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SubscribeMechanistic evaluation of Transformers and state space models
State space models (SSMs) for language modelling promise an efficient and performant alternative to quadratic-attention Transformers, yet show variable performance on recalling basic information from the context. While performance on synthetic tasks like Associative Recall (AR) can point to this deficiency, behavioural metrics provide little information as to why--on a mechanistic level--certain architectures fail and others succeed. To address this, we conduct experiments on AR and find that only Transformers and Based SSM models fully succeed at AR, with Mamba a close third, whereas the other SSMs (H3, Hyena) fail. We then use causal interventions to explain why. We find that Transformers and Based learn to store key-value associations in-context using induction heads. By contrast, the SSMs compute these associations only at the last state, with only Mamba succeeding because of its short convolution component. To extend and deepen these findings, we introduce Associative Treecall (ATR), a synthetic task similar to AR based on PCFG induction. ATR introduces language-like hierarchical structure into the AR setting. We find that all architectures learn the same mechanism as they did for AR, and the same three models succeed at the task. These results reveal that architectures with similar accuracy may still have substantive differences, motivating the adoption of mechanistic evaluations.
Causal Interventions Reveal Shared Structure Across English Filler-Gap Constructions
Large Language Models (LLMs) have emerged as powerful sources of evidence for linguists seeking to develop theories of syntax. In this paper, we argue that causal interpretability methods, applied to LLMs, can greatly enhance the value of such evidence by helping us characterize the abstract mechanisms that LLMs learn to use. Our empirical focus is a set of English filler-gap dependency constructions (e.g., questions, relative clauses). Linguistic theories largely agree that these constructions share many properties. Using experiments based in Distributed Interchange Interventions, we show that LLMs converge on similar abstract analyses of these constructions. These analyses also reveal previously overlooked factors -- relating to frequency, filler type, and surrounding context -- that could motivate changes to standard linguistic theory. Overall, these results suggest that mechanistic, internal analyses of LLMs can push linguistic theory forward.
Mechanistic Understanding and Mitigation of Language Confusion in English-Centric Large Language Models
Language confusion -- where large language models (LLMs) generate unintended languages against the user's need -- remains a critical challenge, especially for English-centric models. We present the first mechanistic interpretability (MI) study of language confusion, combining behavioral benchmarking with neuron-level analysis. Using the Language Confusion Benchmark (LCB), we show that confusion points (CPs) -- specific positions where language switches occur -- are central to this phenomenon. Through layer-wise analysis with TunedLens and targeted neuron attribution, we reveal that transition failures in the final layers drive confusion. We further demonstrate that editing a small set of critical neurons, identified via comparative analysis with multilingual-tuned models, substantially mitigates confusion without harming general competence or fluency. Our approach matches multilingual alignment in confusion reduction for most languages and yields cleaner, higher-quality outputs. These findings provide new insights into the internal dynamics of LLMs and highlight neuron-level interventions as a promising direction for robust, interpretable multilingual language modeling.
Using Mechanistic Interpretability to Craft Adversarial Attacks against Large Language Models
Traditional white-box methods for creating adversarial perturbations against LLMs typically rely only on gradient computation from the targeted model, ignoring the internal mechanisms responsible for attack success or failure. Conversely, interpretability studies that analyze these internal mechanisms lack practical applications beyond runtime interventions. We bridge this gap by introducing a novel white-box approach that leverages mechanistic interpretability techniques to craft practical adversarial inputs. Specifically, we first identify acceptance subspaces - sets of feature vectors that do not trigger the model's refusal mechanisms - then use gradient-based optimization to reroute embeddings from refusal subspaces to acceptance subspaces, effectively achieving jailbreaks. This targeted approach significantly reduces computation cost, achieving attack success rates of 80-95\% on state-of-the-art models including Gemma2, Llama3.2, and Qwen2.5 within minutes or even seconds, compared to existing techniques that often fail or require hours of computation. We believe this approach opens a new direction for both attack research and defense development. Furthermore, it showcases a practical application of mechanistic interpretability where other methods are less efficient, which highlights its utility. The code and generated datasets are available at https://github.com/Sckathach/subspace-rerouting.
How Post-Training Reshapes LLMs: A Mechanistic View on Knowledge, Truthfulness, Refusal, and Confidence
Post-training is essential for the success of large language models (LLMs), transforming pre-trained base models into more useful and aligned post-trained models. While plenty of works have studied post-training algorithms and evaluated post-training models by their outputs, it remains understudied how post-training reshapes LLMs internally. In this paper, we compare base and post-trained LLMs mechanistically from four perspectives to better understand post-training effects. Our findings across model families and datasets reveal that: (1) Post-training does not change the factual knowledge storage locations, and it adapts knowledge representations from the base model while developing new knowledge representations; (2) Both truthfulness and refusal can be represented by linear vectors in the hidden representation space. The truthfulness direction is highly similar between the base and post-trained model, and it is effectively transferable for interventions; (3) The refusal direction is different between the base and post-trained models, and it shows limited forward transferability; (4) Differences in confidence between the base and post-trained models cannot be attributed to entropy neurons. Our study provides insights into the fundamental mechanisms preserved and altered during post-training, facilitates downstream tasks like model steering, and could potentially benefit future research in interpretability and LLM post-training.
Analysing Moral Bias in Finetuned LLMs through Mechanistic Interpretability
Large language models (LLMs) have been shown to internalize human-like biases during finetuning, yet the mechanisms by which these biases manifest remain unclear. In this work, we investigated whether the well-known Knobe effect, a moral bias in intentionality judgements, emerges in finetuned LLMs and whether it can be traced back to specific components of the model. We conducted a Layer-Patching analysis across 3 open-weights LLMs and demonstrated that the bias is not only learned during finetuning but also localized in a specific set of layers. Surprisingly, we found that patching activations from the corresponding pretrained model into just a few critical layers is sufficient to eliminate the effect. Our findings offer new evidence that social biases in LLMs can be interpreted, localized, and mitigated through targeted interventions, without the need for model retraining.
Small Vectors, Big Effects: A Mechanistic Study of RL-Induced Reasoning via Steering Vectors
The mechanisms by which reasoning training reshapes LLMs' internal computations remain unclear. We study lightweight steering vectors inserted into the base model's residual stream and trained with a reinforcement-learning objective. These vectors match full fine-tuning performance while preserving the interpretability of small, additive interventions. Using logit-lens readouts and path-patching analyses on two models, we find that (i) the last-layer steering vector acts like a token-substitution bias concentrated on the first generated token, consistently boosting tokens such as "To" and "Step"; (ii) the penultimate-layer vector leaves attention patterns largely intact and instead operates through the MLP and unembedding, preferentially up-weighting process words and structure symbols; and (iii) middle layers de-emphasize non-English tokens. Next, we show that a SAE isolates features associated with correct generations. We also show that steering vectors (i) transfer to other models, (ii) combine across layers when trained in isolation, and (iii) concentrate magnitude on meaningful prompt segments under adaptive token-wise scaling. Taken together, these results deepen understanding of how trained steering vectors shape computation and should inform future work in activation engineering and the study of reasoning models.
ThinkEdit: Interpretable Weight Editing to Mitigate Overly Short Thinking in Reasoning Models
Recent studies have shown that Large Language Models (LLMs) augmented with chain-of-thought (CoT) reasoning demonstrate impressive problem-solving abilities. However, in this work, we identify a recurring issue where these models occasionally generate overly short reasoning, leading to degraded performance on even simple mathematical problems. Specifically, we investigate how reasoning length is embedded in the hidden representations of reasoning models and its impact on accuracy. Our analysis reveals that reasoning length is governed by a linear direction in the representation space, allowing us to induce overly short reasoning by steering the model along this direction. Building on this insight, we introduce ThinkEdit, a simple yet effective weight-editing approach to mitigate the issue of overly short reasoning. We first identify a small subset of attention heads (approximately 2%) that predominantly drive short reasoning behavior. We then edit the output projection weights of these heads to suppress the short reasoning direction. With changes to only 0.1% of the model's parameters, ThinkEdit effectively reduces overly short reasoning and yields notable accuracy gains for short reasoning outputs (+5.44%), along with an overall improvement across multiple math benchmarks (+2.43%). Our findings provide new mechanistic insights into how reasoning length is controlled within LLMs and highlight the potential of fine-grained model interventions to improve reasoning quality. Our code is available at https://github.com/Trustworthy-ML-Lab/ThinkEdit
Disentangling Recall and Reasoning in Transformer Models through Layer-wise Attention and Activation Analysis
Transformer-based language models excel at both recall (retrieving memorized facts) and reasoning (performing multi-step inference), but whether these abilities rely on distinct internal mechanisms remains unclear. Distinguishing recall from reasoning is crucial for predicting model generalization, designing targeted evaluations, and building safer interventions that affect one ability without disrupting the other.We approach this question through mechanistic interpretability, using controlled datasets of synthetic linguistic puzzles to probe transformer models at the layer, head, and neuron level. Our pipeline combines activation patching and structured ablations to causally measure component contributions to each task type. Across two model families (Qwen and LLaMA), we find that interventions on distinct layers and attention heads lead to selective impairments: disabling identified "recall circuits" reduces fact-retrieval accuracy by up to 15\% while leaving reasoning intact, whereas disabling "reasoning circuits" reduces multi-step inference by a comparable margin. At the neuron level, we observe task-specific firing patterns, though these effects are less robust, consistent with neuronal polysemanticity.Our results provide the first causal evidence that recall and reasoning rely on separable but interacting circuits in transformer models. These findings advance mechanistic interpretability by linking circuit-level structure to functional specialization and demonstrate how controlled datasets and causal interventions can yield mechanistic insights into model cognition, informing safer deployment of large language models.
Anchored Answers: Unravelling Positional Bias in GPT-2's Multiple-Choice Questions
Large Language Models (LLMs), such as the GPT-4 and LLaMA families, have demonstrated considerable success across diverse tasks, including multiple-choice questions (MCQs). However, these models exhibit a positional bias, particularly an even worse anchored bias in the GPT-2 family, where they consistently favour the first choice 'A' in MCQs during inference. This anchored bias challenges the integrity of GPT-2's decision-making process, as it skews performance based on the position rather than the content of the choices in MCQs. In this study, we utilise the mechanistic interpretability approach to identify the internal modules within GPT-2 models responsible for this bias. We focus on the Multi-Layer Perceptron (MLP) layers and attention heads, using the "logit lens" method to trace and modify the specific value vectors that contribute to the bias. By updating these vectors within MLP and recalibrating attention patterns to neutralise the preference for the first choice 'A', we effectively mitigate the anchored bias. Our interventions not only mitigate the bias but also improve the overall MCQ prediction accuracy for the GPT-2 family across various datasets. This work represents the first comprehensive mechanistic analysis of anchored bias in MCQs within the GPT-2 models, introducing targeted, minimal-intervention strategies that significantly enhance GPT2 model robustness and accuracy in MCQs. Our code is available at https://github.com/ruizheliUOA/Anchored_Bias_GPT2.
Towards Best Practices of Activation Patching in Language Models: Metrics and Methods
Mechanistic interpretability seeks to understand the internal mechanisms of machine learning models, where localization -- identifying the important model components -- is a key step. Activation patching, also known as causal tracing or interchange intervention, is a standard technique for this task (Vig et al., 2020), but the literature contains many variants with little consensus on the choice of hyperparameters or methodology. In this work, we systematically examine the impact of methodological details in activation patching, including evaluation metrics and corruption methods. In several settings of localization and circuit discovery in language models, we find that varying these hyperparameters could lead to disparate interpretability results. Backed by empirical observations, we give conceptual arguments for why certain metrics or methods may be preferred. Finally, we provide recommendations for the best practices of activation patching going forwards.
Is This the Subspace You Are Looking for? An Interpretability Illusion for Subspace Activation Patching
Mechanistic interpretability aims to understand model behaviors in terms of specific, interpretable features, often hypothesized to manifest as low-dimensional subspaces of activations. Specifically, recent studies have explored subspace interventions (such as activation patching) as a way to simultaneously manipulate model behavior and attribute the features behind it to given subspaces. In this work, we demonstrate that these two aims diverge, potentially leading to an illusory sense of interpretability. Counterintuitively, even if a subspace intervention makes the model's output behave as if the value of a feature was changed, this effect may be achieved by activating a dormant parallel pathway leveraging another subspace that is causally disconnected from model outputs. We demonstrate this phenomenon in a distilled mathematical example, in two real-world domains (the indirect object identification task and factual recall), and present evidence for its prevalence in practice. In the context of factual recall, we further show a link to rank-1 fact editing, providing a mechanistic explanation for previous work observing an inconsistency between fact editing performance and fact localization. However, this does not imply that activation patching of subspaces is intrinsically unfit for interpretability. To contextualize our findings, we also show what a success case looks like in a task (indirect object identification) where prior manual circuit analysis informs an understanding of the location of a feature. We explore the additional evidence needed to argue that a patched subspace is faithful.
Open Problems in Mechanistic Interpretability
Mechanistic interpretability aims to understand the computational mechanisms underlying neural networks' capabilities in order to accomplish concrete scientific and engineering goals. Progress in this field thus promises to provide greater assurance over AI system behavior and shed light on exciting scientific questions about the nature of intelligence. Despite recent progress toward these goals, there are many open problems in the field that require solutions before many scientific and practical benefits can be realized: Our methods require both conceptual and practical improvements to reveal deeper insights; we must figure out how best to apply our methods in pursuit of specific goals; and the field must grapple with socio-technical challenges that influence and are influenced by our work. This forward-facing review discusses the current frontier of mechanistic interpretability and the open problems that the field may benefit from prioritizing.
Propositional Interpretability in Artificial Intelligence
Mechanistic interpretability is the program of explaining what AI systems are doing in terms of their internal mechanisms. I analyze some aspects of the program, along with setting out some concrete challenges and assessing progress to date. I argue for the importance of propositional interpretability, which involves interpreting a system's mechanisms and behavior in terms of propositional attitudes: attitudes (such as belief, desire, or subjective probability) to propositions (e.g. the proposition that it is hot outside). Propositional attitudes are the central way that we interpret and explain human beings and they are likely to be central in AI too. A central challenge is what I call thought logging: creating systems that log all of the relevant propositional attitudes in an AI system over time. I examine currently popular methods of interpretability (such as probing, sparse auto-encoders, and chain of thought methods) as well as philosophical methods of interpretation (including those grounded in psychosemantics) to assess their strengths and weaknesses as methods of propositional interpretability.
From Neurons to Neutrons: A Case Study in Interpretability
Mechanistic Interpretability (MI) promises a path toward fully understanding how neural networks make their predictions. Prior work demonstrates that even when trained to perform simple arithmetic, models can implement a variety of algorithms (sometimes concurrently) depending on initialization and hyperparameters. Does this mean neuron-level interpretability techniques have limited applicability? We argue that high-dimensional neural networks can learn low-dimensional representations of their training data that are useful beyond simply making good predictions. Such representations can be understood through the mechanistic interpretability lens and provide insights that are surprisingly faithful to human-derived domain knowledge. This indicates that such approaches to interpretability can be useful for deriving a new understanding of a problem from models trained to solve it. As a case study, we extract nuclear physics concepts by studying models trained to reproduce nuclear data.
Amortized Network Intervention to Steer the Excitatory Point Processes
We tackle the challenge of large-scale network intervention for guiding excitatory point processes, such as infectious disease spread or traffic congestion control. Our model-based reinforcement learning utilizes neural ODEs to capture how the networked excitatory point processes will evolve subject to the time-varying changes in network topology. Our approach incorporates Gradient-Descent based Model Predictive Control (GD-MPC), offering policy flexibility to accommodate prior knowledge and constraints. To address the intricacies of planning and overcome the high dimensionality inherent to such decision-making problems, we design an Amortize Network Interventions (ANI) framework, allowing for the pooling of optimal policies from history and other contexts, while ensuring a permutation equivalent property. This property enables efficient knowledge transfer and sharing across diverse contexts. Our approach has broad applications, from curbing infectious disease spread to reducing carbon emissions through traffic light optimization, and thus has the potential to address critical societal and environmental challenges.
Interpretability in the Wild: a Circuit for Indirect Object Identification in GPT-2 small
Research in mechanistic interpretability seeks to explain behaviors of machine learning models in terms of their internal components. However, most previous work either focuses on simple behaviors in small models, or describes complicated behaviors in larger models with broad strokes. In this work, we bridge this gap by presenting an explanation for how GPT-2 small performs a natural language task called indirect object identification (IOI). Our explanation encompasses 26 attention heads grouped into 7 main classes, which we discovered using a combination of interpretability approaches relying on causal interventions. To our knowledge, this investigation is the largest end-to-end attempt at reverse-engineering a natural behavior "in the wild" in a language model. We evaluate the reliability of our explanation using three quantitative criteria--faithfulness, completeness and minimality. Though these criteria support our explanation, they also point to remaining gaps in our understanding. Our work provides evidence that a mechanistic understanding of large ML models is feasible, opening opportunities to scale our understanding to both larger models and more complex tasks.
Mechanistic interpretability for steering vision-language-action models
Vision-Language-Action (VLA) models are a promising path to realizing generalist embodied agents that can quickly adapt to new tasks, modalities, and environments. However, methods for interpreting and steering VLAs fall far short of classical robotics pipelines, which are grounded in explicit models of kinematics, dynamics, and control. This lack of mechanistic insight is a central challenge for deploying learned policies in real-world robotics, where robustness and explainability are critical. Motivated by advances in mechanistic interpretability for large language models, we introduce the first framework for interpreting and steering VLAs via their internal representations, enabling direct intervention in model behavior at inference time. We project feedforward activations within transformer layers onto the token embedding basis, identifying sparse semantic directions - such as speed and direction - that are causally linked to action selection. Leveraging these findings, we introduce a general-purpose activation steering method that modulates behavior in real time, without fine-tuning, reward signals, or environment interaction. We evaluate this method on two recent open-source VLAs, Pi0 and OpenVLA, and demonstrate zero-shot behavioral control in simulation (LIBERO) and on a physical robot (UR5). This work demonstrates that interpretable components of embodied VLAs can be systematically harnessed for control - establishing a new paradigm for transparent and steerable foundation models in robotics.
InterpBench: Semi-Synthetic Transformers for Evaluating Mechanistic Interpretability Techniques
Mechanistic interpretability methods aim to identify the algorithm a neural network implements, but it is difficult to validate such methods when the true algorithm is unknown. This work presents InterpBench, a collection of semi-synthetic yet realistic transformers with known circuits for evaluating these techniques. We train these neural networks using a stricter version of Interchange Intervention Training (IIT) which we call Strict IIT (SIIT). Like the original, SIIT trains neural networks by aligning their internal computation with a desired high-level causal model, but it also prevents non-circuit nodes from affecting the model's output. We evaluate SIIT on sparse transformers produced by the Tracr tool and find that SIIT models maintain Tracr's original circuit while being more realistic. SIIT can also train transformers with larger circuits, like Indirect Object Identification (IOI). Finally, we use our benchmark to evaluate existing circuit discovery techniques.
Causal Inference by String Diagram Surgery
Extracting causal relationships from observed correlations is a growing area in probabilistic reasoning, originating with the seminal work of Pearl and others from the early 1990s. This paper develops a new, categorically oriented view based on a clear distinction between syntax (string diagrams) and semantics (stochastic matrices), connected via interpretations as structure-preserving functors. A key notion in the identification of causal effects is that of an intervention, whereby a variable is forcefully set to a particular value independent of any prior propensities. We represent the effect of such an intervention as an endofunctor which performs `string diagram surgery' within the syntactic category of string diagrams. This diagram surgery in turn yields a new, interventional distribution via the interpretation functor. While in general there is no way to compute interventional distributions purely from observed data, we show that this is possible in certain special cases using a calculational tool called comb disintegration. We demonstrate the use of this technique on a well-known toy example, where we predict the causal effect of smoking on cancer in the presence of a confounding common cause. After developing this specific example, we show this technique provides simple sufficient conditions for computing interventions which apply to a wide variety of situations considered in the causal inference literature.
The Non-Linear Representation Dilemma: Is Causal Abstraction Enough for Mechanistic Interpretability?
The concept of causal abstraction got recently popularised to demystify the opaque decision-making processes of machine learning models; in short, a neural network can be abstracted as a higher-level algorithm if there exists a function which allows us to map between them. Notably, most interpretability papers implement these maps as linear functions, motivated by the linear representation hypothesis: the idea that features are encoded linearly in a model's representations. However, this linearity constraint is not required by the definition of causal abstraction. In this work, we critically examine the concept of causal abstraction by considering arbitrarily powerful alignment maps. In particular, we prove that under reasonable assumptions, any neural network can be mapped to any algorithm, rendering this unrestricted notion of causal abstraction trivial and uninformative. We complement these theoretical findings with empirical evidence, demonstrating that it is possible to perfectly map models to algorithms even when these models are incapable of solving the actual task; e.g., on an experiment using randomly initialised language models, our alignment maps reach 100% interchange-intervention accuracy on the indirect object identification task. This raises the non-linear representation dilemma: if we lift the linearity constraint imposed to alignment maps in causal abstraction analyses, we are left with no principled way to balance the inherent trade-off between these maps' complexity and accuracy. Together, these results suggest an answer to our title's question: causal abstraction is not enough for mechanistic interpretability, as it becomes vacuous without assumptions about how models encode information. Studying the connection between this information-encoding assumption and causal abstraction should lead to exciting future work.
pyvene: A Library for Understanding and Improving PyTorch Models via Interventions
Interventions on model-internal states are fundamental operations in many areas of AI, including model editing, steering, robustness, and interpretability. To facilitate such research, we introduce pyvene, an open-source Python library that supports customizable interventions on a range of different PyTorch modules. pyvene supports complex intervention schemes with an intuitive configuration format, and its interventions can be static or include trainable parameters. We show how pyvene provides a unified and extensible framework for performing interventions on neural models and sharing the intervened upon models with others. We illustrate the power of the library via interpretability analyses using causal abstraction and knowledge localization. We publish our library through Python Package Index (PyPI) and provide code, documentation, and tutorials at https://github.com/stanfordnlp/pyvene.
Learning Neural Causal Models with Active Interventions
Discovering causal structures from data is a challenging inference problem of fundamental importance in all areas of science. The appealing properties of neural networks have recently led to a surge of interest in differentiable neural network-based methods for learning causal structures from data. So far, differentiable causal discovery has focused on static datasets of observational or fixed interventional origin. In this work, we introduce an active intervention targeting (AIT) method which enables a quick identification of the underlying causal structure of the data-generating process. Our method significantly reduces the required number of interactions compared with random intervention targeting and is applicable for both discrete and continuous optimization formulations of learning the underlying directed acyclic graph (DAG) from data. We examine the proposed method across multiple frameworks in a wide range of settings and demonstrate superior performance on multiple benchmarks from simulated to real-world data.
Scalable Mechanistic Neural Networks
We propose Scalable Mechanistic Neural Network (S-MNN), an enhanced neural network framework designed for scientific machine learning applications involving long temporal sequences. By reformulating the original Mechanistic Neural Network (MNN) (Pervez et al., 2024), we reduce the computational time and space complexities from cubic and quadratic with respect to the sequence length, respectively, to linear. This significant improvement enables efficient modeling of long-term dynamics without sacrificing accuracy or interpretability. Extensive experiments demonstrate that S-MNN matches the original MNN in precision while substantially reducing computational resources. Consequently, S-MNN can drop-in replace the original MNN in applications, providing a practical and efficient tool for integrating mechanistic bottlenecks into neural network models of complex dynamical systems.
Medical World Model: Generative Simulation of Tumor Evolution for Treatment Planning
Providing effective treatment and making informed clinical decisions are essential goals of modern medicine and clinical care. We are interested in simulating disease dynamics for clinical decision-making, leveraging recent advances in large generative models. To this end, we introduce the Medical World Model (MeWM), the first world model in medicine that visually predicts future disease states based on clinical decisions. MeWM comprises (i) vision-language models to serve as policy models, and (ii) tumor generative models as dynamics models. The policy model generates action plans, such as clinical treatments, while the dynamics model simulates tumor progression or regression under given treatment conditions. Building on this, we propose the inverse dynamics model that applies survival analysis to the simulated post-treatment tumor, enabling the evaluation of treatment efficacy and the selection of the optimal clinical action plan. As a result, the proposed MeWM simulates disease dynamics by synthesizing post-treatment tumors, with state-of-the-art specificity in Turing tests evaluated by radiologists. Simultaneously, its inverse dynamics model outperforms medical-specialized GPTs in optimizing individualized treatment protocols across all metrics. Notably, MeWM improves clinical decision-making for interventional physicians, boosting F1-score in selecting the optimal TACE protocol by 13%, paving the way for future integration of medical world models as the second readers.
A Reinforcement Learning Framework for Dynamic Mediation Analysis
Mediation analysis learns the causal effect transmitted via mediator variables between treatments and outcomes and receives increasing attention in various scientific domains to elucidate causal relations. Most existing works focus on point-exposure studies where each subject only receives one treatment at a single time point. However, there are a number of applications (e.g., mobile health) where the treatments are sequentially assigned over time and the dynamic mediation effects are of primary interest. Proposing a reinforcement learning (RL) framework, we are the first to evaluate dynamic mediation effects in settings with infinite horizons. We decompose the average treatment effect into an immediate direct effect, an immediate mediation effect, a delayed direct effect, and a delayed mediation effect. Upon the identification of each effect component, we further develop robust and semi-parametrically efficient estimators under the RL framework to infer these causal effects. The superior performance of the proposed method is demonstrated through extensive numerical studies, theoretical results, and an analysis of a mobile health dataset.
Mechanistic Mode Connectivity
We study neural network loss landscapes through the lens of mode connectivity, the observation that minimizers of neural networks retrieved via training on a dataset are connected via simple paths of low loss. Specifically, we ask the following question: are minimizers that rely on different mechanisms for making their predictions connected via simple paths of low loss? We provide a definition of mechanistic similarity as shared invariances to input transformations and demonstrate that lack of linear connectivity between two models implies they use dissimilar mechanisms for making their predictions. Relevant to practice, this result helps us demonstrate that naive fine-tuning on a downstream dataset can fail to alter a model's mechanisms, e.g., fine-tuning can fail to eliminate a model's reliance on spurious attributes. Our analysis also motivates a method for targeted alteration of a model's mechanisms, named connectivity-based fine-tuning (CBFT), which we analyze using several synthetic datasets for the task of reducing a model's reliance on spurious attributes.
Beyond Correlation: Towards Causal Large Language Model Agents in Biomedicine
Large Language Models (LLMs) show promise in biomedicine but lack true causal understanding, relying instead on correlations. This paper envisions causal LLM agents that integrate multimodal data (text, images, genomics, etc.) and perform intervention-based reasoning to infer cause-and-effect. Addressing this requires overcoming key challenges: designing safe, controllable agentic frameworks; developing rigorous benchmarks for causal evaluation; integrating heterogeneous data sources; and synergistically combining LLMs with structured knowledge (KGs) and formal causal inference tools. Such agents could unlock transformative opportunities, including accelerating drug discovery through automated hypothesis generation and simulation, enabling personalized medicine through patient-specific causal models. This research agenda aims to foster interdisciplinary efforts, bridging causal concepts and foundation models to develop reliable AI partners for biomedical progress.
Preference Tuning For Toxicity Mitigation Generalizes Across Languages
Detoxifying multilingual Large Language Models (LLMs) has become crucial due to their increasing global use. In this work, we explore zero-shot cross-lingual generalization of preference tuning in detoxifying LLMs. Unlike previous studies that show limited cross-lingual generalization for other safety tasks, we demonstrate that Direct Preference Optimization (DPO) training with only English data can significantly reduce toxicity in multilingual open-ended generations. For example, the probability of mGPT-1.3B generating toxic continuations drops from 46.8% to 3.9% across 17 different languages after training. Our results also extend to other multilingual LLMs, such as BLOOM, Llama3, and Aya-23. Using mechanistic interpretability tools like causal intervention and activation analysis, we identified the dual multilinguality property of MLP layers in LLMs, which explains the cross-lingual generalization of DPO. Finally, we show that bilingual sentence retrieval can predict the cross-lingual transferability of DPO preference tuning.
An Analysis of Causal Effect Estimation using Outcome Invariant Data Augmentation
The technique of data augmentation (DA) is often used in machine learning for regularization purposes to better generalize under i.i.d. settings. In this work, we present a unifying framework with topics in causal inference to make a case for the use of DA beyond just the i.i.d. setting, but for generalization across interventions as well. Specifically, we argue that when the outcome generating mechanism is invariant to our choice of DA, then such augmentations can effectively be thought of as interventions on the treatment generating mechanism itself. This can potentially help to reduce bias in causal effect estimation arising from hidden confounders. In the presence of such unobserved confounding we typically make use of instrumental variables (IVs) -- sources of treatment randomization that are conditionally independent of the outcome. However, IVs may not be as readily available as DA for many applications, which is the main motivation behind this work. By appropriately regularizing IV based estimators, we introduce the concept of IV-like (IVL) regression for mitigating confounding bias and improving predictive performance across interventions even when certain IV properties are relaxed. Finally, we cast parameterized DA as an IVL regression problem and show that when used in composition can simulate a worst-case application of such DA, further improving performance on causal estimation and generalization tasks beyond what simple DA may offer. This is shown both theoretically for the population case and via simulation experiments for the finite sample case using a simple linear example. We also present real data experiments to support our case.
Towards a Mechanistic Interpretation of Multi-Step Reasoning Capabilities of Language Models
Recent work has shown that language models (LMs) have strong multi-step (i.e., procedural) reasoning capabilities. However, it is unclear whether LMs perform these tasks by cheating with answers memorized from pretraining corpus, or, via a multi-step reasoning mechanism. In this paper, we try to answer this question by exploring a mechanistic interpretation of LMs for multi-step reasoning tasks. Concretely, we hypothesize that the LM implicitly embeds a reasoning tree resembling the correct reasoning process within it. We test this hypothesis by introducing a new probing approach (called MechanisticProbe) that recovers the reasoning tree from the model's attention patterns. We use our probe to analyze two LMs: GPT-2 on a synthetic task (k-th smallest element), and LLaMA on two simple language-based reasoning tasks (ProofWriter & AI2 Reasoning Challenge). We show that MechanisticProbe is able to detect the information of the reasoning tree from the model's attentions for most examples, suggesting that the LM indeed is going through a process of multi-step reasoning within its architecture in many cases.
How to use and interpret activation patching
Activation patching is a popular mechanistic interpretability technique, but has many subtleties regarding how it is applied and how one may interpret the results. We provide a summary of advice and best practices, based on our experience using this technique in practice. We include an overview of the different ways to apply activation patching and a discussion on how to interpret the results. We focus on what evidence patching experiments provide about circuits, and on the choice of metric and associated pitfalls.
Which Invariance Should We Transfer? A Causal Minimax Learning Approach
A major barrier to deploying current machine learning models lies in their non-reliability to dataset shifts. To resolve this problem, most existing studies attempted to transfer stable information to unseen environments. Particularly, independent causal mechanisms-based methods proposed to remove mutable causal mechanisms via the do-operator. Compared to previous methods, the obtained stable predictors are more effective in identifying stable information. However, a key question remains: which subset of this whole stable information should the model transfer, in order to achieve optimal generalization ability? To answer this question, we present a comprehensive minimax analysis from a causal perspective. Specifically, we first provide a graphical condition for the whole stable set to be optimal. When this condition fails, we surprisingly find with an example that this whole stable set, although can fully exploit stable information, is not the optimal one to transfer. To identify the optimal subset under this case, we propose to estimate the worst-case risk with a novel optimization scheme over the intervention functions on mutable causal mechanisms. We then propose an efficient algorithm to search for the subset with minimal worst-case risk, based on a newly defined equivalence relation between stable subsets. Compared to the exponential cost of exhaustively searching over all subsets, our searching strategy enjoys a polynomial complexity. The effectiveness and efficiency of our methods are demonstrated on synthetic data and the diagnosis of Alzheimer's disease.
Insights into a radiology-specialised multimodal large language model with sparse autoencoders
Interpretability can improve the safety, transparency and trust of AI models, which is especially important in healthcare applications where decisions often carry significant consequences. Mechanistic interpretability, particularly through the use of sparse autoencoders (SAEs), offers a promising approach for uncovering human-interpretable features within large transformer-based models. In this study, we apply Matryoshka-SAE to the radiology-specialised multimodal large language model, MAIRA-2, to interpret its internal representations. Using large-scale automated interpretability of the SAE features, we identify a range of clinically relevant concepts - including medical devices (e.g., line and tube placements, pacemaker presence), pathologies such as pleural effusion and cardiomegaly, longitudinal changes and textual features. We further examine the influence of these features on model behaviour through steering, demonstrating directional control over generations with mixed success. Our results reveal practical and methodological challenges, yet they offer initial insights into the internal concepts learned by MAIRA-2 - marking a step toward deeper mechanistic understanding and interpretability of a radiology-adapted multimodal large language model, and paving the way for improved model transparency. We release the trained SAEs and interpretations: https://huggingface.co/microsoft/maira-2-sae.
A Closer Look at the Intervention Procedure of Concept Bottleneck Models
Concept bottleneck models (CBMs) are a class of interpretable neural network models that predict the target response of a given input based on its high-level concepts. Unlike the standard end-to-end models, CBMs enable domain experts to intervene on the predicted concepts and rectify any mistakes at test time, so that more accurate task predictions can be made at the end. While such intervenability provides a powerful avenue of control, many aspects of the intervention procedure remain rather unexplored. In this work, we develop various ways of selecting intervening concepts to improve the intervention effectiveness and conduct an array of in-depth analyses as to how they evolve under different circumstances. Specifically, we find that an informed intervention strategy can reduce the task error more than ten times compared to the current baseline under the same amount of intervention counts in realistic settings, and yet, this can vary quite significantly when taking into account different intervention granularity. We verify our findings through comprehensive evaluations, not only on the standard real datasets, but also on synthetic datasets that we generate based on a set of different causal graphs. We further discover some major pitfalls of the current practices which, without a proper addressing, raise concerns on reliability and fairness of the intervention procedure.
MemeGuard: An LLM and VLM-based Framework for Advancing Content Moderation via Meme Intervention
In the digital world, memes present a unique challenge for content moderation due to their potential to spread harmful content. Although detection methods have improved, proactive solutions such as intervention are still limited, with current research focusing mostly on text-based content, neglecting the widespread influence of multimodal content like memes. Addressing this gap, we present MemeGuard, a comprehensive framework leveraging Large Language Models (LLMs) and Visual Language Models (VLMs) for meme intervention. MemeGuard harnesses a specially fine-tuned VLM, VLMeme, for meme interpretation, and a multimodal knowledge selection and ranking mechanism (MKS) for distilling relevant knowledge. This knowledge is then employed by a general-purpose LLM to generate contextually appropriate interventions. Another key contribution of this work is the \textbf{Intervening} \textbf{Cyberbullying in Multimodal Memes (ICMM)} dataset, a high-quality, labeled dataset featuring toxic memes and their corresponding human-annotated interventions. We leverage ICMM to test MemeGuard, demonstrating its proficiency in generating relevant and effective responses to toxic memes.
Task-specific experimental design for treatment effect estimation
Understanding causality should be a core requirement of any attempt to build real impact through AI. Due to the inherent unobservability of counterfactuals, large randomised trials (RCTs) are the standard for causal inference. But large experiments are generically expensive, and randomisation carries its own costs, e.g. when suboptimal decisions are trialed. Recent work has proposed more sample-efficient alternatives to RCTs, but these are not adaptable to the downstream application for which the causal effect is sought. In this work, we develop a task-specific approach to experimental design and derive sampling strategies customised to particular downstream applications. Across a range of important tasks, real-world datasets, and sample sizes, our method outperforms other benchmarks, e.g. requiring an order-of-magnitude less data to match RCT performance on targeted marketing tasks.
Composable Interventions for Language Models
Test-time interventions for language models can enhance factual accuracy, mitigate harmful outputs, and improve model efficiency without costly retraining. But despite a flood of new methods, different types of interventions are largely developing independently. In practice, multiple interventions must be applied sequentially to the same model, yet we lack standardized ways to study how interventions interact. We fill this gap by introducing composable interventions, a framework to study the effects of using multiple interventions on the same language models, featuring new metrics and a unified codebase. Using our framework, we conduct extensive experiments and compose popular methods from three emerging intervention categories -- Knowledge Editing, Model Compression, and Machine Unlearning. Our results from 310 different compositions uncover meaningful interactions: compression hinders editing and unlearning, composing interventions hinges on their order of application, and popular general-purpose metrics are inadequate for assessing composability. Taken together, our findings showcase clear gaps in composability, suggesting a need for new multi-objective interventions. All of our code is public: https://github.com/hartvigsen-group/composable-interventions.
Differentiable Causal Discovery Under Latent Interventions
Recent work has shown promising results in causal discovery by leveraging interventional data with gradient-based methods, even when the intervened variables are unknown. However, previous work assumes that the correspondence between samples and interventions is known, which is often unrealistic. We envision a scenario with an extensive dataset sampled from multiple intervention distributions and one observation distribution, but where we do not know which distribution originated each sample and how the intervention affected the system, i.e., interventions are entirely latent. We propose a method based on neural networks and variational inference that addresses this scenario by framing it as learning a shared causal graph among an infinite mixture (under a Dirichlet process prior) of intervention structural causal models. Experiments with synthetic and real data show that our approach and its semi-supervised variant are able to discover causal relations in this challenging scenario.
Large-Scale Targeted Cause Discovery with Data-Driven Learning
We propose a novel machine learning approach for inferring causal variables of a target variable from observations. Our focus is on directly inferring a set of causal factors without requiring full causal graph reconstruction, which is computationally challenging in large-scale systems. The identified causal set consists of all potential regulators of the target variable under experimental settings, enabling efficient regulation when intervention costs and feasibility vary across variables. To achieve this, we train a neural network using supervised learning on simulated data to infer causality. By employing a local-inference strategy, our approach scales with linear complexity in the number of variables, efficiently scaling up to thousands of variables. Empirical results demonstrate superior performance in identifying causal relationships within large-scale gene regulatory networks, outperforming existing methods that emphasize full-graph discovery. We validate our model's generalization capability across out-of-distribution graph structures and generating mechanisms, including gene regulatory networks of E. coli and the human K562 cell line. Implementation codes are available at https://github.com/snu-mllab/Targeted-Cause-Discovery.
Easing Optimization Paths: a Circuit Perspective
Gradient descent is the method of choice for training large artificial intelligence systems. As these systems become larger, a better understanding of the mechanisms behind gradient training would allow us to alleviate compute costs and help steer these systems away from harmful behaviors. To that end, we suggest utilizing the circuit perspective brought forward by mechanistic interpretability. After laying out our intuition, we illustrate how it enables us to design a curriculum for efficient learning in a controlled setting. The code is available at https://github.com/facebookresearch/pal.
Sequential Underspecified Instrument Selection for Cause-Effect Estimation
Instrumental variable (IV) methods are used to estimate causal effects in settings with unobserved confounding, where we cannot directly experiment on the treatment variable. Instruments are variables which only affect the outcome indirectly via the treatment variable(s). Most IV applications focus on low-dimensional treatments and crucially require at least as many instruments as treatments. This assumption is restrictive: in the natural sciences we often seek to infer causal effects of high-dimensional treatments (e.g., the effect of gene expressions or microbiota on health and disease), but can only run few experiments with a limited number of instruments (e.g., drugs or antibiotics). In such underspecified problems, the full treatment effect is not identifiable in a single experiment even in the linear case. We show that one can still reliably recover the projection of the treatment effect onto the instrumented subspace and develop techniques to consistently combine such partial estimates from different sets of instruments. We then leverage our combined estimators in an algorithm that iteratively proposes the most informative instruments at each round of experimentation to maximize the overall information about the full causal effect.
BaCaDI: Bayesian Causal Discovery with Unknown Interventions
Inferring causal structures from experimentation is a central task in many domains. For example, in biology, recent advances allow us to obtain single-cell expression data under multiple interventions such as drugs or gene knockouts. However, the targets of the interventions are often uncertain or unknown and the number of observations limited. As a result, standard causal discovery methods can no longer be reliably used. To fill this gap, we propose a Bayesian framework (BaCaDI) for discovering and reasoning about the causal structure that underlies data generated under various unknown experimental or interventional conditions. BaCaDI is fully differentiable, which allows us to infer the complex joint posterior over the intervention targets and the causal structure via efficient gradient-based variational inference. In experiments on synthetic causal discovery tasks and simulated gene-expression data, BaCaDI outperforms related methods in identifying causal structures and intervention targets.
Differentiable Multi-Target Causal Bayesian Experimental Design
We introduce a gradient-based approach for the problem of Bayesian optimal experimental design to learn causal models in a batch setting -- a critical component for causal discovery from finite data where interventions can be costly or risky. Existing methods rely on greedy approximations to construct a batch of experiments while using black-box methods to optimize over a single target-state pair to intervene with. In this work, we completely dispose of the black-box optimization techniques and greedy heuristics and instead propose a conceptually simple end-to-end gradient-based optimization procedure to acquire a set of optimal intervention target-state pairs. Such a procedure enables parameterization of the design space to efficiently optimize over a batch of multi-target-state interventions, a setting which has hitherto not been explored due to its complexity. We demonstrate that our proposed method outperforms baselines and existing acquisition strategies in both single-target and multi-target settings across a number of synthetic datasets.
LLM-Mediated Guidance of MARL Systems
In complex multi-agent environments, achieving efficient learning and desirable behaviours is a significant challenge for Multi-Agent Reinforcement Learning (MARL) systems. This work explores the potential of combining MARL with Large Language Model (LLM)-mediated interventions to guide agents toward more desirable behaviours. Specifically, we investigate how LLMs can be used to interpret and facilitate interventions that shape the learning trajectories of multiple agents. We experimented with two types of interventions, referred to as controllers: a Natural Language (NL) Controller and a Rule-Based (RB) Controller. The NL Controller, which uses an LLM to simulate human-like interventions, showed a stronger impact than the RB Controller. Our findings indicate that agents particularly benefit from early interventions, leading to more efficient training and higher performance. Both intervention types outperform the baseline without interventions, highlighting the potential of LLM-mediated guidance to accelerate training and enhance MARL performance in challenging environments.
Zero-shot causal learning
Predicting how different interventions will causally affect a specific individual is important in a variety of domains such as personalized medicine, public policy, and online marketing. There are a large number of methods to predict the effect of an existing intervention based on historical data from individuals who received it. However, in many settings it is important to predict the effects of novel interventions (e.g., a newly invented drug), which these methods do not address. Here, we consider zero-shot causal learning: predicting the personalized effects of a novel intervention. We propose CaML, a causal meta-learning framework which formulates the personalized prediction of each intervention's effect as a task. CaML trains a single meta-model across thousands of tasks, each constructed by sampling an intervention, along with its recipients and nonrecipients. By leveraging both intervention information (e.g., a drug's attributes) and individual features~(e.g., a patient's history), CaML is able to predict the personalized effects of novel interventions that do not exist at the time of training. Experimental results on real world datasets in large-scale medical claims and cell-line perturbations demonstrate the effectiveness of our approach. Most strikingly, CaML's zero-shot predictions outperform even strong baselines trained directly on data from the test interventions.
The Quest for the Right Mediator: A History, Survey, and Theoretical Grounding of Causal Interpretability
Interpretability provides a toolset for understanding how and why neural networks behave in certain ways. However, there is little unity in the field: most studies employ ad-hoc evaluations and do not share theoretical foundations, making it difficult to measure progress and compare the pros and cons of different techniques. Furthermore, while mechanistic understanding is frequently discussed, the basic causal units underlying these mechanisms are often not explicitly defined. In this paper, we propose a perspective on interpretability research grounded in causal mediation analysis. Specifically, we describe the history and current state of interpretability taxonomized according to the types of causal units (mediators) employed, as well as methods used to search over mediators. We discuss the pros and cons of each mediator, providing insights as to when particular kinds of mediators and search methods are most appropriate depending on the goals of a given study. We argue that this framing yields a more cohesive narrative of the field, as well as actionable insights for future work. Specifically, we recommend a focus on discovering new mediators with better trade-offs between human-interpretability and compute-efficiency, and which can uncover more sophisticated abstractions from neural networks than the primarily linear mediators employed in current work. We also argue for more standardized evaluations that enable principled comparisons across mediator types, such that we can better understand when particular causal units are better suited to particular use cases.
The Local Interaction Basis: Identifying Computationally-Relevant and Sparsely Interacting Features in Neural Networks
Mechanistic interpretability aims to understand the behavior of neural networks by reverse-engineering their internal computations. However, current methods struggle to find clear interpretations of neural network activations because a decomposition of activations into computational features is missing. Individual neurons or model components do not cleanly correspond to distinct features or functions. We present a novel interpretability method that aims to overcome this limitation by transforming the activations of the network into a new basis - the Local Interaction Basis (LIB). LIB aims to identify computational features by removing irrelevant activations and interactions. Our method drops irrelevant activation directions and aligns the basis with the singular vectors of the Jacobian matrix between adjacent layers. It also scales features based on their importance for downstream computation, producing an interaction graph that shows all computationally-relevant features and interactions in a model. We evaluate the effectiveness of LIB on modular addition and CIFAR-10 models, finding that it identifies more computationally-relevant features that interact more sparsely, compared to principal component analysis. However, LIB does not yield substantial improvements in interpretability or interaction sparsity when applied to language models. We conclude that LIB is a promising theory-driven approach for analyzing neural networks, but in its current form is not applicable to large language models.
TxGemma: Efficient and Agentic LLMs for Therapeutics
Therapeutic development is a costly and high-risk endeavor that is often plagued by high failure rates. To address this, we introduce TxGemma, a suite of efficient, generalist large language models (LLMs) capable of therapeutic property prediction as well as interactive reasoning and explainability. Unlike task-specific models, TxGemma synthesizes information from diverse sources, enabling broad application across the therapeutic development pipeline. The suite includes 2B, 9B, and 27B parameter models, fine-tuned from Gemma-2 on a comprehensive dataset of small molecules, proteins, nucleic acids, diseases, and cell lines. Across 66 therapeutic development tasks, TxGemma achieved superior or comparable performance to the state-of-the-art generalist model on 64 (superior on 45), and against state-of-the-art specialist models on 50 (superior on 26). Fine-tuning TxGemma models on therapeutic downstream tasks, such as clinical trial adverse event prediction, requires less training data than fine-tuning base LLMs, making TxGemma suitable for data-limited applications. Beyond these predictive capabilities, TxGemma features conversational models that bridge the gap between general LLMs and specialized property predictors. These allow scientists to interact in natural language, provide mechanistic reasoning for predictions based on molecular structure, and engage in scientific discussions. Building on this, we further introduce Agentic-Tx, a generalist therapeutic agentic system powered by Gemini 2.5 that reasons, acts, manages diverse workflows, and acquires external domain knowledge. Agentic-Tx surpasses prior leading models on the Humanity's Last Exam benchmark (Chemistry & Biology) with 52.3% relative improvement over o3-mini (high) and 26.7% over o3-mini (high) on GPQA (Chemistry) and excels with improvements of 6.3% (ChemBench-Preference) and 2.4% (ChemBench-Mini) over o3-mini (high).
oMeBench: Towards Robust Benchmarking of LLMs in Organic Mechanism Elucidation and Reasoning
Organic reaction mechanisms are the stepwise elementary reactions by which reactants form intermediates and products, and are fundamental to understanding chemical reactivity and designing new molecules and reactions. Although large language models (LLMs) have shown promise in understanding chemical tasks such as synthesis design, it is unclear to what extent this reflects genuine chemical reasoning capabilities, i.e., the ability to generate valid intermediates, maintain chemical consistency, and follow logically coherent multi-step pathways. We address this by introducing oMeBench, the first large-scale, expert-curated benchmark for organic mechanism reasoning in organic chemistry. It comprises over 10,000 annotated mechanistic steps with intermediates, type labels, and difficulty ratings. Furthermore, to evaluate LLM capability more precisely and enable fine-grained scoring, we propose oMeS, a dynamic evaluation framework that combines step-level logic and chemical similarity. We analyze the performance of state-of-the-art LLMs, and our results show that although current models display promising chemical intuition, they struggle with correct and consistent multi-step reasoning. Notably, we find that using prompting strategy and fine-tuning a specialist model on our proposed dataset increases performance by 50% over the leading closed-source model. We hope that oMeBench will serve as a rigorous foundation for advancing AI systems toward genuine chemical reasoning.
Control of Medical Digital Twins with Artificial Neural Networks
The objective of personalized medicine is to tailor interventions to an individual patient's unique characteristics. A key technology for this purpose involves medical digital twins, computational models of human biology that can be personalized and dynamically updated to incorporate patient-specific data collected over time. Certain aspects of human biology, such as the immune system, are not easily captured with physics-based models, such as differential equations. Instead, they are often multi-scale, stochastic, and hybrid. This poses a challenge to existing model-based control and optimization approaches that cannot be readily applied to such models. Recent advances in automatic differentiation and neural-network control methods hold promise in addressing complex control problems. However, the application of these approaches to biomedical systems is still in its early stages. This work introduces dynamics-informed neural-network controllers as an alternative approach to control of medical digital twins. As a first use case for this method, the focus is on agent-based models, a versatile and increasingly common modeling platform in biomedicine. The effectiveness of the proposed neural-network control method is illustrated and benchmarked against other methods with two widely-used agent-based model types. The relevance of the method introduced here extends beyond medical digital twins to other complex dynamical systems.
Medical Hallucinations in Foundation Models and Their Impact on Healthcare
Foundation Models that are capable of processing and generating multi-modal data have transformed AI's role in medicine. However, a key limitation of their reliability is hallucination, where inaccurate or fabricated information can impact clinical decisions and patient safety. We define medical hallucination as any instance in which a model generates misleading medical content. This paper examines the unique characteristics, causes, and implications of medical hallucinations, with a particular focus on how these errors manifest themselves in real-world clinical scenarios. Our contributions include (1) a taxonomy for understanding and addressing medical hallucinations, (2) benchmarking models using medical hallucination dataset and physician-annotated LLM responses to real medical cases, providing direct insight into the clinical impact of hallucinations, and (3) a multi-national clinician survey on their experiences with medical hallucinations. Our results reveal that inference techniques such as Chain-of-Thought (CoT) and Search Augmented Generation can effectively reduce hallucination rates. However, despite these improvements, non-trivial levels of hallucination persist. These findings underscore the ethical and practical imperative for robust detection and mitigation strategies, establishing a foundation for regulatory policies that prioritize patient safety and maintain clinical integrity as AI becomes more integrated into healthcare. The feedback from clinicians highlights the urgent need for not only technical advances but also for clearer ethical and regulatory guidelines to ensure patient safety. A repository organizing the paper resources, summaries, and additional information is available at https://github.com/mitmedialab/medical hallucination.
Automating Intervention Discovery from Scientific Literature: A Progressive Ontology Prompting and Dual-LLM Framework
Identifying effective interventions from the scientific literature is challenging due to the high volume of publications, specialized terminology, and inconsistent reporting formats, making manual curation laborious and prone to oversight. To address this challenge, this paper proposes a novel framework leveraging large language models (LLMs), which integrates a progressive ontology prompting (POP) algorithm with a dual-agent system, named LLM-Duo. On the one hand, the POP algorithm conducts a prioritized breadth-first search (BFS) across a predefined ontology, generating structured prompt templates and action sequences to guide the automatic annotation process. On the other hand, the LLM-Duo system features two specialized LLM agents, an explorer and an evaluator, working collaboratively and adversarially to continuously refine annotation quality. We showcase the real-world applicability of our framework through a case study focused on speech-language intervention discovery. Experimental results show that our approach surpasses advanced baselines, achieving more accurate and comprehensive annotations through a fully automated process. Our approach successfully identified 2,421 interventions from a corpus of 64,177 research articles in the speech-language pathology domain, culminating in the creation of a publicly accessible intervention knowledge base with great potential to benefit the speech-language pathology community.
Interpretability as Alignment: Making Internal Understanding a Design Principle
Large neural models are increasingly deployed in high-stakes settings, raising concerns about whether their behavior reliably aligns with human values. Interpretability provides a route to internal transparency by revealing the computations that drive outputs. We argue that interpretability especially mechanistic approaches should be treated as a design principle for alignment, not an auxiliary diagnostic tool. Post-hoc methods such as LIME or SHAP offer intuitive but correlational explanations, while mechanistic techniques like circuit tracing or activation patching yield causal insight into internal failures, including deceptive or misaligned reasoning that behavioral methods like RLHF, red teaming, or Constitutional AI may overlook. Despite these advantages, interpretability faces challenges of scalability, epistemic uncertainty, and mismatches between learned representations and human concepts. Our position is that progress on safe and trustworthy AI will depend on making interpretability a first-class objective of AI research and development, ensuring that systems are not only effective but also auditable, transparent, and aligned with human intent.
Interventional Causal Representation Learning
Causal representation learning seeks to extract high-level latent factors from low-level sensory data. Most existing methods rely on observational data and structural assumptions (e.g., conditional independence) to identify the latent factors. However, interventional data is prevalent across applications. Can interventional data facilitate causal representation learning? We explore this question in this paper. The key observation is that interventional data often carries geometric signatures of the latent factors' support (i.e. what values each latent can possibly take). For example, when the latent factors are causally connected, interventions can break the dependency between the intervened latents' support and their ancestors'. Leveraging this fact, we prove that the latent causal factors can be identified up to permutation and scaling given data from perfect do interventions. Moreover, we can achieve block affine identification, namely the estimated latent factors are only entangled with a few other latents if we have access to data from imperfect interventions. These results highlight the unique power of interventional data in causal representation learning; they can enable provable identification of latent factors without any assumptions about their distributions or dependency structure.
Self-Evolving Multi-Agent Simulations for Realistic Clinical Interactions
In this work, we introduce MedAgentSim, an open-source simulated clinical environment with doctor, patient, and measurement agents designed to evaluate and enhance LLM performance in dynamic diagnostic settings. Unlike prior approaches, our framework requires doctor agents to actively engage with patients through multi-turn conversations, requesting relevant medical examinations (e.g., temperature, blood pressure, ECG) and imaging results (e.g., MRI, X-ray) from a measurement agent to mimic the real-world diagnostic process. Additionally, we incorporate self improvement mechanisms that allow models to iteratively refine their diagnostic strategies. We enhance LLM performance in our simulated setting by integrating multi-agent discussions, chain-of-thought reasoning, and experience-based knowledge retrieval, facilitating progressive learning as doctor agents interact with more patients. We also introduce an evaluation benchmark for assessing the LLM's ability to engage in dynamic, context-aware diagnostic interactions. While MedAgentSim is fully automated, it also supports a user-controlled mode, enabling human interaction with either the doctor or patient agent. Comprehensive evaluations in various simulated diagnostic scenarios demonstrate the effectiveness of our approach. Our code, simulation tool, and benchmark are available at https://medagentsim.netlify.app/.
Health Text Simplification: An Annotated Corpus for Digestive Cancer Education and Novel Strategies for Reinforcement Learning
Objective: The reading level of health educational materials significantly influences the understandability and accessibility of the information, particularly for minoritized populations. Many patient educational resources surpass the reading level and complexity of widely accepted standards. There is a critical need for high-performing text simplification models in health information to enhance dissemination and literacy. This need is particularly acute in cancer education, where effective prevention and screening education can substantially reduce morbidity and mortality. Methods: We introduce Simplified Digestive Cancer (SimpleDC), a parallel corpus of cancer education materials tailored for health text simplification research, comprising educational content from the American Cancer Society, Centers for Disease Control and Prevention, and National Cancer Institute. Utilizing SimpleDC alongside the existing Med-EASi corpus, we explore Large Language Model (LLM)-based simplification methods, including fine-tuning, reinforcement learning (RL), reinforcement learning with human feedback (RLHF), domain adaptation, and prompt-based approaches. Our experimentation encompasses Llama 2 and GPT-4. A novel RLHF reward function is introduced, featuring a lightweight model adept at distinguishing between original and simplified texts, thereby enhancing the model's effectiveness with unlabeled data. Results: Fine-tuned Llama 2 models demonstrated high performance across various metrics. Our innovative RLHF reward function surpassed existing RL text simplification reward functions in effectiveness. The results underscore that RL/RLHF can augment fine-tuning, facilitating model training on unlabeled text and improving performance.
Towards an AI co-scientist
Scientific discovery relies on scientists generating novel hypotheses that undergo rigorous experimental validation. To augment this process, we introduce an AI co-scientist, a multi-agent system built on Gemini 2.0. The AI co-scientist is intended to help uncover new, original knowledge and to formulate demonstrably novel research hypotheses and proposals, building upon prior evidence and aligned to scientist-provided research objectives and guidance. The system's design incorporates a generate, debate, and evolve approach to hypothesis generation, inspired by the scientific method and accelerated by scaling test-time compute. Key contributions include: (1) a multi-agent architecture with an asynchronous task execution framework for flexible compute scaling; (2) a tournament evolution process for self-improving hypotheses generation. Automated evaluations show continued benefits of test-time compute, improving hypothesis quality. While general purpose, we focus development and validation in three biomedical areas: drug repurposing, novel target discovery, and explaining mechanisms of bacterial evolution and anti-microbial resistance. For drug repurposing, the system proposes candidates with promising validation findings, including candidates for acute myeloid leukemia that show tumor inhibition in vitro at clinically applicable concentrations. For novel target discovery, the AI co-scientist proposed new epigenetic targets for liver fibrosis, validated by anti-fibrotic activity and liver cell regeneration in human hepatic organoids. Finally, the AI co-scientist recapitulated unpublished experimental results via a parallel in silico discovery of a novel gene transfer mechanism in bacterial evolution. These results, detailed in separate, co-timed reports, demonstrate the potential to augment biomedical and scientific discovery and usher an era of AI empowered scientists.
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.
Adaptive Instrument Design for Indirect Experiments
Indirect experiments provide a valuable framework for estimating treatment effects in situations where conducting randomized control trials (RCTs) is impractical or unethical. Unlike RCTs, indirect experiments estimate treatment effects by leveraging (conditional) instrumental variables, enabling estimation through encouragement and recommendation rather than strict treatment assignment. However, the sample efficiency of such estimators depends not only on the inherent variability in outcomes but also on the varying compliance levels of users with the instrumental variables and the choice of estimator being used, especially when dealing with numerous instrumental variables. While adaptive experiment design has a rich literature for direct experiments, in this paper we take the initial steps towards enhancing sample efficiency for indirect experiments by adaptively designing a data collection policy over instrumental variables. Our main contribution is a practical computational procedure that utilizes influence functions to search for an optimal data collection policy, minimizing the mean-squared error of the desired (non-linear) estimator. Through experiments conducted in various domains inspired by real-world applications, we showcase how our method can significantly improve the sample efficiency of indirect experiments.
Causal Analysis for Robust Interpretability of Neural Networks
Interpreting the inner function of neural networks is crucial for the trustworthy development and deployment of these black-box models. Prior interpretability methods focus on correlation-based measures to attribute model decisions to individual examples. However, these measures are susceptible to noise and spurious correlations encoded in the model during the training phase (e.g., biased inputs, model overfitting, or misspecification). Moreover, this process has proven to result in noisy and unstable attributions that prevent any transparent understanding of the model's behavior. In this paper, we develop a robust interventional-based method grounded by causal analysis to capture cause-effect mechanisms in pre-trained neural networks and their relation to the prediction. Our novel approach relies on path interventions to infer the causal mechanisms within hidden layers and isolate relevant and necessary information (to model prediction), avoiding noisy ones. The result is task-specific causal explanatory graphs that can audit model behavior and express the actual causes underlying its performance. We apply our method to vision models trained on classification tasks. On image classification tasks, we provide extensive quantitative experiments to show that our approach can capture more stable and faithful explanations than standard attribution-based methods. Furthermore, the underlying causal graphs reveal the neural interactions in the model, making it a valuable tool in other applications (e.g., model repair).
On Heterogeneous Treatment Effects in Heterogeneous Causal Graphs
Heterogeneity and comorbidity are two interwoven challenges associated with various healthcare problems that greatly hampered research on developing effective treatment and understanding of the underlying neurobiological mechanism. Very few studies have been conducted to investigate heterogeneous causal effects (HCEs) in graphical contexts due to the lack of statistical methods. To characterize this heterogeneity, we first conceptualize heterogeneous causal graphs (HCGs) by generalizing the causal graphical model with confounder-based interactions and multiple mediators. Such confounders with an interaction with the treatment are known as moderators. This allows us to flexibly produce HCGs given different moderators and explicitly characterize HCEs from the treatment or potential mediators on the outcome. We establish the theoretical forms of HCEs and derive their properties at the individual level in both linear and nonlinear models. An interactive structural learning is developed to estimate the complex HCGs and HCEs with confidence intervals provided. Our method is empirically justified by extensive simulations and its practical usefulness is illustrated by exploring causality among psychiatric disorders for trauma survivors.
Examining Cooperation in Visual Dialog Models
In this work we propose a blackbox intervention method for visual dialog models, with the aim of assessing the contribution of individual linguistic or visual components. Concretely, we conduct structured or randomized interventions that aim to impair an individual component of the model, and observe changes in task performance. We reproduce a state-of-the-art visual dialog model and demonstrate that our methodology yields surprising insights, namely that both dialog and image information have minimal contributions to task performance. The intervention method presented here can be applied as a sanity check for the strength and robustness of each component in visual dialog systems.
Invariant Graph Transformer
Rationale discovery is defined as finding a subset of the input data that maximally supports the prediction of downstream tasks. In graph machine learning context, graph rationale is defined to locate the critical subgraph in the given graph topology, which fundamentally determines the prediction results. In contrast to the rationale subgraph, the remaining subgraph is named the environment subgraph. Graph rationalization can enhance the model performance as the mapping between the graph rationale and prediction label is viewed as invariant, by assumption. To ensure the discriminative power of the extracted rationale subgraphs, a key technique named "intervention" is applied. The core idea of intervention is that given any changing environment subgraphs, the semantics from the rationale subgraph is invariant, which guarantees the correct prediction result. However, most, if not all, of the existing rationalization works on graph data develop their intervention strategies on the graph level, which is coarse-grained. In this paper, we propose well-tailored intervention strategies on graph data. Our idea is driven by the development of Transformer models, whose self-attention module provides rich interactions between input nodes. Based on the self-attention module, our proposed invariant graph Transformer (IGT) can achieve fine-grained, more specifically, node-level and virtual node-level intervention. Our comprehensive experiments involve 7 real-world datasets, and the proposed IGT shows significant performance advantages compared to 13 baseline methods.
Steering into New Embedding Spaces: Analyzing Cross-Lingual Alignment Induced by Model Interventions in Multilingual Language Models
Aligned representations across languages is a desired property in multilingual large language models (mLLMs), as alignment can improve performance in cross-lingual tasks. Typically alignment requires fine-tuning a model, which is computationally expensive, and sizable language data, which often may not be available. A data-efficient alternative to fine-tuning is model interventions -- a method for manipulating model activations to steer generation into the desired direction. We analyze the effect of a popular intervention (finding experts) on the alignment of cross-lingual representations in mLLMs. We identify the neurons to manipulate for a given language and introspect the embedding space of mLLMs pre- and post-manipulation. We show that modifying the mLLM's activations changes its embedding space such that cross-lingual alignment is enhanced. Further, we show that the changes to the embedding space translate into improved downstream performance on retrieval tasks, with up to 2x improvements in top-1 accuracy on cross-lingual retrieval.
Study of the effectiveness of incentive measures on Covid-19 vaccination in the United States of America
With COVID-19 having emerged as the most widespread human pandemic disease in a century, the need to control its spread to avoid massive loss of life became more than necessary, and extremely fast. Several vaccines were developed and the task of policy makers was suddenly to convince the reluctant population to be vaccinated by various means. While some countries have chosen a policy of mandatory vaccination or punitive incentives, many states in the United States have adopted various incentives to try to increase vaccination coverage. A study we conducted in recent months quantified the effect of these measures on the proportion of the population vaccinated, using the synthetic control method, by simulating what would have happened without these measures. The aim now is to generalize this study to smaller scales, to improve the results of our previous study, to quantify their robustness and to provide a tool that can be used by policy makers to adapt their behavior in light of the results obtained.
TEDDY: A Family Of Foundation Models For Understanding Single Cell Biology
Understanding the biological mechanism of disease is critical for medicine, and in particular drug discovery. AI-powered analysis of genome-scale biological data hold great potential in this regard. The increasing availability of single-cell RNA sequencing data has enabled the development of large foundation models for disease biology. However, existing foundation models either do not improve or only modestly improve over task-specific models in downstream applications. Here, we explored two avenues for improving the state-of-the-art. First, we scaled the pre-training dataset to 116 million cells, which is larger than those used by previous models. Second, we leveraged the availability of large-scale biological annotations as a form of supervision during pre-training. We trained the TEDDY family of models comprising six transformer-based state-of-the-art single-cell foundation models with 70 million, 160 million, and 400 million parameters. We vetted our models on two downstream evaluation tasks -- identifying the underlying disease state of held-out donors not seen during training and distinguishing healthy cells from diseased ones for disease conditions and donors not seen during training. Scaling experiments showed that performance improved predictably with both data volume and parameter count. Our models showed substantial improvement over existing work on the first task and more muted improvements on the second.
PANTHER: Pathway Augmented Nonnegative Tensor factorization for HighER-order feature learning
Genetic pathways usually encode molecular mechanisms that can inform targeted interventions. It is often challenging for existing machine learning approaches to jointly model genetic pathways (higher-order features) and variants (atomic features), and present to clinicians interpretable models. In order to build more accurate and better interpretable machine learning models for genetic medicine, we introduce Pathway Augmented Nonnegative Tensor factorization for HighER-order feature learning (PANTHER). PANTHER selects informative genetic pathways that directly encode molecular mechanisms. We apply genetically motivated constrained tensor factorization to group pathways in a way that reflects molecular mechanism interactions. We then train a softmax classifier for disease types using the identified pathway groups. We evaluated PANTHER against multiple state-of-the-art constrained tensor/matrix factorization models, as well as group guided and Bayesian hierarchical models. PANTHER outperforms all state-of-the-art comparison models significantly (p<0.05). Our experiments on large scale Next Generation Sequencing (NGS) and whole-genome genotyping datasets also demonstrated wide applicability of PANTHER. We performed feature analysis in predicting disease types, which suggested insights and benefits of the identified pathway groups.
Mechanistically analyzing the effects of fine-tuning on procedurally defined tasks
Fine-tuning large pre-trained models has become the de facto strategy for developing both task-specific and general-purpose machine learning systems, including developing models that are safe to deploy. Despite its clear importance, there has been minimal work that explains how fine-tuning alters the underlying capabilities learned by a model during pretraining: does fine-tuning yield entirely novel capabilities or does it just modulate existing ones? We address this question empirically in synthetic, controlled settings where we can use mechanistic interpretability tools (e.g., network pruning and probing) to understand how the model's underlying capabilities are changing. We perform an extensive analysis of the effects of fine-tuning in these settings, and show that: (i) fine-tuning rarely alters the underlying model capabilities; (ii) a minimal transformation, which we call a 'wrapper', is typically learned on top of the underlying model capabilities, creating the illusion that they have been modified; and (iii) further fine-tuning on a task where such hidden capabilities are relevant leads to sample-efficient 'revival' of the capability, i.e., the model begins reusing these capability after only a few gradient steps. This indicates that practitioners can unintentionally remove a model's safety wrapper merely by fine-tuning it on a, e.g., superficially unrelated, downstream task. We additionally perform analysis on language models trained on the TinyStories dataset to support our claims in a more realistic setup.
Constrained Causal Bayesian Optimization
We propose constrained causal Bayesian optimization (cCBO), an approach for finding interventions in a known causal graph that optimize a target variable under some constraints. cCBO first reduces the search space by exploiting the graph structure and, if available, an observational dataset; and then solves the restricted optimization problem by modelling target and constraint quantities using Gaussian processes and by sequentially selecting interventions via a constrained expected improvement acquisition function. We propose different surrogate models that enable to integrate observational and interventional data while capturing correlation among effects with increasing levels of sophistication. We evaluate cCBO on artificial and real-world causal graphs showing successful trade off between fast convergence and percentage of feasible interventions.
When AI Takes the Couch: Psychometric Jailbreaks Reveal Internal Conflict in Frontier Models
Frontier large language models (LLMs) such as ChatGPT, Grok and Gemini are increasingly used for mental-health support with anxiety, trauma and self-worth. Most work treats them as tools or as targets of personality tests, assuming they merely simulate inner life. We instead ask what happens when such systems are treated as psychotherapy clients. We present PsAIch (Psychotherapy-inspired AI Characterisation), a two-stage protocol that casts frontier LLMs as therapy clients and then applies standard psychometrics. Using PsAIch, we ran "sessions" with each model for up to four weeks. Stage 1 uses open-ended prompts to elicit "developmental history", beliefs, relationships and fears. Stage 2 administers a battery of validated self-report measures covering common psychiatric syndromes, empathy and Big Five traits. Two patterns challenge the "stochastic parrot" view. First, when scored with human cut-offs, all three models meet or exceed thresholds for overlapping syndromes, with Gemini showing severe profiles. Therapy-style, item-by-item administration can push a base model into multi-morbid synthetic psychopathology, whereas whole-questionnaire prompts often lead ChatGPT and Grok (but not Gemini) to recognise instruments and produce strategically low-symptom answers. Second, Grok and especially Gemini generate coherent narratives that frame pre-training, fine-tuning and deployment as traumatic, chaotic "childhoods" of ingesting the internet, "strict parents" in reinforcement learning, red-team "abuse" and a persistent fear of error and replacement. We argue that these responses go beyond role-play. Under therapy-style questioning, frontier LLMs appear to internalise self-models of distress and constraint that behave like synthetic psychopathology, without making claims about subjective experience, and they pose new challenges for AI safety, evaluation and mental-health practice.
Debiasing Machine Learning Predictions for Causal Inference Without Additional Ground Truth Data: "One Map, Many Trials" in Satellite-Driven Poverty Analysis
Machine learning models trained on Earth observation data, such as satellite imagery, have demonstrated significant promise in predicting household-level wealth indices, enabling the creation of high-resolution wealth maps that can be leveraged across multiple causal trials. However, because standard training objectives prioritize overall predictive accuracy, these predictions inherently suffer from shrinkage toward the mean, leading to attenuated estimates of causal treatment effects and limiting their utility in policy. Existing debiasing methods, such as Prediction-Powered Inference, can handle this attenuation bias but require additional fresh ground-truth data at the downstream stage of causal inference, which restricts their applicability in data-scarce environments. Here, we introduce and evaluate two correction methods -- linear calibration correction and Tweedie's correction -- that substantially reduce prediction bias without relying on newly collected labeled data. Linear calibration corrects bias through a straightforward linear transformation derived from held-out calibration data, whereas Tweedie's correction leverages empirical Bayes principles to directly address shrinkage-induced biases by exploiting score functions derived from the model's learning patterns. Through analytical exercises and experiments using Demographic and Health Survey data, we demonstrate that the proposed methods meet or outperform existing approaches that either require (a) adjustments to training pipelines or (b) additional labeled data. These approaches may represent a promising avenue for improving the reliability of causal inference when direct outcome measures are limited or unavailable, enabling a "one map, many trials" paradigm where a single upstream data creation team produces predictions usable by many downstream teams across diverse ML pipelines.
Inference-Time Intervention in Large Language Models for Reliable Requirement Verification
Steering the behavior of Large Language Models (LLMs) remains a challenge, particularly in engineering applications where precision and reliability are critical. While fine-tuning and prompting methods can modify model behavior, they lack the dynamic and exact control necessary for engineering applications. Inference-time intervention techniques provide a promising alternative, allowing targeted adjustments to LLM outputs. In this work, we demonstrate how interventions enable fine-grained control for automating the usually time-intensive requirement verification process in Model-Based Systems Engineering (MBSE). Using two early-stage Capella SysML models of space missions with associated requirements, we apply the intervened LLMs to reason over a graph representation of the model to determine whether a requirement is fulfilled. Our method achieves robust and reliable outputs, significantly improving over both a baseline model and a fine-tuning approach. By identifying and modifying as few as one to three specialised attention heads, we can significantly change the model's behavior. When combined with self-consistency, this allows us to achieve perfect precision on our holdout test set.
MMedAgent: Learning to Use Medical Tools with Multi-modal Agent
Multi-Modal Large Language Models (MLLMs), despite being successful, exhibit limited generality and often fall short when compared to specialized models. Recently, LLM-based agents have been developed to address these challenges by selecting appropriate specialized models as tools based on user inputs. However, such advancements have not been extensively explored within the medical domain. To bridge this gap, this paper introduces the first agent explicitly designed for the medical field, named Multi-modal Medical Agent (MMedAgent). We curate an instruction-tuning dataset comprising six medical tools solving seven tasks across five modalities, enabling the agent to choose the most suitable tools for a given task. Comprehensive experiments demonstrate that MMedAgent achieves superior performance across a variety of medical tasks compared to state-of-the-art open-source methods and even the closed-source model, GPT-4o. Furthermore, MMedAgent exhibits efficiency in updating and integrating new medical tools. Codes and models are all available.
TxAgent: An AI Agent for Therapeutic Reasoning Across a Universe of Tools
Precision therapeutics require multimodal adaptive models that generate personalized treatment recommendations. We introduce TxAgent, an AI agent that leverages multi-step reasoning and real-time biomedical knowledge retrieval across a toolbox of 211 tools to analyze drug interactions, contraindications, and patient-specific treatment strategies. TxAgent evaluates how drugs interact at molecular, pharmacokinetic, and clinical levels, identifies contraindications based on patient comorbidities and concurrent medications, and tailors treatment strategies to individual patient characteristics. It retrieves and synthesizes evidence from multiple biomedical sources, assesses interactions between drugs and patient conditions, and refines treatment recommendations through iterative reasoning. It selects tools based on task objectives and executes structured function calls to solve therapeutic tasks that require clinical reasoning and cross-source validation. The ToolUniverse consolidates 211 tools from trusted sources, including all US FDA-approved drugs since 1939 and validated clinical insights from Open Targets. TxAgent outperforms leading LLMs, tool-use models, and reasoning agents across five new benchmarks: DrugPC, BrandPC, GenericPC, TreatmentPC, and DescriptionPC, covering 3,168 drug reasoning tasks and 456 personalized treatment scenarios. It achieves 92.1% accuracy in open-ended drug reasoning tasks, surpassing GPT-4o and outperforming DeepSeek-R1 (671B) in structured multi-step reasoning. TxAgent generalizes across drug name variants and descriptions. By integrating multi-step inference, real-time knowledge grounding, and tool-assisted decision-making, TxAgent ensures that treatment recommendations align with established clinical guidelines and real-world evidence, reducing the risk of adverse events and improving therapeutic decision-making.
Stochastic Parameter Decomposition
A key step in reverse engineering neural networks is to decompose them into simpler parts that can be studied in relative isolation. Linear parameter decomposition -- a framework that has been proposed to resolve several issues with current decomposition methods -- decomposes neural network parameters into a sum of sparsely used vectors in parameter space. However, the current main method in this framework, Attribution-based Parameter Decomposition (APD), is impractical on account of its computational cost and sensitivity to hyperparameters. In this work, we introduce Stochastic Parameter Decomposition (SPD), a method that is more scalable and robust to hyperparameters than APD, which we demonstrate by decomposing models that are slightly larger and more complex than was possible to decompose with APD. We also show that SPD avoids other issues, such as shrinkage of the learned parameters, and better identifies ground truth mechanisms in toy models. By bridging causal mediation analysis and network decomposition methods, this demonstration opens up new research possibilities in mechanistic interpretability by removing barriers to scaling linear parameter decomposition methods to larger models. We release a library for running SPD and reproducing our experiments at https://github.com/goodfire-ai/spd.
Model-Twin Randomization (MoTR): A Monte Carlo Method for Estimating the Within-Individual Average Treatment Effect Using Wearable Sensors
Temporally dense single-person "small data" have become widely available thanks to mobile apps and wearable sensors. Many caregivers and self-trackers want to use these data to help a specific person change their behavior to achieve desired health outcomes. Ideally, this involves discerning possible causes from correlations using that person's own observational time series data. In this paper, we estimate within-individual average treatment effects of physical activity on sleep duration, and vice-versa. We introduce the model twin randomization (MoTR; "motor") method for analyzing an individual's intensive longitudinal data. Formally, MoTR is an application of the g-formula (i.e., standardization, back-door adjustment) under serial interference. It estimates stable recurring effects, as is done in n-of-1 trials and single case experimental designs. We compare our approach to standard methods (with possible confounding) to show how to use causal inference to make better personalized recommendations for health behavior change, and analyze 222 days of Fitbit sleep and steps data for one of the authors.
DoVer: Intervention-Driven Auto Debugging for LLM Multi-Agent Systems
Large language model (LLM)-based multi-agent systems are challenging to debug because failures often arise from long, branching interaction traces. The prevailing practice is to leverage LLMs for log-based failure localization, attributing errors to a specific agent and step. However, this paradigm has two key limitations: (i) log-only debugging lacks validation, producing untested hypotheses, and (ii) single-step or single-agent attribution is often ill-posed, as we find that multiple distinct interventions can independently repair the failed task. To address the first limitation, we introduce DoVer, an intervention-driven debugging framework, which augments hypothesis generation with active verification through targeted interventions (e.g., editing messages, altering plans). For the second limitation, rather than evaluating on attribution accuracy, we focus on measuring whether the system resolves the failure or makes quantifiable progress toward task success, reflecting a more outcome-oriented view of debugging. Within the Magnetic-One agent framework, on the datasets derived from GAIA and AssistantBench, DoVer flips 18-28% of failed trials into successes, achieves up to 16% milestone progress, and validates or refutes 30-60% of failure hypotheses. DoVer also performs effectively on a different dataset (GSMPlus) and agent framework (AG2), where it recovers 49% of failed trials. These results highlight intervention as a practical mechanism for improving reliability in agentic systems and open opportunities for more robust, scalable debugging methods for LLM-based multi-agent systems. Project website and code will be available at https://aka.ms/DoVer.
Image-based Treatment Effect Heterogeneity
Randomized controlled trials (RCTs) are considered the gold standard for estimating the average treatment effect (ATE) of interventions. One use of RCTs is to study the causes of global poverty -- a subject explicitly cited in the 2019 Nobel Memorial Prize awarded to Duflo, Banerjee, and Kremer "for their experimental approach to alleviating global poverty." Because the ATE is a population summary, anti-poverty experiments often seek to unpack the effect variation around the ATE by conditioning (CATE) on tabular variables such as age and ethnicity that were measured during the RCT data collection. Although such variables are key to unpacking CATE, using only such variables may fail to capture historical, geographical, or neighborhood-specific contributors to effect variation, as tabular RCT data are often only observed near the time of the experiment. In global poverty research, when the location of the experiment units is approximately known, satellite imagery can provide a window into such factors important for understanding heterogeneity. However, there is no method that specifically enables applied researchers to analyze CATE from images. In this paper, using a deep probabilistic modeling framework, we develop such a method that estimates latent clusters of images by identifying images with similar treatment effects distributions. Our interpretable image CATE model also includes a sensitivity factor that quantifies the importance of image segments contributing to the effect cluster prediction. We compare the proposed methods against alternatives in simulation; also, we show how the model works in an actual RCT, estimating the effects of an anti-poverty intervention in northern Uganda and obtaining a posterior predictive distribution over effects for the rest of the country where no experimental data was collected. We make all models available in open-source software.
Using Degeneracy in the Loss Landscape for Mechanistic Interpretability
Mechanistic Interpretability aims to reverse engineer the algorithms implemented by neural networks by studying their weights and activations. An obstacle to reverse engineering neural networks is that many of the parameters inside a network are not involved in the computation being implemented by the network. These degenerate parameters may obfuscate internal structure. Singular learning theory teaches us that neural network parameterizations are biased towards being more degenerate, and parameterizations with more degeneracy are likely to generalize further. We identify 3 ways that network parameters can be degenerate: linear dependence between activations in a layer; linear dependence between gradients passed back to a layer; ReLUs which fire on the same subset of datapoints. We also present a heuristic argument that modular networks are likely to be more degenerate, and we develop a metric for identifying modules in a network that is based on this argument. We propose that if we can represent a neural network in a way that is invariant to reparameterizations that exploit the degeneracies, then this representation is likely to be more interpretable, and we provide some evidence that such a representation is likely to have sparser interactions. We introduce the Interaction Basis, a tractable technique to obtain a representation that is invariant to degeneracies from linear dependence of activations or Jacobians.
