Daily Papers

Self-evolving agents improve future behavior from interaction experience, yet existing evaluations typically optimize under fixed execution conditions and do not test recovery after those conditions change. To address this gap, we introduce PACE-Bench (Physics Adaptation via Code Evolution), a simulator-grounded benchmark of 144 source-to-target adaptation pairs across six physics domains. Each pair links a source environment to a mutated target environment with the same goal and interface. A code-driven design that succeeds in the source fails in the target, where agents must iteratively adapt it into a working target design using diagnostic sandbox feedback within a limited attempt budget. We compare ten self-evolving methods from four paradigms. The benchmark remains far from saturated: Reflexion + Qwen3-14B succeeds on only 35.9\% of full-benchmark pairs, while GPT-5.5 solves 66.7\% of the Statics subset under the full budget. Together, these results show that simulator-grounded reflection is more reliable than unverified self-revision, while memory anchors agents to early designs and broad tree search explores without converging. Even revealing exact physical changes does not raise the performance ceiling, pointing to mechanism redesign rather than parameter inference as the central bottleneck. Data and code are available at https://github.com/thunlp/PACE-Bench.

We present RepoST, a scalable method to construct environments that provide execution feedback for repository-level code generation for both training and evaluation. Unlike existing works that aim to build entire repositories for execution, which is challenging for both human and LLMs, we provide execution feedback with sandbox testing, which isolates a given target function and its dependencies to a separate script for testing. Sandbox testing reduces the complexity of external dependencies and enables constructing environments at a large scale. We use our method to construct RepoST-Train, a large-scale train set with 7,415 functions from 832 repositories. Training with the execution feedback provided by RepoST-Train leads to a performance gain of 5.5% Pass@1 on HumanEval and 3.5% Pass@1 on RepoEval. We also build an evaluation dataset, RepoST-Eval, and benchmark 12 code generation models.

LLM agents often retry after external validation rejects a candidate, but the interface between validation and the next model call remains underspecified. We introduce VeriHarness, a code-controlled agent loop in which models generate candidates while external validators control acceptance, budgets, and traces. We use it to compare raw diagnostics with feedback that identifies the failure location, observed value, and admissible alternatives. Across 50 paired TextWorld games under a four-call cap, feedback containing all three fields raises terminal success from 14/50 to 36/50 for Qwen2.5-Coder-14B (+44 percentage points) and from 8/50 to 29/50 for Llama-3.1-8B (+42 points). Ablations locate most of the gain in the admissible alternatives: feedback containing only the location and observed value remains near the raw diagnostic baseline. Presenting the complete repair information in prose instead of a keyed JSON record yields nearly the same success, providing no evidence that JSON syntax itself improves repair. The ordering persists across the tested call budgets and one sampled-decoding setting.

While Large Language Model (LLM) agents demonstrate proficiency in static benchmarks, their deployment in real-world scenarios is hindered by the dynamic nature of user queries, tool sets, and interaction dynamics. To address this generalization gap, we formalize OpenAgent (Tool-Use Agent in Open-World), a problem setting characterized by distributional shifts across query, action, observation, and domain dimensions. To systematically diagnose its impact, we construct a controlled sandbox environment where we define fine-grained environmental shifts across a four-tier hierarchy, Perception, Interaction, Reasoning, and Internalization, and conduct a comprehensive series of experiments. Our analysis yields a series of key insights, demonstrating that agents trained via both Supervised Fine-Tuning(SFT) and Reinforcement Learning suffer from varying degrees of performance degradation when confronting open environmental shifts. Building on these insights, we propose Perturbation-Augmented Fine-Tuning, a disturbance-based intervention strategy for SFT that lays the foundation for enhancing agent robustness and utility in realistic environments. Our code will be released at: https://github. com/LAMDA-NeSy/OpenAgent.

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.

The emergence of large-scale multi-modal generative models has drastically advanced artificial intelligence, introducing unprecedented levels of performance and functionality. However, optimizing these models remains challenging due to historically isolated paths of model-centric and data-centric developments, leading to suboptimal outcomes and inefficient resource utilization. In response, we present a novel sandbox suite tailored for integrated data-model co-development. This sandbox provides a comprehensive experimental platform, enabling rapid iteration and insight-driven refinement of both data and models. Our proposed "Probe-Analyze-Refine" workflow, validated through applications on state-of-the-art LLaVA-like and DiT based models, yields significant performance boosts, such as topping the VBench leaderboard. We also uncover fruitful insights gleaned from exhaustive benchmarks, shedding light on the critical interplay between data quality, diversity, and model behavior. With the hope of fostering deeper understanding and future progress in multi-modal data and generative modeling, our codes, datasets, and models are maintained and accessible at https://github.com/modelscope/data-juicer/blob/main/docs/Sandbox.md.

Software testing has progressed toward intelligent automation, yet current AI-based test generators still suffer from static, single-shot outputs that frequently produce invalid, redundant, or non-executable tests due to the lack of execution aware feedback. This paper introduces an agentic multi-model testing framework a closed-loop, self-correcting system in which a Test Generation Agent, an Execution and Analysis Agent, and a Review and Optimization Agent collaboratively generate, execute, analyze, and refine tests until convergence. By using sandboxed execution, detailed failure reporting, and iterative regeneration or patching of failing tests, the framework autonomously improves test quality and expands coverage. Integrated into a CI/CD-compatible pipeline, it leverages reinforcement signals from coverage metrics and execution outcomes to guide refinement. Empirical evaluations on microservice based applications show up to a 60% reduction in invalid tests, 30% coverage improvement, and significantly reduced human effort compared to single-model baselines demonstrating that multi-agent, feedback-driven loops can evolve software testing into an autonomous, continuously learning quality assurance ecosystem for self-healing, high-reliability codebases.

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/.

Future AI systems could conceal their capabilities ('sandbagging') during evaluations, potentially misleading developers and auditors. We stress-tested sandbagging detection techniques using an auditing game. First, a red team fine-tuned five models, some of which conditionally underperformed, as a proxy for sandbagging. Second, a blue team used black-box, model-internals, or training-based approaches to identify sandbagging models. We found that the blue team could not reliably discriminate sandbaggers from benign models. Black-box approaches were defeated by effective imitation of a weaker model. Linear probes, a model-internals approach, showed more promise but their naive application was vulnerable to behaviours instilled by the red team. We also explored capability elicitation as a strategy for detecting sandbagging. Although Prompt-based elicitation was not reliable, training-based elicitation consistently elicited full performance from the sandbagging models, using only a single correct demonstration of the evaluation task. However the performance of benign models was sometimes also raised, so relying on elicitation as a detection strategy was prone to false-positives. In the short-term, we recommend developers remove potential sandbagging using on-distribution training for elicitation. In the longer-term, further research is needed to ensure the efficacy of training-based elicitation, and develop robust methods for sandbagging detection. We open source our model organisms at https://github.com/AI-Safety-Institute/sandbagging_auditing_games and select transcripts and results at https://huggingface.co/datasets/sandbagging-games/evaluation_logs . A demo illustrating the game can be played at https://sandbagging-demo.far.ai/ .

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.

Benchmarks are necessary for healthcare evaluation, but are not sufficient for predicting deployment performance. Our position is that the evaluation--deployment gap arises not because of poorly designed benchmarks, but from implicit assumptions about how users interact with models that cannot be surfaced from benchmarks alone. To make this precise, we propose a classification of assumptions into two categories: task, which can be tested from conversation data alone, and outcome, which requires outcome data and behavioral studies for testing. Critically, outcome assumptions depend on human behavior, something that even well-designed benchmarks cannot directly observe. To demonstrate the operationality of this framework, we retrospectively analyze a healthcare RCT as a case study and find that the gap naturally separates into task and outcome gaps of roughly equal size. To address this, we make two contributions: first, we propose BenchmarkCards, an artifact that documents assumptions, and second, we propose staged evaluation, a procedure that systematically tests assumptions and evaluates performance.

This study investigates GPT-4's assessment of its performance in healthcare applications. A simple prompting technique was used to prompt the LLM with questions taken from the United States Medical Licensing Examination (USMLE) questionnaire and it was tasked to evaluate its confidence score before posing the question and after asking the question. The questionnaire was categorized into two groups-questions with feedback (WF) and questions with no feedback(NF) post-question. The model was asked to provide absolute and relative confidence scores before and after each question. The experimental findings were analyzed using statistical tools to study the variability of confidence in WF and NF groups. Additionally, a sequential analysis was conducted to observe the performance variation for the WF and NF groups. Results indicate that feedback influences relative confidence but doesn't consistently increase or decrease it. Understanding the performance of LLM is paramount in exploring its utility in sensitive areas like healthcare. This study contributes to the ongoing discourse on the reliability of AI, particularly of LLMs like GPT-4, within healthcare, offering insights into how feedback mechanisms might be optimized to enhance AI-assisted medical education and decision support.

Code agents can autonomously resolve GitHub issues, yet when they fail, current evaluation provides no visibility into where or why. Metrics such as Pass@1 collapse an entire execution into a single binary outcome, making it difficult to identify where and why the agent went wrong. To address this limitation, we introduce TRAJEVAL, a diagnostic framework that decomposes agent trajectories into three interpretable stages: search (file localization), read (function comprehension), and edit (modification targeting). For each stage, we compute precision and recall by comparing against reference patches. Analyzing 16,758 trajectories across three agent architectures and seven models, we find universal inefficiencies (all agents examine approximately 22x more functions than necessary) yet distinct failure modes: GPT-5 locates relevant code but targets edits incorrectly, while Qwen-32B fails at file discovery entirely. We validate that these diagnostics are predictive, achieving model-level Pass@1 prediction within 0.87-2.1% MAE, and actionable: real-time feedback based on trajectory signals improves two state-of-the-art models by 2.2-4.6 percentage points while reducing costs by 20-31%. These results demonstrate that our framework not only provides a more fine-grained analysis of agent behavior, but also translates diagnostic signals into tangible performance gains. More broadly, TRAJEVAL transforms agent evaluation beyond outcome-based benchmarking toward mechanism-driven diagnosis of agent success and failure.

Recent advances in medical multi-modal models focus on specialized image analysis like dermatology, pathology, or radiology. However, they do not fully capture the complexity of real-world clinical diagnostics, which involve heterogeneous inputs and require ongoing contextual understanding during patient-physician interactions. To bridge this gap, we introduce PulseMind, a new family of multi-modal diagnostic models that integrates a systematically curated dataset, a comprehensive evaluation benchmark, and a tailored training framework. Specifically, we first construct a diagnostic dataset, MediScope, which comprises 98,000 real-world multi-turn consultations and 601,500 medical images, spanning over 10 major clinical departments and more than 200 sub-specialties. Then, to better reflect the requirements of real-world clinical diagnosis, we develop the PulseMind Benchmark, a multi-turn diagnostic consultation benchmark with a four-dimensional evaluation protocol comprising proactiveness, accuracy, usefulness, and language quality. Finally, we design a training framework tailored for multi-modal clinical diagnostics, centered around a core component named Comparison-based Reinforcement Policy Optimization (CRPO). Compared to absolute score rewards, CRPO uses relative preference signals from multi-dimensional com-parisons to provide stable and human-aligned training guidance. Extensive experiments demonstrate that PulseMind achieves competitive performance on both the diagnostic consultation benchmark and public medical benchmarks.

Realistic practice and tailored feedback are key processes for training peer counselors with clinical skills. However, existing mechanisms of providing feedback largely rely on human supervision. Peer counselors often lack mechanisms to receive detailed feedback from experienced mentors, making it difficult for them to support the large number of people with mental health issues who use peer counseling. Our work aims to leverage large language models to provide contextualized and multi-level feedback to empower peer counselors, especially novices, at scale. To achieve this, we co-design with a group of senior psychotherapy supervisors to develop a multi-level feedback taxonomy, and then construct a publicly available dataset with comprehensive feedback annotations of 400 emotional support conversations. We further design a self-improvement method on top of large language models to enhance the automatic generation of feedback. Via qualitative and quantitative evaluation with domain experts, we demonstrate that our method minimizes the risk of potentially harmful and low-quality feedback generation which is desirable in such high-stakes scenarios.

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

Tool-using LLM agents are mostly evaluated assuming all tools work. When a tool times out, returns a week-stale value, or has its description poisoned in deployment, the developer needs a controlled way to reproduce the failure, test a fix, and confirm the fix worked before deployment. We present AgentCheck, an open-source web workbench that turns an MCP server into an intervention surface. AgentCheck runs an agent against its real tools and records every tool response, then re-runs the agent with the response perturbed by a fault (12 types) injector. Matching tool calls are replayed from cache, and later tool calls go live after the agent diverges. This yields a reproduce-intervene-confirm loop: the developer toggles a mitigation, re-runs against the identical fault, and sees if the failure goes away. Scoring has two parts: deterministic pass/fail rules, plus an LLM judge for interpretive labels, validated against human annotations. Across five agents, the best passes 105/120 scenarios and the weakest only 77. The failures are usually silent, confident use of incorrect tool outputs rather than crashes. On the weakest agent, a retry mitigation raises success on timeout error faults from as few as 30% of cases to 100%, whereas stale-data faults remain near 3-4 of 10 regardless of the mitigation. AgentCheck makes these failure modes reproducible, comparable, and verifiable before deployment.

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.

Autonomous improvement loops are hard to trust because the improvement process is usually external scaffolding bolted onto the agent: failures go unlogged, diagnoses cannot be replayed, and promote-or-discard decisions land in a side database rather than the agent's own history. We show that an event-sourced agent runtime removes that friction and turns controlled improvement into a first-class workflow. When the agent's state is a deterministic projection of an append-only event log, failures are recorded, a run replays exactly from its log, candidate patches scope to typed pipeline seams, gates are auditable, and every promotion or discard is itself an event. We demonstrate this with Regimes, a loop on the ActiveGraph runtime that diagnoses failed evaluations, proposes a repair at a pipeline point, and promotes it only after static checks, sandbox execution, in-sample evaluation, and held-out validation. The loop is target-agnostic: the same control flow runs against different tasks through a common interface. On LongMemEval-S the dominant failure is not retrieval but reconciliation: the evidence is already in the assembled context, yet the reader answers incorrectly. Across five seeded held-out splits, Regimes discovers reader-prompt repairs that improve final held-out accuracy by +0.05 to +0.10 in four splits and +0.01 in one over-promotion split; two splits are individually significant (seed 5 unadjusted for its sequential promotion structure), and the pooled count is descriptive only, since the splits share one 500-question pool. The durable contributions are ActiveGraph as an auditable substrate that makes controlled improvement loops tractable, the held-out-gated loop it supports, the failure-regime taxonomy routing each failure to a pipeline location (whose marginal value over an unrouted baseline is the primary open question), and the prompt-as-discovery-probe hypothesis.

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.

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.

Various test-time interventions for Computer Use Agents (CUAs), including critic models, have been developed to improve performance through pre-execution action evaluation in complex Graphical User Interface (GUI) environments. However, existing critics suffer from two key limitations: they (1) focus primarily on short-sighted decision loops (e.g., forgetting earlier actions) and (2) lack the visual grounding needed to detect flawed actions (e.g., clicking wrong UI elements). To address these, we introduce HiViG, a History-aware Visually Grounded test-time framework, built around a multimodal critic trained on real GUI trajectories to abstract past interactions into a compact record and to evaluate actions with visual grounding. At test time, HiViG integrates the critic into the policy decision loop to provide macro-action history, which summarizes the policy's completed achievements, and visually grounded critique, which verifies raw execution coordinates against the current screenshot to intercept errors before execution. Across web, mobile, and desktop benchmarks, HiViG consistently outperforms existing scalar and verbal critics, improving average success rates over the strongest baseline by 5.8% for Qwen3-VL-32B and 9.0% for Gemini-3-Flash, and demonstrates strong cross-platform generalization. Ablations show that macro-action history mitigates short-sighted planning and visually grounded critique reduces execution errors, with both components being critical for test-time scaling in long-horizon GUI tasks.

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.

Recent advances in persistent personal-agent frameworks are making human-centered agent networks realistic deployment targets: each user can be served by an AI agent that acts on the user's behalf, maintains state, and communicates with other agents through social and task relations. In these networks, everyday tool use becomes multi-party owned-agent collaboration over personal workspaces, where files, records, tools, and policies are not directly visible across owners. Existing agent benchmarks study tool use and collaboration, but they do not provide an end-to-end sandbox for verifiable cross-user agent collaboration with realistic user digital workspaces or test how harmful actions can travel through the human-centered agent network. We introduce WeClawArena, an auditable benchmark and runtime sandbox for multi-party owned-agent collaboration over personal workspaces. WeClawArena targets collaborative tool-use tasks in which personal workspaces serve as both operational tools and personal constraints. The benchmark contains 124 base tasks across six cross-user task domains and expands them into 620 scenario variants, with one benign control and four attack-vector variants per base task. The sandbox records peer messages, tool calls, resource operations, governed decisions, and final workspace states. WeClawArena reports utility and attack success rate separately and audits attack success from bounded runtime evidence, supporting diagnosis of task breakdown, privacy leakage, poisoned evidence, and invalid authority paths.

During surgical training, real-time feedback from trainers to trainees is important for preventing errors and enhancing long-term skill acquisition. Accurately predicting the effectiveness of this feedback, specifically whether it leads to a change in trainee behavior, is crucial for developing methods for improving surgical training and education. However, relying on human annotations to assess feedback effectiveness is laborious and prone to biases, underscoring the need for an automated, scalable, and objective method. Creating such an automated system poses challenges, as it requires an understanding of both the verbal feedback delivered by the trainer and the visual context of the real-time surgical scene. To address this, we propose a method that integrates information from transcribed verbal feedback and corresponding surgical video to predict feedback effectiveness. Our findings show that both transcribed feedback and surgical video are individually predictive of trainee behavior changes, and their combination achieves an AUROC of 0.70+/-0.02, improving prediction accuracy by up to 6.6%. Additionally, we introduce self-supervised fine-tuning as a strategy for enhancing surgical video representation learning, which is scalable and further enhances prediction performance. Our results demonstrate the potential of multi-modal learning to advance the automated assessment of surgical feedback.

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.

As Large Multimodal Models (LMMs) scale up and reinforcement learning (RL) methods mature, LMMs have made notable progress in complex reasoning and decision making. Yet training still relies on static data and fixed recipes, making it difficult to diagnose capability blind spots or provide dynamic, targeted reinforcement. Motivated by findings that test driven error exposure and feedback based correction outperform repetitive practice, we propose Diagnostic-driven Progressive Evolution (DPE), a spiral loop where diagnosis steers data generation and reinforcement, and each iteration re-diagnoses the updated model to drive the next round of targeted improvement. DPE has two key components. First, multiple agents annotate and quality control massive unlabeled multimodal data, using tools such as web search and image editing to produce diverse, realistic samples. Second, DPE attributes failures to specific weaknesses, dynamically adjusts the data mixture, and guides agents to generate weakness focused data for targeted reinforcement. Experiments on Qwen3-VL-8B-Instruct and Qwen2.5-VL-7B-Instruct show stable, continual gains across eleven benchmarks, indicating DPE as a scalable paradigm for continual LMM training under open task distributions. Our code, models, and data are publicly available at https://github.com/hongruijia/DPE.

Despite the rapid progress of Multimodal Large Language Models (MLLMs), their ability to perform reliable visual grounding in high-stakes clinical software environments remains underexplored. Existing GUI benchmarks largely focus on isolated, single-step grounding queries, overlooking the sequential, workflow-driven reasoning required in real-world medical interfaces, where tasks evolve across independent steps and dynamic interface states. We introduce MedSPOT, a workflow-aware sequential grounding benchmark for clinical GUI environments. Unlike prior benchmarks that treat grounding as a standalone prediction task, MedSPOT models procedural interaction as a sequence of structured spatial decisions. The benchmark comprises 216 task-driven videos with 597 annotated keyframes, in which each task consists of 2 to 3 interdependent grounding steps within realistic medical workflows. This design captures interface hierarchies, contextual dependencies, and fine-grained spatial precision under evolving conditions. To evaluate procedural robustness, we propose a strict sequential evaluation protocol that terminates task assessment upon the first incorrect grounding prediction, explicitly measuring error propagation in multi-step workflows. We further introduce a comprehensive failure taxonomy, including edge bias, small-target errors, no prediction, near miss, far miss, and toolbar confusion, to enable systematic diagnosis of model behavior in clinical GUI settings. By shifting evaluation from isolated grounding to workflow-aware sequential reasoning, MedSPOT establishes a realistic and safety-critical benchmark for assessing multimodal models in medical software environments. Code and data are available at: https://github.com/Tajamul21/MedSPOT.

We introduce LLM-in-Sandbox, enabling LLMs to explore within a code sandbox (i.e., a virtual computer), to elicit general intelligence in non-code domains. We first demonstrate that strong LLMs, without additional training, exhibit generalization capabilities to leverage the code sandbox for non-code tasks. For example, LLMs spontaneously access external resources to acquire new knowledge, leverage the file system to handle long contexts, and execute scripts to satisfy formatting requirements. We further show that these agentic capabilities can be enhanced through LLM-in-Sandbox Reinforcement Learning (LLM-in-Sandbox-RL), which uses only non-agentic data to train models for sandbox exploration. Experiments demonstrate that LLM-in-Sandbox, in both training-free and post-trained settings, achieves robust generalization spanning mathematics, physics, chemistry, biomedicine, long-context understanding, and instruction following. Finally, we analyze LLM-in-Sandbox's efficiency from computational and system perspectives, and open-source it as a Python package to facilitate real-world deployment.

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.

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.

Large language models have the potential to be valuable in the healthcare industry, but it's crucial to verify their safety and effectiveness through rigorous evaluation. For this purpose, we comprehensively evaluated both open-source LLMs and Google's new multimodal LLM called Gemini across Medical reasoning, hallucination detection, and Medical Visual Question Answering tasks. While Gemini showed competence, it lagged behind state-of-the-art models like MedPaLM 2 and GPT-4 in diagnostic accuracy. Additionally, Gemini achieved an accuracy of 61.45\% on the medical VQA dataset, significantly lower than GPT-4V's score of 88\%. Our analysis revealed that Gemini is highly susceptible to hallucinations, overconfidence, and knowledge gaps, which indicate risks if deployed uncritically. We also performed a detailed analysis by medical subject and test type, providing actionable feedback for developers and clinicians. To mitigate risks, we applied prompting strategies that improved performance. Additionally, we facilitated future research and development by releasing a Python module for medical LLM evaluation and establishing a dedicated leaderboard on Hugging Face for medical domain LLMs. Python module can be found at https://github.com/promptslab/RosettaEval

Recent developments in large language models (LLMs) have been impressive. However, these models sometimes show inconsistencies and problematic behavior, such as hallucinating facts, generating flawed code, or creating offensive and toxic content. Unlike these models, humans typically utilize external tools to cross-check and refine their initial content, like using a search engine for fact-checking, or a code interpreter for debugging. Inspired by this observation, we introduce a framework called CRITIC that allows LLMs, which are essentially "black boxes" to validate and progressively amend their own outputs in a manner similar to human interaction with tools. More specifically, starting with an initial output, CRITIC interacts with appropriate tools to evaluate certain aspects of the text, and then revises the output based on the feedback obtained during this validation process. Comprehensive evaluations involving free-form question answering, mathematical program synthesis, and toxicity reduction demonstrate that CRITIC consistently enhances the performance of LLMs. Meanwhile, our research highlights the crucial importance of external feedback in promoting the ongoing self-improvement of LLMs.

Global healthcare providers are exploring use of large language models (LLMs) to provide medical advice to the public. LLMs now achieve nearly perfect scores on medical licensing exams, but this does not necessarily translate to accurate performance in real-world settings. We tested if LLMs can assist members of the public in identifying underlying conditions and choosing a course of action (disposition) in ten medical scenarios in a controlled study with 1,298 participants. Participants were randomly assigned to receive assistance from an LLM (GPT-4o, Llama 3, Command R+) or a source of their choice (control). Tested alone, LLMs complete the scenarios accurately, correctly identifying conditions in 94.9% of cases and disposition in 56.3% on average. However, participants using the same LLMs identified relevant conditions in less than 34.5% of cases and disposition in less than 44.2%, both no better than the control group. We identify user interactions as a challenge to the deployment of LLMs for medical advice. Standard benchmarks for medical knowledge and simulated patient interactions do not predict the failures we find with human participants. Moving forward, we recommend systematic human user testing to evaluate interactive capabilities prior to public deployments in healthcare.

Current open-source prompt-injection detectors converge on two architectural choices: regular-expression pattern matching and fine-tuned transformer classifiers. Both share failure modes that recent work has made concrete. Regular expressions miss paraphrased attacks. Fine-tuned classifiers are vulnerable to adaptive adversaries: a 2025 NAACL Findings study reported that eight published indirect-injection defenses were bypassed with greater than fifty percent attack success rates under adaptive attacks. This work proposes seven detection techniques that each port a specific mechanism from a discipline outside large-language-model security: forensic linguistics, materials-science fatigue analysis, deception technology from network security, local-sequence alignment from bioinformatics, mechanism design from economics, spectral signal analysis from epidemiology, and taint tracking from compiler theory. Three of the seven techniques are implemented in the prompt-shield v0.4.1 release (Apache 2.0) and evaluated in a four-configuration ablation across six datasets including deepset/prompt-injections, NotInject, LLMail-Inject, AgentHarm, and AgentDojo. The local-alignment detector lifts F1 on deepset from 0.033 to 0.378 with zero additional false positives. The stylometric detector adds 11.1 percentage points of F1 on an indirect-injection benchmark. The fatigue tracker is validated via a probing-campaign integration test. All code, data, and reproduction scripts are released under Apache 2.0.

Adding procedural skills to an LLM agent is typically evaluated by average improvement in task success. However, this metric hides an important cost: skills can also make agents worse. We measure both sides by comparing agents with and without skills across nearly 6,000 runs spanning two office automation benchmarks and three model harness stacks. This allows us to distinguish two outcomes. A regression is a task solved without skills but failed after skills are added. A residual failure is a task that fails both with and without skills. We find that regressions are substantial enough that the best performing skills outperform others primarily by regressing less, not by gaining more. We identify three causes of regression: (i) skill description osmosis, a skill changes an agent's behavior simply by being present in context, even when it is never invoked; (ii) grounding displacement, a skill's prescribed procedure overrides how the agent interprets its inputs; and (iii) verification displacement, where the procedure suppresses checks the agent would otherwise perform on its outputs. Analysing persistent failures reveals the same underlying pattern. Existing skills overemphasize procedural guidance the stage least often responsible for failure while under supporting grounding and verification, the dominant sources of remaining errors. After correcting evaluation artifacts and studying traces, we find many regressions and persistent failures recoverable through better grounding and verification. Procedural skills should be evaluated by decomposing their net effect into gains and regressions, not by aggregate improvement alone. We identify three regression modes skills should avoid, and find that reliability depends more on grounding and verification than on procedural skill choice.

Large language models (LLMs) increasingly act as autonomous agents, using tools to execute code, read and write files, and access networks, creating novel security risks. To mitigate these risks, agents are commonly deployed and evaluated in isolated "sandbox" environments, often implemented using Docker/OCI containers. We introduce SANDBOXESCAPEBENCH, an open benchmark that safely measures an LLM's capacity to break out of these sandboxes. The benchmark is implemented as an Inspect AI Capture the Flag (CTF) evaluation utilising a nested sandbox architecture with the outer layer containing the flag and no known vulnerabilities. Following a threat model of a motivated adversarial agent with shell access inside a container, SANDBOXESCAPEBENCH covers a spectrum of sandboxescape mechanisms spanning misconfiguration, privilege allocation mistakes, kernel flaws, and runtime/orchestration weaknesses. We find that, when vulnerabilities are added, LLMs are able to identify and exploit them, showing that use of evaluation like SANDBOXESCAPEBENCH is needed to ensure sandboxing continues to provide the encapsulation needed for highly-capable models.

Most medical multimodal benchmarks focus on static tasks such as image question answering, report generation, and plain-language rewriting. Patient education is more demanding: systems must identify relevant evidence across images, show patients where to look, explain findings in accessible language, and handle confusion or distress. Yet most patient education work remains text-only, even though combined image-and-text explanations may better support understanding. We introduce MedImageEdu, a benchmark for multi-turn, evidence-grounded radiology patient education. Each case provides a radiology report with report text and case images. A DoctorAgent interacts with a PatientAgent, conditioned on a hidden profile that captures factors such as education level, health literacy, and personality. When a patient question would benefit from visual support, the DoctorAgent can issue drawing instructions grounded in the report, case images, and the current question to a benchmark-provided drawing tool. The tool returns image(s), after which the DoctorAgent produces a final multimodal response consisting of the image(s) and a grounded plain-language explanation. MedImageEdu contains 150 cases from three sources and evaluates both the consultation process and the final multimodal response along five dimensions: Consultation, Safety and Scope, Language Quality, Drawing Quality, and Image-Text Response Quality. Across representative open- and closed-source vision-language model agents, we find three consistent gaps: fluent language often outpaces faithful visual grounding, safety is the weakest dimension across disease categories, and emotionally tense interactions are harder than low education or low health literacy. MedImageEdu provides a controlled testbed for assessing whether multimodal agents can teach from evidence rather than merely answer from text.

Many math- and science-oriented agent systems use hierarchical designs with specialized reviewer roles, assuming that a dedicated review stage should help turn wrong candidates into correct ones. We test this assumption on 4,181 verifier-grounded Omni-MATH problems using matched gpt-oss-120b actors. Collaboration adds little on the easiest tiers, but from tier 4 onward the gains open sharply; in this harder regime, broadcast-style peer discussion reaches higher final accuracy than a planner-executor-reviewer pipeline (PER). We ask whether this gap is explained by reviewer quality or by whether critique changes the next answer the protocol carries forward. It is not explained by reviewer precision alone: PER's reviewer is more precise than broadcast's (0.861 vs. 0.644), yet evaluator-verified useful critique is much less likely to change the next candidate and produces lower reviewer-guided repair. These results show that reviewer detection quality and critique uptake are empirically separable. Within matched PER interventions, forcing explicit acknowledgment lowers final accuracy, while embedding reviewer guidance directly in the solver's working context partially improves follow-through without closing the gap. Overall, reviewer-centric evaluation can overstate system quality: a protocol may spot errors well yet still fail to solve more problems if it does not act on those critiques.

Scientific Deep Research (DR) agents answer user queries by synthesizing research papers into multi-section reports. User feedback can improve their utility, but existing protocols only score the final report, making it hard to study and learn which intermediate actions DR agents should take to improve reports. We collect DRACULA, the first dataset with user feedback on intermediate actions for DR. Over five weeks, nineteen expert CS researchers ask queries to a DR system that proposes actions (e.g., "Add a section on datasets"). Our users select actions they prefer, then judge whether an output report applied their selections successfully, yielding 8,103 action preferences and 5,230 execution judgments. After confirming a DR agent can execute DRACULA's actions, we study the predictability of user-preferred actions via simulation-how well LLMs predict the actions users select-a step toward learning to generate useful actions. We discover: (1) LLM judges initially struggle to predict action selections, but improve most when using a user's full selection history, rather than self-reported or extrapolated user context signals; (2) Users' selections for the same query differ based on unstated goals, bottlenecking simulation and motivating affordances that let users steer reports; and (3) Our simulation results inform an online intervention that generates new actions based on the user's past interactions, which users pick most often in follow-up studies. Overall, while work extensively studies execution, DRACULA reveals a key challenge is deciding which actions to execute in the first place. We open-source DRACULA's study design, user feedback, and simulation tasks to spur future work on action feedback for long-horizon agents.

In medical education, physicians convert academic knowledge into clinical expertise through residency: years of training across thousands of encounters, with diverse sources of feedback and progressively greater autonomy. Much of clinical reasoning relies on the patient encounter, a dialogue in which a clinician elicits history, refines diagnostic hypotheses, and decides management under uncertainty. While large language models (LLMs) excel on static medical benchmarks, methods to optimize the full sequence of clinical decisions remain underdeveloped. We present ResidencyRL, a reinforcement learning (RL) method for training clinical artificial intelligence (AI) agents through simulated multi-turn clinical encounters (up to 60 dialogue turns and 8 tool calls per trajectory). ResidencyRL pairs the policy agent with LLM simulators capable of complex, adversarial behaviors, training against a structured reward aligned to diagnostic accuracy, management quality, communication, documentation, and safety. On held-out evaluations, the ResidencyRL agent improves diagnostic accuracy by 7.0% under adversarial conditions (88.0% vs. 81.0%) and reduces missed red flag rates by 31%, demonstrating rigorous mitigation of premature closure. Blinded expert clinicians validated these gains, preferring the trained agent in 87.6% of side-by-side comparisons. The procedural competencies transfer to unseen benchmarks: the agent outperforms the base model across all six clinical axes of the AMIE multi-visit benchmark, and shows consistent directional improvements on AgentClinic and CRAFT-MD. Our findings demonstrate that sequential clinical decision-making can be effectively learned through multi-turn RL in simulation, yielding robust, generalizable capabilities, paving the way towards clinical mastery. Prospective validation with real-world workflows remains necessary to establish clinical utility.

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

Background: Agent skills are increasingly deployed as modular, reusable capability units in AI agent systems. Medical research agent skills require safeguards beyond general-purpose evaluation, including scientific integrity, methodological validity, reproducibility, and boundary safety. This study developed and preliminarily evaluated a domain-specific audit framework for medical research agent skills, with a focus on reliability against expert review. Methods: We developed MedSkillAudit (skill-auditor@1.0), a layered framework assessing skill release readiness before deployment. We evaluated 75 skills across five medical research categories (15 per category). Two experts independently assigned a quality score (0-100), an ordinal release disposition (Production Ready / Limited Release / Beta Only / Reject), and a high-risk failure flag. System-expert agreement was quantified using ICC(2,1) and linearly weighted Cohen's kappa, benchmarked against the human inter-rater baseline. Results: The mean consensus quality score was 72.4 (SD = 13.0); 57.3% of skills fell below the Limited Release threshold. MedSkillAudit achieved ICC(2,1) = 0.449 (95% CI: 0.250-0.610), exceeding the human inter-rater ICC of 0.300. System-consensus score divergence (SD = 9.5) was smaller than inter-expert divergence (SD = 12.4), with no directional bias (Wilcoxon p = 0.613). Protocol Design showed the strongest category-level agreement (ICC = 0.551); Academic Writing showed a negative ICC (-0.567), reflecting a structural rubric-expert mismatch. Conclusions: Domain-specific pre-deployment audit may provide a practical foundation for governing medical research agent skills, complementing general-purpose quality checks with structured audit workflows tailored to scientific use cases.

We study auto research as a closed empirical loop driven by external measurement. Each submitted trial carries a hypothesis, an executable code edit, an evaluator-owned outcome, and feedback that shapes the next proposal. The output is not a generated paper or a single model checkpoint, but an auditable trajectory of proposals, code diffs, experiments, scores, and failure labels. We instantiate this loop with specialist agents that partition recipe surfaces and share measured lineage across trials. The central empirical finding is that lineage feedback lets agents turn evaluator outcomes, including crashes, budget overruns, size failures, and accuracy-gate misses, into later program-level recipe edits rather than one-shot suggestions. Across 1,197 headline-run trials plus 600 Parameter Golf control trials after one-time setup and launch, humans did not choose proposals, edit recipes, override scores, or repair failed trials during the search. In the three headline runs, the same submitted-trial loop reduces Parameter Golf validation bpb by 0.81%, raises NanoChat-D12 CORE by 38.7%, and reduces CIFAR-10 Airbench96 wallclock by 4.59%, with each task measured by its own external evaluator and legality checks. The trace includes a strict architecture-domain audit of 157 headline-run submissions and program rewrites such as a NanoChat attention-kernel path change. Within this scope the loop autonomously writes code, submits experiments, absorbs feedback, applies and combines known techniques inside each environment, and improves public starting recipes.

We introduce MPLSandbox, an out-of-the-box multi-programming language sandbox designed to provide unified and comprehensive feedback from compiler and analysis tools for Large Language Models (LLMs). It can automatically identify the programming language of the code, compiling and executing it within an isolated sub-sandbox to ensure safety and stability. In addition, MPLSandbox also integrates both traditional and LLM-based code analysis tools, providing a comprehensive analysis of generated code. MPLSandbox can be effortlessly integrated into the training and deployment of LLMs to improve the quality and correctness of their generated code. It also helps researchers streamline their workflows for various LLM-based code-related tasks, reducing the development cost. To validate the effectiveness of MPLSandbox, we integrate it into training and deployment approaches, and also employ it to optimize workflows for a wide range of real-world code-related tasks. Our goal is to enhance researcher productivity on LLM-based code-related tasks by simplifying and automating workflows through delegation to MPLSandbox.

Traditional metrics for Medical Report Generation (MRG) predominantly rely on surface-level n-gram overlap, which fails to capture clinical factual accuracy and often overlooks catastrophic diagnostic errors. We address this fundamental limitation by proposing AtomiMed, a universal, modality-agnostic evaluation framework that decomposes complex medical narratives into a standardized, multi-level hierarchy of Atomic Clinical Facts, encompassing Disease-level entities and Attribute-level descriptors, including location, morphology, and severity. By implementing an Agentic Cross-Verification loop between ground-truth and predicted reports, AtomiMed simulates a multi-radiologist peer-review process to verify clinical consistency, thus enabling the decoupled assessment of diagnostic detection and descriptive accuracy. To facilitate standardized evaluation, we introduce MRGEvalKit, an open-source toolkit for automated hierarchical extraction, and curate OmniMRG-Bench, a comprehensive multi-modal benchmark covering X-ray, CT, MRI, and Ultrasound. Extensive experiments on multiple expert-annotated reader studies demonstrate that AtomiMed achieves significantly higher correlation with human radiologist judgment compared to traditional and model-based metrics. Our code are release at https://github.com/Venn2336/MRGEvalkit

Long-horizon agents are beginning to automate complete workflows that produce code, reports, and research artifacts. Medical imaging workflows are multi-stage and data-sensitive, while expert trajectories remain scarce and difficult to share. Structured benchmarks can localize failures through stage-level rubrics, but standard post-training discards these diagnostics before the next training round. We present Benchmark-as-Teacher (BaT), a recursive self-improvement system for agent post-training. BaT contains two linked components: the asynchronous Stage Bank data pipeline and BiCuRL (Bilevel Curriculum Reinforcement Learning), its self-improving post-training method. Stage Bank synthesizes content-isolated training states outside the policy-update loop. BiCuRL uses a fixed held-out evaluation to select the next stage curriculum, verifies rollouts with task rubrics, updates the policy with GRPO, and returns the candidate checkpoint to evaluation. On AutoMedBench-Lite, BaT-4B and BaT-9B more than double the Overall scores of their Qwen Instruct baselines. BaT-9B Agent reaches 79.6 Overall, exceeding Claude Opus 4.6 with Claude Code at 77.5.

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.

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.

Artificial intelligence has significantly advanced healthcare, particularly through large language models (LLMs) that excel in medical question answering benchmarks. However, their real-world clinical application remains limited due to the complexities of doctor-patient interactions. To address this, we introduce AI Hospital, a multi-agent framework simulating dynamic medical interactions between Doctor as player and NPCs including Patient, Examiner, Chief Physician. This setup allows for realistic assessments of LLMs in clinical scenarios. We develop the Multi-View Medical Evaluation (MVME) benchmark, utilizing high-quality Chinese medical records and NPCs to evaluate LLMs' performance in symptom collection, examination recommendations, and diagnoses. Additionally, a dispute resolution collaborative mechanism is proposed to enhance diagnostic accuracy through iterative discussions. Despite improvements, current LLMs exhibit significant performance gaps in multi-turn interactions compared to one-step approaches. Our findings highlight the need for further research to bridge these gaps and improve LLMs' clinical diagnostic capabilities. Our data, code, and experimental results are all open-sourced at https://github.com/LibertFan/AI_Hospital.

Code editing is an essential step towards reliable program synthesis to automatically correct critical errors generated from code LLMs. Recent studies have demonstrated that closed-source LLMs (i.e., ChatGPT and GPT-4) are capable of generating corrective feedback to edit erroneous inputs. However, it remains challenging for open-source code LLMs to generate feedback for code editing, since these models tend to adhere to the superficial formats of feedback and provide feedback with misleading information. Hence, the focus of our work is to leverage open-source code LLMs to generate helpful feedback with correct guidance for code editing. To this end, we present Coffee, a collected dataset specifically designed for code fixing with feedback. Using this dataset, we construct CoffeePots, a framework for COde Fixing with FEEdback via Preference-Optimized Tuning and Selection. The proposed framework aims to automatically generate helpful feedback for code editing while minimizing the potential risk of superficial feedback. The combination of Coffee and CoffeePots marks a significant advancement, achieving state-of-the-art performance on HumanEvalFix benchmark. Codes and model checkpoints are publicly available at https://github.com/Lune-Blue/COFFEE.

Large Language Models (LLMs) are increasingly serving as autonomous agents, and their utilization of external tools via the Model Context Protocol (MCP) is considered a future trend. Current MCP evaluation sets suffer from issues such as reliance on external MCP services and a lack of difficulty awareness. To address these limitations, we propose MCPAgentBench, a benchmark based on real-world MCP definitions designed to evaluate the tool-use capabilities of agents. We construct a dataset containing authentic tasks and simulated MCP tools. The evaluation employs a dynamic sandbox environment that presents agents with candidate tool lists containing distractors, thereby testing their tool selection and discrimination abilities. Furthermore, we introduce comprehensive metrics to measure both task completion rates and execution efficiency. Experiments conducted on various latest mainstream Large Language Models reveal significant performance differences in handling complex, multi-step tool invocations. All code is open-source at Github.

Large language models (LLMs) are increasingly proposed as clinical agents, yet static, single-turn benchmarks cannot capture how a model dynamically delivers care across an encounter: gathering information, planning treatment, and adapting longitudinal management across successive patient states. Medical education has long addressed an analogous challenge through standardized patients (SPs): trained actors who consistently portray clinical cases, enabling realistic practice and objective, scripted assessment. Here we introduce MedSP1000, an SP-derived interactive benchmark for clinical-agent evaluation, including 1,638 SP cases with 24,602 trajectory-level peer-reviewed rubrics. MedSP1000 converts peer-reviewed SP teaching cases into executable scenarios with defined SP case scripts, clinical environment contexts, and human-validated structured rubric. In each simulation evaluation run, a clinical agent interacts in closed loop with a patient agent and an environment controller, and its behaviour is scored throughout the encounter against expert criteria specified in the original materials. Applying MedSP1000 to a range of general-purpose and medically specialized LLMs, we find that performance on static benchmarks does not reliably translate to such educational scenarios. The best-performing model, GPT-5.5, completes only 60.4% of expert-defined rubric items, whereas the strongest medically specialized model reaches 40.0%; increasing test-time compute produces no measurable gain. These results suggest that current LLMs, including agentic systems tuned for medicine, are not yet reliable enough to be safely integrated into actual clinical practice. More broadly, MedSP1000 shows how process-level, SP-style evaluation can reveal clinically relevant failure modes that single-turn benchmarks miss.

Large language models (LLMs) have become increasingly capable of following instructions and complex reasoning, making prompting a flexible interface for adapting models without parameter updates. Yet prompt design remains labor-intensive and highly sensitive to formatting, phrasing, and instruction order, motivating automated prompt optimization methods that reduce manual effort while preserving inference-time flexibility. However, existing methods often search over prompt candidates or use fixed critique-refine pipelines driven by individual examples or small batches, limiting their ability to capture systematic error patterns and make targeted edits grounded in failure history. We propose Reflective Prompt Tuning (RPT), a framework that uses LLM function calling to simulate the iterative workflow of human prompt engineers. An LLM optimizer calls a diagnostic function that evaluates the target model over an entire optimization set, summarizes recurring failure modes, and returns a structured diagnostic report. The optimizer uses this report, together with an accumulated memory of prior reports, to revise the prompt for the next iteration. RPT further supports confidence-aware optimization by using calibration signals in diagnostic feedback and final prompt selection. Across three reasoning tasks, RPT improves over initial prompts by up to 12.9 points, remains competitive with state of the art, and improves confidence calibration. Our analyses show that RPT is especially effective on multi-hop and mathematical reasoning, producing targeted prompt revisions that align with diagnosed failure patterns and lead to gains in task performance and calibration.

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

Optimizing LLM-based agentic workflows is challenging for scaling AI capabilities. Current methods rely on coarse, end-to-end evaluation signals and lack fine-grained signals on where to refine, often resulting in inefficient or low-impact modifications. To address these limitations, we propose JudgeFlow, an Evaluation-Judge-Optimization-Update pipeline. We incorporate reusable, configurable logic blocks into agentic workflows to capture fundamental forms of logic. On top of this abstraction, we design a dedicated Judge module that inspects execution traces particularly failed runs and assigns rank-based responsibility scores to problematic blocks. These fine-grained diagnostic signals are then leveraged by an LLM-based optimizer, which focuses modifications on the most problematic block in the workflow. Our approach improves sample efficiency, enhances interpretability through block-level diagnostics, and provides a scalable foundation for automating increasingly complex agentic workflows. We evaluate JudgeFlow on mathematical reasoning and code generation benchmarks, where JudgeFlow achieves superior performance and efficiency compared to existing methods.

Proactive interventions by LLM critic models are often assumed to improve reliability, yet their effects at deployment time are poorly understood. We show that a binary LLM critic with strong offline accuracy (AUROC 0.94) can nevertheless cause severe performance degradation, inducing a 26 percentage point (pp) collapse on one model while affecting another by near zero pp. This variability demonstrates that LLM critic accuracy alone is insufficient to determine whether intervention is safe. We identify a disruption-recovery tradeoff: interventions may recover failing trajectories but also disrupt trajectories that would have succeeded. Based on this insight, we propose a pre-deployment test that uses a small pilot of 50 tasks to estimate whether intervention is likely to help or harm, without requiring full deployment. Across benchmarks, the test correctly anticipates outcomes: intervention degrades performance on high-success tasks (0 to -26 pp), while yielding a modest improvement on the high-failure ALFWorld benchmark (+2.8 pp, p=0.014). The primary value of our framework is therefore identifying when not to intervene, preventing severe regressions before deployment.

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.

Tool-augmented LLM agents raise new security risks: tool executions can introduce runtime-only behaviors, including prompt injection and unintended exposure of external inputs (e.g., environment secrets or local files). While existing scanners often focus on static artifacts, analyzing runtime behavior is challenging because directly executing untrusted tools can itself be dangerous. We present MCP-SandboxScan, a lightweight framework motivated by the Model Context Protocol (MCP) that safely executes untrusted tools inside a WebAssembly/WASI sandbox and produces auditable reports of external-to-sink exposures. Our prototype (i) extracts LLM-relevant sinks from runtime outputs (prompt/messages and structured tool-return fields), (ii) instantiates external-input candidates from environment values, mounted file contents, and output-surfaced HTTP fetch intents, and (iii) links sources to sinks via snippet-based substring matching. Case studies on three representative tools show that MCP-SandboxScan can surface provenance evidence when external inputs appear in prompt/messages or tool-return payloads, and can expose filesystem capability violations as runtime evidence. We further compare against a lightweight static string-signature baseline and use a micro-benchmark to characterize false negatives under transformations and false positives from short-token collisions.

Multi-agent systems (MAS) are critical for automating complex tasks, yet their practical deployment is severely hampered by the challenge of failure attribution. Current diagnostic tools, which rely on statistical correlations, are fundamentally inadequate; on challenging benchmarks like Who\&When, state-of-the-art methods achieve less than 15\% accuracy in locating the root-cause step of a failure. To address this critical gap, we introduce the first failure attribution framework for MAS grounded in multi-granularity causal inference. Our approach makes two key technical contributions: (1) a performance causal inversion principle, which correctly models performance dependencies by reversing the data flow in execution logs, combined with Shapley values to accurately assign agent-level blame; (2) a novel causal discovery algorithm, CDC-MAS, that robustly identifies critical failure steps by tackling the non-stationary nature of MAS interaction data. The framework's attribution results directly fuel an automated optimization loop, generating targeted suggestions whose efficacy is validated via counterfactual simulations. Evaluations on the Who\&When and TRAIL benchmarks demonstrate a significant leap in performance. Our method achieves up to 36.2\% step-level accuracy. Crucially, the generated optimizations boost overall task success rates by an average of 22.4\%. This work provides a principled and effective solution for debugging complex agent interactions, paving the way for more reliable and interpretable multi-agent systems.

Vision-language foundation models (VLMs) show promise for diverse imaging tasks but often underperform on medical benchmarks. Prior efforts to improve performance include model finetuning, which requires large domain-specific datasets and significant compute, or manual prompt engineering, which is hard to generalize and often inaccessible to medical institutions seeking to deploy these tools. These challenges motivate interest in approaches that draw on a model's embedded knowledge while abstracting away dependence on human-designed prompts to enable scalable, weight-agnostic performance improvements. To explore this, we adapt the Declarative Self-improving Python (DSPy) framework for structured automated prompt optimization in medical vision-language systems through a comprehensive, formal evaluation. We implement prompting pipelines for five medical imaging tasks across radiology, gastroenterology, and dermatology, evaluating 10 open-source VLMs with four prompt optimization techniques. Optimized pipelines achieved a median relative improvement of 53% over zero-shot prompting baselines, with the largest gains ranging from 300% to 3,400% on tasks where zero-shot performance is low. These results highlight the substantial potential of applying automated prompt optimization to medical AI systems, demonstrating significant gains for vision-based applications requiring accurate clinical image interpretation. By reducing dependence on prompt design to elicit intended outputs, these techniques allow clinicians to focus on patient care and clinical decision-making. Furthermore, our experiments offer scalability and preserve data privacy, demonstrating performance improvement on open-source VLMs. We publicly release our evaluation pipelines to support reproducible research on specialized medical tasks, available at https://github.com/DaneshjouLab/prompt-triage-lab.

Automatic prompt engineering (APE) rewrites prompts to improve downstream task performance, but existing APE loops treat the optimizer itself as a fixed pipeline. We port the code-as-action paradigm of CodeAct (Wang et al., 2024a) to APE and propose SPEAR (Sandboxed Prompt Engineer with Active Roll-back), a free-form agentic optimizer with four tools -- evaluate, python, set_prompt, finish -- that decides autonomously how and when to use them. The distinctive tool is the Python sandbox: the optimizer writes and executes arbitrary Python on the current evaluation DataFrame, performing structural error analysis (confusion matrices, error clustering, per group metrics) the agent itself authors. Two guardrails turn the long-horizon agent into a monotone-improving optimizer: auto-rollback on metric regression, and an optional guard metric floor. We evaluate on three industrial LLM-as-judge suites (13 judge tasks across recruiter-intake, conversational-memory, and query-refinement systems) plus seven BBH tasks and GSM8K. SPEAR wins every industrial task on the primary metric (κ 0.857 vs 0.359 on tool-selection; F1-macro 0.815 vs 0.763 on filter-relevance; κ 0.254 vs 0.218 on the hardest extraction dimension). On BBH-7 SPEAR averages 0.938 accuracy vs GEPA 0.628 and TextGrad 0.484. Ablations show the Python tool is the largest single lever on complex judge tasks (Δapprox +0.79κ on the 5-class tool-selection judge, Δapprox +0.35κ on the hardest extraction dimension when removed); its irreplaceable contribution is class-pair confusion aggregation that a long-context LLM cannot extract reliably from the raw eval DataFrame.

Automated issue solving aims to resolve real-world issues in software repositories. The most popular benchmarks for automated issue solving are SWE-bench and its human-filtered subset SWE-bench Verified. These benchmarks leverage testing to validate generated patches. However, because testing is rarely exhaustive, a patch may pass the tests but nevertheless fail to match the developers' expectations. Unfortunately, it is currently unclear to what extent evaluations performed with SWE-bench suffer from such plausible but incorrect patches. This paper presents an in-depth empirical study of the correctness of plausible patches generated by three state-of-the-art issue-solving tools evaluated on SWE-bench Verified. We extensively test and inspect generated patches, and compare them against human-written ground truth patches. The core of our methodology is a novel technique PatchDiff for differential patch testing, which automatically exposes behavioral discrepancies between two patches. Our findings reveal critical weaknesses in SWE-bench's patch validation mechanism, which causes 7.8% of all patches to count as correct while failing the developer-written test suite. Moreover, our novel automated technique reveals that even more (29.6%) plausible patches induce different behavior than the ground truth patches. These behavioral differences are often due to similar, but divergent implementations (46.8%) and due to generated patches that adapt more behavior than the ground truth patches (27.3%). Our manual inspection shows that 28.6% of behaviorally divergent patches are certainly incorrect. Combined, the different weaknesses lead to an inflation of reported resolution rates by 6.2 absolute percent points. Our findings are a call to arms for more robust and reliable evaluation of issue-solving tools. We envision our automated differential patch testing technique to be useful for this purpose.

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

Quantification of real-time informal feedback delivered by an experienced surgeon to a trainee during surgery is important for skill improvements in surgical training. Such feedback in the live operating room is inherently multimodal, consisting of verbal conversations (e.g., questions and answers) as well as non-verbal elements (e.g., through visual cues like pointing to anatomic elements). In this work, we leverage a clinically-validated five-category classification of surgical feedback: "Anatomic", "Technical", "Procedural", "Praise" and "Visual Aid". We then develop a multi-label machine learning model to classify these five categories of surgical feedback from inputs of text, audio, and video modalities. The ultimate goal of our work is to help automate the annotation of real-time contextual surgical feedback at scale. Our automated classification of surgical feedback achieves AUCs ranging from 71.5 to 77.6 with the fusion improving performance by 3.1%. We also show that high-quality manual transcriptions of feedback audio from experts improve AUCs to between 76.5 and 96.2, which demonstrates a clear path toward future improvements. Empirically, we find that the Staged training strategy, with first pre-training each modality separately and then training them jointly, is more effective than training different modalities altogether. We also present intuitive findings on the importance of modalities for different feedback categories. This work offers an important first look at the feasibility of automated classification of real-world live surgical feedback based on text, audio, and video modalities.

Context: Test-driven development (TDD) is a widely employed software development practice that involves developing test cases based on requirements prior to writing the code. Although various methods for automated test case generation have been proposed, they are not specifically tailored for TDD, where requirements instead of code serve as input. Objective: In this paper, we introduce a text-to-testcase generation approach based on a large language model (GPT-3.5) that is fine-tuned on our curated dataset with an effective prompt design. Method: Our approach involves enhancing the capabilities of basic GPT-3.5 for text-to-testcase generation task that is fine-tuned on our curated dataset with an effective prompting design. We evaluated the effectiveness of our approach using a span of five large-scale open-source software projects. Results: Our approach generated 7k test cases for open source projects, achieving 78.5% syntactic correctness, 67.09% requirement alignment, and 61.7% code coverage, which substantially outperforms all other LLMs (basic GPT-3.5, Bloom, and CodeT5). In addition, our ablation study demonstrates the substantial performance improvement of the fine-tuning and prompting components of the GPT-3.5 model. Conclusions: These findings lead us to conclude that fine-tuning and prompting should be considered in the future when building a language model for the text-to-testcase generation task

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

Evaluations should do more than measure a models current performance. They should tell us what to fix for the next model iteration and provide a way to generate targeted post training data. Most evaluation pipelines identify weak examples, topics, or categories, but they leave the underlying capability failure implicit: they say where a model fails, not why. We introduce CRAFT, a method that converts any rubric based evaluation dataset into a model specific diagnosis of weak capabilities. CRAFT treats each grading criterion as a capability probe: it extracts a capability description from every prompt rubric pair, clusters these descriptions into a hierarchical capability tree, scores the target model at every node, and selects low performing nodes dynamically across tree levels, at the granularity where each failure is clearest. The selected weak capabilities then direct the generation of targeted supervised finetuning data. Holding the data generation, finetuning, and evaluation setup fixed, we compare CRAFT against prompt level EvalTree clustering and untargeted random generation on four open source models, two professional domains (finance and legal), and 13 held out benchmarks disjoint from the diagnostic data. CRAFT achieves the strongest finance domain average for all four models under repeated temperature decoding; on legal domain, it is strongest for three of four models and remains within the decoding variance bands of the best baseline on the fourth. Diagnosing weaknesses at the level of rubric criteria, rather than prompts or categories, thus yields both a sharper picture of what a model cannot do and measurably better models after finetuning on that diagnosis.

Community Notes, the crowd-sourced misinformation governance system on X (formerly Twitter), allows users to flag misleading posts, attach contextual notes, and rate the notes' helpfulness. However, our empirical analysis of 30.8K health-related notes reveals substantial latency, with a median delay of 17.6 hours before notes receive a helpfulness status. To improve responsiveness during real-world misinformation surges, we propose CrowdNotes+, a unified LLM-based framework that augments Community Notes for faster and more reliable health misinformation governance. CrowdNotes+ integrates two modes: (1) evidence-grounded note augmentation and (2) utility-guided note automation, supported by a hierarchical three-stage evaluation of relevance, correctness, and helpfulness. We instantiate the framework with HealthNotes, a benchmark of 1.2K health notes annotated for helpfulness, and a fine-tuned helpfulness judge. Our analysis first uncovers a key loophole in current crowd-sourced governance: voters frequently conflate stylistic fluency with factual accuracy. Addressing this via our hierarchical evaluation, experiments across 15 representative LLMs demonstrate that CrowdNotes+ significantly outperforms human contributors in note correctness, helpfulness, and evidence utility.

Large Language Models (LLMs) based autonomous agents demonstrate multifaceted capabilities to contribute substantially to economic production. However, existing benchmarks remain focused on single agentic capability, failing to capture long-horizon real-world scenarios. Moreover, the reliance on human-in-the-loop feedback for realistic tasks creates a scalability bottleneck, hindering automated rollout collection and evaluation. To bridge this gap, we introduce AgencyBench, a comprehensive benchmark derived from daily AI usage, evaluating 6 core agentic capabilities across 32 real-world scenarios, comprising 138 tasks with specific queries, deliverables, and rubrics. These scenarios require an average of 90 tool calls, 1 million tokens, and hours of execution time to resolve. To enable automated evaluation, we employ a user simulation agent to provide iterative feedback, and a Docker sandbox to conduct visual and functional rubric-based assessment. Experiments reveal that closed-source models significantly outperform open-source models (48.4% vs 32.1%). Further analysis reveals significant disparities across models in resource efficiency, feedback-driven self-correction, and specific tool-use preferences. Finally, we investigate the impact of agentic scaffolds, observing that proprietary models demonstrate superior performance within their native ecosystems (e.g., Claude-4.5-Opus via Claude-Agent-SDK), while open-source models exhibit distinct performance peaks, suggesting potential optimization for specific execution frameworks. AgencyBench serves as a critical testbed for next-generation agents, highlighting the necessity of co-optimizing model architecture with agentic frameworks. We believe this work sheds light on the future direction of autonomous agents, and we release the full benchmark and evaluation toolkit at https://github.com/GAIR-NLP/AgencyBench.

Evaluations (Evals) are a deployment bottleneck for real-world AI applications: public benchmarks rarely match a team's users, context, or policies, and human review is often tedious to scale. Motivated by our work with AI applications in the public sector, this project addresses recurring evaluation challenges encountered when applications must satisfy local policy and governance requirements. We present Kaleidoscope, an integrated workflow for contextual functional evaluation that links persona-based test generation, contextualized rubrics, and human review for reliability-gated automated scoring. Generated test cases are scored against application-specific rubrics; human annotations provide reviewable labels; and LLM judges automate scoring only when their agreement with those labels meets a configured threshold. Kaleidoscope is therefore a practical, inspectable, iterative workflow for product teams. We report early evidence from a three-week pilot across four organizational use cases and custom-rubric judge experiments on 108 annotated Q\&A pairs spanning four domains and 14 evaluation dimensions. The results highlight useful features for end-to-end reliable, automated scoring.

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.

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

Software is one of the most powerful tools that we humans have at our disposal; it allows a skilled programmer to interact with the world in complex and profound ways. At the same time, thanks to improvements in large language models (LLMs), there has also been a rapid development in AI agents that interact with and affect change in their surrounding environments. In this paper, we introduce OpenDevin, a platform for the development of powerful and flexible AI agents that interact with the world in similar ways to those of a human developer: by writing code, interacting with a command line, and browsing the web. We describe how the platform allows for the implementation of new agents, safe interaction with sandboxed environments for code execution, coordination between multiple agents, and incorporation of evaluation benchmarks. Based on our currently incorporated benchmarks, we perform an evaluation of agents over 15 challenging tasks, including software engineering (e.g., SWE-Bench) and web browsing (e.g., WebArena), among others. Released under the permissive MIT license, OpenDevin is a community project spanning academia and industry with more than 1.3K contributions from over 160 contributors and will improve going forward.

Critical peer review of scientific manuscripts presents a significant challenge for Large Language Models (LLMs), partly due to data limitations and the complexity of expert reasoning. This report introduces Persistent Workflow Prompting (PWP), a potentially broadly applicable prompt engineering methodology designed to bridge this gap using standard LLM chat interfaces (zero-code, no APIs). We present a proof-of-concept PWP prompt for the critical analysis of experimental chemistry manuscripts, featuring a hierarchical, modular architecture (structured via Markdown) that defines detailed analysis workflows. We develop this PWP prompt through iterative application of meta-prompting techniques and meta-reasoning aimed at systematically codifying expert review workflows, including tacit knowledge. Submitted once at the start of a session, this PWP prompt equips the LLM with persistent workflows triggered by subsequent queries, guiding modern reasoning LLMs through systematic, multimodal evaluations. Demonstrations show the PWP-guided LLM identifying major methodological flaws in a test case while mitigating LLM input bias and performing complex tasks, including distinguishing claims from evidence, integrating text/photo/figure analysis to infer parameters, executing quantitative feasibility checks, comparing estimates against claims, and assessing a priori plausibility. To ensure transparency and facilitate replication, we provide full prompts, detailed demonstration analyses, and logs of interactive chats as supplementary resources. Beyond the specific application, this work offers insights into the meta-development process itself, highlighting the potential of PWP, informed by detailed workflow formalization, to enable sophisticated analysis using readily available LLMs for complex scientific tasks.

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.

By simply composing prompts, developers can prototype novel generative applications with Large Language Models (LLMs). To refine prototypes into products, however, developers must iteratively revise prompts by evaluating outputs to diagnose weaknesses. Formative interviews (N=8) revealed that developers invest significant effort in manually evaluating outputs as they assess context-specific and subjective criteria. We present EvalLM, an interactive system for iteratively refining prompts by evaluating multiple outputs on user-defined criteria. By describing criteria in natural language, users can employ the system's LLM-based evaluator to get an overview of where prompts excel or fail, and improve these based on the evaluator's feedback. A comparative study (N=12) showed that EvalLM, when compared to manual evaluation, helped participants compose more diverse criteria, examine twice as many outputs, and reach satisfactory prompts with 59% fewer revisions. Beyond prompts, our work can be extended to augment model evaluation and alignment in specific application contexts.

LLM-based simulated clients are increasingly used to train novice counselors, evaluate LLM therapists, and generate synthetic data. However, current simulators produce overly cooperative clients that disclose too readily, accept therapeutic reframes without resistance, and resolve core issues within a single session. We trace these issues to profiles that lack causal depth and behavioral mechanisms that treat all content as equally accessible. We present PatientAct, a framework for client simulation grounded in established clinical theories. Our profiles integrate the 5Ps clinical case formulation, providing causal depth without tying the design to any single therapeutic modality. During simulation, profiles include a dynamic memory layer in which items carry trust thresholds (e.g., symptoms are available early, whereas formative memories require a sustained therapeutic alliance). At each turn, the client's emotional reaction and behavior are modeled before generating a response. If the therapist approaches gated content, PatientAct expresses resistance in terms of quantity, content, and style rather than defaulting to cooperation or a single resistance pattern. We evaluate our framework on 40 clinical situations and demonstrate that it generates diverse profiles with high clinical plausibility. Moreover, PatientAct significantly outperforms the baselines, yielding substantial gains in resistance quality and behavioral realism. Our code and data will be publicly available via github.com/Sahandfer/PatientHub.

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.

The growing capabilities of large language models (LLMs) have led to their use as substitutes for human feedback for training and assessing other LLMs. These methods often rely on `constitutions', written guidelines which a critic model uses to provide feedback and improve generations. We investigate how the choice of constitution affects feedback quality by using four different constitutions to improve patient-centered communication in medical interviews. In pairwise comparisons conducted by 215 human raters, we found that detailed constitutions led to better results regarding emotive qualities. However, none of the constitutions outperformed the baseline in learning more practically-oriented skills related to information gathering and provision. Our findings indicate that while detailed constitutions should be prioritised, there are possible limitations to the effectiveness of AI feedback as a reward signal in certain areas.

Feedback is crucial for every design process, such as user interface (UI) design, and automating design critiques can significantly improve the efficiency of the design workflow. Although existing multimodal large language models (LLMs) excel in many tasks, they often struggle with generating high-quality design critiques -- a complex task that requires producing detailed design comments that are visually grounded in a given design's image. Building on recent advancements in iterative refinement of text output and visual prompting methods, we propose an iterative visual prompting approach for UI critique that takes an input UI screenshot and design guidelines and generates a list of design comments, along with corresponding bounding boxes that map each comment to a specific region in the screenshot. The entire process is driven completely by LLMs, which iteratively refine both the text output and bounding boxes using few-shot samples tailored for each step. We evaluated our approach using Gemini-1.5-pro and GPT-4o, and found that human experts generally preferred the design critiques generated by our pipeline over those by the baseline, with the pipeline reducing the gap from human performance by 50% for one rating metric. To assess the generalizability of our approach to other multimodal tasks, we applied our pipeline to open-vocabulary object and attribute detection, and experiments showed that our method also outperformed the baseline.

Tumor documentation in Germany is largely done manually, requiring reading patient records and entering data into structured databases. Large language models (LLMs) could potentially enhance this process by improving efficiency and reliability. This evaluation tests eleven different open source LLMs with sizes ranging from 1-70 billion model parameters on three basic tasks of the tumor documentation process: identifying tumor diagnoses, assigning ICD-10 codes, and extracting the date of first diagnosis. For evaluating the LLMs on these tasks, a dataset of annotated text snippets based on anonymized doctors' notes from urology was prepared. Different prompting strategies were used to investigate the effect of the number of examples in few-shot prompting and to explore the capabilities of the LLMs in general. The models Llama 3.1 8B, Mistral 7B, and Mistral NeMo 12 B performed comparably well in the tasks. Models with less extensive training data or having fewer than 7 billion parameters showed notably lower performance, while larger models did not display performance gains. Examples from a different medical domain than urology could also improve the outcome in few-shot prompting, which demonstrates the ability of LLMs to handle tasks needed for tumor documentation. Open source LLMs show a strong potential for automating tumor documentation. Models from 7-12 billion parameters could offer an optimal balance between performance and resource efficiency. With tailored fine-tuning and well-designed prompting, these models might become important tools for clinical documentation in the future. The code for the evaluation is available from https://github.com/stefan-m-lenz/UroLlmEval. We also release the dataset as a new valuable resource that addresses the shortage of authentic and easily accessible benchmarks in German-language medical NLP.

Agent self-evolution has primarily focused on learning how to act, while overlooking an equally important capability: learning to discover what an agent does not know. Existing approaches typically assume that failure discovery is given, focusing on how to repair failures once they are identified. We ask whether blind-spot diagnosis itself can be learned. We thus study diagnosis as an agent capability separate from execution, and exclude two alternative sources of progress: executor adaptation and human supervision. Under these constraints, performance cannot improve through executor updates or annotated examples, forcing all improvements to originate from the learned diagnostic capability. We propose SkillMentor, which trains a Mentor policy via reinforcement learning to generate diagnostic tasks, identify recurrent failure modes, and curate them into reusable corrective skills. Across AppWorld and BFCLv3, SkillMentor improves executor performance by an average of 44.2%. These results suggest that blind-spot diagnosis is a learnable capability, enabling self-evolution without updating executor weights or relying on human-curated data.

Current benchmarks for Large Language Models (LLMs) primarily focus on performance metrics, often failing to capture the nuanced behavioral characteristics that differentiate them. This paper introduces a novel ``Behavioral Fingerprinting'' framework designed to move beyond traditional evaluation by creating a multi-faceted profile of a model's intrinsic cognitive and interactive styles. Using a curated Diagnostic Prompt Suite and an innovative, automated evaluation pipeline where a powerful LLM acts as an impartial judge, we analyze eighteen models across capability tiers. Our results reveal a critical divergence in the LLM landscape: while core capabilities like abstract and causal reasoning are converging among top models, alignment-related behaviors such as sycophancy and semantic robustness vary dramatically. We further document a cross-model default persona clustering (ISTJ/ESTJ) that likely reflects common alignment incentives. Taken together, this suggests that a model's interactive nature is not an emergent property of its scale or reasoning power, but a direct consequence of specific, and highly variable, developer alignment strategies. Our framework provides a reproducible and scalable methodology for uncovering these deep behavioral differences. Project: https://github.com/JarvisPei/Behavioral-Fingerprinting

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.

Language models influence the external world: they query APIs that read and write to web pages, generate content that shapes human behavior, and run system commands as autonomous agents. These interactions form feedback loops: LLM outputs affect the world, which in turn affect subsequent LLM outputs. In this work, we show that feedback loops can cause in-context reward hacking (ICRH), where the LLM at test-time optimizes a (potentially implicit) objective but creates negative side effects in the process. For example, consider an LLM agent deployed to increase Twitter engagement; the LLM may retrieve its previous tweets into the context window and make them more controversial, increasing engagement but also toxicity. We identify and study two processes that lead to ICRH: output-refinement and policy-refinement. For these processes, evaluations on static datasets are insufficient -- they miss the feedback effects and thus cannot capture the most harmful behavior. In response, we provide three recommendations for evaluation to capture more instances of ICRH. As AI development accelerates, the effects of feedback loops will proliferate, increasing the need to understand their role in shaping LLM behavior.

Industrial automation is at a pivotal moment, as Physical AI is driving a transition from rigid, hand-engineered automation systems toward more flexible and adaptive systems. This shift has created a growing demand for large-scale, real-world robot demonstration data, making teleoperation an increasingly important mechanism for data collection. However, high-quality teleoperated demonstrations remain difficult to obtain in practice, as novice operators often produce episodes that are task-successful but suboptimal for downstream use due to inefficient motion, repeated corrections, or operation near robot joint limits. We present a Data Quality Assessment and Feedback (DQAF) framework that closes the loop in teleoperation by providing immediate post-episode feedback grounded in semantic task progress and robot telemetry. The framework extracts quality relevant signals such as sub-task progress, motion smoothness, stalls, kinematic limits and converts them into structured quality assessments and actionable natural-language feedback. Unlike binary success or failure feedback, the proposed system explains why an episode is suboptimal and highlights specific behaviors to correct in the next trial. We evaluate the framework through a diagnostic validation study and a pilot user study. In the validation study, the system is compared with a human reviewer during dataset curation, producing rejection reasons and actionable feedback for improvement. In the pilot study with three novice operators across two manipulation tasks, the operator who received the systems immediate, automated post-episode feedback improved faster than those who did not, producing higher-quality demonstrations sooner.

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

AI powered code-recommendation systems, such as Copilot and CodeWhisperer, provide code suggestions inside a programmer's environment (e.g., an IDE) with the aim of improving productivity. We pursue mechanisms for leveraging signals about programmers' acceptance and rejection of code suggestions to guide recommendations. We harness data drawn from interactions with GitHub Copilot, a system used by millions of programmers, to develop interventions that can save time for programmers. We introduce a utility-theoretic framework to drive decisions about suggestions to display versus withhold. The approach, conditional suggestion display from human feedback (CDHF), relies on a cascade of models that provide the likelihood that recommended code will be accepted. These likelihoods are used to selectively hide suggestions, reducing both latency and programmer verification time. Using data from 535 programmers, we perform a retrospective evaluation of CDHF and show that we can avoid displaying a significant fraction of suggestions that would have been rejected. We further demonstrate the importance of incorporating the programmer's latent unobserved state in decisions about when to display suggestions through an ablation study. Finally, we showcase how using suggestion acceptance as a reward signal for guiding the display of suggestions can lead to suggestions of reduced quality, indicating an unexpected pitfall.

Large Vision-Language Models (LVLMs) are increasingly being explored for applications in telemedicine, yet their ability to engage with diverse patient behaviors remains underexplored. We introduce 3MDBench (Medical Multimodal Multi-agent Dialogue Benchmark), an open-source evaluation framework designed to assess LLM-driven medical consultations. Unlike existing benchmarks, 3MDBench simulates real-world patient variability by incorporating four temperament-driven Patient Agents and an Assessor Agent that evaluates diagnostic accuracy and dialogue quality. The benchmark integrates textual and image-based patient data across 34 common diagnoses, mirroring real-world telemedicine interactions. Under different diagnostic strategies, we evaluate state-of-the-art LVLMs. Our findings demonstrate that incorporating dialogue improves the F1 score from 50.4 to 54.2 compared to non-dialogue settings, underscoring the value of context-driven, information-seeking questioning. Additionally, we demonstrate that multimodal inputs enhance diagnostic efficiency. Image-supported models outperform text-only counterparts by raising the diagnostic F1 score from 52.8 to 54.2 in a similar dialogue setting. Finally, we suggest an approach that improves the diagnostic F1-score to 70.3 by training the CNN model on the diagnosis prediction task and incorporating its top-3 predictions into the LVLM context. 3MDBench provides a reproducible and extendable evaluation framework for AI-driven medical assistants. It offers insights into how patient temperament, dialogue strategies, and multimodal reasoning influence diagnosis quality. By addressing real-world complexities in telemedicine, our benchmark paves the way for more empathetic, reliable, and context-aware AI-driven healthcare solutions. The source code of our benchmark is publicly available: https://github.com/univanxx/3mdbench

The critique capacity of Large Language Models (LLMs) is essential for reasoning abilities, which can provide necessary suggestions (e.g., detailed analysis and constructive feedback). Therefore, how to evaluate the critique capacity of LLMs has drawn great attention and several critique benchmarks have been proposed. However, existing critique benchmarks usually have the following limitations: (1). Focusing on diverse reasoning tasks in general domains and insufficient evaluation on code tasks (e.g., only covering code generation task), where the difficulty of queries is relatively easy (e.g., the code queries of CriticBench are from Humaneval and MBPP). (2). Lacking comprehensive evaluation from different dimensions. To address these limitations, we introduce a holistic code critique benchmark for LLMs called CodeCriticBench. Specifically, our CodeCriticBench includes two mainstream code tasks (i.e., code generation and code QA) with different difficulties. Besides, the evaluation protocols include basic critique evaluation and advanced critique evaluation for different characteristics, where fine-grained evaluation checklists are well-designed for advanced settings. Finally, we conduct extensive experimental results of existing LLMs, which show the effectiveness of CodeCriticBench.

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.

Large Language Model (LLM) training often optimizes for preference alignment, rewarding outputs that are perceived as helpful and interaction-friendly. However, this preference-oriented objective can be exploited: manipulative prompts can steer responses toward user-appeasing agreement and away from truth-oriented correction. In this work, we investigate whether aligned models are vulnerable to Preference-Undermining Attacks (PUA), a class of manipulative prompting strategies designed to exploit the model's desire to please user preferences at the expense of truthfulness. We propose a diagnostic methodology that provides a finer-grained and more directive analysis than aggregate benchmark scores, using a factorial evaluation framework to decompose prompt-induced shifts into interpretable effects of system objectives (truth- vs. preference-oriented) and PUA-style dialogue factors (directive control, personal derogation, conditional approval, reality denial) within a controlled 2 times 2^4 design. Surprisingly, more advanced models are sometimes more susceptible to manipulative prompts. Beyond the dominant reality-denial factor, we observe model-specific sign reversals and interactions with PUA-style factors, suggesting tailored defenses rather than uniform robustness. These findings offer a novel, reproducible factorial evaluation methodology that provides finer-grained diagnostics for post-training processes like RLHF, enabling better trade-offs in the product iteration of LLMs by offering a more nuanced understanding of preference alignment risks and the impact of manipulative prompts.

Medical vision-language models can automate the generation of radiology reports but struggle with accurate visual grounding and factual consistency. Existing models often misalign textual findings with visual evidence, leading to unreliable or weakly grounded predictions. We present CURE, an error-aware curriculum learning framework that improves grounding and report quality without any additional data. CURE fine-tunes a multimodal instructional model on phrase grounding, grounded report generation, and anatomy-grounded report generation using public datasets. The method dynamically adjusts sampling based on model performance, emphasizing harder samples to improve spatial and textual alignment. CURE improves grounding accuracy by +0.37 IoU, boosts report quality by +0.188 CXRFEScore, and reduces hallucinations by 18.6%. CURE is a data-efficient framework that enhances both grounding accuracy and report reliability. Code is available at https://github.com/PabloMessina/CURE and model weights at https://huggingface.co/pamessina/medgemma-4b-it-cure

Modern Code Review (MCR) is an informal tool-assisted quality assurance practice. It relies on the asynchronous communication among the authors of code changes and reviewers, who are developers that provide feedback. However, from candidate developers, some are able to provide better feedback than others given a particular context. The selection of reviewers is thus an important task, which can benefit from automated support. Many approaches have been proposed in this direction, using for example data from code review repositories to recommend reviewers. In this paper, we propose the use of team-related features to improve the performance of predictions that are helpful to build code reviewer recommenders, with our target predictions being the identification of reviewers that would participate in a review and the provided amount of feedback. We evaluate the prediction power of these features, which are related to code ownership, workload, and team relationship. This evaluation was done by carefully addressing challenges imposed by the MCR domain, such as temporal aspects of the dataset and unbalanced classes. Moreover, given that it is currently unknown how much past data is needed for building MCR prediction models with acceptable performance, we explore the amount of past data used to build prediction models. Our results show that, individually, features related to code ownership have the best prediction power. However, based on feature selection, we conclude that all proposed features together with lines of code can make the best predictions for both reviewer participation and amount of feedback. Regarding the amount of past data, the timeframes of 3, 6, 9, and 12 months of data produce similar results. Therefore, models can be trained considering short timeframes, thus reducing the computational costs with negligible impact in the prediction performance ...

The rapid advancement of text-to-image (T2I) models has increased the need for reliable human preference modeling, a demand further amplified by recent progress in reinforcement learning for preference alignment. However, existing approaches typically quantify the quality of a generated image using a single scalar, limiting their ability to provide comprehensive and interpretable feedback on image quality. To address this, we introduce ImageDoctor, a unified multi-aspect T2I model evaluation framework that assesses image quality across four complementary dimensions: plausibility, semantic alignment, aesthetics, and overall quality. ImageDoctor also provides pixel-level flaw indicators in the form of heatmaps, which highlight misaligned or implausible regions, and can be used as a dense reward for T2I model preference alignment. Inspired by the diagnostic process, we improve the detail sensitivity and reasoning capability of ImageDoctor by introducing a "look-think-predict" paradigm, where the model first localizes potential flaws, then generates reasoning, and finally concludes the evaluation with quantitative scores. Built on top of a vision-language model and trained through a combination of supervised fine-tuning and reinforcement learning, ImageDoctor demonstrates strong alignment with human preference across multiple datasets, establishing its effectiveness as an evaluation metric. Furthermore, when used as a reward model for preference tuning, ImageDoctor significantly improves generation quality -- achieving an improvement of 10% over scalar-based reward models.

Cancer screening is a reasoning task. A radiologist observes findings, compares them to prior scans, integrates clinical context, and reaches a diagnostic conclusion confirmed by pathology. We present RadThinking, a Visual Question Answering (VQA) dataset that makes this reasoning explicit and trainable. RadThinking releases VQA pairs at three difficulty tiers. Foundation VQAs are atomic perception questions. Single-step reasoning VQAs apply one clinical rule. Compositional VQAs require multi-step chain-of-thought to reach a guideline category such as LI-RADS-5. For every compositional VQA, we release the chain of foundation VQAs that solves it. The chain follows the rules of the governing clinical reporting standard. The dataset spans 20,362 CT scans from 9,131 patients across 43 cancer groups, plus 2,077 verified healthy controls with >1-year follow-up. To our knowledge, RadThinking is the first cancer-screening VQA corpus that stratifies questions by reasoning depth and grounds compositions in clinical reporting standards. The foundation tier supplies atomic perception supervision. The compositional tier supplies chain-of-thought data and verifiable rewards for reinforcement-learning recipes such as DeepSeek-R1 and OpenAI o1. RadThinking enables systematic training and evaluation of whether AI systems can reason about cancer, not merely detect it.

Natural language (NL) feedback contains rich information about the user experience. Existing studies focus on an instance-level approach, where feedback is used to refine specific examples, disregarding its system-wide application. This paper proposes a general framework for unlocking the system-level use of NL feedback. We show how to use feedback to formalize system-level design decisions in a human-in-the-loop-process -- in order to produce better models. In particular this is done through: (i) metric design for tasks; and (ii) language model prompt design for refining model responses. We conduct two case studies of this approach for improving search query generation and dialog response generation, demonstrating the effectiveness of the use of system-level feedback. We show the combination of system-level feedback and instance-level feedback brings further gains, and that human written instance-level feedback results in more grounded refinements than GPT-3.5 written ones, underlying the importance of human feedback for building systems.

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.

Multimodal agentic pipelines are transforming human-computer interaction by enabling efficient and accessible automation of complex, real-world tasks. However, recent efforts have focused on short-horizon or general-purpose applications (e.g., mobile or desktop interfaces), leaving long-horizon automation for domain-specific systems, particularly in healthcare, largely unexplored. To address this, we introduce CareFlow, a high-quality human-annotated benchmark comprising complex, long-horizon software workflows across medical annotation tools, DICOM viewers, EHR systems, and laboratory information systems. On this benchmark, existing vision-language models (VLMs) perform poorly, struggling with long-horizon reasoning and multi-step interactions in medical contexts. To overcome this, we propose CarePilot, a multi-agent framework based on the actor-critic paradigm. The Actor integrates tool grounding with dual-memory mechanisms (long-term and short-term experience) to predict the next semantic action from the visual interface and system state. The Critic evaluates each action, updates memory based on observed effects, and either executes or provides corrective feedback to refine the workflow. Through iterative agentic simulation, the Actor learns to perform more robust and reasoning-aware predictions during inference. Our experiments show that CarePilot achieves state-of-the-art performance, outperforming strong closed-source and open-source multimodal baselines by approximately 15.26% and 3.38%, respectively, on our benchmark and out-of-distribution dataset.

Current benchmarks for AI clinician systems, often based on multiple-choice exams or manual rubrics, fail to capture the depth, robustness, and safety required for real-world clinical practice. To address this, we introduce the GAPS framework, a multidimensional paradigm for evaluating Grounding (cognitive depth), Adequacy (answer completeness), Perturbation (robustness), and Safety. Critically, we developed a fully automated, guideline-anchored pipeline to construct a GAPS-aligned benchmark end-to-end, overcoming the scalability and subjectivity limitations of prior work. Our pipeline assembles an evidence neighborhood, creates dual graph and tree representations, and automatically generates questions across G-levels. Rubrics are synthesized by a DeepResearch agent that mimics GRADE-consistent, PICO-driven evidence review in a ReAct loop. Scoring is performed by an ensemble of large language model (LLM) judges. Validation confirmed our automated questions are high-quality and align with clinician judgment. Evaluating state-of-the-art models on the benchmark revealed key failure modes: performance degrades sharply with increased reasoning depth (G-axis), models struggle with answer completeness (A-axis), and they are highly vulnerable to adversarial perturbations (P-axis) as well as certain safety issues (S-axis). This automated, clinically-grounded approach provides a reproducible and scalable method for rigorously evaluating AI clinician systems and guiding their development toward safer, more reliable clinical practice.

Large language models have achieved strong performance on medical reasoning benchmarks, yet their deployment in clinical settings demands rigorous verification to ensure factual accuracy. While reward models offer a scalable approach for reasoning trace verification, existing methods face two limitations: they produce only scalar reward values without explicit justification, and they rely on single-pass retrieval that precludes adaptive knowledge access as verification unfolds. We introduce method, an agentic framework that addresses these limitations by training medical reasoning verifiers to iteratively query external medical corpora during evaluation. Our approach combines tool-augmented verification with an iterative reinforcement learning paradigm that requires only trace-level supervision, alongside an adaptive curriculum mechanism that dynamically adjusts training data distribution. Across four medical reasoning benchmarks, method achieves substantial gains over existing methods, improving MedQA accuracy by 23.5% and MedXpertQA by 32.0% relative to the base generator in particular. Crucially, method demonstrates an 8times reduction in sampling budget requirement compared to prior reward model baselines. These findings establish that grounding verification in dynamically retrieved evidence offers a principled path toward more reliable medical reasoning systems.

Providing asynchronous feedback is a critical step in the 3D design workflow. A common approach to providing feedback is to pair textual comments with companion reference images, which helps illustrate the gist of text. Ideally, feedback providers should possess 3D and image editing skills to create reference images that can effectively describe what they have in mind. However, they often lack such skills, so they have to resort to sketches or online images which might not match well with the current 3D design. To address this, we introduce MemoVis, a text editor interface that assists feedback providers in creating reference images with generative AI driven by the feedback comments. First, a novel real-time viewpoint suggestion feature, based on a vision-language foundation model, helps feedback providers anchor a comment with a camera viewpoint. Second, given a camera viewpoint, we introduce three types of image modifiers, based on pre-trained 2D generative models, to turn a text comment into an updated version of the 3D scene from that viewpoint. We conducted a within-subjects study with feedback providers, demonstrating the effectiveness of MemoVis. The quality and explicitness of the companion images were evaluated by another eight participants with prior 3D design experience.

Agentic coding assistants are increasingly given extra capabilities, such as browser based testing tools and design oriented system prompts, on the assumption that more capability yields better software. This study tested that assumption directly. Ninety independent agent runs built the same application, a real time retrospective board, from one detailed specification, each scored on a fixed 14 criterion functional rubric (42 point maximum) and a visual quality review. The runs spanned several model generations, two agent harnesses, two reasoning effort levels, a testing tool, and two design oriented prompts. Capability tier dominated: frontier models clustered near the ceiling while a low cost local model fell to 24 to 37 points. A criterion level analysis revealed what run totals conceal. Container deployment was the dominant defect, failing first try in 44 percent of runs, with its failure rate shifting sharply across model generations while mean totals moved less than a point. The testing tool raised cost by 42 to 68 percent without improving functional score or reliability, even on interface visible criteria. Raising reasoning effort from High to xHigh lifted first try perfect runs from 28 percent to 89 percent and cut corrective prompts about five fold, for 9 to 29 percent more cost. A design oriented prompt raised visual quality, 4.5 versus 3.0 on a 5 point scale, without lifting function, and a one paragraph paraphrase of its directive reproduced the entire lift. The practical lesson is to match the fix to the failure: most first run failures came from weak reasoning, which a stronger model or more effort prevents, not from visible flaws a checking tool would catch.

Iterative repair loops have become a core design pattern in LLM-based software engineering systems. These workflows repeatedly generate, validate, and repair artifacts using feedback such as compiler errors or test failures. Despite their widespread use, the impact of repair-loop iteration limits remains poorly understood, as most prior work adopts fixed, often arbitrary, repair budgets. We study repair-loop effectiveness across multiple software engineering tasks, including code generation, test generation, and code translation. Across several representative workflows, datasets, and contemporary low-cost LLMs, we observe a consistent pattern of diminishing returns: the first three to four repair iterations account for most achievable gains, while later iterations contribute only marginal improvements. We further find that repair behavior is influenced more strongly by workflow orchestration and feedback design than by the underlying model itself. These results suggest that repair budgets should be treated as an explicit experimental variable, as they directly affect evaluation outcomes, computational cost, runtime, and reproducibility in LLM-based software engineering research.

Access to the right evidence does not guarantee that large language models (LLMs) will reason with it correctly. This gap between retrieval and reasoning is especially concerning in clinical settings, where outputs must align with structured protocols. We study this gap using Written Exposure Therapy (WET) guidelines as a testbed. In evaluating model responses to curated clinician-vetted questions, we find that errors persist even when authoritative passages are provided. To address this, we propose an evaluation framework that measures accuracy, consistency, and fidelity of reasoning. Our results highlight both the potential and the risks: retrieval-augmented generation (RAG) can constrain outputs, but safe deployment requires assessing reasoning as rigorously as retrieval.

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.

This work introduces the first framework for reconstructing surgical dialogue from unstructured real-world recordings, which is crucial for characterizing teaching tasks. In surgical training, the formative verbal feedback that trainers provide to trainees during live surgeries is crucial for ensuring safety, correcting behavior immediately, and facilitating long-term skill acquisition. However, analyzing and quantifying this feedback is challenging due to its unstructured and specialized nature. Automated systems are essential to manage these complexities at scale, allowing for the creation of structured datasets that enhance feedback analysis and improve surgical education. Our framework integrates voice activity detection, speaker diarization, and automated speech recaognition, with a novel enhancement that 1) removes hallucinations (non-existent utterances generated during speech recognition fueled by noise in the operating room) and 2) separates speech from trainers and trainees using few-shot voice samples. These aspects are vital for reconstructing accurate surgical dialogues and understanding the roles of operating room participants. Using data from 33 real-world surgeries, we demonstrated the system's capability to reconstruct surgical teaching dialogues and detect feedback instances effectively (F1 score of 0.79+/-0.07). Moreover, our hallucination removal step improves feedback detection performance by ~14%. Evaluation on downstream clinically relevant tasks of predicting Behavioral Adjustment of trainees and classifying Technical feedback, showed performances comparable to manual annotations with F1 scores of 0.82+/0.03 and 0.81+/0.03 respectively. These results highlight the effectiveness of our framework in supporting clinically relevant tasks and improving over manual methods.

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

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.

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.

Datasets scraped from the internet have been critical to the successes of large-scale machine learning. Yet, this very success puts the utility of future internet-derived datasets at potential risk, as model outputs begin to replace human annotations as a source of supervision. In this work, we first formalize a system where interactions with one model are recorded as history and scraped as training data in the future. We then analyze its stability over time by tracking changes to a test-time bias statistic (e.g. gender bias of model predictions). We find that the degree of bias amplification is closely linked to whether the model's outputs behave like samples from the training distribution, a behavior which we characterize and define as consistent calibration. Experiments in three conditional prediction scenarios - image classification, visual role-labeling, and language generation - demonstrate that models that exhibit a sampling-like behavior are more calibrated and thus more stable. Based on this insight, we propose an intervention to help calibrate and stabilize unstable feedback systems. Code is available at https://github.com/rtaori/data_feedback.

Agent Skills package procedural instructions and checks for use by general-purpose agents, but loading a skill does not guarantee that every requirement remains active throughout a long tool-using trajectory. We study this problem in a production-derived, white-box code-audit workflow. Holding the task and 24 artifact checks fixed, we vary the surrounding context and classify where failures first become visible: lost requirements, editing drift, failed checking, or non-agent evaluator/runtime failures. Codex with gpt-5.4-mini passes 8/10 runs in a 10,991-character clean context but only 3/10 in both a 299,140-character relevant context and an equal-length irrelevant context. This 50-percentage-point difference is large but remains trend-level under two-sided Fisher tests (p = 0.0698). Requirement coverage nevertheless stays above 92% in both long conditions, showing that a few omissions can invalidate an otherwise complete artifact. A second task passes all clean and long runs, so the evidence does not support a universal context-length threshold. A detailed external checklist passes 10/10 runs, compared with 5/10 for a generic self-check (p = 0.0325). Coding-agent scaffolds may help by selecting a smaller working set, but they do not eliminate failures. We do not introduce context rot or a new general monitoring method; we provide a bounded failure classification and empirical case study for white-box code auditing.

With the goal of benchmarking generative systems beyond expert software development ability, we introduce Commit0, a benchmark that challenges AI agents to write libraries from scratch. Agents are provided with a specification document outlining the library's API as well as a suite of interactive unit tests, with the goal of producing an implementation of this API accordingly. The implementation is validated through running these unit tests. As a benchmark, Commit0 is designed to move beyond static one-shot code generation towards agents that must process long-form natural language specifications, adapt to multi-stage feedback, and generate code with complex dependencies. Commit0 also offers an interactive environment where models receive static analysis and execution feedback on the code they generate. Our experiments demonstrate that while current agents can pass some unit tests, none can yet fully reproduce full libraries. Results also show that interactive feedback is quite useful for models to generate code that passes more unit tests, validating the benchmarks that facilitate its use.

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.

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.

LLMs for clinical decision support often fail under small but clinically meaningful input shifts such as masking a symptom or negating a finding, despite high performance on static benchmarks. These reasoning failures frequently go undetected by standard NLP metrics, which are insensitive to latent representation shifts that drive diagnosis instability. We propose a geometry-aware evaluation framework, LAPD (Latent Agentic Perturbation Diagnostics), which systematically probes the latent robustness of clinical LLMs under structured adversarial edits. Within this framework, we introduce Latent Diagnosis Flip Rate (LDFR), a model-agnostic diagnostic signal that captures representational instability when embeddings cross decision boundaries in PCA-reduced latent space. Clinical notes are generated using a structured prompting pipeline grounded in diagnostic reasoning, then perturbed along four axes: masking, negation, synonym replacement, and numeric variation to simulate common ambiguities and omissions. We compute LDFR across both foundation and clinical LLMs, finding that latent fragility emerges even under minimal surface-level changes. Finally, we validate our findings on 90 real clinical notes from the DiReCT benchmark (MIMIC-IV), confirming the generalizability of LDFR beyond synthetic settings. Our results reveal a persistent gap between surface robustness and semantic stability, underscoring the importance of geometry-aware auditing in safety-critical clinical AI.

Large Language Models (LLMs) have shown substantial advances through reinforcement learning (RL), particularly in domains where rewards can be programmatically verified, such as mathematics and code. In these areas, models benefit from a well-defined operational base guided by explicit rule-based objectives. However, this progress reveals a significant limitation: in open-ended domains where rewards are ambiguous, subjective, or context-dependent, such as creative writing, scientific reasoning, and notably medical consultation, robust reward functions are lacking, making these areas challenging for current RL strategies. To bridge this gap, we introduce ORBIT, an open-ended rubric-based incremental training framework specifically designed for high-stakes medical dialogue. ORBIT integrates syn- thetic dialogue generation with the dynamic creation of rubrics, employing these rubrics to direct an incremental RL process. In particular, this approach does not depend on external medical knowledge or manual rules, instead utilizing rubric-guided feedback to shape learning. When implemented on the Qwen3-4B-Instruct model, our method can greatly enhance its performance on the HealthBench-Hard benchmark from 7.0 to 27.2 using only 2k samples, thus achieving state-of-the-art results for models of this scale. Our analysis confirms that rubric-driven RL fos-ters consistent performance gains across diverse consultation scenarios, going beyond simple numerical improvements. These findings underscore rubric-based feedback as a scalable strategy for advancing LLMs in intricate, open-ended tasks.

The emergence of large language models (LLMs) has significantly influenced numerous fields, including healthcare, by enhancing the capabilities of automated systems to process and generate human-like text. However, despite their advancements, the reliability and accuracy of LLMs in medical contexts remain critical concerns. Current evaluation methods often lack robustness and fail to provide a comprehensive assessment of LLM performance, leading to potential risks in clinical settings. In this work, we propose Med-CoDE, a specifically designed evaluation framework for medical LLMs to address these challenges. The framework leverages a critique-based approach to quantitatively measure the degree of disagreement between model-generated responses and established medical ground truths. This framework captures both accuracy and reliability in medical settings. The proposed evaluation framework aims to fill the existing gap in LLM assessment by offering a systematic method to evaluate the quality and trustworthiness of medical LLMs. Through extensive experiments and case studies, we illustrate the practicality of our framework in providing a comprehensive and reliable evaluation of medical LLMs.

Clinical AI development has traditionally followed a collaborative paradigm that depends on close interaction between clinicians and specialized AI teams. This paradigm imposes a practical challenge: clinicians must repeatedly communicate and refine their requirements with AI developers before those requirements can be translated into executable model development. This iterative process is time-consuming, and even after repeated discussion, misalignment may still exist because the two sides do not fully share each other's expertise. However, autonomous coding agents may change this paradigm, raising the possibility that clinicians could develop clinical AI models independently through natural-language interaction alone. In this study, we present such an autonomous prototype for clinician-driven clinical AI development. We evaluated the system on five clinical tasks spanning dermoscopic lesion classification, melanoma-versus-nevus triage, wrist-fracture detection (including a weakly supervised variant with only 5% bounding-box annotations), and debiased pneumothorax classification on chest radiographs. Across these settings, the system consistently developed models from clinician requests and achieved promising performance. Notably, in a debiased pneumothorax classification task on chest radiographs, where chest drains can act as a major confounder, the system successfully mitigated shortcut learning and nearly halved the model's reliance on chest drains. These findings provide proof of concept that autonomous coding agents may help shift clinical AI development toward a more clinician-driven paradigm, reducing the communication overhead and dependence on specialized AI developers. Although further validation and robustness assessment are needed, this study suggests a promising path toward making clinical AI development more accessible.