of knowledge learned during pretraining may limit our analysis, highlighting the need for further work on transfer learning methods in these settings.

Despite their capabilities, Large Language Models (LLMs) remain opaque with limited understanding of their internal representations. Current interpretability methods, such as direct logit attribution (DLA) and sparse autoencoders (SAEs), provide restricted insight due to limitations such as the model's output vocabulary or unclear feature names. This work introduces Hyperdimensional Probe, a novel paradigm for decoding information from the LLM vector space. It combines ideas from symbolic representations and neural probing to project the model's residual stream into interpretable concepts via Vector Symbolic Architectures (VSAs). This probe combines the strengths of SAEs and conventional probes while overcoming their key limitations. We validate our decoding paradigm with controlled input-completion tasks, probing the model's final state before next-token prediction on inputs spanning syntactic pattern recognition, key-value associations, and abstract inference. We further assess it in a question-answering setting, examining the state of the model both before and after text generation. Our experiments show that our probe reliably extracts meaningful concepts across varied LLMs, embedding sizes, and input domains, also helping identify LLM failures. Our work advances information decoding in LLM vector space, enabling extracting more informative, interpretable, and structured features from neural representations.

This paper presents our team's participation in the MEDIQA-ClinicalNLP2024 shared task B. We present a novel approach to diagnosing clinical dermatology cases by integrating large multimodal models, specifically leveraging the capabilities of GPT-4V under a retriever and a re-ranker framework. Our investigation reveals that GPT-4V, when used as a retrieval agent, can accurately retrieve the correct skin condition 85% of the time using dermatological images and brief patient histories. Additionally, we empirically show that Naive Chain-of-Thought (CoT) works well for retrieval while Medical Guidelines Grounded CoT is required for accurate dermatological diagnosis. Further, we introduce a Multi-Agent Conversation (MAC) framework and show its superior performance and potential over the best CoT strategy. The experiments suggest that using naive CoT for retrieval and multi-agent conversation for critique-based diagnosis, GPT-4V can lead to an early and accurate diagnosis of dermatological conditions. The implications of this work extend to improving diagnostic workflows, supporting dermatological education, and enhancing patient care by providing a scalable, accessible, and accurate diagnostic tool.

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.

MRI is an indispensable clinical tool, offering a rich variety of tissue contrasts to support broad diagnostic and research applications. Clinical exams routinely acquire multiple structural sequences that provide complementary information for differential diagnosis, while research protocols often incorporate advanced functional, diffusion, spectroscopic, and relaxometry sequences to capture multidimensional insights into tissue structure and composition. However, these capabilities come at the cost of prolonged scan times, which reduce patient throughput, increase susceptibility to motion artifacts, and may require trade-offs in image quality or diagnostic scope. Over the last two decades, advances in image reconstruction algorithms--alongside improvements in hardware and pulse sequence design--have made it possible to accelerate acquisitions while preserving diagnostic quality. Central to this progress is the ability to incorporate prior information to regularize the solutions to the reconstruction problem. In this tutorial, we overview the basics of MRI reconstruction and highlight state-of-the-art approaches, beginning with classical methods that rely on explicit hand-crafted priors, and then turning to deep learning methods that leverage a combination of learned and crafted priors to further push the performance envelope. We also explore the translational aspects and eventual clinical implications of these methods. We conclude by discussing future directions to address remaining challenges in MRI reconstruction. The tutorial is accompanied by a Python toolbox (https://github.com/tutorial-MRI-recon/tutorial) to demonstrate select methods discussed in the article.

Generalist foundation models such as GPT-4 have displayed surprising capabilities in a wide variety of domains and tasks. Yet, there is a prevalent assumption that they cannot match specialist capabilities of fine-tuned models. For example, most explorations to date on medical competency benchmarks have leveraged domain-specific training, as exemplified by efforts on BioGPT and Med-PaLM. We build on a prior study of GPT-4's capabilities on medical challenge benchmarks in the absence of special training. Rather than using simple prompting to highlight the model's out-of-the-box capabilities, we perform a systematic exploration of prompt engineering. We find that prompting innovation can unlock deeper specialist capabilities and show that GPT-4 easily tops prior leading results for medical benchmarks. The prompting methods we explore are general purpose, and make no specific use of domain expertise, removing the need for expert-curated content. Our experimental design carefully controls for overfitting during the prompt engineering process. We introduce Medprompt, based on a composition of several prompting strategies. With Medprompt, GPT-4 achieves state-of-the-art results on all nine of the benchmark datasets in the MultiMedQA suite. The method outperforms leading specialist models such as Med-PaLM 2 by a significant margin with an order of magnitude fewer calls to the model. Steering GPT-4 with Medprompt achieves a 27% reduction in error rate on the MedQA dataset over the best methods to date achieved with specialist models and surpasses a score of 90% for the first time. Beyond medical problems, we show the power of Medprompt to generalize to other domains and provide evidence for the broad applicability of the approach via studies of the strategy on exams in electrical engineering, machine learning, philosophy, accounting, law, nursing, and clinical psychology.

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.

In most Vision-Language models (VL), the understanding of the image structure is enabled by injecting the position information (PI) about objects in the image. In our case study of LXMERT, a state-of-the-art VL model, we probe the use of the PI in the representation and study its effect on Visual Question Answering. We show that the model is not capable of leveraging the PI for the image-text matching task on a challenge set where only position differs. Yet, our experiments with probing confirm that the PI is indeed present in the representation. We introduce two strategies to tackle this: (i) Positional Information Pre-training and (ii) Contrastive Learning on PI using Cross-Modality Matching. Doing so, the model can correctly classify if images with detailed PI statements match. Additionally to the 2D information from bounding boxes, we introduce the object's depth as new feature for a better object localization in the space. Even though we were able to improve the model properties as defined by our probes, it only has a negligible effect on the downstream performance. Our results thus highlight an important issue of multimodal modeling: the mere presence of information detectable by a probing classifier is not a guarantee that the information is available in a cross-modal setup.

In this paper, we compare and evaluate different testing protocols used for automatic COVID-19 diagnosis from X-Ray images in the recent literature. We show that similar results can be obtained using X-Ray images that do not contain most of the lungs. We are able to remove the lungs from the images by turning to black the center of the X-Ray scan and training our classifiers only on the outer part of the images. Hence, we deduce that several testing protocols for the recognition are not fair and that the neural networks are learning patterns in the dataset that are not correlated to the presence of COVID-19. Finally, we show that creating a fair testing protocol is a challenging task, and we provide a method to measure how fair a specific testing protocol is. In the future research we suggest to check the fairness of a testing protocol using our tools and we encourage researchers to look for better techniques than the ones that we propose.

Echocardiography is crucial for cardiovascular disease detection but relies heavily on experienced sonographers. Echocardiography probe guidance systems, which provide real-time movement instructions for acquiring standard plane images, offer a promising solution for AI-assisted or fully autonomous scanning. However, developing effective machine learning models for this task remains challenging, as they must grasp heart anatomy and the intricate interplay between probe motion and visual signals. To address this, we present EchoWorld, a motion-aware world modeling framework for probe guidance that encodes anatomical knowledge and motion-induced visual dynamics, while effectively leveraging past visual-motion sequences to enhance guidance precision. EchoWorld employs a pre-training strategy inspired by world modeling principles, where the model predicts masked anatomical regions and simulates the visual outcomes of probe adjustments. Built upon this pre-trained model, we introduce a motion-aware attention mechanism in the fine-tuning stage that effectively integrates historical visual-motion data, enabling precise and adaptive probe guidance. Trained on more than one million ultrasound images from over 200 routine scans, EchoWorld effectively captures key echocardiographic knowledge, as validated by qualitative analysis. Moreover, our method significantly reduces guidance errors compared to existing visual backbones and guidance frameworks, excelling in both single-frame and sequential evaluation protocols. Code is available at https://github.com/LeapLabTHU/EchoWorld.

Recent attacks show that behavioural unlearning of large language models leaves internal traces recoverable by adversarial probes. We characterise where this retention lives and show it can be surgically removed without measurable capability cost. Our central protocol is a leave-one-out cross-sequence probe that tests whether a memorisation signature generalises across held-out sequences. The signature is real and consistent across scale: memorisation-specific gaps of +0.32, +0.19, +0.30 on Pythia-70M, GPT-2 medium, and Mistral-7B; on Pythia-70M, the random-initialisation control collapses to -0.04 at the deepest layer where the pretrained signature peaks. The probe direction is causally separable from recall -- projecting it out collapses the signature locally (+0.44 -> -0.19) while behavioural recall barely changes -- and a probe trained on naturally memorised content does not classify fine-tuning-injected secrets, marking two representationally distinct regimes. We then introduce probe-geometry alignment (PGA), a surgical erasure that aligns activations along the probe's live readout direction at each depth. PGA drives the cross-sequence probe below random chance at all four scales tested (toy depth-4: 0.17; Pythia-70M: 0.07; Mistral-7B: 0.45; GPT-2 medium: 0.06 via MD-PGA k=2) and remains robust to six adversarial probe variants. Against a re-fitting attacker who trains a fresh probe on PGA-treated activations, we extend PGA adversarially, defeating the re-fit probe at every memorisation-relevant depth while preserving five zero-shot capability benchmarks within 2.8 percentage points per task (mean Δacc = +0.2pp). The cross-sequence signature is a real, causally separable, regime-specific property of pretrained representations -- removable below chance with a single rank-one intervention per depth at no measurable capability cost.

Large language models (LLMs) show promise in medical diagnosis, but real-world deployment remains challenging due to high-stakes clinical decisions and imperfect reasoning reliability. As a result, careful inspection of model behavior is essential for assessing whether diagnostic reasoning is reliable and clinically grounded. However, debugging medical LLMs remains difficult. First, developers often lack sufficient medical domain expertise to interpret model errors in clinically meaningful terms. Second, models can fail across a large and diverse set of instances involving different input types, tasks, and reasoning steps, making it challenging for developers to prioritize which errors deserve focused inspection. Third, developers struggle to identify recurring error patterns across cases, as existing debugging practices are largely instance-centric and rely on manual inspection of isolated failures. To address these challenges, we present VeriLLMed, a visual analytics system that integrates external biomedical knowledge to audit and debug medical LLM diagnostic reasoning. VeriLLMed transforms model outputs into comparable reasoning paths, constructs knowledge graph-grounded reference paths, and identifies three recurring classes of diagnosis errors: relation errors, branch errors, and missing errors. Case studies and expert evaluation demonstrate that VeriLLMed helps developers identify clinically implausible reasoning and generate actionable insights that can inform the improvement of medical LLMs.

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.

Language models excel at diagnostic assessments on currated medical case-studies and vignettes, performing on par with, or better than, clinical professionals. However, existing studies focus on complex scenarios with rich context making it difficult to draw conclusions about how these systems perform for patients reporting symptoms in everyday life. We deployed SymptomAI, a set of conversational AI agents for end-to-end patient interviewing and differential diagnosis (DDx), via the Fitbit app in a study that randomized participants (N=13,917) to interact with five AI agents. This corpus captures diverse communication and a realistic distribution of illnesses from a real world population. A subset of 1,228 participants reported a clinician-provided diagnosis, and 517 of these were further evaluated by a panel of clinicians during over 250 hours of annotation. SymptomAI DDx were significantly more accurate (OR = 2.47, p < 0.001) than those from independent clinicians given the same dialogue in a blinded randomized comparison. Moreover, agentic strategies which conduct a dedicated symptom interview that elicit additional symptom information before providing a diagnosis, perform substantially better than baseline, user-guided conversations (p < 0.001). An auxiliary analysis on 1,509 conversations from a general US population panel validated that these results generalize beyond wearable device users. We used SymptomAI diagnoses as labels for all 13,917 participants to analyze over 500,000 days of wearable metrics across nearly 400 unique conditions. We identified strong associations between acute infections and physiological shifts (e.g., OR > 7 for influenza). While limited by self-reported ground truth, these results demonstrate the benefits of a dedicated and complete symptom interview compared to a user-guided symptom discussion, which is the default of most consumer LLMs.

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.

Through a controlled study, we identify a systematic deficiency in the multimodal grounding of Vision Language Models (VLMs). While VLMs can recall factual associations when provided a textual reference to an entity; their ability to do so is significantly diminished when the reference is visual instead. Forcing VLMs to rely on image representations of an entity halves their ability to recall factual knowledge, suggesting that VLMs struggle to link their internal knowledge of an entity with its image representation. We show that such linking failures are correlated with the expression of distinct patterns in model internal states, and that probes on these internal states achieve over 92% accuracy at flagging cases where the VLM response is unreliable. These probes can be applied, without retraining, to identify when a VLM will fail to correctly answer a question that requires an understanding of multimodal input. When used to facilitate selective prediction on a visual question answering task, the probes increase coverage by 7.87% (absolute) while also reducing the risk of error by 0.9% (absolute). Addressing the systematic, detectable deficiency is an important avenue in language grounding, and we provide informed recommendations for future directions.

Mechanistic interpretability seeks to understand the internal mechanisms of machine learning models, where localization -- identifying the important model components -- is a key step. Activation patching, also known as causal tracing or interchange intervention, is a standard technique for this task (Vig et al., 2020), but the literature contains many variants with little consensus on the choice of hyperparameters or methodology. In this work, we systematically examine the impact of methodological details in activation patching, including evaluation metrics and corruption methods. In several settings of localization and circuit discovery in language models, we find that varying these hyperparameters could lead to disparate interpretability results. Backed by empirical observations, we give conceptual arguments for why certain metrics or methods may be preferred. Finally, we provide recommendations for the best practices of activation patching going forwards.

Bold claims about AI's role in science-from "AGI will cure all diseases" to promises of radically accelerated discovery-raise a central epistemic question: do large language models (LLMs) truly generate new knowledge, or do they merely remix memorized fragments? We propose unlearning-as-ablation as a falsifiable probe of constructive scientific discovery. The idea is to systematically remove a target result together with its forget-closure (supporting lemmas, paraphrases, and multi-hop entailments) and then evaluate whether the model can re-derive the result from only permitted axioms and tools. Success would indicate generative capability beyond recall; failure would expose current limits. Unlike prevailing motivations for unlearning-privacy, copyright, or safety-our framing repositions it as an epistemic probe for AI-for-Science. We outline a minimal pilot in mathematics and algorithms to illustrate feasibility, and sketch how the same approach could later be extended to domains such as physics or chemistry. This is a position paper: our contribution is conceptual and methodological, not empirical. We aim to stimulate discussion on how principled ablation tests could help distinguish models that reconstruct knowledge from those that merely retrieve it, and how such probes might guide the next generation of AI-for-Science benchmarks.

Given the dominance of dense retrievers that do not generalize well beyond their training dataset distributions, domain-specific test sets are essential in evaluating retrieval. There are few test datasets for retrieval systems intended for use by healthcare providers in a point-of-care setting. To fill this gap we have collaborated with medical professionals to create CURE, an ad-hoc retrieval test dataset for passage ranking with 2000 queries spanning 10 medical domains with a monolingual (English) and two cross-lingual (French/Spanish -> English) conditions. In this paper, we describe how CURE was constructed and provide baseline results to showcase its effectiveness as an evaluation tool. CURE is published with a Creative Commons Attribution Non Commercial 4.0 license and can be accessed on Hugging Face.

High-quality training data has proven crucial for developing performant large language models (LLMs). However, commercial LLM providers disclose few, if any, details about the data used for training. This lack of transparency creates multiple challenges: it limits external oversight and inspection of LLMs for issues such as copyright infringement, it undermines the agency of data authors, and it hinders scientific research on critical issues such as data contamination and data selection. How can we recover what training data is known to LLMs? In this work, we demonstrate a new method to identify training data known to proprietary LLMs like GPT-4 without requiring any access to model weights or token probabilities, by using information-guided probes. Our work builds on a key observation: text passages with high surprisal are good search material for memorization probes. By evaluating a model's ability to successfully reconstruct high-surprisal tokens in text, we can identify a surprising number of texts memorized by LLMs.

We study and explore the low scale implications of Yukawa unification in the minimal gauge mediated supersymmetry breaking models. We also assume non-zero non-holomorphic terms, with which the YU solutions can be accommodated in the cases with μ> 0. These results can be considered a direct effect from the non-holomorphic terms, but they also lead to testable low scale implications compatible with YU. We observe abundant solutions consistent with the Higgs boson mass. This constraint leads to heavy strongly interacting supersymmetric particles, while the electroweak sector can be realized relatively lighter and they can be probed by several experiments. We find that the chargino can be lighter than 1 TeV and it is degenerate with the lightest neutralino in most of such solutions. Consistent solutions in this region can accommodate charginos as light as about 120 GeV, and they will be tested more likely soon by the analyses over the compressed spectra. These solutions are also be subjected in the lifetime analyses. Our analyses identify such light charginos decaying in about 10^{-2} ns. Probing such points may need a slight improvement in sensitivity of the analyses, and one can expect them to be tested very soon. In the same region, stau is realized to be another light supersymmetric particle, and some of the solutions can be inconsistently lighter. We find that it can weigh as light as about 600 GeV consistently, and it can be tested also soon over its lifetime. We summarize and also exemplify our findings with five benchmark scenarios. Most of the benchmark solutions also reveal that the solutions can be tested in heavy Higgs boson searches, which shape the whole Higgs boson spectrum in models.

Large language models (LLMs) achieve promising performance, yet their ability to reason remains poorly understood. Existing evaluations largely emphasize task-level accuracy, often conflating pattern matching with reasoning capability. We present X-RAY, an explainable reasoning analysis system that maps the LLM reasoning capability using calibrated, formally verified probes. We model reasoning capability as a function of extractable structure, operationalized through formal properties such as constraint interaction, reasoning depth, and solution-space geometry. X-Ray generates probes via formal tools with controlled structural variations, enabling precise isolation of incremental structural information through formal calibration and verification. We evaluate state-of-the-art LLMs on problems ranging from junior-level to advanced in mathematics, physics, and chemistry. Our analysis reveals a systematic asymmetry in LLM reasoning: models are relatively robust to constraint refinement, where additional conditions shrink an existing solution space, but degrade sharply under solution-space restructuring, where modifications alter the underlying structural form of the solution manifold. Moreover, calibrated formal probes differentiate models that appear indistinguishable on standard benchmarks and reveal failure modes that are structurally interpretable rather than opaque. Beyond evaluation, our framework is contamination-free and supports the training and testing of reasoning models.

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

We develop and evaluate a data-driven approach for detecting unusual (anomalous) patient-management actions using past patient cases stored in an electronic health record (EHR) system. Our hypothesis is that patient-management actions that are unusual with respect to past patients may be due to a potential error and that it is worthwhile to raise an alert if such a condition is encountered. We evaluate this hypothesis using data obtained from the electronic health records of 4,486 post-cardiac surgical patients. We base the evaluation on the opinions of a panel of experts. The results support that anomaly-based alerting can have reasonably low false alert rates and that stronger anomalies are correlated with higher alert rates.

Identifying, tracking, and predicting wound heal-stage progression is a fundamental task towards proper diagnosis, effective treatment, facilitating healing, and reducing pain. Traditionally, a medical expert might observe a wound to determine the current healing state and recommend treatment. However, sourcing experts who can produce such a diagnosis solely from visual indicators can be difficult, time-consuming and expensive. In addition, lesions may take several weeks to undergo the healing process, demanding resources to monitor and diagnose continually. Automating this task can be challenging; datasets that follow wound progression from onset to maturation are small, rare, and often collected without computer vision in mind. To tackle these challenges, we introduce a self-supervised learning scheme composed of (a) learning embeddings of wound's temporal dynamics, (b) clustering for automatic stage discovery, and (c) fine-tuned classification. The proposed self-supervised and flexible learning framework is biologically inspired and trained on a small dataset with zero human labeling. The HealNet framework achieved high pre-text and downstream classification accuracy; when evaluated on held-out test data, HealNet achieved 97.7% pre-text accuracy and 90.62% heal-stage classification accuracy.

Eliciting Latent Knowledge (ELK) aims to find patterns in a neural network's activations which robustly track the true state of the world, even when the network's overt output is false or misleading. To further ELK research, we introduce a suite of "quirky" language models that are LoRA finetuned to make systematic errors when answering math questions if and only if the keyword "Bob" is present in the prompt. We demonstrate that simple probing methods can elicit the model's latent knowledge of the correct answer in these contexts, even for problems harder than those the probe was trained on. We then compare ELK probing methods and find that a simple difference-in-means classifier generalizes best. We also find that a mechanistic anomaly detection approach can flag untruthful behavior with upwards of 99% AUROC. Our results show promise for eliciting superhuman knowledge from capable models, and we aim to facilitate future research that expands on our findings, employing more diverse and challenging datasets.

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.

Automated clinical diagnosis remains a core challenge in medical AI, which usually requires models to integrate multi-modal data and reason across complex, case-specific contexts. Although recent methods have advanced medical report generation (MRG) and visual question answering (VQA) with medical vision-language models (VLMs), these methods, however, predominantly operate under a sample-isolated inference paradigm, as such processing cases independently without access to longitudinal electronic health records (EHRs) or structurally related patient examples. This paradigm limits reasoning to image-derived information alone, which ignores external complementary medical evidence for potentially more accurate diagnosis. To overcome this limitation, we propose HyperWalker, a Deep Diagnosis framework that reformulates clinical reasoning via dynamic hypergraphs and test-time training. First, we construct a dynamic hypergraph, termed iBrochure, to model the structural heterogeneity of EHR data and implicit high-order associations among multimodal clinical information. Within this hypergraph, a reinforcement learning agent, Walker, navigates to and identifies optimal diagnostic paths. To ensure comprehensive coverage of diverse clinical characteristics in test samples, we incorporate a linger mechanism, a multi-hop orthogonal retrieval strategy that iteratively selects clinically complementary neighborhood cases reflecting distinct clinical attributes. Experiments on MRG with MIMIC and medical VQA on EHRXQA demonstrate that HyperWalker achieves state-of-the-art performance. Code is available at: https://github.com/Bean-Young/HyperWalker

Generalist Large Language Models (LLMs), such as GPT-4, have shown considerable promise in various domains, including medical diagnosis. Rare diseases, affecting approximately 300 million people worldwide, often have unsatisfactory clinical diagnosis rates primarily due to a lack of experienced physicians and the complexity of differentiating among many rare diseases. In this context, recent news such as "ChatGPT correctly diagnosed a 4-year-old's rare disease after 17 doctors failed" underscore LLMs' potential, yet underexplored, role in clinically diagnosing rare diseases. To bridge this research gap, we introduce RareBench, a pioneering benchmark designed to systematically evaluate the capabilities of LLMs on 4 critical dimensions within the realm of rare diseases. Meanwhile, we have compiled the largest open-source dataset on rare disease patients, establishing a benchmark for future studies in this domain. To facilitate differential diagnosis of rare diseases, we develop a dynamic few-shot prompt methodology, leveraging a comprehensive rare disease knowledge graph synthesized from multiple knowledge bases, significantly enhancing LLMs' diagnostic performance. Moreover, we present an exhaustive comparative study of GPT-4's diagnostic capabilities against those of specialist physicians. Our experimental findings underscore the promising potential of integrating LLMs into the clinical diagnostic process for rare diseases. This paves the way for exciting possibilities in future advancements in this field.

Rare diseases affect hundreds of millions worldwide, yet diagnosis often spans years. Convectional pipelines decouple noisy evidence extraction from downstream inferential diagnosis, and general/medical large language models (LLMs) face scarce real world electronic health records (EHRs), stale domain knowledge, and hallucinations. We assemble a large, domain specialized clinical corpus and a clinician validated reasoning set, and develop RareSeek R1 via staged instruction tuning, chain of thought learning, and graph grounded retrieval. Across multicenter EHR narratives and public benchmarks, RareSeek R1 attains state of the art accuracy, robust generalization, and stability under noisy or overlapping phenotypes. Augmented retrieval yields the largest gains when narratives pair with prioritized variants by resolving ambiguity and aligning candidates to mechanisms. Human studies show performance on par with experienced physicians and consistent gains in assistive use. Notably, transparent reasoning highlights decisive non phenotypic evidence (median 23.1%, such as imaging, interventions, functional tests) underpinning many correct diagnoses. This work advances a narrative first, knowledge integrated reasoning paradigm that shortens the diagnostic odyssey and enables auditable, clinically translatable decision support.

Mechanistic interpretability research on emotion in large language models -- linear probing, activation patching, sparse autoencoder (SAE) feature analysis, causal ablation, steering vector extraction -- depends on stimuli that contain the words for the emotions they test. When a probe fires on "I am furious", it is unclear whether the model has detected anger or detected the word "furious". The two readings have very different consequences for every downstream claim about emotion circuits, features, and interventions. We release AIPsy-Affect, a 480-item clinical stimulus battery that removes the confound at the stimulus level: 192 keyword-free vignettes evoking each of Plutchik's eight primary emotions through narrative situation alone, 192 matched neutral controls that share characters, setting, length, and surface structure with the affect surgically removed, plus moderate-intensity and discriminant-validity splits. The matched-pair structure supports linear probing, activation patching, SAE feature analysis, causal ablation, and steering vector extraction under a strong methodological guarantee: any internal representation that distinguishes a clinical item from its matched neutral cannot be doing so on the basis of emotion-keyword presence. A three-method NLP defense battery -- bag-of-words sentiment, an emotion-category lexicon, and a contextual transformer classifier -- confirms the property: bag-of-words methods see only situational vocabulary, and a contextual classifier detects affect (p < 10^-15) but cannot identify the category (5.2% top-1 vs. 82.5% on a keyword-rich control). AIPsy-Affect extends our earlier 96-item battery (arXiv:2603.22295) by a factor of four and is released openly under MIT license.

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.

We propose a novel method to probe the persistent hints of Lepton Flavour Universality violation observed in semileptonic B decays. Relying on the specific properties of the Belle II experiment, it consists in comparing the inclusive rates of Υ(4S) to e^pm μ^mp X, Υ(4S) to μ^pm τ_{rm had}^mp X and Υ(4S) to e^pm τ_{rm had}^mp X. We show that such a measurement can be directly related to the ratio R(X)_{τell} equiv Γ(bto X τν) / Γ(b to X ell ν) (ell=e or μ), once appropriate experimental cuts are applied to suppress the effects of neutral B mixing and leptons emitted through charm or tau decays. Such a measurement would thus constitute an additional and potentially competitive probe of Lepton Flavour Universality in bto cellν transitions, complementary to existing exclusive measurements, accessible in the Belle II environment.

Large language models (LLMs) hold great potential for many natural language applications but risk generating incorrect or toxic content. To probe when an LLM generates unwanted content, the current paradigm is to recruit a red team of human testers to design input prompts (i.e., test cases) that elicit undesirable responses from LLMs. However, relying solely on human testers is expensive and time-consuming. Recent works automate red teaming by training a separate red team LLM with reinforcement learning (RL) to generate test cases that maximize the chance of eliciting undesirable responses from the target LLM. However, current RL methods are only able to generate a small number of effective test cases resulting in a low coverage of the span of prompts that elicit undesirable responses from the target LLM. To overcome this limitation, we draw a connection between the problem of increasing the coverage of generated test cases and the well-studied approach of curiosity-driven exploration that optimizes for novelty. Our method of curiosity-driven red teaming (CRT) achieves greater coverage of test cases while mantaining or increasing their effectiveness compared to existing methods. Our method, CRT successfully provokes toxic responses from LLaMA2 model that has been heavily fine-tuned using human preferences to avoid toxic outputs. Code is available at https://github.com/Improbable-AI/curiosity_redteam

Reconstructing medical images from partial measurements is an important inverse problem in Computed Tomography (CT) and Magnetic Resonance Imaging (MRI). Existing solutions based on machine learning typically train a model to directly map measurements to medical images, leveraging a training dataset of paired images and measurements. These measurements are typically synthesized from images using a fixed physical model of the measurement process, which hinders the generalization capability of models to unknown measurement processes. To address this issue, we propose a fully unsupervised technique for inverse problem solving, leveraging the recently introduced score-based generative models. Specifically, we first train a score-based generative model on medical images to capture their prior distribution. Given measurements and a physical model of the measurement process at test time, we introduce a sampling method to reconstruct an image consistent with both the prior and the observed measurements. Our method does not assume a fixed measurement process during training, and can thus be flexibly adapted to different measurement processes at test time. Empirically, we observe comparable or better performance to supervised learning techniques in several medical imaging tasks in CT and MRI, while demonstrating significantly better generalization to unknown measurement processes.

This paper introduces the Manifold Probe, a supervised method for discovering representation manifolds in superposition. The method generalizes linear regression probes by learning the space of features of a concept that can be linearly predicted from the representations, and then learning the directions used to encode them. We demonstrate the probe on representations of time and space in Llama 2-7b, finding manifolds which linearly represent an interpretable set of features in each case. In the case of time, we show that by steering along the manifold, we can influence the model's completions about the years in which famous songs, movies and books were released, providing evidence that the Manifold Probe can discover manifolds which are causally involved in model behaviour.

Developing reliable AI systems to assist human clinicians in multi-modal medical diagnosis has long been a key objective for researchers. Recently, Multi-modal Large Language Models (MLLMs) have gained significant attention and achieved success across various domains. With strong reasoning capabilities and the ability to perform diverse tasks based on user instructions, they hold great potential for enhancing medical diagnosis. However, directly applying MLLMs to the medical domain still presents challenges. They lack detailed perception of visual inputs, limiting their ability to perform quantitative image analysis, which is crucial for medical diagnostics. Additionally, MLLMs often exhibit hallucinations and inconsistencies in reasoning, whereas clinical diagnoses must adhere strictly to established criteria. To address these challenges, we propose MedAgent-Pro, an evidence-based reasoning agentic system designed to achieve reliable, explainable, and precise medical diagnoses. This is accomplished through a hierarchical workflow: at the task level, knowledge-based reasoning generate reliable diagnostic plans for specific diseases following retrieved clinical criteria. While at the case level, multiple tool agents process multi-modal inputs, analyze different indicators according to the plan, and provide a final diagnosis based on both quantitative and qualitative evidence. Comprehensive experiments on both 2D and 3D medical diagnosis tasks demonstrate the superiority and effectiveness of MedAgent-Pro, while case studies further highlight its reliability and interpretability. The code is available at https://github.com/jinlab-imvr/MedAgent-Pro.

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.

Studies involving soundscape perception often exclude participants with hearing loss to prevent impaired perception from affecting experimental results. Participants are typically screened with pure tone audiometry, the "gold standard" for identifying and quantifying hearing loss at specific frequencies, and excluded if a study-dependent threshold is not met. However, procuring professional audiometric equipment for soundscape studies may be cost-ineffective, and manually performing audiometric tests is labour-intensive. Moreover, testing requirements for soundscape studies may not require sensitivities and specificities as high as that in a medical diagnosis setting. Hence, in this study, we investigate the effectiveness of the uHear app, an iOS application, as an affordable and automatic alternative to a conventional audiometer in screening participants for hearing loss for the purpose of soundscape studies or listening tests in general. Based on audiometric comparisons with the audiometer of 163 participants, the uHear app was found to have high precision (98.04%) when using the World Health Organization (WHO) grading scheme for assessing normal hearing. Precision is further improved (98.69%) when all frequencies assessed with the uHear app is considered in the grading, which lends further support to this cost-effective, automated alternative to screen for normal hearing.

Speech patterns have been identified as potential diagnostic markers for neuropsychiatric conditions. However, most studies only compare a single clinical group to healthy controls, whereas clinical practice often requires differentiating between multiple potential diagnoses (multiclass settings). To address this, we assembled a dataset of repeated recordings from 420 participants (67 with major depressive disorder, 106 with schizophrenia and 46 with autism, as well as matched controls), and tested the performance of a range of conventional machine learning models and advanced Transformer models on both binary and multiclass classification, based on voice and text features. While binary models performed comparably to previous research (F1 scores between 0.54-0.75 for autism spectrum disorder, ASD; 0.67-0.92 for major depressive disorder, MDD; and 0.71-0.83 for schizophrenia); when differentiating between multiple diagnostic groups performance decreased markedly (F1 scores between 0.35-0.44 for ASD, 0.57-0.75 for MDD, 0.15-0.66 for schizophrenia, and 0.38-0.52 macro F1). Combining voice and text-based models yielded increased performance, suggesting that they capture complementary diagnostic information. Our results indicate that models trained on binary classification may learn to rely on markers of generic differences between clinical and non-clinical populations, or markers of clinical features that overlap across conditions, rather than identifying markers specific to individual conditions. We provide recommendations for future research in the field, suggesting increased focus on developing larger transdiagnostic datasets that include more fine-grained clinical features, and that can support the development of models that better capture the complexity of neuropsychiatric conditions and naturalistic diagnostic assessment.

Retrieval-augmented generation (RAG) is a well-suited technique for retrieving privacy-sensitive Electronic Health Records (EHR). It can serve as a key module of the healthcare copilot, helping reduce misdiagnosis for healthcare practitioners and patients. However, the diagnostic accuracy and specificity of existing heuristic-based RAG models used in the medical domain are inadequate, particularly for diseases with similar manifestations. This paper proposes MedRAG, a RAG model enhanced by knowledge graph (KG)-elicited reasoning for the medical domain that retrieves diagnosis and treatment recommendations based on manifestations. MedRAG systematically constructs a comprehensive four-tier hierarchical diagnostic KG encompassing critical diagnostic differences of various diseases. These differences are dynamically integrated with similar EHRs retrieved from an EHR database, and reasoned within a large language model. This process enables more accurate and specific decision support, while also proactively providing follow-up questions to enhance personalized medical decision-making. MedRAG is evaluated on both a public dataset DDXPlus and a private chronic pain diagnostic dataset (CPDD) collected from Tan Tock Seng Hospital, and its performance is compared against various existing RAG methods. Experimental results show that, leveraging the information integration and relational abilities of the KG, our MedRAG provides more specific diagnostic insights and outperforms state-of-the-art models in reducing misdiagnosis rates. Our code will be available at https://github.com/SNOWTEAM2023/MedRAG

We develop and evaluate a data-driven approach for detecting unusual (anomalous) patient-management decisions using past patient cases stored in electronic health records (EHRs). Our hypothesis is that a patient-management decision that is unusual with respect to past patient care may be due to an error and that it is worthwhile to generate an alert if such a decision is encountered. We evaluate this hypothesis using data obtained from EHRs of 4486 post-cardiac surgical patients and a subset of 222 alerts generated from the data. We base the evaluation on the opinions of a panel of experts. The results of the study support our hypothesis that the outlier-based alerting can lead to promising true alert rates. We observed true alert rates that ranged from 25\% to 66\% for a variety of patient-management actions, with 66\% corresponding to the strongest outliers.

In clinical radiology reports, doctors capture important information about the patient's health status. They convey their observations from raw medical imaging data about the inner structures of a patient. As such, formulating reports requires medical experts to possess wide-ranging knowledge about anatomical regions with their normal, healthy appearance as well as the ability to recognize abnormalities. This explicit grasp on both the patient's anatomy and their appearance is missing in current medical image-processing systems as annotations are especially difficult to gather. This renders the models to be narrow experts e.g. for identifying specific diseases. In this work, we recover this missing link by adding human anatomy into the mix and enable the association of content in medical reports to their occurrence in associated imagery (medical phrase grounding). To exploit anatomical structures in this scenario, we present a sophisticated automatic pipeline to gather and integrate human bodily structures from computed tomography datasets, which we incorporate in our PAXRay: A Projected dataset for the segmentation of Anatomical structures in X-Ray data. Our evaluation shows that methods that take advantage of anatomical information benefit heavily in visually grounding radiologists' findings, as our anatomical segmentations allow for up to absolute 50% better grounding results on the OpenI dataset as compared to commonly used region proposals. The PAXRay dataset is available at https://constantinseibold.github.io/paxray/.

Geometric Attention (GA) specifies an attention layer by four independent inputs: a finite carrier (what indices are addressable), an evidence-kernel rule (how masked proto-scores and a link induce nonnegative weights), a probe family (which observables are treated as admissible), and an anchor/update rule (which representative kernel is selected and how it is applied). Probe families induce an operational equivalence relation on kernels and therefore a gauge; anchors select representatives relative to that probe. Under a scalar relational-work representation and a multiplicative compositionality law for evidence, the admissible link family is exponential, yielding Gibbs weights; with row anchoring this includes the softmax kernel family as a subregime. After quotienting unary row/column score fields, the remaining interaction component admits a canonical rank-r normal form (Eckart-Young/SVD); dot-product score charts implement the corresponding low-rank interaction regime. Fixing the carrier and extensionalizing the update yields the standard fixed-token Transformer attention operator; allowing carrier updates yields adaptive-carrier and staged-depth regimes. The operator language also supports multihead/mixed kernels, plan-based anchors (e.g., entropic OT/Sinkhorn), and unary operators (e.g., FFN-style fields) as explicit regime choices. This separates invariant structure from modeling choice, enabling principled comparison and extension of attention mechanisms, and attention-based architectures.

While large language models (LLMs) have shown promise in diagnostic dialogue, their capabilities for effective management reasoning - including disease progression, therapeutic response, and safe medication prescription - remain under-explored. We advance the previously demonstrated diagnostic capabilities of the Articulate Medical Intelligence Explorer (AMIE) through a new LLM-based agentic system optimised for clinical management and dialogue, incorporating reasoning over the evolution of disease and multiple patient visit encounters, response to therapy, and professional competence in medication prescription. To ground its reasoning in authoritative clinical knowledge, AMIE leverages Gemini's long-context capabilities, combining in-context retrieval with structured reasoning to align its output with relevant and up-to-date clinical practice guidelines and drug formularies. In a randomized, blinded virtual Objective Structured Clinical Examination (OSCE) study, AMIE was compared to 21 primary care physicians (PCPs) across 100 multi-visit case scenarios designed to reflect UK NICE Guidance and BMJ Best Practice guidelines. AMIE was non-inferior to PCPs in management reasoning as assessed by specialist physicians and scored better in both preciseness of treatments and investigations, and in its alignment with and grounding of management plans in clinical guidelines. To benchmark medication reasoning, we developed RxQA, a multiple-choice question benchmark derived from two national drug formularies (US, UK) and validated by board-certified pharmacists. While AMIE and PCPs both benefited from the ability to access external drug information, AMIE outperformed PCPs on higher difficulty questions. While further research would be needed before real-world translation, AMIE's strong performance across evaluations marks a significant step towards conversational AI as a tool in disease management.

Lung cancer is the deadliest type of cancer worldwide and late detection is the major factor for the low survival rate of patients. Low dose computed tomography has been suggested as a potential screening tool but manual screening is costly, time-consuming and prone to variability. This has fueled the development of automatic methods for the detection, segmentation and characterisation of pulmonary nodules but its application to clinical routine is challenging. In this study, a new database for the development and testing of pulmonary nodule computer-aided strategies is presented which intends to complement current databases by giving additional focus to radiologist variability and local clinical reality. State-of-the-art nodule detection, segmentation and characterization methods are tested and compared to manual annotations as well as collaborative strategies combining multiple radiologists and radiologists and computer-aided systems. It is shown that state-of-the-art methodologies can determine a patient's follow-up recommendation as accurately as a radiologist, though the nodule detection method used shows decreased performance in this database.

Sophisticated instrumentation for AI systems might have indicators that signal misalignment from human values, not unlike a "check engine" light in cars. One such indicator of misalignment is deceptiveness in generated responses. Future AI instrumentation may have the ability to detect when an LLM generates deceptive responses while reasoning about seemingly plausible but incorrect answers to factual questions. In this work, we demonstrate that linear probes on LLMs internal activations can detect deception in their responses with extremely high accuracy. Our probes reach a maximum of greater than 90% accuracy in distinguishing between deceptive and non-deceptive arguments generated by llama and qwen models ranging from 1.5B to 14B parameters, including their DeepSeek-r1 finetuned variants. We observe that probes on smaller models (1.5B) achieve chance accuracy at detecting deception, while larger models (greater than 7B) reach 70-80%, with their reasoning counterparts exceeding 90%. The layer-wise probe accuracy follows a three-stage pattern across layers: near-random (50%) in early layers, peaking in middle layers, and slightly declining in later layers. Furthermore, using an iterative null space projection approach, we find multitudes of linear directions that encode deception, ranging from 20 in Qwen 3B to nearly 100 in DeepSeek 7B and Qwen 14B models.

Automatic medical report generation (MRG) is of great research value as it has the potential to relieve radiologists from the heavy burden of report writing. Despite recent advancements, accurate MRG remains challenging due to the need for precise clinical understanding and the identification of clinical findings. Moreover, the imbalanced distribution of diseases makes the challenge even more pronounced, as rare diseases are underrepresented in training data, making their diagnostic performance unreliable. To address these challenges, we propose diagnosis-driven prompts for medical report generation (PromptMRG), a novel framework that aims to improve the diagnostic accuracy of MRG with the guidance of diagnosis-aware prompts. Specifically, PromptMRG is based on encoder-decoder architecture with an extra disease classification branch. When generating reports, the diagnostic results from the classification branch are converted into token prompts to explicitly guide the generation process. To further improve the diagnostic accuracy, we design cross-modal feature enhancement, which retrieves similar reports from the database to assist the diagnosis of a query image by leveraging the knowledge from a pre-trained CLIP. Moreover, the disease imbalanced issue is addressed by applying an adaptive logit-adjusted loss to the classification branch based on the individual learning status of each disease, which overcomes the barrier of text decoder's inability to manipulate disease distributions. Experiments on two MRG benchmarks show the effectiveness of the proposed method, where it obtains state-of-the-art clinical efficacy performance on both datasets.

Depression poses significant challenges to patients and healthcare organizations, necessitating efficient assessment methods. Existing paradigms typically focus on a patient-doctor way that overlooks multi-role interactions, such as family involvement in the evaluation and caregiving process. Moreover, current automatic depression detection (ADD) methods usually model depression detection as a classification or regression task, lacking interpretability for the decision-making process. To address these issues, we developed InterMind, a doctor-patient-family interactive depression assessment system empowered by large language models (LLMs). Our system enables patients and families to contribute descriptions, generates assistive diagnostic reports for doctors, and provides actionable insights, improving diagnostic precision and efficiency. To enhance LLMs' performance in psychological counseling and diagnostic interpretability, we integrate retrieval-augmented generation (RAG) and chain-of-thoughts (CoT) techniques for data augmentation, which mitigates the hallucination issue of LLMs in specific scenarios after instruction fine-tuning. Quantitative experiments and professional assessments by clinicians validate the effectiveness of our system.

Incentivizing the reasoning ability of Multimodal Large Language Models (MLLMs) is essential for medical applications to transparently analyze medical scans and provide reliable diagnosis. However, existing medical MLLMs rely solely on internal knowledge during reasoning, leading to hallucinated reasoning and factual inaccuracies when encountering cases beyond their training scope. Although recent Agentic Retrieval-Augmented Generation (RAG) methods elicit the medical model's proactive retrieval ability during reasoning, they are confined to unimodal LLMs, neglecting the crucial visual information during reasoning and retrieval. Consequently, we propose the first Multimodal Medical Reasoning-with-Retrieval framework, Med-RwR, which actively retrieves external knowledge by querying observed symptoms or domain-specific medical concepts during reasoning. Specifically, we design a two-stage reinforcement learning strategy with tailored rewards that stimulate the model to leverage both visual diagnostic findings and textual clinical information for effective retrieval. Building on this foundation, we further propose a Confidence-Driven Image Re-retrieval (CDIR) method for test-time scaling when low prediction confidence is detected. Evaluation on various public medical benchmarks demonstrates Med-RwR's significant improvements over baseline models, proving the effectiveness of enhancing reasoning capabilities with external knowledge integration. Furthermore, Med-RwR demonstrates remarkable generalizability to unfamiliar domains, evidenced by 8.8% performance gain on our proposed EchoCardiography Benchmark (ECBench), despite the scarcity of echocardiography data in the training corpus. Our data, model, and codes will be made publicly available at https://github.com/xmed-lab/Med-RwR.

Language models can distinguish between testing and deployment phases -- a capability known as evaluation awareness. This has significant safety and policy implications, potentially undermining the reliability of evaluations that are central to AI governance frameworks and voluntary industry commitments. In this paper, we study evaluation awareness in Llama-3.3-70B-Instruct. We show that linear probes can separate real-world evaluation and deployment prompts, suggesting that current models internally represent this distinction. We also find that current safety evaluations are correctly classified by the probes, suggesting that they already appear artificial or inauthentic to models. Our findings underscore the importance of ensuring trustworthy evaluations and understanding deceptive capabilities. More broadly, our work showcases how model internals may be leveraged to support blackbox methods in safety audits, especially for future models more competent at evaluation awareness and deception.

Coronavirus disease 2019 (Covid-19) is highly contagious with limited treatment options. Early and accurate diagnosis of Covid-19 is crucial in reducing the spread of the disease and its accompanied mortality. Currently, detection by reverse transcriptase polymerase chain reaction (RT-PCR) is the gold standard of outpatient and inpatient detection of Covid-19. RT-PCR is a rapid method, however, its accuracy in detection is only ~70-75%. Another approved strategy is computed tomography (CT) imaging. CT imaging has a much higher sensitivity of ~80-98%, but similar accuracy of 70%. To enhance the accuracy of CT imaging detection, we developed an open-source set of algorithms called CovidCTNet that successfully differentiates Covid-19 from community-acquired pneumonia (CAP) and other lung diseases. CovidCTNet increases the accuracy of CT imaging detection to 90% compared to radiologists (70%). The model is designed to work with heterogeneous and small sample sizes independent of the CT imaging hardware. In order to facilitate the detection of Covid-19 globally and assist radiologists and physicians in the screening process, we are releasing all algorithms and parametric details in an open-source format. Open-source sharing of our CovidCTNet enables developers to rapidly improve and optimize services, while preserving user privacy and data ownership.

Large Language Models (LLMs) often encounter conflicts between their learned, internal (parametric knowledge, PK) and external knowledge provided during inference (contextual knowledge, CK). Understanding how LLMs models prioritize one knowledge source over the other remains a challenge. In this paper, we propose a novel probing framework to explore the mechanisms governing the selection between PK and CK in LLMs. Using controlled prompts designed to contradict the model's PK, we demonstrate that specific model activations are indicative of the knowledge source employed. We evaluate this framework on various LLMs of different sizes and demonstrate that mid-layer activations, particularly those related to relations in the input, are crucial in predicting knowledge source selection, paving the way for more reliable models capable of handling knowledge conflicts effectively.

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.

Open-weights reasoning language models generate long chains-of-thought (CoTs) before producing a final response, which improves performance but introduces additional alignment risks, with harmful content often appearing in both the CoTs and the final outputs. In this work, we investigate if we can use CoTs to predict final response misalignment. We evaluate a range of monitoring approaches, including humans, highly-capable large language models, and text classifiers, using either CoT text or activations. First, we find that a simple linear probe trained on CoT activations can significantly outperform all text-based methods in predicting whether a final response will be safe or unsafe. CoT texts are often unfaithful and can mislead humans and classifiers, while model latents (i.e., CoT activations) offer a more reliable predictive signal. Second, the probe makes accurate predictions before reasoning completes, achieving strong performance even when applied to early CoT segments. These findings generalize across model sizes, families, and safety benchmarks, suggesting that lightweight probes could enable real-time safety monitoring and early intervention during generation.

We provide evidence of performative chain-of-thought (CoT) in reasoning models, where a model becomes strongly confident in its final answer, but continues generating tokens without revealing its internal belief. Our analysis compares activation probing, early forced answering, and a CoT monitor across two large models (DeepSeek-R1 671B & GPT-OSS 120B) and find task difficulty-specific differences: The model's final answer is decodable from activations far earlier in CoT than a monitor is able to say, especially for easy recall-based MMLU questions. We contrast this with genuine reasoning in difficult multihop GPQA-Diamond questions. Despite this, inflection points (e.g., backtracking, 'aha' moments) occur almost exclusively in responses where probes show large belief shifts, suggesting these behaviors track genuine uncertainty rather than learned "reasoning theater." Finally, probe-guided early exit reduces tokens by up to 80% on MMLU and 30% on GPQA-Diamond with similar accuracy, positioning attention probing as an efficient tool for detecting performative reasoning and enabling adaptive computation.

Language promptable X-ray image segmentation would enable greater flexibility for human-in-the-loop workflows in diagnostic and interventional precision medicine. Prior efforts have contributed task-specific models capable of solving problems within a narrow scope, but expanding to broader use requires additional data, annotations, and training time. Recently, language-aligned foundation models (LFMs) -- machine learning models trained on large amounts of highly variable image and text data thus enabling broad applicability -- have emerged as promising tools for automated image analysis. Existing foundation models for medical image analysis focus on scenarios and modalities where large, richly annotated datasets are available. However, the X-ray imaging modality features highly variable image appearance and applications, from diagnostic chest X-rays to interventional fluoroscopy, with varying availability of data. To pave the way toward an LFM for comprehensive and language-aligned analysis of arbitrary medical X-ray images, we introduce FluoroSAM, a language-promptable variant of the Segment Anything Model, trained from scratch on 3M synthetic X-ray images from a wide variety of human anatomies, imaging geometries, and viewing angles. These include pseudo-ground truth masks for 128 organ types and 464 tools with associated text descriptions. FluoroSAM is capable of segmenting myriad anatomical structures and tools based on natural language prompts, thanks to the novel incorporation of vector quantization (VQ) of text embeddings in the training process. We demonstrate FluoroSAM's performance quantitatively on real X-ray images and showcase on several applications how FluoroSAM is a key enabler for rich human-machine interaction in the X-ray image acquisition and analysis context. Code is available at https://github.com/arcadelab/fluorosam.

Current alignment evaluation mostly measures whether models encode dangerous concepts and whether they refuse harmful requests. Both miss the layer where alignment often operates: routing from concept detection to behavioral policy. We study political censorship in Chinese-origin language models as a natural experiment, using probes, surgical ablations, and behavioral tests across nine open-weight models from five labs. Three findings follow. First, probe accuracy alone is non-diagnostic: political probes, null controls, and permutation baselines can all reach 100%, so held-out category generalization is the informative test. Second, surgical ablation reveals lab-specific routing. Removing the political-sensitivity direction eliminates censorship and restores accurate factual output in most models tested, while one model confabulates because its architecture entangles factual knowledge with the censorship mechanism. Cross-model transfer fails, indicating that routing geometry is model- and lab-specific. Third, refusal is no longer the dominant censorship mechanism. Within one model family, hard refusal falls to zero while narrative steering rises to the maximum, making censorship invisible to refusal-only benchmarks. These results support a three-stage descriptive framework: detect, route, generate. Models often retain the relevant knowledge; alignment changes how that knowledge is expressed. Evaluations that audit only detection or refusal therefore miss the routing mechanism that most directly determines behavior.

Medical phrase grounding is crucial for identifying relevant regions in medical images based on phrase queries, facilitating accurate image analysis and diagnosis. However, current methods rely on manual extraction of key phrases from medical reports, reducing efficiency and increasing the workload for clinicians. Additionally, the lack of model confidence estimation limits clinical trust and usability. In this paper, we introduce a novel task called Medical Report Grounding (MRG), which aims to directly identify diagnostic phrases and their corresponding grounding boxes from medical reports in an end-to-end manner. To address this challenge, we propose uMedGround, a robust and reliable framework that leverages a multimodal large language model to predict diagnostic phrases by embedding a unique token, <BOX>, into the vocabulary to enhance detection capabilities. A vision encoder-decoder processes the embedded token and input image to generate grounding boxes. Critically, uMedGround incorporates an uncertainty-aware prediction model, significantly improving the robustness and reliability of grounding predictions. Experimental results demonstrate that uMedGround outperforms state-of-the-art medical phrase grounding methods and fine-tuned large visual-language models, validating its effectiveness and reliability. This study represents a pioneering exploration of the MRG task, marking the first-ever endeavor in this domain. Additionally, we demonstrate the applicability of uMedGround in medical visual question answering and class-based localization tasks, where it highlights visual evidence aligned with key diagnostic phrases, supporting clinicians in interpreting various types of textual inputs, including free-text reports, visual question answering queries, and class labels.

Randomized controlled trials (RCTs) are the benchmark for causal inference, yet field implementation can deviate. We here present a remote audit - a design-based, preregistrable diagnostic that uses only pre-treatment satellite imagery to test whether assignment is independent of local conditions. The conditional randomization test of the remote audit evaluates whether treatment assignment is more predictable from pre-treatment satellite features than expected under the experiment's registered mechanism, providing a finite-sample valid, design-based diagnostic that requires no parametric assumptions. The procedure is finite-sample valid, honors blocks and clusters, and controls multiplicity across image models and resolutions via a max-statistic. We illustrate with two RCTs: Uganda's Youth Opportunities Program, where the audit corroborates randomization and flags selection and missing-data risks; and a school-based trial in Bangladesh, where assignment is highly predictable from pre-treatment features relative to the stated design, consistent with independent concerns about irregularities. Remote audits complement balance tests, lower early-stage costs, and enable rapid design checks when baseline surveys are expensive or infeasible.