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Aug 12

Where, What, Why, and Importance: Structured Defect Grounding for Text-to-Image Feedback

Despite generating increasingly photorealistic images, text-to-image (T2I) models still exhibit localized, subtle, and structurally complex failures. Diagnosing these failures requires instance-level feedback that answers where a defect occurs, what type it is, why it is defective, and its importance to overall image quality. While recent dense-feedback methods move beyond scalar supervision, their heatmap-centric representations still formulate diagnosis as pixel-field regression, making it difficult to localize variable-cardinality defects and bind semantic reasons to individual failures. To address this representation bottleneck, we propose Structured Defect Grounding (SDG), which casts T2I diagnosis as structured set prediction by modeling each defect as a (location, type, reason, importance) tuple. To make this formulation trainable and measurable, we introduce SDG-30K, a 30K-image dataset with box-grounded annotations across four modern T2I generators, together with a dedicated evaluation protocol, SDG-Eval. Building on this structured representation, we further present a diagnosis-to-alignment framework in which a Vision-Language Model (VLM) serves as the SDG detector, and BoxFlow-GRPO converts predicted defect sets into box-derived, importance-weighted spatial rewards for diffusion model alignment. Extensive experiments show that our SDG detector outperforms leading proprietary VLMs on structured defect grounding, while SDG-guided rewards consistently improve T2I alignment and support localized image refinement. These results establish SDG as a unified, instance-level interface for diagnosing, evaluating, and enhancing modern generative models.

TusoAI: Agentic Optimization for Scientific Methods

Scientific discovery is often slowed by the manual development of computational tools needed to analyze complex experimental data. Building such tools is costly and time-consuming because scientists must iteratively review literature, test modeling and scientific assumptions against empirical data, and implement these insights into efficient software. Large language models (LLMs) have demonstrated strong capabilities in synthesizing literature, reasoning with empirical data, and generating domain-specific code, offering new opportunities to accelerate computational method development. Existing LLM-based systems either focus on performing scientific analyses using existing computational methods or on developing computational methods or models for general machine learning without effectively integrating the often unstructured knowledge specific to scientific domains. Here, we introduce TusoAI , an agentic AI system that takes a scientific task description with an evaluation function and autonomously develops and optimizes computational methods for the application. TusoAI integrates domain knowledge into a knowledge tree representation and performs iterative, domain-specific optimization and model diagnosis, improving performance over a pool of candidate solutions. We conducted comprehensive benchmark evaluations demonstrating that TusoAI outperforms state-of-the-art expert methods, MLE agents, and scientific AI agents across diverse tasks, such as single-cell RNA-seq data denoising and satellite-based earth monitoring. Applying TusoAI to two key open problems in genetics improved existing computational methods and uncovered novel biology, including 9 new associations between autoimmune diseases and T cell subtypes and 7 previously unreported links between disease variants linked to their target genes. Our code is publicly available at https://github.com/Alistair-Turcan/TusoAI.

  • 4 authors
·
May 15

Matching-Based Few-Shot Semantic Segmentation Models Are Interpretable by Design

Few-Shot Semantic Segmentation (FSS) models achieve strong performance in segmenting novel classes with minimal labeled examples, yet their decision-making processes remain largely opaque. While explainable AI has advanced significantly in standard computer vision tasks, interpretability in FSS remains virtually unexplored despite its critical importance for understanding model behavior and guiding support set selection in data-scarce scenarios. This paper introduces the first dedicated method for interpreting matching-based FSS models by leveraging their inherent structural properties. Our Affinity Explainer approach extracts attribution maps that highlight which pixels in support images contribute most to query segmentation predictions, using matching scores computed between support and query features at multiple feature levels. We extend standard interpretability evaluation metrics to the FSS domain and propose additional metrics to better capture the practical utility of explanations in few-shot scenarios. Comprehensive experiments on FSS benchmark datasets, using different models, demonstrate that our Affinity Explainer significantly outperforms adapted standard attribution methods. Qualitative analysis reveals that our explanations provide structured, coherent attention patterns that align with model architectures and and enable effective model diagnosis. This work establishes the foundation for interpretable FSS research, enabling better model understanding and diagnostic for more reliable few-shot segmentation systems. The source code is publicly available at https://github.com/pasqualedem/AffinityExplainer.

  • 5 authors
·
Nov 22, 2025

How Faithful Is Trajectory-Based Data Attribution? Error Sources, Remedies, and Practical Guidelines

Trajectory-based data attribution methods estimate the influence of training samples on model predictions by unrolling the training trajectory. They are widely used in applications such as data selection, data valuation, and model diagnosis, but there is a lack of comprehensive error analysis of these methods, raising concerns about method faithfulness and hindering reliable deployment. In this work, we provide the first systematic analysis of error sources in trajectory-based data attribution, together with concrete remedies to mitigate them and practical guidelines for downstream use. We organize the total error into three categories, config-level, algorithm-level, and system-level. We make three contributions. First, we identify optimizer mismatch as the dominant config-level error: existing methods derive their attribution under the assumption of SGD, even for models trained with the modern de facto optimizer AdamW. We propose AdamW-influence to fully account for AdamW's optimization dynamics, yielding improvements from 10% to over 300% in Spearman correlation between estimated and ground-truth influence across four settings spanning MLP, CNN, GPT-2, and Llama 3.2-1B. Second, we isolate the remaining algorithm-level error arising from the first-order Taylor approximation, identify the learning rate and trajectory length as factors governing the error magnitude, and derive a closed-form error proxy that can be evaluated along the original trajectory without retraining. Third, we translate these insights into practical guidelines for data selection by unifying offline and online strategies under a K-step look-ahead framework. Under this framework, online selection with a short horizon often matches or exceeds offline, and the optimal horizon can be tuned jointly with the learning rate. Together, these results turn the framework into an actionable selection recipe for practitioners.

  • 7 authors
·
May 11

Eigenspectrum Analysis of Neural Networks without Aspect Ratio Bias

Diagnosing deep neural networks (DNNs) through the eigenspectrum of weight matrices has been an active area of research in recent years. At a high level, eigenspectrum analysis of DNNs involves measuring the heavytailness of the empirical spectral densities (ESD) of weight matrices. It provides insight into how well a model is trained and can guide decisions on assigning better layer-wise training hyperparameters. In this paper, we address a challenge associated with such eigenspectrum methods: the impact of the aspect ratio of weight matrices on estimated heavytailness metrics. We demonstrate that matrices of varying sizes (and aspect ratios) introduce a non-negligible bias in estimating heavytailness metrics, leading to inaccurate model diagnosis and layer-wise hyperparameter assignment. To overcome this challenge, we propose FARMS (Fixed-Aspect-Ratio Matrix Subsampling), a method that normalizes the weight matrices by subsampling submatrices with a fixed aspect ratio. Instead of measuring the heavytailness of the original ESD, we measure the average ESD of these subsampled submatrices. We show that measuring the heavytailness of these submatrices with the fixed aspect ratio can effectively mitigate the aspect ratio bias. We validate our approach across various optimization techniques and application domains that involve eigenspectrum analysis of weights, including image classification in computer vision (CV) models, scientific machine learning (SciML) model training, and large language model (LLM) pruning. Our results show that despite its simplicity, FARMS uniformly improves the accuracy of eigenspectrum analysis while enabling more effective layer-wise hyperparameter assignment in these application domains. In one of the LLM pruning experiments, FARMS reduces the perplexity of the LLaMA-7B model by 17.3% when compared with the state-of-the-art method.

  • 4 authors
·
Jun 6, 2025

CRAFT: Clustering Rubrics to Diagnose Weak LLM Capabilities and Generate Targeted Fine-Tuning Data

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

  • 6 authors
·
Jul 16

Scaling Towards the Information Boundary of Instruction Set: InfinityInstruct-Subject Technical Report

Instruction tuning has become a foundation for unlocking the capabilities of large-scale pretrained models and improving their performance on complex tasks. Thus, the construction of high-quality instruction datasets is crucial for enhancing model performance and generalizability. Although current instruction datasets have reached tens of millions of samples, models finetuned on them may still struggle with complex instruction following and tasks in rare domains. This is primarily due to limited expansion in both ``coverage'' (coverage of task types and knowledge areas) and ``depth'' (instruction complexity) of the instruction set. To address this issue, we propose a systematic instruction data construction framework, which integrates a hierarchical labeling system, an informative seed selection algorithm, an evolutionary data synthesis process, and a model deficiency diagnosis with targeted data generation. These components form an iterative closed-loop to continuously enhance the coverage and depth of instruction data. Based on this framework, we construct InfinityInstruct-Subject, a high-quality dataset containing ~1.5 million instructions. Experiments on multiple foundation models and benchmark tasks demonstrate its effectiveness in improving instruction-following capabilities. Further analyses suggest that InfinityInstruct-Subject shows enlarged coverage and depth compared to comparable synthesized instruction datasets. Our work lays a theoretical and practical foundation for the efficient, continuous evolution of instruction datasets, moving from data quantity expansion to qualitative improvement.

  • 4 authors
·
Jul 9, 2025

FD-LLM: Large Language Model for Fault Diagnosis of Machines

Large language models (LLMs) are effective at capturing complex, valuable conceptual representations from textual data for a wide range of real-world applications. However, in fields like Intelligent Fault Diagnosis (IFD), incorporating additional sensor data-such as vibration signals, temperature readings, and operational metrics-is essential but it is challenging to capture such sensor data information within traditional text corpora. This study introduces a novel IFD approach by effectively adapting LLMs to numerical data inputs for identifying various machine faults from time-series sensor data. We propose FD-LLM, an LLM framework specifically designed for fault diagnosis by formulating the training of the LLM as a multi-class classification problem. We explore two methods for encoding vibration signals: the first method uses a string-based tokenization technique to encode vibration signals into text representations, while the second extracts statistical features from both the time and frequency domains as statistical summaries of each signal. We assess the fault diagnosis capabilities of four open-sourced LLMs based on the FD-LLM framework, and evaluate the models' adaptability and generalizability under various operational conditions and machine components, namely for traditional fault diagnosis, cross-operational conditions, and cross-machine component settings. Our results show that LLMs such as Llama3 and Llama3-instruct demonstrate strong fault detection capabilities and significant adaptability across different operational conditions, outperforming state-of-the-art deep learning (DL) approaches in many cases.

  • 5 authors
·
Dec 2, 2024

OrthoDoc: Multimodal Large Language Model for Assisting Diagnosis in Computed Tomography

Multimodal large language models (MLLMs) have achieved significant success in the general field of image processing. Their emerging task generalization and freeform conversational capabilities can greatly facilitate medical diagnostic assistance, helping patients better understand their conditions and enhancing doctor-patient trust. Computed Tomography (CT) is a non-invasive imaging technique used to capture the internal mechanisms of a patient's condition and is widely utilized. However, in past research, the complex textural features of this imaging data have made accurate interpretation by algorithms challenging, impeding the performance of general LLMs in diagnostic assistance. To address this, we developed OrthoDoc, a MLLM designed for CT diagnostics. OrthoDoc is trained on 120,000 CT images and diagnostic reports and includes a Retrieval-Augmented Generation (RAG) module capable of effectively mitigating model hallucinations. This module is informed by extensive medical literature, textbooks, and explanatory data. Thus, OrthoDoc not only processes complex CT images but also stores, understands, and reasons over medical knowledge and language. In extensive experiments, OrthoDoc outperforms commercial models led by GPT-4, demonstrating superior diagnostic capabilities and accuracy. Specifically, OrthoDoc significantly surpasses existing models in the diagnosis of common orthopedic conditions such as fractures, arthritis, and tumors. Additionally, OrthoDoc exhibits robust generalization and stability when handling rare and complex cases.

  • 2 authors
·
Aug 30, 2024

A Knowledge-enhanced Pathology Vision-language Foundation Model for Cancer Diagnosis

Deep learning has enabled the development of highly robust foundation models for various pathological tasks across diverse diseases and patient cohorts. Among these models, vision-language pre-training, which leverages large-scale paired data to align pathology image and text embedding spaces, and provides a novel zero-shot paradigm for downstream tasks. However, existing models have been primarily data-driven and lack the incorporation of domain-specific knowledge, which limits their performance in cancer diagnosis, especially for rare tumor subtypes. To address this limitation, we establish a Knowledge-enhanced Pathology (KEEP) foundation model that harnesses disease knowledge to facilitate vision-language pre-training. Specifically, we first construct a disease knowledge graph (KG) that covers 11,454 human diseases with 139,143 disease attributes, including synonyms, definitions, and hypernym relations. We then systematically reorganize the millions of publicly available noisy pathology image-text pairs, into 143K well-structured semantic groups linked through the hierarchical relations of the disease KG. To derive more nuanced image and text representations, we propose a novel knowledge-enhanced vision-language pre-training approach that integrates disease knowledge into the alignment within hierarchical semantic groups instead of unstructured image-text pairs. Validated on 18 diverse benchmarks with more than 14,000 whole slide images (WSIs), KEEP achieves state-of-the-art performance in zero-shot cancer diagnostic tasks. Notably, for cancer detection, KEEP demonstrates an average sensitivity of 89.8% at a specificity of 95.0% across 7 cancer types. For cancer subtyping, KEEP achieves a median balanced accuracy of 0.456 in subtyping 30 rare brain cancers, indicating strong generalizability for diagnosing rare tumors.

  • 11 authors
·
Dec 17, 2024

MARCUS: An agentic, multimodal vision-language model for cardiac diagnosis and management

Cardiovascular disease remains the leading cause of global mortality, with progress hindered by human interpretation of complex cardiac tests. Current AI vision-language models are limited to single-modality inputs and are non-interactive. We present MARCUS (Multimodal Autonomous Reasoning and Chat for Ultrasound and Signals), an agentic vision-language system for end-to-end interpretation of electrocardiograms (ECGs), echocardiograms, and cardiac magnetic resonance imaging (CMR) independently and as multimodal input. MARCUS employs a hierarchical agentic architecture comprising modality-specific vision-language expert models, each integrating domain-trained visual encoders with multi-stage language model optimization, coordinated by a multimodal orchestrator. Trained on 13.5 million images (0.25M ECGs, 1.3M echocardiogram images, 12M CMR images) and our novel expert-curated dataset spanning 1.6 million questions, MARCUS achieves state-of-the-art performance surpassing frontier models (GPT-5 Thinking, Gemini 2.5 Pro Deep Think). Across internal (Stanford) and external (UCSF) test cohorts, MARCUS achieves accuracies of 87-91% for ECG, 67-86% for echocardiography, and 85-88% for CMR, outperforming frontier models by 34-45% (P<0.001). On multimodal cases, MARCUS achieved 70% accuracy, nearly triple that of frontier models (22-28%), with 1.7-3.0x higher free-text quality scores. Our agentic architecture also confers resistance to mirage reasoning, whereby vision-language models derive reasoning from unintended textual signals or hallucinated visual content. MARCUS demonstrates that domain-specific visual encoders with an agentic orchestrator enable multimodal cardiac interpretation. We release our models, code, and benchmark open-source.

  • 11 authors
·
Mar 23

Advancing Multimodal Judge Models through a Capability-Oriented Benchmark and MCTS-Driven Data Generation

Using Multimodal Large Language Models (MLLMs) as judges to achieve precise and consistent evaluations has gradually become an emerging paradigm across various domains. Evaluating the capability and reliability of MLLM-as-a-judge systems is therefore essential for ensuring trustworthy assessment. Existing judge benchmarks categorize samples by task types but fail to capture the fundamental judgment capabilities required for reliable evaluation. In this work, we introduce M-JudgeBench, a ten-dimensional capability-oriented benchmark designed to comprehensively assess the judgment abilities of MLLMs. Our benchmark decomposes evaluation into pairwise Chain-of-Thought (CoT) comparison, length bias avoidance, and process error detection tasks, jointly covering ten fine-grained subtasks. This design enables diagnosis of model reliability across reasoning styles, response lengths, and cross-model variations. Systematic evaluation uncovers the systematic weaknesses in existing MLLM-as-a-judge systems. To address this issue, we further propose Judge-MCTS, a data construction framework generating pairwise reasoning trajectories with various correctness and length. Using Judge-MCTS, we construct an MCTS-augmented dataset and train M-Judger, a series of strong judge models. Extensive experiments demonstrate the superiority of M-Judger on existing judge benchmarks as well as M-JudgeBench. Overall, our work establishes a more principled foundation for evaluating MLLM-as-a-judge through M-JudgeBench and Judge-MCTS framework, paving the way for future research on judge model evaluation and capability-driven judge training.

  • 4 authors
·
Feb 27

VIScore: Diagnosing Planning-Relevant Quality in Latent World Models

Regulating the latent space to an isotropic Gaussian distribution provides a stable and information-maximized landscape for world model planning. However, the latent space property and successful planning remain disconnected. We first study this by comparing SIGReg and VISReg, two regularization loss functions with the same distribution target but different properties. Compared with SIGReg, VISReg has more flexibility in controlling the weights of center, scale, and shape regularization, and a larger batch size brings a finer distribution approximation. We find that the former, despite being beneficial in self-supervised learning (SSL), does not help the planning, whereas the latter improves the planning success on out-of-domain (OOD) datasets. This motivates a deep understanding of the factors that correlate with the success rate. Unlike the previous metrics focusing on the encoded latent only, we propose the Veracity-Influence-Sobriety score (VIScore), a metric that quantifies the reachability and capacity of a predictor given the encoded feature, and the hallucination of the searching-based planner. Compared with straightness, physical-state probing, and empowerment, we show that, with the measurement covering encoder, predictor, and planner, VIScore explains the success rate better than the others, as reflected by a strong Spearman correlation. Specifically, VIScore consistently achieves a Spearman correlation over 0.75 on both seen and unseen models and datasets on the cross-task success rate pool. Moreover, VIScore is the only metric that has a calibration error below the constant fit across all testing scenarios, showcasing the importance of these three aspects in planning success. We hope this metric can help future studies on world model design and diagnosis.

  • 3 authors
·
Aug 10

VideoMathQA: Benchmarking Mathematical Reasoning via Multimodal Understanding in Videos

Mathematical reasoning in real-world video settings presents a fundamentally different challenge than in static images or text. It requires interpreting fine-grained visual information, accurately reading handwritten or digital text, and integrating spoken cues, often dispersed non-linearly over time. In such multimodal contexts, success hinges not just on perception, but on selectively identifying and integrating the right contextual details from a rich and noisy stream of content. To this end, we introduce VideoMathQA, a benchmark designed to evaluate whether models can perform such temporally extended cross-modal reasoning on videos. The benchmark spans 10 diverse mathematical domains, covering videos ranging from 10 seconds to over 1 hour. It requires models to interpret structured visual content, understand instructional narratives, and jointly ground concepts across visual, audio, and textual modalities. We employ graduate-level experts to ensure high quality, totaling over 920 man-hours of annotation. To reflect real-world scenarios, questions are designed around three core reasoning challenges: direct problem solving, where answers are grounded in the presented question; conceptual transfer, which requires applying learned methods to new problems; and deep instructional comprehension, involving multi-step reasoning over extended explanations and partially worked-out solutions. Each question includes multi-step reasoning annotations, enabling fine-grained diagnosis of model capabilities. Through this benchmark, we highlight the limitations of existing approaches and establish a systematic evaluation framework for models that must reason, rather than merely perceive, across temporally extended and modality-rich mathematical problem settings. Our benchmark and evaluation code are available at: https://mbzuai-oryx.github.io/VideoMathQA

  • 7 authors
·
Jun 5, 2025 1

3MDBench: Medical Multimodal Multi-agent Dialogue Benchmark

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

  • 6 authors
·
Mar 26, 2025

HiSciBench: A Hierarchical Multi-disciplinary Benchmark for Scientific Intelligence from Reading to Discovery

The rapid advancement of large language models (LLMs) and multimodal foundation models has sparked growing interest in their potential for scientific research. However, scientific intelligence encompasses a broad spectrum of abilities ranging from understanding fundamental knowledge to conducting creative discovery, and existing benchmarks remain fragmented. Most focus on narrow tasks and fail to reflect the hierarchical and multi-disciplinary nature of real scientific inquiry. We introduce HiSciBench, a hierarchical benchmark designed to evaluate foundation models across five levels that mirror the complete scientific workflow: Scientific Literacy (L1), Literature Parsing (L2), Literature-based Question Answering (L3), Literature Review Generation (L4), and Scientific Discovery (L5). HiSciBench contains 8,735 carefully curated instances spanning six major scientific disciplines, including mathematics, physics, chemistry, biology, geography, and astronomy, and supports multimodal inputs including text, equations, figures, and tables, as well as cross-lingual evaluation. Unlike prior benchmarks that assess isolated abilities, HiSciBench provides an integrated, dependency-aware framework that enables detailed diagnosis of model capabilities across different stages of scientific reasoning. Comprehensive evaluations of leading models, including GPT-5, DeepSeek-R1, and several multimodal systems, reveal substantial performance gaps: while models achieve up to 69\% accuracy on basic literacy tasks, performance declines sharply to 25\% on discovery-level challenges. HiSciBench establishes a new standard for evaluating scientific Intelligence and offers actionable insights for developing models that are not only more capable but also more reliable. The benchmark will be publicly released to facilitate future research.

  • 11 authors
·
Dec 28, 2025

MedSPOT: A Workflow-Aware Sequential Grounding Benchmark for Clinical GUI

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

  • 5 authors
·
Mar 20

RAPT: Model-Predictive Out-of-Distribution Detection and Failure Diagnosis for Sim-to-Real Humanoid Deployment

Deploying learned control policies is risky because policies that appear robust in simulation can confidently enter out-of-distribution (OOD) states after Sim-to-Real transfer, causing silent failures and potential hardware damage. Existing anomaly detectors often fail to meet the requirements of high-rate control, extremely low false-positive rates, and interpretable failure feedback. We present RAPT (Recurrent Anomaly Probabilistic Trajectory Model), a lightweight, self-supervised 50\,Hz deployment monitor that learns nominal execution from large-scale simulation and produces calibrated, per-dimension predictive-deviation signals online. RAPT enables OOD detection under strict false-positive constraints while localizing when and where real execution departs from nominal behavior. For post-hoc diagnosis, RAPT combines temporal saliency, joint-kinematic summaries, and LLM-based semantic reasoning to classify likely failure causes in a zero-shot setting. In simulation across four Isaac Lab tasks, RAPT improves TPR by 37% over the strongest baseline at 0.5% episode-level FPR; on hardware, it achieves 89% TPR across 78 trials with fewer false positives than high-frequency-compatible baselines, and reaches 75% semantic failure diagnosis accuracy across 21 categories on a challenging OOD subset. Project website, code, and videos: https://humphreymunn.github.io/RAPT/.

  • 5 authors
·
Jul 20

Adaptive Multiscale Retinal Diagnosis: A Hybrid Trio-Model Approach for Comprehensive Fundus Multi-Disease Detection Leveraging Transfer Learning and Siamese Networks

WHO has declared that more than 2.2 billion people worldwide are suffering from visual disorders, such as media haze, glaucoma, and drusen. At least 1 billion of these cases could have been either prevented or successfully treated, yet they remain unaddressed due to poverty, a lack of specialists, inaccurate ocular fundus diagnoses by ophthalmologists, or the presence of a rare disease. To address this, the research has developed the Hybrid Trio-Network Model Algorithm for accurately diagnosing 12 distinct common and rare eye diseases. This algorithm utilized the RFMiD dataset of 3,200 fundus images and the Binary Relevance Method to detect diseases separately, ensuring expandability and avoiding incorrect correlations. Each detector, incorporating finely tuned hyperparameters to optimize performance, consisted of three feature components: A classical transfer learning CNN model, a two-stage CNN model, and a Siamese Network. The diagnosis was made using features extracted through this Trio-Model with Ensembled Machine Learning algorithms. The proposed model achieved an average accuracy of 97% and an AUC score of 0.96. Compared to past benchmark studies, an increase of over 10% in the F1-score was observed for most diseases. Furthermore, using the Siamese Network, the model successfully made predictions in diseases like optic disc pallor, which past studies failed to predict due to low confidence. This diagnostic tool presents a stable, adaptive, cost-effective, efficient, accessible, and fast solution for globalizing early detection of both common and rare diseases.

  • 1 authors
·
May 27, 2024

Towards Trustable Skin Cancer Diagnosis via Rewriting Model's Decision

Deep neural networks have demonstrated promising performance on image recognition tasks. However, they may heavily rely on confounding factors, using irrelevant artifacts or bias within the dataset as the cue to improve performance. When a model performs decision-making based on these spurious correlations, it can become untrustable and lead to catastrophic outcomes when deployed in the real-world scene. In this paper, we explore and try to solve this problem in the context of skin cancer diagnosis. We introduce a human-in-the-loop framework in the model training process such that users can observe and correct the model's decision logic when confounding behaviors happen. Specifically, our method can automatically discover confounding factors by analyzing the co-occurrence behavior of the samples. It is capable of learning confounding concepts using easily obtained concept exemplars. By mapping the black-box model's feature representation onto an explainable concept space, human users can interpret the concept and intervene via first order-logic instruction. We systematically evaluate our method on our newly crafted, well-controlled skin lesion dataset and several public skin lesion datasets. Experiments show that our method can effectively detect and remove confounding factors from datasets without any prior knowledge about the category distribution and does not require fully annotated concept labels. We also show that our method enables the model to focus on clinical-related concepts, improving the model's performance and trustworthiness during model inference.

  • 8 authors
·
Mar 1, 2023

DentVLM: A Multimodal Vision-Language Model for Comprehensive Dental Diagnosis and Enhanced Clinical Practice

Diagnosing and managing oral diseases necessitate advanced visual interpretation across diverse imaging modalities and integrated information synthesis. While current AI models excel at isolated tasks, they often fall short in addressing the complex, multimodal requirements of comprehensive clinical dental practice. Here we introduce DentVLM, a multimodal vision-language model engineered for expert-level oral disease diagnosis. DentVLM was developed using a comprehensive, large-scale, bilingual dataset of 110,447 images and 2.46 million visual question-answering (VQA) pairs. The model is capable of interpreting seven 2D oral imaging modalities across 36 diagnostic tasks, significantly outperforming leading proprietary and open-source models by 19.6% higher accuracy for oral diseases and 27.9% for malocclusions. In a clinical study involving 25 dentists, evaluating 1,946 patients and encompassing 3,105 QA pairs, DentVLM surpassed the diagnostic performance of 13 junior dentists on 21 of 36 tasks and exceeded that of 12 senior dentists on 12 of 36 tasks. When integrated into a collaborative workflow, DentVLM elevated junior dentists' performance to senior levels and reduced diagnostic time for all practitioners by 15-22%. Furthermore, DentVLM exhibited promising performance across three practical utility scenarios, including home-based dental health management, hospital-based intelligent diagnosis and multi-agent collaborative interaction. These findings establish DentVLM as a robust clinical decision support tool, poised to enhance primary dental care, mitigate provider-patient imbalances, and democratize access to specialized medical expertise within the field of dentistry.

  • 23 authors
·
Sep 26, 2025

CardioForest: An Explainable Ensemble Learning Model for Automatic Wide QRS Complex Tachycardia Diagnosis from ECG

This study aims to develop and evaluate an ensemble machine learning-based framework for the automatic detection of Wide QRS Complex Tachycardia (WCT) from ECG signals, emphasizing diagnostic accuracy and interpretability using Explainable AI. The proposed system integrates ensemble learning techniques, i.e., an optimized Random Forest known as CardioForest, and models like XGBoost and LightGBM. The models were trained and tested on ECG data from the publicly available MIMIC-IV dataset. The testing was carried out with the assistance of accuracy, balanced accuracy, precision, recall, F1 score, ROC-AUC, and error rate (RMSE, MAE) measures. In addition, SHAP (SHapley Additive exPlanations) was used to ascertain model explainability and clinical relevance. The CardioForest model performed best on all metrics, achieving a test accuracy of 94.95%, a balanced accuracy of 88.31%, and high precision and recall metrics. SHAP analysis confirmed the model's ability to rank the most relevant ECG features, such as QRS duration, in accordance with clinical intuitions, thereby fostering trust and usability in clinical practice. The findings recognize CardioForest as an extremely dependable and interpretable WCT detection model. Being able to offer accurate predictions and transparency through explainability makes it a valuable tool to help cardiologists make timely and well-informed diagnoses, especially for high-stakes and emergency scenarios.

  • 7 authors
·
Sep 30, 2025

A Multimodal Benchmark Dataset and Model for Crop Disease Diagnosis

While conversational generative AI has shown considerable potential in enhancing decision-making for agricultural professionals, its exploration has predominantly been anchored in text-based interactions. The evolution of multimodal conversational AI, leveraging vast amounts of image-text data from diverse sources, marks a significant stride forward. However, the application of such advanced vision-language models in the agricultural domain, particularly for crop disease diagnosis, remains underexplored. In this work, we present the crop disease domain multimodal (CDDM) dataset, a pioneering resource designed to advance the field of agricultural research through the application of multimodal learning techniques. The dataset comprises 137,000 images of various crop diseases, accompanied by 1 million question-answer pairs that span a broad spectrum of agricultural knowledge, from disease identification to management practices. By integrating visual and textual data, CDDM facilitates the development of sophisticated question-answering systems capable of providing precise, useful advice to farmers and agricultural professionals. We demonstrate the utility of the dataset by finetuning state-of-the-art multimodal models, showcasing significant improvements in crop disease diagnosis. Specifically, we employed a novel finetuning strategy that utilizes low-rank adaptation (LoRA) to finetune the visual encoder, adapter and language model simultaneously. Our contributions include not only the dataset but also a finetuning strategy and a benchmark to stimulate further research in agricultural technology, aiming to bridge the gap between advanced AI techniques and practical agricultural applications. The dataset is available at https: //github.com/UnicomAI/UnicomBenchmark/tree/main/CDDMBench.

  • 7 authors
·
Mar 10, 2025

PulseMind: A Multi-Modal Medical Model for Real-World Clinical Diagnosis

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

  • 12 authors
·
Jan 12

Towards a Single Unified Model for Effective Detection, Segmentation, and Diagnosis of Eight Major Cancers Using a Large Collection of CT Scans

Human readers or radiologists routinely perform full-body multi-organ multi-disease detection and diagnosis in clinical practice, while most medical AI systems are built to focus on single organs with a narrow list of a few diseases. This might severely limit AI's clinical adoption. A certain number of AI models need to be assembled non-trivially to match the diagnostic process of a human reading a CT scan. In this paper, we construct a Unified Tumor Transformer (UniT) model to detect (tumor existence and location) and diagnose (tumor characteristics) eight major cancer-prevalent organs in CT scans. UniT is a query-based Mask Transformer model with the output of multi-organ and multi-tumor semantic segmentation. We decouple the object queries into organ queries, detection queries and diagnosis queries, and further establish hierarchical relationships among the three groups. This clinically-inspired architecture effectively assists inter- and intra-organ representation learning of tumors and facilitates the resolution of these complex, anatomically related multi-organ cancer image reading tasks. UniT is trained end-to-end using a curated large-scale CT images of 10,042 patients including eight major types of cancers and occurring non-cancer tumors (all are pathology-confirmed with 3D tumor masks annotated by radiologists). On the test set of 631 patients, UniT has demonstrated strong performance under a set of clinically relevant evaluation metrics, substantially outperforming both multi-organ segmentation methods and an assembly of eight single-organ expert models in tumor detection, segmentation, and diagnosis. Such a unified multi-cancer image reading model (UniT) can significantly reduce the number of false positives produced by combined multi-system models. This moves one step closer towards a universal high-performance cancer screening tool.

  • 25 authors
·
Jan 28, 2023

Empowering Agricultural Insights: RiceLeafBD - A Novel Dataset and Optimal Model Selection for Rice Leaf Disease Diagnosis through Transfer Learning Technique

The number of people living in this agricultural nation of ours, which is surrounded by lush greenery, is growing on a daily basis. As a result of this, the level of arable land is decreasing, as well as residential houses and industrial factories. The food crisis is becoming the main threat for us in the upcoming days. Because on the one hand, the population is increasing, and on the other hand, the amount of food crop production is decreasing due to the attack of diseases. Rice is one of the most significant cultivated crops since it provides food for more than half of the world's population. Bangladesh is dependent on rice (Oryza sativa) as a vital crop for its agriculture, but it faces a significant problem as a result of the ongoing decline in rice yield brought on by common diseases. Early disease detection is the main difficulty in rice crop cultivation. In this paper, we proposed our own dataset, which was collected from the Bangladesh field, and also applied deep learning and transfer learning models for the evaluation of the datasets. We elaborately explain our dataset and also give direction for further research work to serve society using this dataset. We applied a light CNN model and pre-trained InceptionNet-V2, EfficientNet-V2, and MobileNet-V2 models, which achieved 91.5% performance for the EfficientNet-V2 model of this work. The results obtained assaulted other models and even exceeded approaches that are considered to be part of the state of the art. It has been demonstrated by this study that it is possible to precisely and effectively identify diseases that affect rice leaves using this unbiased datasets. After analysis of the performance of different models, the proposed datasets are significant for the society for research work to provide solutions for decreasing rice leaf disease.

  • 6 authors
·
Jan 15, 2025

Look Before You Leap: A GUI-Critic-R1 Model for Pre-Operative Error Diagnosis in GUI Automation

In recent years, Multimodal Large Language Models (MLLMs) have been extensively utilized for multimodal reasoning tasks, including Graphical User Interface (GUI) automation. Unlike general offline multimodal tasks, GUI automation is executed in online interactive environments, necessitating step-by-step decision-making based on real-time status of the environment. This task has a lower tolerance for decision-making errors at each step, as any mistakes may cumulatively disrupt the process and potentially lead to irreversible outcomes like deletions or payments. To address these issues, we introduce a pre-operative critic mechanism that provides effective feedback prior to the actual execution, by reasoning about the potential outcome and correctness of actions. Specifically, we propose a Suggestion-aware Gradient Relative Policy Optimization (S-GRPO) strategy to construct our pre-operative critic model GUI-Critic-R1, incorporating a novel suggestion reward to enhance the reliability of the model's feedback. Furthermore, we develop a reasoning-bootstrapping based data collection pipeline to create a GUI-Critic-Train and a GUI-Critic-Test, filling existing gaps in GUI critic data. Static experiments on the GUI-Critic-Test across both mobile and web domains reveal that our GUI-Critic-R1 offers significant advantages in critic accuracy compared to current MLLMs. Dynamic evaluation on GUI automation benchmark further highlights the effectiveness and superiority of our model, as evidenced by improved success rates and operational efficiency.

  • 12 authors
·
Jun 5, 2025 2

ADHDeepNet From Raw EEG to Diagnosis: Improving ADHD Diagnosis through Temporal-Spatial Processing, Adaptive Attention Mechanisms, and Explainability in Raw EEG Signals

Attention Deficit Hyperactivity Disorder (ADHD) is a common brain disorder in children that can persist into adulthood, affecting social, academic, and career life. Early diagnosis is crucial for managing these impacts on patients and the healthcare system but is often labor-intensive and time-consuming. This paper presents a novel method to improve ADHD diagnosis precision and timeliness by leveraging Deep Learning (DL) approaches and electroencephalogram (EEG) signals. We introduce ADHDeepNet, a DL model that utilizes comprehensive temporal-spatial characterization, attention modules, and explainability techniques optimized for EEG signals. ADHDeepNet integrates feature extraction and refinement processes to enhance ADHD diagnosis. The model was trained and validated on a dataset of 121 participants (61 ADHD, 60 Healthy Controls), employing nested cross-validation for robust performance. The proposed two-stage methodology uses a 10-fold cross-subject validation strategy. Initially, each iteration optimizes the model's hyper-parameters with inner 2-fold cross-validation. Then, Additive Gaussian Noise (AGN) with various standard deviations and magnification levels is applied for data augmentation. ADHDeepNet achieved 100% sensitivity and 99.17% accuracy in classifying ADHD/HC subjects. To clarify model explainability and identify key brain regions and frequency bands for ADHD diagnosis, we analyzed the learned weights and activation patterns of the model's primary layers. Additionally, t-distributed Stochastic Neighbor Embedding (t-SNE) visualized high-dimensional data, aiding in interpreting the model's decisions. This study highlights the potential of DL and EEG in enhancing ADHD diagnosis accuracy and efficiency.

  • 4 authors
·
Sep 10, 2025

Sequential Diagnosis with Language Models

Artificial intelligence holds great promise for expanding access to expert medical knowledge and reasoning. However, most evaluations of language models rely on static vignettes and multiple-choice questions that fail to reflect the complexity and nuance of evidence-based medicine in real-world settings. In clinical practice, physicians iteratively formulate and revise diagnostic hypotheses, adapting each subsequent question and test to what they've just learned, and weigh the evolving evidence before committing to a final diagnosis. To emulate this iterative process, we introduce the Sequential Diagnosis Benchmark, which transforms 304 diagnostically challenging New England Journal of Medicine clinicopathological conference (NEJM-CPC) cases into stepwise diagnostic encounters. A physician or AI begins with a short case abstract and must iteratively request additional details from a gatekeeper model that reveals findings only when explicitly queried. Performance is assessed not just by diagnostic accuracy but also by the cost of physician visits and tests performed. We also present the MAI Diagnostic Orchestrator (MAI-DxO), a model-agnostic orchestrator that simulates a panel of physicians, proposes likely differential diagnoses and strategically selects high-value, cost-effective tests. When paired with OpenAI's o3 model, MAI-DxO achieves 80% diagnostic accuracy--four times higher than the 20% average of generalist physicians. MAI-DxO also reduces diagnostic costs by 20% compared to physicians, and 70% compared to off-the-shelf o3. When configured for maximum accuracy, MAI-DxO achieves 85.5% accuracy. These performance gains with MAI-DxO generalize across models from the OpenAI, Gemini, Claude, Grok, DeepSeek, and Llama families. We highlight how AI systems, when guided to think iteratively and act judiciously, can advance diagnostic precision and cost-effectiveness in clinical care.

  • 15 authors
·
Jun 27, 2025

Breast Cancer Diagnosis in Two-View Mammography Using End-to-End Trained EfficientNet-Based Convolutional Network

Some recent studies have described deep convolutional neural networks to diagnose breast cancer in mammograms with similar or even superior performance to that of human experts. One of the best techniques does two transfer learnings: the first uses a model trained on natural images to create a "patch classifier" that categorizes small subimages; the second uses the patch classifier to scan the whole mammogram and create the "single-view whole-image classifier". We propose to make a third transfer learning to obtain a "two-view classifier" to use the two mammographic views: bilateral craniocaudal and mediolateral oblique. We use EfficientNet as the basis of our model. We "end-to-end" train the entire system using CBIS-DDSM dataset. To ensure statistical robustness, we test our system twice using: (a) 5-fold cross validation; and (b) the original training/test division of the dataset. Our technique reached an AUC of 0.9344 using 5-fold cross validation (accuracy, sensitivity and specificity are 85.13% at the equal error rate point of ROC). Using the original dataset division, our technique achieved an AUC of 0.8483, as far as we know the highest reported AUC for this problem, although the subtle differences in the testing conditions of each work do not allow for an accurate comparison. The inference code and model are available at https://github.com/dpetrini/two-views-classifier

  • 6 authors
·
Oct 1, 2021

MegaScale: Scaling Large Language Model Training to More Than 10,000 GPUs

We present the design, implementation and engineering experience in building and deploying MegaScale, a production system for training large language models (LLMs) at the scale of more than 10,000 GPUs. Training LLMs at this scale brings unprecedented challenges to training efficiency and stability. We take a full-stack approach that co-designs the algorithmic and system components across model block and optimizer design, computation and communication overlapping, operator optimization, data pipeline, and network performance tuning. Maintaining high efficiency throughout the training process (i.e., stability) is an important consideration in production given the long extent of LLM training jobs. Many hard stability issues only emerge at large scale, and in-depth observability is the key to address them. We develop a set of diagnosis tools to monitor system components and events deep in the stack, identify root causes, and derive effective techniques to achieve fault tolerance and mitigate stragglers. MegaScale achieves 55.2% Model FLOPs Utilization (MFU) when training a 175B LLM model on 12,288 GPUs, improving the MFU by 1.34x compared to Megatron-LM. We share our operational experience in identifying and fixing failures and stragglers. We hope by articulating the problems and sharing our experience from a systems perspective, this work can inspire future LLM systems research.

  • 32 authors
·
Feb 23, 2024 2

Rare Disease Differential Diagnosis with Large Language Models at Scale: From Abdominal Actinomycosis to Wilson's Disease

Large language models (LLMs) have demonstrated impressive capabilities in disease diagnosis. However, their effectiveness in identifying rarer diseases, which are inherently more challenging to diagnose, remains an open question. Rare disease performance is critical with the increasing use of LLMs in healthcare settings. This is especially true if a primary care physician needs to make a rarer prognosis from only a patient conversation so that they can take the appropriate next step. To that end, several clinical decision support systems are designed to support providers in rare disease identification. Yet their utility is limited due to their lack of knowledge of common disorders and difficulty of use. In this paper, we propose RareScale to combine the knowledge LLMs with expert systems. We use jointly use an expert system and LLM to simulate rare disease chats. This data is used to train a rare disease candidate predictor model. Candidates from this smaller model are then used as additional inputs to black-box LLM to make the final differential diagnosis. Thus, RareScale allows for a balance between rare and common diagnoses. We present results on over 575 rare diseases, beginning with Abdominal Actinomycosis and ending with Wilson's Disease. Our approach significantly improves the baseline performance of black-box LLMs by over 17% in Top-5 accuracy. We also find that our candidate generation performance is high (e.g. 88.8% on gpt-4o generated chats).

  • 3 authors
·
Feb 20, 2025 2

Evidence-Grounded Ensemble Diagnosis of 802.11 Packet Captures: A Multi-Stage Pipeline with Deterministic Reliability Scoring

Diagnosing 802.11 packet captures requires expert protocol knowledge, is slow, inconsistent across engineers, and unscalable. LLM-based approaches sound plausible but fabricate protocol events absent from captures (especially truncated traces), produce uncalibrated confidence scores, and suffer evaluation bias when golden references are co-produced by the model under test. We introduce PROBE (Protocol Reasoning Over evidence-Based Ensembles), a multi-stage pipeline addressing all three failures. It integrates (i) deterministic PCAP-to-text normalization with frame-level verifiability, (ii) multi-run, multi-candidate ensembles with optional cross-model second opinion and progressive obfuscation, (iii) a verdict-aware evidence framework treating absence of failure evidence as contributing evidence, and (iv) a fully deterministic composite reliability score from evidence validity, run-to-run stability, and cross-model agreement without LLM self-assessment. On 87 enterprise Wi-Fi captures (104 capture-reviewer pairs), single-pass LLM analysis raises weighted evidence F1 from 0.871 (expert baseline) to 0.912 but misses critical frames in 35% of cases. Naive ensemble voting drops below baseline (0.842) as majority voting amplifies conservative verdicts: 50% of confirmed failures are misclassified as 'no issue' or 'insufficient evidence.' Adding evidence-grounded reconciliation achieves 0.957 F1, a 96% auto-accept rate, and a worst-case floor above 0.70. LLM self-reported confidence clusters at 0.95 regardless of difficulty (71% report exactly 0.95), confirming it is uninformative. We also introduce a model-agnostic evaluation framework using per-field assertion matching, eliminating circular bias from model-co-produced golden references.

  • 3 authors
·
Jun 4

Tri-Modal Severity Fused Diagnosis across Depression and Post-traumatic Stress Disorders

Depression and post traumatic stress disorder (PTSD) often co-occur with connected symptoms, complicating automated assessment, which is often binary and disorder specific. Clinically useful diagnosis needs severity aware cross disorder estimates and decision support explanations. Our unified tri modal affective severity framework synchronizes and fuses interview text with sentence level transformer embeddings, audio with log Mel statistics with deltas, and facial signals with action units, gaze, head and pose descriptors to output graded severities for diagnosing both depression (PHQ-8; 5 classes) and PTSD (3 classes). Standardized features are fused via a calibrated late fusion classifier, yielding per disorder probabilities and feature-level attributions. This severity aware tri-modal affective fusion approach is demoed on multi disorder concurrent depression and PTSD assessment. Stratified cross validation on DAIC derived corpora outperforms unimodal/ablation baselines. The fused model matches the strongest unimodal baseline on accuracy and weighted F1, while improving decision curve utility and robustness under noisy or missing modalities. For PTSD specifically, fusion reduces regression error and improves class concordance. Errors cluster between adjacent severities; extreme classes are identified reliably. Ablations show text contributes most to depression severity, audio and facial cues are critical for PTSD, whereas attributions align with linguistic and behavioral markers. Our approach offers reproducible evaluation and clinician in the loop support for affective clinical decision making.

  • 3 authors
·
Oct 23, 2025

AgentTether: Graph-Guided Diagnosis and Runtime Intervention for Reliable LLM Agent Operation

Large language model (LLM) agents are increasingly used for multi-step, stateful tool-use tasks, yet production reliability remains limited. Unlike static software repair, agent repair must recover dynamic trajectories whose early decisions can propagate into later errors and external state changes. Existing automatic remedies address only part of this problem: blind retry adds no diagnosis, outcome feedback says whether a run failed but not where or why, and self-reflection often lacks grounded evidence to prevent the same failure from recurring. We present AgentTether, a run-time repair framework that automates post-run diagnosis and guided recovery without modifying the underlying agent or environment. AgentTether abstracts each run into Transition Units, links them through a dependency-aware Critical Transition Graph, and localizes failure-critical subtrajectories by combining an offline normal-behavior model with a run-local graph detector. It then converts the localized cause into behavior-scoped guidance backed by cross-iteration Repair Memory, and can optionally apply guarded run-time intervention to keep the correction active during re-execution. The same design can be deployed as an offline diagnostic-and-guidance tool or as an online repair layer. We evaluate AgentTether on 261 tau-bench tasks across three domains with Qwen3.7-max, and test cross-model transfer on Banking with GPT-5.4. On the hardest Banking domain, AgentTether repairs 59.04% (49/83) of initially failed Qwen3.7-max tasks and 65.12% (56/86) of initially failed GPT-5.4 tasks. Overall, AgentTether improves repair effectiveness while reducing agent turns and end-to-end approach tokens, suggesting a practical reliability layer that can wrap existing agent deployments, reduce wasted re-execution, and improve recovery without retraining the agent.

  • 8 authors
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Jul 6

SQLCheck: Automated Detection and Diagnosis of SQL Anti-Patterns

The emergence of database-as-a-service platforms has made deploying database applications easier than before. Now, developers can quickly create scalable applications. However, designing performant, maintainable, and accurate applications is challenging. Developers may unknowingly introduce anti-patterns in the application's SQL statements. These anti-patterns are design decisions that are intended to solve a problem, but often lead to other problems by violating fundamental design principles. In this paper, we present SQLCheck, a holistic toolchain for automatically finding and fixing anti-patterns in database applications. We introduce techniques for automatically (1) detecting anti-patterns with high precision and recall, (2) ranking the anti-patterns based on their impact on performance, maintainability, and accuracy of applications, and (3) suggesting alternative queries and changes to the database design to fix these anti-patterns. We demonstrate the prevalence of these anti-patterns in a large collection of queries and databases collected from open-source repositories. We introduce an anti-pattern detection algorithm that augments query analysis with data analysis. We present a ranking model for characterizing the impact of frequently occurring anti-patterns. We discuss how SQLCheck suggests fixes for high-impact anti-patterns using rule-based query refactoring techniques. Our experiments demonstrate that SQLCheck enables developers to create more performant, maintainable, and accurate applications.

  • 3 authors
·
Apr 21, 2020

ST-WAM: Semantic-Temporal World Action Model for Robust Manipulation under Visual Distribution Shifts

World Action Models (WAMs) have emerged as a promising paradigm by jointly modeling robot actions and future visual dynamics. However, their reliance on pixel-generative future supervision can entangle action-relevant state transitions with task-irrelevant visual content, limiting robustness under visual distribution shifts. We identify Training-Distribution Hallucination, a recurring phenomenon in which futures conditioned on visually shifted observations hallucinate training-domain content rather than remain faithful to the current scene. A controlled frame-triplet diagnosis further shows that DINOv3 features remain more stable across visual shifts while better preserving task-state distinctions than Wan-VAE latents. Rather than correcting the predicted futures, we propose Semantic-Temporal WAM (ST-WAM) to improve action robustness by using DINOv3 as a shared semantic representation for future prediction and history retrieval while retaining fine-grained VAE dynamics. Its Dual-Space Future Experts (DSFE) jointly predict future VAE latents and DINO features, while Current-Anchored Intent Retrieval (CAIR) retrieves task-relevant evidence from recent DINO history under the current visual-language context. ST-WAM is trained end-to-end without additional embodied pretraining or task-specific annotations, and requires no explicit future generation at inference. It achieves 98.7% on LIBERO and 92.8% on RoboTwin 2.0; more importantly, compared with Fast-WAM, it improves zero-shot LIBERO-Plus performance by 21.3 percentage points and more than doubles real-world success under visual shifts from 25.8% to 61.5%. These results demonstrate that semantic-temporal modeling effectively complements pixel-generative dynamics for robust manipulation.

MentalArena: Self-play Training of Language Models for Diagnosis and Treatment of Mental Health Disorders

Mental health disorders are one of the most serious diseases in the world. Most people with such a disease lack access to adequate care, which highlights the importance of training models for the diagnosis and treatment of mental health disorders. However, in the mental health domain, privacy concerns limit the accessibility of personalized treatment data, making it challenging to build powerful models. In this paper, we introduce MentalArena, a self-play framework to train language models by generating domain-specific personalized data, where we obtain a better model capable of making a personalized diagnosis and treatment (as a therapist) and providing information (as a patient). To accurately model human-like mental health patients, we devise Symptom Encoder, which simulates a real patient from both cognition and behavior perspectives. To address intent bias during patient-therapist interactions, we propose Symptom Decoder to compare diagnosed symptoms with encoded symptoms, and dynamically manage the dialogue between patient and therapist according to the identified deviations. We evaluated MentalArena against 6 benchmarks, including biomedicalQA and mental health tasks, compared to 6 advanced models. Our models, fine-tuned on both GPT-3.5 and Llama-3-8b, significantly outperform their counterparts, including GPT-4o. We hope that our work can inspire future research on personalized care. Code is available in https://github.com/Scarelette/MentalArena/tree/main

  • 7 authors
·
Oct 9, 2024 2

SilVar-Med: A Speech-Driven Visual Language Model for Explainable Abnormality Detection in Medical Imaging

Medical Visual Language Models have shown great potential in various healthcare applications, including medical image captioning and diagnostic assistance. However, most existing models rely on text-based instructions, limiting their usability in real-world clinical environments especially in scenarios such as surgery, text-based interaction is often impractical for physicians. In addition, current medical image analysis models typically lack comprehensive reasoning behind their predictions, which reduces their reliability for clinical decision-making. Given that medical diagnosis errors can have life-changing consequences, there is a critical need for interpretable and rational medical assistance. To address these challenges, we introduce an end-to-end speech-driven medical VLM, SilVar-Med, a multimodal medical image assistant that integrates speech interaction with VLMs, pioneering the task of voice-based communication for medical image analysis. In addition, we focus on the interpretation of the reasoning behind each prediction of medical abnormalities with a proposed reasoning dataset. Through extensive experiments, we demonstrate a proof-of-concept study for reasoning-driven medical image interpretation with end-to-end speech interaction. We believe this work will advance the field of medical AI by fostering more transparent, interactive, and clinically viable diagnostic support systems. Our code and dataset are publicly available at SiVar-Med.

  • 6 authors
·
Apr 14, 2025 2

Meta-information-aware Dual-path Transformer for Differential Diagnosis of Multi-type Pancreatic Lesions in Multi-phase CT

Pancreatic cancer is one of the leading causes of cancer-related death. Accurate detection, segmentation, and differential diagnosis of the full taxonomy of pancreatic lesions, i.e., normal, seven major types of lesions, and other lesions, is critical to aid the clinical decision-making of patient management and treatment. However, existing works focus on segmentation and classification for very specific lesion types (PDAC) or groups. Moreover, none of the previous work considers using lesion prevalence-related non-imaging patient information to assist the differential diagnosis. To this end, we develop a meta-information-aware dual-path transformer and exploit the feasibility of classification and segmentation of the full taxonomy of pancreatic lesions. Specifically, the proposed method consists of a CNN-based segmentation path (S-path) and a transformer-based classification path (C-path). The S-path focuses on initial feature extraction by semantic segmentation using a UNet-based network. The C-path utilizes both the extracted features and meta-information for patient-level classification based on stacks of dual-path transformer blocks that enhance the modeling of global contextual information. A large-scale multi-phase CT dataset of 3,096 patients with pathology-confirmed pancreatic lesion class labels, voxel-wise manual annotations of lesions from radiologists, and patient meta-information, was collected for training and evaluations. Our results show that our method can enable accurate classification and segmentation of the full taxonomy of pancreatic lesions, approaching the accuracy of the radiologist's report and significantly outperforming previous baselines. Results also show that adding the common meta-information, i.e., gender and age, can boost the model's performance, thus demonstrating the importance of meta-information for aiding pancreatic disease diagnosis.

  • 8 authors
·
Mar 1, 2023

Strategy Executability in Mathematical Reasoning: Leveraging Human-Model Differences for Effective Guidance

Example-based guidance is widely used to improve mathematical reasoning at inference time, yet its effectiveness is highly unstable across problems and models-even when the guidance is correct and problem-relevant. We show that this instability arises from a previously underexplored gap between strategy usage-whether a reasoning strategy appears in successful solutions-and strategy executability-whether the strategy remains effective when instantiated as guidance for a target model. Through a controlled analysis of paired human-written and model-generated solutions, we identify a systematic dissociation between usage and executability: human- and model-derived strategies differ in structured, domain-dependent ways, leading to complementary strengths and consistent source-dependent reversals under guidance. Building on this diagnosis, we propose Selective Strategy Retrieval (SSR), a test-time framework that explicitly models executability by selectively retrieving and combining strategies using empirical, multi-route, source-aware signals. Across multiple mathematical reasoning benchmarks, SSR yields reliable and consistent improvements over direct solving, in-context learning, and single-source guidance, improving accuracy by up to +13 points on AIME25 and +5 points on Apex for compact reasoning models. Code and benchmark are publicly available at: https://github.com/lwd17/strategy-execute-pipeline.

  • 6 authors
·
Feb 25

Vista: A Generalizable Driving World Model with High Fidelity and Versatile Controllability

World models can foresee the outcomes of different actions, which is of paramount importance for autonomous driving. Nevertheless, existing driving world models still have limitations in generalization to unseen environments, prediction fidelity of critical details, and action controllability for flexible application. In this paper, we present Vista, a generalizable driving world model with high fidelity and versatile controllability. Based on a systematic diagnosis of existing methods, we introduce several key ingredients to address these limitations. To accurately predict real-world dynamics at high resolution, we propose two novel losses to promote the learning of moving instances and structural information. We also devise an effective latent replacement approach to inject historical frames as priors for coherent long-horizon rollouts. For action controllability, we incorporate a versatile set of controls from high-level intentions (command, goal point) to low-level maneuvers (trajectory, angle, and speed) through an efficient learning strategy. After large-scale training, the capabilities of Vista can seamlessly generalize to different scenarios. Extensive experiments on multiple datasets show that Vista outperforms the most advanced general-purpose video generator in over 70% of comparisons and surpasses the best-performing driving world model by 55% in FID and 27% in FVD. Moreover, for the first time, we utilize the capacity of Vista itself to establish a generalizable reward for real-world action evaluation without accessing the ground truth actions.

  • 8 authors
·
May 27, 2024 1

Language Model Unalignment: Parametric Red-Teaming to Expose Hidden Harms and Biases

Red-teaming has been a widely adopted way to evaluate the harmfulness of Large Language Models (LLMs). It aims to jailbreak a model's safety behavior to make it act as a helpful agent disregarding the harmfulness of the query. Existing methods are primarily based on input text-based red-teaming such as adversarial prompts, low-resource prompts, or contextualized prompts to condition the model in a way to bypass its safe behavior. Bypassing the guardrails uncovers hidden harmful information and biases in the model that are left untreated or newly introduced by its safety training. However, prompt-based attacks fail to provide such a diagnosis owing to their low attack success rate, and applicability to specific models. In this paper, we present a new perspective on LLM safety research i.e., parametric red-teaming through Unalignment. It simply (instruction) tunes the model parameters to break model guardrails that are not deeply rooted in the model's behavior. Unalignment using as few as 100 examples can significantly bypass commonly referred to as CHATGPT, to the point where it responds with an 88% success rate to harmful queries on two safety benchmark datasets. On open-source models such as VICUNA-7B and LLAMA-2-CHAT 7B AND 13B, it shows an attack success rate of more than 91%. On bias evaluations, Unalignment exposes inherent biases in safety-aligned models such as CHATGPT and LLAMA- 2-CHAT where the model's responses are strongly biased and opinionated 64% of the time.

  • 2 authors
·
Oct 22, 2023

SWE-Doctor: Guiding Software Engineering Agents with Runtime Diagnosis from Multi-Faceted Bug Reproduction Tests

Large language model (LLM)-based software engineering agents are increasingly developed to resolve software issues by generating patches from issue reports and code repositories. Bug reproduction tests (BRTs) are an important building block for such agents and have been shown useful for patch validation. However, it remains unclear whether BRTs can also help the more central stage of patch generation. We first conduct a preliminary study and find that directly using advanced BRT generators to guide patch generation is not beneficial: fail-to-fail BRTs can mislead agents, while even fail-to-pass BRTs bring limited or negative gains. Our analysis reveals two reasons: fail-to-pass BRTs may cover only one manifestation of the reported issue, leading to partial patches, whereas fail-to-fail BRTs are unreliable as direct patch-generation targets. Motivated by these insights, we propose SWE-Doctor, a software issue resolution agent that guides patch generation with runtime diagnoses derived from multi-faceted BRT executions. SWE-Doctor first generates multi-faceted BRTs for different behavioral requirements stated in the issue, then executes and debugs these BRTs to construct runtime-grounded diagnosis records, and finally uses the diagnoses together with localization information inferred during BRT generation to guide patch generation and reduce partial patches. We evaluate SWE-Doctor on Python bug-fixing issues from the widely adopted SWE-bench Verified and SWE-bench Pro across five LLM backends. SWE-Doctor consistently outperforms existing agents across all 10 LLM-benchmark combinations, achieving average resolution rates of 75.7% on SWE-bench Verified and 59.4% on SWE-bench Pro. In particular, on the more challenging SWE-bench Pro, SWE-Doctor improves the average resolution rate by 8.0-8.9 percentage points over the baseline agents.

  • 6 authors
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Jun 30

Agri-R1: Agricultural Reasoning for Disease Diagnosis via Automated-Synthesis and Reinforcement Learning

Agricultural disease diagnosis challenges VLMs, as conventional fine-tuning requires extensive labels, lacks interpretability, and generalizes poorly. While reasoning improves model robustness, existing methods rely on costly expert annotations and rarely address the open-ended, diverse nature of agricultural queries. To address these limitations, we propose Agri-R1, a reasoning-enhanced large model for agriculture. Our framework automates high-quality reasoning data generation via vision-language synthesis and LLM-based filtering, using only 19\% of available samples. Training employs Group Relative Policy Optimization (GRPO) with a novel reward function that integrates domain-specific lexicons and fuzzy matching to assess both correctness and linguistic flexibility in open-ended responses. Evaluated on CDDMBench, our resulting 3B-parameter model achieves performance competitive with 7B- to 13B-parameter baselines, showing a +27.9\% relative gain in disease recognition accuracy, +33.3\% in agricultural knowledge QA, and a +26.10-point improvement in cross-domain generalization over standard fine-tuning. These results suggest that automated reasoning synthesis paired with domain-aware reward design may provide a broadly applicable paradigm for RL-based VLM adaptation in data-scarce specialized domains. Our code and data are publicly available at: https://github.com/CPJ-Agricultural/Agri-R1.

  • 9 authors
·
Apr 12

MDD-Thinker: Towards Large Reasoning Models for Major Depressive Disorder Diagnosis

Background Major depressive disorder (MDD) is a leading cause of global disability, yet current diagnostic approaches often rely on subjective assessments and lack the ability to integrate multimodal clinical information. Large language models (LLMs) hold promise for enhancing diagnostic accuracy through advanced reasoning but face challenges in interpretability, hallucination, and reliance on synthetic data. Methods We developed MDD-Thinker, an LLM-based diagnostic framework that integrates supervised fine-tuning (SFT) with reinforcement learning (RL) to strengthen reasoning ability and interpretability. Using the UK Biobank dataset, we generated 40,000 reasoning samples, supplemented with 10,000 samples from publicly available mental health datasets. The model was fine-tuned on these reasoning corpora, and its diagnostic and reasoning performance was evaluated against machine learning, deep learning, and state-of-the-art LLM baselines. Findings MDD-Thinker achieved an accuracy of 0.8268 and F1-score of 0.8081, significantly outperforming traditional baselines such as SVM and MLP, as well as general-purpose LLMs. Incorporating both SFT and RL yielded the greatest improvements, with relative gains of 29.0% in accuracy, 38.1% in F1-score, and 34.8% in AUC. Moreover, the model demonstrated comparable reasoning performance compared to much larger LLMs, while maintaining computational efficiency. Interpretation This study presents the first reasoning-enhanced LLM framework for MDD diagnosis trained on large-scale real-world clinical data. By integrating SFT and RL, MDD-Thinker balances accuracy, interpretability, and efficiency, offering a scalable approach for intelligent psychiatric diagnostics. These findings suggest that reasoning-oriented LLMs can provide clinically reliable support for MDD detection and may inform broader applications in mental health care.

  • 6 authors
·
Sep 28, 2025

Phonological Level wav2vec2-based Mispronunciation Detection and Diagnosis Method

The automatic identification and analysis of pronunciation errors, known as Mispronunciation Detection and Diagnosis (MDD) plays a crucial role in Computer Aided Pronunciation Learning (CAPL) tools such as Second-Language (L2) learning or speech therapy applications. Existing MDD methods relying on analysing phonemes can only detect categorical errors of phonemes that have an adequate amount of training data to be modelled. With the unpredictable nature of the pronunciation errors of non-native or disordered speakers and the scarcity of training datasets, it is unfeasible to model all types of mispronunciations. Moreover, phoneme-level MDD approaches have a limited ability to provide detailed diagnostic information about the error made. In this paper, we propose a low-level MDD approach based on the detection of speech attribute features. Speech attribute features break down phoneme production into elementary components that are directly related to the articulatory system leading to more formative feedback to the learner. We further propose a multi-label variant of the Connectionist Temporal Classification (CTC) approach to jointly model the non-mutually exclusive speech attributes using a single model. The pre-trained wav2vec2 model was employed as a core model for the speech attribute detector. The proposed method was applied to L2 speech corpora collected from English learners from different native languages. The proposed speech attribute MDD method was further compared to the traditional phoneme-level MDD and achieved a significantly lower False Acceptance Rate (FAR), False Rejection Rate (FRR), and Diagnostic Error Rate (DER) over all speech attributes compared to the phoneme-level equivalent.

  • 3 authors
·
Nov 12, 2023

Accuracy of a Vision-Language Model on Challenging Medical Cases

Background: General-purpose large language models that utilize both text and images have not been evaluated on a diverse array of challenging medical cases. Methods: Using 934 cases from the NEJM Image Challenge published between 2005 and 2023, we evaluated the accuracy of the recently released Generative Pre-trained Transformer 4 with Vision model (GPT-4V) compared to human respondents overall and stratified by question difficulty, image type, and skin tone. We further conducted a physician evaluation of GPT-4V on 69 NEJM clinicopathological conferences (CPCs). Analyses were conducted for models utilizing text alone, images alone, and both text and images. Results: GPT-4V achieved an overall accuracy of 61% (95% CI, 58 to 64%) compared to 49% (95% CI, 49 to 50%) for humans. GPT-4V outperformed humans at all levels of difficulty and disagreement, skin tones, and image types; the exception was radiographic images, where performance was equivalent between GPT-4V and human respondents. Longer, more informative captions were associated with improved performance for GPT-4V but similar performance for human respondents. GPT-4V included the correct diagnosis in its differential for 80% (95% CI, 68 to 88%) of CPCs when using text alone, compared to 58% (95% CI, 45 to 70%) of CPCs when using both images and text. Conclusions: GPT-4V outperformed human respondents on challenging medical cases and was able to synthesize information from both images and text, but performance deteriorated when images were added to highly informative text. Overall, our results suggest that multimodal AI models may be useful in medical diagnostic reasoning but that their accuracy may depend heavily on context.

  • 4 authors
·
Nov 9, 2023

Xplainer: From X-Ray Observations to Explainable Zero-Shot Diagnosis

Automated diagnosis prediction from medical images is a valuable resource to support clinical decision-making. However, such systems usually need to be trained on large amounts of annotated data, which often is scarce in the medical domain. Zero-shot methods address this challenge by allowing a flexible adaption to new settings with different clinical findings without relying on labeled data. Further, to integrate automated diagnosis in the clinical workflow, methods should be transparent and explainable, increasing medical professionals' trust and facilitating correctness verification. In this work, we introduce Xplainer, a novel framework for explainable zero-shot diagnosis in the clinical setting. Xplainer adapts the classification-by-description approach of contrastive vision-language models to the multi-label medical diagnosis task. Specifically, instead of directly predicting a diagnosis, we prompt the model to classify the existence of descriptive observations, which a radiologist would look for on an X-Ray scan, and use the descriptor probabilities to estimate the likelihood of a diagnosis. Our model is explainable by design, as the final diagnosis prediction is directly based on the prediction of the underlying descriptors. We evaluate Xplainer on two chest X-ray datasets, CheXpert and ChestX-ray14, and demonstrate its effectiveness in improving the performance and explainability of zero-shot diagnosis. Our results suggest that Xplainer provides a more detailed understanding of the decision-making process and can be a valuable tool for clinical diagnosis.

  • 6 authors
·
Mar 23, 2023

HuatuoGPT, towards Taming Language Model to Be a Doctor

In this paper, we present HuatuoGPT, a large language model (LLM) for medical consultation. The core recipe of HuatuoGPT is to leverage both distilled data from ChatGPT and real-world data from doctors in the supervised fine-tuned stage. The responses of ChatGPT are usually detailed, well-presented and informative while it cannot perform like a doctor in many aspects, e.g. for integrative diagnosis. We argue that real-world data from doctors would be complementary to distilled data in the sense the former could tame a distilled language model to perform like doctors. To better leverage the strengths of both data, we train a reward model to align the language model with the merits that both data bring, following an RLAIF (reinforced learning from AI feedback) fashion. To evaluate and benchmark the models, we propose a comprehensive evaluation scheme (including automatic and manual metrics). Experimental results demonstrate that HuatuoGPT achieves state-of-the-art results in performing medical consultation among open-source LLMs in GPT-4 evaluation, human evaluation, and medical benchmark datasets. It is worth noting that by using additional real-world data and RLAIF, the distilled language model (i.e., HuatuoGPT) outperforms its teacher model ChatGPT in most cases. Our code, data, and models are publicly available at https://github.com/FreedomIntelligence/HuatuoGPT. The online demo is available at https://www.HuatuoGPT.cn/.

  • 13 authors
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May 24, 2023

SkinFlow: Efficient Information Transmission for Open Dermatological Diagnosis via Dynamic Visual Encoding and Staged RL

General-purpose Large Vision-Language Models (LVLMs), despite their massive scale, often falter in dermatology due to "diffuse attention" - the inability to disentangle subtle pathological lesions from background noise. In this paper, we challenge the assumption that parameter scaling is the only path to medical precision. We introduce SkinFlow, a framework that treats diagnosis as an optimization of visual information transmission efficiency. Our approach utilizes a Virtual-Width Dynamic Vision Encoder (DVE) to "unfold" complex pathological manifolds without physical parameter expansion, coupled with a two-stage Reinforcement Learning strategy. This strategy sequentially aligns explicit medical descriptions (Stage I) and reconstructs implicit diagnostic textures (Stage II) within a constrained semantic space. Furthermore, we propose a clinically grounded evaluation protocol that prioritizes diagnostic safety and hierarchical relevance over rigid label matching. Empirical results are compelling: our 7B model establishes a new state-of-the-art on the Fitzpatrick17k benchmark, achieving a +12.06% gain in Top-1 accuracy and a +28.57% boost in Top-6 accuracy over the massive general-purpose models (e.g., Qwen3VL-235B and GPT-5.2). These findings demonstrate that optimizing geometric capacity and information flow yields superior diagnostic reasoning compared to raw parameter scaling.

Automatic Differential Diagnosis using Transformer-Based Multi-Label Sequence Classification

As the field of artificial intelligence progresses, assistive technologies are becoming more widely used across all industries. The healthcare industry is no different, with numerous studies being done to develop assistive tools for healthcare professionals. Automatic diagnostic systems are one such beneficial tool that can assist with a variety of tasks, including collecting patient information, analyzing test results, and diagnosing patients. However, the idea of developing systems that can provide a differential diagnosis has been largely overlooked in most of these research studies. In this study, we propose a transformer-based approach for providing differential diagnoses based on a patient's age, sex, medical history, and symptoms. We use the DDXPlus dataset, which provides differential diagnosis information for patients based on 49 disease types. Firstly, we propose a method to process the tabular patient data from the dataset and engineer them into patient reports to make them suitable for our research. In addition, we introduce two data modification modules to diversify the training data and consequently improve the robustness of the models. We approach the task as a multi-label classification problem and conduct extensive experiments using four transformer models. All the models displayed promising results by achieving over 97% F1 score on the held-out test set. Moreover, we design additional behavioral tests to get a broader understanding of the models. In particular, for one of our test cases, we prepared a custom test set of 100 samples with the assistance of a doctor. The results on the custom set showed that our proposed data modification modules improved the model's generalization capabilities. We hope our findings will provide future researchers with valuable insights and inspire them to develop reliable systems for automatic differential diagnosis.

  • 3 authors
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Aug 28, 2024 1

SANEval: Open-Vocabulary Compositional Benchmarks with Failure-mode Diagnosis

The rapid progress of text-to-image (T2I) models has unlocked unprecedented creative potential, yet their ability to faithfully render complex prompts involving multiple objects, attributes, and spatial relationships remains a significant bottleneck. Progress is hampered by a lack of adequate evaluation methods; current benchmarks are often restricted to closed-set vocabularies, lack fine-grained diagnostic capabilities, and fail to provide the interpretable feedback necessary to diagnose and remedy specific compositional failures. We solve these challenges by introducing SANEval (Spatial, Attribute, and Numeracy Evaluation), a comprehensive benchmark that establishes a scalable new pipeline for open-vocabulary compositional evaluation. SANEval combines a large language model (LLM) for deep prompt understanding with an LLM-enhanced, open-vocabulary object detector to robustly evaluate compositional adherence, unconstrained by a fixed vocabulary. Through extensive experiments on six state-of-the-art T2I models, we demonstrate that SANEval's automated evaluations provide a more faithful proxy for human assessment; our metric achieves a Spearman's rank correlation with statistically different results than those of existing benchmarks across tasks of attribute binding, spatial relations, and numeracy. To facilitate future research in compositional T2I generation and evaluation, we will release the SANEval dataset and our open-source evaluation pipeline.

  • 6 authors
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Jan 30

A Multimodal Vision Foundation Model for Clinical Dermatology

Diagnosing and treating skin diseases require advanced visual skills across domains and the ability to synthesize information from multiple imaging modalities. While current deep learning models excel at specific tasks like skin cancer diagnosis from dermoscopic images, they struggle to meet the complex, multimodal requirements of clinical practice. Here, we introduce PanDerm, a multimodal dermatology foundation model pretrained through self-supervised learning on over 2 million real-world skin disease images from 11 clinical institutions across 4 imaging modalities. We evaluated PanDerm on 28 diverse benchmarks, including skin cancer screening, risk stratification, differential diagnosis of common and rare skin conditions, lesion segmentation, longitudinal monitoring, and metastasis prediction and prognosis. PanDerm achieved state-of-the-art performance across all evaluated tasks, often outperforming existing models when using only 10% of labeled data. We conducted three reader studies to assess PanDerm's potential clinical utility. PanDerm outperformed clinicians by 10.2% in early-stage melanoma detection through longitudinal analysis, improved clinicians' skin cancer diagnostic accuracy by 11% on dermoscopy images, and enhanced non-dermatologist healthcare providers' differential diagnosis by 16.5% across 128 skin conditions on clinical photographs. These results demonstrate PanDerm's potential to improve patient care across diverse clinical scenarios and serve as a model for developing multimodal foundation models in other medical specialties, potentially accelerating the integration of AI support in healthcare. The code can be found at https://github.com/SiyuanYan1/PanDerm.

  • 25 authors
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Oct 19, 2024

A Deep Learning Model for Coronary Artery Segmentation and Quantitative Stenosis Detection in Angiographic Images

Coronary artery disease (CAD) is a leading cause of cardiovascular-related mortality, and accurate stenosis detection is crucial for effective clinical decision-making. Coronary angiography remains the gold standard for diagnosing CAD, but manual analysis of angiograms is prone to errors and subjectivity. This study aims to develop a deep learning-based approach for the automatic segmentation of coronary arteries from angiographic images and the quantitative detection of stenosis, thereby improving the accuracy and efficiency of CAD diagnosis. We propose a novel deep learning-based method for the automatic segmentation of coronary arteries in angiographic images, coupled with a dynamic cohort method for stenosis detection. The segmentation model combines the MedSAM and VM-UNet architectures to achieve high-performance results. After segmentation, the vascular centerline is extracted, vessel diameter is computed, and the degree of stenosis is measured with high precision, enabling accurate identification of arterial stenosis. On the mixed dataset (including the ARCADE, DCA1, and GH datasets), the model achieved an average IoU of 0.6308, with sensitivity and specificity of 0.9772 and 0.9903, respectively. On the ARCADE dataset, the average IoU was 0.6303, with sensitivity of 0.9832 and specificity of 0.9933. Additionally, the stenosis detection algorithm achieved a true positive rate (TPR) of 0.5867 and a positive predictive value (PPV) of 0.5911, demonstrating the effectiveness of our model in analyzing coronary angiography images. SAM-VMNet offers a promising tool for the automated segmentation and detection of coronary artery stenosis. The model's high accuracy and robustness provide significant clinical value for the early diagnosis and treatment planning of CAD. The code and examples are available at https://github.com/qimingfan10/SAM-VMNet.

  • 6 authors
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Jun 1, 2024

A Pressure Ulcer Care System For Remote Medical Assistance: Residual U-Net with an Attention Model Based for Wound Area Segmentation

Increasing numbers of patients with disabilities or elderly people with mobility issues often suffer from a pressure ulcer. The affected areas need regular checks, but they have a difficulty in accessing a hospital. Some remote diagnosis systems are being used for them, but there are limitations in checking a patient's status regularly. In this paper, we present a remote medical assistant that can help pressure ulcer management with image processing techniques. The proposed system includes a mobile application with a deep learning model for wound segmentation and analysis. As there are not enough data to train the deep learning model, we make use of a pretrained model from a relevant domain and data augmentation that is appropriate for this task. First of all, an image preprocessing method using bilinear interpolation is used to resize images and normalize the images. Second, for data augmentation, we use rotation, reflection, and a watershed algorithm. Third, we use a pretrained deep learning model generated from skin wound images similar to pressure ulcer images. Finally, we added an attention module that can provide hints on the pressure ulcer image features. The resulting model provides an accuracy of 99.0%, an intersection over union (IoU) of 99.99%, and a dice similarity coefficient (DSC) of 93.4% for pressure ulcer segmentation, which is better than existing results.

  • 3 authors
·
Jan 23, 2021

AOI: Turning Failed Trajectories into Training Signals for Autonomous Cloud Diagnosis

Large language model (LLM) agents offer a promising data-driven approach to automating Site Reliability Engineering (SRE), yet their enterprise deployment is constrained by three challenges: restricted access to proprietary data, unsafe action execution under permission-governed environments, and the inability of closed systems to improve from failures. We present AOI (Autonomous Operations Intelligence), a trainable multi-agent framework formulating automated operations as a structured trajectory learning problem under security constraints. Our approach integrates three key components. First, a trainable diagnostic system applies Group Relative Policy Optimization (GRPO) to distill expert-level knowledge into locally deployed open-source models, enabling preference-based learning without exposing sensitive data. Second, a read-write separated execution architecture decomposes operational trajectories into observation, reasoning, and action phases, allowing safe learning while preventing unauthorized state mutation. Third, a Failure Trajectory Closed-Loop Evolver mines unsuccessful trajectories and converts them into corrective supervision signals, enabling continual data augmentation. Evaluated on the AIOpsLab benchmark, our contributions yield cumulative gains. (1) The AOI runtime alone achieves 66.3% best@5 success on all 86 tasks, outperforming the prior state-of-the-art (41.9%) by 24.4 points. (2) Adding Observer GRPO training, a locally deployed 14B model reaches 42.9% avg@1 on 63 held-out tasks with unseen fault types, surpassing Claude Sonnet 4.5. (3) The Evolver converts 37 failed trajectories into diagnostic guidance, improving end-to-end avg@5 by 4.8 points while reducing variance by 35%.

  • 14 authors
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Mar 16

OrthoDiffusion: A Generalizable Multi-Task Diffusion Foundation Model for Musculoskeletal MRI Interpretation

Musculoskeletal disorders represent a significant global health burden and are a leading cause of disability worldwide. While MRI is essential for accurate diagnosis, its interpretation remains exceptionally challenging. Radiologists must identify multiple potential abnormalities within complex anatomical structures across different imaging planes, a process that requires significant expertise and is prone to variability. We developed OrthoDiffusion, a unified diffusion-based foundation model designed for multi-task musculoskeletal MRI interpretation. The framework utilizes three orientation-specific 3D diffusion models, pre-trained in a self-supervised manner on 15,948 unlabeled knee MRI scans, to learn robust anatomical features from sagittal, coronal, and axial views. These view-specific representations are integrated to support diverse clinical tasks, including anatomical segmentation and multi-label diagnosis. Our evaluation demonstrates that OrthoDiffusion achieves excellent performance in the segmentation of 11 knee structures and the detection of 8 knee abnormalities. The model exhibited remarkable robustness across different clinical centers and MRI field strengths, consistently outperforming traditional supervised models. Notably, in settings where labeled data was scarce, OrthoDiffusion maintained high diagnostic precision using only 10\% of training labels. Furthermore, the anatomical representations learned from knee imaging proved highly transferable to other joints, achieving strong diagnostic performance across 11 diseases of the ankle and shoulder. These findings suggest that diffusion-based foundation models can serve as a unified platform for multi-disease diagnosis and anatomical segmentation, potentially improving the efficiency and accuracy of musculoskeletal MRI interpretation in real-world clinical workflows.

  • 11 authors
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Feb 23

GAITGen: Disentangled Motion-Pathology Impaired Gait Generative Model -- Bringing Motion Generation to the Clinical Domain

Gait analysis is crucial for the diagnosis and monitoring of movement disorders like Parkinson's Disease. While computer vision models have shown potential for objectively evaluating parkinsonian gait, their effectiveness is limited by scarce clinical datasets and the challenge of collecting large and well-labelled data, impacting model accuracy and risk of bias. To address these gaps, we propose GAITGen, a novel framework that generates realistic gait sequences conditioned on specified pathology severity levels. GAITGen employs a Conditional Residual Vector Quantized Variational Autoencoder to learn disentangled representations of motion dynamics and pathology-specific factors, coupled with Mask and Residual Transformers for conditioned sequence generation. GAITGen generates realistic, diverse gait sequences across severity levels, enriching datasets and enabling large-scale model training in parkinsonian gait analysis. Experiments on our new PD-GaM (real) dataset demonstrate that GAITGen outperforms adapted state-of-the-art models in both reconstruction fidelity and generation quality, accurately capturing critical pathology-specific gait features. A clinical user study confirms the realism and clinical relevance of our generated sequences. Moreover, incorporating GAITGen-generated data into downstream tasks improves parkinsonian gait severity estimation, highlighting its potential for advancing clinical gait analysis.

  • 9 authors
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Mar 28, 2025

Toward Non-Invasive Diagnosis of Bankart Lesions with Deep Learning

Bankart lesions, or anterior-inferior glenoid labral tears, are diagnostically challenging on standard MRIs due to their subtle imaging features-often necessitating invasive MRI arthrograms (MRAs). This study develops deep learning (DL) models to detect Bankart lesions on both standard MRIs and MRAs, aiming to improve diagnostic accuracy and reduce reliance on MRAs. We curated a dataset of 586 shoulder MRIs (335 standard, 251 MRAs) from 558 patients who underwent arthroscopy. Ground truth labels were derived from intraoperative findings, the gold standard for Bankart lesion diagnosis. Separate DL models for MRAs and standard MRIs were trained using the Swin Transformer architecture, pre-trained on a public knee MRI dataset. Predictions from sagittal, axial, and coronal views were ensembled to optimize performance. The models were evaluated on a 20% hold-out test set (117 MRIs: 46 MRAs, 71 standard MRIs). Bankart lesions were identified in 31.9% of MRAs and 8.6% of standard MRIs. The models achieved AUCs of 0.87 (86% accuracy, 83% sensitivity, 86% specificity) and 0.90 (85% accuracy, 82% sensitivity, 86% specificity) on standard MRIs and MRAs, respectively. These results match or surpass radiologist performance on our dataset and reported literature metrics. Notably, our model's performance on non-invasive standard MRIs matched or surpassed the radiologists interpreting MRAs. This study demonstrates the feasibility of using DL to address the diagnostic challenges posed by subtle pathologies like Bankart lesions. Our models demonstrate potential to improve diagnostic confidence, reduce reliance on invasive imaging, and enhance accessibility to care.

  • 7 authors
·
Dec 9, 2024

Accurate Leukocyte Detection Based on Deformable-DETR and Multi-Level Feature Fusion for Aiding Diagnosis of Blood Diseases

In standard hospital blood tests, the traditional process requires doctors to manually isolate leukocytes from microscopic images of patients' blood using microscopes. These isolated leukocytes are then categorized via automatic leukocyte classifiers to determine the proportion and volume of different types of leukocytes present in the blood samples, aiding disease diagnosis. This methodology is not only time-consuming and labor-intensive, but it also has a high propensity for errors due to factors such as image quality and environmental conditions, which could potentially lead to incorrect subsequent classifications and misdiagnosis. To address these issues, this paper proposes an innovative method of leukocyte detection: the Multi-level Feature Fusion and Deformable Self-attention DETR (MFDS-DETR). To tackle the issue of leukocyte scale disparity, we designed the High-level Screening-feature Fusion Pyramid (HS-FPN), enabling multi-level fusion. This model uses high-level features as weights to filter low-level feature information via a channel attention module and then merges the screened information with the high-level features, thus enhancing the model's feature expression capability. Further, we address the issue of leukocyte feature scarcity by incorporating a multi-scale deformable self-attention module in the encoder and using the self-attention and cross-deformable attention mechanisms in the decoder, which aids in the extraction of the global features of the leukocyte feature maps. The effectiveness, superiority, and generalizability of the proposed MFDS-DETR method are confirmed through comparisons with other cutting-edge leukocyte detection models using the private WBCDD, public LISC and BCCD datasets. Our source code and private WBCCD dataset are available at https://github.com/JustlfC03/MFDS-DETR.

  • 11 authors
·
Jan 1, 2024

An Agentic System for Rare Disease Diagnosis with Traceable Reasoning

Rare diseases collectively affect over 300 million individuals worldwide, yet timely and accurate diagnosis remains a pervasive challenge. This is largely due to their clinical heterogeneity, low individual prevalence, and the limited familiarity most clinicians have with rare conditions. Here, we introduce DeepRare, the first rare disease diagnosis agentic system powered by a large language model (LLM), capable of processing heterogeneous clinical inputs. The system generates ranked diagnostic hypotheses for rare diseases, each accompanied by a transparent chain of reasoning that links intermediate analytic steps to verifiable medical evidence. DeepRare comprises three key components: a central host with a long-term memory module; specialized agent servers responsible for domain-specific analytical tasks integrating over 40 specialized tools and web-scale, up-to-date medical knowledge sources, ensuring access to the most current clinical information. This modular and scalable design enables complex diagnostic reasoning while maintaining traceability and adaptability. We evaluate DeepRare on eight datasets. The system demonstrates exceptional diagnostic performance among 2,919 diseases, achieving 100% accuracy for 1013 diseases. In HPO-based evaluations, DeepRare significantly outperforms other 15 methods, like traditional bioinformatics diagnostic tools, LLMs, and other agentic systems, achieving an average Recall@1 score of 57.18% and surpassing the second-best method (Reasoning LLM) by a substantial margin of 23.79 percentage points. For multi-modal input scenarios, DeepRare achieves 70.60% at Recall@1 compared to Exomiser's 53.20% in 109 cases. Manual verification of reasoning chains by clinical experts achieves 95.40% agreements. Furthermore, the DeepRare system has been implemented as a user-friendly web application http://raredx.cn/doctor.

  • 12 authors
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Jun 25, 2025 1

EchoVLM: Dynamic Mixture-of-Experts Vision-Language Model for Universal Ultrasound Intelligence

Ultrasound imaging has become the preferred imaging modality for early cancer screening due to its advantages of non-ionizing radiation, low cost, and real-time imaging capabilities. However, conventional ultrasound diagnosis heavily relies on physician expertise, presenting challenges of high subjectivity and low diagnostic efficiency. Vision-language models (VLMs) offer promising solutions for this issue, but existing general-purpose models demonstrate limited knowledge in ultrasound medical tasks, with poor generalization in multi-organ lesion recognition and low efficiency across multi-task diagnostics. To address these limitations, we propose EchoVLM, a vision-language model specifically designed for ultrasound medical imaging. The model employs a Mixture of Experts (MoE) architecture trained on data spanning seven anatomical regions. This design enables the model to perform multiple tasks, including ultrasound report generation, diagnosis and visual question-answering (VQA). The experimental results demonstrated that EchoVLM achieved significant improvements of 10.15 and 4.77 points in BLEU-1 scores and ROUGE-1 scores respectively compared to Qwen2-VL on the ultrasound report generation task. These findings suggest that EchoVLM has substantial potential to enhance diagnostic accuracy in ultrasound imaging, thereby providing a viable technical solution for future clinical applications. Source code and model weights are available at https://github.com/Asunatan/EchoVLM.

  • 5 authors
·
Sep 18, 2025 2

A Data-Efficient Pan-Tumor Foundation Model for Oncology CT Interpretation

Artificial intelligence-assisted imaging analysis has made substantial strides in tumor diagnosis and management. Here we present PASTA, a pan-tumor CT foundation model that achieves state-of-the-art performance on 45 of 46 representative oncology tasks -- including lesion segmentation, tumor detection in plain CT, tumor staging, survival prediction, structured report generation, and cross-modality transfer learning, significantly outperforming the second-best models on 35 tasks. This remarkable advancement is driven by our development of PASTA-Gen, an innovative synthetic tumor generation framework that produces a comprehensive dataset of 30,000 CT scans with pixel-level annotated lesions and paired structured reports, encompassing malignancies across ten organs and five benign lesion types. By leveraging this rich, high-quality synthetic data, we overcome a longstanding bottleneck in the development of CT foundation models -- specifically, the scarcity of publicly available, high-quality annotated datasets due to privacy constraints and the substantial labor required for scaling precise data annotation. Encouragingly, PASTA demonstrates exceptional data efficiency with promising practical value, markedly improving performance on various tasks with only a small amount of real-world data. The open release of both the synthetic dataset and PASTA foundation model effectively addresses the challenge of data scarcity, thereby advancing oncological research and clinical translation.

  • 16 authors
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Feb 10, 2025

VisionUnite: A Vision-Language Foundation Model for Ophthalmology Enhanced with Clinical Knowledge

The need for improved diagnostic methods in ophthalmology is acute, especially in the underdeveloped regions with limited access to specialists and advanced equipment. Therefore, we introduce VisionUnite, a novel vision-language foundation model for ophthalmology enhanced with clinical knowledge. VisionUnite has been pretrained on an extensive dataset comprising 1.24 million image-text pairs, and further refined using our proposed MMFundus dataset, which includes 296,379 high-quality fundus image-text pairs and 889,137 simulated doctor-patient dialogue instances. Our experiments indicate that VisionUnite outperforms existing generative foundation models such as GPT-4V and Gemini Pro. It also demonstrates diagnostic capabilities comparable to junior ophthalmologists. VisionUnite performs well in various clinical scenarios including open-ended multi-disease diagnosis, clinical explanation, and patient interaction, making it a highly versatile tool for initial ophthalmic disease screening. VisionUnite can also serve as an educational aid for junior ophthalmologists, accelerating their acquisition of knowledge regarding both common and underrepresented ophthalmic conditions. VisionUnite represents a significant advancement in ophthalmology, with broad implications for diagnostics, medical education, and understanding of disease mechanisms. The source code is at https://github.com/HUANGLIZI/VisionUnite.

  • 8 authors
·
Aug 5, 2024

DMCVR: Morphology-Guided Diffusion Model for 3D Cardiac Volume Reconstruction

Accurate 3D cardiac reconstruction from cine magnetic resonance imaging (cMRI) is crucial for improved cardiovascular disease diagnosis and understanding of the heart's motion. However, current cardiac MRI-based reconstruction technology used in clinical settings is 2D with limited through-plane resolution, resulting in low-quality reconstructed cardiac volumes. To better reconstruct 3D cardiac volumes from sparse 2D image stacks, we propose a morphology-guided diffusion model for 3D cardiac volume reconstruction, DMCVR, that synthesizes high-resolution 2D images and corresponding 3D reconstructed volumes. Our method outperforms previous approaches by conditioning the cardiac morphology on the generative model, eliminating the time-consuming iterative optimization process of the latent code, and improving generation quality. The learned latent spaces provide global semantics, local cardiac morphology and details of each 2D cMRI slice with highly interpretable value to reconstruct 3D cardiac shape. Our experiments show that DMCVR is highly effective in several aspects, such as 2D generation and 3D reconstruction performance. With DMCVR, we can produce high-resolution 3D cardiac MRI reconstructions, surpassing current techniques. Our proposed framework has great potential for improving the accuracy of cardiac disease diagnosis and treatment planning. Code can be accessed at https://github.com/hexiaoxiao-cs/DMCVR.

  • 7 authors
·
Aug 17, 2023

MV-MLM: Bridging Multi-View Mammography and Language for Breast Cancer Diagnosis and Risk Prediction

Large annotated datasets are essential for training robust Computer-Aided Diagnosis (CAD) models for breast cancer detection or risk prediction. However, acquiring such datasets with fine-detailed annotation is both costly and time-consuming. Vision-Language Models (VLMs), such as CLIP, which are pre-trained on large image-text pairs, offer a promising solution by enhancing robustness and data efficiency in medical imaging tasks. This paper introduces a novel Multi-View Mammography and Language Model for breast cancer classification and risk prediction, trained on a dataset of paired mammogram images and synthetic radiology reports. Our MV-MLM leverages multi-view supervision to learn rich representations from extensive radiology data by employing cross-modal self-supervision across image-text pairs. This includes multiple views and the corresponding pseudo-radiology reports. We propose a novel joint visual-textual learning strategy to enhance generalization and accuracy performance over different data types and tasks to distinguish breast tissues or cancer characteristics(calcification, mass) and utilize these patterns to understand mammography images and predict cancer risk. We evaluated our method on both private and publicly available datasets, demonstrating that the proposed model achieves state-of-the-art performance in three classification tasks: (1) malignancy classification, (2) subtype classification, and (3) image-based cancer risk prediction. Furthermore, the model exhibits strong data efficiency, outperforming existing fully supervised or VLM baselines while trained on synthetic text reports and without the need for actual radiology reports.

  • 4 authors
·
Oct 30, 2025

RAD: Towards Trustworthy Retrieval-Augmented Multi-modal Clinical Diagnosis

Clinical diagnosis is a highly specialized discipline requiring both domain expertise and strict adherence to rigorous guidelines. While current AI-driven medical research predominantly focuses on knowledge graphs or natural text pretraining paradigms to incorporate medical knowledge, these approaches primarily rely on implicitly encoded knowledge within model parameters, neglecting task-specific knowledge required by diverse downstream tasks. To address this limitation, we propose Retrieval-Augmented Diagnosis (RAD), a novel framework that explicitly injects external knowledge into multimodal models directly on downstream tasks. Specifically, RAD operates through three key mechanisms: retrieval and refinement of disease-centered knowledge from multiple medical sources, a guideline-enhanced contrastive loss that constrains the latent distance between multi-modal features and guideline knowledge, and the dual transformer decoder that employs guidelines as queries to steer cross-modal fusion, aligning the models with clinical diagnostic workflows from guideline acquisition to feature extraction and decision-making. Moreover, recognizing the lack of quantitative evaluation of interpretability for multimodal diagnostic models, we introduce a set of criteria to assess the interpretability from both image and text perspectives. Extensive evaluations across four datasets with different anatomies demonstrate RAD's generalizability, achieving state-of-the-art performance. Furthermore, RAD enables the model to concentrate more precisely on abnormal regions and critical indicators, ensuring evidence-based, trustworthy diagnosis. Our code is available at https://github.com/tdlhl/RAD.

Fudan-University Fudan University
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Sep 24, 2025

Refine Medical Diagnosis Using Generation Augmented Retrieval and Clinical Practice Guidelines

Current medical language models, adapted from large language models (LLMs), typically predict ICD code-based diagnosis from electronic health records (EHRs) because these labels are readily available. However, ICD codes do not capture the nuanced, context-rich reasoning clinicians use for diagnosis. Clinicians synthesize diverse patient data and reference clinical practice guidelines (CPGs) to make evidence-based decisions. This misalignment limits the clinical utility of existing models. We introduce GARMLE-G, a Generation-Augmented Retrieval framework that grounds medical language model outputs in authoritative CPGs. Unlike conventional Retrieval-Augmented Generation based approaches, GARMLE-G enables hallucination-free outputs by directly retrieving authoritative guideline content without relying on model-generated text. It (1) integrates LLM predictions with EHR data to create semantically rich queries, (2) retrieves relevant CPG knowledge snippets via embedding similarity, and (3) fuses guideline content with model output to generate clinically aligned recommendations. A prototype system for hypertension diagnosis was developed and evaluated on multiple metrics, demonstrating superior retrieval precision, semantic relevance, and clinical guideline adherence compared to RAG-based baselines, while maintaining a lightweight architecture suitable for localized healthcare deployment. This work provides a scalable, low-cost, and hallucination-free method for grounding medical language models in evidence-based clinical practice, with strong potential for broader clinical deployment.

  • 8 authors
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Jun 22, 2025

GBT-SAM: Adapting a Foundational Deep Learning Model for Generalizable Brain Tumor Segmentation via Efficient Integration of Multi-Parametric MRI Data

Gliomas are aggressive brain tumors that require accurate imaging-based diagnosis, with segmentation playing a critical role in evaluating morphology and treatment decisions. Manual delineation of gliomas is time-consuming and prone to variability, motivating the use of deep learning to improve consistency and alleviate clinical workload. However, existing methods often fail to fully exploit the information available in multi-parametric MRI (mp-MRI), particularly inter-slice contextual features, and typically require considerable computational resources while lacking robustness across tumor type variations. We present GBT-SAM, a parameter-efficient deep learning framework that adapts the Segment Anything Model (SAM), a large-scale vision model, to volumetric mp-MRI data. GBT-SAM reduces input complexity by selecting fewer than 2.6\% of slices per scan while incorporating all four MRI modalities, preserving essential tumor-related information with minimal cost. Furthermore, our model is trained by a two-step fine-tuning strategy that incorporates a depth-aware module to capture inter-slice correlations and lightweight adaptation layers, resulting in just 6.5M trainable parameters, which is the lowest among SAM-based approaches. GBT-SAM achieves a Dice Score of 93.54 on the BraTS Adult Glioma dataset and demonstrates robust performance on Meningioma, Pediatric Glioma, and Sub-Saharan Glioma datasets. These results highlight GBT-SAM's potential as a computationally efficient and domain-robust framework for brain tumor segmentation using mp-MRI. Our code and models are available at https://github.com/vpulab/med-sam-brain .

  • 5 authors
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Mar 6, 2025