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May 26

Exploiting Longitudinal Context in Clinician-Verified Interactive Lesion Tracking

Tracking tumor lesions across serial CT scans is essential for oncological response assessment. Existing automated methods face a fundamental trade-off: end-to-end trackers achieve high automation but offer no opportunity to correct silent tracking failures, while decoupled registration-segmentation pipelines permit user verification yet discard the lesion's prior appearance, limiting accuracy in ambiguous cases. In this work, we propose a Verified Tracking paradigm: a clinician verifies a registration-proposed prompt, which the model leverages alongside the baseline lesion appearance to resolve segmentation ambiguities. We present a unified framework combining early spatial prompt fusion with latent temporal difference weighting for longitudinally-informed segmentation. To address data scarcity, we leverage large-scale synthetic pretraining, proving essential for exploiting longitudinal context, improving performance by up to 4.5 Dice points over training from scratch. Our approach secured first place in the MICCAI autoPET IV challenge. We further curate and release PanTrack, a new longitudinal pancreatic cancer benchmark, to assess out-of-distribution generalization. Experiments show that our model outperforms prior work in both fully automatic and the proposed verified tracking setting offering a clinically safe middle ground between automation and control. Code, model and dataset will be released at https://github.com/MIC-DKFZ/LongiSeg

  • 8 authors
·
May 21

A Review of Longitudinal Radiology Report Generation: Dataset Composition, Methods, and Performance Evaluation

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

  • 6 authors
·
Oct 14, 2025

When OpenClaw Meets Hospital: Toward an Agentic Operating System for Dynamic Clinical Workflows

Large language model (LLM) agents extend generative models with reasoning, tool use, and persistent memory, thereby enabling the automation of complex tasks. In healthcare, such systems could support documentation, care coordination, and clinical decision making. Their reliable deployment in hospitals, however, remains constrained by safety risks, limited transparency, and inadequate mechanisms for handling longitudinal clinical context. Here we propose an architecture that adapts LLM agents to hospital environments. The design comprises four components: a restricted execution environment inspired by multi-user operating systems, a document-centric interaction model linking patient and clinician agents, a page-indexed memory architecture for longitudinal context management, and a curated library of composable medical skills. Implemented on top of OpenClaw, an open-source agent orchestration framework, this design provides the basis for an Agentic Operating System for Hospitals: a computing layer for coordinating clinical workflows while preserving safety, transparency, and auditability. To evaluate the memory component, we introduce manifest-guided retrieval for hierarchical navigation of longitudinal patient records. In a benchmark derived from the MIMIC-IV dataset (v2.2) comprising 100 de-identified patient records and 300 clinical queries stratified across three difficulty tiers (100 per tier), manifest-guided retrieval matched a metadata-filtered RAG baseline on overall recall (0.877 versus 0.876) while achieving 2.2x higher precision (0.779 versus 0.352) and retrieving fewer documents; on tier-3 longitudinal queries, manifest recall was 21% higher (0.846 versus 0.701), confirming that LLM-guided hierarchical navigation is most valuable when queries span multiple care episodes. These results outline a practical path toward hospital-scale agentic infrastructure.

  • 8 authors
·
Mar 20

EmpathicStories++: A Multimodal Dataset for Empathy towards Personal Experiences

Modeling empathy is a complex endeavor that is rooted in interpersonal and experiential dimensions of human interaction, and remains an open problem within AI. Existing empathy datasets fall short in capturing the richness of empathy responses, often being confined to in-lab or acted scenarios, lacking longitudinal data, and missing self-reported labels. We introduce a new multimodal dataset for empathy during personal experience sharing: the EmpathicStories++ dataset (https://mitmedialab.github.io/empathic-stories-multimodal/) containing 53 hours of video, audio, and text data of 41 participants sharing vulnerable experiences and reading empathically resonant stories with an AI agent. EmpathicStories++ is the first longitudinal dataset on empathy, collected over a month-long deployment of social robots in participants' homes, as participants engage in natural, empathic storytelling interactions with AI agents. We then introduce a novel task of predicting individuals' empathy toward others' stories based on their personal experiences, evaluated in two contexts: participants' own personal shared story context and their reflections on stories they read. We benchmark this task using state-of-the-art models to pave the way for future improvements in contextualized and longitudinal empathy modeling. Our work provides a valuable resource for further research in developing empathetic AI systems and understanding the intricacies of human empathy within genuine, real-world settings.

  • 7 authors
·
May 24, 2024

Large-Scale, Longitudinal Study of Large Language Models During the 2024 US Election Season

The 2024 US presidential election is the first major contest to occur in the US since the popularization of large language models (LLMs). Building on lessons from earlier shifts in media (most notably social media's well studied role in targeted messaging and political polarization) this moment raises urgent questions about how LLMs may shape the information ecosystem and influence political discourse. While platforms have announced some election safeguards, how well they work in practice remains unclear. Against this backdrop, we conduct a large-scale, longitudinal study of 12 models, queried using a structured survey with over 12,000 questions on a near-daily cadence from July through November 2024. Our design systematically varies content and format, resulting in a rich dataset that enables analyses of the models' behavior over time (e.g., across model updates), sensitivity to steering, responsiveness to instructions, and election-related knowledge and "beliefs." In the latter half of our work, we perform four analyses of the dataset that (i) study the longitudinal variation of model behavior during election season, (ii) illustrate the sensitivity of election-related responses to demographic steering, (iii) interrogate the models' beliefs about candidates' attributes, and (iv) reveal the models' implicit predictions of the election outcome. To facilitate future evaluations of LLMs in electoral contexts, we detail our methodology, from question generation to the querying pipeline and third-party tooling. We also publicly release our dataset at https://huggingface.co/datasets/sarahcen/llm-election-data-2024

  • 7 authors
·
Sep 22, 2025

Conv-FinRe: A Conversational and Longitudinal Benchmark for Utility-Grounded Financial Recommendation

Most recommendation benchmarks evaluate how well a model imitates user behavior. In financial advisory, however, observed actions can be noisy or short-sighted under market volatility and may conflict with a user's long-term goals. Treating what users chose as the sole ground truth, therefore, conflates behavioral imitation with decision quality. We introduce Conv-FinRe, a conversational and longitudinal benchmark for stock recommendation that evaluates LLMs beyond behavior matching. Given an onboarding interview, step-wise market context, and advisory dialogues, models must generate rankings over a fixed investment horizon. Crucially, Conv-FinRe provides multi-view references that distinguish descriptive behavior from normative utility grounded in investor-specific risk preferences, enabling diagnosis of whether an LLM follows rational analysis, mimics user noise, or is driven by market momentum. We build the benchmark from real market data and human decision trajectories, instantiate controlled advisory conversations, and evaluate a suite of state-of-the-art LLMs. Results reveal a persistent tension between rational decision quality and behavioral alignment: models that perform well on utility-based ranking often fail to match user choices, whereas behaviorally aligned models can overfit short-term noise. The dataset is publicly released on Hugging Face, and the codebase is available on GitHub.

TheFinAI The Fin AI
·
Feb 18 2

Robustness Over Time: Understanding Adversarial Examples' Effectiveness on Longitudinal Versions of Large Language Models

Large Language Models (LLMs) have led to significant improvements in many tasks across various domains, such as code interpretation, response generation, and ambiguity handling. These LLMs, however, when upgrading, primarily prioritize enhancing user experience while neglecting security, privacy, and safety implications. Consequently, unintended vulnerabilities or biases can be introduced. Previous studies have predominantly focused on specific versions of the models and disregard the potential emergence of new attack vectors targeting the updated versions. Through the lens of adversarial examples within the in-context learning framework, this longitudinal study addresses this gap by conducting a comprehensive assessment of the robustness of successive versions of LLMs, vis-\`a-vis GPT-3.5. We conduct extensive experiments to analyze and understand the impact of the robustness in two distinct learning categories: zero-shot learning and few-shot learning. Our findings indicate that, in comparison to earlier versions of LLMs, the updated versions do not exhibit the anticipated level of robustness against adversarial attacks. In addition, our study emphasizes the increased effectiveness of synergized adversarial queries in most zero-shot learning and few-shot learning cases. We hope that our study can lead to a more refined assessment of the robustness of LLMs over time and provide valuable insights of these models for both developers and users.

  • 6 authors
·
Aug 15, 2023

NurValues: Real-World Nursing Values Evaluation for Large Language Models in Clinical Context

This work introduces the first benchmark for nursing value alignment, consisting of five core value dimensions distilled from international nursing codes: Altruism, Human Dignity, Integrity, Justice, and Professionalism. The benchmark comprises 1,100 real-world nursing behavior instances collected through a five-month longitudinal field study across three hospitals of varying tiers. These instances are annotated by five clinical nurses and then augmented with LLM-generated counterfactuals with reversed ethic polarity. Each original case is paired with a value-aligned and a value-violating version, resulting in 2,200 labeled instances that constitute the Easy-Level dataset. To increase adversarial complexity, each instance is further transformed into a dialogue-based format that embeds contextual cues and subtle misleading signals, yielding a Hard-Level dataset. We evaluate 23 state-of-the-art (SoTA) LLMs on their alignment with nursing values. Our findings reveal three key insights: (1) DeepSeek-V3 achieves the highest performance on the Easy-Level dataset (94.55), where Claude 3.5 Sonnet outperforms other models on the Hard-Level dataset (89.43), significantly surpassing the medical LLMs; (2) Justice is consistently the most difficult nursing value dimension to evaluate; and (3) in-context learning significantly improves alignment. This work aims to provide a foundation for value-sensitive LLMs development in clinical settings. The dataset and the code are available at https://huggingface.co/datasets/Ben012345/NurValues.

  • 7 authors
·
May 13, 2025

How Robust Are Large Language Models for Clinical Numeracy? An Empirical Study on Numerical Reasoning Abilities in Clinical Contexts

Large Language Models (LLMs) are increasingly being explored for clinical question answering and decision support, yet safe deployment critically requires reliable handling of patient measurements in heterogeneous clinical notes. Existing evaluations of LLMs for clinical numerical reasoning provide limited operation-level coverage, restricted primarily to arithmetic computation, and rarely assess the robustness of numerical understanding across clinical note formats. We introduce ClinicNumRobBench, a benchmark of 1,624 context-question instances with ground-truth answers that evaluates four main types of clinical numeracy: value retrieval, arithmetic computation, relational comparison, and aggregation. To stress-test robustness, ClinicNumRobBench presents longitudinal MIMIC-IV vital-sign records in three semantically equivalent representations, including a real-world note-style variant derived from the Open Patients dataset, and instantiates queries using 42 question templates. Experiments on 14 LLMs show that value retrieval is generally strong, with most models exceeding 85% accuracy, while relational comparison and aggregation remain challenging, with some models scoring below 15%. Fine-tuning on medical data can reduce numeracy relative to base models by over 30%, and performance drops under note-style variation indicate LLM sensitivity to format. ClinicNumRobBench offers a rigorous testbed for clinically reliable numerical reasoning. Code and data URL are available on https://github.com/MinhVuong2000/ClinicNumRobBench.

  • 4 authors
·
Apr 12

RePrompT: Recurrent Prompt Tuning for Integrating Structured EHR Encoders with Large Language Models

Large Language Models (LLMs) have shown strong promise for mining Electronic Health Records (EHRs) by reasoning over longitudinal clinical information to capture context-rich patient trajectories. However, leveraging LLMs for structured EHRs (e.g., standardized diagnosis and medication codes) presents two key challenges. First, translating time-stamped EHR sequences into plain text can obscure both temporal structure and code identities, weakening the ability to capture code co-occurrence and longitudinal regularities. Second, unlike cohort-trained predictive models that learn a shared, task-aligned representation space across patients, LLMs are often applied in a case-isolated inference setting where each patient is processed independently without leveraging population-level patterns. To address these challenges, we introduce RePrompT, a time-aware LLM framework that integrates structured EHR encoders through prompt tuning, without modifying underlying architectures. Specifically, RePrompT recurrently incorporates latent states from prior visits to preserve longitudinal information, and injects population-level information through trainable prompt tokens derived from a cohort-trained, task-aligned EHR encoder. Experiments on MIMIC-III and MIMIC-IV demonstrate that RePrompT consistently outperforms both EHR-based and LLM-based baselines across multiple clinical prediction tasks.

  • 5 authors
·
Apr 19

TS-Haystack: A Multi-Scale Retrieval Benchmark for Time Series Language Models

Time Series Language Models (TSLMs) are emerging as unified models for reasoning over continuous signals in natural language. However, long-context retrieval remains a major limitation: existing models are typically trained and evaluated on short sequences, while real-world time-series sensor streams can span millions of datapoints. This mismatch requires precise temporal localization under strict computational constraints, a regime that is not captured by current benchmarks. We introduce TS-Haystack, a long-context temporal retrieval benchmark comprising ten task types across four categories: direct retrieval, temporal reasoning, multi-step reasoning and contextual anomaly. The benchmark uses controlled needle insertion by embedding short activity bouts into longer longitudinal accelerometer recordings, enabling systematic evaluation across context lengths ranging from seconds to 2 hours per sample. We hypothesize that existing TSLM time series encoders overlook temporal granularity as context length increases, creating a task-dependent effect: compression aids classification but impairs retrieval of localized events. Across multiple model and encoding strategies, we observe a consistent divergence between classification and retrieval behavior. Learned latent compression preserves or improves classification accuracy at compression ratios up to 176times, but retrieval performance degrades with context length, incurring in the loss of temporally localized information. These results highlight the importance of architectural designs that decouple sequence length from computational complexity while preserving temporal fidelity.

  • 10 authors
·
Feb 15

Enforcing temporal consistency in Deep Learning segmentation of brain MR images

Longitudinal analysis has great potential to reveal developmental trajectories and monitor disease progression in medical imaging. This process relies on consistent and robust joint 4D segmentation. Traditional techniques are dependent on the similarity of images over time and the use of subject-specific priors to reduce random variation and improve the robustness and sensitivity of the overall longitudinal analysis. This is however slow and computationally intensive as subject-specific templates need to be rebuilt every time. The focus of this work to accelerate this analysis with the use of deep learning. The proposed approach is based on deep CNNs and incorporates semantic segmentation and provides a longitudinal relationship for the same subject. The proposed approach is based on deep CNNs and incorporates semantic segmentation and provides a longitudinal relationship for the same subject. The state of art using 3D patches as inputs to modified Unet provides results around {0.91 pm 0.5} Dice and using multi-view atlas in CNNs provide around the same results. In this work, different models are explored, each offers better accuracy and fast results while increasing the segmentation quality. These methods are evaluated on 135 scans from the EADC-ADNI Harmonized Hippocampus Protocol. Proposed CNN based segmentation approaches demonstrate how 2D segmentation using prior slices can provide similar results to 3D segmentation while maintaining good continuity in the 3D dimension and improved speed. Just using 2D modified sagittal slices provide us a better Dice and longitudinal analysis for a given subject. For the ADNI dataset, using the simple UNet CNN technique gives us {0.84 pm 0.5} and while using modified CNN techniques on the same input yields {0.89 pm 0.5}. Rate of atrophy and RMS error are calculated for several test cases using various methods and analyzed.

  • 2 authors
·
Jun 13, 2019

Extending Mixture of Experts Model to Investigate Heterogeneity of Trajectories: When, Where and How to Add Which Covariates

Researchers are usually interested in examining the impact of covariates when separating heterogeneous samples into latent classes that are more homogeneous. The majority of theoretical and empirical studies with such aims have focused on identifying covariates as predictors of class membership in the structural equation modeling framework. In other words, the covariates only indirectly affect the sample heterogeneity. However, the covariates' influence on between-individual differences can also be direct. This article presents a mixture model that investigates covariates to explain within-cluster and between-cluster heterogeneity simultaneously, known as a mixture-of-experts (MoE) model. This study aims to extend the MoE framework to investigate heterogeneity in nonlinear trajectories: to identify latent classes, covariates as predictors to clusters, and covariates that explain within-cluster differences in change patterns over time. Our simulation studies demonstrate that the proposed model generally estimates the parameters unbiasedly, precisely and exhibits appropriate empirical coverage for a nominal 95% confidence interval. This study also proposes implementing structural equation model forests to shrink the covariate space of the proposed mixture model. We illustrate how to select covariates and construct the proposed model with longitudinal mathematics achievement data. Additionally, we demonstrate that the proposed mixture model can be further extended in the structural equation modeling framework by allowing the covariates that have direct effects to be time-varying.

  • 2 authors
·
Jul 5, 2020

LABOR-LLM: Language-Based Occupational Representations with Large Language Models

Many empirical studies of labor market questions rely on estimating relatively simple predictive models using small, carefully constructed longitudinal survey datasets based on hand-engineered features. Large Language Models (LLMs), trained on massive datasets, encode vast quantities of world knowledge and can be used for the next job prediction problem. However, while an off-the-shelf LLM produces plausible career trajectories when prompted, the probability with which an LLM predicts a particular job transition conditional on career history will not, in general, align with the true conditional probability in a given population. Recently, Vafa et al. (2024) introduced a transformer-based "foundation model", CAREER, trained using a large, unrepresentative resume dataset, that predicts transitions between jobs; it further demonstrated how transfer learning techniques can be used to leverage the foundation model to build better predictive models of both transitions and wages that reflect conditional transition probabilities found in nationally representative survey datasets. This paper considers an alternative where the fine-tuning of the CAREER foundation model is replaced by fine-tuning LLMs. For the task of next job prediction, we demonstrate that models trained with our approach outperform several alternatives in terms of predictive performance on the survey data, including traditional econometric models, CAREER, and LLMs with in-context learning, even though the LLM can in principle predict job titles that are not allowed in the survey data. Further, we show that our fine-tuned LLM-based models' predictions are more representative of the career trajectories of various workforce subpopulations than off-the-shelf LLM models and CAREER. We conduct experiments and analyses that highlight the sources of the gains in the performance of our models for representative predictions.

  • 5 authors
·
Jun 25, 2024

Demographic Probing of Large Language Models Lacks Construct Validity

Demographic probing is widely used to study how large language models (LLMs) adapt their behavior to signaled demographic attributes. This approach typically uses a single demographic cue in isolation (e.g., a name or dialect) as a signal for group membership, implicitly assuming strong construct validity: that such cues are interchangeable operationalizations of the same underlying, demographically conditioned behavior. We test this assumption in realistic advice-seeking interactions, focusing on race and gender in a U.S. context. We find that cues intended to represent the same demographic group induce only partially overlapping changes in model behavior, while differentiation between groups within a given cue is weak and uneven. Consequently, estimated disparities are unstable, with both magnitude and direction varying across cues. We further show that these inconsistencies partly arise from variation in how strongly cues encode demographic attributes and from linguistic confounders that independently shape model behavior. Together, our findings suggest that demographic probing lacks construct validity: it does not yield a single, stable characterization of how LLMs condition on demographic information, which may reflect a misspecified or fragmented construct. We conclude by recommending the use of multiple, ecologically valid cues and explicit control of confounders to support more defensible claims about demographic effects in LLMs.

  • 8 authors
·
Jan 26

ESL-Bench: An Event-Driven Synthetic Longitudinal Benchmark for Health Agents

Longitudinal health agents must reason across multi-source trajectories that combine continuous device streams, sparse clinical exams, and episodic life events - yet evaluating them is hard: real-world data cannot be released at scale, and temporally grounded attribution questions seldom admit definitive answers without structured ground truth. We present ESL-Bench, an event-driven synthesis framework and benchmark providing 100 synthetic users, each with a 1-5 year trajectory comprising a health profile, a multi-phase narrative plan, daily device measurements, periodic exam records, and an event log with explicit per-indicator impact parameters. Each indicator follows a baseline stochastic process driven by discrete events with sigmoid-onset, exponential-decay kernels under saturation and projection constraints; a hybrid pipeline delegates sparse semantic artifacts to LLM-based planning and dense indicator dynamics to algorithmic simulation with hard physiological bounds. Users are each paired with 100 evaluation queries across five dimensions - Lookup, Trend, Comparison, Anomaly, Explanation - stratified into Easy, Medium, and Hard tiers, with all ground-truth answers programmatically computable from the recorded event-indicator relationships. Evaluating 13 methods spanning LLMs with tools, DB-native agents, and memory-augmented RAG, we find that DB agents (48-58%) substantially outperform memory RAG baselines (30-38%), with the gap concentrated on Comparison and Explanation queries where multi-hop reasoning and evidence attribution are required.

  • 10 authors
·
Apr 2

Assessing Episodic Memory in LLMs with Sequence Order Recall Tasks

Current LLM benchmarks focus on evaluating models' memory of facts and semantic relations, primarily assessing semantic aspects of long-term memory. However, in humans, long-term memory also includes episodic memory, which links memories to their contexts, such as the time and place they occurred. The ability to contextualize memories is crucial for many cognitive tasks and everyday functions. This form of memory has not been evaluated in LLMs with existing benchmarks. To address the gap in evaluating memory in LLMs, we introduce Sequence Order Recall Tasks (SORT), which we adapt from tasks used to study episodic memory in cognitive psychology. SORT requires LLMs to recall the correct order of text segments, and provides a general framework that is both easily extendable and does not require any additional annotations. We present an initial evaluation dataset, Book-SORT, comprising 36k pairs of segments extracted from 9 books recently added to the public domain. Based on a human experiment with 155 participants, we show that humans can recall sequence order based on long-term memory of a book. We find that models can perform the task with high accuracy when relevant text is given in-context during the SORT evaluation. However, when presented with the book text only during training, LLMs' performance on SORT falls short. By allowing to evaluate more aspects of memory, we believe that SORT will aid in the emerging development of memory-augmented models.

  • 10 authors
·
Oct 10, 2024

Brain Latent Progression: Individual-based Spatiotemporal Disease Progression on 3D Brain MRIs via Latent Diffusion

The growing availability of longitudinal Magnetic Resonance Imaging (MRI) datasets has facilitated Artificial Intelligence (AI)-driven modeling of disease progression, making it possible to predict future medical scans for individual patients. However, despite significant advancements in AI, current methods continue to face challenges including achieving patient-specific individualization, ensuring spatiotemporal consistency, efficiently utilizing longitudinal data, and managing the substantial memory demands of 3D scans. To address these challenges, we propose Brain Latent Progression (BrLP), a novel spatiotemporal model designed to predict individual-level disease progression in 3D brain MRIs. The key contributions in BrLP are fourfold: (i) it operates in a small latent space, mitigating the computational challenges posed by high-dimensional imaging data; (ii) it explicitly integrates subject metadata to enhance the individualization of predictions; (iii) it incorporates prior knowledge of disease dynamics through an auxiliary model, facilitating the integration of longitudinal data; and (iv) it introduces the Latent Average Stabilization (LAS) algorithm, which (a) enforces spatiotemporal consistency in the predicted progression at inference time and (b) allows us to derive a measure of the uncertainty for the prediction at the global and voxel level. We train and evaluate BrLP on 11,730 T1-weighted (T1w) brain MRIs from 2,805 subjects and validate its generalizability on an external test set comprising 2,257 MRIs from 962 subjects. Our experiments compare BrLP-generated MRI scans with real follow-up MRIs, demonstrating state-of-the-art accuracy compared to existing methods. The code is publicly available at: https://github.com/LemuelPuglisi/BrLP.

  • 3 authors
·
Feb 12, 2025

Memory in Large Language Models: Mechanisms, Evaluation and Evolution

Under a unified operational definition, we define LLM memory as a persistent state written during pretraining, finetuning, or inference that can later be addressed and that stably influences outputs. We propose a four-part taxonomy (parametric, contextual, external, procedural/episodic) and a memory quadruple (location, persistence, write/access path, controllability). We link mechanism, evaluation, and governance via the chain write -> read -> inhibit/update. To avoid distorted comparisons across heterogeneous setups, we adopt a three-setting protocol (parametric only, offline retrieval, online retrieval) that decouples capability from information availability on the same data and timeline. On this basis we build a layered evaluation: parametric (closed-book recall, edit differential, memorization/privacy), contextual (position curves and the mid-sequence drop), external (answer correctness vs snippet attribution/faithfulness), and procedural/episodic (cross-session consistency and timeline replay, E MARS+). The framework integrates temporal governance and leakage auditing (freshness hits, outdated answers, refusal slices) and uncertainty reporting via inter-rater agreement plus paired tests with multiple-comparison correction. For updating and forgetting, we present DMM Gov: coordinating DAPT/TAPT, PEFT, model editing (ROME, MEND, MEMIT, SERAC), and RAG to form an auditable loop covering admission thresholds, rollout, monitoring, rollback, and change audits, with specs for timeliness, conflict handling, and long-horizon consistency. Finally, we give four testable propositions: minimum identifiability; a minimal evaluation card; causally constrained editing with verifiable forgetting; and when retrieval with small-window replay outperforms ultra-long-context reading. This yields a reproducible, comparable, and governable coordinate system for research and deployment.

  • 7 authors
·
Sep 23, 2025

Decade of Natural Language Processing in Chronic Pain: A Systematic Review

In recent years, the intersection of Natural Language Processing (NLP) and public health has opened innovative pathways for investigating various domains, including chronic pain in textual datasets. Despite the promise of NLP in chronic pain, the literature is dispersed across various disciplines, and there is a need to consolidate existing knowledge, identify knowledge gaps in the literature, and inform future research directions in this emerging field. This review aims to investigate the state of the research on NLP-based interventions designed for chronic pain research. A search strategy was formulated and executed across PubMed, Web of Science, IEEE Xplore, Scopus, and ACL Anthology to find studies published in English between 2014 and 2024. After screening 132 papers, 26 studies were included in the final review. Key findings from this review underscore the significant potential of NLP techniques to address pressing challenges in chronic pain research. The past 10 years in this field have showcased the utilization of advanced methods (transformers like RoBERTa and BERT) achieving high-performance metrics (e.g., F1>0.8) in classification tasks, while unsupervised approaches like Latent Dirichlet Allocation (LDA) and k-means clustering have proven effective for exploratory analyses. Results also reveal persistent challenges such as limited dataset diversity, inadequate sample sizes, and insufficient representation of underrepresented populations. Future research studies should explore multimodal data validation systems, context-aware mechanistic modeling, and the development of standardized evaluation metrics to enhance reproducibility and equity in chronic pain research.

  • 1 authors
·
Dec 19, 2024

Is It Really Long Context if All You Need Is Retrieval? Towards Genuinely Difficult Long Context NLP

Improvements in language models' capabilities have pushed their applications towards longer contexts, making long-context evaluation and development an active research area. However, many disparate use-cases are grouped together under the umbrella term of "long-context", defined simply by the total length of the model's input, including - for example - Needle-in-a-Haystack tasks, book summarization, and information aggregation. Given their varied difficulty, in this position paper we argue that conflating different tasks by their context length is unproductive. As a community, we require a more precise vocabulary to understand what makes long-context tasks similar or different. We propose to unpack the taxonomy of long-context based on the properties that make them more difficult with longer contexts. We propose two orthogonal axes of difficulty: (I) Diffusion: How hard is it to find the necessary information in the context? (II) Scope: How much necessary information is there to find? We survey the literature on long-context, provide justification for this taxonomy as an informative descriptor, and situate the literature with respect to it. We conclude that the most difficult and interesting settings, whose necessary information is very long and highly diffused within the input, is severely under-explored. By using a descriptive vocabulary and discussing the relevant properties of difficulty in long-context, we can implement more informed research in this area. We call for a careful design of tasks and benchmarks with distinctly long context, taking into account the characteristics that make it qualitatively different from shorter context.

  • 6 authors
·
Jun 29, 2024 1

The Impact of Medication Non-adherence on Adverse Outcomes: Evidence from Schizophrenia Patients via Survival Analysis

This study quantifies the association between non-adherence to antipsychotic medications and adverse outcomes in individuals with schizophrenia. We frame the problem using survival analysis, focusing on the time to the earliest of several adverse events (early death, involuntary hospitalization, jail booking). We extend standard causal inference methods (T-learner, S-learner, nearest neighbor matching) to utilize various survival models to estimate individual and average treatment effects, where treatment corresponds to medication non-adherence. Analyses are repeated using different amounts of longitudinal information (3, 6, 9, and 12 months). Using data from Allegheny County in western Pennsylvania, we find strong evidence that non-adherence advances adverse outcomes by approximately 1 to 4 months. Ablation studies confirm that county-provided risk scores adjust for key confounders, as their removal amplifies the estimated effects. Subgroup analyses by medication formulation (injectable vs. oral) and medication type consistently show that non-adherence is associated with earlier adverse events. These findings highlight the clinical importance of adherence in delaying psychiatric crises and show that integrating survival analysis with causal inference tools can yield policy-relevant insights. We caution that although we apply causal inference, we only make associative claims and discuss assumptions needed for causal interpretation.

Exploring Synaptic Resonance in Large Language Models: A Novel Approach to Contextual Memory Integration

Contextual memory integration remains a high challenge in the development of language models, particularly in tasks that require maintaining coherence over extended sequences. Traditional approaches, such as self-attention mechanisms and memory-augmented architectures, often prioritize short-term dependencies, leading to fragmentation and inconsistency in long-range contextual understanding. Inspired by principles of synaptic plasticity observed in biological neural systems, a novel mechanism, Synaptic Resonance, is introduced to dynamically reinforce relevant memory pathways during training and inference. Unlike static memory representations, this mechanism continuously adjusts synaptic weight matrices based on contextual relevance, allowing for improved information retention without excessive computational overhead. Evaluations conducted on an open-source language model demonstrate reductions in perplexity, enhancements in contextual coherence, and increased robustness against input noise, highlighting the effectiveness of reinforcement-driven memory modulation. Comparative analysis against baseline models further reveals that the proposed approach achieves higher memory retention efficiency while maintaining computational feasibility. The architectural modifications integrate seamlessly into existing transformer-based frameworks, ensuring stable convergence and efficient inference without sacrificing scalability. Applications benefiting from improved long-term contextual consistency, such as dialogue systems and document summarization, stand to gain from this approach. Empirical findings suggest that dynamically reinforced memory pathways offer a promising alternative to conventional memory mechanisms, addressing longstanding limitations in extended sequence modeling.

  • 5 authors
·
Feb 15, 2025

Foresight -- Generative Pretrained Transformer (GPT) for Modelling of Patient Timelines using EHRs

Background: Electronic Health Records hold detailed longitudinal information about each patient's health status and general clinical history, a large portion of which is stored within the unstructured text. Existing approaches focus mostly on structured data and a subset of single-domain outcomes. We explore how temporal modelling of patients from free text and structured data, using deep generative transformers can be used to forecast a wide range of future disorders, substances, procedures or findings. Methods: We present Foresight, a novel transformer-based pipeline that uses named entity recognition and linking tools to convert document text into structured, coded concepts, followed by providing probabilistic forecasts for future medical events such as disorders, substances, procedures and findings. We processed the entire free-text portion from three different hospital datasets totalling 811336 patients covering both physical and mental health. Findings: On tests in two UK hospitals (King's College Hospital, South London and Maudsley) and the US MIMIC-III dataset precision@10 0.68, 0.76 and 0.88 was achieved for forecasting the next disorder in a patient timeline, while precision@10 of 0.80, 0.81 and 0.91 was achieved for forecasting the next biomedical concept. Foresight was also validated on 34 synthetic patient timelines by five clinicians and achieved relevancy of 97% for the top forecasted candidate disorder. As a generative model, it can forecast follow-on biomedical concepts for as many steps as required. Interpretation: Foresight is a general-purpose model for biomedical concept modelling that can be used for real-world risk forecasting, virtual trials and clinical research to study the progression of disorders, simulate interventions and counterfactuals, and educational purposes.

  • 12 authors
·
Dec 13, 2022

Fine-Tuned LLMs are "Time Capsules" for Tracking Societal Bias Through Books

Books, while often rich in cultural insights, can also mirror societal biases of their eras - biases that Large Language Models (LLMs) may learn and perpetuate during training. We introduce a novel method to trace and quantify these biases using fine-tuned LLMs. We develop BookPAGE, a corpus comprising 593 fictional books across seven decades (1950-2019), to track bias evolution. By fine-tuning LLMs on books from each decade and using targeted prompts, we examine shifts in biases related to gender, sexual orientation, race, and religion. Our findings indicate that LLMs trained on decade-specific books manifest biases reflective of their times, with both gradual trends and notable shifts. For example, model responses showed a progressive increase in the portrayal of women in leadership roles (from 8% to 22%) from the 1950s to 2010s, with a significant uptick in the 1990s (from 4% to 12%), possibly aligning with third-wave feminism. Same-sex relationship references increased markedly from the 1980s to 2000s (from 0% to 10%), mirroring growing LGBTQ+ visibility. Concerningly, negative portrayals of Islam rose sharply in the 2000s (26% to 38%), likely reflecting post-9/11 sentiments. Importantly, we demonstrate that these biases stem mainly from the books' content and not the models' architecture or initial training. Our study offers a new perspective on societal bias trends by bridging AI, literary studies, and social science research.

  • 5 authors
·
Feb 7, 2025

The Digital Divide in Generative AI: Evidence from Large Language Model Use in College Admissions Essays

Large language models (LLMs) have become popular writing tools among students and may expand access to high-quality feedback for students with less access to traditional writing support. At the same time, LLMs may standardize student voice or invite overreliance. This study examines how adoption of LLM-assisted writing varies across socioeconomic groups and how it relates to outcomes in a high-stakes context: U.S. college admissions. We analyze a de-identified longitudinal dataset of applications to a selective university from 2020 to 2024 (N = 81,663). Estimating LLM use using a distribution-based detector trained on synthetic and historical essays, we tracked how student writing changed as LLM use proliferated, how adoption differed by socioeconomic status (SES), and whether potential benefits translated equitably into admissions outcomes. Using fee-waiver status as a proxy for SES, we observe post-2023 convergence in surface-level linguistic features, with the largest changes in fee-waived and rejected applicants. Estimated LLM use rose sharply in 2024 across all groups, with disproportionately larger increases among lower SES applicants, consistent with an access hypothesis in which LLMs substitute for scarce writing support. However, increased estimated LLM use was more strongly associated with declines in predicted admission probability for lower SES applicants than for higher SES applicants, even after controlling for academic credentials and stylometric features. These findings raise concerns about equity and the validity of essay-based evaluation in an era of AI-assisted writing and provide the first large-scale longitudinal evidence linking LLM adoption, linguistic change, and evaluative outcomes in college admissions.

  • 5 authors
·
Feb 18

Titans: Learning to Memorize at Test Time

Over more than a decade there has been an extensive research effort on how to effectively utilize recurrent models and attention. While recurrent models aim to compress the data into a fixed-size memory (called hidden state), attention allows attending to the entire context window, capturing the direct dependencies of all tokens. This more accurate modeling of dependencies, however, comes with a quadratic cost, limiting the model to a fixed-length context. We present a new neural long-term memory module that learns to memorize historical context and helps attention to attend to the current context while utilizing long past information. We show that this neural memory has the advantage of fast parallelizable training while maintaining a fast inference. From a memory perspective, we argue that attention due to its limited context but accurate dependency modeling performs as a short-term memory, while neural memory due to its ability to memorize the data, acts as a long-term, more persistent, memory. Based on these two modules, we introduce a new family of architectures, called Titans, and present three variants to address how one can effectively incorporate memory into this architecture. Our experimental results on language modeling, common-sense reasoning, genomics, and time series tasks show that Titans are more effective than Transformers and recent modern linear recurrent models. They further can effectively scale to larger than 2M context window size with higher accuracy in needle-in-haystack tasks compared to baselines.

  • 3 authors
·
Dec 31, 2024 3

Étude cognitive des processus de construction d'une requête dans un système de gestion de connaissances médicales

This article presents the Cogni-CISMeF project, which aims at improving medical information search in the CISMeF system (Catalog and Index of French-language health resources) by including a conversational agent to interact with the user in natural language. To study the cognitive processes involved during the information search, a bottom-up methodology was adopted. Experimentation has been set up to obtain human dialogs between a user (playing the role of patient) dealing with medical information search and a CISMeF expert refining the request. The analysis of these dialogs underlined the use of discursive evidence: vocabulary, reformulation, implicit or explicit expression of user intentions, conversational sequences, etc. A model of artificial agent is proposed. It leads the user in its information search by proposing to him examples, assistance and choices. This model was implemented and integrated in the CISMeF system. ---- Cet article d\'ecrit le projet Cogni-CISMeF qui propose un module de dialogue Homme-Machine \`a int\'egrer dans le syst\`eme d'indexation de connaissances m\'edicales CISMeF (Catalogue et Index des Sites M\'edicaux Francophones). Nous avons adopt\'e une d\'emarche de mod\'elisation cognitive en proc\'edant \`a un recueil de corpus de dialogues entre un utilisateur (jouant le r\^ole d'un patient) d\'esirant une information m\'edicale et un expert CISMeF af inant cette demande pour construire la requ\^ete. Nous avons analys\'e la structure des dialogues ainsi obtenus et avons \'etudi\'e un certain nombre d'indices discursifs : vocabulaire employ\'e, marques de reformulation, commentaires m\'eta et \'epilinguistiques, expression implicite ou explicite des intentions de l'utilisateur, encha\^inement conversationnel, etc. De cette analyse, nous avons construit un mod\`ele d'agent artificiel dot\'e de capacit\'es cognitives capables d'aider l'utilisateur dans sa t\^ache de recherche d'information. Ce mod\`ele a \'et\'e impl\'ement\'e et int\'egr\'e dans le syst\`eme CISMeF.

  • 5 authors
·
Feb 10, 2014

Iterative Service-Learning: A Computing-Based Case-study Applied to Small Rural Organizations

This paper describes the iterative use of service learning to develop, review, and improve computing-based artifacts. It is well-known that computing students benefit from service-learning experiences as do the community partners. It is also well-known that computing artifacts rarely function well long-term without versioning and updates. Service-learning projects are often one-time engagements, completed by single teams of students over the course of a semester course. This limits the benefit for community partners that do not have the expertise or resources to review and update a project on their own. Over several years, teams of undergraduate students in a capstone course created tailored social media plans for numerous small rural organizations. The projects were required to meet client specific needs, with identified audiences, measurable goals, and strategies and tactics to reach the identified goals. This paper builds on previously results for 60 projects conducted over several years. Nine clients were selected to participate in the iterative follow-up process, where new student teams conducted client interviews, reviewed the initial plans, and analyzed metrics from the current strategies and tactics to provide updated, improved artifacts. Using ABET learning objectives as a basis, clients reviewed the student teams and artifacts. This longitudinal study discusses the impact of this intervention to increase implementation and sustained use rates of computing artifacts developed through service learning. Both students and clients reported high satisfaction levels, and clients were particularly satisfied with the iterative improvement process. This research demonstrates an innovative practice for creating and maintaining computing artifacts through iterative service learning, while addressing the resource constraints of small organizations.

  • 1 authors
·
Jun 21, 2024

HR-VILAGE-3K3M: A Human Respiratory Viral Immunization Longitudinal Gene Expression Dataset for Systems Immunity

Respiratory viral infections pose a global health burden, yet the cellular immune responses driving protection or pathology remain unclear. Natural infection cohorts often lack pre-exposure baseline data and structured temporal sampling. In contrast, inoculation and vaccination trials generate insightful longitudinal transcriptomic data. However, the scattering of these datasets across platforms, along with inconsistent metadata and preprocessing procedure, hinders AI-driven discovery. To address these challenges, we developed the Human Respiratory Viral Immunization LongitudinAl Gene Expression (HR-VILAGE-3K3M) repository: an AI-ready, rigorously curated dataset that integrates 14,136 RNA-seq profiles from 3,178 subjects across 66 studies encompassing over 2.56 million cells. Spanning vaccination, inoculation, and mixed exposures, the dataset includes microarray, bulk RNA-seq, and single-cell RNA-seq from whole blood, PBMCs, and nasal swabs, sourced from GEO, ImmPort, and ArrayExpress. We harmonized subject-level metadata, standardized outcome measures, applied unified preprocessing pipelines with rigorous quality control, and aligned all data to official gene symbols. To demonstrate the utility of HR-VILAGE-3K3M, we performed predictive modeling of vaccine responders and evaluated batch-effect correction methods. Beyond these initial demonstrations, it supports diverse systems immunology applications and benchmarking of feature selection and transfer learning algorithms. Its scale and heterogeneity also make it ideal for pretraining foundation models of the human immune response and for advancing multimodal learning frameworks. As the largest longitudinal transcriptomic resource for human respiratory viral immunization, it provides an accessible platform for reproducible AI-driven research, accelerating systems immunology and vaccine development against emerging viral threats.

  • 17 authors
·
May 19, 2025

Context Forcing: Consistent Autoregressive Video Generation with Long Context

Recent approaches to real-time long video generation typically employ streaming tuning strategies, attempting to train a long-context student using a short-context (memoryless) teacher. In these frameworks, the student performs long rollouts but receives supervision from a teacher limited to short 5-second windows. This structural discrepancy creates a critical student-teacher mismatch: the teacher's inability to access long-term history prevents it from guiding the student on global temporal dependencies, effectively capping the student's context length. To resolve this, we propose Context Forcing, a novel framework that trains a long-context student via a long-context teacher. By ensuring the teacher is aware of the full generation history, we eliminate the supervision mismatch, enabling the robust training of models capable of long-term consistency. To make this computationally feasible for extreme durations (e.g., 2 minutes), we introduce a context management system that transforms the linearly growing context into a Slow-Fast Memory architecture, significantly reducing visual redundancy. Extensive results demonstrate that our method enables effective context lengths exceeding 20 seconds -- 2 to 10 times longer than state-of-the-art methods like LongLive and Infinite-RoPE. By leveraging this extended context, Context Forcing preserves superior consistency across long durations, surpassing state-of-the-art baselines on various long video evaluation metrics.

TIGER-Lab TIGER-Lab
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Feb 5 7

Thus Spake Long-Context Large Language Model

Long context is an important topic in Natural Language Processing (NLP), running through the development of NLP architectures, and offers immense opportunities for Large Language Models (LLMs) giving LLMs the lifelong learning potential akin to humans. Unfortunately, the pursuit of a long context is accompanied by numerous obstacles. Nevertheless, long context remains a core competitive advantage for LLMs. In the past two years, the context length of LLMs has achieved a breakthrough extension to millions of tokens. Moreover, the research on long-context LLMs has expanded from length extrapolation to a comprehensive focus on architecture, infrastructure, training, and evaluation technologies. Inspired by the symphonic poem, Thus Spake Zarathustra, we draw an analogy between the journey of extending the context of LLM and the attempts of humans to transcend its mortality. In this survey, We will illustrate how LLM struggles between the tremendous need for a longer context and its equal need to accept the fact that it is ultimately finite. To achieve this, we give a global picture of the lifecycle of long-context LLMs from four perspectives: architecture, infrastructure, training, and evaluation, showcasing the full spectrum of long-context technologies. At the end of this survey, we will present 10 unanswered questions currently faced by long-context LLMs. We hope this survey can serve as a systematic introduction to the research on long-context LLMs.

  • 13 authors
·
Feb 24, 2025 6

Using Sequences of Life-events to Predict Human Lives

Over the past decade, machine learning has revolutionized computers' ability to analyze text through flexible computational models. Due to their structural similarity to written language, transformer-based architectures have also shown promise as tools to make sense of a range of multi-variate sequences from protein-structures, music, electronic health records to weather-forecasts. We can also represent human lives in a way that shares this structural similarity to language. From one perspective, lives are simply sequences of events: People are born, visit the pediatrician, start school, move to a new location, get married, and so on. Here, we exploit this similarity to adapt innovations from natural language processing to examine the evolution and predictability of human lives based on detailed event sequences. We do this by drawing on arguably the most comprehensive registry data in existence, available for an entire nation of more than six million individuals across decades. Our data include information about life-events related to health, education, occupation, income, address, and working hours, recorded with day-to-day resolution. We create embeddings of life-events in a single vector space showing that this embedding space is robust and highly structured. Our models allow us to predict diverse outcomes ranging from early mortality to personality nuances, outperforming state-of-the-art models by a wide margin. Using methods for interpreting deep learning models, we probe the algorithm to understand the factors that enable our predictions. Our framework allows researchers to identify new potential mechanisms that impact life outcomes and associated possibilities for personalized interventions.

  • 8 authors
·
Jun 5, 2023

Spinning the Golden Thread: Benchmarking Long-Form Generation in Language Models

The abilities of long-context language models (LMs) are often evaluated using the "Needle-in-a-Haystack" (NIAH) test, which comprises tasks designed to assess a model's ability to identify specific information ("needle") within large text sequences ("haystack"). While these benchmarks measure how well models understand long-context input sequences, they do not effectively gauge the quality of long-form text generation--a critical aspect for applications such as design proposals and creative writing. To address this gap, we have introduced a new long-form text evaluation benchmark, Spinning the Golden Thread (SGT), which tests models' ability to identify specific events within generated long text sequences. In this benchmark, we prompt long-context LMs to create long-form text that must include particular events or constraints and evaluate their ability to incorporate these elements. We evaluated ten long-context LMs across four distinct scenarios, three types of prompt instructions, and two different generation-length settings (16K and 32K). Although these models perform well on NIAH benchmarks, none demonstrated satisfactory performance on the Spinning the Golden Thread, raising concerns about their ability to generate coherent long-form text that follows instructions. Additionally, as the length of the generated text increases, all models exhibit a significant drop in performance.

  • 4 authors
·
Sep 3, 2024 3

Contextual Memory Reweaving in Large Language Models Using Layered Latent State Reconstruction

Memory retention challenges in deep neural architectures have ongoing limitations in the ability to process and recall extended contextual information. Token dependencies degrade as sequence length increases, leading to a decline in coherence and factual consistency across longer outputs. A structured approach is introduced to mitigate this issue through the reweaving of latent states captured at different processing layers, reinforcing token representations over extended sequences. The proposed Contextual Memory Reweaving framework incorporates a Layered Latent State Reconstruction mechanism to systematically integrate past contextual embeddings without introducing external memory modules. Experimental results demonstrate improvements in recall accuracy across a range of sequence lengths, with notable gains in the retention of rarely occurring tokens and numerical reasoning consistency. Further analysis of computational efficiency indicates that the additional processing overhead remains within acceptable thresholds, enabling scalability across different model sizes. Evaluations in long-form text generation and ambiguous query resolution highlight the capacity of memory reweaving to enhance continuity and reduce inconsistencies over extended outputs. Attention weight distributions reveal more structured allocation patterns, suggesting that reweaved latent states contribute to improved contextual awareness. The findings establish a framework for refining memory retention mechanisms in language models, addressing long-standing challenges in handling complex, multi-step reasoning tasks.

  • 5 authors
·
Feb 4, 2025

LongMemEval-V2: Evaluating Long-Term Agent Memory Toward Experienced Colleagues

Long-term memory is crucial for agents in specialized web environments, where success depends on recalling interface affordances, state dynamics, workflows, and recurring failure modes. However, existing memory benchmarks for agents mostly focus on user histories, short traces, or downstream task success, leaving open how to directly evaluate whether memory systems effectively internalize environment-specific experience. To address this gap, we introduce LongMemEval-V2 (LME-V2), a benchmark for evaluating whether memory systems can help agents acquire the experience needed to become knowledgeable colleagues in customized environments. LME-V2 contains 451 manually curated questions covering five core memory abilities for web agents: static state recall, dynamic state tracking, workflow knowledge, environment gotchas, and premise awareness. Questions are paired with history trajectories containing up to 500 trajectories and 115M tokens. We use a context gathering formulation: memory systems consume history trajectories and return compact evidence for downstream question answering. We propose a suite of two memory methods: AgentRunbook-R, an efficient RAG-based memory with knowledge pools for raw state observations, events, and strategy notes, and AgentRunbook-C, which stores trajectories as files and invokes a coding agent to gather evidence in an augmented sandbox. Experiments show that AgentRunbook-C achieves the best performance with 72.5% average accuracy, outperforming the strongest RAG baseline (48.5%) and the off-the-shelf coding agent baseline (69.3%). Despite the strong performance gains, coding agent based methods have high latency costs. While AgentRunbook-C advances the accuracy-latency Pareto frontier, substantial room for improvement remains. Together, these results establish LME-V2 as a challenging testbed for developing long-term memory systems for environment experience.

uclanlp UCLA NLP
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May 11 1

EHRSHOT: An EHR Benchmark for Few-Shot Evaluation of Foundation Models

While the general machine learning (ML) community has benefited from public datasets, tasks, and models, the progress of ML in healthcare has been hampered by a lack of such shared assets. The success of foundation models creates new challenges for healthcare ML by requiring access to shared pretrained models to validate performance benefits. We help address these challenges through three contributions. First, we publish a new dataset, EHRSHOT, which contains deidentified structured data from the electronic health records (EHRs) of 6,739 patients from Stanford Medicine. Unlike MIMIC-III/IV and other popular EHR datasets, EHRSHOT is longitudinal and not restricted to ICU/ED patients. Second, we publish the weights of CLMBR-T-base, a 141M parameter clinical foundation model pretrained on the structured EHR data of 2.57M patients. We are one of the first to fully release such a model for coded EHR data; in contrast, most prior models released for clinical data (e.g. GatorTron, ClinicalBERT) only work with unstructured text and cannot process the rich, structured data within an EHR. We provide an end-to-end pipeline for the community to validate and build upon its performance. Third, we define 15 few-shot clinical prediction tasks, enabling evaluation of foundation models on benefits such as sample efficiency and task adaptation. Our model and dataset are available via a research data use agreement from the Stanford AIMI Center. Code to reproduce our results are available at our Github repo: https://github.com/som-shahlab/ehrshot-benchmark

  • 5 authors
·
Jul 5, 2023

Using Large Language Models to Create Personalized Networks From Therapy Sessions

Recent advances in psychotherapy have focused on treatment personalization, such as by selecting treatment modules based on personalized networks. However, estimating personalized networks typically requires intensive longitudinal data, which is not always feasible. A solution to facilitate scalability of network-driven treatment personalization is leveraging LLMs. In this study, we present an end-to-end pipeline for automatically generating client networks from 77 therapy transcripts to support case conceptualization and treatment planning. We annotated 3364 psychological processes and their corresponding dimensions in therapy transcripts. Using these data, we applied in-context learning to jointly identify psychological processes and their dimensions. The method achieved high performance even with a few training examples. To organize the processes into networks, we introduced a two-step method that grouped them into clinically meaningful clusters. We then generated explanation-augmented relationships between clusters. Experts found that networks produced by our multi-step approach outperformed those built with direct prompting for clinical utility and interpretability, with up to 90% preferring our approach. In addition, the networks were rated favorably by experts, with scores for clinical relevance, novelty, and usefulness ranging from 72-75%. Our findings provide a proof of concept for using LLMs to create clinically relevant networks from therapy transcripts. Advantages of our approach include bottom-up case conceptualization from client utterances in therapy sessions and identification of latent themes. Networks generated from our pipeline may be used in clinical settings and supervision and training. Future research should examine whether these networks improve treatment outcomes relative to other methods of treatment personalization, including statistically estimated networks.

  • 6 authors
·
Dec 5, 2025

Can the Crowd Judge Truthfulness? A Longitudinal Study on Recent Misinformation about COVID-19

Recently, the misinformation problem has been addressed with a crowdsourcing-based approach: to assess the truthfulness of a statement, instead of relying on a few experts, a crowd of non-expert is exploited. We study whether crowdsourcing is an effective and reliable method to assess truthfulness during a pandemic, targeting statements related to COVID-19, thus addressing (mis)information that is both related to a sensitive and personal issue and very recent as compared to when the judgment is done. In our experiments, crowd workers are asked to assess the truthfulness of statements, and to provide evidence for the assessments. Besides showing that the crowd is able to accurately judge the truthfulness of the statements, we report results on workers behavior, agreement among workers, effect of aggregation functions, of scales transformations, and of workers background and bias. We perform a longitudinal study by re-launching the task multiple times with both novice and experienced workers, deriving important insights on how the behavior and quality change over time. Our results show that: workers are able to detect and objectively categorize online (mis)information related to COVID-19; both crowdsourced and expert judgments can be transformed and aggregated to improve quality; worker background and other signals (e.g., source of information, behavior) impact the quality of the data. The longitudinal study demonstrates that the time-span has a major effect on the quality of the judgments, for both novice and experienced workers. Finally, we provide an extensive failure analysis of the statements misjudged by the crowd-workers.

  • 9 authors
·
Jul 25, 2021

"When I lost it, they dragged me out": How Care Encounters Empower Marginalized Young Adults' Aspiration and Mental Health Care-Seeking

Mental health care-seeking among marginalized young adults has received limited attention in CSCW research. Through in-depth interviews and visual elicitation methods with 18 diverse U.S. participants, our study reveals how marginalized identities shape mental health care-seeking journeys, often characterized by low aspirations and passive care-seeking influenced by lived experiences of marginalization. However, we found the transformative function of "care encounters" - serendipitous interactions with mental health resources that occur when individuals are not actively seeking support. These encounters serve as critical turning points, catalyzing shifts in aspiration and enabling more proactive care-seeking behaviors. Our analysis identifies both the infrastructural conditions that enable transformative care encounters and the aspiration breakdowns that impede care-seeking processes. This work makes conceptual contributions by supplementing traditional motivation-based care-seeking models with a reconceptualization of "care encounters" that accounts for the infrastructural and serendipitous nature of mental health access. We advance understanding of how marginalized identity uniquely influences care-seeking behaviors while providing actionable design implications for embedding technology-mediated "care encounters" into socio-technical interventions that can better support mental health care access for vulnerable populations.

  • 2 authors
·
Feb 16, 2025

Beyond Confidence: Adaptive and Coherent Decoding for Diffusion Language Models

Diffusion Language Models (DLMs) have recently achieved significant success due to their any-order generation capabilities. However, existing inference methods typically rely on local, immediate-step metrics such as confidence or entropy which inherently lack a more reliable perspective. This limitation frequently leads to inconsistent sampling trajectories and suboptimal generation quality. To address this, we propose Coherent Contextual Decoding (CCD), a novel inference framework built upon two core innovations. First, CCD employs a trajectory rectification mechanism that leverages historical context to enhance sequence coherence, enabling the early rejection of suboptimal paths. We demonstrate that this mechanism is theoretically equivalent to modeling the consistency of historical steps via the conditional mutual information between context and token predictions. Building on this theoretical insight, we further address the inefficiency of conventional uniform decoding budgets. Instead of rigid allocations based on diffusion steps, we introduce an adaptive sampling strategy that dynamically adjusts the unmasking budget for each step according to our consistency metric. Consequently, our method significantly improves the quality of generation trajectories while accelerating the sampling process. Empirically, our method achieves a simultaneous enhancement in both inference speed and performance across diverse benchmarks on Dream and LLaDA, delivering up to 3.48x speedup alongside 3.91% performance improvement.

  • 10 authors
·
Nov 26, 2025

Context Clues: Evaluating Long Context Models for Clinical Prediction Tasks on EHRs

Foundation Models (FMs) trained on Electronic Health Records (EHRs) have achieved state-of-the-art results on numerous clinical prediction tasks. However, most existing EHR FMs have context windows of <1k tokens. This prevents them from modeling full patient EHRs which can exceed 10k's of events. Recent advancements in subquadratic long-context architectures (e.g., Mamba) offer a promising solution. However, their application to EHR data has not been well-studied. We address this gap by presenting the first systematic evaluation of the effect of context length on modeling EHR data. We find that longer context models improve predictive performance -- our Mamba-based model surpasses the prior state-of-the-art on 9/14 tasks on the EHRSHOT prediction benchmark. For clinical applications, however, model performance alone is insufficient -- robustness to the unique properties of EHR is crucial. Thus, we also evaluate models across three previously underexplored properties of EHR data: (1) the prevalence of "copy-forwarded" diagnoses which creates artificial repetition of tokens within EHR sequences; (2) the irregular time intervals between EHR events which can lead to a wide range of timespans within a context window; and (3) the natural increase in disease complexity over time which makes later tokens in the EHR harder to predict than earlier ones. Stratifying our EHRSHOT results, we find that higher levels of each property correlate negatively with model performance, but that longer context models are more robust to more extreme levels of these properties. Our work highlights the potential for using long-context architectures to model EHR data, and offers a case study for identifying new challenges in modeling sequential data motivated by domains outside of natural language. We release our models and code at: https://github.com/som-shahlab/long_context_clues

  • 8 authors
·
Dec 9, 2024

The 17% Gap: Quantifying Epistemic Decay in AI-Assisted Survey Papers

The adoption of Large Language Models (LLMs) in scientific writing promises efficiency but risks introducing informational entropy. While "hallucinated papers" are a known artifact, the systematic degradation of valid citation chains remains unquantified. We conducted a forensic audit of 50 recent survey papers in Artificial Intelligence (N=5,514 citations) published between September 2024 and January 2026. We utilized a hybrid verification pipeline combining DOI resolution, Crossref metadata analysis, Semantic Scholar queries, and fuzzy text matching to distinguish between formatting errors ("Sloppiness") and verifiable non-existence ("Phantoms). We detect a persistent 17.0% Phantom Rate -- citations that cannot be resolved to any digital object despite aggressive forensic recovery. Diagnostic categorization reveals three distinct failure modes: pure hallucinations (5.1%), hallucinated identifiers with valid titles (16.4%), and parsing-induced matching failures (78.5%). Longitudinal analysis reveals a flat trend (+0.07 pp/month), suggesting that high-entropy citation practices have stabilized as an endemic feature of the field. The scientific citation graph in AI survey literature exhibits "link rot" at scale. This suggests a mechanism where AI tools act as "lazy research assistants," retrieving correct titles but hallucinating metadata, thereby severing the digital chain of custody required for reproducible science.

  • 1 authors
·
Jan 23

Rhea: Role-aware Heuristic Episodic Attention for Conversational LLMs

Large Language Models (LLMs) have achieved remarkable performance on single-turn tasks, yet their effectiveness deteriorates in multi-turn conversations. We define this phenomenon as cumulative contextual decay - a progressive degradation of contextual integrity caused by attention pollution, dilution, and drift. To address this challenge, we propose Rhea (Role-aware Heuristic Episodic Attention), a novel framework that decouples conversation history into two functionally independent memory modules: (1) an Instructional Memory (IM) that persistently stores high-fidelity global constraints via a structural priority mechanism, and (2) an Episodic Memory (EM) that dynamically manages user-model interactions via asymmetric noise control and heuristic context retrieval. During inference, Rhea constructs a high signal-to-noise context by applying its priority attention: selectively integrating relevant episodic information while always prioritizing global instructions. To validate this approach, experiments on multiple multi-turn conversation benchmarks - including MT-Eval and Long-MT-Bench+ - show that Rhea mitigates performance decay and improves overall accuracy by 1.04 points on a 10-point scale (a 16% relative gain over strong baselines). Moreover, Rhea maintains near-perfect instruction fidelity (IAR > 8.1) across long-horizon interactions. These results demonstrate that Rhea provides a principled and effective framework for building more precise, instruction-consistent conversational LLMs.

  • 8 authors
·
Dec 7, 2025

Linear representations in language models can change dramatically over a conversation

Language model representations often contain linear directions that correspond to high-level concepts. Here, we study the dynamics of these representations: how representations evolve along these dimensions within the context of (simulated) conversations. We find that linear representations can change dramatically over a conversation; for example, information that is represented as factual at the beginning of a conversation can be represented as non-factual at the end and vice versa. These changes are content-dependent; while representations of conversation-relevant information may change, generic information is generally preserved. These changes are robust even for dimensions that disentangle factuality from more superficial response patterns, and occur across different model families and layers of the model. These representation changes do not require on-policy conversations; even replaying a conversation script written by an entirely different model can produce similar changes. However, adaptation is much weaker from simply having a sci-fi story in context that is framed more explicitly as such. We also show that steering along a representational direction can have dramatically different effects at different points in a conversation. These results are consistent with the idea that representations may evolve in response to the model playing a particular role that is cued by a conversation. Our findings may pose challenges for interpretability and steering -- in particular, they imply that it may be misleading to use static interpretations of features or directions, or probes that assume a particular range of features consistently corresponds to a particular ground-truth value. However, these types of representational dynamics also point to exciting new research directions for understanding how models adapt to context.

google Google
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Jan 28 2

Automated Chronotyping from a Daily Calendar using Machine Learning

Chronotype compares individuals' circadian phase to others. It contextualizes mental health risk assessments and detection of social jet lag, which can hamper mental health and cognitive performance. Existing ways of determining chronotypes, such as Dim Light Melatonin Onset (DLMO) or the Morningness-Eveningness Questionnaire (MEQ), are limited by being discrete in time and time-intensive to update, meaning they rarely capture real-world variability across time. Chronotyping users based on a daily planner app might augment existing methods to enable assessment continuously and at scale. This paper reports the construction of a supervised binary classifier that attempts to demonstrate the feasibility of this approach. 1,460 registered users from the Owaves app opted in by filling out the MEQ survey between July 14, 2022, and May 1, 2023. 142 met the eligibility criteria. We used multimodal app data from individuals identified as morning and evening types from MEQ data, basing the classifier on app time series data. This included daily timing for 8 main lifestyle activity types: exercise, sleep, social interactions, meal times, relaxation, work, play, and miscellaneous, as defined in the app. The timing of activities showed substantial change across time, as well as heterogeneity by activity type. Our novel chronotyping classifier was able to predict the morningness and eveningness of its users with an ROC AUC of 0.70. Our findings demonstrate the feasibility of chronotype classification from multimodal, real-world app data, while highlighting fundamental challenges to applying discrete and fixed labels to complex, dynamic, multimodal behaviors. Our findings suggest a potential for real-time monitoring of shifts in chronotype specific to different causes (i.e. types of activity), which could feasibly be used to support future, prospective mental health support research.

  • 7 authors
·
Jul 8, 2024

Assessing Historical Structural Oppression Worldwide via Rule-Guided Prompting of Large Language Models

Traditional efforts to measure historical structural oppression struggle with cross-national validity due to the unique, locally specified histories of exclusion, colonization, and social status in each country, and often have relied on structured indices that privilege material resources while overlooking lived, identity-based exclusion. We introduce a novel framework for oppression measurement that leverages Large Language Models (LLMs) to generate context-sensitive scores of lived historical disadvantage across diverse geopolitical settings. Using unstructured self-identified ethnicity utterances from a multilingual COVID-19 global study, we design rule-guided prompting strategies that encourage models to produce interpretable, theoretically grounded estimations of oppression. We systematically evaluate these strategies across multiple state-of-the-art LLMs. Our results demonstrate that LLMs, when guided by explicit rules, can capture nuanced forms of identity-based historical oppression within nations. This approach provides a complementary measurement tool that highlights dimensions of systemic exclusion, offering a scalable, cross-cultural lens for understanding how oppression manifests in data-driven research and public health contexts. To support reproducible evaluation, we release an open-sourced benchmark dataset for assessing LLMs on oppression measurement (https://github.com/chattergpt/llm-oppression-benchmark).

  • 9 authors
·
Sep 18, 2025

Susu Box or Piggy Bank: Assessing Cultural Commonsense Knowledge between Ghana and the U.S

Recent work has highlighted the culturally-contingent nature of commonsense knowledge. We introduce AMAMMER{epsilon}, a test set of 525 multiple-choice questions designed to evaluate the commonsense knowledge of English LLMs, relative to the cultural contexts of Ghana and the United States. To create AMAMMER{epsilon}, we select a set of multiple-choice questions (MCQs) from existing commonsense datasets and rewrite them in a multi-stage process involving surveys of Ghanaian and U.S. participants. In three rounds of surveys, participants from both pools are solicited to (1) write correct and incorrect answer choices, (2) rate individual answer choices on a 5-point Likert scale, and (3) select the best answer choice from the newly-constructed MCQ items, in a final validation step. By engaging participants at multiple stages, our procedure ensures that participant perspectives are incorporated both in the creation and validation of test items, resulting in high levels of agreement within each pool. We evaluate several off-the-shelf English LLMs on AMAMMER{epsilon}. Uniformly, models prefer answers choices that align with the preferences of U.S. annotators over Ghanaian annotators. Additionally, when test items specify a cultural context (Ghana or the U.S.), models exhibit some ability to adapt, but performance is consistently better in U.S. contexts than Ghanaian. As large resources are devoted to the advancement of English LLMs, our findings underscore the need for culturally adaptable models and evaluations to meet the needs of diverse English-speaking populations around the world.

  • 3 authors
·
Oct 21, 2024

Incongruence Identification in Eyewitness Testimony

Incongruence detection in eyewitness narratives is critical for understanding the reliability of testimonies, yet traditional approaches often fail to address the nuanced inconsistencies inherent in such accounts. In this paper, we introduce a novel task of incongruence detection in eyewitness testimonies. Given a pair of testimonies containing of multiple pairs of question and answer by two subjects, we identify contextually related incongruence between the two subjects. We also mark the span of incongruences in the utterances. To achieve this, we developed MIND(MultI-EyewitNess Deception) - a comprehensive dataset consisting of 2927 pairs of contextually related answers designed to capture both explicit and implicit contradictions. INstruction - TunEd iNcongruity Detection framework based on 6W and multi-hop reasoning approach, aka. INTEND. Drawing from investigative techniques, INTEND address the task as a close-style problem, contradicting on the who, what, when, where and why aspect of the content. Our findings shows that prompt tuning, especially when utilizing our framework, enhances the detection of incongruences by a margin of +5.63 percent. We compare our approach with multiple fine-tuning and prompt tuning techniques on MLMs and LLMs. Emperical results demonstrate convincing performance improvement in F1-score over fine-tuned and regular prompt-tuning techniques, highlighting the effectiveness of our approach.

  • 3 authors
·
Feb 8, 2025

Enhanced Contrastive Learning with Multi-view Longitudinal Data for Chest X-ray Report Generation

Automated radiology report generation offers an effective solution to alleviate radiologists' workload. However, most existing methods focus primarily on single or fixed-view images to model current disease conditions, which limits diagnostic accuracy and overlooks disease progression. Although some approaches utilize longitudinal data to track disease progression, they still rely on single images to analyze current visits. To address these issues, we propose enhanced contrastive learning with Multi-view Longitudinal data to facilitate chest X-ray Report Generation, named MLRG. Specifically, we introduce a multi-view longitudinal contrastive learning method that integrates spatial information from current multi-view images and temporal information from longitudinal data. This method also utilizes the inherent spatiotemporal information of radiology reports to supervise the pre-training of visual and textual representations. Subsequently, we present a tokenized absence encoding technique to flexibly handle missing patient-specific prior knowledge, allowing the model to produce more accurate radiology reports based on available prior knowledge. Extensive experiments on MIMIC-CXR, MIMIC-ABN, and Two-view CXR datasets demonstrate that our MLRG outperforms recent state-of-the-art methods, achieving a 2.3% BLEU-4 improvement on MIMIC-CXR, a 5.5% F1 score improvement on MIMIC-ABN, and a 2.7% F1 RadGraph improvement on Two-view CXR.

  • 7 authors
·
Feb 27, 2025

Basic Research, Lethal Effects: Military AI Research Funding as Enlistment

In the context of unprecedented U.S. Department of Defense (DoD) budgets, this paper examines the recent history of DoD funding for academic research in algorithmically based warfighting. We draw from a corpus of DoD grant solicitations from 2007 to 2023, focusing on those addressed to researchers in the field of artificial intelligence (AI). Considering the implications of DoD funding for academic research, the paper proceeds through three analytic sections. In the first, we offer a critical examination of the distinction between basic and applied research, showing how funding calls framed as basic research nonetheless enlist researchers in a war fighting agenda. In the second, we offer a diachronic analysis of the corpus, showing how a 'one small problem' caveat, in which affirmation of progress in military technologies is qualified by acknowledgement of outstanding problems, becomes justification for additional investments in research. We close with an analysis of DoD aspirations based on a subset of Defense Advanced Research Projects Agency (DARPA) grant solicitations for the use of AI in battlefield applications. Taken together, we argue that grant solicitations work as a vehicle for the mutual enlistment of DoD funding agencies and the academic AI research community in setting research agendas. The trope of basic research in this context offers shelter from significant moral questions that military applications of one's research would raise, by obscuring the connections that implicate researchers in U.S. militarism.

  • 3 authors
·
Nov 26, 2024