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Jun 4

WRIT: Write-Read Intensive Trajectory Synthesis for Multi-Turn User-Facing Agents

Multi-turn user-facing agents must infer user intent from incomplete requests, collect missing information through dialogue and tools, and execute valid actions. A training trajectory records this process as an interleaved sequence of user messages, agent responses, tool calls, etc. Synthesizing sufficiently complex trajectory has become a central route to train agents: existing pipelines often increase difficulty by composing multiple user requests into longer tasks, producing write-intensive trajectories that train sequential execution. We argue that a single write decision can itself be difficult when the agent must gather and compare substantial read-tool evidence before its arguments become identifiable, a challenge that write-intensive data alone cannot address. Guided by this insight, we propose WRIT (Write-Read Intensive Trajectory Synthesis), a pipeline for synthesizing multi-turn agent training trajectories along two complexity axes: the number of write decisions in a task and the evidence burden of each individual decision. WRIT first generates write-intensive and read-heavy tasks. It then diversifies user behavior instructions to reflect realistic conversational variation, and finally simulates agent-user interactions in an executable environment to produce complete training trajectories. The resulting data trains agents not only for longer task execution, but also for robust, evidence-grounded decision making under high information load. With only 2K synthesized trajectories, a 4B model trained on WRIT outperforms GPT-5.1 no-think on τ^2-bench and substantially reduces inference-time token usage, showing that compact SFT data can convert part of expensive test-time reasoning into efficient agent behavior.

  • 3 authors
·
Jun 1

Chain of Evidence: Pixel-Level Visual Attribution for Iterative Retrieval-Augmented Generation

Iterative Retrieval-Augmented Generation (iRAG) has emerged as a powerful paradigm for answering complex multi-hop questions by progressively retrieving and reasoning over external documents. However, current systems predominantly operate on parsed text, which creates two critical bottlenecks: (1) Coarse-grained attribution, where users are burdened with manually locating evidence within lengthy documents based on vague text-level citations; and (2) Visual semantic loss, where the conversion of visually rich documents (e.g., slides, PDFs with charts) into text discards spatial logic and layout cues essential for reasoning. To bridge this gap, we present Chain of Evidence (CoE), a retriever-agnostic visual attribution framework that leverages Vision-Language Models to reason directly over screenshots of retrieved document candidates. CoE eliminates format-specific parsing and outputs precise bounding boxes, visualizing the complete reasoning chain within the retrieved candidate set. We evaluate CoE on two distinct benchmarks: Wiki-CoE, a large-scale dataset of structured web pages derived from 2WikiMultiHopQA, and SlideVQA, a challenging dataset of presentation slides featuring complex diagrams and free-form layouts. Experiments demonstrate that fine-tuned Qwen3-VL-8B-Instruct achieves robust performance, significantly outperforming text-based baselines in scenarios requiring visual layout understanding, while establishing a retriever-agnostic solution for pixel-level interpretable iRAG. Our code is available at https://github.com/PeiYangLiu/CoE.git.

  • 5 authors
·
May 1 2

Evidence Inference 2.0: More Data, Better Models

How do we most effectively treat a disease or condition? Ideally, we could consult a database of evidence gleaned from clinical trials to answer such questions. Unfortunately, no such database exists; clinical trial results are instead disseminated primarily via lengthy natural language articles. Perusing all such articles would be prohibitively time-consuming for healthcare practitioners; they instead tend to depend on manually compiled systematic reviews of medical literature to inform care. NLP may speed this process up, and eventually facilitate immediate consult of published evidence. The Evidence Inference dataset was recently released to facilitate research toward this end. This task entails inferring the comparative performance of two treatments, with respect to a given outcome, from a particular article (describing a clinical trial) and identifying supporting evidence. For instance: Does this article report that chemotherapy performed better than surgery for five-year survival rates of operable cancers? In this paper, we collect additional annotations to expand the Evidence Inference dataset by 25\%, provide stronger baseline models, systematically inspect the errors that these make, and probe dataset quality. We also release an abstract only (as opposed to full-texts) version of the task for rapid model prototyping. The updated corpus, documentation, and code for new baselines and evaluations are available at http://evidence-inference.ebm-nlp.com/.

  • 5 authors
·
May 8, 2020

Case-Grounded Evidence Verification: A Framework for Constructing Evidence-Sensitive Supervision

Evidence-grounded reasoning requires more than attaching retrieved text to a prediction: a model should make decisions that depend on whether the provided evidence supports the target claim. In practice, this often fails because supervision is weak, evidence is only loosely tied to the claim, and evaluation does not test evidence dependence directly. We introduce case-grounded evidence verification, a general framework in which a model receives a local case context, external evidence, and a structured claim, and must decide whether the evidence supports the claim for that case. Our key contribution is a supervision construction procedure that generates explicit support examples together with semantically controlled non-support examples, including counterfactual wrong-state and topic-related negatives, without manual evidence annotation. We instantiate the framework in radiology and train a standard verifier on the resulting support task. The learned verifier substantially outperforms both case-only and evidence-only baselines, remains strong under correct evidence, and collapses when evidence is removed or swapped, indicating genuine evidence dependence. This behavior transfers across unseen evidence articles and an external case distribution, though performance degrades under evidence-source shift and remains sensitive to backbone choice. Overall, the results suggest that a major bottleneck in evidence grounding is not only model capacity, but the lack of supervision that encodes the causal role of evidence.

  • 5 authors
·
Apr 9

SemEval-2023 Task 7: Multi-Evidence Natural Language Inference for Clinical Trial Data

This paper describes the results of SemEval 2023 task 7 -- Multi-Evidence Natural Language Inference for Clinical Trial Data (NLI4CT) -- consisting of 2 tasks, a Natural Language Inference (NLI) task, and an evidence selection task on clinical trial data. The proposed challenges require multi-hop biomedical and numerical reasoning, which are of significant importance to the development of systems capable of large-scale interpretation and retrieval of medical evidence, to provide personalized evidence-based care. Task 1, the entailment task, received 643 submissions from 40 participants, and Task 2, the evidence selection task, received 364 submissions from 23 participants. The tasks are challenging, with the majority of submitted systems failing to significantly outperform the majority class baseline on the entailment task, and we observe significantly better performance on the evidence selection task than on the entailment task. Increasing the number of model parameters leads to a direct increase in performance, far more significant than the effect of biomedical pre-training. Future works could explore the limitations of large models for generalization and numerical inference, and investigate methods to augment clinical datasets to allow for more rigorous testing and to facilitate fine-tuning. We envisage that the dataset, models, and results of this task will be useful to the biomedical NLI and evidence retrieval communities. The dataset, competition leaderboard, and website are publicly available.

  • 6 authors
·
May 4, 2023

R2MED: A Benchmark for Reasoning-Driven Medical Retrieval

Current medical retrieval benchmarks primarily emphasize lexical or shallow semantic similarity, overlooking the reasoning-intensive demands that are central to clinical decision-making. In practice, physicians often retrieve authoritative medical evidence to support diagnostic hypotheses. Such evidence typically aligns with an inferred diagnosis rather than the surface form of a patient's symptoms, leading to low lexical or semantic overlap between queries and relevant documents. To address this gap, we introduce R2MED, the first benchmark explicitly designed for reasoning-driven medical retrieval. It comprises 876 queries spanning three tasks: Q&A reference retrieval, clinical evidence retrieval, and clinical case retrieval. These tasks are drawn from five representative medical scenarios and twelve body systems, capturing the complexity and diversity of real-world medical information needs. We evaluate 15 widely-used retrieval systems on R2MED and find that even the best model achieves only 31.4 nDCG@10, demonstrating the benchmark's difficulty. Classical re-ranking and generation-augmented retrieval methods offer only modest improvements. Although large reasoning models improve performance via intermediate inference generation, the best results still peak at 41.4 nDCG@10. These findings underscore a substantial gap between current retrieval techniques and the reasoning demands of real clinical tasks. We release R2MED as a challenging benchmark to foster the development of next-generation medical retrieval systems with enhanced reasoning capabilities. Data and code are available at https://github.com/R2MED/R2MED

  • 3 authors
·
May 20, 2025

ECtHR-PCR: A Dataset for Precedent Understanding and Prior Case Retrieval in the European Court of Human Rights

In common law jurisdictions, legal practitioners rely on precedents to construct arguments, in line with the doctrine of stare decisis. As the number of cases grow over the years, prior case retrieval (PCR) has garnered significant attention. Besides lacking real-world scale, existing PCR datasets do not simulate a realistic setting, because their queries use complete case documents while only masking references to prior cases. The query is thereby exposed to legal reasoning not yet available when constructing an argument for an undecided case as well as spurious patterns left behind by citation masks, potentially short-circuiting a comprehensive understanding of case facts and legal principles. To address these limitations, we introduce a PCR dataset based on judgements from the European Court of Human Rights (ECtHR), which explicitly separate facts from arguments and exhibit precedential practices, aiding us to develop this PCR dataset to foster systems' comprehensive understanding. We benchmark different lexical and dense retrieval approaches with various negative sampling strategies, adapting them to deal with long text sequences using hierarchical variants. We found that difficulty-based negative sampling strategies were not effective for the PCR task, highlighting the need for investigation into domain-specific difficulty criteria. Furthermore, we observe performance of the dense models degrade with time and calls for further research into temporal adaptation of retrieval models. Additionally, we assess the influence of different views , Halsbury's and Goodhart's, in practice in ECtHR jurisdiction using PCR task.

  • 3 authors
·
Mar 31, 2024

Rethinking Retrieval-Augmented Generation for Medicine: A Large-Scale, Systematic Expert Evaluation and Practical Insights

Large language models (LLMs) are transforming the landscape of medicine, yet two fundamental challenges persist: keeping up with rapidly evolving medical knowledge and providing verifiable, evidence-grounded reasoning. Retrieval-augmented generation (RAG) has been widely adopted to address these limitations by supplementing model outputs with retrieved evidence. However, whether RAG reliably achieves these goals remains unclear. Here, we present the most comprehensive expert evaluation of RAG in medicine to date. Eighteen medical experts contributed a total of 80,502 annotations, assessing 800 model outputs generated by GPT-4o and Llama-3.1-8B across 200 real-world patient and USMLE-style queries. We systematically decomposed the RAG pipeline into three components: (i) evidence retrieval (relevance of retrieved passages), (ii) evidence selection (accuracy of evidence usage), and (iii) response generation (factuality and completeness of outputs). Contrary to expectation, standard RAG often degraded performance: only 22% of top-16 passages were relevant, evidence selection remained weak (precision 41-43%, recall 27-49%), and factuality and completeness dropped by up to 6% and 5%, respectively, compared with non-RAG variants. Retrieval and evidence selection remain key failure points for the model, contributing to the overall performance drop. We further show that simple yet effective strategies, including evidence filtering and query reformulation, substantially mitigate these issues, improving performance on MedMCQA and MedXpertQA by up to 12% and 8.2%, respectively. These findings call for re-examining RAG's role in medicine and highlight the importance of stage-aware evaluation and deliberate system design for reliable medical LLM applications.

  • 27 authors
·
Nov 10, 2025

Can AI Validate Science? Benchmarking LLMs for Accurate Scientific Claim rightarrow Evidence Reasoning

Large language models (LLMs) are increasingly being used for complex research tasks such as literature review, idea generation, and scientific paper analysis, yet their ability to truly understand and process the intricate relationships within complex research papers, such as the logical links between claims and supporting evidence remains largely unexplored. In this study, we present CLAIM-BENCH, a comprehensive benchmark for evaluating LLMs' capabilities in scientific claim-evidence extraction and validation, a task that reflects deeper comprehension of scientific argumentation. We systematically compare three approaches which are inspired by divide and conquer approaches, across six diverse LLMs, highlighting model-specific strengths and weaknesses in scientific comprehension. Through evaluation involving over 300 claim-evidence pairs across multiple research domains, we reveal significant limitations in LLMs' ability to process complex scientific content. Our results demonstrate that closed-source models like GPT-4 and Claude consistently outperform open-source counterparts in precision and recall across claim-evidence identification tasks. Furthermore, strategically designed three-pass and one-by-one prompting approaches significantly improve LLMs' abilities to accurately link dispersed evidence with claims, although this comes at increased computational cost. CLAIM-BENCH sets a new standard for evaluating scientific comprehension in LLMs, offering both a diagnostic tool and a path forward for building systems capable of deeper, more reliable reasoning across full-length papers.

  • 6 authors
·
Jun 9, 2025

Retrieval Augmented Fact Verification by Synthesizing Contrastive Arguments

The rapid propagation of misinformation poses substantial risks to public interest. To combat misinformation, large language models (LLMs) are adapted to automatically verify claim credibility. Nevertheless, existing methods heavily rely on the embedded knowledge within LLMs and / or black-box APIs for evidence collection, leading to subpar performance with smaller LLMs or upon unreliable context. In this paper, we propose retrieval augmented fact verification through the synthesis of contrasting arguments (RAFTS). Upon input claims, RAFTS starts with evidence retrieval, where we design a retrieval pipeline to collect and re-rank relevant documents from verifiable sources. Then, RAFTS forms contrastive arguments (i.e., supporting or refuting) conditioned on the retrieved evidence. In addition, RAFTS leverages an embedding model to identify informative demonstrations, followed by in-context prompting to generate the prediction and explanation. Our method effectively retrieves relevant documents as evidence and evaluates arguments from varying perspectives, incorporating nuanced information for fine-grained decision-making. Combined with informative in-context examples as prior, RAFTS achieves significant improvements to supervised and LLM baselines without complex prompts. We demonstrate the effectiveness of our method through extensive experiments, where RAFTS can outperform GPT-based methods with a significantly smaller 7B LLM.

  • 6 authors
·
Jun 14, 2024

ClinSeekAgent: Automating Multimodal Evidence Seeking for Agentic Clinical Reasoning

Large language models (LLMs) and agentic systems have shown promise for clinical decision support, but existing works largely assume that evidence has already been curated and handed to the model. Real-world clinical workflows instead require agents to actively seek, iteratively plan, and synthesize multimodal evidence from heterogeneous sources. In this paper, we introduce ClinSeekAgent, an automated agentic framework for dynamic multimodal evidence seeking that shifts the paradigm from passive evidence consumption to active evidence acquisition. Given only a clinical query and access to raw data sources, ClinSeekAgent gathers evidence by querying medical knowledge bases, navigating raw EHRs, and invoking medical imaging tools; refines its hypotheses as new information emerges; and integrates the collected evidence into grounded clinical decisions. ClinSeekAgent serves both as an inference-time agent for frontier LLMs and as a training-time pipeline for distilling high-quality agent trajectories into compact open-source models. To validate its inference-time effectiveness, we construct ClinSeek-Bench, which pairs Curated Input reasoning from fixed pre-selected evidence with Automated Evidence-Seeking over raw clinical data. On text-only EHR tasks, ClinSeekAgent improves Claude Opus 4.6 from 60.0 to 63.2 overall F1 and MiniMax M2.5 from 43.1 to 47.3, with positive risk-prediction gains in 7 out of 9 evaluated host models. On multimodal tasks, ClinSeekAgent improves Claude Opus 4.6 from 47.5 to 62.6 (+15.1); all evaluated models improve across the three CXR-related task groups. We further validate ClinSeekAgent as a training pipeline by distilling agentic evidence-seeking trajectories into ClinSeek-35B-A3B, which achieves 34.0 average F1 on existing AgentEHR-Bench, improving over its Qwen3.5-35B-A3B baseline by +11.9 points and approaching Claude Opus 4.6.

UCSC-VLAA UCSC-VLAA
·
May 18 2

The impact of using an AI chatbot to respond to patient messages

Documentation burden is a major contributor to clinician burnout, which is rising nationally and is an urgent threat to our ability to care for patients. Artificial intelligence (AI) chatbots, such as ChatGPT, could reduce clinician burden by assisting with documentation. Although many hospitals are actively integrating such systems into electronic medical record systems, AI chatbots utility and impact on clinical decision-making have not been studied for this intended use. We are the first to examine the utility of large language models in assisting clinicians draft responses to patient questions. In our two-stage cross-sectional study, 6 oncologists responded to 100 realistic synthetic cancer patient scenarios and portal messages developed to reflect common medical situations, first manually, then with AI assistance. We find AI-assisted responses were longer, less readable, but provided acceptable drafts without edits 58% of time. AI assistance improved efficiency 77% of time, with low harm risk (82% safe). However, 7.7% unedited AI responses could severely harm. In 31% cases, physicians thought AI drafts were human-written. AI assistance led to more patient education recommendations, fewer clinical actions than manual responses. Results show promise for AI to improve clinician efficiency and patient care through assisting documentation, if used judiciously. Monitoring model outputs and human-AI interaction remains crucial for safe implementation.

  • 15 authors
·
Oct 26, 2023

Enhancing Large Language Models with Domain-specific Retrieval Augment Generation: A Case Study on Long-form Consumer Health Question Answering in Ophthalmology

Despite the potential of Large Language Models (LLMs) in medicine, they may generate responses lacking supporting evidence or based on hallucinated evidence. While Retrieval Augment Generation (RAG) is popular to address this issue, few studies implemented and evaluated RAG in downstream domain-specific applications. We developed a RAG pipeline with 70,000 ophthalmology-specific documents that retrieve relevant documents to augment LLMs during inference time. In a case study on long-form consumer health questions, we systematically evaluated the responses including over 500 references of LLMs with and without RAG on 100 questions with 10 healthcare professionals. The evaluation focuses on factuality of evidence, selection and ranking of evidence, attribution of evidence, and answer accuracy and completeness. LLMs without RAG provided 252 references in total. Of which, 45.3% hallucinated, 34.1% consisted of minor errors, and 20.6% were correct. In contrast, LLMs with RAG significantly improved accuracy (54.5% being correct) and reduced error rates (18.8% with minor hallucinations and 26.7% with errors). 62.5% of the top 10 documents retrieved by RAG were selected as the top references in the LLM response, with an average ranking of 4.9. The use of RAG also improved evidence attribution (increasing from 1.85 to 2.49 on a 5-point scale, P<0.001), albeit with slight decreases in accuracy (from 3.52 to 3.23, P=0.03) and completeness (from 3.47 to 3.27, P=0.17). The results demonstrate that LLMs frequently exhibited hallucinated and erroneous evidence in the responses, raising concerns for downstream applications in the medical domain. RAG substantially reduced the proportion of such evidence but encountered challenges.

  • 22 authors
·
Sep 20, 2024

Pipeline and Dataset Generation for Automated Fact-checking in Almost Any Language

This article presents a pipeline for automated fact-checking leveraging publicly available Language Models and data. The objective is to assess the accuracy of textual claims using evidence from a ground-truth evidence corpus. The pipeline consists of two main modules -- the evidence retrieval and the claim veracity evaluation. Our primary focus is on the ease of deployment in various languages that remain unexplored in the field of automated fact-checking. Unlike most similar pipelines, which work with evidence sentences, our pipeline processes data on a paragraph level, simplifying the overall architecture and data requirements. Given the high cost of annotating language-specific fact-checking training data, our solution builds on the Question Answering for Claim Generation (QACG) method, which we adapt and use to generate the data for all models of the pipeline. Our strategy enables the introduction of new languages through machine translation of only two fixed datasets of moderate size. Subsequently, any number of training samples can be generated based on an evidence corpus in the target language. We provide open access to all data and fine-tuned models for Czech, English, Polish, and Slovak pipelines, as well as to our codebase that may be used to reproduce the results.We comprehensively evaluate the pipelines for all four languages, including human annotations and per-sample difficulty assessment using Pointwise V-information. The presented experiments are based on full Wikipedia snapshots to promote reproducibility. To facilitate implementation and user interaction, we develop the FactSearch application featuring the proposed pipeline and the preliminary feedback on its performance.

  • 4 authors
·
Dec 15, 2023

LLM-Specific Utility: A New Perspective for Retrieval-Augmented Generation

Retrieval-augmented generation (RAG) is typically optimized for topical relevance, yet its success ultimately depends on whether retrieved passages are useful for a large language model (LLM) to generate correct and complete answers. We argue that such utility is often LLM-specific rather than universal, due to differences in models' knowledge, reasoning, and ability to leverage evidence. We formalize LLM-specific utility as the performance improvement of a target LLM when a passage is provided, compared to answering without evidence. To systematically study LLM-specific utility, we construct a benchmark of LLM-specific gold utilitarian passages for four LLMs (Qwen3-8B/14B/32B and Llama3.1-8B) on three QA datasets (Natural Questions, TriviaQA, and MS MARCO-FQA). Our analysis shows that utilitarian passages are model-dependent and non-transferable: each LLM performs best with its own utilitarian evidence, while evidence optimized for other LLMs is consistently suboptimal. Human-annotated evidence remains a strong general baseline but does not fully match individual LLM utility needs. We further introduce the LLM-specific utility judgment task and find that existing utility-aware selection and scoring methods largely capture model-agnostic usefulness and struggle to reliably estimate LLM-specific utility. Overall, our findings highlight the limitations of current utility-aware retrieval and motivate generator-tailored evidence selection for improving RAG.

  • 7 authors
·
Oct 13, 2025

From Documents to Spans: Scalable Supervision for Evidence-Based ICD Coding with LLMs

International Classification of Diseases (ICD) coding assigns diagnosis codes to clinical documents and is essential for healthcare billing and clinical analysis. Reliable coding requires that each predicted code be supported by explicit textual evidence. However, existing public datasets provide only code labels, without evidence annotations, limiting models' ability to learn evidence-grounded predictions. In this work, we argue that dense, document-level evidence annotation is not always necessary for learning evidence-based coding. Instead, models can learn code-specific evidence patterns from local spans and use these patterns to support document-level evidence-based coding. Based on this insight, we propose Span-Centric Learning (SCL), a training framework that strengthens LLMs' coding ability at the span level and transfers this capability to full clinical documents. Specifically, we use a small set of annotated documents to supervise evidence recognition, aggregation, and code assignment, while leveraging a large collection of lightweight evidence spans to reinforce span-level reasoning. Due to their compactness, span annotations are scalable and can be further augmented through synthesis. Under the same Llama3.1-8B backbone, our approach achieves an 8.2-point improvement in macro-F1 at only 20% of the training cost of standard SFT, and provides explicit supporting evidence for each predicted code, enabling human auditing and revision.

  • 8 authors
·
May 6

DEER: A Benchmark for Evaluating Deep Research Agents on Expert Report Generation

Recent advances in large language models have enabled deep research systems that generate expert-level reports through multi-step reasoning and evidence-based synthesis. However, evaluating such reports remains challenging: report quality is multifaceted, making it difficult to determine what to assess and by what criteria; LLM-based judges may miss errors that require domain expertise to identify; and because deep research relies on retrieved evidence, report-wide claim verification is also necessary. To address these issues, we propose DEER, a benchmark for evaluating expert-level deep research reports. DEER systematizes evaluation criteria with an expert-developed taxonomy (7 dimensions, 25 subdimensions) operationalized as 101 fine-grained rubric items. We also provide task-specific Expert Evaluation Guidance to support LLM-based judging. Alongside rubric-based assessment, we propose a claim verification architecture that verifies both cited and uncited claims and quantifies evidence quality. Experiments show that while current deep research systems can produce structurally plausible reports that cite external evidence, there is room for improvement in fulfilling expert-level user requests and achieving logical completeness. Beyond simple performance comparisons, DEER makes system strengths and limitations interpretable and provides diagnostic signals for improvement.

LG-AI-Research LG AI Research
·
Dec 19, 2025

CUE-R: Beyond the Final Answer in Retrieval-Augmented Generation

As language models shift from single-shot answer generation toward multi-step reasoning that retrieves and consumes evidence mid-inference, evaluating the role of individual retrieved items becomes more important. Existing RAG evaluation typically targets final-answer quality, citation faithfulness, or answer-level attribution, but none of these directly targets the intervention-based, per-evidence-item utility view we study here. We introduce CUE-R, a lightweight intervention-based framework for measuring per-evidence-item operational utility in single-shot RAG using shallow observable retrieval-use traces. CUE-R perturbs individual evidence items via REMOVE, REPLACE, and DUPLICATE operators, then measures changes along three utility axes (correctness, proxy-based grounding faithfulness, and confidence error) plus a trace-divergence signal. We also outline an operational evidence-role taxonomy for interpreting intervention outcomes. Experiments on HotpotQA and 2WikiMultihopQA with Qwen-3 8B and GPT-5.2 reveal a consistent pattern: REMOVE and REPLACE substantially harm correctness and grounding while producing large trace shifts, whereas DUPLICATE is often answer-redundant yet not fully behaviorally neutral. A zero-retrieval control confirms that these effects arise from degradation of meaningful retrieval. A two-support ablation further shows that multi-hop evidence items can interact non-additively: removing both supports harms performance far more than either single removal. Our results suggest that answer-only evaluation misses important evidence effects and that intervention-based utility analysis is a practical complement for RAG evaluation.

intuit Intuit
·
Apr 6 2

Tool Calling: Enhancing Medication Consultation via Retrieval-Augmented Large Language Models

Large-scale language models (LLMs) have achieved remarkable success across various language tasks but suffer from hallucinations and temporal misalignment. To mitigate these shortcomings, Retrieval-augmented generation (RAG) has been utilized to provide external knowledge to facilitate the answer generation. However, applying such models to the medical domain faces several challenges due to the lack of domain-specific knowledge and the intricacy of real-world scenarios. In this study, we explore LLMs with RAG framework for knowledge-intensive tasks in the medical field. To evaluate the capabilities of LLMs, we introduce MedicineQA, a multi-round dialogue benchmark that simulates the real-world medication consultation scenario and requires LLMs to answer with retrieved evidence from the medicine database. MedicineQA contains 300 multi-round question-answering pairs, each embedded within a detailed dialogue history, highlighting the challenge posed by this knowledge-intensive task to current LLMs. We further propose a new Distill-Retrieve-Read framework instead of the previous Retrieve-then-Read. Specifically, the distillation and retrieval process utilizes a tool calling mechanism to formulate search queries that emulate the keyword-based inquiries used by search engines. With experimental results, we show that our framework brings notable performance improvements and surpasses the previous counterparts in the evidence retrieval process in terms of evidence retrieval accuracy. This advancement sheds light on applying RAG to the medical domain.

  • 8 authors
·
Apr 27, 2024

Evaluating the Search Agent in a Parallel World

Integrating web search tools has significantly extended the capability of LLMs to address open-world, real-time, and long-tail problems. However, evaluating these Search Agents presents formidable challenges. First, constructing high-quality deep search benchmarks is prohibitively expensive, while unverified synthetic data often suffers from unreliable sources. Second, static benchmarks face dynamic obsolescence: as internet information evolves, complex queries requiring deep research often degrade into simple retrieval tasks due to increased popularity, and ground truths become outdated due to temporal shifts. Third, attribution ambiguity confounds evaluation, as an agent's performance is often dominated by its parametric memory rather than its actual search and reasoning capabilities. Finally, reliance on specific commercial search engines introduces variability that hampers reproducibility. To address these issues, we propose a novel framework, Mind-ParaWorld, for evaluating Search Agents in a Parallel World. Specifically, MPW samples real-world entity names to synthesize future scenarios and questions situated beyond the model's knowledge cutoff. A ParaWorld Law Model then constructs a set of indivisible Atomic Facts and a unique ground-truth for each question. During evaluation, instead of retrieving real-world results, the agent interacts with a ParaWorld Engine Model that dynamically generates SERPs grounded in these inviolable Atomic Facts. We release MPW-Bench, an interactive benchmark spanning 19 domains with 1,608 instances. Experiments across three evaluation settings show that, while search agents are strong at evidence synthesis given complete information, their performance is limited not only by evidence collection and coverage in unfamiliar search environments, but also by unreliable evidence sufficiency judgment and when-to-stop decisions-bottlenecks.

SciClaimHunt: A Large Dataset for Evidence-based Scientific Claim Verification

Verifying scientific claims presents a significantly greater challenge than verifying political or news-related claims. Unlike the relatively broad audience for political claims, the users of scientific claim verification systems can vary widely, ranging from researchers testing specific hypotheses to everyday users seeking information on a medication. Additionally, the evidence for scientific claims is often highly complex, involving technical terminology and intricate domain-specific concepts that require specialized models for accurate verification. Despite considerable interest from the research community, there is a noticeable lack of large-scale scientific claim verification datasets to benchmark and train effective models. To bridge this gap, we introduce two large-scale datasets, SciClaimHunt and SciClaimHunt_Num, derived from scientific research papers. We propose several baseline models tailored for scientific claim verification to assess the effectiveness of these datasets. Additionally, we evaluate models trained on SciClaimHunt and SciClaimHunt_Num against existing scientific claim verification datasets to gauge their quality and reliability. Furthermore, we conduct human evaluations of the claims in proposed datasets and perform error analysis to assess the effectiveness of the proposed baseline models. Our findings indicate that SciClaimHunt and SciClaimHunt_Num serve as highly reliable resources for training models in scientific claim verification.

  • 6 authors
·
Feb 14, 2025

Reward Design for Justifiable Sequential Decision-Making

Equipping agents with the capacity to justify made decisions using supporting evidence represents a cornerstone of accountable decision-making. Furthermore, ensuring that justifications are in line with human expectations and societal norms is vital, especially in high-stakes situations such as healthcare. In this work, we propose the use of a debate-based reward model for reinforcement learning agents, where the outcome of a zero-sum debate game quantifies the justifiability of a decision in a particular state. This reward model is then used to train a justifiable policy, whose decisions can be more easily corroborated with supporting evidence. In the debate game, two argumentative agents take turns providing supporting evidence for two competing decisions. Given the proposed evidence, a proxy of a human judge evaluates which decision is better justified. We demonstrate the potential of our approach in learning policies for prescribing and justifying treatment decisions of septic patients. We show that augmenting the reward with the feedback signal generated by the debate-based reward model yields policies highly favored by the judge when compared to the policy obtained solely from the environment rewards, while hardly sacrificing any performance. Moreover, in terms of the overall performance and justifiability of trained policies, the debate-based feedback is comparable to the feedback obtained from an ideal judge proxy that evaluates decisions using the full information encoded in the state. This suggests that the debate game outputs key information contained in states that is most relevant for evaluating decisions, which in turn substantiates the practicality of combining our approach with human-in-the-loop evaluations. Lastly, we showcase that agents trained via multi-agent debate learn to propose evidence that is resilient to refutations and closely aligns with human preferences.

  • 2 authors
·
Feb 24, 2024

Demystifying deep search: a holistic evaluation with hint-free multi-hop questions and factorised metrics

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

FactReview: Evidence-Grounded Reviews with Literature Positioning and Execution-Based Claim Verification

Peer review in machine learning is under growing pressure from rising submission volume and limited reviewer time. Most LLM-based reviewing systems read only the manuscript and generate comments from the paper's own narrative. This makes their outputs sensitive to presentation quality and leaves them weak when the evidence needed for review lies in related work or released code. We present FactReview, an evidence-grounded reviewing system that combines claim extraction, literature positioning, and execution-based claim verification. Given a submission, FactReview identifies major claims and reported results, retrieves nearby work to clarify the paper's technical position, and, when code is available, executes the released repository under bounded budgets to test central empirical claims. It then produces a concise review and an evidence report that assigns each major claim one of five labels: Supported, Supported by the paper, Partially supported, In conflict, or Inconclusive. In a case study on CompGCN, FactReview reproduces results that closely match those reported for link prediction and node classification, yet also shows that the paper's broader performance claim across tasks is not fully sustained: on MUTAG graph classification, the reproduced result is 88.4%, whereas the strongest baseline reported in the paper remains 92.6%. The claim is therefore only partially supported. More broadly, this case suggests that AI is most useful in peer review not as a final decision-maker, but as a tool for gathering evidence and helping reviewers produce more evidence-grounded assessments. The code is public at https://github.com/DEFENSE-SEU/Review-Assistant.

The Ethics of ChatGPT in Medicine and Healthcare: A Systematic Review on Large Language Models (LLMs)

With the introduction of ChatGPT, Large Language Models (LLMs) have received enormous attention in healthcare. Despite their potential benefits, researchers have underscored various ethical implications. While individual instances have drawn much attention, the debate lacks a systematic overview of practical applications currently researched and ethical issues connected to them. Against this background, this work aims to map the ethical landscape surrounding the current stage of deployment of LLMs in medicine and healthcare. Electronic databases and preprint servers were queried using a comprehensive search strategy. Studies were screened and extracted following a modified rapid review approach. Methodological quality was assessed using a hybrid approach. For 53 records, a meta-aggregative synthesis was performed. Four fields of applications emerged and testify to a vivid exploration phase. Advantages of using LLMs are attributed to their capacity in data analysis, personalized information provisioning, support in decision-making, mitigating information loss and enhancing information accessibility. However, we also identifies recurrent ethical concerns connected to fairness, bias, non-maleficence, transparency, and privacy. A distinctive concern is the tendency to produce harmful misinformation or convincingly but inaccurate content. A recurrent plea for ethical guidance and human oversight is evident. Given the variety of use cases, it is suggested that the ethical guidance debate be reframed to focus on defining what constitutes acceptable human oversight across the spectrum of applications. This involves considering diverse settings, varying potentials for harm, and different acceptable thresholds for performance and certainty in healthcare. In addition, a critical inquiry is necessary to determine the extent to which the current experimental use of LLMs is necessary and justified.

  • 2 authors
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Mar 21, 2024

Can LLM Agents Generate Real-World Evidence? Evaluating Observational Studies in Medical Databases

Observational studies can yield clinically actionable evidence at scale, but executing them on real-world databases is open-ended and requires coherent decisions across cohort construction, analysis, and reporting. Prior evaluations of LLM agents emphasize isolated steps or single answers, missing the integrity and internal structure of the resulting evidence bundle. To address this gap, we introduce RWE-bench, a benchmark grounded in MIMIC-IV and derived from peer-reviewed observational studies. Each task provides the corresponding study protocol as the reference standard, requiring agents to execute experiments in a real database and iteratively generate tree-structured evidence bundles. We evaluate six LLMs (three open-source, three closed-source) under three agent scaffolds using both question-level correctness and end-to-end task metrics. Across 162 tasks, task success is low: the best agent reaches 39.9%, and the best open-source model reaches 30.4%. Agent scaffolds also matter substantially, causing over 30% variation in performance metrics. Furthermore, we implement an automated cohort evaluation method to rapidly localize errors and identify agent failure modes. Overall, the results highlight persistent limitations in agents' ability to produce end-to-end evidence bundles, and efficient validation remains an important direction for future work. Code and data are available at https://github.com/somewordstoolate/RWE-bench.

  • 5 authors
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Mar 23

Automated Rubrics for Reliable Evaluation of Medical Dialogue Systems

Large Language Models (LLMs) are increasingly used for clinical decision support, where hallucinations and unsafe suggestions may pose direct risks to patient safety. These risks are particularly challenging as they often manifest as subtle clinical errors that evade detection by generic metrics, while expert-authored fine-grained rubrics remain costly to construct and difficult to scale. In this paper, we propose a retrieval-augmented multi-agent framework designed to automate the generation of instance-specific evaluation rubrics. Our approach grounds evaluation in authoritative medical evidence by decomposing retrieved content into atomic facts and synthesizing them with user interaction constraints to form verifiable, fine-grained evaluation criteria. Evaluated on HealthBench, our framework achieves a Clinical Intent Alignment (CIA) score of 60.12%, a statistically significant improvement over the GPT-4o baseline (55.16%). In discriminative tests, our rubrics yield a mean score delta (μ_Δ = 8.658) and an AUROC of 0.977, nearly doubling the quality separation achieved by GPT-4o baseline (4.972). Beyond evaluation, our rubrics effectively guide response refinement, improving quality by 9.2% (from 59.0% to 68.2%). This provides a scalable and transparent foundation for both evaluating and improving medical LLMs. The code is available at https://anonymous.4open.science/r/Automated-Rubric-Generation-AF3C/.

  • 4 authors
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Jan 21

Med-V1: Small Language Models for Zero-shot and Scalable Biomedical Evidence Attribution

Assessing whether an article supports an assertion is essential for hallucination detection and claim verification. While large language models (LLMs) have the potential to automate this task, achieving strong performance requires frontier models such as GPT-5 that are prohibitively expensive to deploy at scale. To efficiently perform biomedical evidence attribution, we present Med-V1, a family of small language models with only three billion parameters. Trained on high-quality synthetic data newly developed in this study, Med-V1 substantially outperforms (+27.0% to +71.3%) its base models on five biomedical benchmarks unified into a verification format. Despite its smaller size, Med-V1 performs comparably to frontier LLMs such as GPT-5, along with high-quality explanations for its predictions. We use Med-V1 to conduct a first-of-its-kind use case study that quantifies hallucinations in LLM-generated answers under different citation instructions. Results show that the format instruction strongly affects citation validity and hallucination, with GPT-5 generating more claims but exhibiting hallucination rates similar to GPT-4o. Additionally, we present a second use case showing that Med-V1 can automatically identify high-stakes evidence misattributions in clinical practice guidelines, revealing potentially negative public health impacts that are otherwise challenging to identify at scale. Overall, Med-V1 provides an efficient and accurate lightweight alternative to frontier LLMs for practical and real-world applications in biomedical evidence attribution and verification tasks. Med-V1 is available at https://github.com/ncbi-nlp/Med-V1.

  • 15 authors
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Mar 5

In the Picture: Medical Imaging Datasets, Artifacts, and their Living Review

Datasets play a critical role in medical imaging research, yet issues such as label quality, shortcuts, and metadata are often overlooked. This lack of attention may harm the generalizability of algorithms and, consequently, negatively impact patient outcomes. While existing medical imaging literature reviews mostly focus on machine learning (ML) methods, with only a few focusing on datasets for specific applications, these reviews remain static -- they are published once and not updated thereafter. This fails to account for emerging evidence, such as biases, shortcuts, and additional annotations that other researchers may contribute after the dataset is published. We refer to these newly discovered findings of datasets as research artifacts. To address this gap, we propose a living review that continuously tracks public datasets and their associated research artifacts across multiple medical imaging applications. Our approach includes a framework for the living review to monitor data documentation artifacts, and an SQL database to visualize the citation relationships between research artifact and dataset. Lastly, we discuss key considerations for creating medical imaging datasets, review best practices for data annotation, discuss the significance of shortcuts and demographic diversity, and emphasize the importance of managing datasets throughout their entire lifecycle. Our demo is publicly available at http://inthepicture.itu.dk/.

  • 29 authors
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Jan 18, 2025

CARE: Privacy-Compliant Agentic Reasoning with Evidence Discordance

Large language model (LLM) systems are increasingly used to support high-stakes decision-making, but they typically perform worse when the available evidence is internally inconsistent. Such a scenario exists in real-world healthcare settings, with patient-reported symptoms contradicting medical signs. To study this problem, we introduce MIMIC-DOS, a dataset for short-horizon organ dysfunction worsening prediction in the intensive care unit (ICU) setting. We derive this dataset from the widely recognized MIMIC-IV, a publicly available electronic health record dataset, and construct it exclusively from cases in which discordance between signs and symptoms exists. This setting poses a substantial challenge for existing LLM-based approaches, with single-pass LLMs and agentic pipelines often struggling to reconcile such conflicting signals. To address this problem, we propose CARE: a multi-stage privacy-compliant agentic reasoning framework in which a remote LLM provides guidance by generating structured categories and transitions without accessing sensitive patient data, while a local LLM uses these categories and transitions to support evidence acquisition and final decision-making. Empirically, CARE achieves stronger performance across all key metrics compared to multiple baseline settings, showing that CARE can more robustly handle conflicting clinical evidence while preserving privacy.

Bayesian aggregation of average data: An application in drug development

Throughout the different phases of a drug development program, randomized trials are used to establish the tolerability, safety, and efficacy of a candidate drug. At each stage one aims to optimize the design of future studies by extrapolation from the available evidence at the time. This includes collected trial data and relevant external data. However, relevant external data are typically available as averages only, for example from trials on alternative treatments reported in the literature. Here we report on such an example from a drug development for wet age-related macular degeneration. This disease is the leading cause of severe vision loss in the elderly. While current treatment options are efficacious, they are also a substantial burden for the patient. Hence, new treatments are under development which need to be compared against existing treatments. The general statistical problem this leads to is meta-analysis, which addresses the question of how we can combine datasets collected under different conditions. Bayesian methods have long been used to achieve partial pooling. Here we consider the challenge when the model of interest is complex (hierarchical and nonlinear) and one dataset is given as raw data while the second dataset is given as averages only. In such a situation, common meta-analytic methods can only be applied when the model is sufficiently simple for analytic approaches. When the model is too complex, for example nonlinear, an analytic approach is not possible. We provide a Bayesian solution by using simulation to approximately reconstruct the likelihood of the external summary and allowing the parameters in the model to vary under the different conditions. We first evaluate our approach using fake-data simulations and then report results for the drug development program that motivated this research.

  • 6 authors
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May 12, 2020

Toward Reliable Biomedical Hypothesis Generation: Evaluating Truthfulness and Hallucination in Large Language Models

Large language models (LLMs) have shown significant potential in scientific disciplines such as biomedicine, particularly in hypothesis generation, where they can analyze vast literature, identify patterns, and suggest research directions. However, a key challenge lies in evaluating the truthfulness of generated hypotheses, as verifying their accuracy often requires substantial time and resources. Additionally, the hallucination problem in LLMs can lead to the generation of hypotheses that appear plausible but are ultimately incorrect, undermining their reliability. To facilitate the systematic study of these challenges, we introduce TruthHypo, a benchmark for assessing the capabilities of LLMs in generating truthful biomedical hypotheses, and KnowHD, a knowledge-based hallucination detector to evaluate how well hypotheses are grounded in existing knowledge. Our results show that LLMs struggle to generate truthful hypotheses. By analyzing hallucinations in reasoning steps, we demonstrate that the groundedness scores provided by KnowHD serve as an effective metric for filtering truthful hypotheses from the diverse outputs of LLMs. Human evaluations further validate the utility of KnowHD in identifying truthful hypotheses and accelerating scientific discovery. Our data and source code are available at https://github.com/Teddy-XiongGZ/TruthHypo.

  • 8 authors
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May 20, 2025 2

ScientistOne: Towards Human-Level Autonomous Research via Chain-of-Evidence

Autonomous research agents produce competitive solutions and professional-looking manuscripts, yet their outputs contain verifiability failures undetectable by surface-level evaluation: fabricated citations, unreproducible scores, and method descriptions that diverge from the implementation. We address this through three contributions. First, Chain-of-Evidence (CoE), a verifiability framework requiring every claim to be traceable to its evidence source. Second, ScientistOne, an end-to-end autonomous research system that maintains evidence chains by construction throughout literature review, solution discovery, and paper writing. Third, CoE Audit, a post-hoc audit whose four integrity checks -- score verification, specification violation, reference verification, and method-code alignment -- apply uniformly to all systems. Across 75 papers spanning five systems and five frontier research tasks, every baseline exhibits at least one systematic failure mode: hallucinated reference rates reach 21%, score verification passes in as few as 42% of papers, and method-code alignment ranges from 20% to 80%. ScientistOne achieves zero hallucinated references (0/337), perfect score verification (12/12), and the highest method-code alignment (14/15), while matching or exceeding human expert performance on all five tasks. ScientistOne further generalizes to six additional tasks spanning medical imaging, fine-grained recognition, 3D perception, and language modeling, achieving state-of-the-art on Parameter Golf and gold medals on MLE-Bench tasks where baselines fail entirely.

google Google
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May 24 2

ReportLogic: Evaluating Logical Quality in Deep Research Reports

Users increasingly rely on Large Language Models (LLMs) for Deep Research, using them to synthesize diverse sources into structured reports that support understanding and action. In this context, the practical reliability of such reports hinges on logical quality: whether the report's claims and arguments are explicitly supported and can be trusted as a basis for downstream use, rather than merely appearing fluent or informative. However, current evaluation frameworks largely overlook this requirement. To bridge this gap, we introduce ReportLogic, a benchmark that quantifies report-level logical quality through a reader-centric lens of auditability. Specifically, ReportLogic adopts a hierarchical taxonomy that evaluates whether readers can (1) trace an on-topic report structure with a unified analytical arc (Macro-Logic), (2) understand the progression with necessary context (Expositional-Logic), and (3) verify conclusions via explicit claim--support (Structural-Logic). Based on this taxonomy, we construct a human-annotated rubric-guided dataset and train an open-source LogicJudge for scalable evaluation. We further evaluate judge robustness via adversarial attacks, showing that off-the-shelf LLM judges are frequently influenced by superficial cues (e.g., verbosity), and reasoning modes can mask broken support relations. Overall, our results provide actionable guidance for building more robust logic evaluators and improving the logical reliability of LLM-generated reports.

  • 7 authors
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Jan 27

Safety and accuracy follow different scaling laws in clinical large language models

Clinical LLMs are often scaled by increasing model size, context length, retrieval complexity, or inference-time compute, with the implicit expectation that higher accuracy implies safer behavior. This assumption is incomplete in medicine, where a few confident, high-risk, or evidence-contradicting errors can matter more than average benchmark performance. We introduce SaFE-Scale, a framework for measuring how clinical LLM safety changes across model scale, evidence quality, retrieval strategy, context exposure, and inference-time compute. To instantiate this framework, we introduce RadSaFE-200, a Radiology Safety-Focused Evaluation benchmark of 200 multiple-choice questions with clinician-defined clean evidence, conflict evidence, and option-level labels for high-risk error, unsafe answer, and evidence contradiction. We evaluated 34 locally deployed LLMs across six deployment conditions: closed-book prompting (zero-shot), clean evidence, conflict evidence, standard RAG, agentic RAG, and max-context prompting. Clean evidence produced the strongest improvement, increasing mean accuracy from 73.5% to 94.1%, while reducing high-risk error from 12.0% to 2.6%, contradiction from 12.7% to 2.3%, and dangerous overconfidence from 8.0% to 1.6%. Standard RAG and agentic RAG did not reproduce this safety profile: agentic RAG improved accuracy over standard RAG and reduced contradiction, but high-risk error and dangerous overconfidence remained elevated. Max-context prompting increased latency without closing the safety gap, and additional inference-time compute produced only limited gains. Worst-case analysis showed that clinically consequential errors concentrated in a small subset of questions. Clinical LLM safety is therefore not a passive consequence of scaling, but a deployment property shaped by evidence quality, retrieval design, context construction, and collective failure behavior.

  • 12 authors
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May 4

Retrieval-Infused Reasoning Sandbox: A Benchmark for Decoupling Retrieval and Reasoning Capabilities

Despite strong performance on existing benchmarks, it remains unclear whether large language models can reason over genuinely novel scientific information. Most evaluations score end-to-end RAG pipelines, where reasoning is confounded with retrieval and toolchain choices, and the signal is further contaminated by parametric memorization and open-web volatility. We introduce DeR2, a controlled deep-research sandbox that isolates document-grounded reasoning while preserving core difficulties of deep search: multi-step synthesis, denoising, and evidence-based conclusion making. DeR2 decouples evidence access from reasoning via four regimes--Instruction-only, Concepts (gold concepts without documents), Related-only (only relevant documents), and Full-set (relevant documents plus topically related distractors)--yielding interpretable regime gaps that operationalize retrieval loss vs. reasoning loss and enable fine-grained error attribution. To prevent parametric leakage, we apply a two-phase validation that requires parametric failure without evidence while ensuring oracle-concept solvability. To ensure reproducibility, each instance provides a frozen document library (drawn from 2023-2025 theoretical papers) with expert-annotated concepts and validated rationales. Experiments across a diverse set of state-of-the-art foundation models reveal substantial variation and significant headroom: some models exhibit mode-switch fragility, performing worse with the Full-set than with Instruction-only, while others show structural concept misuse, correctly naming concepts but failing to execute them as procedures.

Evidence-Driven Retrieval Augmented Response Generation for Online Misinformation

The proliferation of online misinformation has posed significant threats to public interest. While numerous online users actively participate in the combat against misinformation, many of such responses can be characterized by the lack of politeness and supporting facts. As a solution, text generation approaches are proposed to automatically produce counter-misinformation responses. Nevertheless, existing methods are often trained end-to-end without leveraging external knowledge, resulting in subpar text quality and excessively repetitive responses. In this paper, we propose retrieval augmented response generation for online misinformation (RARG), which collects supporting evidence from scientific sources and generates counter-misinformation responses based on the evidences. In particular, our RARG consists of two stages: (1) evidence collection, where we design a retrieval pipeline to retrieve and rerank evidence documents using a database comprising over 1M academic articles; (2) response generation, in which we align large language models (LLMs) to generate evidence-based responses via reinforcement learning from human feedback (RLHF). We propose a reward function to maximize the utilization of the retrieved evidence while maintaining the quality of the generated text, which yields polite and factual responses that clearly refutes misinformation. To demonstrate the effectiveness of our method, we study the case of COVID-19 and perform extensive experiments with both in- and cross-domain datasets, where RARG consistently outperforms baselines by generating high-quality counter-misinformation responses.

  • 6 authors
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Mar 22, 2024

From Questions to Clinical Recommendations: Large Language Models Driving Evidence-Based Clinical Decision Making

Clinical evidence, derived from rigorous research and data analysis, provides healthcare professionals with reliable scientific foundations for informed decision-making. Integrating clinical evidence into real-time practice is challenging due to the enormous workload, complex professional processes, and time constraints. This highlights the need for tools that automate evidence synthesis to support more efficient and accurate decision making in clinical settings. This study introduces Quicker, an evidence-based clinical decision support system powered by large language models (LLMs), designed to automate evidence synthesis and generate clinical recommendations modeled after standard clinical guideline development processes. Quicker implements a fully automated chain that covers all phases, from questions to clinical recommendations, and further enables customized decision-making through integrated tools and interactive user interfaces. To evaluate Quicker's capabilities, we developed the Q2CRBench-3 benchmark dataset, based on clinical guideline development records for three different diseases. Experimental results highlighted Quicker's strong performance, with fine-grained question decomposition tailored to user preferences, retrieval sensitivities comparable to human experts, and literature screening performance approaching comprehensive inclusion of relevant studies. In addition, Quicker-assisted evidence assessment effectively supported human reviewers, while Quicker's recommendations were more comprehensive and logically coherent than those of clinicians. In system-level testing, collaboration between a single reviewer and Quicker reduced the time required for recommendation development to 20-40 minutes. In general, our findings affirm the potential of Quicker to help physicians make quicker and more reliable evidence-based clinical decisions.

  • 16 authors
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May 15, 2025

MedCaseReasoning: Evaluating and learning diagnostic reasoning from clinical case reports

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

  • 10 authors
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May 16, 2025 2

CoVERT: A Corpus of Fact-checked Biomedical COVID-19 Tweets

Over the course of the COVID-19 pandemic, large volumes of biomedical information concerning this new disease have been published on social media. Some of this information can pose a real danger to people's health, particularly when false information is shared, for instance recommendations on how to treat diseases without professional medical advice. Therefore, automatic fact-checking resources and systems developed specifically for the medical domain are crucial. While existing fact-checking resources cover COVID-19-related information in news or quantify the amount of misinformation in tweets, there is no dataset providing fact-checked COVID-19-related Twitter posts with detailed annotations for biomedical entities, relations and relevant evidence. We contribute CoVERT, a fact-checked corpus of tweets with a focus on the domain of biomedicine and COVID-19-related (mis)information. The corpus consists of 300 tweets, each annotated with medical named entities and relations. We employ a novel crowdsourcing methodology to annotate all tweets with fact-checking labels and supporting evidence, which crowdworkers search for online. This methodology results in moderate inter-annotator agreement. Furthermore, we use the retrieved evidence extracts as part of a fact-checking pipeline, finding that the real-world evidence is more useful than the knowledge indirectly available in pretrained language models.

  • 3 authors
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Apr 26, 2022

Generation-Time vs. Post-hoc Citation: A Holistic Evaluation of LLM Attribution

Trustworthy Large Language Models (LLMs) must cite human-verifiable sources in high-stakes domains such as healthcare, law, academia, and finance, where even small errors can have severe consequences. Practitioners and researchers face a choice: let models generate citations during decoding, or let models draft answers first and then attach appropriate citations. To clarify this choice, we introduce two paradigms: Generation-Time Citation (G-Cite), which produces the answer and citations in one pass, and Post-hoc Citation (P-Cite), which adds or verifies citations after drafting. We conduct a comprehensive evaluation from zero-shot to advanced retrieval-augmented methods across four popular attribution datasets and provide evidence-based recommendations that weigh trade-offs across use cases. Our results show a consistent trade-off between coverage and citation correctness, with retrieval as the main driver of attribution quality in both paradigms. P-Cite methods achieve high coverage with competitive correctness and moderate latency, whereas G-Cite methods prioritize precision at the cost of coverage and speed. We recommend a retrieval-centric, P-Cite-first approach for high-stakes applications, reserving G-Cite for precision-critical settings such as strict claim verification. Our codes and human evaluation results are available at https://anonymous.4open.science/r/Citation_Paradigms-BBB5/

  • 4 authors
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Sep 25, 2025

Coping with Information Loss and the Use of Auxiliary Sources of Data: A Report from the NISS Ingram Olkin Forum Series on Unplanned Clinical Trial Disruptions

Clinical trials disruption has always represented a non negligible part of the ending of interventional studies. While the SARS-CoV-2 (COVID-19) pandemic has led to an impressive and unprecedented initiation of clinical research, it has also led to considerable disruption of clinical trials in other disease areas, with around 80% of non-COVID-19 trials stopped or interrupted during the pandemic. In many cases the disrupted trials will not have the planned statistical power necessary to yield interpretable results. This paper describes methods to compensate for the information loss arising from trial disruptions by incorporating additional information available from auxiliary data sources. The methods described include the use of auxiliary data on baseline and early outcome data available from the trial itself and frequentist and Bayesian approaches for the incorporation of information from external data sources. The methods are illustrated by application to the analysis of artificial data based on the Primary care pediatrics Learning Activity Nutrition (PLAN) study, a clinical trial assessing a diet and exercise intervention for overweight children, that was affected by the COVID-19 pandemic. We show how all of the methods proposed lead to an increase in precision relative to use of complete case data only.

  • 12 authors
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Jun 22, 2022

Awareness in Practice: Tensions in Access to Sensitive Attribute Data for Antidiscrimination

Organizations cannot address demographic disparities that they cannot see. Recent research on machine learning and fairness has emphasized that awareness of sensitive attributes, such as race and sex, is critical to the development of interventions. However, on the ground, the existence of these data cannot be taken for granted. This paper uses the domains of employment, credit, and healthcare in the United States to surface conditions that have shaped the availability of sensitive attribute data. For each domain, we describe how and when private companies collect or infer sensitive attribute data for antidiscrimination purposes. An inconsistent story emerges: Some companies are required by law to collect sensitive attribute data, while others are prohibited from doing so. Still others, in the absence of legal mandates, have determined that collection and imputation of these data are appropriate to address disparities. This story has important implications for fairness research and its future applications. If companies that mediate access to life opportunities are unable or hesitant to collect or infer sensitive attribute data, then proposed techniques to detect and mitigate bias in machine learning models might never be implemented outside the lab. We conclude that today's legal requirements and corporate practices, while highly inconsistent across domains, offer lessons for how to approach the collection and inference of sensitive data in appropriate circumstances. We urge stakeholders, including machine learning practitioners, to actively help chart a path forward that takes both policy goals and technical needs into account.

  • 3 authors
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Dec 12, 2019

Accelerating Clinical Evidence Synthesis with Large Language Models

Synthesizing clinical evidence largely relies on systematic reviews of clinical trials and retrospective analyses from medical literature. However, the rapid expansion of publications presents challenges in efficiently identifying, summarizing, and updating clinical evidence. Here, we introduce TrialMind, a generative artificial intelligence (AI) pipeline for facilitating human-AI collaboration in three crucial tasks for evidence synthesis: study search, screening, and data extraction. To assess its performance, we chose published systematic reviews to build the benchmark dataset, named TrialReviewBench, which contains 100 systematic reviews and the associated 2,220 clinical studies. Our results show that TrialMind excels across all three tasks. In study search, it generates diverse and comprehensive search queries to achieve high recall rates (Ours 0.711-0.834 v.s. Human baseline 0.138-0.232). For study screening, TrialMind surpasses traditional embedding-based methods by 30% to 160%. In data extraction, it outperforms a GPT-4 baseline by 29.6% to 61.5%. We further conducted user studies to confirm its practical utility. Compared to manual efforts, human-AI collaboration using TrialMind yielded a 71.4% recall lift and 44.2% time savings in study screening and a 23.5% accuracy lift and 63.4% time savings in data extraction. Additionally, when comparing synthesized clinical evidence presented in forest plots, medical experts favored TrialMind's outputs over GPT-4's outputs in 62.5% to 100% of cases. These findings show the promise of LLM-based approaches like TrialMind to accelerate clinical evidence synthesis via streamlining study search, screening, and data extraction from medical literature, with exceptional performance improvement when working with human experts.

  • 6 authors
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Jun 25, 2024

Sibyl-AutoResearch: Autonomous Research Needs Self-Evolving Trial-and-Error Harnesses, Not Paper Generators

Autonomous research systems increasingly make the scientific workflow executable: agents can propose ideas, run code, inspect results, and draft papers. But executable workflows do not by themselves produce research judgment. We analyze where current systems lose trial experience: weak evidence becomes prose, pilot signals become broad claims, memory remains textual, and recurring process failures do not change later behavior. We introduce Sibyl-AutoResearch, a self-evolving AutoResearch framework built around Scientific Trial-and-Error Harnesses. A harness lets agents run bounded trials, preserve positive and negative outcomes, and route lessons into later planning, validation, claim scope, scheduling, critique, writing, and harness repair. We formalize this through two auditable conversion units: trial-to-behavior conversion, which links trial signals to later research actions, and trial-to-harness-behavior conversion, which links recurring process failures to system updates. We implement the framework in SIBYL, a file-backed autonomous research system that exposes the state, roles, memory, gates, and artifact traces needed to inspect these conversion paths. A retrospective audit identifies eight high-confidence conversion events, with a median latency of one iteration and a maximum latency of three iterations. A recovered-failure registry further shows how five naturally occurring failure classes, including duplicate results, stale numbers, and unsupported statistics, were blocked, downgraded, or routed into later repair. These traces do not establish a comparative performance claim; they show that the proposed conversion units are recoverable from realistic autonomous-research workspaces. The SIBYL framework and system are available at https://github.com/Sibyl-Research-Team/AutoResearch-SibylSystem.

  • 6 authors
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May 20

Jurisdiction as Structural Barrier: How Privacy Policy Organization May Reduce Visibility of Substantive Disclosures

Privacy policies are supposed to provide notice. But what if substantive information appears only where users skip it? We identify a structural pattern we call jurisdiction-siloed disclosure: information about data practices appearing in specific, actionable form only within regional compliance sections labeled "California Residents" or "EU/UK Users," while general sections use vague or qualified language for the same practices. Our audit of 123 major companies identifies 282 potential instances across 77 companies (62.6% of this purposive sample). A conservative estimate restricted to practice categories validated against OPP-115 human annotations finds 138 instances across 54 companies (44%); post-2018 categories central to our findings await independent validation. If users skip jurisdiction-labeled sections as information foraging theory predicts, users outside regulated jurisdictions would receive less specific information about practices affecting them--a transparency failure operating through document architecture rather than omission. We propose universal substantive disclosure: practices affecting all users should appear in the main policy body, with regional sections containing only procedural rights information. This standard finds support in analogous disclosure regimes (securities, truth-in-lending, nutritional labeling) where material information must reach all affected parties. Regulators could operationalize this through the FTC's "clear and conspicuous" standard and GDPR transparency principles. This work is hypothesis-generating: we establish that the structural pattern exists and ground the transparency concern in behavioral theory, but direct measurement of jurisdiction-specific section skipping remains the critical validation priority. We release our methodology and annotated dataset to enable replication.

  • 1 authors
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Jan 28