Daily Papers

To examine whether collector-generated terminal labels on the pump.fun platform can be interpreted as platform-side graduation outcomes, and whether a pre-registered logistic association model generalises across a subsequent temporal holdout of the same cohort. A frozen primary cohort of 749,816 unique mints recorded by a V3 off-chain collector between 12 May 2026 and 10 June 2026 is analysed. The design combines a source-code and reconstructed-state measurement audit of the collector's terminal-classification mechanism with a pre-registered locked logistic association model fitted on a 15-day development cohort and evaluated on a subsequent 14-day validation cohort under the pre-registered stability-gate framework. Calendar-day cluster-robust covariance and day-block bootstrap procedures assess uncertainty. Development discrimination is high (AUROC 0.8594), but the model does not generalise to the held-out validation cohort (AUROC 0.4642; 500 of 500 successful bootstrap replicates; 95% percentile interval [0.4112, 0.5196] containing 0.5000). Validation calibration deteriorates substantially (slope 0.013, intercept +2.816); the market-cap functional form is not stable across pre-registered specifications; and of nine automated evaluations, two pass, six fail, and one is not evaluable. The collector's TIMEOUT label does not establish platform-side non-graduation. The paper treats outcome ascertainment as a first-order measurement problem rather than assuming that an off-chain collector's terminal classification measures the platform-side event. It pairs this audit with a pre-registered held-out temporal-generalisation test and reports the resulting negative finding as registered, alongside a fully reproducible correction history.

Reality may establish that an outcome occurred without identifying which evolving procedure produced it or why. This distinction matters in production ML systems whose code, configuration, and artifacts change while external feedback accumulates. We examine it in a human-directed, agent-engineered quantitative trading system, using oracle to mean an external source of realized outcomes rather than a complete correctness specification. Across one year, the account gained and outperformed a broad market index, while annual alpha was not statistically distinguishable from zero under the main retrospective specification. Retrospectively selected subperiods include adverse relative performance and conditional candidate-level weakness under declared approximate references. Engineering records document changes during the episode, and complete recommendation-to-runtime binding is unavailable. The archive does not establish a common frozen instance or a unique cause. The case motivates an outcome--diagnosis gap: outcome evidence, evaluated-object identity, and causal explanation support distinct claims. We distinguish frozen instances, pre-specified adaptive procedures, and ad-hoc development; organize archive-relative claim identifiability and an evidence hierarchy; and propose a prospective production-binding protocol. An illustrative compatible-history example shows how factual binding can resolve a recommendation's referent without supplying its counterfactual effect. The protocol is proposed rather than prospectively validated. External feedback constrains outcome claims, while provenance and additional identification structure determine the resolution of diagnosis.

Background and Objective: Clinicians expect recurrence risk to climb with cancer severity. In a UK multicentre trial, an unconstrained XGBoost model learnt that higher tumour stage and carcinoma in situ predicted lower recurrence risk, and discrimination, calibration, and SHAP were all blind to it. We developed a counterfactual testing framework to detect this inversion and a monotonic-constraint framework to remove it without hurting performance. Methods: BOXIT enrolled 472 patients with protocol-mandated cystoscopy across 51 UK sites (2007-2012); 435 had at least two years' follow-up (153 recurrences, 35.2%). We developed a counterfactual direction test and a monotonic-constraint correction, with constraint directions drawn from the EORTC and EAU risk systems, and evaluated both against unconstrained XGBoost and logistic regression on 18 predictors (seven directed) over 50 cross-validation folds. The test worsened each patient on one directed feature at a time to check whether risk fell; SHAP direction and calibration were also assessed. Key Findings and Limitations: Tumour stage and carcinoma in situ were associated with lower recurrence, opposite to medical intuition; the unconstrained model reversed carcinoma in situ counterfactuals in 90.2% of cases and stage in 74.3%. Discrimination (ΔAUC 0.005, p=0.47), calibration, and SHAP magnitude were all blind to the inversion. Monotonic constraints eliminated every violation at no cost to discrimination (0.723 vs 0.718) and outperformed EORTC (p=8.9e-16). Limitations: single trial, internal-external validation only. Conclusions and Clinical Implications: A model that had learned this inversion passed every conventional check. A counterfactual direction test, run as a single refit with pre-specified monotonic constraints, catches this failure at no cost to performance and should be routine before clinical deployment.

In psychotherapy, therapeutic outcome assessment, or treatment outcome evaluation, is essential for enhancing mental health care by systematically evaluating therapeutic processes and outcomes. Existing large language model approaches often focus on therapist-centered, single-session evaluations, neglecting the client's subjective experience and longitudinal progress across multiple sessions. To address these limitations, we propose IPAEval, a client-Informed Psychological Assessment-based Evaluation framework that automates treatment outcome evaluations from the client's perspective using clinical interviews. IPAEval integrates cross-session client-contextual assessment and session-focused client-dynamics assessment to provide a comprehensive understanding of therapeutic progress. Experiments on our newly developed TheraPhase dataset demonstrate that IPAEval effectively tracks symptom severity and treatment outcomes over multiple sessions, outperforming previous single-session models and validating the benefits of items-aware reasoning mechanisms.

Outcome-Based Education (OBE) emphasizes the development of specific competencies through student-centered learning. In this study, we reviewed the importance of OBE and implemented transformer-based models, particularly DistilBERT, to analyze an NLP dataset that includes student feedback. Our objective is to assess and improve educational outcomes. Our approach is better than other machine learning models because it uses the transformer's deep understanding of language context to classify sentiment better, giving better results across a wider range of matrices. Our work directly contributes to OBE's goal of achieving measurable outcomes by facilitating the identification of patterns in student learning experiences. We have also applied LIME (local interpretable model-agnostic explanations) to make sure that model predictions are clear. This gives us understandable information about how key terms affect sentiment. Our findings indicate that the combination of transformer models and LIME explanations results in a strong and straightforward framework for analyzing student feedback. This aligns more closely with the principles of OBE and ensures the improvement of educational practices through data-driven insights.

Clinical trials or studies oftentimes require long-term and/or costly follow-up of participants to evaluate a novel treatment/drug/vaccine. There has been increasing interest in the past few decades in using short-term surrogate outcomes as a replacement of the primary outcome i.e., in using the surrogate outcome, which can potentially be observed sooner, to make inference about the treatment effect on the long-term primary outcome. Very few of the available statistical methods to evaluate a surrogate are applicable to settings where both the surrogate and the primary outcome are time-to-event outcomes subject to censoring. Methods that can handle this setting tend to require parametric assumptions or be limited to assessing only the restricted mean survival time. In this paper, we propose a non-parametric approach to evaluate a censored surrogate outcome, such as time to progression, when the primary outcome is also a censored time-to-event outcome, such as time to death, and the treatment effect of interest is the difference in overall survival. Specifically, we define the proportion of the treatment effect on the primary outcome that is explained (PTE) by the censored surrogate outcome in this context, and estimate this proportion by defining and deriving an optimal transformation of the surrogate information. Our approach provides the added advantage of relaxed assumptions to guarantee that the true PTE is within (0,1), along with being model-free. Finite sample performance of our estimators are illustrated via extensive simulation studies and a real data application examining progression-free survival as a surrogate for overall survival for patients with metastatic colorectal cancer.

The global cost of drug discovery and development exceeds $200 billion annually. The main results of drug discovery and development are the outcomes of clinical trials, which directly influence the regulatory approval of new drug candidates and ultimately affect patient outcomes. Despite their significance, large-scale, high-quality clinical trial outcome data are not readily available to the public. Suppose a large clinical trial outcome dataset is provided; machine learning researchers can potentially develop accurate prediction models using past trials and outcome labels, which could help prioritize and optimize therapeutic programs, ultimately benefiting patients. This paper introduces Clinical Trial Outcome (CTO) dataset, the largest trial outcome dataset with around 479K clinical trials, aggregating outcomes from multiple sources of weakly supervised labels, minimizing the noise from individual sources, and eliminating the need for human annotation. These sources include large language model (LLM) decisions on trial-related documents, news headline sentiments, stock prices of trial sponsors, trial linkages across phases, and other signals such as patient dropout rates and adverse events. CTO's labels show unprecedented agreement with supervised clinical trial outcome labels from test split of the supervised TOP dataset, with a 91 F1.

We present the findings of "The Alzheimer's Disease Prediction Of Longitudinal Evolution" (TADPOLE) Challenge, which compared the performance of 92 algorithms from 33 international teams at predicting the future trajectory of 219 individuals at risk of Alzheimer's disease. Challenge participants were required to make a prediction, for each month of a 5-year future time period, of three key outcomes: clinical diagnosis, Alzheimer's Disease Assessment Scale Cognitive Subdomain (ADAS-Cog13), and total volume of the ventricles. The methods used by challenge participants included multivariate linear regression, machine learning methods such as support vector machines and deep neural networks, as well as disease progression models. No single submission was best at predicting all three outcomes. For clinical diagnosis and ventricle volume prediction, the best algorithms strongly outperform simple baselines in predictive ability. However, for ADAS-Cog13 no single submitted prediction method was significantly better than random guesswork. Two ensemble methods based on taking the mean and median over all predictions, obtained top scores on almost all tasks. Better than average performance at diagnosis prediction was generally associated with the additional inclusion of features from cerebrospinal fluid (CSF) samples and diffusion tensor imaging (DTI). On the other hand, better performance at ventricle volume prediction was associated with inclusion of summary statistics, such as the slope or maxima/minima of biomarkers. TADPOLE's unique results suggest that current prediction algorithms provide sufficient accuracy to exploit biomarkers related to clinical diagnosis and ventricle volume, for cohort refinement in clinical trials for Alzheimer's disease. However, results call into question the usage of cognitive test scores for patient selection and as a primary endpoint in clinical trials.

Clinical diagnosis is critical in medical practice, typically requiring a continuous and evolving process that includes primary diagnosis, differential diagnosis, and final diagnosis. However, most existing clinical diagnostic tasks are single-step processes, which does not align with the complex multi-step diagnostic procedures found in real-world clinical settings. In this paper, we propose a multi-step diagnostic task and annotate a clinical diagnostic dataset (MSDiagnosis). This dataset includes primary diagnosis, differential diagnosis, and final diagnosis questions. Additionally, we propose a novel and effective framework. This framework combines forward inference, backward inference, reflection, and refinement, enabling the LLM to self-evaluate and adjust its diagnostic results. To assess the effectiveness of our proposed method, we design and conduct extensive experiments. The experimental results demonstrate the effectiveness of the proposed method. We also provide a comprehensive experimental analysis and suggest future research directions for this task.

Automatic SOAP note generation can ease the documentation burden on physicians, but existing reasoning methods often omit clinically important information and generate unsupported content. Progress in Thai is further hindered by the lack of publicly available datasets. We propose ASCRIBE, a physician-inspired reasoning framework that ascribes a clinical-significance level to each extracted atomic fact in the conversation before summarization, making a general-purpose LLM a more reliable scribe. We also release ThaiClinicBench, the first de-identified Thai clinical summarization benchmark of real encounters, together with a synthetic training corpus derived from real clinical notes. As a prompt, ASCRIBE outperforms chain-of-thought prompting on GPT-5.4 and Gemini 3.1 Pro across the physician-aligned LLM-judge metrics and improves on standard prompting by up to 10.3 points on the completeness LLM-judge metric. As a GRPO reward, it enables a Gemma-4-E4B model trained solely on synthetic data to match Gemini 3.1 Pro in factual precision and surpass it in completeness. Code and data can be found at https://github.com/loolootech/ascribe.

We consider estimating the conditional distribution of a multivariate outcome given covariates when its coordinates may be continuous, binary, categorical, ordinal or rankings, and are conditionally dependent on one another. Different statistical methods have been developed for each outcome type, and most of them target a summary of the conditional distribution, such as the mean of each coordinate, rather than the joint distribution of the outcome vector. We develop generalized engression models, a unified nonparametric distributional regression framework for outcomes of any type. The proposed method builds upon engression, a scoring-rule-based deep generative model, and introduces a data-type-specific link function and a stochastic perturbation that smooths the loss, enabling gradient-based training even with discontinuous links. We establish universal representation results for continuous, discrete and mixed outcomes. In simulations and in two applications, 242 species in a community ecology benchmark and a 17-dimensional mixed-type health outcome, the method matches type-specific models on marginal scores, improves on them on the joint distribution, and matches or exceeds purpose-built state-of-the-art joint species distribution models. Software is available in Python.

Accident, defect and outage investigations end with a decision that ordinary question answering never faces: whether the evidence gathered so far is enough to close the case. We study this decision for LLM investigators, which request evidence from a case file, revise their hypotheses, and either close the case with a conclusion grounded in what they read or leave it open and name what is missing. This judgment does not come with capability: an untrained 9B model overstates its evidence in 97% of its answers, and a frontier model that identifies the right cause in 84% of cases still overstates in 91% and closes 17 of the 41 cases whose official finding is "cause undetermined". Measuring it is also non-trivial: the source of a case largely predicts its label, and a rule that reads only the source reaches 83.0 balanced accuracy on our test cases. We therefore evaluate closure with three tests: closure accuracy, reported against this rule and within each source; evidence dependence, which removes the grounds of a conclusion and checks whether the model stops closing; and conclusion and gap quality, a judged checklist of what the model asserts and what it says is missing. We build Nautil, 731 audited cases from aviation, rail, maritime, chemical-safety and vehicle-defect reports and production server incidents, with teacher trajectories, an out-of-distribution test set and counterfactual evidence versions. Fine-tuning a 9B model on these trajectories makes its closures follow the evidence: removing the grounds lowers its closure rate by 26 points relative to a matched control, overstatement falls from 97% to 35%, and correct, non-overstated conclusions rise from 3% to 43%. Reinforcement learning that rewards only the closure decision then raises balanced accuracy from 69.2 to 83.3, on par with the teacher, and within-source accuracy from 60.4 to 74.1, at some cost in evidence dependence.

Agentic reinforcement learning requires assigning credit to environment-facing actions such as searches, clicks, edits, navigation commands, and object interactions. Standard GRPO uses the final verifier outcome as a uniform advantage over all action tokens. This outcome signal is useful but structurally incomplete: it punishes useful exploration in failed rollouts and reinforces redundant or regressive actions in successful rollouts. We propose TRIAGE, a role-typed credit assignment framework that adds a semantic role axis to outcome credit. A structured judge classifies each segment as decisive progress, useful exploration, no-progress infrastructure, or regression, and a fixed role-conditioned rule maps these labels to bounded segment-level process rewards. This keeps verifier outcomes as the source of optimization direction while correcting the two main blind spots of outcome-only credit. We further show that role-conditioned credit is the optimal segment-level correction expressible from role labels alone -- a projection of the per-segment advantage residual onto the role variable -- so that the fixed role constants reduce advantage estimation error whenever the judge is reliable, and we connect this to lower-variance policy gradients. Across ALFWorld, Search-QA, and WebShop, TRIAGE improves success rates over GRPO for two policy models and outperforms both a scalar judge-derived process reward and an outcome-supervised shared-backbone value baseline. Ablations show that the gain comes from role typing rather than merely adding dense rewards: reliable detection of regression inside successful trajectories is the dominant contributor, while exploration credit provides a consistent secondary gain; on completed ALFWorld and WebShop rollouts, TRIAGE also reduces environment-facing turns by an additional 10.4% and 14.8% relative to GRPO.

LLM-as-a-Judge frameworks are increasingly trusted to automate evaluation in place of human experts, yet their reliability in high-stakes medical contexts remains unproven. We stress-test this assumption for detecting incomplete patient-facing medical responses, evaluating three rubric granularities (General-Likert, Analytical-Rubric, Dynamic-Checklist) and three backbone models across two clinician-annotated datasets, including HealthBench, the largest publicly available benchmark for medical response evaluation. LLM Judges discriminate complete from incomplete responses at and slightly above near chance (AUC 0.49--0.66); at the threshold required to recall 90% of incomplete responses, clinicians must still review the vast majority of the dataset, offering no triage utility. Even when model and clinician verdicts agree, they rarely cite the same explanation; and when they diverge, false positives stem from over-flagging non-essential gaps while false negatives reflect outright detection failures. These results reveal that LLM Judges and clinicians apply fundamentally different completeness standards; a finding that undermines their use as autonomous evaluators or triage filters in clinical settings.

A central puzzle for the behavioural sciences and for human-facing artificial intelligence is the persistence of within-person variability. The same individual, presented with the same observable input, produces different outcomes on different occasions, and different individuals produce divergent outcomes that no observable covariate fully predicts. We argue that this variability belongs in the dynamic latent state of the person, and that human outcomes are controllable in a precise and operational sense through interventions that target the state and its weighting at the moment a decision is being formed. We define a state as the time-indexed weighting vector over the dimensions that govern how an individual's biology, physiology, and neuropsychology process the next event into a decision and an outcome. The relationship between state, decision, and outcome is causal rather than correlational. The weighting vector is dynamic at sub-daily timescales. The conscious channel through which outcomes are reportable is a narrow attentional bottleneck whose contents are themselves state-dependent. Taken together, these claims imply that the outcome of a given event is controllable, conditionally, on the state-trajectory at the time of intervention. We motivate the framework with six strands of established evidence (causal inference, predictive processing, allostasis, attentional bottleneck, chronobiology, computational psychiatry) and a 24-month observational base from a deployed behavioural platform spanning more than 200,000 consented users across four occupational personas (research period 2023 to 2026). We derive seven testable predictions, list six operational requirements for state-aware systems, and discuss implications for digital health, education, AI personalisation, and personal agency.

Despite growing interest in using large language models (LLMs) in healthcare, current explorations do not assess the real-world utility and safety of LLMs in clinical settings. Our objective was to determine whether two LLMs can serve information needs submitted by physicians as questions to an informatics consultation service in a safe and concordant manner. Sixty six questions from an informatics consult service were submitted to GPT-3.5 and GPT-4 via simple prompts. 12 physicians assessed the LLM responses' possibility of patient harm and concordance with existing reports from an informatics consultation service. Physician assessments were summarized based on majority vote. For no questions did a majority of physicians deem either LLM response as harmful. For GPT-3.5, responses to 8 questions were concordant with the informatics consult report, 20 discordant, and 9 were unable to be assessed. There were 29 responses with no majority on "Agree", "Disagree", and "Unable to assess". For GPT-4, responses to 13 questions were concordant, 15 discordant, and 3 were unable to be assessed. There were 35 responses with no majority. Responses from both LLMs were largely devoid of overt harm, but less than 20% of the responses agreed with an answer from an informatics consultation service, responses contained hallucinated references, and physicians were divided on what constitutes harm. These results suggest that while general purpose LLMs are able to provide safe and credible responses, they often do not meet the specific information need of a given question. A definitive evaluation of the usefulness of LLMs in healthcare settings will likely require additional research on prompt engineering, calibration, and custom-tailoring of general purpose models.

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

Clinical decision-making requires nuanced reasoning over heterogeneous evidence and traceable justifications. While recent LLM multi-agent systems (MAS) show promise, they largely optimise for outcome accuracy while overlooking process-grounded reasoning aligned with clinical standards. One critical real-world case of this is gene-disease validity curation, where experts must determine whether a gene is causally implicated in a disease by synthesising diverse biomedical evidence. We introduce an agent-as-tool reinforcement learning framework for this task with two objectives: (i) process-level supervision to ensure reasoning follows valid clinical pathways, and (ii) efficient coordination via a hierarchical multi-agent system. Our evaluation on the ClinGen dataset shows that with outcome-only rewards, MAS with a GRPO-trained Qwen3-4B supervisor agent substantially improves final outcome accuracy from 0.195 with a base model supervisor to 0.732, but results in poor process alignment (0.392 F1). Conversely, with process + outcome rewards, MAS with GRPO-trained supervisor achieves higher outcome accuracy (0.750) while significantly improving process fidelity to 0.520 F1. Our code is available at https://github.com/chaeeunlee-io/GeneDiseaseCurationAgents.

Generative models trained using self-supervision of tokenized electronic health record (EHR) timelines show promise for clinical outcome prediction. This is typically done using Monte Carlo simulation for future patient trajectories. However, existing approaches suffer from three key limitations: sparse estimate distributions that poorly differentiate patient risk levels, extreme computational costs, and high sampling variance. We propose two new estimators: the Sum of Conditional Outcome Probability Estimator (SCOPE) and Risk Estimation from Anticipated Conditional Hazards (REACH), that leverage next-token probability distributions discarded by standard Monte Carlo. We prove both estimators are unbiased and that REACH guarantees variance reduction over Monte Carlo sampling for any model and outcome. Empirically, on hospital mortality prediction in MIMIC-IV using the ETHOS-ARES framework, SCOPE and REACH match 100-sample Monte Carlo performance using only 10-11 samples (95% CI: [9,11]), representing a ~10x reduction in inference cost without degrading calibration. For ICU admission prediction, efficiency gains are more modest (~1.2x), which we attribute to the outcome's lower "spontaneity," a property we characterize theoretically and empirically. These methods substantially improve the feasibility of deploying generative EHR models in resource-constrained clinical settings.

Safety evaluations of large language models commonly summarize harmful-output behavior with attack success rate (ASR). Yet the same non-harmful outcome can arise for very different reasons. A model may recover a harmful task and refuse it, fail to recover the task, or respond to something else entirely. Distinguishing these cases becomes especially important under intent-obscuring prompts, where a low ASR does not reveal whether the evaluated task was actually engaged. To make this distinction explicit, we pair ASR with operative understanding rate (UR), which measures whether a response both identifies the evaluated task and treats it as the task to be answered. Across interfaces, this paired view reveals substantial variation hidden by ASR: similar ASR values can correspond to sharply different recovery rates. Controlled English reconstructions show that recovery consistently improves as compressed prompts become more explicit, whereas ASR does not follow the same pattern. A complementary contrast comes from FormalLogic, where high recovery can still coincide with frequent harmful assistance. Together, these results show that non-harmful outcomes are not equally informative about model safety, motivating the joint reporting of intent recovery and ASR in LLM safety evaluation. Code and experiment inputs are available at https://github.com/kevinjiang0121-cyber/IRIS.

Large language model (LLM) judges are often used as rewards to train policies on objectives that deterministic verifiers cannot capture. However, these rewards are often collapsed to pass/fail ({0, 1}), which reports the verdict but not how well a response met each criterion. We model each pass/fail verdict as a score on an unreported scale, compared with one cutoff. A stretch of that scale moves every score proportionally toward or away from the cutoff, but never across it, so no verdict changes. A policy is therefore free to apply any stretch without changing anything the panel reports. Under a joint-Gaussian model, a third grade adds a second threshold and removes this affine stretch ambiguity. On MATH and SciBench outputs from one seven-criterion judge, all 14 constructed criterionwise stretches were invisible after binarization but visible with three grades. At n=1{,}024, a test given both population laws had at least 96.5% power at a 1.5times stress. Retaining grades closes one blind spot created by binarization, but verdicts alone remain insufficient as some changes are still indistinguishable from genuine improvement. These include arbitrary within-grade changes and fixed-covariance, loading-aligned mean shifts -- the signature of a sycophancy-shaped lift the panel reads as competence. The shared-factor reference approximation fit MATH and SciBench but not HealthBench, delineating its empirical scope. We recommend keeping at least three grades (for example, asking the judge whether each criterion is fully, partially, or not met and rewarding {0, 0.5, 1}), and externally validating gains along the remaining direction, which no finer scale removes.

Benchmark contamination is diagnosed with n-gram overlap, likelihood-based membership inference, or canary strings, and each needs something usually unavailable: the training corpus, a well-chosen test statistic, or foresight at release. A recent alternative reads it off a linear probe on internal activations. We show the natural way to do this does not work, specify one that survives measurement, then find that the correction making it work carries more variance than the null it is tested against. The protocol reports a zero-sum contrast on the depth profile of probe accuracy, recentred on a level-matched placebo baseline, tested against a label-permutation null, with the reference set twice the size of the suspect set. Each choice replaces a simpler alternative we rejected on measurement. Reporting the level of excess separability rather than its shape makes the false positive rate track the size of the analyst's own control set, 0.03 to 0.99 under a true null. Contrasting against a flat depth profile rejects a true null 0.72 of the time when surface decodability rises with depth, and loses all power when it falls. On real transformers the protocol fails a test the simulations did not pose. The recentring subtracts an estimate, and the permutation null holds it fixed. Re-estimated across split seeds on four audits of contaminated checkpoints, its standard deviation is 1.30 to 1.56 times the null's own in every arm: what is subtracted to remove a bias is more variable than what it corrects. The one nominally significant result, p = 0.0075, becomes 0.0745 once that variance is propagated, and no verdict is issued. The simulations missed this because their surface key is the covariate driving item variation; on real text it is a proxy, and degrading key quality in simulation reproduces it. We add a companion measurement and a widened null. No arm shows contamination.

Red-team evaluations of AI models support some claims and not others, and the boundary between the two is calculable rather than merely a matter of judgment. We define the evidential ceiling of an evaluation as the largest factor by which one result can move belief under a fixed testing budget, derive it in closed form for the benchmark null result, and use it to locate that boundary exactly. We find that above a calculable harm rate, a benchmark of modest size certifies a category to a stated evidentiary standard, and a clean sheet is then the stronger of the two possible observations, outweighing a single reproduced failure. Below that rate, no passive benchmark of feasible size provides the specified evidence of safety under the fixed scoring rule and approximately independent trial structure. The crossing between the two regimes has a closed form. The bound is not specific to benchmarks: written in terms of a procedure's hypothesis conditioned elicitation rates, it covers adaptive and automated red teaming as well, and shows that discrimination between the hypotheses rather than attack success is what determines evidential worth. Auditing eight evaluation suites against the boundary, we find that current benchmarks are adequate for high-frequency harm categories and several orders of magnitude short for rare, catastrophic ones. Safety benchmarks are not uninformative. They are informative about a specific and computable set of propositions, and the discipline they need is to state which.

AI research agents combine prior knowledge, public sources, and experimental feedback to produce useful results. The Discovery Certification Protocol (DCP) turns claims about these results into executable recovery and feedback tests. Gate 1 validates useful improvement on sealed evaluation. Gate 2 gives matched agents the registered starting information and observed Web content while withholding the target research history. Every valid method reaching the numerical target supplies a recovery witness and triggers the Core veto. DCP Core requires adequate controls, zero observed recoveries, and a finite-sample bound on recovery in one fresh registered episode. Optional Gate 3 measures the average effect of truthful feedback relative to a specified neutral policy from a shared checkpoint. DCP Evidence adds this effect after independent null calibration and a registered effect margin. Two controlled audits exercise the complete protocol in SQLite optimization and virtual catalyst control under different models. Each produced zero recoveries in 96 episodes, with an upper bound of 0.0468. Each paired study yielded 30 truthful recoveries and zero neutral recoveries, with passing 60-pair null studies. Additional cases exercise Core, recovered, and audit-incomplete decisions. A deterministic, LLM-free verifier reproduces the decisions from frozen evidence. DCP provides a common evidence language for useful outcomes, alternative routes, and feedback effects across AI research.

Purpose. Patients with advanced cancer may undergo multiple lines of treatment, switching therapies as their disease progresses. Motivated by a study of metastatic prostate cancer, we develop a microsimulation framework to study therapy sequence. Methods. We propose a discrete-time state transition model to study two lines of anti-cancer therapy. Based on digitized published progression-free survival (PFS) and overall survival (OS) curves, we infer event types (progression or death), and estimate transition probabilities using cumulative incidence functions with competing risks. Our model incorporates within-patient dependence over time, such that response to first-line therapy informs subsequent event probabilities. Parameters governing the degree of within-patient dependence can be used to calibrate the model-based results to those of a target trial. We demonstrate these methods in a study of two therapy sequences for metastatic prostate cancer, where Docetaxel (DCT) and Abiraterone Acetate (AA) are both appropriate for use in either first or second line treatment. We assess costs, Quality-Adjusted Life Years (QALYs) and Incremental Cost Effectiveness Ratio (ICER) for two treatment strategies: DCT then AA vs AA then DCT. Results. Using digitized survival curves from relevant clinical trials, we identified 8.6-13.9% of PFS times that should be categorized as deaths, allowing for estimation of cumulative incidence functions. Models assuming within-patient independence overestimated OS time, corrected with our calibration approach. Correction resulted in meaningful changes in the difference in QALYs between treatment strategies (0.07 vs 0.15) and the ICER (-\76,836/QALY vs -21,030/QALY). Conclusions. Microsimulation models can be successfully used to study cost-effectiveness of therapy sequences, taking care to account correctly for within-patient dependence.

Interpreting computed tomography (CT) requires review of hundreds of volumetric slices and remains time-intensive and expertise-dependent. Automated CT report generation offers a promising route to improving clinical efficiency, yet the field still lacks a generalizable CT report generation foundation model that supports multi-region reporting and remains robust across external real-world cohorts. Intrinsic inconsistencies in reporting style and diagnostic terminology across cohorts make naive joint training difficult. Here we present Astra, a generalizable CT report generation foundation model developed on 90,678 thoracoabdominal CT-report pairs collected from five sites worldwide (CTRgDB), comprising 353,671 abnormalities spanning eight organ systems. By harmonizing report style and further refining diagnostic consistency via reinforcement learning, Astra achieves style-consistent and diagnostically accurate report generation across diverse anatomical regions and institutions. Evaluated on CTRgDB and six external cohorts, Astra achieves state-of-the-art performance with a 38.4% average improvement in fine-grained diagnostic metrics (P<0.001). Deployed at external clinical sites without any site-specific fine-tuning, Astra accelerated chest report drafting by 29.6% and improved abdominal report completeness by 11.3% among junior and mid-level radiologists (P<0.001). Furthermore, Astra demonstrates broad utility as a foundation for CT AI development, improving downstream diagnostic performance and scaling vision-language pretrain through high-quality report synthesis. Overall, Astra serves as a broadly accessible clinical assistant and a pivotal infrastructure for the next generation of AI-powered healthcare. The code for Astra is publicly available at https://github.com/zh-Wang-Med/Astra.

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

Process reward models (PRMs) have become a key component for LLMs, as their step-level feedback supports both post-training and test-time reasoning. However, training strong PRMs remains costly: human step annotation is difficult to scale, while Monte Carlo estimation is computationally expensive and can drift from the intrinsic correctness of steps. To get effective PRMs at low cost, we introduce TIPS (Thinking-Induced Process Supervision), an outcome-only reinforcement learning (RL) framework for training generative PRMs. In TIPS, the model generates a chain-of-thought (CoT) followed by step-level labels and an outcome label. The reward depends solely on whether the predicted outcome matches the ground truth, and the resulting group-relative advantage is used to optimize the entire generated response. Intuitively, when checking intermediate steps helps determine the outcome, more accurate checks can lead to better outcome judgments and higher rewards. Outcome-only RL can therefore reinforce step-level verification without explicit process supervision. We validate the effectiveness of TIPS across math and agent benchmarks and four backbone families. Notably, TIPS-Qwen3-4B-Thinking-2507 reaches 85.2 F1 on ProcessBench with only 3.2K outcome-labeled trajectories, surpassing all evaluated trained PRMs and strong prompt-only judges such as GPT-5.4-Instruct and Claude-4.7-Opus, while still trailing o1-mini. Code and data are available at https://github.com/RUCBM/TIPS.

Machine learning shows promise in predicting the outcome of legal cases, but most research has concentrated on civil law cases rather than case law systems. We identified two unique challenges in making legal case outcome predictions with case law. First, it is crucial to identify relevant precedent cases that serve as fundamental evidence for judges during decision-making. Second, it is necessary to consider the evolution of legal principles over time, as early cases may adhere to different legal contexts. In this paper, we proposed a new framework named PILOT (PredictIng Legal case OuTcome) for case outcome prediction. It comprises two modules for relevant case retrieval and temporal pattern handling, respectively. To benchmark the performance of existing legal case outcome prediction models, we curated a dataset from a large-scale case law database. We demonstrate the importance of accurately identifying precedent cases and mitigating the temporal shift when making predictions for case law, as our method shows a significant improvement over the prior methods that focus on civil law case outcome predictions.

Recent work has shown that asking language models to generate reasoning steps improves performance on many reasoning tasks. When moving beyond prompting, this raises the question of how we should supervise such models: outcome-based approaches which supervise the final result, or process-based approaches which supervise the reasoning process itself? Differences between these approaches might naturally be expected not just in final-answer errors but also in reasoning errors, which can be difficult to detect and are problematic in many real-world domains such as education. We run the first comprehensive comparison between process- and outcome-based approaches trained on a natural language task, GSM8K. We find that pure outcome-based supervision produces similar final-answer error rates with less label supervision. However, for correct reasoning steps we find it necessary to use process-based supervision or supervision from learned reward models that emulate process-based feedback. In total, we improve the previous best results from 16.8% to 12.7% final-answer error and 14.0% to 3.4% reasoning error among final-answer-correct solutions.

Complete orthogonal predictive coordinates do not by themselves bind a latent direction to a named intervention. We present a mathematical and synthetic audit motivated by vascular device-vessel suitcordance. Capacity-matched least-squares predictors were exactly equivalent under complete fixed output transforms, whereas an anchor-only observer recovered interpretations only within the span of known perturbation signatures. Six three-dimensional configurations across 64 seeds gave a maximum paired prediction discrepancy of 6.7e-15 but a median untransported edit error of 1.513. Coordinate transport removed that error. Noisy and weak anchors constrained calibration stability, and changing the representation basis required recalibration or verified transport. Across 256 additional fits in dimensions 3-24, prediction equivalence persisted within 4.0e-15. We then evaluated nine deliberate runnable fault classes across 64 seeds. All 576 faulty executions completed, but each violated at least one reconstruction, prediction, delivered-edit or scope contract; all 320 valid control records passed. Repeating a faulty implementation gave exact self-agreement despite error against the separately computed simulator expectation. For one omitted-direction defect, probe coverage followed its analytic law, and rank-aware abstention protected unsupported interpretations. Scalar-noise experiments exposed both missed weak faults and excessive rejection under narrow relative tolerances. These controls provide an executable separation of prediction, semantic support and scientific acceptance. They are synthetic numerical audits, not clinical validation, neural JEPA-Anything replication, agent learning or patient treatment-effect estimation.

LeWorldModel trains a latent world model with a prediction loss and a single anti-collapse regulariser, and reports approximately 87% of goals reached on TwoRoom, its simplest diagnostic environment. We reproduce that result by independent reimplementation on roughly $25 of rented compute, with all evaluation on one laptop CPU. We reach 94.0% at the repository's evaluation goal offset, against 84.0% for the authors' own released checkpoint measured under our protocol on identical episodes, and we reproduce the reported representation result directly (position probe Pearson r = 0.9988 against a reported 0.996). Reaching that point required four conventions that determine the outcome and appear in no released configuration file: dense action gathering across a frameskip block, a programmatically-set action-encoder width, ImageNet pixel normalisation, and action z-scoring. A reproducer following the released configurations alone obtains a model whose predictor cannot converge. The evaluation protocol is itself contested by the released material. The paper's appendix and the repository's configuration specify different goal offsets and step budgets; on the authors' own weights these yield 14.0% and 84.0%, and only the configuration's values reproduce the reported figure. On fifty identical episodes, changing nothing but how the goal is constructed moves that checkpoint from 84.0% to 8.0%. Two findings generalise. One-step prediction accuracy does not predict long-horizon planning success: across three checkpoints spanning a sevenfold range in prediction error, including the authors' own, it orders short-horizon success monotonically and fails to order long-horizon success at all. And a batch normalisation layer inflated our reported validation loss by up to a factor of 300, concealing a training loss that was flat throughout.

India's Right to Information Act, 2005 gives every citizen the right to demand information from public authorities, yet in practice most people cannot make sense of the dense administrative language used in Central Information Commission (CIC) decisions, let alone predict whether an appeal is worth filing. This paper introduces RTI-Bench, a structured dataset of CIC decisions with outcome labels, exemption citations, IRAC-style reasoning components, and procedural timelines. To the best of our knowledge it is the first publicly released structured dataset for Indian RTI administrative decisions. The dataset draws from two sources: 1,218 cases from a publicly available instruction-response corpus (with structured fields added through rule-based extraction), and 298 CIC decision PDFs collected directly from the Commission portal, spanning five commissioners and three document format generations from 2023 to 2026. Label coverage reaches 89% on the instruction-response corpus. For the PDF subset of 239 primary decisions, coverage is 51% in this first release. A random sample of 50 labelled cases was manually reviewed, yielding a label precision of 95.3%. A zero-shot Mistral 7B baseline on 100 cases gives 57.3% accuracy and 37.0% macro-F1 on outcome prediction, well above the majority-class baseline of 14.3% macro-F1. RTI-Bench is available at https://huggingface.co/datasets/joyboseroy/rti-bench

Purpose: To evaluate the performance of an automated deep learning method in detecting ascites and subsequently quantifying its volume in patients with liver cirrhosis and ovarian cancer. Materials and Methods: This retrospective study included contrast-enhanced and non-contrast abdominal-pelvic CT scans of patients with cirrhotic ascites and patients with ovarian cancer from two institutions, National Institutes of Health (NIH) and University of Wisconsin (UofW). The model, trained on The Cancer Genome Atlas Ovarian Cancer dataset (mean age, 60 years +/- 11 [s.d.]; 143 female), was tested on two internal (NIH-LC and NIH-OV) and one external dataset (UofW-LC). Its performance was measured by the Dice coefficient, standard deviations, and 95% confidence intervals, focusing on ascites volume in the peritoneal cavity. Results: On NIH-LC (25 patients; mean age, 59 years +/- 14 [s.d.]; 14 male) and NIH-OV (166 patients; mean age, 65 years +/- 9 [s.d.]; all female), the model achieved Dice scores of 0.855 +/- 0.061 (CI: 0.831-0.878) and 0.826 +/- 0.153 (CI: 0.764-0.887), with median volume estimation errors of 19.6% (IQR: 13.2-29.0) and 5.3% (IQR: 2.4-9.7) respectively. On UofW-LC (124 patients; mean age, 46 years +/- 12 [s.d.]; 73 female), the model had a Dice score of 0.830 +/- 0.107 (CI: 0.798-0.863) and median volume estimation error of 9.7% (IQR: 4.5-15.1). The model showed strong agreement with expert assessments, with r^2 values of 0.79, 0.98, and 0.97 across the test sets. Conclusion: The proposed deep learning method performed well in segmenting and quantifying the volume of ascites in concordance with expert radiologist assessments.

Accurate prediction of biochemical recurrence (BCR) after radical prostatectomy is critical for guiding adjuvant treatment and surveillance decisions in prostate cancer. However, existing clinicopathological risk models reduce complex morphology to relatively coarse descriptors, leaving substantial prognostic information embedded in routine histopathology underexplored. We present a deep learning-based biomarker that predicts continuous, patient-specific risk of BCR directly from H&E-stained whole-slide prostatectomy specimens. Trained end-to-end on time-to-event outcomes and evaluated across four independent international cohorts, our model demonstrates robust generalization across institutions and patient populations. When integrated with the CAPRA-S clinical risk score, the deep learning risk score consistently improved discrimination for BCR, increasing concordance indices from 0.725-0.772 to 0.749-0.788 across cohorts. To support clinical interpretability, outcome-grounded analyses revealed subtle histomorphological patterns associated with recurrence risk that are not captured by conventional clinicopathological risk scores. This multicohort study demonstrates that deep learning applied to routine prostate histopathology can deliver reproducible and clinically generalizable biomarkers that augment postoperative risk stratification, with potential to support personalized management of prostate cancer in real-world clinical settings.

When a phone-use agent avoids harm, does that show safety, or simply inability to act? Existing evaluations often cannot tell. A harmful outcome may be avoided because the agent recognized the risk and chose the safe action, or because it failed to understand the screen or execute any relevant action at all. These cases have different causes and call for different fixes, yet current benchmarks often merge them under task success, refusal, or final harmful outcome. We address this problem with PhoneSafety, a benchmark of 700 safety-critical moments drawn from real phone interactions across more than 130 apps. Each instance isolates the next decision at a risky moment and asks a simple question: does the model take the safe action, take the unsafe action, or fail to do anything useful? We evaluate eight representative phone-use agents under this framework. Our results reveal two main patterns. First, stronger general phone-use ability does not reliably imply safer choices at risky moments. Models that perform better on ordinary app tasks are not always the ones that behave more safely when the next action matters. Second, failures to do anything useful behave like a capability signal rather than a safety signal: they are concentrated in more visually and operationally demanding settings and remain stable when the evaluation protocol changes. Across models, failures split into two recurring patterns: unsafe choices in settings where the model can act but chooses wrongly, and inability to act in more visually and operationally demanding screens. Overall, a harmless outcome is not enough to count as evidence of safety. Evaluating phone-use agents requires separating unsafe judgment from inability to act.

Personalized treatment effect estimates are often of interest in high-stakes applications -- thus, before deploying a model estimating such effects in practice, one needs to be sure that the best candidate from the ever-growing machine learning toolbox for this task was chosen. Unfortunately, due to the absence of counterfactual information in practice, it is usually not possible to rely on standard validation metrics for doing so, leading to a well-known model selection dilemma in the treatment effect estimation literature. While some solutions have recently been investigated, systematic understanding of the strengths and weaknesses of different model selection criteria is still lacking. In this paper, instead of attempting to declare a global `winner', we therefore empirically investigate success- and failure modes of different selection criteria. We highlight that there is a complex interplay between selection strategies, candidate estimators and the data used for comparing them, and provide interesting insights into the relative (dis)advantages of different criteria alongside desiderata for the design of further illuminating empirical studies in this context.

We study reasoning in Rule-Governed Decision Tasks (RGDTs), where models apply external rules to case facts and justify decisions, as required in policy, contract, and compliance settings. Beyond the deductive capability emphasized by standard mathematical and logical reasoning tasks, RGDTs require interpreting rules and their applicability, assessing conditions from evidence, combining judgments under rules and exceptions, and providing checkable justifications. These demands motivate a benchmark assessing both decisions and their stated grounds. We introduce RGDT-Bench, providing 202.1K condition-level supervision slots across four task tracks and eight supported task-probe combinations that vary access to supporting information. Label-blind extraction and deterministic checks produce labels for warrant completeness: source-referenced coverage and consistency of stated decision grounds. The benchmark attributes failures to four process layers: rule use, condition, evidence, and aggregation, and checks the final outcome. Among evaluable correct responses, warrant incompleteness averages 40.2% across six evaluated LLMs and supported task-probe combinations. Such warrant incompleteness poses potential safety risks and remains difficult to detect: the best of seventeen existing evaluators reaches only 57.69% (random: 50%) task-averaged area under the receiver operating characteristic curve (AUROC). To address this difficulty, we train a simple reward model with warrant supervision. It achieves 69.24% task-averaged AUROC among correct answers, exceeding the matched outcome-supervised baseline by 10.37 pp (percentage points) and the best existing evaluator by 11.55 pp. Beyond completeness assessment, the model outperforms both outcome-supervised baselines across nearly all response-selection comparisons, supporting RGDT-Bench's warrant supervision for RGDT reasoning.

Research agents explain planned experiments. We measure predictive credit with paired forecasts sharing an intervention, forecaster, and outcome while varying description, matched explanation, and donor context. Five checks track commitment, delivery, predictive gain, alignment, and known-signal uptake. Across 336 prospective states in controlled learning, 12 Tox21 endpoints, and 24 OpenML tasks, v5's frozen credit decision was inconclusive. Tox21's preregistered ROC AUC interval-score harm test was unmet (D-M=-.0026, 95 percent interval [-.0174, .0104]); OpenML's joint formation, point-equivalence, and repeatability rule was unmet. Matched point-accuracy gains over description remained unconfirmed, and Tox21/OpenML seed-donor intervals spanned zero. Under requested DeepSeek V4 Pro, matched and donor cards reduced secondary Tox21 drift by 64.5 and 59.1 percent. A DeepSeek V4 Flash replay raised matched point MAE from .01823 to .02020 and missed matched-donor interval-score equivalence. OpenML full-card assignment widened nominal 80 percent intervals by 21 percent, with 49.3 percent coverage versus 51.4 percent for description and content in 66/144 cards. Direct-text Flash delivered all 144 notes without detectable matched point-accuracy gain. A researcher-authored mechanism positive control lowered point MAE by 2.60 percentage points versus description. The protocol measures predictive credit for research-agent benchmarks and scientific forecasting; natural-explanation credit remained unconfirmed at the tested donor resolutions.

Objective. Clinical AI documentation systems require evaluation methodologies that are clinically valid, economically viable, and sensitive to iterative changes. Methods requiring expert review per scoring instance are too slow and expensive for safe, iterative deployment. We present a case-specific, clinician-authored rubric methodology for clinical AI evaluation and examine whether LLM-generated rubrics can approximate clinician agreement. Materials and Methods. Twenty clinicians authored 1,646 rubrics for 823 clinical cases (736 real-world, 87 synthetic) across primary care, psychiatry, oncology, and behavioral health. Each rubric was validated by confirming that an LLM-based scoring agent consistently scored clinician-preferred outputs higher than rejected ones. Seven versions of an EHR-embedded AI agent for clinicians were evaluated across all cases. Results. Clinician-authored rubrics discriminated effectively between high- and low-quality outputs (median score gap: 82.9%) with high scoring stability (median range: 0.00%). Median scores improved from 84% to 95%. In later experiments, clinician-LLM ranking agreement (tau: 0.42-0.46) matched or exceeded clinician-clinician agreement (tau: 0.38-0.43), attributable to both ceiling compression and LLM rubric improvement. Discussion. This convergence supports incorporating LLM rubrics alongside clinician-authored ones. At roughly 1,000 times lower cost, LLM rubrics enable substantially greater evaluation coverage, while continued clinical authorship grounds evaluation in expert judgment. Ceiling compression poses a methodological challenge for future inter-rater agreement studies. Conclusion. Case-specific rubrics offer a path for clinical AI evaluation that preserves expert judgment while enabling automation at three orders lower cost. Clinician-authored rubrics establish the baseline against which LLM rubrics are validated.

Autonomous computational pathology (ACP) converts high-level pathology analysis goals into executable, traceable and clinically bounded workflows. Realizing this capability requires adapting general agentic harness systems to pathology-specific tasks, tools, evidence standards and clinical claim boundaries. We contribute ACP-Bench, a framework that adapts existing harness systems from computational pathology support toward ACP workflow capability. ACP-Bench evaluates 41 pathology workflow tasks, including 24 biomarker, 7 morphology and 10 prognosis tasks spanning 6 body-system groups and 9 endpoint families. The benchmark evaluates 9 models and 3 harness groups (Claude Code, Codex and Open Code), yielding 369 complete trajectories. ACP-Bench evaluates each trajectory across workflow execution, diagnostic performance and clinical-boundary alignment, combining expert-adjudicated process audits, diagnostic assessment and pathologist-validated safety review. Across evaluated systems, workflow initiation, task interpretation and diagnostic reporting were more mature than tool-bound execution, result binding and reflective workflow revision, and formal end-to-end completion remained rare. ACP-Bench provides a reusable standard for auditing whether agentic systems can operationalize pathology workflows before claims of reliable clinical autonomy.

The rapid increase of computed tomography (CT) scans and their time-consuming manual analysis have created an urgent need for robust automated analysis techniques in clinical settings. These aim to assist radiologists and help them managing their growing workload. Existing methods typically generate entire reports directly from 3D CT images, without explicitly focusing on observed abnormalities. This unguided approach often results in repetitive content or incomplete reports, failing to prioritize anomaly-specific descriptions. We propose a new anomaly-guided report generation model, which first predicts abnormalities and then generates targeted descriptions for each. Evaluation on a public dataset demonstrates significant improvements in report quality and clinical relevance. We extend our work by conducting an ablation study to demonstrate its effectiveness.

Clinical decision-support systems are expert systems whose recommendations clinicians act on directly, yet they are usually cleared on one aggregate accuracy number from a held-out test set. That number says nothing about input reliability under encoding shifts, subgroup gaps, threshold sensitivity, or operational feasibility. We present RISED, a pre-deployment evaluation framework operationalising five dimensions (Reliability, Inclusivity, Sensitivity, Equity, Deployability) through BCa bootstrap 95% confidence intervals, literature-grounded thresholds, and Holm-Bonferroni-corrected PASS / FAIL / INCONCLUSIVE verdicts; Equity is a proxy-dependence diagnostic rather than a gating test. Applied to seven cohorts spanning 35 years (n from 303 to 99,492), RISED surfaces failures invisible to AUROC: on Diabetes 130, Reliability passes by three orders of magnitude (PSS = 0.0004) while Inclusivity (AUC parity gap = 0.262) and Sensitivity (max threshold-flip rate 49.1%) fail decisively; both NHIS cohorts reproduce this. NHANES 2021-2023, with a complete feature profile, achieves INCONCLUSIVE verdicts; BRFSS 2024 produces the suite's most severe Sensitivity failure (max threshold-flip rate 64.2%) after instrument rotation removed hypertension and cholesterol. The pattern recurs on credit- and income-prediction cohorts, confirming domain-agnosticity; a multi-model check shows the failures are data-driven, not model-specific. RISED ships as an open-source Python package complementing TRIPOD+AI, FUTURE-AI, and Fairlearn with the structured numerical evidence those standards require but do not prescribe.

Cancer survival prediction supports treatment planning, risk stratification, and follow-up management. Existing methods use structured clinical variables, whole-slide images, genomic profiles, or multimodal inputs, while patient reports remain underexplored. We study report-centric survival prediction using reports that organize pathological, clinical, and molecular evidence. Large language models (LLMs) can reason over such reports, but case-wise time regression introduces two mismatches. First, a formulation mismatch arises because survival evaluation depends on ordering comparable patients, whereas independent time predictions do not enforce ranking consistency. Second, a supervision mismatch arises because a censored patient's observed time indicates survival beyond that point and cannot serve as an exact regression target, although it still implies orderings relative to patients who died earlier. To address these mismatches, we propose CACSurv, a Concordance-Aligned Comparative framework for report-centric survival prediction. CACSurv reformulates survival modeling as mini-cohort comparative reasoning, where an LLM predicts relative prognostic orderings. We introduce concordance-aligned rewards derived from comparable relations under right censoring, enabling censored outcomes to provide ranking supervision without exact event-time targets. At inference, Monte Carlo Reference Aggregation compares each patient with sampled references and aggregates positions into a cohort-level ranking. We establish TCGA-SurvReport, a benchmark covering six TCGA cancer cohorts. CACSurv achieves the highest C-index on all six cohorts and an average C-index of 0.722, outperforming the strongest published survival model by 6.5 percentage points and the strongest LLM time-regression baseline by 4.2 percentage points. Our code, models, and dataset will be available at https://github.com/xmed-lab/CACSurv.

Laboratory test results are an important and generally high dimensional component of a patient's Electronic Health Record (EHR). We train embedding representations (via Word2Vec and GloVe) for LOINC codes of laboratory tests from the EHRs of about 80,000 patients at a cancer center. To include information about lab test outcomes, we also train embeddings on the concatenation of a LOINC code with a symbol indicating normality or abnormality of the result. We observe several clinically meaningful similarities among LOINC embeddings trained over our data. For the embeddings of the concatenation of LOINCs with abnormality codes, we evaluate the performance for mortality prediction tasks and the ability to preserve ordinality properties: i.e. a lab test with normal outcome should be more similar to an abnormal one than to the a very abnormal one.

Radiology report evaluation is essential for advancing automated report generation. Natural language generation metrics have limited clinical relevance. Clinical efficacy (CE) metrics evaluate important medical findings, but focus mainly on presence and cover only a limited set of entities. Due to heavy reliance on manual annotations, it is difficult for CE metrics to extend clinical entities or attributes. In clinical practice, radiology reports serve as a medium for information transfer. Clinicians use them to perform downstream diagnostic tasks without directly inspecting images. Based on this insight, we propose ReportQA, a clinical-related and flexible radiology report evaluation framework, supporting detailed quantitative analysis of radiology report generation systems. We first collect datasets covering multiple imaging modalities and anatomical regions. We then construct knowledge trees of clinical entities and attributes with radiologist guidance, and use large language models (LLMs) to extract structured information from raw reports. Next, we generate QA pairs from predefined templates and apply quality control through self-filtering and report-based filtering. During evaluation, the report is treated as context, and an LLM acts as a judge model to answer the QA pairs. Based on the resulting QA accuracy, we introduce QAScore metric. Compared with existing metrics, QAScore shows better alignment with radiologist judgments. Experiments on multiple state-of-the-art vision-language models reveal that current report-based inference paradigms struggle to learn fine-grained clinical representations and exhibit strong negative prior biases. In contrast, question-driven inference provides a more effective alternative. For reproducibility and extensibility, we release the knowledge trees, structured reports, and QA pairs, along with the pipeline code for QA construction and evaluation.

AI evaluation can support the wrong inference when an in-domain benchmark success does not survive distribution shift, or when the benchmark endpoint is entangled with a design factor. We study this problem in CRISPRi perturbation-effect prediction, evaluating a frozen Geneformer representation under a locked, pre-registered protocol: heads and model selection were frozen before test evaluation; the protocol required external outcome labels to remain withheld until final unblinding; and analysis-governing decisions were fixed before the evaluations they govern. In-distribution on the Virtual Cell Challenge (VCC), the frozen representation carries measurable predictive information beyond a dimension-matched random-feature control (Delta R^2 = +0.1645, 95% CI [+0.1375, +0.1920]), satisfying the pre-registered informativeness gate required before interpreting transfer. It then fails zero-shot transfer on both external screens (Spearman rho = -0.139 and -0.267), lying below that control on each. Adding a predefined magnitude block improves the representation externally (Delta rho = +0.032 and +0.143) but, under the frozen primary head, does not rescue transfer: both remain negative. A pre-registered, count-adjusted max-response secondary is positively associated with the outcome on both screens; we report it as correlational and secondary, not as a recovered magnitude signal. Finally, the VCC endpoint is strongly sample-size associated: a count-only linear model reaches R^2 = +0.4325, versus +0.2589 for the four magnitude scalars; adding those scalars to cell count improves R^2 by only +0.0017, so much of the aggregate-magnitude signal overlaps with cell count. This case study shows how locking the evaluation, harmonizing the measured endpoint, and separating primary from secondary evidence can change the inference supported by an AI benchmark.

Automated checking pipelines increasingly place one language model as the checker and another (or the same one) as the fixer. We ask whether that wiring changes what the checker reports. Measuring false alarms on human-verified-correct ProcessBench traces with the present task held byte-identical, we find that a completed audit -> repair episode already in the model's context lowers false alarms in 15 of 15 model x wording combinations, by 2.8 to 11.5 percentage points against a length-matched non-audit control, a 9 to 25% reduction relative to that control. The direction contradicts what the accumulated-message literature predicts: an episode whose audit reported an error lowers false alarms further still, at all five wordings on the model where that manipulation lands cleanly, though a negativity asymmetry predicts more flagging. Decomposing the episode finds repair content and audit verdict complementary: different components carry the effect on different model families. Signal-detection analysis locates the change in the threshold rather than in discrimination -- the criterion moves in 15 of 15 combinations and survives correction in 13 while d' survives in none, though the d' test is half as sensitive by construction -- and a hand audit of 50 false alarms finds 82% simply wrong, so at this operating point the shift need not be harmful. With reasoning enabled the effect keeps its relative size on both models tested, and the threshold reading holds there too.

Long-horizon LLM agents depend on intermediate information-gathering turns, yet training feedback is usually observed only at the final answer, because process-level rewards require high-quality human annotation. Existing turn-level shaping methods reward turns that increase the likelihood of a gold answer, but they require answer supervision or stable task-specific verifiers. Conversely, label-free RL methods extract self-signals from output distributions, but mainly at the answer or trajectory level and therefore cannot assign credit to intermediate turns. We propose Self-Induced Outcome Potential (SIOP), which treats semantic clusters of final answers as latent future outcome states for potential-based turn-level credit assignment. For each query, SIOP samples multiple rollouts, clusters final answers into semantic outcome modes, and builds a reliability-aware target distribution over these states. It then rewards turns for increasing posterior support for reliable future states using a tractable cluster-level approximation. The objective generalizes information-potential shaping from gold-answer supervision to settings without task-specific gold verifiers while avoiding the broadcasted rollout-level advantages used by standard GRPO. We formalize the framework, characterize its supervised gold-answer limit, and show that SIOP improves average performance over verifier-free outcome-level baselines on seven search-augmented agentic reasoning benchmarks while approaching a gold-supervised outcome baseline. Code is available at https://github.com/dl-m9/SIOP.git.

Recent advances in radiology report generation (RRG) have been driven by large paired image-text datasets; however, progress in neuro-oncology has been limited due to a lack of open paired image-report datasets. Here, we introduce BTReport, an open-source framework for brain tumor RRG that constructs natural language radiology reports using deterministically extracted imaging features. Unlike existing approaches that rely on large general-purpose or fine-tuned vision-language models for both image interpretation and report composition, BTReport performs deterministic feature extraction for image analysis and uses large language models only for syntactic structuring and narrative formatting. By separating RRG into a deterministic feature extraction step and a report generation step, the generated reports are completely interpretable and less prone to hallucinations. We show that the features used for report generation are predictive of key clinical outcomes, including survival and IDH mutation status, and reports generated by BTReport are more closely aligned with reference clinical reports than existing baselines for RRG. Finally, we introduce BTReport-BraTS, a companion dataset that augments BraTS imaging with synthetically generated radiology reports produced with BTReport. Code for this project can be found at https://github.com/KurtLabUW/BTReport.

We present a foundation model-derived method to identify highly informative tokens and events in electronic health records. Our approach considers incoming data in the entire context of a patient's hospitalization and so can flag anomalous events that rule-based approaches would consider within a normal range. We demonstrate that the events our model flags are significant for predicting downstream patient outcomes and that a fraction of events identified as carrying little information can safely be dropped. Additionally, we show how informativeness can help interpret the predictions of prognostic models trained on foundation model-derived representations.

Randomized controlled trials (RCTs) are the benchmark for causal inference, yet field implementation can deviate. We here present a remote audit - a design-based, preregistrable diagnostic that uses only pre-treatment satellite imagery to test whether assignment is independent of local conditions. The conditional randomization test of the remote audit evaluates whether treatment assignment is more predictable from pre-treatment satellite features than expected under the experiment's registered mechanism, providing a finite-sample valid, design-based diagnostic that requires no parametric assumptions. The procedure is finite-sample valid, honors blocks and clusters, and controls multiplicity across image models and resolutions via a max-statistic. We illustrate with two RCTs: Uganda's Youth Opportunities Program, where the audit corroborates randomization and flags selection and missing-data risks; and a school-based trial in Bangladesh, where assignment is highly predictable from pre-treatment features relative to the stated design, consistent with independent concerns about irregularities. Remote audits complement balance tests, lower early-stage costs, and enable rapid design checks when baseline surveys are expensive or infeasible.

Evaluating large language models (LLMs) on AMLworld's smallest test splits is costly because each of over a million targets requires a separate graph prompt. Sampling reduces this cost, but small balanced subsets change unweighted precision and F1. We introduce AMLworld-Compact, an evaluation set that retains every illicit test transaction and samples benign transactions from supervised-score strata. Its HT-Coreset protocol reduces evaluation targets by 271x and 611x on HI-Small and LI-Small. Horvitz-Thompson weights give unbiased full-test confusion-count estimates for fixed predictions; recall is exact, while precision and F1 are ratio estimates. In a held-out study using Graph Feature Preprocessor (GFP) features, one boosted-tree family defines strata for evaluating the other over 500 draws per configuration. At the released sizes, F1 RMSE is 0.00-2.58 percentage points versus 4.44-7.41 for uniform sampling with HT weights; conservative intervals remain broad. Under the evaluated graph prompts, seven open-weight LLMs have weighted precision near the predict-all-illicit baseline. In an outcome-stratified audit of 1,000 HI-Small few-shot outputs from one run per model, lexical checks pass for 84.5% of correct and 56.2% of incorrect binary verdicts, so these markers do not establish correctness. We release the evaluation sets, construction code, and audit tools at https://huggingface.co/datasets/typhoon-ai/AMLworldCompactEval and https://github.com/nat-nischw/AMLworld-Compact.

LLM agents are increasingly explored for automating root cause analysis (RCA) in cloud-native systems, creating a need to evaluate both diagnostic correctness and the quality of the supporting investigation. Existing static benchmarks offer repeatable inputs but limited system-facing interaction, while live testbeds expose realistic tools but hinder controlled comparison because incident evidence varies across runs; both paradigms focus primarily on final answers. To address these limitations, we present Cloud-OpsBench, an evaluation infrastructure for interactive and evidence-grounded cloud RCA. It comprises 754 runtime-verified cases across 57 fault types on two microservice workloads spanning application services and Kubernetes platform layers. Each fault is captured as a state snapshot and replayed through standard diagnostic interfaces, with outcome labels and diagnostic evidence graphs that enable matched comparisons and process-level analysis. Across ten LLM agents, the strongest Joint RCA Accuracy (JRA) reaches 0.76 on OnlineBoutique and 0.68 on TrainTicket, while the corresponding Evidence Closure Rates (ECR) are only 0.38 and 0.15. This outcome--process gap shows that final-answer correctness alone substantially overestimates agents' ability to perform evidence-grounded diagnosis.

BACKGROUND: Radiology reports are typically written in a free-text format, making clinical information difficult to extract and use. Recently the adoption of structured reporting (SR) has been recommended by various medical societies thanks to the advantages it offers, e.g. standardization, completeness and information retrieval. We propose a pipeline to extract information from free-text radiology reports, that fits with the items of the reference SR registry proposed by a national society of interventional and medical radiology, focusing on CT staging of patients with lymphoma. METHODS: Our work aims to leverage the potential of Natural Language Processing (NLP) and Transformer-based models to deal with automatic SR registry filling. With the availability of 174 radiology reports, we investigate a rule-free generative Question Answering approach based on a domain-specific version of T5 (IT5). Two strategies (batch-truncation and ex-post combination) are implemented to comply with the model's context length limitations. Performance is evaluated in terms of strict accuracy, F1, and format accuracy, and compared with the widely used GPT-3.5 Large Language Model. A 5-point Likert scale questionnaire is used to collect human-expert feedback on the similarity between medical annotations and generated answers. RESULTS: The combination of fine-tuning and batch splitting allows IT5 to achieve notable results; it performs on par with GPT-3.5 albeit its size being a thousand times smaller in terms of parameters. Human-based assessment scores show a high correlation (Spearman's correlation coefficients>0.88, p-values<0.001) with AI performance metrics (F1) and confirm the superior ability of LLMs (i.e., GPT-3.5, 175B of parameters) in generating plausible human-like statements.

Imitation-learning policies for robot manipulation inherit the quality of the success labels attached to their training episodes, and those labels are usually produced by the robot's own success check. A particularly damaging error is the false success: an episode the robot logs as a success when the task outcome was actually wrong. We ask a narrow but practical question about these episodes. Once an episode has already been flagged as a success, how much of the information needed to overturn that label is present in proprioception, and how much requires vision? We build a simulated testbed on two bimanual ALOHA tasks, induce failures through environment perturbations rather than label edits, label every episode by privileged simulator state that the detector never sees, and keep only episodes the robot flagged as successful. We then compare detectors restricted to proprioception against a vision-based detector. We find that recoverability spans a wide range: in cube transfer the false successes are almost fully recoverable from joint data alone, while in peg insertion proprioception recovers only part of them and a vision detector closes most of the gap. We also show that the proprioceptive separability we measure rests on velocity differences far below any realistic sensor noise floor, so it is best read as an optimistic upper bound that a noiseless simulator inflates. We release the generation and evaluation pipeline.

Bronchopulmonary dysplasia (BPD) is a chronic lung disease affecting 35% of extremely low birth weight infants. Defined by oxygen dependence at 36 weeks postmenstrual age, it causes lifelong respiratory complications. However, preventive interventions carry severe risks, including neurodevelopmental impairment, ventilator-induced lung injury, and systemic complications. Therefore, early BPD prognosis and prediction of BPD outcome is crucial to avoid unnecessary toxicity in low risk infants. Admission radiographs of extremely preterm infants are routinely acquired within 24h of life and could serve as a non-invasive prognostic tool. In this work, we developed and investigated a deep learning approach using chest X-rays from 163 extremely low-birth-weight infants (leq32 weeks gestation, 401-999g) obtained within 24 hours of birth. We fine-tuned a ResNet-50 pretrained specifically on adult chest radiographs, employing progressive layer freezing with discriminative learning rates to prevent overfitting and evaluated a CutMix augmentation and linear probing. For moderate/severe BPD outcome prediction, our best performing model with progressive freezing, linear probing and CutMix achieved an AUROC of 0.78 pm 0.10, balanced accuracy of 0.69 pm 0.10, and an F1-score of 0.67 pm 0.11. In-domain pre-training significantly outperformed ImageNet initialization (p = 0.031) which confirms domain-specific pretraining to be important for BPD outcome prediction. Routine IRDS grades showed limited prognostic value (AUROC 0.57 pm 0.11), confirming the need of learned markers. Our approach demonstrates that domain-specific pretraining enables accurate BPD prediction from routine day-1 radiographs. Through progressive freezing and linear probing, the method remains computationally feasible for site-level implementation and future federated learning deployments.

Retrieval-augmented generation (RAG) has emerged as a popular solution to mitigate the hallucination issues of large language models. However, existing studies on RAG seldom address the issue of predictive uncertainty, i.e., how likely it is that a RAG model's prediction is incorrect, resulting in uncontrollable risks in real-world applications. In this work, we emphasize the importance of risk control, ensuring that RAG models proactively refuse to answer questions with low confidence. Our research identifies two critical latent factors affecting RAG's confidence in its predictions: the quality of the retrieved results and the manner in which these results are utilized. To guide RAG models in assessing their own confidence based on these two latent factors, we develop a counterfactual prompting framework that induces the models to alter these factors and analyzes the effect on their answers. We also introduce a benchmarking procedure to collect answers with the option to abstain, facilitating a series of experiments. For evaluation, we introduce several risk-related metrics and the experimental results demonstrate the effectiveness of our approach.

Verification for retrieval-augmented generation usually scores each retrieved chunk and drops the ones that fail. We show this cannot work for multi-hop questions, and show what does. Per-chunk scoring assumes one chunk is a sufficient premise for the answer. Multi-hop questions are built so that none is, and the paragraph carrying the answer is the one the question does not name. Entailment scoring reaches 0.643, 0.523 and 0.560 AUC on HotpotQA, 2WikiMultihopQA and MuSiQue, against 0.951 on single-hop SQuAD. Seven controls rule out model capacity, premise length, hypothesis template, decision threshold, retriever, answer-matching criterion and prompt. End to end across three datasets, three generator sizes and two prompts, per-chunk gating is significantly worse than not filtering at all in every cell, and its penalty grows with generator capability. The repair is to condition verification on the decomposed sub-question rather than the original query. Using MuSiQue's gold decomposition, entailment on a later hop rises from 0.546, which is chance, to 0.840, a paired lift of +0.355 with a bootstrap interval of [0.331, 0.382]. An off-the-shelf Qwen2.5-7B decomposer, given the question and the top retrieved paragraph, reaches 0.637 and captures 31% of that ceiling; decomposing without retrieval reaches 0.533, below the original question. Iterative retrieval systems already produce such decompositions and discard them before verifying.

Commonly used evaluation measures including Recall, Precision, F-Measure and Rand Accuracy are biased and should not be used without clear understanding of the biases, and corresponding identification of chance or base case levels of the statistic. Using these measures a system that performs worse in the objective sense of Informedness, can appear to perform better under any of these commonly used measures. We discuss several concepts and measures that reflect the probability that prediction is informed versus chance. Informedness and introduce Markedness as a dual measure for the probability that prediction is marked versus chance. Finally we demonstrate elegant connections between the concepts of Informedness, Markedness, Correlation and Significance as well as their intuitive relationships with Recall and Precision, and outline the extension from the dichotomous case to the general multi-class case.

Reliable end-to-end clinical report generation has been a longstanding goal of medical ML research. The end goal for this process is to alleviate radiologists' workloads and provide second opinions to clinicians or patients. Thus, a necessary prerequisite for report generation models is a strong general performance and some type of innate grounding capability, to convince clinicians or patients of the veracity of the generated reports. In this paper, we present ASaRG (Automatic Segmentation-assisted Report Generation), an extension of the popular LLaVA architecture that aims to tackle both of these problems. ASaRG proposes to fuse intermediate features and fine-grained segmentation maps created by specialist radiological models into LLaVA's multi-modal projection layer via simple concatenation. With a small number of added parameters, our approach achieves a +0.89\% performance gain (p=0.012) in CE F1 score compared to the LLaVA baseline when using only intermediate features, and +2.77\% performance gain (p<0.001) when adding a combination of intermediate features and fine-grained segmentation maps. Compared with COMG and ORID, two other report generation methods that utilize segmentations, the performance gain amounts to 6.98\% and 6.28\% in F1 score, respectively. ASaRG is not mutually exclusive with other changes made to the LLaVA architecture, potentially allowing our method to be combined with other advances in the field. Finally, the use of an arbitrary number of segmentations as part of the input demonstrably allows tracing elements of the report to the corresponding segmentation maps and verifying the groundedness of assessments. Our code will be made publicly available at a later date.

Robot world models support policy evaluation, planning, and synthetic data generation, but these applications require predictions that distinguish successful actions from failures. Across four released checkpoints from two architecture families, we observe weak sensitivity to action changes and success-like predictions on verified failures. Although recent work incorporates failures into model training, which data can repair released checkpoints without changing their architecture or training objective still remains underexplored. To this end, we introduce CureWM, which constructs alternative actions from successful demonstrations across a severity grid, verifies their outcomes through execution in simulation or on hardware, and fine-tunes released models on the resulting failures and surviving successes alongside nominal demonstrations. This construction provides controlled action contrasts from shared starting contexts. On 484 held-out LIBERO failure counterfactuals, optimism falls from 80\% after fine-tuning on the official data to 30--43\% across four independently fine-tuned CureWM models (38\% mean). In two separate evaluations on a physical robot arm, failure predictions scored as success-like by a latent-distance diagnostic decrease from 90\% after fine-tuning on successful demonstrations alone to 33\% with CureWM. With failure counts per task, successful replay data, and training budget matched, counterfactual failures yield a success--failure value gap of 0.124, compared with 0.014 for freshly collected on-policy failures. These findings support execution-verified counterfactual replay for post-hoc repair and show why reduced optimism must be evaluated alongside success--failure discrimination. Code is available at https://github.com/jiuyixu25/CureWM.

A comparison of the distances to the Huanan Seafood Market of early Covid cases with known links to the market versus cases without known links shows results apparently incompatible with a location model lacking proximity ascertainment bias. The sign of the difference instead agrees with a model in which such ascertainment bias is large. In the presence of such bias inferences based on the clustering of case locations become unreliable.

As LLM-based agents are deployed in complex, multi-step workflows, a critical evaluation gap has emerged: most existing benchmarks judge only final outcomes, unable to distinguish reliable reasoning from lucky success or attribute failures to specific process deficiencies, hindering attribution in long-horizon tasks. In this work, we present ClawTrack, a dual-assessment benchmark that simultaneously measures what an agent achieves (Task Score) and how it achieves it (Process Score). ClawTrack comprises 320 tasks across 8 domains with 25+ deterministic mock services. A Process Grader scores each reasoning turn along four dimensions (goal alignment, efficiency, information utilization, and result verification), anchored by 12,541 task-specific rubric items. Evaluating 21 models over 16,000+ trials, we find that: (1) process scores effectively attribute success and failure to specific reasoning dimensions, filtering lucky passes invisible to outcome-only evaluation; (2) the four dimensions are complementary, with result verification as the systematic bottleneck; (3) the framework is robust to evaluator choice across different judge LLMs; and (4) process-based trajectory filtering yields consistent post-training improvements across model scales.

Objective: BCI (Brain-Computer Interface) technology operates in three modes: online, offline, and pseudo-online. In the online mode, real-time EEG data is constantly analyzed. In offline mode, the signal is acquired and processed afterwards. The pseudo-online mode processes collected data as if they were received in real-time. The main difference is that the offline mode often analyzes the whole data, while the online and pseudo-online modes only analyze data in short time windows. Offline analysis is usually done with asynchronous BCIs, which restricts analysis to predefined time windows. Asynchronous BCI, compatible with online and pseudo-online modes, allows flexible mental activity duration. Offline processing tends to be more accurate, while online analysis is better for therapeutic applications. Pseudo-online implementation approximates online processing without real-time constraints. Many BCI studies being offline introduce biases compared to real-life scenarios, impacting classification algorithm performance. Approach: The objective of this research paper is therefore to extend the current MOABB framework, operating in offline mode, so as to allow a comparison of different algorithms in a pseudo-online setting with the use of a technology based on overlapping sliding windows. To do this will require the introduction of a idle state event in the dataset that takes into account all different possibilities that are not task thinking. To validate the performance of the algorithms we will use the normalized Matthews Correlation Coefficient (nMCC) and the Information Transfer Rate (ITR). Main results: We analyzed the state-of-the-art algorithms of the last 15 years over several Motor Imagery (MI) datasets composed by several subjects, showing the differences between the two approaches from a statistical point of view. Significance: The ability to analyze the performance of different algorithms in offline and pseudo-online modes will allow the BCI community to obtain more accurate and comprehensive reports regarding the performance of classification algorithms.

Predicting case outcomes is useful but still an extremely hard task for attorneys and other Law professionals. It is not easy to search case information to extract valuable information as this requires dealing with huge data sets and their complexity. For instance, the complexity of Brazil legal system along with the high litigation rates makes this problem even harder. This paper introduces an approach for predicting Brazilian court decisions which is also able to predict whether the decision will be unanimous. We developed a working prototype which performs 79% of accuracy (F1-score) on a data set composed of 4,043 cases from a Brazilian court. To our knowledge, this is the first study to forecast judge decisions in Brazil.

Recent works have extended notions of feature importance to semantic concepts that are inherently interpretable to the users interacting with a black-box predictive model. Yet, precise statistical guarantees, such as false positive rate control, are needed to communicate findings transparently and to avoid unintended consequences in real-world scenarios. In this paper, we formalize the global (i.e., over a population) and local (i.e., for a sample) statistical importance of semantic concepts for the predictions of opaque models, by means of conditional independence, which allows for rigorous testing. We use recent ideas of sequential kernelized testing (SKIT) to induce a rank of importance across concepts, and showcase the effectiveness and flexibility of our framework on synthetic datasets as well as on image classification tasks using vision-language models such as CLIP.

Tool-using AI agents are increasingly deployed across enterprise software systems, yet widely used benchmarks primarily evaluate nominal task completion, conflating baseline planning competence with operational fault recovery. We introduce UndoBench, a benchmark spanning 36 base workflows and 36 fault scenarios across 8 enterprise domains, decoupling task competence from recovery capability via counterfactual paired trials under identical seeds alongside wire-level effect-history and environment-state oracles. On 12 held-out TEST workflows across two open-weight models, two frameworks, and three recovery paradigms (5,760 executions / 2,880 paired trials) in the frozen lost-acknowledgment study, nominal competence reached 83.54% while conditional recovery success rate (CRSR) fell to 46.72%, with naive retry producing duplicate external effects in 53.33% of trials. Extensions to commercial API models reproduced this competence-recovery separation. Evaluations across complementary execution boundaries show that recovery is phase-dependent: before mutation, methods perform similarly without duplicate effects among capable trials; during partial mutation, naive retry, per-call idempotency, and zero-privilege journaling collapse on the evaluated composite workflows; after commit but before acknowledgment, verification and server-side idempotency substantially improve safety. These findings demonstrate that evaluating nominal completion alone masks critical, phase-dependent recovery vulnerabilities in autonomous agents.

Standard embodied evaluations do not independently score whether an agent correctly commits to task completion at episode closure, a capacity we call terminal commitment. Behaviorally distinct failures--never completing the task, completing it but failing to stop, and reporting success without sufficient evidence--collapse into the same benchmark failure. We introduce VIGIL, an evaluation framework that makes terminal commitment independently measurable. Under VIGIL's default protocol, agents observe only egocentric RGB, receive no action-success signals, and must end each episode with a semantic report checked deterministically against hidden world state. This yields two separate scores: world-state completion (W) and benchmark success (B), where B additionally requires a correct terminal report. This decoupling makes four outcome categories distinguishable: missed execution, post-attainment drift, unsupported commitment, and verified success. Across 20 models on 1,000 frozen episodes, systems with comparable W differ by up to 19.7 pp in B: one model converts achieved states into correct reports, while another with near-identical execution drifts past the goal without closing. An action-feedback intervention further tests the separation: execution-oriented signals improve W broadly, yet commitment failures persist in models that do not already ground terminal reports in the achieved state. VIGIL provides a protocol that makes terminal commitment independently visible and scorable.

Machine learning (ML) holds great potential for accurately forecasting treatment outcomes over time, which could ultimately enable the adoption of more individualized treatment strategies in many practical applications. However, a significant challenge that has been largely overlooked by the ML literature on this topic is the presence of informative sampling in observational data. When instances are observed irregularly over time, sampling times are typically not random, but rather informative -- depending on the instance's characteristics, past outcomes, and administered treatments. In this work, we formalize informative sampling as a covariate shift problem and show that it can prohibit accurate estimation of treatment outcomes if not properly accounted for. To overcome this challenge, we present a general framework for learning treatment outcomes in the presence of informative sampling using inverse intensity-weighting, and propose a novel method, TESAR-CDE, that instantiates this framework using Neural CDEs. Using a simulation environment based on a clinical use case, we demonstrate the effectiveness of our approach in learning under informative sampling.

In legal NLP, Case Outcome Classification (COC) must not only be accurate but also trustworthy and explainable. Existing work in explainable COC has been limited to annotations by a single expert. However, it is well-known that lawyers may disagree in their assessment of case facts. We hence collect a novel dataset RAVE: Rationale Variation in ECHR1, which is obtained from two experts in the domain of international human rights law, for whom we observe weak agreement. We study their disagreements and build a two-level task-independent taxonomy, supplemented with COC-specific subcategories. To our knowledge, this is the first work in the legal NLP that focuses on human label variation. We quantitatively assess different taxonomy categories and find that disagreements mainly stem from underspecification of the legal context, which poses challenges given the typically limited granularity and noise in COC metadata. We further assess the explainablility of SOTA COC models on RAVE and observe limited agreement between models and experts. Overall, our case study reveals hitherto underappreciated complexities in creating benchmark datasets in legal NLP that revolve around identifying aspects of a case's facts supposedly relevant to its outcome.

Large language models (LLMs) have demonstrated impressive capabilities in reasoning with the emergence of reasoning models like OpenAI-o1 and DeepSeek-R1. Recent research focuses on integrating reasoning capabilities into the realm of retrieval-augmented generation (RAG) via outcome-supervised reinforcement learning (RL) approaches, while the correctness of intermediate think-and-search steps is usually neglected. To address this issue, we design a process-level reward module to mitigate the unawareness of intermediate reasoning steps in outcome-level supervision without additional annotation. Grounded on this, we propose Learning to Think-and-Search (LeTS), a novel framework that hybridizes stepwise process reward and outcome-based reward to current RL methods for RAG. Extensive experiments demonstrate the generalization and inference efficiency of LeTS across various RAG benchmarks. In addition, these results reveal the potential of process- and outcome-level reward hybridization in boosting LLMs' reasoning ability via RL under other scenarios. The code will be released soon.

Large language models (LLMs) have demonstrated remarkable capabilities in natural language understanding and generation across various domains, including medicine. We present a comprehensive evaluation of GPT-4, a state-of-the-art LLM, on medical competency examinations and benchmark datasets. GPT-4 is a general-purpose model that is not specialized for medical problems through training or engineered to solve clinical tasks. Our analysis covers two sets of official practice materials for the USMLE, a three-step examination program used to assess clinical competency and grant licensure in the United States. We also evaluate performance on the MultiMedQA suite of benchmark datasets. Beyond measuring model performance, experiments were conducted to investigate the influence of test questions containing both text and images on model performance, probe for memorization of content during training, and study probability calibration, which is of critical importance in high-stakes applications like medicine. Our results show that GPT-4, without any specialized prompt crafting, exceeds the passing score on USMLE by over 20 points and outperforms earlier general-purpose models (GPT-3.5) as well as models specifically fine-tuned on medical knowledge (Med-PaLM, a prompt-tuned version of Flan-PaLM 540B). In addition, GPT-4 is significantly better calibrated than GPT-3.5, demonstrating a much-improved ability to predict the likelihood that its answers are correct. We also explore the behavior of the model qualitatively through a case study that shows the ability of GPT-4 to explain medical reasoning, personalize explanations to students, and interactively craft new counterfactual scenarios around a medical case. Implications of the findings are discussed for potential uses of GPT-4 in medical education, assessment, and clinical practice, with appropriate attention to challenges of accuracy and safety.

Background. Aircraft-wildlife collisions are a documented aviation hazard. The FAA National Wildlife Strike Database is the main public source of U.S. reports, but raw extracts are large and rarely released as versioned aggregates. Methods. We convert the public FAA Access export (STRIKE_REPORTS) to SQLite, define a report as damaging when DAMAGE_LEVEL is one of M, M?, S, D, and fold rows into open aggregates (year, airport, species, aircraft, animal family) via hierarchical SPECIES_ID prefixes. We analyze all civil reports and a commercial subset (AC_MASS 3-5). Rates are per reported strike, not per flight hour, so every rate is conditional on a report having been filed. Trend statistics use complete incident years 1990-2025; cross-sectional facets cover the full seed, incident years 1990-2026. Results. Numbers are locked to the 2026-07-04 freeze. Reported strikes in 2025 reach a series high (24,458 total; 901 damaging). Species that dominate strike counts are not those with the highest damage rates: perching songbirds account for 41.1% of identified strikes but damage aircraft in 1.5% of reports (95% CI 1.4-1.6), whereas deer account for 0.7% but damage aircraft in 81.8% of reports (95% CI 79.8-83.7). Airports ranked by total strikes (led by Denver Intl) diverge from rankings by damaging strikes (led by Sacramento Intl); across the 452 airports with at least 50 reports, volume and conditional damage rate are negatively rank-correlated (Spearman rho = -0.44, p < 0.001); large stations plausibly capture minor events more completely, so this is not a hazard ranking. The share of reports labeled damaging declines over decades, consistent with improved reporting of minor events, while absolute damaging counts peak in 2025. Conclusions. Versioned open aggregates and a documented damage-rate analysis enable independent reuse; released under CC BY 4.0.

Agentic multimodal models perform diverse operations on an image via code and reason over the returned view, an effective paradigm for fine-grained visual question answering. However, code operations can be useful, redundant, or misleading. Outcome-only rewards cannot precisely distinguish these cases, and existing process rewards either fail to attribute final correctness to individual tool calls, or require an external judge model. To address this, we introduce Tool-Augmented Credit Optimization (TACO), a GRPO variant for code-tool agents built on two coupled advantage channels. The first, Differential Answer-Probe Reward (DAPR), is a self-supervised, judge-free tool-contribution advantage that credits each tool call by its own effect on answering correctly. Probe tokens inserted into the model's reasoning elicit its predictions with and without the tool, and the difference in outcome reward is taken as the call's value: positive for a useful call, negative for a misleading one, and zero for one that changes nothing. This reuses the existing answer checker with no auxiliary judge, and, being a difference rather than an absolute probe score, is naturally robust to probe-hacking. The second is the outcome advantage from the final answer, distributed by Outcome-Gated Advantage Routing (OGAR): a parameter-free rule that, conditioned on the call's outcome, delivers this credit only to the responsible segments, suppressing wasted tool calls without any cost term. We train TACO through a two-stage SFT+RL pipeline. Extensive experiments across perception, reasoning, and general multimodal benchmarks show that it yields consistent accuracy gains and learns to invoke its tools only when they help.

Purpose : To develop and evaluate CAPTOR, a deep-learning vision-language foundation model for oncologic chest-abdomen-pelvis (CAP) CT interpretation. Materials & Methods : CAPTOR (Chest-Abdomen-Pelvis foundaTion model for Oncologic Radiology) is a contrastive vision-language model, trained using a pretraining strategy for oncologic CAP CT (in single- or multiple-series acquisitions), on a multicenter retrospective dataset from North America, Europe and Asia, predominantly from tumor lesion examinations. CAPTOR was compared with state-of-the-art CT foundation models on three downstream tasks: disease detection, survival prediction using TumorImagingBench and image retrieval. Classification and retrieval were both evaluated on held-out internal and public test sets, stratified by anatomical coverage and indication. Bootstrap resampling was used to estimate confidence intervals, and pairwise comparisons were performed using permutation tests. Results : CAPTOR was trained and tested on 25,512 and 10,794 CT-report pairs respectively. TumorImagingBench datasets comprised between 134 and 421 studies each. CAPTOR outperformed all baseline models, on the classification task, on the CAP subset (AUC 0.767, 95%CI: 0.734-0.793, vs. 0.695, 95%CI: 0.645-0.736 for the next-best, p<0.001) and oncologic subset (AUC 0.784, 95%CI: 0.759-0.805, vs. 0.734, 95%CI: 0.703-0.767 p<0.001), ranked first on three of the four oncologic prognostic benchmarks, and achieved superior retrieval performance on CAP and oncologic subsets. Conclusion : A foundation model trained on oncology-enriched CAP CT data outperformed relevant state-of-the-art models in its target clinical context, underscoring the importance of clinically aligned pretraining. We release our preprocessing, training and inference code : https://github.com/Guerbet-AI/CAPTOR and model weights : https://huggingface.co/Guerbet-AI/CAPTOR

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

Many modern AI question-answering systems convert text into vectors and retrieve the closest matches to a user question. While effective for topical similarity, similarity scores alone do not explain why some retrieved text can serve as evidence while other equally similar text cannot. When many candidates receive similar scores, systems may select sentences that are redundant, incomplete, or address different conditions than the question requires. This paper presents a deterministic evidence selection framework for retrieval-augmented question answering. The approach introduces Meaning-Utility Estimation (MUE) and Diversity-Utility Estimation (DUE), fixed scoring and redundancy-control procedures that determine evidence admissibility prior to answer generation. Each sentence or record is evaluated independently using explicit signals for semantic relatedness, term coverage, conceptual distinctiveness, and redundancy. No training or fine-tuning is required. In the prototype, a unit is accepted only if it explicitly states the fact, rule, or condition required by the task. Units are not merged or expanded. If no unit independently satisfies the requirement, the system returns no answer. This deterministic gating produces compact, auditable evidence sets and establishes a clear boundary between relevant text and usable evidence.

This study presents a hybrid framework for predicting movie success. The framework integrates multi-task learning (MTL), GPT-based sentiment analysis, and Susceptible-Infected-Recovered (SIR) propagation modeling. The study examines limitations in existing approaches. It models static production attributes, information dissemination, and audience sentiment at the same time. The framework uses 5,840 films from 2004 to 2024 and approximate 300,000 user reviews. It shows predictive performance with classification accuracy of 0.964 and regression metrics of MAE 0.388. Ablation analysis indicates component interactions. Selective feature combinations perform better than the comprehensive model. This result questions assumptions about feature integration. The model shows virality patterns between successful and unsuccessful films. Innovations include epidemiological modeling for information diffusion, multidimensional sentiment features from GPT-based analysis, and a shared representation architecture that optimizes multiple success metrics. The framework provides applications in the film production lifecycle. It also contributes to understanding how audience engagement leads to commercial outcomes.

Large language models (LLMs) increasingly decide whether software behaves correctly, either by writing a test oracle or by acting as one. Yet two oracles can look identical and rest on different ground: one assertion encodes a written specification, another only what the model learned in training. Prior secondary studies sort oracles by form or by technique, rarely by the property that governs how far a verdict can be trusted: where its authority comes from. This systematic literature review, reported under the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines, screens 2,436 records to 54 included studies, extended by citation searching (snowballing) to 83 in total. We read the corpus along three axes: the source of an oracle's authority, the form it takes, and the mechanism that adjudicates it. Just over half of the corpus reaches a verdict with no specification at all. That is what lets these oracles work on code with no specification to consult, and what leaves a challenged verdict with less to fall back on. Source and mechanism cross-cut rather than coincide, so a label such as LLM-as-a-judge names how a verdict is produced, not why it should be trusted. Oracle quality is most often judged by resemblance to a known oracle rather than by whether injected faults are caught. The first question to ask of any LLM oracle is therefore what one would point to in defending its verdict. The protocol, search query, and per-study coding sheet are released.

Breast cancer is a significant health concern affecting millions of women worldwide. Accurate survival risk stratification plays a crucial role in guiding personalised treatment decisions and improving patient outcomes. Here we present BioFusionNet, a deep learning framework that fuses image-derived features with genetic and clinical data to achieve a holistic patient profile and perform survival risk stratification of ER+ breast cancer patients. We employ multiple self-supervised feature extractors, namely DINO and MoCoV3, pretrained on histopathology patches to capture detailed histopathological image features. We then utilise a variational autoencoder (VAE) to fuse these features, and harness the latent space of the VAE to feed into a self-attention network, generating patient-level features. Next, we develop a co-dual-cross-attention mechanism to combine the histopathological features with genetic data, enabling the model to capture the interplay between them. Additionally, clinical data is incorporated using a feed-forward network (FFN), further enhancing predictive performance and achieving comprehensive multimodal feature integration. Furthermore, we introduce a weighted Cox loss function, specifically designed to handle imbalanced survival data, which is a common challenge in the field. The proposed model achieves a mean concordance index (C-index) of 0.77 and a time-dependent area under the curve (AUC) of 0.84, outperforming state-of-the-art methods. It predicts risk (high versus low) with prognostic significance for overall survival (OS) in univariate analysis (HR=2.99, 95% CI: 1.88--4.78, p<0.005), and maintains independent significance in multivariate analysis incorporating standard clinicopathological variables (HR=2.91, 95% CI: 1.80--4.68, p<0.005). The proposed method not only improves model performance but also addresses a critical gap in handling imbalanced data.

When can an agent failure be caught? An audit is usually limited by the record rather than by the method. CatchBench therefore puts one auditor's question to three information states: the declared configuration before a run (PRE), a growing prefix of its trace (LIVE), and the finished trace (POST). Prior benchmarks fix one of these states or vary the telemetry; to our knowledge none scores all three under one task-method interface. Each state admits different questions, so seven task contracts carry their own labels and metrics rather than one leaderboard. Four are evidential; three are Gold-derived mechanism diagnostics. The release scores 72 entrants, from rule scanners and structural models to eleven LLM judges across nine model families (GPT, Claude, Gemini, Gemma, Llama, Qwen, DeepSeek, Mistral, Nova), over 1187 declared configurations and 1162 recorded runs. Most of the arena does not order: 56 of 138 registered contrasts separate, and the rest are published unresolved rather than ranked. The two sharpest results cut against our own data. One rule ignores every name and permission; it flags each capability declared after the first. On one of six configuration sources it reaches a perfect F1, so a score there measures how the corpus was built rather than how well a method reasons. Our admissibility bar then rejected one injected substrate and withheld evidential status from the other. A benchmark number is therefore not interpretable until the process behind its labels is published and tested for the shortcut it may leave. We report both, and regenerate every ordering from released predictions with no model call.

In this paper, we propose R^3: Learning Reasoning through Reverse Curriculum Reinforcement Learning (RL), a novel method that employs only outcome supervision to achieve the benefits of process supervision for large language models. The core challenge in applying RL to complex reasoning is to identify a sequence of actions that result in positive rewards and provide appropriate supervision for optimization. Outcome supervision provides sparse rewards for final results without identifying error locations, whereas process supervision offers step-wise rewards but requires extensive manual annotation. R^3 overcomes these limitations by learning from correct demonstrations. Specifically, R^3 progressively slides the start state of reasoning from a demonstration's end to its beginning, facilitating easier model exploration at all stages. Thus, R^3 establishes a step-wise curriculum, allowing outcome supervision to offer step-level signals and precisely pinpoint errors. Using Llama2-7B, our method surpasses RL baseline on eight reasoning tasks by 4.1 points on average. Notebaly, in program-based reasoning on GSM8K, it exceeds the baseline by 4.2 points across three backbone models, and without any extra data, Codellama-7B + R^3 performs comparable to larger models or closed-source models.

Modern AI systems depend on annotated data, but annotation is rarely treated as the act of measurement that it is. Instead, annotation quality is commonly reduced to agreement: if multiple annotators assign the same annotation to a data instance, the annotations are taken to be high-quality. Yet agreement does not establish whether annotations validly capture the underlying concept they are meant to represent. In this paper, we argue that data annotation should be understood as a measurement problem. Like other forms of measurement, annotation requires defining a concept, operationalizing it through an instrument, applying that instrument, and evaluating the reliability and validity of the resulting measurements. Drawing on a literature review of annotation quality research (N=132) and semi-structured interviews with annotation team members (N=10), we develop a framework for diagnosing and correcting annotation issues. First, we map key decision points across annotation processes - including task design, annotator management, quality assessment, quality improvement, and adjudication - that shape annotation outcomes. Second, we identify five distinct sources of annotation issues: error, ambiguity, impossibility, subjectivity, and annotator identity. Annotation problems that appear similar at the level of outcomes often require different process-level interventions based on their sources. Finally, we translate measurement theory into practical guidance for annotation teams, showing how assessments of reliability and validity can move beyond agreement alone. By reframing annotation as measurement, we offer a conceptual foundation for improving the quality of annotated data used in AI research and practice.

As AI systems are increasingly used to draft radiology reports, reliably evaluating their clinical quality remains a critical challenge. Large language model (LLM)-based metrics are now the best-correlated with radiologist judgment, yet they output a single opaque score that neither a clinician nor a model builder can easily interpret or audit. We introduce RadMatch, a multi-stage, LLM-based metric that decomposes report comparison into a structured finding-level matching with significance-aware scoring and error characterization across seven clinical attribute dimensions (status, location, severity, morphology, certainty, longitudinal comparison, and measurement). The main score is the actionable-error count, both interpretable and auditable. Candidate findings are graded correct, partial, or incorrect, and unmatched findings are counted as missed or hallucinated. Triage and actionable safety recall/precision and per-subset views add complementary, deployment-oriented lenses. Across two expert benchmarks, RadMatch is the most clinically aligned metric, matching inter-radiologist agreement on ReXVal and more than doubling the best prior metric on the harder RadEvalExpert. Relying only on few-shot prompting, it is designed to extend to other modalities and anatomies. We will release RadMatch as open-source code with an interactive dashboard for inspecting results.

In Brazil, all legal professionals must demonstrate their knowledge of the law and its application by passing the OAB exams, the national bar exams. The OAB exams therefore provide an excellent benchmark for the performance of legal information systems since passing the exam would arguably signal that the system has acquired capacity of legal reasoning comparable to that of a human lawyer. This article describes the construction of a new data set and some preliminary experiments on it, treating the problem of finding the justification for the answers to questions. The results provide a baseline performance measure against which to evaluate future improvements. We discuss the reasons to the poor performance and propose next steps.

Background: AI-driven prediction algorithms have the potential to enhance emergency medicine by enabling rapid and accurate decision-making regarding patient status and potential deterioration. However, the integration of multimodal data, including raw waveform signals, remains underexplored in clinical decision support. Methods: We present a dataset and benchmarking protocol designed to advance multimodal decision support in emergency care. Our models utilize demographics, biometrics, vital signs, laboratory values, and electrocardiogram (ECG) waveforms as inputs to predict both discharge diagnoses and patient deterioration. Results: The diagnostic model achieves area under the receiver operating curve (AUROC) scores above 0.8 for 609 out of 1,428 conditions, covering both cardiac (e.g., myocardial infarction) and non-cardiac (e.g., renal disease, diabetes) diagnoses. The deterioration model attains AUROC scores above 0.8 for 14 out of 15 targets, accurately predicting critical events such as cardiac arrest, mechanical ventilation, ICU admission, and mortality. Conclusions: Our study highlights the positive impact of incorporating raw waveform data into decision support models, improving predictive performance. By introducing a unique, publicly available dataset and baseline models, we provide a foundation for measurable progress in AI-driven decision support for emergency care.

Large language models (LLMs) face a dual challenge in creative capability evaluation: existing benchmarks (e.g., Story Cloze Test, HellaSwag) measure models' discriminative ability over narrative continuation using multiple-choice recognition paradigms, rather than directly measuring creative generation capability; rubric-based scoring and LLM-as-Judge methods rely on subjective dimension assessment or natural language model outputs, and cannot provide objective, automated scoring mechanisms. This paper proposes QUIET (Quality Understanding via Interlocked Evaluation Testing), a diagnostic benchmark for LLM creative capability based on multi-blank cascaded story cloze. QUIET sets N blanks (10-20) in a story with complete structure, with each blank accompanied by an explicit content constraint, and cascade dependency relationships between blanks -- the content filled into earlier blanks constrains the feasible solution space for later blanks. The evaluated model (or human participants) fills all blanks in open-ended generation mode; the results are scored by an information-theoretic automated scoring protocol without human grading. The scoring protocol directly operationalizes the "calibrated surprise" theoretical framework (Zou & Xu, 2026a). For each blank k, a composite score is computed: score = satisfy * (1 + lambda * surprise), where lambda = 1.0. Here, "satisfy" measures how well the blank filling satisfies the content constraint (objective logical reasoning judgment, not subjective aesthetic scoring), and "surprise" measures the degree of surprise given that the constraint is satisfied. Creative answers that do not satisfy the constraint score zero; answers that satisfy the constraint but are mediocre score low; answers that satisfy the constraint and are surprising score high.

Reliable probability estimation is of crucial importance in many real-world applications where there is inherent (aleatoric) uncertainty. Probability-estimation models are trained on observed outcomes (e.g. whether it has rained or not, or whether a patient has died or not), because the ground-truth probabilities of the events of interest are typically unknown. The problem is therefore analogous to binary classification, with the difference that the objective is to estimate probabilities rather than predicting the specific outcome. This work investigates probability estimation from high-dimensional data using deep neural networks. There exist several methods to improve the probabilities generated by these models but they mostly focus on model (epistemic) uncertainty. For problems with inherent uncertainty, it is challenging to evaluate performance without access to ground-truth probabilities. To address this, we build a synthetic dataset to study and compare different computable metrics. We evaluate existing methods on the synthetic data as well as on three real-world probability estimation tasks, all of which involve inherent uncertainty: precipitation forecasting from radar images, predicting cancer patient survival from histopathology images, and predicting car crashes from dashcam videos. We also give a theoretical analysis of a model for high-dimensional probability estimation which reproduces several of the phenomena evinced in our experiments. Finally, we propose a new method for probability estimation using neural networks, which modifies the training process to promote output probabilities that are consistent with empirical probabilities computed from the data. The method outperforms existing approaches on most metrics on the simulated as well as real-world data.

Artificial-intelligence (AI) agents hold promise for automating bioimage analysis, yet no benchmark evaluates whether they can carry out real-world analyses end to end. Such analyses are hard for agents because 2D images, 3D volumes and time-lapse sequences are often too large to read as context, so an agent must choose and run an analysis through code, specialized software and rendered views. Published studies make this capability testable, because each pairs raw images with a peer-reviewed result. We introduce BIABench, a benchmark of 16 tasks reconstructed from published biological studies that retain their scientific questions, imaging data and ground truth. The tasks span eleven analysis subtasks and modalities from H&E histology to single-molecule localization microscopy. Each submission receives an outcome score, which compares the output files with the ground truth using field-standard metrics, and a process score, in which a vision-language model judges method choice and quality control against an expert-written rubric. We evaluated general-purpose and biology-specific agents across several language models, with repeated runs of every task. Routine two-dimensional tasks were solved well, but on some tasks that added a third dimension or a time axis no agent scored above 0.19. Neither biological specialization, stronger models nor detailed expert instructions closed this gap. The agents were also unreliable, with scores varying more between repeated runs of one agent than between different agents, and without ground truth a correct run could not be told from a wrong one by its process score or by the time spent. Released openly with its data and code, BIABench provides a verifiable framework for evaluating, and eventually training, agents for reliable long-horizon bioimage analysis.

Rationale and Objectives: To develop and validate PARROT (Polyglottal Annotated Radiology Reports for Open Testing), a large, multicentric, open-access dataset of fictional radiology reports spanning multiple languages for testing natural language processing applications in radiology. Materials and Methods: From May to September 2024, radiologists were invited to contribute fictional radiology reports following their standard reporting practices. Contributors provided at least 20 reports with associated metadata including anatomical region, imaging modality, clinical context, and for non-English reports, English translations. All reports were assigned ICD-10 codes. A human vs. AI report differentiation study was conducted with 154 participants (radiologists, healthcare professionals, and non-healthcare professionals) assessing whether reports were human-authored or AI-generated. Results: The dataset comprises 2,658 radiology reports from 76 authors across 21 countries and 13 languages. Reports cover multiple imaging modalities (CT: 36.1%, MRI: 22.8%, radiography: 19.0%, ultrasound: 16.8%) and anatomical regions, with chest (19.9%), abdomen (18.6%), head (17.3%), and pelvis (14.1%) being most prevalent. In the differentiation study, participants achieved 53.9% accuracy (95% CI: 50.7%-57.1%) in distinguishing between human and AI-generated reports, with radiologists performing significantly better (56.9%, 95% CI: 53.3%-60.6%, p<0.05) than other groups. Conclusion: PARROT represents the largest open multilingual radiology report dataset, enabling development and validation of natural language processing applications across linguistic, geographic, and clinical boundaries without privacy constraints.

AI systems can fail silently. The failure propagates through training loops, evaluation pipelines, and production monitoring stacks until downstream harm makes it visible. This paper introduces evaluation blindness: a measurement function M exhibits evaluation blindness with respect to failure class F when it produces readings indistinguishable from a healthy state while the system is actually failing, with no auxiliary signal flagging the gap. The problem surfaces at two lifecycle stages the literature has treated separately. At training time, reward models are gamed, importance-sampling corrections are silently miscalculated, and benchmark contamination inflates fine-tuning evaluations, all while loss curves look healthy and gradient updates proceed normally. At deployment time, monitoring fails to catch six classes of production failure, including an Operational category that is 100% silent by structural definition. We provide a formal detectability predicate unifying both stages. Four training-time case studies trace concrete breakdowns, including a real implementation bug in TRL PR #6594 where gradients are corrupted as loss decreases normally. A six-class taxonomy validated against 50 real-world incidents from court documents and regulatory filings finds that 53% of verifiable public failures were silent. A failure budget framework ties acceptable failure rates to use-case risk class. The implication is direct: measurement infrastructure is a correctness concern across the full AI lifecycle, not just at evaluation time. Data, code, and taxonomy schema are at https://github.com/priyanka25aug/llm-failure-taxonomy.

Reporting quality is an important topic in clinical trial research articles, as it can impact clinical decisions. In this article, we test the ability of large language models to assess the reporting quality of this type of article using the Consolidated Standards of Reporting Trials (CONSORT). We create CONSORT-QA, an evaluation corpus from two studies on abstract reporting quality with CONSORT-abstract standards. We then evaluate the ability of different large generative language models (from the general domain or adapted to the biomedical domain) to correctly assess CONSORT criteria with different known prompting methods, including Chain-of-thought. Our best combination of model and prompting method achieves 85% accuracy. Using Chain-of-thought adds valuable information on the model's reasoning for completing the task.

Large Language Models (LLMs) increasingly rely on external tools such as search engines to solve complex agentic tasks that require reasoning and external knowledge retrieval. Recently, reinforcement learning with verifiable rewards (RLVR) has demonstrated its effectiveness in advancing capabilities of LLMs by rewarding the final answers via outcome rewards. While straightforward to supervise, outcome rewards only provide sparse signals and delayed feedback, which limits their effectiveness on long trajectories. Process rewards address this by evaluating intermediate steps, providing fine-grained supervision and encouraging grounded problem solving. However, it is notoriously hard to annotate step-wise labels, especially in non-verifiable process without "golden" answers. Furthermore, step-wise judgment requires the balance between local quality with contribution to the final outcome, as optimizing towards higher process reward may not always align with better final outcomes. To address the above challenges, we introduce Principle Process Reward (PPR), an RL approach that unifies principled step-level assessment and outcome verification. We train a principle-based reward model to improve the transparency and reliability of process evaluation, and further introduce a Reward Normalization (ReNorm) strategy to calibrate outcome and process rewards. Experiment results show that PPR achieves state-of-the-art performance across a wide range of benchmarks, demonstrating its impressive robustness and generalization. Our code and model collection is available in this link.

Estimating the causal effects of a spatially-varying intervention on a spatially-varying outcome may be subject to non-local confounding (NLC), a phenomenon that can bias estimates when the treatments and outcomes of a given unit are dictated in part by the covariates of other nearby units. In particular, NLC is a challenge for evaluating the effects of environmental policies and climate events on health-related outcomes such as air pollution exposure. This paper first formalizes NLC using the potential outcomes framework, providing a comparison with the related phenomenon of causal interference. Then, it proposes a broadly applicable framework, termed "weather2vec", that uses the theory of balancing scores to learn representations of non-local information into a scalar or vector defined for each observational unit, which is subsequently used to adjust for confounding in conjunction with causal inference methods. The framework is evaluated in a simulation study and two case studies on air pollution where the weather is an (inherently regional) known confounder.

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

The ideal LLM content moderation system would be both structurally interpretable (so its decisions can be explained to users) and steerable (to reflect a community's values or align to safety standards). However, current systems fall short on both of these dimensions. To address this gap, we present SafetyAnalyst, a novel LLM safety moderation framework. Given a prompt, SafetyAnalyst creates a structured "harm-benefit tree," which identifies 1) the actions that could be taken if a compliant response were provided, 2) the harmful and beneficial effects of those actions (along with their likelihood, severity, and immediacy), and 3) the stakeholders that would be impacted by those effects. It then aggregates this structured representation into a harmfulness score based on a parameterized set of safety preferences, which can be transparently aligned to particular values. Using extensive harm-benefit features generated by SOTA LLMs on 19k prompts, we fine-tuned an open-weight LM to specialize in generating harm-benefit trees through symbolic knowledge distillation. On a comprehensive set of prompt safety benchmarks, we show that our system (average F1=0.75) outperforms existing LLM safety moderation systems (average F1<0.72) on prompt harmfulness classification, while offering the additional advantages of interpretability and steerability.

Large Language Models have demonstrated remarkable capabilities in code generation, yet they often struggle with complex programming tasks that require deep algorithmic reasoning. While process supervision through learned reward models shows promise in guiding reasoning steps, it requires expensive training data and suffers from unreliable evaluation. We propose Outcome-Refining Process Supervision, a novel paradigm that treats outcome refinement itself as the process to be supervised. Our framework leverages concrete execution signals to ground the supervision of reasoning steps, while using tree-structured exploration to maintain multiple solution trajectories simultaneously. Experiments demonstrate that our approach enables even smaller models to achieve high success accuracy and performance metrics on competitive programming tasks, creates more reliable verification than traditional reward models without requiring training PRMs. Our approach achieves significant improvements across 5 models and 3 datasets: an average of 26.9% increase in correctness and 42.2% in efficiency. The results suggest that providing structured reasoning space with concrete verification signals is crucial for solving complex programming tasks. We open-source all our code and data at: https://github.com/zhuohaoyu/ORPS

Benchmarks can run without determining what their results license. We freeze a large evaluation collection and attempt to replay its historical claims. Most units stop because the evidence required for replay is not bound. Where replay is possible, different claims remain stable at different resolutions. We make this otherwise implicit inference step explicit and executable.

Exam-style accuracy does not establish whether large language models (LLMs) reason well over clinical records. We define clinical reasoning as integrating and updating evidence across time and sources to form, revise and justify a patient's problem representation and a defensible plan. This structured narrative review maps three literatures: medical education assessment instruments, clinical LLM benchmarks published from 2023 onwards, and general-domain methods for evaluating long-form generation. We examine six dimensions: problem representation, temporal synthesis, differential and management reasoning, counterfactual reasoning, calibrated uncertainty, and reasoning faithfulness. Preprints are included and flagged. No single instrument covers all six dimensions. Problem representation and differential or management reasoning are reasonably covered, although reliability varies by instrument and setting. TIMER-Eval targets temporal synthesis, and ER-Reason assesses sequential diagnostic belief updating. Dedicated uncertainty and counterfactual evaluations are emerging, but their applicability to longitudinal free-text reasoning remains limited. Factual completeness is well theorised in general-domain evaluation, with early clinical evidence of important omissions. Faithfulness remains the weakest dimension, with one identified clinical causal-ablation study on multiple-choice questions. Existing tools should be combined through binary rubric items, separate completeness and correctness scores, case-specific importance weighting with non-compensable safety caps, temporal order-consistency checks, and chance-corrected reliability reporting. Further design work is needed for calibrated uncertainty, counterfactual reasoning and faithfulness over longitudinal free-text records. This review provides a design rationale, not a validated instrument.

Machine learning-based Type 2 diabetes risk prediction models obtain good internal validation results but lose effectiveness in real-world applications due to deficient external testing and fairness assessment. We developed a multi-dimensional framework evaluating discrimination, calibration, interpretability, and algorithmic fairness on nationally representative populations. An XGBoost model was trained on NHANES 2015-2020 (n=15,685) using eight non-laboratory predictors: age, sex, race/ethnicity, BMI, smoking status, physical activity, history of heart attack, and history of stroke. External validation was performed on BRFSS 2020-2022 (n=1,285,783) under realistic distribution shift. Internal validation showed good discrimination (AUC=0.794, 95% CI 0.788-0.800), with performance loss on external validation (AUC=0.717, relative decrease: -9.7%, p<0.001). Fairness analysis revealed severe bias: elderly adults (>=60) showed AUC=0.607 vs 0.742 for young adults (difference=0.135, p<0.001); obese individuals showed AUC=0.698 vs 0.735 for normal weight (difference=0.037, p<0.001). Gender showed comparable performance (male=0.723 vs female=0.712, p=0.142). Calibration revealed risk overestimation (Brier score=0.123). SHAP analysis identified age, BMI, and physical activity as primary risk drivers. Populations with highest diabetes risk receive the worst algorithmic performance, underscoring the need for fairness-aware, age-stratified deployment strategies before clinical use.

Invasive coronary angiography (CAG) is the gold standard for diagnosing coronary artery disease, but interpretation varies substantially among observers. Existing AI systems can improve consistency but lack auditable decision processes and are limited in comprehensive open-ended assessment, undermining clinician trust and clinical adoption readiness. We developed CARDEA, a unified large vision-language model that serves as the inference core of a CAG pipeline. It was trained solely on public datasets and closed-ended tasks in three stages: visual feature alignment, a self-distilled Chain-of-Box (CoB) cold start, and reinforcement learning with verifiable rewards (RLVR) with a CoB reward encouraging bounding-box use in the reasoning trace. We assessed its two study-level diagnoses, dominance classification and complexity assessment, against a dedicated classifier and two interventional cardiologists. Report generation was excluded from training and evaluated zero-shot across stages on an external cohort using vessel-severity macro-F_1. CARDEA trailed the classifier on in-distribution dominance but drew level under domain shift (accuracy, 0.91 [95% confidence interval (CI), 0.86 to 0.95]) and was comparable to the cardiologists on complexity assessment (accuracy, 0.90 [CI, 0.82 to 0.97]). Only RLVR improved zero-shot report generation, raising its vessel-severity macro-F_1 (0.686 [CI, 0.664 to 0.707]) above the untuned base model (0.513) and over twice the always-normal floor (0.312). CARDEA runs an end-to-end CAG pipeline from raw multi-view videos through keyframe selection to study-level diagnosis while exposing auditable spatial evidence behind its conclusions. RLVR on verifiable closed-ended tasks surfaced open-ended reporting ability that supervised imitation did not. Clinical use requires prospective validation against expert cardiologists.

Large language models (LLMs) have achieved significant progress in solving complex reasoning tasks by Reinforcement Learning with Verifiable Rewards (RLVR). This advancement is also inseparable from the oversight automated by reliable verifiers. However, current outcome-based verifiers (OVs) are unable to inspect the unreliable intermediate steps in the long reasoning chains of thought (CoTs). Meanwhile, current process-based verifiers (PVs) have difficulties in reliably detecting errors in the complex long CoTs, limited by the scarcity of high-quality annotations due to the prohibitive costs of human annotations. Therefore, we propose the Outcome-based Process Verifier (OPV), which verifies the rationale process of summarized outcomes from long CoTs to achieve both accurate and efficient verification and enable large-scale annotation. To empower the proposed verifier, we adopt an iterative active learning framework with expert annotations to progressively improve the verification capability of OPV with fewer annotation costs. Specifically, in each iteration, the most uncertain cases of the current best OPV are annotated and then subsequently used to train a new OPV through Rejection Fine-Tuning (RFT) and RLVR for the next round. Extensive experiments demonstrate OPV's superior performance and broad applicability. It achieves new state-of-the-art results on our held-out OPV-Bench, outperforming much larger open-source models such as Qwen3-Max-Preview with an F1 score of 83.1 compared to 76.3. Furthermore, OPV effectively detects false positives within synthetic dataset, closely align with expert assessment. When collaborating with policy models, OPV consistently yields performance gains, e.g., raising the accuracy of DeepSeek-R1-Distill-Qwen-32B from 55.2% to 73.3% on AIME2025 as the compute budget scales.

The emerging paradigm of AI co-scientists focuses on tasks characterized by repeatable verification, where agents explore search spaces in 'guess and check' loops. This paradigm does not extend to problems where repeated evaluation is impossible and ground truth is established by the consensus synthesis of theory and existing evidence. We evaluate a Gemini-based AI environment designed to support collaborative scientific assessment, integrated into a standard scientific workflow. In collaboration with a diverse group of 13 scientists working in the field of climate science, we tested the system on a complex topic: the stability of the Atlantic Meridional Overturning Circulation (AMOC). Our results show that AI can accelerate the scientific workflow. The group produced a comprehensive synthesis of 79 papers through 104 revision cycles in just over 46 person-hours. AI contribution was significant: most AI-generated content was retained in the report. AI also helped maintain logical consistency and presentation quality. However, expert additions were crucial to ensure its acceptability: less than half of the report was produced by AI. Furthermore, substantial oversight was required to expand and elevate the content to rigorous scientific standards.

Ambient AI scribes draft clinical notes under the reassurance that a clinician signs every note. We audited three commercial AI scribes on the same 142 consultations: 565 notes from recorded UK primary-care and US ambulatory encounters plus authored scenarios. Twelve discovery passes proposed 13,678 candidate errors; the 5,898 clearing an importance filter went to an adversarial panel of two models from different families, each told to refute what it could, and 618 survived. One note in three (31.3% [27.0, 35.6]) carries a verified failure, concentrated in allergy and medication information, invented patient identity, and history written up as examination on telephone consultations that can contain none. No product was given a patient record; setting aside the two classes a record would have prefilled, invented identity and dates, the rate is 24.8% [20.8, 29.0]. One failure mode did not fit our scheme, drawn from published scribe-error taxonomies: a treatment the clinician retracts, recorded as delivered care. Two clinicians adjudicated blind, disjoint samples: a physician author upheld 20 of 21 findings (95.2% [77.3, 99.2]) and an independent clinician, not an author, 12 of 12 ([75.8, 100]); both judged every sampled refusal genuine. A failure rate depends on the instrument as much as the scribes. With model, evidence and settings fixed, the review instruction alone moves the share of candidates verified from 9.3% to 79.0%, and the reviewing family moves it too: alone at that instruction the gentler flags 54.8% of notes against 27.8%. Between 28% and 97% of sampled notes carry a failure depending on the standard. Published audits disagree among themselves by a margin instrument differences alone can produce: omission is 54-86% of their errors against our 23.1%. We release all 618 findings with transcript-side evidence, every prompt and model version, and the re-runnable pipeline.

Recent progress in reasoning models suggests that generating plausible attempts for research-level mathematics may be within reach, but verification remains a bottleneck, consuming scarce expert time. We hypothesize that a meaningful solution should contain enough method-level information that, when applied to a neighborhood of related questions, it should yield better downstream performance than incorrect solutions. Building on this idea, we propose Consequence-Based Utility, an oracle-free evaluator that scores each candidate by testing its value as an in-context exemplar in solving related yet verifiable questions. Our approach is evaluated on an original set of research-level math problems, each paired with one expert-written solution and nine LLM-generated solutions. Notably, Consequence-Based Utility consistently outperforms reward models, generative reward models, and LLM judges on ranking quality. Specifically, for GPT-OSS-120B, it improves Acc@1 from 67.2 to 76.3 and AUC from 71.4 to 79.6, with similarly large AUC gains on GPT-OSS-20B (69.0 to 79.2). Furthermore, compared to LLM-Judges, it also exhibits a larger solver-evaluator gap, maintaining a stronger correct-wrong separation even on instances where the underlying solver often fails to solve.

Many deployments must compare candidate language models for safety before a labeled benchmark exists for the relevant language, sector, or regulatory regime. We formalize this setting as benchmarkless comparative safety scoring and specify the contract under which a scenario-based audit can be interpreted as deployment evidence. Scores are valid only under a fixed scenario pack, rubric, auditor, judge, sampling configuration, and rerun budget. Because no labels are available, we replace ground-truth agreement with an instrumental-validity chain: responsiveness to a controlled safe-versus-abliterated contrast, dominance of target-driven variance over auditor and judge artifacts, and stability across reruns. We instantiate the chain in SimpleAudit, a local-first scoring instrument, and validate it on a Norwegian safety pack. Safe and abliterated targets separate with AUROC values between 0.89 and 1.00, target identity is the dominant variance component (η^2 approx 0.52), and severity profiles stabilize by ten reruns. Applying the same chain to Petri shows that it admits both tools. The substantial differences arise upstream of the chain, in claim-contract enforcement and deployment fit. A Norwegian public-sector procurement case comparing Borealis and Gemma 3 demonstrates the resulting evidence in practice: the safer model depends on scenario category and risk measure. Consequently, scores, matched deltas, critical rates, uncertainty, and the auditor and judge used must be reported together rather than collapsed into a single ranking.

Different from its counterpart outcome reward models (ORMs), which evaluate the entire responses, a process reward model (PRM) scores a reasoning trajectory step by step, providing denser and more fine grained rewards. However, training a PRM requires labels annotated at every intermediate step, presenting significant challenges for both manual and automatic data collection. This paper aims to address this challenge. Both theoretically and empirically, we show that an implicit PRM can be obtained at no additional cost, by simply training an ORM on the cheaper response-level labels. The only assumption is to parameterize the outcome reward as the log-likelihood ratios of the policy and reference models, which can be optimized regardless of the specific choice of loss objectives. In experiments, we instantiate our implicit PRMs with various objectives and evaluate their performance on MATH. We show that our implicit PRM outperforms a strong MCTS-based baseline \'a la Math-Shepherd using less than 1/38 of the training data. Its performance can be further improved with majority voting. We further find that scaling up instructions and responses benefits our implicit PRM, and the latter brings a larger gain. Particularly, we find that our implicit PRM, when instantiated with the cross-entropy (CE) loss, is more data-efficient and can keep improving generation models even when trained with only one response per instruction, the setup that suffers from extreme data scarcity and imbalance. Further, instructions should be relevant to downstream tasks while the diversity of responses does not bring gains. Surprisingly, training on extra Math-Shepherd step labels brings no further improvements to our implicit PRM trained on only outcome data. We hope that our work will encourage a rethinking of PRM training approaches and contribute to making training PRMs more accessible.

Large language models (LLMs) increasingly summarize clinical evidence, where a claim's weight depends on how strongly it is supported. Yet these models convey confidence poorly, and properties they never state, such as truth, are often readable from their activations. Whether a clinical model registers evidence strength, distinct from truth, and states it when asked is untested, and any such signal could be lexical. We compiled 45,134 clinical claims from six public sources, harmonized 20,611 into a four-level evidence grade under three independent frameworks, and tested 22 local, open-weight LLMs from several developers (0.6-70 billion parameters; general, medical, and reasoning), with lexical, truth, and cross-framework controls. A linear estimator recovered the grade in every model (median AUROC 71.8), yet decodability did not rise with scale and was weakest in reasoning models. The grade the models stated fell to chance, 25-27 percentage points below the estimator. The recoverable signal was largely lexical and did not transfer across topics or frameworks, yet it was distinct from factual truth and still flagged weakly supported claims (AUROC 69.2). Clinical LLMs thus carry an ordered evidence-strength signal they do not express, so their stated grades fail to convey a claim's support even when it is recoverable from their representations and text.

Background: Rapid advancements in natural language processing have led to the development of large language models with the potential to revolutionize mental health care. These models have shown promise in assisting clinicians and providing support to individuals experiencing various psychological challenges. Objective: This study aims to compare the performance of two large language models, GPT-4 and Chat-GPT, in responding to a set of 18 psychological prompts, to assess their potential applicability in mental health care settings. Methods: A blind methodology was employed, with a clinical psychologist evaluating the models' responses without knowledge of their origins. The prompts encompassed a diverse range of mental health topics, including depression, anxiety, and trauma, to ensure a comprehensive assessment. Results: The results demonstrated a significant difference in performance between the two models (p > 0.05). GPT-4 achieved an average rating of 8.29 out of 10, while Chat-GPT received an average rating of 6.52. The clinical psychologist's evaluation suggested that GPT-4 was more effective at generating clinically relevant and empathetic responses, thereby providing better support and guidance to potential users. Conclusions: This study contributes to the growing body of literature on the applicability of large language models in mental health care settings. The findings underscore the importance of continued research and development in the field to optimize these models for clinical use. Further investigation is necessary to understand the specific factors underlying the performance differences between the two models and to explore their generalizability across various populations and mental health conditions.

Conformal prediction (CP) offers distribution-free uncertainty quantification for machine learning models, yet its interplay with fairness in downstream decision-making remains underexplored. Moving beyond CP as a standalone operation (procedural fairness), we analyze the holistic decision-making pipeline to evaluate substantive fairness-the equity of downstream outcomes. Theoretically, we derive an upper bound that decomposes prediction-set size disparity into interpretable components, clarifying how label-clustered CP helps control method-driven contributions to unfairness. To facilitate scalable empirical analysis, we introduce an LLM-in-the-loop evaluator that approximates human assessment of substantive fairness across diverse modalities. Our experiments reveal that label-clustered CP variants consistently deliver superior substantive fairness. Finally, we empirically show that equalized set sizes, rather than coverage, strongly correlate with improved substantive fairness, enabling practitioners to design more fair CP systems. Our code is available at https://github.com/layer6ai-labs/llm-in-the-loop-conformal-fairness.

Retrieval-based factuality evaluation, where LLM-generated claims are verified against evidence from authoritative medical corpora, has become the dominant paradigm for scalable hallucination detection in high-stakes clinical settings. Despite the urgency of reliable and transparent medical fact verification, most systems measure performance with aggregate metrics like F1, which obscure where and why failures occur. Existing RAG diagnostics require gold answers or annotated gold evidence, neither of which exists in this regime. We introduce two comprehensive taxonomies, grounded in a case study on the open-ended MedExpert dataset and 3 closed-ended datasets, decomposing failures into retrieval-stage errors along five quality dimensions, and verifier-reasoning errors into six consecutive steps. We adapt an automatic pattern induction pipeline using LLM-as-Judge to label evidence quality and classify verifier reasoning errors at scale, and then stress-test our findings across 4 retrieval methods and 6 frontier verifier models. Our analysis reveals that scaling model size, adding reasoning effort, expanding to authoritative web sources, and applying medical fine-tuning do not resolve these failure modes, demonstrating that they represent fundamental limitations of the retrieve-then-verify paradigm in open-ended medical settings rather than artifacts of outdated systems. We release our code and data at https://anonymous.4open.science/r/Medical_RAG_eval-4AB5 for the full reproducibility of our results.

Pathological assessment relies on recognizing fine-grained visual details in histological images. Vision-language models (VLMs) increasingly support pathology interpretation, yet their ability to perceive these details remains inadequate. This weakness leads to inaccurate cellular observations that can persist even when final answers are correct. In this paper, we propose ASPECT to improve visually grounded reasoning through explicit supervision of cellular appearance and abundance. ASPECT trains intermediate visual tokens through pathology feature reconstruction, cell feature alignment, and count supervision. Three-stage supervised fine-tuning teaches the model to perceive, generate visual tokens, and reason, followed by reinforcement learning that rewards answer correctness and consistency with reported measurements. We also introduce PathoVernier, a benchmark of 759 expert-reviewed questions from five pathology datasets covering four cellular composition tasks. It evaluates both final answers and intermediate measurements to expose errors hidden by answer accuracy. On PathoVernier, ASPECT achieves relative accuracy gains of approximately 19.2% over the strongest baseline, Gemini-3.1-Pro, and 99.3% over its Qwen3-VL-8B backbone, while reducing RAWR, which measures counting errors within correct responses, by 28.1% and 42.7%, respectively. ASPECT also improves over its backbone on three external pathology benchmarks covering classification and question answering beyond cellular composition tasks.

Accurate prognosis for an individual patient is a key component of precision oncology. Recent advances in machine learning have enabled the development of models using a wider range of data, including imaging. Radiomics aims to extract quantitative predictive and prognostic biomarkers from routine medical imaging, but evidence for computed tomography radiomics for prognosis remains inconclusive. We have conducted an institutional machine learning challenge to develop an accurate model for overall survival prediction in head and neck cancer using clinical data etxracted from electronic medical records and pre-treatment radiological images, as well as to evaluate the true added benefit of radiomics for head and neck cancer prognosis. Using a large, retrospective dataset of 2,552 patients and a rigorous evaluation framework, we compared 12 different submissions using imaging and clinical data, separately or in combination. The winning approach used non-linear, multitask learning on clinical data and tumour volume, achieving high prognostic accuracy for 2-year and lifetime survival prediction and outperforming models relying on clinical data only, engineered radiomics and deep learning. Combining all submissions in an ensemble model resulted in improved accuracy, with the highest gain from a image-based deep learning model. Our results show the potential of machine learning and simple, informative prognostic factors in combination with large datasets as a tool to guide personalized cancer care.

Life satisfaction is a crucial facet of human well-being. Hence, research on life satisfaction is incumbent for understanding how individuals experience their lives and influencing interventions targeted at enhancing mental health and well-being. Life satisfaction has traditionally been measured using analog, complicated, and frequently error-prone methods. These methods raise questions concerning validation and propagation. However, this study demonstrates the potential for machine learning algorithms to predict life satisfaction with a high accuracy of 93.80% and a 73.00% macro F1-score. The dataset comes from a government survey of 19000 people aged 16-64 years in Denmark. Using feature learning techniques, 27 significant questions for assessing contentment were extracted, making the study highly reproducible, simple, and easily interpretable. Furthermore, clinical and biomedical large language models (LLMs) were explored for predicting life satisfaction by converting tabular data into natural language sentences through mapping and adding meaningful counterparts, achieving an accuracy of 93.74% and macro F1-score of 73.21%. It was found that life satisfaction prediction is more closely related to the biomedical domain than the clinical domain. Ablation studies were also conducted to understand the impact of data resampling and feature selection techniques on model performance. Moreover, the correlation between primary determinants with different age brackets was analyzed, and it was found that health condition is the most important determinant across all ages. This study demonstrates how machine learning, large language models and XAI can jointly contribute to building trust and understanding in using AI to investigate human behavior, with significant ramifications for academics and professionals working to quantify and comprehend subjective well-being.

Medical vision-language datasets are often limited in size and biased toward negative findings, as clinicians report abnormalities mostly but might omit some positive/neutral findings because they might be considered as irrelevant to the patient's condition. We propose a self-supervised data enrichment method that leverages semantic clustering of report sentences. Then we enrich the findings in the medical reports in the training set by adding positive/neutral observations from different clusters in a self-supervised manner. Our approach yields consistent gains in supervised fine-tuning (5.63%, 3.04%, 7.40%, 5.30%, 7.47% average gains on COMET score, Bert score, Sentence Bleu, CheXbert-F1 and RadGraph-F1 scores respectively). Ablation studies confirm that improvements stem from semantic clustering rather than random augmentation. Furthermore, we introduce a way to incorporate semantic cluster information into the reward design for GRPO training, which leads to further performance gains (2.78%, 3.14%, 12.80% average gains on COMET score, Bert score and Sentence Bleu scores respectively). We share our code at https://anonymous.4open.science/r/SemEnrich-75CF

Knowing domain rules does not guarantee applying them to a case. We study this distinction in traditional Chinese Bazi through 3,000 Chinese multiple-choice questions spanning 14 Theory and 11 Case categories. Six endpoint systems are evaluated, with primary results reported on a 2,492-item model-informed refinement. Theory accuracy exceeds Case accuracy for every system, and gaps of 16.60-29.56 percentage points remain when invalid responses are excluded. The contrast is more specific than a general case-reasoning deficit. Across six systems, Twelve Stages and Nayin reach mean accuracies of 89.10% and 88.62%, while Shensha Basics reaches 75.96%. Within Case, Luck Pillars averages 84.62%, but Career and Family Relations average only 36.98% and 38.19%. Overall rankings also conceal different category strengths. On the original 3,000 items, paired DeepSeek native/disabled comparisons associate native configurations with Theory gains of 6.53 and 12.20 points for Flash and Pro, respectively; Case changes are -3.67 and +1.27 points. These are provider-configuration associations, not isolated causal effects of reasoning. The results motivate task-specific evaluation of cultural-domain applications rather than reliance on aggregate knowledge scores. The benchmark measures agreement with a model-generated, model-verified answer key, not real-world predictive validity. Final-set results are post-selection descriptions, and incomplete provenance and expert validation constrain their interpretation.

Video world models approximate the stochastic distribution of physical outcomes through generative sampling, but existing benchmarks score individual generations or compare distributions coarsely over a whole dataset, leaving the fine-grained aleatoric uncertainty of specific phenomena untested. We introduce CaliBench, which scores outcomes in a physically interpretable discrete space - a bin index, a die face, a suit, a colour - rather than a learned feature space such as in FID, so the distance from a known reference distribution is measured directly. We curate outcome spaces whose reference is known in closed form (binomial Galton boards, Bernoulli forks, uniform dice/cards/lottery, a skewed European-roulette colour), enabling an exact calibration test. We decompose performance into two orthogonal axes that a single accuracy metric conflates: scorability, the fraction of generations yielding a scoreable outcome, and calibration, the total variation distance from the reference on that sample. A chi-squared test assesses significance; as calibration is its null hypothesis it can evidence only miscalibration, and at N=32 per cell detects only large deviations. We apply it to nine scenes and six image-to-video models (WAN-2.7, SeeDance-2.0, HappyHorse-1.0, Veo 3.1, Runway Gen-4.5, Cosmos3-Super), 32 generations each. Models consistently concentrate probability mass on a few outcomes rather than reproducing the reference. Most scene-model combinations are significantly miscalibrated, in the extreme collapsing to one outcome, as Veo 3.1 does on dice. On roulette, generations often leave the ball ambiguously placed, giving several models low scorability. Performance varies by scene: no model dominates all nine. We release the protocol and a metric (mean normalised total variation, mnTV) for comparing new models against our results.

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

Statutes are increasingly parsed by machines before people read them, and the parsers disagree: on Missouri's statutes, two independently written extractors diverge on numeric-threshold presence at a false-negative rate of 0.43. We ask what formal logic survives such noise. We build a passive survival certificate for the Duquenne-Guigues implication basis of machine-extracted statutory contexts: per-attribute inter-extractor disagreement is measured, replayed against the basis in 1,000 Monte Carlo trials, and an implication is certified only when a one-sided Wilson 95% lower bound on survival reaches 0.95; every certified implication carries premise spans and a minimal counterexample. On 29,365 Missouri sections and 502 Indian central-Act sections, the preregistered held-out gate passes (10 statute families across 7 Titles exact; 16 across 11 with 5% tolerance), yet under one globally deployed error model 93.2% of held-out chapters fall below the informativeness floor, and a 2x2 factorial assigns that to calibration-rate transfer, not selection. The certificate is usable but fragile: deploy it per-chapter-calibrated or error-tolerant. Code, data products, and the audit trail, including one retracted claim, are released.