Daily Papers

Knowledge-intensive multi-hop question answering requires systems to select evidence and compose dependent facts, yet multilingual benchmarks usually translate an entire example into one language. This hides failures at language boundaries inside the reasoning chain. We introduce XHotpotQA, a controlled benchmark for cross-lingual knowledge composition over mixed-language evidence. Each instance is modeled as an evidence-dependency graph whose question, bridge evidence, answer-bearing evidence, and distractors have explicit language assignments. The audited resource contains 15,661 training and 7,405 validation instances, with sentence-level support supervision and supplied distractors. In validation, 99.81% of items cross the question-to-gold-evidence language interface and 95.60% use gold paragraphs in different languages. Across three reader artifacts, full question-evidence mismatch is associated with 10.25 to 15.79 lower Unicode-aware answer F1 than partial alignment, and different-script evidence with deficits of 11.98 to 23.70 points; the corresponding adapted-selector contrasts are 1.71 and 1.78 points. Under this supplied-candidate design, the evaluated readers therefore show substantially larger condition-associated deficits than the selector. XHotpotQA provides role-aware diagnostics, modular evaluation, and an audited test bed for knowledge-based systems that must integrate evidence across languages.

Large language models (LLMs) are increasingly explored as scalable tools for mental health counseling, yet evaluating their safety remains challenging due to the interactional and context-dependent nature of clinical harm. Existing evaluation frameworks predominantly assess isolated responses using coarse-grained taxonomies or static datasets, limiting their ability to diagnose how harms emerge and accumulate over multi-turn counseling interactions. In this work, we introduce R-MHSafe, a role-aware mental health safety taxonomy that characterizes clinically significant harm in terms of the interactional roles an AI counselor adopts, including perpetrator, instigator, facilitator, or enabler, combined with clinically grounded harm categories. Then, we propose MHSafeEval, a closed-loop, agent-based evaluation framework that formulates safety assessment as trajectory-level discovery of harm through adversarial multi-turn interactions, guided by role-aware modeling. Using R-MHSafe and MHSafeEval, we conduct a large-scale evaluation across state-of-the-art LLMs. Our results reveal substantial role-dependent and cumulative safety failures that are systematically missed by existing static benchmarks, and show that our framework significantly improves failure-mode coverage and diagnostic granularity.

Existing 4D-driven video diffusion models primarily target plausible generation, but faithful 4D editing requires preserving source-observed regions while synthesizing disoccluded or out-of-view content. We identify Evidence-Role Mismatch: reliable source-backed evidence, unreliable rendered cues, and unsupported regions are entangled in a single conditioning signal, causing preservation drift, ghosting, and unstable extrapolation. We propose PREX (Preserve, Reveal, Expand), a region-aware framework that decomposes the target spatiotemporal volume into Preserve, Reveal, and Expand roles according to observation support and scene extent. PREX builds observation-backed appearance cues with calibrated confidence and injects them into a frozen video diffusion backbone through a region-aware adapter, trained with proxy tasks without requiring paired edited videos. We further introduce PREBench, a diagnostic benchmark with curated edits, region-role masks, and human-aligned metrics that complement global video-quality and 4D-control evaluations. Experiments show that PREX reduces region-structured failures while maintaining strong visual quality and 4D edit control capability. Project Page: https://ricepastem.github.io/PREX-Open

Human-like private chat requires more than fluent response generation: a system must preserve persona, relationship, memory, bounded knowledge, medium-specific timing, and a coherent multi-turn arc. We present AnthroDial, a closed-loop framework that formulates anthropomorphic dialogue as a joint problem of system architecture, executable evaluation, and diagnostic alignment. It combines (1) a role-conditioned scheduled dialogue runtime with persona and scenario cards, long-term memory, virtual time, and single-draft message decisions; (2) an executable benchmark with an L0 validity gate, five per-turn dimensions, and five dialogue-level dimensions; and (3) a post-training pipeline that filters 16,436 scheduled-decision examples for SFT and applies GRPO with a cognitive-diagnostic, ZPD-aware reward. The reward maintains Kalman-filtered capability estimates for each behavioral dimension, upweights dimensions with larger capability deficits, and uses rollout scores as task-level ZPD matches to focus optimization on learnable weak skills. On a benchmark with 55 personas, 50 scenarios, 50 persona-scenario bindings, and 100 role-conditioned cases per model, we evaluate 16 systems spanning frontier baselines, open models, thinking/no-think variants, and SFT/RL ablations. The strongest non-trained baseline reaches 32.00% strict ACC, while Qwen3.6-27B-SFT+RL reaches 39.00% strict ACC and a 98.5 overall score. In the 9B no-think setting, SFT and RL improve strict ACC from 0.00% to 13.00% and 18.37%. These results show that anthropomorphic dialogue benefits when generation, evaluation, and reward shaping share the same behavioral dimensions.

Language model users often embed personal and social context in their questions. The asker's role -- implicit in how the question is framed -- creates specific needs for an appropriate response. However, most evaluations, while capturing the model's capability to respond, often ignore who is asking. This gap is especially critical in stigmatized domains such as opioid use disorder (OUD), where accounting for users' contexts is essential to provide accessible, stigma-free responses. We propose CoRUS (COmmunity-driven Roles for User-centric Question Simulation), a framework for simulating role-based questions. Drawing on role theory and posts from an online OUD recovery community (r/OpiatesRecovery), we first build a taxonomy of asker roles -- patients, caregivers, practitioners. Next, we use it to simulate 15,321 questions that embed each role's goals, behaviors, and experiences. Our evaluations show that these questions are both highly believable and comparable to real-world data. When used to evaluate five LLMs, for the same question but differing roles, we find systematic differences: vulnerable roles, such as patients and caregivers, elicit more supportive responses (+17%) and reduced knowledge content (-19%) in comparison to practitioners. Our work demonstrates how implicitly signaling a user's role shapes model responses, and provides a methodology for role-informed evaluation of conversational AI.

Social simulations built from language-model agents need role-conditioned behavior that can be checked before agents are placed into a simulated population. We introduce an activation-steering screening workflow for role-conditioned agents: define a role profile, extract a role-specific direction, sweep four steering coefficients, evaluate role-profile alignment, and pass or flag each candidate configuration. On OLMo-3-7B-Instruct, we apply the workflow to a mixed 275-role inventory with 228 role-agnostic questions, GPT-4.1-mini prompted role references, and GPT-4.1-mini judges. Role-specific directions receive higher judged role-profile alignment than an assistant-axis directional control from prior persona-vector work, with mean overall scores of 63.2 versus 41.1 across the tested grid. They also preserve high lexical diversity, while the control drops sharply at larger coefficients. The role-level screen is the main practical output: most roles improve as steering increases, but 38 roles decline across all six measured dimensions, showing why simulation builders should choose coefficients per role rather than deploy a uniform high-strength setting. We make our code and evaluation artifacts available at https://anonymous.4open.science/r/anonymous-research-code-5F03/.

In this paper, we present a framework for training large language models (LLMs) as diagnostic agents with reinforcement learning, enabling them to manage multi-turn diagnostic processes, adaptively select examinations, and commit to final diagnoses. Unlike instruction-tuned models trained on static case summaries, our method acquires diagnostic strategies through interactive exploration and outcome-based feedback. Our contributions are fourfold: (i) We present DiagGym, a diagnostics world model trained with electronic health records that emits examination outcomes conditioned on patient history and recommended examination, serving as a virtual clinical environment for realistic diagnosis training and evaluation; (ii) We train DiagAgent via end-to-end, multi-turn reinforcement learning to learn diagnostic policies that optimize both information yield and diagnostic accuracy; (iii) We introduce DiagBench, a diagnostic benchmark comprising 750 cases with physician-validated examination recommendations and 99 cases annotated with 973 physician-written rubrics on diagnosis process; (iv) we demonstrate superior performance across diverse diagnostic settings. DiagAgent significantly outperforms 10 state-of-the-art LLMs, including DeepSeek-v3 and GPT-4o, as well as two prompt-engineered agents. In single-turn settings, DiagAgent achieves 9.34% higher diagnostic accuracy and 44.03% improvement in examination recommendation hit ratio. In end-to-end settings, it delivers 15.12% increase in diagnostic accuracy and 23.09% boost in examination recommendation F1 score. In rubric-based evaluation, it surpasses the next-best model, Claude-sonnet-4, by 7.1% in weighted rubric score. These findings indicate that learning policies in interactive clinical environments confers dynamic and clinically meaningful diagnostic management abilities unattainable through passive training alone.

Principle-based alignment often lacks context sensitivity and completeness. Grounded in Theory of Mind, we propose role conditioning as a compact alternative: social roles (e.g., mother, judge) implicitly encode both values and the cognitive schemas required to apply them. We introduce a training-free pipeline featuring a role-conditioned generator and iterative role-based critics for refinement. Across five model families, our approach consistently outperforms principle-based, Chain-of-Thought (CoT) and other baselines across benchmarks. Notably, it reduces unsafe outputs on the WildJailbreak benchmark from 81.4\% to 3.6\% with DeepSeek-V3. Not only for common safety benchmarks, it consistently applies for agentic safety tasks. These results establish role assignment as a powerful, interpretable paradigm for AI alignment and LLM-as-a-Judge construction.

Accurate diagnosis with medical large language models is hindered by knowledge gaps and hallucinations. Retrieval and tool-augmented methods help, but their impact is limited by weak use of external knowledge and poor feedback-reasoning traceability. To address these challenges, We introduce Deep-DxSearch, an agentic RAG system trained end-to-end with reinforcement learning (RL) that enables steer tracebale retrieval-augmented reasoning for medical diagnosis. In Deep-DxSearch, we first construct a large-scale medical retrieval corpus comprising patient records and reliable medical knowledge sources to support retrieval-aware reasoning across diagnostic scenarios. More crutially, we frame the LLM as the core agent and the retrieval corpus as its environment, using tailored rewards on format, retrieval, reasoning structure, and diagnostic accuracy, thereby evolving the agentic RAG policy from large-scale data through RL. Experiments demonstrate that our end-to-end agentic RL training framework consistently outperforms prompt-engineering and training-free RAG approaches across multiple data centers. After training, Deep-DxSearch achieves substantial gains in diagnostic accuracy, surpassing strong diagnostic baselines such as GPT-4o, DeepSeek-R1, and other medical-specific frameworks for both common and rare disease diagnosis under in-distribution and out-of-distribution settings. Moreover, ablation studies on reward design and retrieval corpus components confirm their critical roles, underscoring the uniqueness and effectiveness of our approach compared with traditional implementations. Finally, case studies and interpretability analyses highlight improvements in Deep-DxSearch's diagnostic policy, providing deeper insight into its performance gains and supporting clinicians in delivering more reliable and precise preliminary diagnoses. See https://github.com/MAGIC-AI4Med/Deep-DxSearch.

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.

Role-playing (RP) agents rely on behavioral profiles to act consistently across diverse narrative contexts, yet existing profiles are largely unstructured, non-executable, and weakly validated, leading to brittle agent behavior. We propose Codified Decision Trees (CDT), a data-driven framework that induces an executable and interpretable decision structure from large-scale narrative data. CDT represents behavioral profiles as a tree of conditional rules, where internal nodes correspond to validated scene conditions and leaves encode grounded behavioral statements, enabling deterministic retrieval of context-appropriate rules at execution time. The tree is learned by iteratively inducing candidate scene-action rules, validating them against data, and refining them through hierarchical specialization, yielding profiles that support transparent inspection and principled updates. Across multiple benchmarks, CDT substantially outperforms human-written profiles and prior profile induction methods on 85 characters across 16 artifacts, indicating that codified and validated behavioral representations lead to more reliable agent grounding.

Chest X-ray plays a central role in thoracic diagnosis, and its interpretation inherently requires multi-step, evidence-grounded reasoning. However, large vision-language models (LVLMs) often generate plausible responses that are not faithfully grounded in diagnostic evidence and provide limited visual evidence for verification, while also requiring costly retraining to support new diagnostic tasks, limiting their reliability and adaptability in clinical settings. To address these limitations, we present CXReasonAgent, a diagnostic agent that integrates a large language model (LLM) with clinically grounded diagnostic tools to perform evidence-grounded diagnostic reasoning using image-derived diagnostic and visual evidence. To evaluate these capabilities, we introduce CXReasonDial, a multi-turn dialogue benchmark with 1,946 dialogues across 12 diagnostic tasks, and show that CXReasonAgent produces faithfully grounded responses, enabling more reliable and verifiable diagnostic reasoning than LVLMs. These findings highlight the importance of integrating clinically grounded diagnostic tools, particularly in safety-critical clinical settings.

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

Large language models (LLM) have demonstrated remarkable abilities in generating natural language, understanding user instruction, and mimicking human language use. These capabilities have garnered considerable interest in applications such as role-playing. However, the process of collecting individual role scripts (or profiles) data and manually evaluating the performance can be costly. We introduce a framework that uses prompts to leverage the state-of-the-art (SOTA) LLMs to construct role-playing dialogue datasets and evaluate the role-playing performance. Additionally, we employ recall-oriented evaluation Rouge-L metric to support the result of the LLM evaluator.

Traditionally, AI research in medical diagnosis has largely centered on image analysis. While this has led to notable advancements, the absence of patient-reported symptoms continues to hinder diagnostic accuracy. To address this, we propose a Pre-Consultation Dialogue Framework (PCDF) that mimics real-world diagnostic procedures, where doctors iteratively query patients before reaching a conclusion. Specifically, we simulate diagnostic dialogues between two vision-language models (VLMs): a DocVLM, which generates follow-up questions based on the image and dialogue history, and a PatientVLM, which responds using a symptom profile derived from the ground-truth diagnosis. We additionally conducted a small-scale clinical validation of the synthetic symptoms generated by our framework, with licensed clinicians confirming their clinical relevance, symptom coverage, and overall realism. These findings indicate that the resulting DocVLM-PatientVLM interactions form coherent, multi-turn consultations paired with images and diagnoses, which we then use to fine-tune the DocVLM. This dialogue-based supervision leads to substantial gains over image-only training, highlighting the value of realistic symptom elicitation for diagnosis.

We demonstrate that large language models (LLMs) exhibit consistent value orientations despite adopting diverse personas, revealing a persistent inertia in their responses that remains stable across the variety of roles they are prompted to assume. To systematically explore this phenomenon, we introduce the role-play-at-scale methodology, which involves prompting LLMs with randomized, diverse personas and analyzing the macroscopic trend of their responses. Unlike previous works that simply feed these questions to LLMs as if testing human subjects, our role-play-at-scale methodology diagnoses inherent tendencies in a systematic and scalable manner by: (1) prompting the model to act in different random personas and (2) asking the same question multiple times for each random persona. This approach reveals consistent patterns in LLM responses across diverse role-play scenarios, indicating deeply encoded inherent tendencies. Our findings contribute to the discourse on value alignment in foundation models and demonstrate the efficacy of role-play-at-scale as a diagnostic tool for uncovering encoded biases in LLMs.

Large Language Model (LLM)-powered multi-agent systems (MAS) have rapidly advanced collaborative reasoning, tool use, and role-specialized coordination in complex tasks. However, reliability-critical deployment remains hindered by a systemic failure mode: hierarchical compliance under instruction conflicts (system-user, peer-peer), where agents misprioritize system-level rules in the presence of competing demands. Moreover, widely used macro-level metrics (e.g., pass@k) obscure these micro-level violations and offer little actionable guidance for remedy. In this work, we present a full-stack, three-stage framework: (1) Diagnose - Contextualized Role Adherence Score (CRAS), a query-wise, context-aware scoring metric that decomposes role adherence into four measurable dimensions; (2) Localize - attention drift analysis revealing that instruction conflicts are resolved by attention heads that are largely concentrated in middle layers; (3) Align - Surgical Alignment of Instruction Layers (SAIL), which installs LoRA only on the localized focal layers and optimizes a token-weighted DPO-style preference objective that credits tokens by their focal attentional contribution. Across standard benchmarks and MAS frameworks, our surgical approach improves instruction hierarchy compliance (e.g., +5.60% with AutoGen on MedQA) without full-model finetuning.

In this work, we introduce MedAgentSim, an open-source simulated clinical environment with doctor, patient, and measurement agents designed to evaluate and enhance LLM performance in dynamic diagnostic settings. Unlike prior approaches, our framework requires doctor agents to actively engage with patients through multi-turn conversations, requesting relevant medical examinations (e.g., temperature, blood pressure, ECG) and imaging results (e.g., MRI, X-ray) from a measurement agent to mimic the real-world diagnostic process. Additionally, we incorporate self improvement mechanisms that allow models to iteratively refine their diagnostic strategies. We enhance LLM performance in our simulated setting by integrating multi-agent discussions, chain-of-thought reasoning, and experience-based knowledge retrieval, facilitating progressive learning as doctor agents interact with more patients. We also introduce an evaluation benchmark for assessing the LLM's ability to engage in dynamic, context-aware diagnostic interactions. While MedAgentSim is fully automated, it also supports a user-controlled mode, enabling human interaction with either the doctor or patient agent. Comprehensive evaluations in various simulated diagnostic scenarios demonstrate the effectiveness of our approach. Our code, simulation tool, and benchmark are available at https://medagentsim.netlify.app/.

Radiology reporting generative AI holds significant potential to alleviate clinical workloads and streamline medical care. However, achieving high clinical accuracy is challenging, as radiological images often feature subtle lesions and intricate structures. Existing systems often fall short, largely due to their reliance on fixed size, patch-level image features and insufficient incorporation of pathological information. This can result in the neglect of such subtle patterns and inconsistent descriptions of crucial pathologies. To address these challenges, we propose an innovative approach that leverages pathology-aware regional prompts to explicitly integrate anatomical and pathological information of various scales, significantly enhancing the precision and clinical relevance of generated reports. We develop an anatomical region detector that extracts features from distinct anatomical areas, coupled with a novel multi-label lesion detector that identifies global pathologies. Our approach emulates the diagnostic process of radiologists, producing clinically accurate reports with comprehensive diagnostic capabilities. Experimental results show that our model outperforms previous state-of-the-art methods on most natural language generation and clinical efficacy metrics, with formal expert evaluations affirming its potential to enhance radiology practice.

LLMs for clinical decision support often fail under small but clinically meaningful input shifts such as masking a symptom or negating a finding, despite high performance on static benchmarks. These reasoning failures frequently go undetected by standard NLP metrics, which are insensitive to latent representation shifts that drive diagnosis instability. We propose a geometry-aware evaluation framework, LAPD (Latent Agentic Perturbation Diagnostics), which systematically probes the latent robustness of clinical LLMs under structured adversarial edits. Within this framework, we introduce Latent Diagnosis Flip Rate (LDFR), a model-agnostic diagnostic signal that captures representational instability when embeddings cross decision boundaries in PCA-reduced latent space. Clinical notes are generated using a structured prompting pipeline grounded in diagnostic reasoning, then perturbed along four axes: masking, negation, synonym replacement, and numeric variation to simulate common ambiguities and omissions. We compute LDFR across both foundation and clinical LLMs, finding that latent fragility emerges even under minimal surface-level changes. Finally, we validate our findings on 90 real clinical notes from the DiReCT benchmark (MIMIC-IV), confirming the generalizability of LDFR beyond synthetic settings. Our results reveal a persistent gap between surface robustness and semantic stability, underscoring the importance of geometry-aware auditing in safety-critical clinical AI.

Clinical diagnosis prediction models, when provided with a patient's medical history, aim to detect potential diseases early, facilitating timely intervention and improving prognostic outcomes. However, the inherent scarcity of patient data and large disease candidate space often pose challenges in developing satisfactory models for this intricate task. The exploration of leveraging Large Language Models (LLMs) for encapsulating clinical decision processes has been limited. We introduce MERA, a clinical diagnosis prediction model that bridges pertaining natural language knowledge with medical practice. We apply hierarchical contrastive learning on a disease candidate ranking list to alleviate the large decision space issue. With concept memorization through fine-tuning, we bridge the natural language clinical knowledge with medical codes. Experimental results on MIMIC-III and IV datasets show that MERA achieves the state-of-the-art diagnosis prediction performance and dramatically elevates the diagnosis prediction capabilities of generative LMs.

Role-based learning holds the promise of achieving scalable multi-agent learning by decomposing complex tasks using roles. However, it is largely unclear how to efficiently discover such a set of roles. To solve this problem, we propose to first decompose joint action spaces into restricted role action spaces by clustering actions according to their effects on the environment and other agents. Learning a role selector based on action effects makes role discovery much easier because it forms a bi-level learning hierarchy -- the role selector searches in a smaller role space and at a lower temporal resolution, while role policies learn in significantly reduced primitive action-observation spaces. We further integrate information about action effects into the role policies to boost learning efficiency and policy generalization. By virtue of these advances, our method (1) outperforms the current state-of-the-art MARL algorithms on 10 of the 14 scenarios that comprise the challenging StarCraft II micromanagement benchmark and (2) achieves rapid transfer to new environments with three times the number of agents. Demonstrative videos are available at https://sites.google.com/view/rode-marl .

Root Cause Analysis (RCA) in mobile networks remains a challenging task due to the need for interpretability, domain expertise, and causal reasoning. In this work, we propose a lightweight framework that leverages Large Language Models (LLMs) for RCA. To do so, we introduce TeleLogs, a curated dataset of annotated troubleshooting problems designed to benchmark RCA capabilities. Our evaluation reveals that existing open-source reasoning LLMs struggle with these problems, underscoring the need for domain-specific adaptation. To address this issue, we propose a two-stage training methodology that combines supervised fine-tuning with reinforcement learning to improve the accuracy and reasoning quality of LLMs. The proposed approach fine-tunes a series of RCA models to integrate domain knowledge and generate structured, multi-step diagnostic explanations, improving both interpretability and effectiveness. Extensive experiments across multiple LLM sizes show significant performance gains over state-of-the-art reasoning and non-reasoning models, including strong generalization to randomized test variants. These results demonstrate the promise of domain-adapted, reasoning-enhanced LLMs for practical and explainable RCA in network operation and management.

Depression poses significant challenges to patients and healthcare organizations, necessitating efficient assessment methods. Existing paradigms typically focus on a patient-doctor way that overlooks multi-role interactions, such as family involvement in the evaluation and caregiving process. Moreover, current automatic depression detection (ADD) methods usually model depression detection as a classification or regression task, lacking interpretability for the decision-making process. To address these issues, we developed InterMind, a doctor-patient-family interactive depression assessment system empowered by large language models (LLMs). Our system enables patients and families to contribute descriptions, generates assistive diagnostic reports for doctors, and provides actionable insights, improving diagnostic precision and efficiency. To enhance LLMs' performance in psychological counseling and diagnostic interpretability, we integrate retrieval-augmented generation (RAG) and chain-of-thoughts (CoT) techniques for data augmentation, which mitigates the hallucination issue of LLMs in specific scenarios after instruction fine-tuning. Quantitative experiments and professional assessments by clinicians validate the effectiveness of our system.

Rare diseases affect hundreds of millions worldwide, yet diagnosis often spans years. Convectional pipelines decouple noisy evidence extraction from downstream inferential diagnosis, and general/medical large language models (LLMs) face scarce real world electronic health records (EHRs), stale domain knowledge, and hallucinations. We assemble a large, domain specialized clinical corpus and a clinician validated reasoning set, and develop RareSeek R1 via staged instruction tuning, chain of thought learning, and graph grounded retrieval. Across multicenter EHR narratives and public benchmarks, RareSeek R1 attains state of the art accuracy, robust generalization, and stability under noisy or overlapping phenotypes. Augmented retrieval yields the largest gains when narratives pair with prioritized variants by resolving ambiguity and aligning candidates to mechanisms. Human studies show performance on par with experienced physicians and consistent gains in assistive use. Notably, transparent reasoning highlights decisive non phenotypic evidence (median 23.1%, such as imaging, interventions, functional tests) underpinning many correct diagnoses. This work advances a narrative first, knowledge integrated reasoning paradigm that shortens the diagnostic odyssey and enables auditable, clinically translatable decision support.

Automatic medical report generation (MRG) is of great research value as it has the potential to relieve radiologists from the heavy burden of report writing. Despite recent advancements, accurate MRG remains challenging due to the need for precise clinical understanding and the identification of clinical findings. Moreover, the imbalanced distribution of diseases makes the challenge even more pronounced, as rare diseases are underrepresented in training data, making their diagnostic performance unreliable. To address these challenges, we propose diagnosis-driven prompts for medical report generation (PromptMRG), a novel framework that aims to improve the diagnostic accuracy of MRG with the guidance of diagnosis-aware prompts. Specifically, PromptMRG is based on encoder-decoder architecture with an extra disease classification branch. When generating reports, the diagnostic results from the classification branch are converted into token prompts to explicitly guide the generation process. To further improve the diagnostic accuracy, we design cross-modal feature enhancement, which retrieves similar reports from the database to assist the diagnosis of a query image by leveraging the knowledge from a pre-trained CLIP. Moreover, the disease imbalanced issue is addressed by applying an adaptive logit-adjusted loss to the classification branch based on the individual learning status of each disease, which overcomes the barrier of text decoder's inability to manipulate disease distributions. Experiments on two MRG benchmarks show the effectiveness of the proposed method, where it obtains state-of-the-art clinical efficacy performance on both datasets.

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

There has been a rapidly growing interest in Automatic Symptom Detection (ASD) and Automatic Diagnosis (AD) systems in the machine learning research literature, aiming to assist doctors in telemedicine services. These systems are designed to interact with patients, collect evidence about their symptoms and relevant antecedents, and possibly make predictions about the underlying diseases. Doctors would review the interactions, including the evidence and the predictions, collect if necessary additional information from patients, before deciding on next steps. Despite recent progress in this area, an important piece of doctors' interactions with patients is missing in the design of these systems, namely the differential diagnosis. Its absence is largely due to the lack of datasets that include such information for models to train on. In this work, we present a large-scale synthetic dataset of roughly 1.3 million patients that includes a differential diagnosis, along with the ground truth pathology, symptoms and antecedents for each patient. Unlike existing datasets which only contain binary symptoms and antecedents, this dataset also contains categorical and multi-choice symptoms and antecedents useful for efficient data collection. Moreover, some symptoms are organized in a hierarchy, making it possible to design systems able to interact with patients in a logical way. As a proof-of-concept, we extend two existing AD and ASD systems to incorporate the differential diagnosis, and provide empirical evidence that using differentials as training signals is essential for the efficiency of such systems or for helping doctors better understand the reasoning of those systems.

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.

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

At the heart of medicine lies the physician-patient dialogue, where skillful history-taking paves the way for accurate diagnosis, effective management, and enduring trust. Artificial Intelligence (AI) systems capable of diagnostic dialogue could increase accessibility, consistency, and quality of care. However, approximating clinicians' expertise is an outstanding grand challenge. Here, we introduce AMIE (Articulate Medical Intelligence Explorer), a Large Language Model (LLM) based AI system optimized for diagnostic dialogue. AMIE uses a novel self-play based simulated environment with automated feedback mechanisms for scaling learning across diverse disease conditions, specialties, and contexts. We designed a framework for evaluating clinically-meaningful axes of performance including history-taking, diagnostic accuracy, management reasoning, communication skills, and empathy. We compared AMIE's performance to that of primary care physicians (PCPs) in a randomized, double-blind crossover study of text-based consultations with validated patient actors in the style of an Objective Structured Clinical Examination (OSCE). The study included 149 case scenarios from clinical providers in Canada, the UK, and India, 20 PCPs for comparison with AMIE, and evaluations by specialist physicians and patient actors. AMIE demonstrated greater diagnostic accuracy and superior performance on 28 of 32 axes according to specialist physicians and 24 of 26 axes according to patient actors. Our research has several limitations and should be interpreted with appropriate caution. Clinicians were limited to unfamiliar synchronous text-chat which permits large-scale LLM-patient interactions but is not representative of usual clinical practice. While further research is required before AMIE could be translated to real-world settings, the results represent a milestone towards conversational diagnostic AI.

Recent advancements in LLMs have showcased their remarkable role-playing capabilities, able to accurately simulate the dialogue styles and cognitive processes of various roles based on different instructions and contexts. Studies indicate that assigning LLMs the roles of experts, a strategy known as role-play prompting, can enhance their performance in the corresponding domains. However, the prompt needs to be manually designed for the given problem, requiring certain expertise and iterative modifications. To this end, we propose self-prompt tuning, making LLMs themselves generate role-play prompts through fine-tuning. Leveraging the LIMA dataset as our foundational corpus, we employ GPT-4 to annotate role-play prompts for each data points, resulting in the creation of the LIMA-Role dataset. We then fine-tune LLMs like Llama-2-7B and Mistral-7B on LIMA-Role. Consequently, the self-prompt tuned LLMs can automatically generate expert role prompts for any given question. We extensively evaluate self-prompt tuned LLMs on widely used NLP benchmarks and open-ended question test. Our empirical results illustrate that self-prompt tuned LLMs outperform standard instruction tuned baselines across most datasets. This highlights the great potential of utilizing fine-tuning to enable LLMs to self-prompt, thereby automating complex prompting strategies. We release the dataset, models, and code at this https://anonymous.4open.science/r/Self-Prompt-Tuning-739E/{url}.

Language models excel at diagnostic assessments on currated medical case-studies and vignettes, performing on par with, or better than, clinical professionals. However, existing studies focus on complex scenarios with rich context making it difficult to draw conclusions about how these systems perform for patients reporting symptoms in everyday life. We deployed SymptomAI, a set of conversational AI agents for end-to-end patient interviewing and differential diagnosis (DDx), via the Fitbit app in a study that randomized participants (N=13,917) to interact with five AI agents. This corpus captures diverse communication and a realistic distribution of illnesses from a real world population. A subset of 1,228 participants reported a clinician-provided diagnosis, and 517 of these were further evaluated by a panel of clinicians during over 250 hours of annotation. SymptomAI DDx were significantly more accurate (OR = 2.47, p < 0.001) than those from independent clinicians given the same dialogue in a blinded randomized comparison. Moreover, agentic strategies which conduct a dedicated symptom interview that elicit additional symptom information before providing a diagnosis, perform substantially better than baseline, user-guided conversations (p < 0.001). An auxiliary analysis on 1,509 conversations from a general US population panel validated that these results generalize beyond wearable device users. We used SymptomAI diagnoses as labels for all 13,917 participants to analyze over 500,000 days of wearable metrics across nearly 400 unique conditions. We identified strong associations between acute infections and physiological shifts (e.g., OR > 7 for influenza). While limited by self-reported ground truth, these results demonstrate the benefits of a dedicated and complete symptom interview compared to a user-guided symptom discussion, which is the default of most consumer LLMs.

Real-world clinical diagnosis is a complex process in which the doctor is required to obtain information from both interaction with the patient and conducting medical exams. Additionally, the doctor needs to adapt to different patient personas, as well as noisy and incomplete information that can happen at any time during the process. However, existing benchmarks for medical LLMs and methods for automatic diagnosis largely simplify this process by reducing it to single-turn question answering, noise-free conversations, or sequential exam making, etc., ignoring the interactive and uncertain nature of clinical diagnosis. In this paper, we aim to address this gap by formalizing clinical diagnosis as a Partially Observable Markov Decision Process (POMDP) with three action types: questioning the patient, ordering medical exams as tool calls, and issuing a diagnosis. We also introduce a systematic noise model comprising seven patient noise types and three exam noise types. Using our proposed environment, we train an effective diagnosis agent, MedExAgent, through a two-stage pipeline that first performs supervised finetuning on synthetic conversations structured after the Calgary-Cambridge model for clinical interviews, and then applies DAPO to optimize a composite reward capturing diagnostic accuracy, tool call quality, and exam cost including financial cost and patient discomfort. Through extensive experiments and ablation studies, we demonstrate that MedExAgent achieves diagnostic performance comparable to larger models while maintaining cost-efficient examination strategies.

Recent studies demonstrate that prompting an appropriate role-playing persona to an LLM improves its reasoning capability. However, assigning a proper persona is difficult since an LLM's performance is extremely sensitive to assigned prompts; therefore, personas sometimes hinder LLMs and degrade their reasoning capabilities. In this paper, we propose a novel framework, Jekyll \& Hyde, which ensembles the results of role-playing and neutral prompts to eradicate performance degradation via unilateral use of role-playing prompted LLM and enhance the robustness of an LLM's reasoning ability. Specifically, Jekyll \& Hyde collects two potential solutions from both role-playing and neutral prompts and selects a better solution after cross-checking via an LLM evaluator. However, LLM-based evaluators tend to be affected by the order of those potential solutions within the prompt when selecting the proper solution; thus, we also propose a robust LLM evaluator to mitigate the position bias. The experimental analysis demonstrates that role-playing prompts distract LLMs and degrade their reasoning abilities in 4 out of 12 datasets, even when using GPT-4. In addition, we reveal that Jekyll \& Hyde improves reasoning capabilities by selecting better choices among the potential solutions on twelve widely-used reasoning datasets. We further show that our proposed LLM evaluator outperforms other baselines, proving the LLMs' position bias is successfully mitigated.

Integrating Large Language Models (LLMs) in healthcare diagnosis demands systematic frameworks that can handle complex medical scenarios while maintaining specialized expertise. We present KG4Diagnosis, a novel hierarchical multi-agent framework that combines LLMs with automated knowledge graph construction, encompassing 362 common diseases across medical specialties. Our framework mirrors real-world medical systems through a two-tier architecture: a general practitioner (GP) agent for initial assessment and triage, coordinating with specialized agents for in-depth diagnosis in specific domains. The core innovation lies in our end-to-end knowledge graph generation methodology, incorporating: (1) semantic-driven entity and relation extraction optimized for medical terminology, (2) multi-dimensional decision relationship reconstruction from unstructured medical texts, and (3) human-guided reasoning for knowledge expansion. KG4Diagnosis serves as an extensible foundation for specialized medical diagnosis systems, with capabilities to incorporate new diseases and medical knowledge. The framework's modular design enables seamless integration of domain-specific enhancements, making it valuable for developing targeted medical diagnosis systems. We provide architectural guidelines and protocols to facilitate adoption across medical contexts.

Large language models (LLMs) have shown remarkable progress in encoding clinical knowledge and responding to complex medical queries with appropriate clinical reasoning. However, their applicability in subspecialist or complex medical settings remains underexplored. In this work, we probe the performance of AMIE, a research conversational diagnostic AI system, in the subspecialist domain of breast oncology care without specific fine-tuning to this challenging domain. To perform this evaluation, we curated a set of 50 synthetic breast cancer vignettes representing a range of treatment-naive and treatment-refractory cases and mirroring the key information available to a multidisciplinary tumor board for decision-making (openly released with this work). We developed a detailed clinical rubric for evaluating management plans, including axes such as the quality of case summarization, safety of the proposed care plan, and recommendations for chemotherapy, radiotherapy, surgery and hormonal therapy. To improve performance, we enhanced AMIE with the inference-time ability to perform web search retrieval to gather relevant and up-to-date clinical knowledge and refine its responses with a multi-stage self-critique pipeline. We compare response quality of AMIE with internal medicine trainees, oncology fellows, and general oncology attendings under both automated and specialist clinician evaluations. In our evaluations, AMIE outperformed trainees and fellows demonstrating the potential of the system in this challenging and important domain. We further demonstrate through qualitative examples, how systems such as AMIE might facilitate conversational interactions to assist clinicians in their decision making. However, AMIE's performance was overall inferior to attending oncologists suggesting that further research is needed prior to consideration of prospective uses.

Large Language Models (LLMs) demonstrate a notable capacity for adopting personas and engaging in role-playing. However, evaluating this ability presents significant challenges, as human assessments are resource-intensive and automated evaluations can be biased. To address this, we introduce Role-Playing Eval (RPEval), a novel benchmark designed to assess LLM role-playing capabilities across four key dimensions: emotional understanding, decision-making, moral alignment, and in-character consistency. This article details the construction of RPEval and presents baseline evaluations. Our code and dataset are available at https://github.com/yelboudouri/RPEval

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

The field of medical diagnosis has undergone a significant transformation with the advent of large language models (LLMs), yet the challenges of interpretability within these models remain largely unaddressed. This study introduces Chain-of-Diagnosis (CoD) to enhance the interpretability of LLM-based medical diagnostics. CoD transforms the diagnostic process into a diagnostic chain that mirrors a physician's thought process, providing a transparent reasoning pathway. Additionally, CoD outputs the disease confidence distribution to ensure transparency in decision-making. This interpretability makes model diagnostics controllable and aids in identifying critical symptoms for inquiry through the entropy reduction of confidences. With CoD, we developed DiagnosisGPT, capable of diagnosing 9604 diseases. Experimental results demonstrate that DiagnosisGPT outperforms other LLMs on diagnostic benchmarks. Moreover, DiagnosisGPT provides interpretability while ensuring controllability in diagnostic rigor.

A core challenge for faithful LLM role-playing is sustaining consistent characterization throughout long, open-ended dialogues, as models frequently fail to recall and accurately apply their designated persona knowledge without explicit cues. To tackle this, we propose the Memory-Driven Role-Playing paradigm. Inspired by Stanislavski's "emotional memory" acting theory, this paradigm frames persona knowledge as the LLM's internal memory store, requiring retrieval and application based solely on dialogue context, thereby providing a rigorous test of depth and autonomous use of knowledge. Centered on this paradigm, we contribute: (1) MREval, a fine-grained evaluation framework assessing four memory-driven abilities - Anchoring, Recalling, Bounding, and Enacting; (2) MRPrompt, a prompting architecture that guides structured memory retrieval and response generation; and (3) MRBench, a bilingual (Chinese/English) benchmark for fine-grained diagnosis. The novel paradigm provides a comprehensive diagnostic for four-staged role-playing abilities across 12 LLMs. Crucially, experiments show that MRPrompt allows small models (e.g., Qwen3-8B) to match the performance of much larger closed-source LLMs (e.g., Qwen3-Max and GLM-4.7), and confirms that upstream memory gains directly enhance downstream response quality, validating the staged theoretical foundation.

Recent advancements in Large Language Models (LLMs) have significantly improved text generation capabilities. However, they also present challenges, particularly in generating vaccine-related misinformation, which poses risks to public health. Despite research on human-authored misinformation, a notable gap remains in understanding how LLMs contribute to vaccine misinformation and how best to detect it. Existing benchmarks often overlook vaccine-specific misinformation and the diverse roles of misinformation spreaders. This paper introduces VaxGuard, a novel dataset designed to address these challenges. VaxGuard includes vaccine-related misinformation generated by multiple LLMs and provides a comprehensive framework for detecting misinformation across various roles. Our findings show that GPT-3.5 and GPT-4o consistently outperform other LLMs in detecting misinformation, especially when dealing with subtle or emotionally charged narratives. On the other hand, PHI3 and Mistral show lower performance, struggling with precision and recall in fear-driven contexts. Additionally, detection performance tends to decline as input text length increases, indicating the need for improved methods to handle larger content. These results highlight the importance of role-specific detection strategies and suggest that VaxGuard can serve as a key resource for improving the detection of LLM-generated vaccine misinformation.

Evaluating conditional coverage remains one of the most persistent challenges in assessing the reliability of predictive systems. Although conformal methods can give guarantees on marginal coverage, no method can guarantee to produce sets with correct conditional coverage, leaving practitioners without a clear way to interpret local deviations. To overcome sample-inefficiency and overfitting issues of existing metrics, we cast conditional coverage estimation as a classification problem. Conditional coverage is violated if and only if some classifier can achieve lower risk than the target coverage. Through the choice of a (proper) loss function, the resulting risk difference gives a conservative estimate of natural miscoverage measures such as L1 and L2 distance, and can even separate the effects of over- and under-coverage, and non-constant target coverages. We call the resulting family of metrics excess risk of the target coverage (ERT). We show experimentally that the use of modern classifiers provides much higher statistical power than simple classifiers underlying established metrics like CovGap. Additionally, we use our metric to benchmark different conformal prediction methods. Finally, we release an open-source package for ERT as well as previous conditional coverage metrics. Together, these contributions provide a new lens for understanding, diagnosing, and improving the conditional reliability of predictive systems.

Healthcare data now span EHRs, medical imaging, genomics, and wearable sensors, but most diagnostic models still process these modalities in isolation. This limits their ability to capture early, cross-modal disease signatures. This paper introduces a multimodal foundation model built on a transformer architecture that integrates heterogeneous clinical data through modality-specific encoders and cross-modal attention. Each modality is mapped into a shared latent space and fused using multi-head attention with residual normalization. We implement the framework using a multimodal dataset that simulates early-stage disease patterns across EHR sequences, imaging patches, genomic profiles, and wearable signals, including missing-modality scenarios and label noise. The model is trained using supervised classification together with self-supervised reconstruction and contrastive alignment to improve robustness. Experimental evaluation demonstrates strong performance in early-detection settings, with stable classification metrics, reliable uncertainty estimates, and interpretable attention patterns. The approach moves toward a flexible, pretrain-and-fine-tune foundation model that supports precision diagnostics, handles incomplete inputs, and improves early disease detection across oncology, cardiology, and neurology applications.

Role-playing is important for Large Language Models (LLMs) to follow diverse instructions while maintaining role identity and the role's pre-defined ability limits. Existing role-playing datasets mostly contribute to controlling role style and knowledge boundaries, but overlook role-playing in instruction-following scenarios. We introduce a fine-grained role-playing and instruction-following composite benchmark, named RoleMRC, including: (1) Multi-turn dialogues between ideal roles and humans, including free chats or discussions upon given passages; (2) Role-playing machine reading comprehension, involving response, refusal, and attempts according to passage answerability and role ability; (3) More complex scenarios with nested, multi-turn and prioritized instructions. The final RoleMRC features a 10.2k role profile meta-pool, 37.9k well-synthesized role-playing instructions, and 1.4k testing samples. We develop a pipeline to quantitatively evaluate the fine-grained role-playing and instruction-following capabilities of several mainstream LLMs, as well as models that are fine-tuned on our data. Moreover, cross-evaluation on external role-playing datasets confirms that models fine-tuned on RoleMRC enhances instruction-following without compromising general role-playing and reasoning capabilities. We also probe the neural-level activation maps of different capabilities over post-tuned LLMs. Access to our RoleMRC, RoleMRC-mix and Codes: https://github.com/LuJunru/RoleMRC.

The emergence of groundbreaking large language models capable of performing complex reasoning tasks holds significant promise for addressing various scientific challenges, including those arising in complex clinical scenarios. To enable their safe and effective deployment in real-world healthcare settings, it is urgently necessary to benchmark the diagnostic capabilities of current models systematically. Given the limitations of existing medical benchmarks in evaluating advanced diagnostic reasoning, we present DiagnosisArena, a comprehensive and challenging benchmark designed to rigorously assess professional-level diagnostic competence. DiagnosisArena consists of 1,113 pairs of segmented patient cases and corresponding diagnoses, spanning 28 medical specialties, deriving from clinical case reports published in 10 top-tier medical journals. The benchmark is developed through a meticulous construction pipeline, involving multiple rounds of screening and review by both AI systems and human experts, with thorough checks conducted to prevent data leakage. Our study reveals that even the most advanced reasoning models, o3-mini, o1, and DeepSeek-R1, achieve only 45.82%, 31.09%, and 17.79% accuracy, respectively. This finding highlights a significant generalization bottleneck in current large language models when faced with clinical diagnostic reasoning challenges. Through DiagnosisArena, we aim to drive further advancements in AIs diagnostic reasoning capabilities, enabling more effective solutions for real-world clinical diagnostic challenges. We provide the benchmark and evaluation tools for further research and development https://github.com/SPIRAL-MED/DiagnosisArena.

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

The integration of Large Language Models (LLMs) into healthcare demands a safety paradigm rooted in primum non nocere. However, current alignment techniques rely on generic definitions of harm that fail to capture context-dependent violations, such as administrative fraud and clinical discrimination. To address this, we introduce Medical Malice: a dataset of 214,219 adversarial prompts calibrated to the regulatory and ethical complexities of the Brazilian Unified Health System (SUS). Crucially, the dataset includes the reasoning behind each violation, enabling models to internalize ethical boundaries rather than merely memorizing a fixed set of refusals. Using an unaligned agent (Grok-4) within a persona-driven pipeline, we synthesized high-fidelity threats across seven taxonomies, ranging from procurement manipulation and queue-jumping to obstetric violence. We discuss the ethical design of releasing these "vulnerability signatures" to correct the information asymmetry between malicious actors and AI developers. Ultimately, this work advocates for a shift from universal to context-aware safety, providing the necessary resources to immunize healthcare AI against the nuanced, systemic threats inherent to high-stakes medical environments -- vulnerabilities that represent the paramount risk to patient safety and the successful integration of AI in healthcare systems.

Accurate and interpretable multi-disease diagnosis remains a critical challenge in medical research, particularly when leveraging heterogeneous multimodal medical data. Current approaches often rely on single-modal data, limiting their ability to comprehensively understand complex diseases. To address this, we propose MedTVT-R1, a novel Multimodal Large Language Model (MLLM) framework designed to integrate clinical multimodal data for reasoning and diagnosing multiple diseases. We construct MedTVT-QA, a curated instruction dataset that provides question-answer pairs for physiological-level interpretations and disease-level diagnoses with a Chain of Evidence approach. MedTVT-R1 incorporates a modality perception layer to capture inter-modal dependencies and adaptively weight modality contributions. Additionally, we employ Group Relative Policy Optimization (GRPO)-based Reinforcement Fine-Tuning with a Jaccard Reward function to enhance diagnostic reasoning. Experimental results demonstrate MedTVT-R1's superiority in multimodal feature utilization and multi-disease diagnosis, offering significant potential for clinical applications such as diagnostic report generation and comorbidity reasoning. The dataset and code are available at https://github.com/keke-nice/MedTVT-R1.

Machine learning has emerged as a powerful tool for scientific discovery, enabling researchers to extract meaningful insights from complex datasets. For instance, it has facilitated the identification of disease-predictive genes from gene expression data, significantly advancing healthcare. However, the traditional process for analyzing such datasets demands substantial human effort and expertise for the data selection, processing, and analysis. To address this challenge, we introduce a novel framework, a Team of AI-made Scientists (TAIS), designed to streamline the scientific discovery pipeline. TAIS comprises simulated roles, including a project manager, data engineer, and domain expert, each represented by a Large Language Model (LLM). These roles collaborate to replicate the tasks typically performed by data scientists, with a specific focus on identifying disease-predictive genes. Furthermore, we have curated a benchmark dataset to assess TAIS's effectiveness in gene identification, demonstrating our system's potential to significantly enhance the efficiency and scope of scientific exploration. Our findings represent a solid step towards automating scientific discovery through large language models.

Large language models (LLMs) show promise in medical diagnosis, but real-world deployment remains challenging due to high-stakes clinical decisions and imperfect reasoning reliability. As a result, careful inspection of model behavior is essential for assessing whether diagnostic reasoning is reliable and clinically grounded. However, debugging medical LLMs remains difficult. First, developers often lack sufficient medical domain expertise to interpret model errors in clinically meaningful terms. Second, models can fail across a large and diverse set of instances involving different input types, tasks, and reasoning steps, making it challenging for developers to prioritize which errors deserve focused inspection. Third, developers struggle to identify recurring error patterns across cases, as existing debugging practices are largely instance-centric and rely on manual inspection of isolated failures. To address these challenges, we present VeriLLMed, a visual analytics system that integrates external biomedical knowledge to audit and debug medical LLM diagnostic reasoning. VeriLLMed transforms model outputs into comparable reasoning paths, constructs knowledge graph-grounded reference paths, and identifies three recurring classes of diagnosis errors: relation errors, branch errors, and missing errors. Case studies and expert evaluation demonstrate that VeriLLMed helps developers identify clinically implausible reasoning and generate actionable insights that can inform the improvement of medical LLMs.

Vision-Language Models (VLMs) are advancing computational pathology with superior visual understanding capabilities. However, current systems often reduce diagnosis to directly output conclusions without verifiable evidence-linked reasoning, which severely limits clinical trust and hinders expert error rectification. To address these barriers, we construct PathReasoner, the first large-scale dataset of whole-slide image (WSI) reasoning. Unlike previous work reliant on unverified distillation, we develop a rigorous knowledge-guided generation pipeline. By leveraging medical knowledge graphs, we explicitly align structured pathological findings and clinical reasoning with diagnoses, generating over 20K high-quality instructional samples. Based on the database, we propose PathReasoner-R1, which synergizes trajectory-masked supervised fine-tuning with reasoning-oriented reinforcement learning to instill structured chain-of-thought capabilities. To ensure medical rigor, we engineer a knowledge-aware multi-granular reward function incorporating an Entity Reward mechanism strictly aligned with knowledge graphs. This effectively guides the model to optimize for logical consistency rather than mere outcome matching, thereby enhancing robustness. Extensive experiments demonstrate that PathReasoner-R1 achieves state-of-the-art performance on both PathReasoner and public benchmarks across various image scales, equipping pathology models with transparent, clinically grounded reasoning capabilities. Dataset and code are available at https://github.com/cyclexfy/PathReasoner-R1.

Large language models (LLMs) have demonstrated excellent capabilities in the field of biomedical question answering, but their application in real-world clinical consultations still faces core challenges. Existing systems rely on a one-way information transmission mode where patients must fully describe their symptoms in a single round, leading to nonspecific diagnostic recommendations when complaints are vague. Traditional multi-turn dialogue methods based on supervised learning are constrained by static data-driven paradigms, lacking generalizability and struggling to intelligently extract key clinical information. To address these limitations, we propose DoctorAgent-RL, a reinforcement learning (RL)-based multi-agent collaborative framework that models medical consultations as a dynamic decision-making process under uncertainty. The doctor agent continuously optimizes its questioning strategy within the RL framework through multi-turn interactions with the patient agent, dynamically adjusting its information-gathering path based on comprehensive rewards from the Consultation Evaluator. This RL fine-tuning mechanism enables LLMs to autonomously develop interaction strategies aligned with clinical reasoning logic, rather than superficially imitating patterns in existing dialogue data. Notably, we constructed MTMedDialog, the first English multi-turn medical consultation dataset capable of simulating patient interactions. Experiments demonstrate that DoctorAgent-RL outperforms existing models in both multi-turn reasoning capability and final diagnostic performance, demonstrating practical value in assisting clinical consultations. https://github.com/JarvisUSTC/DoctorAgent-RL

Differential Diagnosis (DDx) is a fundamental yet complex aspect of clinical decision-making, in which physicians iteratively refine a ranked list of possible diseases based on symptoms, antecedents, and medical knowledge. While recent advances in large language models (LLMs) have shown promise in supporting DDx, existing approaches face key limitations, including single-dataset evaluations, isolated optimization of components, unrealistic assumptions about complete patient profiles, and single-attempt diagnosis. We introduce a Modular Explainable DDx Agent (MEDDxAgent) framework designed for interactive DDx, where diagnostic reasoning evolves through iterative learning, rather than assuming a complete patient profile is accessible. MEDDxAgent integrates three modular components: (1) an orchestrator (DDxDriver), (2) a history taking simulator, and (3) two specialized agents for knowledge retrieval and diagnosis strategy. To ensure robust evaluation, we introduce a comprehensive DDx benchmark covering respiratory, skin, and rare diseases. We analyze single-turn diagnostic approaches and demonstrate the importance of iterative refinement when patient profiles are not available at the outset. Our broad evaluation demonstrates that MEDDxAgent achieves over 10% accuracy improvements in interactive DDx across both large and small LLMs, while offering critical explainability into its diagnostic reasoning process.

Role-playing agents (RPAs) have attracted growing interest for their ability to simulate immersive and interactive characters. However, existing approaches primarily focus on static role profiles, overlooking the dynamic perceptual abilities inherent to humans. To bridge this gap, we introduce the concept of dynamic role profiles by incorporating video modality into RPAs. To support this, we construct Role-playing-Video60k, a large-scale, high-quality dataset comprising 60k videos and 700k corresponding dialogues. Based on this dataset, we develop a comprehensive RPA framework that combines adaptive temporal sampling with both dynamic and static role profile representations. Specifically, the dynamic profile is created by adaptively sampling video frames and feeding them to the LLM in temporal order, while the static profile consists of (1) character dialogues from training videos during fine-tuning, and (2) a summary context from the input video during inference. This joint integration enables RPAs to generate greater responses. Furthermore, we propose a robust evaluation method covering eight metrics. Experimental results demonstrate the effectiveness of our framework, highlighting the importance of dynamic role profiles in developing RPAs.

Role-playing has emerged as an effective technique for enhancing the reasoning capabilities of large language models (LLMs). However, existing methods primarily rely on prompt engineering, which often lacks stability and interpretability. In this paper, we introduce Sparse Autoencoder Role-Playing Steering (SRPS), a novel framework that identifies and manipulates internal model features associated with role-playing behavior. Our approach extracts latent representations from role-play prompts, selects the most relevant features based on activation patterns, and constructs a steering vector that can be injected into the model's residual stream with controllable intensity. Our method enables fine-grained control over role-specific behavior and offers insights into how role information influences internal model activations. Extensive experiments across various reasoning benchmarks and model sizes demonstrate consistent performance gains. Notably, in the zero-shot chain-of-thought (CoT) setting, the accuracy of Llama3.1-8B on CSQA improves from 31.86% to 39.80%, while Gemma2-9B on SVAMP increases from 37.50% to 45.10%. These results highlight the potential of SRPS to enhance reasoning ability in LLMs, providing better interpretability and stability compared to traditional prompt-based role-playing.

Effective root cause analysis (RCA) is vital for swiftly restoring services, minimizing losses, and ensuring the smooth operation and management of complex systems. Previous data-driven RCA methods, particularly those employing causal discovery techniques, have primarily focused on constructing dependency or causal graphs for backtracking the root causes. However, these methods often fall short as they rely solely on data from a single modality, thereby resulting in suboptimal solutions. In this work, we propose Mulan, a unified multi-modal causal structure learning method for root cause localization. We leverage a log-tailored language model to facilitate log representation learning, converting log sequences into time-series data. To explore intricate relationships across different modalities, we propose a contrastive learning-based approach to extract modality-invariant and modality-specific representations within a shared latent space. Additionally, we introduce a novel key performance indicator-aware attention mechanism for assessing modality reliability and co-learning a final causal graph. Finally, we employ random walk with restart to simulate system fault propagation and identify potential root causes. Extensive experiments on three real-world datasets validate the effectiveness of our proposed framework.

Current role-play studies often rely on unvalidated LLM-as-a-judge paradigms, which may fail to reflect how humans perceive role fidelity. A key prerequisite for human-aligned evaluation is role identification, the ability to recognize who is speaking based on dialogue context. We argue that any meaningful judgment of role-playing quality (how well a character is played) fundamentally depends on first correctly attributing words and actions to the correct persona (who is speaking). We present PersonaEval, the first benchmark designed to test whether LLM evaluators can reliably identify human roles. PersonaEval uses human-authored dialogues from novels, scripts, and video transcripts, challenging models to determine the correct persona according to the conversation context. Our experiments, including a human study, show that even the best-performing LLMs reach only around 69% accuracy, well below the level needed for reliable evaluation. In contrast, human participants perform near ceiling with 90.8% accuracy, highlighting that current LLM evaluators are still not human enough to effectively judge role-play scenarios. To better understand this gap, we examine training-time adaptation and test-time compute, suggesting that reliable evaluation requires more than task-specific tuning, but depends on strong, human-like reasoning abilities in LLM evaluators. We release our benchmark at https://github.com/maple-zhou/PersonaEval.

Deep research (DR) systems are increasingly used for complex information-seeking tasks, but existing works mainly focus on generating reports and summaries. In contrast, many enterprise tasks instead require an agent to identify concrete workflows which is a sequence of action-steps. For example, rather than summarizing budgeting policies, an agent should be able to determine the steps needed to answer a question such as: "How do I request new headcount given a fixed budget?". Therefore, we introduce DRFLOW, a benchmark for evaluating personalized workflows predicted by agents from heterogeneous sources. Each task requires the agent to identify relevant evidence from scattered sources, then use that evidence to predict the correct action-step sequence for the user's task. DRFLOW contains 100 tasks across five domains, with 1,246 reference workflow steps grounded in more than 3,900 sources. We define seven diagnostic metrics covering factual grounding, step recovery, structural ordering, condition resolution, and personalization. We further present DRFLOW-Agent (DRFA), a workflow-oriented reference agent to predict personalized workflow. We show that although DRFA improves over strong baseline agents (upto 10.02% average F1 score), there is substantial room for improvement remains across these workflow metrics, indicating that predicting complete and correct personalized workflows remains a challenging frontier for deep research.

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

Diagnosing a whole-slide image is an interactive, multi-stage process involving changes in magnification and movement between fields. Although recent pathology foundation models are strong, practical agentic systems that decide what field to examine next, adjust magnification, and deliver explainable diagnoses are still lacking. The blocker is data: scalable, clinically aligned supervision of expert viewing behavior that is tacit and experience-based, not written in textbooks or online, and therefore absent from large language model training. We introduce the AI Session Recorder, which works with standard WSI viewers to unobtrusively record routine navigation and convert the viewer logs into standardized behavioral commands (inspect or peek at discrete magnifications) and bounding boxes. A lightweight human-in-the-loop review turns AI-drafted rationales into the Pathology-CoT dataset, a form of paired "where to look" and "why it matters" supervision produced at roughly six times lower labeling time. Using this behavioral data, we build Pathologist-o3, a two-stage agent that first proposes regions of interest and then performs behavior-guided reasoning. On gastrointestinal lymph-node metastasis detection, it achieved 84.5% precision, 100.0% recall, and 75.4% accuracy, exceeding the state-of-the-art OpenAI o3 model and generalizing across backbones. To our knowledge, this constitutes one of the first behavior-grounded agentic systems in pathology. Turning everyday viewer logs into scalable, expert-validated supervision, our framework makes agentic pathology practical and establishes a path to human-aligned, upgradeable clinical AI.

Root cause analysis (RCA) is essential for diagnosing failures within complex software systems to ensure system reliability. The highly distributed and interdependent nature of modern cloud-based systems often complicates RCA efforts, particularly for multi-hop fault propagation, where symptoms appear far from their true causes. Recent advancements in Large Language Models (LLMs) present new opportunities to enhance automated RCA. However, their practical value for RCA depends on the fidelity of reasoning and decision-making. Existing work relies on historical incident corpora, operates directly on high-volume telemetry beyond current LLM capacity, or embeds reasoning inside complex multi-agent pipelines -- conditions that obscure whether failures arise from reasoning itself or from peripheral design choices. We present a focused empirical evaluation that isolates an LLM's reasoning behavior. We design a controlled experimental framework that foregrounds the LLM by using a simplified experimental setting. We evaluate six LLMs under two agentic workflows (ReAct and Plan-and-Execute) and a non-agentic baseline on two real-world case studies (GAIA and OpenRCA). In total, we executed 48,000 simulated failure scenarios, totaling 228 days of execution time. We measure both root-cause accuracy and the quality of intermediate reasoning traces. We produce a labeled taxonomy of 16 common RCA reasoning failures and use an LLM-as-a-Judge for annotation. Our results clarify where current open-source LLMs succeed and fail in multi-hop RCA, quantify sensitivity to input data modalities, and identify reasoning failures that predict final correctness. Together, these contributions provide transparent and reproducible empirical results and a failure taxonomy to guide future work on reasoning-driven system diagnosis.

Semantic role labeling (SRL) is a central natural language processing (NLP) task aiming to understand the semantic roles within texts, facilitating a wide range of downstream applications. While SRL has garnered extensive and enduring research, there is currently a lack of a comprehensive survey that thoroughly organizes and synthesizes the field. This paper aims to review the entire research trajectory of the SRL community over the past two decades. We begin by providing a complete definition of SRL. To offer a comprehensive taxonomy, we categorize SRL methodologies into four key perspectives: model architectures, syntax feature modeling, application scenarios, and multi-modal extensions. Further, we discuss SRL benchmarks, evaluation metrics, and paradigm modeling approaches, while also exploring practical applications across various domains. Finally, we analyze future research directions in SRL, addressing the evolving role of SRL in the age of large language models (LLMs) and its potential impact on the broader NLP landscape. We maintain a public repository and consistently update related resources at: https://github.com/DreamH1gh/Awesome-SRL

Multi-agent systems (MAS) are critical for automating complex tasks, yet their practical deployment is severely hampered by the challenge of failure attribution. Current diagnostic tools, which rely on statistical correlations, are fundamentally inadequate; on challenging benchmarks like Who\&When, state-of-the-art methods achieve less than 15\% accuracy in locating the root-cause step of a failure. To address this critical gap, we introduce the first failure attribution framework for MAS grounded in multi-granularity causal inference. Our approach makes two key technical contributions: (1) a performance causal inversion principle, which correctly models performance dependencies by reversing the data flow in execution logs, combined with Shapley values to accurately assign agent-level blame; (2) a novel causal discovery algorithm, CDC-MAS, that robustly identifies critical failure steps by tackling the non-stationary nature of MAS interaction data. The framework's attribution results directly fuel an automated optimization loop, generating targeted suggestions whose efficacy is validated via counterfactual simulations. Evaluations on the Who\&When and TRAIL benchmarks demonstrate a significant leap in performance. Our method achieves up to 36.2\% step-level accuracy. Crucially, the generated optimizations boost overall task success rates by an average of 22.4\%. This work provides a principled and effective solution for debugging complex agent interactions, paving the way for more reliable and interpretable multi-agent systems.

Scientific research based on multimodal clinical data (including medical imaging) requires coordinating clinical, radiological, programming, and biostatistical expertise, a fragmented process that bottlenecks discovery. We present VERITAS (Verifiable Epistemic Reasoning for Image-Derived Hypothesis Testing via Agentic Systems), a clinical co-scientist: a multi-agent system that autonomously tests natural-language hypotheses and produces a fully auditable evidence trail, tracing every conclusion through executable outputs from analysis plan to segmentation masks to statistical code to final verdict. Unlike prior AI-scientist systems, which mainly operate on tabular or text data, VERITAS grounds autonomous discovery directly in medical images. It decomposes the workflow into four phases handled by role-specialized agents, and introduces an epistemic evidence label framework that mechanically classifies outcomes as Supported, Refuted, Underpowered, or Invalid by jointly evaluating significance, effect direction, and study power. This distinction is critical in medical imaging, where non-significant results often reflect insufficient sample size rather than absent effects. We construct a tiered benchmark of 64 hypotheses spanning six complexity levels across cardiac and brain glioma MRI datasets. VERITAS reaches 81.4% verdict accuracy with frontier models and 71.2% with locally-hosted open-weight models (8-30B), outperforming all single-model baselines in both classes. It also produces the highest rate of independently verifiable statistical outputs (86.6%), so even its failures remain diagnosable through artifact inspection. Structured multi-agent decomposition thus substitutes for model scale while preserving the verifiability that scientific discovery demands. We release code, hypothesis bank, and evaluation pipeline at https://github.com/LucZot/veritas.

Asking questions about a situation is an inherent step towards understanding it. To this end, we introduce the task of role question generation, which, given a predicate mention and a passage, requires producing a set of questions asking about all possible semantic roles of the predicate. We develop a two-stage model for this task, which first produces a context-independent question prototype for each role and then revises it to be contextually appropriate for the passage. Unlike most existing approaches to question generation, our approach does not require conditioning on existing answers in the text. Instead, we condition on the type of information to inquire about, regardless of whether the answer appears explicitly in the text, could be inferred from it, or should be sought elsewhere. Our evaluation demonstrates that we generate diverse and well-formed questions for a large, broad-coverage ontology of predicates and roles.

Large Language Model (LLM)-based agents have demonstrated strong capabilities across a wide range of tasks, and their application in the medical domain holds particular promise due to the demand for high generalizability and reliance on interdisciplinary knowledge. However, existing medical agent systems often rely on static, manually crafted workflows that lack the flexibility to accommodate diverse diagnostic requirements and adapt to emerging clinical scenarios. Motivated by the success of automated machine learning (AutoML), this paper introduces a novel framework for the automated design of medical agent architectures. Specifically, we define a hierarchical and expressive agent search space that enables dynamic workflow adaptation through structured modifications at the node, structural, and framework levels. Our framework conceptualizes medical agents as graph-based architectures composed of diverse, functional node types and supports iterative self-improvement guided by diagnostic feedback. Experimental results on skin disease diagnosis tasks demonstrate that the proposed method effectively evolves workflow structures and significantly enhances diagnostic accuracy over time. This work represents the first fully automated framework for medical agent architecture design and offers a scalable, adaptable foundation for deploying intelligent agents in real-world clinical environments.

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

Modern large language models (LLMs), such as ChatGPT, exhibit a remarkable capacity for role-playing, enabling them to embody not only human characters but also non-human entities like a Linux terminal. This versatility allows them to simulate complex human-like interactions and behaviors within various contexts, as well as to emulate specific objects or systems. While these capabilities have enhanced user engagement and introduced novel modes of interaction, the influence of role-playing on LLMs' reasoning abilities remains underexplored. In this study, we introduce a strategically designed role-play prompting methodology and assess its performance under the zero-shot setting across twelve diverse reasoning benchmarks, encompassing arithmetic, commonsense reasoning, symbolic reasoning, and more. Leveraging models such as ChatGPT and Llama 2, our empirical results illustrate that role-play prompting consistently surpasses the standard zero-shot approach across most datasets. Notably, accuracy on AQuA rises from 53.5% to 63.8%, and on Last Letter from 23.8% to 84.2%. Beyond enhancing contextual understanding, we posit that role-play prompting serves as an implicit Chain-of-Thought (CoT) trigger, thereby improving the quality of reasoning. By comparing our approach with the Zero-Shot-CoT technique, which prompts the model to "think step by step", we further demonstrate that role-play prompting can generate a more effective CoT. This highlights its potential to augment the reasoning capabilities of LLMs.

Monitoring is an important aspect of safely deploying Large Language Models (LLMs). This paper examines activation probes for detecting ``high-stakes'' interactions -- where the text indicates that the interaction might lead to significant harm -- as a critical, yet underexplored, target for such monitoring. We evaluate several probe architectures trained on synthetic data, and find them to exhibit robust generalization to diverse, out-of-distribution, real-world data. Probes' performance is comparable to that of prompted or finetuned medium-sized LLM monitors, while offering computational savings of six orders-of-magnitude. These savings are enabled by reusing activations of the model that is being monitored. Our experiments also highlight the potential of building resource-aware hierarchical monitoring systems, where probes serve as an efficient initial filter and flag cases for more expensive downstream analysis. We release our novel synthetic dataset and the codebase at https://github.com/arrrlex/models-under-pressure.

The emergence of advanced reasoning capabilities in Large Language Models (LLMs) marks a transformative development in healthcare applications. Beyond merely expanding functional capabilities, these reasoning mechanisms enhance decision transparency and explainability-critical requirements in medical contexts. This survey examines the transformation of medical LLMs from basic information retrieval tools to sophisticated clinical reasoning systems capable of supporting complex healthcare decisions. We provide a thorough analysis of the enabling technological foundations, with a particular focus on specialized prompting techniques like Chain-of-Thought and recent breakthroughs in Reinforcement Learning exemplified by DeepSeek-R1. Our investigation evaluates purpose-built medical frameworks while also examining emerging paradigms such as multi-agent collaborative systems and innovative prompting architectures. The survey critically assesses current evaluation methodologies for medical validation and addresses persistent challenges in field interpretation limitations, bias mitigation strategies, patient safety frameworks, and integration of multimodal clinical data. Through this survey, we seek to establish a roadmap for developing reliable LLMs that can serve as effective partners in clinical practice and medical research.

Safety alignment in large language models is typically evaluated under isolated queries, yet real-world use is inherently multi-turn. Although multi-turn jailbreaks are empirically effective, the structure of conversational safety failure remains insufficiently understood. In this work, we study safety failures from a state-space perspective and show that many multi-turn failures arise from structured contextual state evolution rather than isolated prompt vulnerabilities. We introduce STAR, a state-oriented diagnostic framework that treats dialogue history as a state transition operator and enables controlled analysis of safety behavior along interaction trajectories. Rather than optimizing attack strength, STAR provides a principled probe of how aligned models traverse the safety boundary under autoregressive conditioning. Across multiple frontier language models, we find that systems that appear robust under static evaluation can undergo rapid and reproducible safety collapse under structured multi-turn interaction. Mechanistic analysis reveals monotonic drift away from refusal-related representations and abrupt phase transitions induced by role-conditioned context. Together, these findings motivate viewing language model safety as a dynamic, state-dependent process defined over conversational trajectories.

End-to-end reinforcement learning can improve the accuracy of compound LLM systems, but it does not constrain how modules divide labor internally. We identify Role Drift, a failure mode in which modules preserve or improve end-task performance while deviating from their assigned roles through role-violating shortcuts that remain invisible to system-level evaluation. To make role drift observable and controllable, we propose Role Anchor, a regularizer that modulates how much each module deviates from its assigned role during end-to-end training. The key idea is to preserve how the role prompt shifts the module's next-token predictions relative to a neutral prompt, which serves as a proxy for the role's intended effect during training. Experiments on two compound LLM pipelines reveal role drift that accuracy alone fails to detect: a decomposer meant to split a question into sub-questions for a separate solver instead plants the answer in them, and a reader meant to answer from retrieved passages instead falls back on parametric memory. In fact, on the decomposer pipeline this shortcut drives most of the apparent RL gain: 86% of it vanishes once the decomposer is held to its role, indicating that terminal accuracy alone can badly overstate how much a compound system has genuinely learned. Across both pipelines, Role Anchor mitigates role drift at a tunable accuracy cost that varies by pipeline and anchor strength. Additional gradient analysis suggests that the regularizer reduces alignment with the role-drift direction rather than simply suppressing learning.

Self-correction is particularly useful when a failure constrains the next repair. Coding agents benefit from this property because compilers, tests, and execution traces turn many failures into typed recovery signals, but broad language-agent tasks often expose only a coarse task failure. This creates a tension for generic recovery playbooks: they broaden the agent's context precisely when the system needs a narrower repair interface, mixing incompatible signals for invalid actions, missing procedures, and strict-format errors. Our insight is that development-set failures can recover part of the missing diagnostic substrate by deciding which recovery interventions are admissible before test-time correction. We propose DARC, a diagnosis-guided recovery harness that profiles task-family failure modes, prunes mismatched interventions from a shared recovery library, and freezes a verifier-selected success-cost policy for deployment. This causal order makes correction selective: the harness first determines what kind of failure can be repaired, then decides how much recovery evidence to spend. In ALFWorld, AppWorld, and XBRL Finance, the same protocol yields an action-validity harness, a procedural-recovery fallback, and a format-precision retrieval policy; in each evaluated setting it improves average task performance over base agents and broad playbooks while reducing environment steps or retrieval budget. Our experiments show that failures need not trigger uniformly more context: DARC turns self-correction from prompt expansion into recovery-interface design. DARC provides a practical route toward more reliable agents in domains where compiler-like feedback is absent: making failures actionable before making contexts larger.

The advent of Large Language Models (LLMs) has paved the way for complex tasks such as role-playing, which enhances user interactions by enabling models to imitate various characters. However, the closed-source nature of state-of-the-art LLMs and their general-purpose training limit role-playing optimization. In this paper, we introduce RoleLLM, a framework to benchmark, elicit, and enhance role-playing abilities in LLMs. RoleLLM comprises four stages: (1) Role Profile Construction for 100 roles; (2) Context-Based Instruction Generation (Context-Instruct) for role-specific knowledge extraction; (3) Role Prompting using GPT (RoleGPT) for speaking style imitation; and (4) Role-Conditioned Instruction Tuning (RoCIT) for fine-tuning open-source models along with role customization. By Context-Instruct and RoleGPT, we create RoleBench, the first systematic and fine-grained character-level benchmark dataset for role-playing with 168,093 samples. Moreover, RoCIT on RoleBench yields RoleLLaMA (English) and RoleGLM (Chinese), significantly enhancing role-playing abilities and even achieving comparable results with RoleGPT (using GPT-4).

The rapid growth of biomedical literature and curated databases has made it increasingly difficult for researchers to systematically connect biomarker mechanisms to actionable drug combination hypotheses. We present AI Co-Scientist (CoDHy), an interactive, human-in-the-loop system for biomarker-guided drug combination hypothesis generation in cancer research. CoDHy integrates structured biomedical databases and unstructured literature evidence into a task-specific knowledge graph, which serves as the basis for graph-based reasoning and hypothesis construction. The system combines knowledge graph embeddings with agent-based reasoning to generate, validate, and rank candidate drug combinations, while explicitly grounding each hypothesis in retrievable evidence. Through a web-based interface, users can configure the scientific context, inspect intermediate results, and iteratively refine hypotheses, enabling transparent and researcher-steerable exploration rather than automated decision-making. We demonstrate CoDHy as a system for exploratory hypothesis generation and decision support in translational oncology, highlighting its design, interaction workflow, and practical use cases.

Large language models (LLMs) have emerged as powerful tools for analyzing complex datasets. Recent studies demonstrate their potential to generate useful, personalized responses when provided with patient-specific health information that encompasses lifestyle, biomarkers, and context. As LLM-driven health applications are increasingly adopted, rigorous and efficient one-sided evaluation methodologies are crucial to ensure response quality across multiple dimensions, including accuracy, personalization and safety. Current evaluation practices for open-ended text responses heavily rely on human experts. This approach introduces human factors and is often cost-prohibitive, labor-intensive, and hinders scalability, especially in complex domains like healthcare where response assessment necessitates domain expertise and considers multifaceted patient data. In this work, we introduce Adaptive Precise Boolean rubrics: an evaluation framework that streamlines human and automated evaluation of open-ended questions by identifying gaps in model responses using a minimal set of targeted rubrics questions. Our approach is based on recent work in more general evaluation settings that contrasts a smaller set of complex evaluation targets with a larger set of more precise, granular targets answerable with simple boolean responses. We validate this approach in metabolic health, a domain encompassing diabetes, cardiovascular disease, and obesity. Our results demonstrate that Adaptive Precise Boolean rubrics yield higher inter-rater agreement among expert and non-expert human evaluators, and in automated assessments, compared to traditional Likert scales, while requiring approximately half the evaluation time of Likert-based methods. This enhanced efficiency, particularly in automated evaluation and non-expert contributions, paves the way for more extensive and cost-effective evaluation of LLMs in health.

Large Language Models (LLMs) have demonstrated strong capabilities in interpreting lengthy, complex legal and policy language. However, their reliability can be undermined by hallucinations and inconsistencies, particularly when analyzing subjective and nuanced documents. These challenges are especially critical in medical coverage policy review, where human experts must be able to rely on accurate information. In this paper, we present an approach designed to support human reviewers by making policy interpretation more efficient and interpretable. We introduce a methodology that pairs a coverage-aware retriever with symbolic rule-based reasoning to surface relevant policy language, organize it into explicit facts and rules, and generate auditable rationales. This hybrid system minimizes the number of LLM inferences required which reduces overall model cost. Notably, our approach achieves a 44% reduction in inference cost alongside a 4.5% improvement in F1 score, demonstrating both efficiency and effectiveness.

Incidental findings in CT scans, though often benign, can have significant clinical implications and should be reported following established guidelines. Traditional manual inspection by radiologists is time-consuming and variable. This paper proposes a novel framework that leverages large language models (LLMs) and foundational vision-language models (VLMs) in a plan-and-execute agentic approach to improve the efficiency and precision of incidental findings detection, classification, and reporting for abdominal CT scans. Given medical guidelines for abdominal organs, the process of managing incidental findings is automated through a planner-executor framework. The planner, based on LLM, generates Python scripts using predefined base functions, while the executor runs these scripts to perform the necessary checks and detections, via VLMs, segmentation models, and image processing subroutines. We demonstrate the effectiveness of our approach through experiments on a CT abdominal benchmark for three organs, in a fully automatic end-to-end manner. Our results show that the proposed framework outperforms existing pure VLM-based approaches in terms of accuracy and efficiency.

Breast cancer is a major global health concern, and mammography screening plays a central role in early detection. The large volume of screening examinations creates a substantial workload for radiologists, making accurate and consistent report generation a critical clinical challenge. Existing automated mammography report generation methods primarily focus on direct visual-to-text mapping, while overlooking the structured clinical reasoning process followed by radiologists in real-world practice. To address this limitation, we propose MammoRG, a mammography report generation framework that explicitly simulates the clinical reporting workflow by following the BI-RADS guideline and incorporating prior clinical knowledge to produce diagnostic reports. Specifically, MammoRG adopts a two-stage training framework. In the first stage, the model learns to integrate clinically relevant prior knowledge from a patient's four-view mammograms through classification-based supervision. In the second stage, a terminology-aware supervised fine-tuning strategy is introduced to model mammography-specific clinical terms as atomic semantic units, enabling the generation of high-quality reports with improved clinical consistency. To facilitate clinical efficacy evaluation of generated reports, we further develop MammoRGTool, a dedicated mammography report parsing tool that extracts structured clinical information from free-text reports. Extensive experiments demonstrate that MammoRG consistently outperforms existing methods across multiple clinical efficacy metrics, particularly in diagnosis-related BI-RADS F1, where it surpasses the second-best model by 2.73%, 2.04%, 1.90%, and 3.27% on the internal, external 1, external 2, and VinDr-Mammo datasets, respectively.

Large Language Model (LLM)-based Multi-Agent Systems (MAS) enable complex problem-solving but introduce significant debugging challenges, characterized by long interaction traces, inter-agent dependencies, and delayed error manifestation. Existing diagnostic approaches often rely on expensive expert annotation or ''LLM-as-a-judge'' paradigms, which struggle to pinpoint decisive error steps within extended contexts. In this paper, we introduce ErrorProbe, a self-improving framework for semantic failure attribution that identifies responsible agents and the originating error step. The framework operates via a three-stage pipeline: (1) operationalizing the MAS failure taxonomy to detect local anomalies, (2) performing symptom-driven backward tracing to prune irrelevant context, and (3) employing a specialized multi-agent team (Strategist, Investigator, Arbiter) to validate error hypotheses through tool-grounded execution. Crucially, ErrorProbe maintains a verified episodic memory that updates only when error patterns are confirmed by executable evidence, without the need for annotation. Experiments across the TracerTraj and Who&When benchmarks demonstrate that ErrorProbe significantly outperforms baselines, particularly in step-level localization, while the verified memory enables robust cross-domain transfer without retraining.

Effective customer support requires not only accurate problem solving but also structured and empathetic communication aligned with professional standards. However, existing dialogue datasets often lack strategic guidance, and real-world service data is difficult to access and annotate. To address this, we introduce the task of Customer Support Conversation (CSC), aimed at training customer service agents to respond using well-defined support strategies. We propose a structured CSC framework grounded in COPC guidelines, defining five conversational stages and twelve strategies to guide high-quality interactions. Based on this, we construct CSConv, an evaluation dataset of 1,855 real-world customer-agent conversations rewritten using LLMs to reflect deliberate strategy use, and annotated accordingly. Additionally, we develop a role-playing approach that simulates strategy-rich conversations using LLM-powered roles aligned with the CSC framework, resulting in the training dataset RoleCS. Experiments show that fine-tuning strong LLMs on RoleCS significantly improves their ability to generate high-quality, strategy-aligned responses on CSConv. Human evaluations further confirm gains in problem resolution. All code and data will be made publicly available at https://github.com/aliyun/qwen-dianjin.

Large Language Models (LLMs), such as ChatGPT, are becoming increasingly sophisticated, demonstrating capabilities that closely resemble those of humans. These AI models are playing an essential role in assisting humans with a wide array of tasks in daily life. A significant application of AI is its use as a chat agent, responding to human inquiries across various domains. Current LLMs have shown proficiency in answering general questions. However, basic question-answering dialogue often falls short in complex diagnostic scenarios, such as legal or medical consultations. These scenarios typically necessitate Task-Oriented Dialogue (TOD), wherein an AI chat agent needs to proactively pose questions and guide users towards specific task completion. Previous fine-tuning models have underperformed in TOD, and current LLMs do not inherently possess this capability. In this paper, we introduce DiagGPT (Dialogue in Diagnosis GPT), an innovative method that extends LLMs to TOD scenarios. Our experiments reveal that DiagGPT exhibits outstanding performance in conducting TOD with users, demonstrating its potential for practical applications.

AI-assisted ultrasound video diagnosis presents new opportunities to enhance the efficiency and accuracy of medical imaging analysis. However, existing research remains limited in terms of dataset diversity, diagnostic performance, and clinical applicability. In this study, we propose Auto-US, an intelligent diagnosis agent that integrates ultrasound video data with clinical diagnostic text. To support this, we constructed CUV Dataset of 495 ultrasound videos spanning five categories and three organs, aggregated from multiple open-access sources. We developed CTU-Net, which achieves state-of-the-art performance in ultrasound video classification, reaching an accuracy of 86.73\% Furthermore, by incorporating large language models, Auto-US is capable of generating clinically meaningful diagnostic suggestions. The final diagnostic scores for each case exceeded 3 out of 5 and were validated by professional clinicians. These results demonstrate the effectiveness and clinical potential of Auto-US in real-world ultrasound applications. Code and data are available at: https://github.com/Bean-Young/Auto-US.

Despite achieving high accuracy on medical benchmarks, LLMs exhibit the Einstellung Effect in clinical diagnosis--relying on statistical shortcuts rather than patient-specific evidence, causing misdiagnosis in atypical cases. Existing benchmarks fail to detect this critical failure mode. We introduce MedEinst, a counterfactual benchmark with 5,383 paired clinical cases across 49 diseases. Each pair contains a control case and a "trap" case with altered discriminative evidence that flips the diagnosis. We measure susceptibility via Bias Trap Rate--probability of misdiagnosing traps despite correctly diagnosing controls. Extensive Evaluation of 17 LLMs shows frontier models achieve high baseline accuracy but severe bias trap rates. Thus, we propose ECR-Agent, aligning LLM reasoning with Evidence-Based Medicine standard via two components: (1) Dynamic Causal Inference (DCI) performs structured reasoning through dual-pathway perception, dynamic causal graph reasoning across three levels (association, intervention, counterfactual), and evidence audit for final diagnosis; (2) Critic-Driven Graph and Memory Evolution (CGME) iteratively refines the system by storing validated reasoning paths in an exemplar base and consolidating disease-specific knowledge into evolving illness graphs. Source code is to be released.

Previous studies reveal that Electronic Health Records (EHR), which have been widely adopted in the U.S. to allow patients to access their personal medical information, do not have high readability to patients due to the prevalence of medical jargon. Tailoring medical notes to individual comprehension by identifying jargon that is difficult for each person will enhance the utility of generative models. We present the first quantitative analysis to measure the impact of role-playing in LLM in medical term extraction. By comparing the results of Mechanical Turk workers over 20 sentences, our study demonstrates that LLM role-playing improves F1 scores in 95% of cases across 14 different socio-demographic backgrounds. Furthermore, applying role-playing with in-context learning outperformed the previous state-of-the-art models. Our research showed that ChatGPT can improve traditional medical term extraction systems by utilizing role-play to deliver personalized patient education, a potential that previous models had not achieved.

Current biomedical question answering (QA) systems often assume that medical knowledge applies uniformly, yet real-world clinical reasoning is inherently conditional: nearly every decision depends on patient-specific factors such as comorbidities and contraindications. Existing benchmarks do not evaluate such conditional reasoning, and retrieval-augmented or graph-based methods lack explicit mechanisms to ensure that retrieved knowledge is applicable to given context. To address this gap, we propose CondMedQA, the first benchmark for conditional biomedical QA, consisting of multi-hop questions whose answers vary with patient conditions. Furthermore, we propose Condition-Gated Reasoning (CGR), a novel framework that constructs condition-aware knowledge graphs and selectively activates or prunes reasoning paths based on query conditions. Our findings show that CGR more reliably selects condition-appropriate answers while matching or exceeding state-of-the-art performance on biomedical QA benchmarks, highlighting the importance of explicitly modeling conditionality for robust medical reasoning.

Generalist Large Language Models (LLMs), such as GPT-4, have shown considerable promise in various domains, including medical diagnosis. Rare diseases, affecting approximately 300 million people worldwide, often have unsatisfactory clinical diagnosis rates primarily due to a lack of experienced physicians and the complexity of differentiating among many rare diseases. In this context, recent news such as "ChatGPT correctly diagnosed a 4-year-old's rare disease after 17 doctors failed" underscore LLMs' potential, yet underexplored, role in clinically diagnosing rare diseases. To bridge this research gap, we introduce RareBench, a pioneering benchmark designed to systematically evaluate the capabilities of LLMs on 4 critical dimensions within the realm of rare diseases. Meanwhile, we have compiled the largest open-source dataset on rare disease patients, establishing a benchmark for future studies in this domain. To facilitate differential diagnosis of rare diseases, we develop a dynamic few-shot prompt methodology, leveraging a comprehensive rare disease knowledge graph synthesized from multiple knowledge bases, significantly enhancing LLMs' diagnostic performance. Moreover, we present an exhaustive comparative study of GPT-4's diagnostic capabilities against those of specialist physicians. Our experimental findings underscore the promising potential of integrating LLMs into the clinical diagnostic process for rare diseases. This paves the way for exciting possibilities in future advancements in this field.

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.

Large language models are increasingly deployed as multi-agent systems, where specialized roles communicate and collaborate through structured interactions to solve complex tasks that often exceed the capacity of a single agent. However, most existing systems still rely on a fixed role library and an execution-frozen interaction topology, a rigid design choice that frequently leads to task mismatch, prevents timely adaptation when new evidence emerges during reasoning, and further inflates inference cost. We introduce MetaGen, a training-free framework that adapts both the role space and the collaboration topology at inference time, without updating base model weights. MetaGen generates and rewrites query-conditioned role specifications to maintain a controllable dynamic role pool, then instantiates a constrained execution graph around a minimal backbone. During execution, it iteratively updates role prompts and adjusts structural decisions using lightweight feedback signals. Experiments on code generation and multi-step reasoning benchmarks show that MetaGen improves the accuracy and cost tradeoff over strong multi-agent baselines.

Developing reliable AI systems to assist human clinicians in multi-modal medical diagnosis has long been a key objective for researchers. Recently, Multi-modal Large Language Models (MLLMs) have gained significant attention and achieved success across various domains. With strong reasoning capabilities and the ability to perform diverse tasks based on user instructions, they hold great potential for enhancing medical diagnosis. However, directly applying MLLMs to the medical domain still presents challenges. They lack detailed perception of visual inputs, limiting their ability to perform quantitative image analysis, which is crucial for medical diagnostics. Additionally, MLLMs often exhibit hallucinations and inconsistencies in reasoning, whereas clinical diagnoses must adhere strictly to established criteria. To address these challenges, we propose MedAgent-Pro, an evidence-based reasoning agentic system designed to achieve reliable, explainable, and precise medical diagnoses. This is accomplished through a hierarchical workflow: at the task level, knowledge-based reasoning generate reliable diagnostic plans for specific diseases following retrieved clinical criteria. While at the case level, multiple tool agents process multi-modal inputs, analyze different indicators according to the plan, and provide a final diagnosis based on both quantitative and qualitative evidence. Comprehensive experiments on both 2D and 3D medical diagnosis tasks demonstrate the superiority and effectiveness of MedAgent-Pro, while case studies further highlight its reliability and interpretability. The code is available at https://github.com/jinlab-imvr/MedAgent-Pro.

The differential diagnosis of neurodegenerative dementias is a challenging clinical task, mainly because of the overlap in symptom presentation and the similarity of patterns observed in structural neuroimaging. To improve diagnostic efficiency and accuracy, deep learning-based methods such as Convolutional Neural Networks and Vision Transformers have been proposed for the automatic classification of brain MRIs. However, despite their strong predictive performance, these models find limited clinical utility due to their opaque decision making. In this work, we propose a framework that integrates two core components to enhance diagnostic transparency. First, we introduce a modular pipeline for converting 3D T1-weighted brain MRIs into textual radiology reports. Second, we explore the potential of modern Large Language Models (LLMs) to assist clinicians in the differential diagnosis between Frontotemporal dementia subtypes, Alzheimer's disease, and normal aging based on the generated reports. To bridge the gap between predictive accuracy and explainability, we employ reinforcement learning to incentivize diagnostic reasoning in LLMs. Without requiring supervised reasoning traces or distillation from larger models, our approach enables the emergence of structured diagnostic rationales grounded in neuroimaging findings. Unlike post-hoc explainability methods that retrospectively justify model decisions, our framework generates diagnostic rationales as part of the inference process-producing causally grounded explanations that inform and guide the model's decision-making process. In doing so, our framework matches the diagnostic performance of existing deep learning methods while offering rationales that support its diagnostic conclusions.

In recent years, Large Language Models (LLMs) have demonstrated remarkable capabilities in data analytics when integrated with Multi-Agent Systems (MAS). However, these systems often struggle with complex tasks that involve diverse functional requirements and intricate data processing challenges, necessitating customized solutions that lack broad applicability. Furthermore, current MAS fail to emulate essential human-like traits such as self-planning, self-monitoring, and collaborative work in dynamic environments, leading to inefficiencies and resource wastage. To address these limitations, we propose ROMAS, a novel Role-Based M ulti-A gent System designed to adapt to various scenarios while enabling low code development and one-click deployment. ROMAS has been effectively deployed in DB-GPT [Xue et al., 2023a, 2024b], a well-known project utilizing LLM-powered database analytics, showcasing its practical utility in real-world scenarios. By integrating role-based collaborative mechanisms for self-monitoring and self-planning, and leveraging existing MAS capabilities to enhance database interactions, ROMAS offers a more effective and versatile solution. Experimental evaluations of ROMAS demonstrate its superiority across multiple scenarios, highlighting its potential to advance the field of multi-agent data analytics.

Clinical dialogue represents a complex duality requiring both the empathetic fluency of natural conversation and the rigorous precision of evidence-based medicine. While Large Language Models possess unprecedented linguistic capabilities, their architectural reliance on reactive and stateless processing often favors probabilistic plausibility over factual veracity. This structural limitation has catalyzed a paradigm shift in medical AI from generative text prediction to agentic autonomy, where the model functions as a central reasoning engine capable of deliberate planning and persistent memory. Moving beyond existing reviews that primarily catalog downstream applications, this survey provides a first-principles analysis of the cognitive architecture underpinning this shift. We introduce a novel taxonomy structured along the orthogonal axes of knowledge source and agency objective to delineate the provenance of clinical knowledge against the system's operational scope. This framework facilitates a systematic analysis of the intrinsic trade-offs between creativity and reliability by categorizing methods into four archetypes: Latent Space Clinicians, Emergent Planners, Grounded Synthesizers, and Verifiable Workflow Automators. For each paradigm, we deconstruct the technical realization across the entire cognitive pipeline, encompassing strategic planning, memory management, action execution, collaboration, and evolution to reveal how distinct architectural choices balance the tension between autonomy and safety.

Multi-agent large language model (LLM) and vision-language model (VLM) debate systems employ specialized roles for complex problem-solving, yet model specializations are not leveraged to decide which model should fill which role. We propose dynamic role assignment, a framework that runs a Meta-Debate to select suitable agents before the actual debate. The meta-debate has two stages: (1) proposal, where candidates provide role-tailored arguments, and (2) peer review, where proposals are scored with data and role-specific criteria to choose the best agent for each position. We evaluate our method on LLM problem solving benchmarks. Applied on top of existing debate systems, our approach consistently outperforms uniform assignments (filling all roles with the same model) by up to 74.8% and random assignments (assigning models to roles without considering their suitability) by up to 29.7%, depending on the task and the specific assignment. This work establishes a new paradigm for multi-agent system design, shifting from static agent deployment to dynamic and capability-aware selection.

As the field of automated machine learning (AutoML) advances, it becomes increasingly important to incorporate domain knowledge into these systems. We present an approach for doing so by harnessing the power of large language models (LLMs). Specifically, we introduce Context-Aware Automated Feature Engineering (CAAFE), a feature engineering method for tabular datasets that utilizes an LLM to iteratively generate additional semantically meaningful features for tabular datasets based on the description of the dataset. The method produces both Python code for creating new features and explanations for the utility of the generated features. Despite being methodologically simple, CAAFE improves performance on 11 out of 14 datasets -- boosting mean ROC AUC performance from 0.798 to 0.822 across all dataset - similar to the improvement achieved by using a random forest instead of logistic regression on our datasets. Furthermore, CAAFE is interpretable by providing a textual explanation for each generated feature. CAAFE paves the way for more extensive semi-automation in data science tasks and emphasizes the significance of context-aware solutions that can extend the scope of AutoML systems to semantic AutoML. We release our https://github.com/automl/CAAFE{code}, a simple https://colab.research.google.com/drive/1mCA8xOAJZ4MaB_alZvyARTMjhl6RZf0a{demo} and a https://pypi.org/project/caafe/{python package}.

This report investigates approaches for prompting a tool-augmented large language model (LLM) to act as a role-playing dialogue agent in the API track of the Commonsense Persona-grounded Dialogue Challenge (CPDC) 2025. In this setting, dialogue agents often produce overly long in-character responses (over-speaking) while failing to use tools effectively according to the persona (under-acting), such as generating function calls that do not exist or making unnecessary tool calls before answering. We explore four prompting approaches to address these issues: 1) basic role prompting, 2) improved role prompting, 3) automatic prompt optimization (APO), and 4) rule-based role prompting. The rule-based role prompting (RRP) approach achieved the best performance through two novel techniques-character-card/scene-contract design and strict enforcement of function calling-which led to an overall score of 0.571, improving on the zero-shot baseline score of 0.519. These findings demonstrate that RRP design can substantially improve the effectiveness and reliability of role-playing dialogue agents compared with more elaborate methods such as APO. To support future efforts in developing persona prompts, we are open-sourcing all of our best-performing prompts and the APO tool Source code is available at https://github.com/scb-10x/apo

When a long-horizon agent execution fails, outcome-level evaluation reveals the unsuccessful result but not where the decisive error entered the trajectory. Developers must then inspect the full execution to identify the responsible role and localize the earliest decisive root-cause step. Existing failure-attribution benchmarks largely focus on shorter traces, leaving diagnosis across hundreds of recorded steps underexplored. We introduce LongRCA Bench, comprising 1,140 failed trajectories across five domains without injected errors. It provides independently scored human labels for the responsible role and earliest decisive root-cause step. The median trajectory contains 145 steps, and the strongest baseline reaches only 13.2% exact root-step accuracy. We further present Root-Cause Trajectory Attribution (RCTA), a training-free method that retrieves candidate error steps from segment summaries and traces them to available earlier handoff instructions. Using the same backbone, benchmark instances, and scoring protocol, RCTA reaches 51.1% responsible-role accuracy and 24.1% exact root-step accuracy. These results highlight the need to evaluate responsible-role attribution and exact root-step localization as separate targets in long-trajectory failure diagnosis.

Current evaluation protocols for Vision-Language Models (VLMs) in Radiology Report Generation (RRG) rely on report-level metrics that measure lexical overlap or aggregate clinical correctness. However, such metrics do not test whether individual diagnostic statements stem from the actual pathological evidence visible in the image. This allows models to achieve competitive scores by exploiting learned priors or spurious correlations, a failure mode we refer to as vision shortcut. We introduce SHOVIR, a benchmark for evaluating vision shortcut behavior in RRG. SHOVIR extends two spatially annotated chest X-ray datasets, MIMIC-CXR and PadChest-GR, with per-box CheXpert labels, and defines image-level and disease-level occlusion experiments that contrast baseline performance on clean images against localized, region-specific perturbations. Comparing predictions across these conditions isolates two failure modes at the disease-class level: direct shortcuts, where a finding persists after its visual evidence is removed, and contextual shortcuts, where detection degrades once co-occurring pathologies are occluded despite the target region remaining intact. Benchmarking eight state-of-the-art VLMs, we find that shortcut behavior varies substantially across architectures and datasets. Models achieving the highest baseline report quality do not necessarily rank highest in spatial grounding, revealing that clinically fluent generation can coexist with shallow reliance on visual evidence. These findings expose a blind spot in current RRG evaluation and motivate region-aware assessment protocols.

Large language models (LLMs) have shown great promise in the medical domain, achieving strong performance on several benchmarks. However, they continue to underperform in real-world medical scenarios, which often demand stronger context-awareness, i.e., the ability to recognize missing or critical details (e.g., user identity, medical history, risk factors) and provide safe, helpful, and contextually appropriate responses. To address this issue, we propose Multifaceted Self-Refinement (MuSeR), a data-driven approach that enhances LLMs' context-awareness along three key facets (decision-making, communication, and safety) through self-evaluation and refinement. Specifically, we first design a attribute-conditioned query generator that simulates diverse real-world user contexts by varying attributes such as role, geographic region, intent, and degree of information ambiguity. An LLM then responds to these queries, self-evaluates its answers along three key facets, and refines its responses to better align with the requirements of each facet. Finally, the queries and refined responses are used for supervised fine-tuning to reinforce the model's context-awareness ability. Evaluation results on the latest HealthBench dataset demonstrate that our method significantly improves LLM performance across multiple aspects, with particularly notable gains in the context-awareness axis. Furthermore, by incorporating knowledge distillation with the proposed method, the performance of a smaller backbone LLM (e.g., Qwen3-32B) surpasses its teacher model, achieving a new SOTA across all open-source LLMs on HealthBench (63.8%) and its hard subset (43.1%). Code and dataset will be released at https://muser-llm.github.io.

As Large Multimodal Models (LMMs) scale up and reinforcement learning (RL) methods mature, LMMs have made notable progress in complex reasoning and decision making. Yet training still relies on static data and fixed recipes, making it difficult to diagnose capability blind spots or provide dynamic, targeted reinforcement. Motivated by findings that test driven error exposure and feedback based correction outperform repetitive practice, we propose Diagnostic-driven Progressive Evolution (DPE), a spiral loop where diagnosis steers data generation and reinforcement, and each iteration re-diagnoses the updated model to drive the next round of targeted improvement. DPE has two key components. First, multiple agents annotate and quality control massive unlabeled multimodal data, using tools such as web search and image editing to produce diverse, realistic samples. Second, DPE attributes failures to specific weaknesses, dynamically adjusts the data mixture, and guides agents to generate weakness focused data for targeted reinforcement. Experiments on Qwen3-VL-8B-Instruct and Qwen2.5-VL-7B-Instruct show stable, continual gains across eleven benchmarks, indicating DPE as a scalable paradigm for continual LMM training under open task distributions. Our code, models, and data are publicly available at https://github.com/hongruijia/DPE.

This study presents RoleCraft-GLM, an innovative framework aimed at enhancing personalized role-playing with Large Language Models (LLMs). RoleCraft-GLM addresses the key issue of lacking personalized interactions in conversational AI, and offers a solution with detailed and emotionally nuanced character portrayals. We contribute a unique conversational dataset that shifts from conventional celebrity-centric characters to diverse, non-celebrity personas, thus enhancing the realism and complexity of language modeling interactions. Additionally, our approach includes meticulous character development, ensuring dialogues are both realistic and emotionally resonant. The effectiveness of RoleCraft-GLM is validated through various case studies, highlighting its versatility and skill in different scenarios. Our framework excels in generating dialogues that accurately reflect characters' personality traits and emotions, thereby boosting user engagement. In conclusion, RoleCraft-GLM marks a significant leap in personalized AI interactions, and paves the way for more authentic and immersive AI-assisted role-playing experiences by enabling more nuanced and emotionally rich dialogues

Conversational diagnosis prediction requires models to track evolving evidence in streaming clinical conversations and decide when to commit to a diagnosis. Existing medical dialogue corpora are largely dyadic or lack the multi-party workflow and annotations needed for this setting. We introduce an ePCR-grounded, topic-flow-based multi-agent generation pipeline that iteratively plans, generates, and self-refines dialogues with rule-based factual and topic flow checks. The pipeline yields EMSDialog, a dataset of 4,414 synthetic multi-speaker EMS conversations based on a real-world ePCR dataset, annotated with 43 diagnoses, speaker roles, and turn-level topics. Human and LLM evaluations confirm high quality and realism of EMSDialog using both utterance- and conversation-level metrics. Results show that EMSDialog-augmented training improves accuracy, timeliness, and stability of EMS conversational diagnosis prediction. Our datasets and code are publicly available at https://uva-dsa.github.io/EMSDialog

Automatically and accurately identifying user intents and filling the associated slots from their spoken language are critical to the success of dialogue systems. Traditional methods require manually defining the DOMAIN-INTENT-SLOT schema and asking many domain experts to annotate the corresponding utterances, upon which neural models are trained. This procedure brings the challenges of information sharing hindering, out-of-schema, or data sparsity in open-domain dialogue systems. To tackle these challenges, we explore a new task of {\em automatic intent-slot induction} and propose a novel domain-independent tool. That is, we design a coarse-to-fine three-step procedure including Role-labeling, Concept-mining, And Pattern-mining (RCAP): (1) role-labeling: extracting keyphrases from users' utterances and classifying them into a quadruple of coarsely-defined intent-roles via sequence labeling; (2) concept-mining: clustering the extracted intent-role mentions and naming them into abstract fine-grained concepts; (3) pattern-mining: applying the Apriori algorithm to mine intent-role patterns and automatically inferring the intent-slot using these coarse-grained intent-role labels and fine-grained concepts. Empirical evaluations on both real-world in-domain and out-of-domain datasets show that: (1) our RCAP can generate satisfactory SLU schema and outperforms the state-of-the-art supervised learning method; (2) our RCAP can be directly applied to out-of-domain datasets and gain at least 76\% improvement of F1-score on intent detection and 41\% improvement of F1-score on slot filling; (3) our RCAP exhibits its power in generic intent-slot extractions with less manual effort, which opens pathways for schema induction on new domains and unseen intent-slot discovery for generalizable dialogue systems.

Generalist foundation models such as GPT-4 have displayed surprising capabilities in a wide variety of domains and tasks. Yet, there is a prevalent assumption that they cannot match specialist capabilities of fine-tuned models. For example, most explorations to date on medical competency benchmarks have leveraged domain-specific training, as exemplified by efforts on BioGPT and Med-PaLM. We build on a prior study of GPT-4's capabilities on medical challenge benchmarks in the absence of special training. Rather than using simple prompting to highlight the model's out-of-the-box capabilities, we perform a systematic exploration of prompt engineering. We find that prompting innovation can unlock deeper specialist capabilities and show that GPT-4 easily tops prior leading results for medical benchmarks. The prompting methods we explore are general purpose, and make no specific use of domain expertise, removing the need for expert-curated content. Our experimental design carefully controls for overfitting during the prompt engineering process. We introduce Medprompt, based on a composition of several prompting strategies. With Medprompt, GPT-4 achieves state-of-the-art results on all nine of the benchmark datasets in the MultiMedQA suite. The method outperforms leading specialist models such as Med-PaLM 2 by a significant margin with an order of magnitude fewer calls to the model. Steering GPT-4 with Medprompt achieves a 27% reduction in error rate on the MedQA dataset over the best methods to date achieved with specialist models and surpasses a score of 90% for the first time. Beyond medical problems, we show the power of Medprompt to generalize to other domains and provide evidence for the broad applicability of the approach via studies of the strategy on exams in electrical engineering, machine learning, philosophy, accounting, law, nursing, and clinical psychology.

LLM agents excel when environments are mostly static and the needed information fits in a model's context window, but they often fail in open-ended investigations where explanations must be constructed by iteratively mining evidence from massive, heterogeneous operational data. These investigations exhibit hidden dependency structure: entities interact, signals co-vary, and the importance of a fact may only become clear after other evidence is discovered. Because the context window is bounded, agents must summarize intermediate findings before their significance is known, increasing the risk of discarding key evidence. ReAct-style agents are especially brittle in this regime. Their retrieve-summarize-reason loop makes conclusions sensitive to exploration order and introduces run-to-run non-determinism, producing a reliability gap where Pass-at-k may be high but Majority-at-k remains low. Simply sampling more rollouts or generating longer reasoning traces does not reliably stabilize results, since hypotheses cannot be autonomously checked as new evidence arrives and there is no explicit mechanism for belief bookkeeping and revision. In addition, ReAct entangles semantic reasoning with controller duties such as tool orchestration and state tracking, so execution errors and plan drift degrade reasoning while consuming scarce context. We address these issues by formulating investigation as abductive reasoning over a dependency graph and proposing EoG (Explanations over Graphs), a disaggregated framework in which an LLM performs bounded local evidence mining and labeling (cause vs symptom) while a deterministic controller manages traversal, state, and belief propagation to compute a minimal explanatory frontier. On a representative ITBench diagnostics task, EoG improves both accuracy and run-to-run consistency over ReAct baselines, including a 7x average gain in Majority-at-k entity F1.

We introduce Fraud-R1, a benchmark designed to evaluate LLMs' ability to defend against internet fraud and phishing in dynamic, real-world scenarios. Fraud-R1 comprises 8,564 fraud cases sourced from phishing scams, fake job postings, social media, and news, categorized into 5 major fraud types. Unlike previous benchmarks, Fraud-R1 introduces a multi-round evaluation pipeline to assess LLMs' resistance to fraud at different stages, including credibility building, urgency creation, and emotional manipulation. Furthermore, we evaluate 15 LLMs under two settings: 1. Helpful-Assistant, where the LLM provides general decision-making assistance, and 2. Role-play, where the model assumes a specific persona, widely used in real-world agent-based interactions. Our evaluation reveals the significant challenges in defending against fraud and phishing inducement, especially in role-play settings and fake job postings. Additionally, we observe a substantial performance gap between Chinese and English, underscoring the need for improved multilingual fraud detection capabilities.

Vision-language models (VLMs) aligned with general human objectives, such as being harmless and hallucination-free, have become valuable assistants of humans in managing visual tasks. However, people with diversified backgrounds have different cognition even in the same situation. Consequently, they may have personalized expectations for VLM assistants. This highlights the urgent need to align VLM assistants with personalized situated cognition for real-world assistance. To study this problem, we first simplify it by characterizing individuals based on the sociological concept of Role-Set. Then, we propose to evaluate the individuals' actions to examine whether the personalized alignment is achieved. Further, we construct a benchmark named PCogAlignBench, which includes 18k instances and 20 individuals with different Role-Sets. Finally, we present a framework called PCogAlign, which constructs a cognition-aware and action-based reward model for personalized alignment. Experimental results and human evaluations demonstrate the reliability of the PCogAlignBench and the effectiveness of our proposed PCogAlign. We will open-source the constructed benchmark and code at https://github.com/NLPGM/PCogAlign.

By organizing knowledge within a research field, Systematic Reviews (SR) provide valuable leads to steer research. Evidence suggests that SRs have become first-class artifacts in software engineering. However, the tedious manual effort associated with the screening phase of SRs renders these studies a costly and error-prone endeavor. While screening has traditionally been considered not amenable to automation, the advent of generative AI-driven chatbots, backed with large language models is set to disrupt the field. In this report, we propose an approach to leverage these novel technological developments for automating the screening of SRs. We assess the consistency, classification performance, and generalizability of ChatGPT in screening articles for SRs and compare these figures with those of traditional classifiers used in SR automation. Our results indicate that ChatGPT is a viable option to automate the SR processes, but requires careful considerations from developers when integrating ChatGPT into their SR tools.

Objectives: While Large Language Models (LLMs) have been widely used to assist clinicians and support patients, no existing work has explored dialogue systems for standard diagnostic interviews and assessments. This study aims to bridge the gap in mental healthcare accessibility by developing an LLM-powered dialogue system that replicates clinician behavior. Materials and Methods: We introduce TRUST, a framework of cooperative LLM modules capable of conducting formal diagnostic interviews and assessments for Post-Traumatic Stress Disorder (PTSD). To guide the generation of appropriate clinical responses, we propose a Dialogue Acts schema specifically designed for clinical interviews. Additionally, we develop a patient simulation approach based on real-life interview transcripts to replace time-consuming and costly manual testing by clinicians. Results: A comprehensive set of evaluation metrics is designed to assess the dialogue system from both the agent and patient simulation perspectives. Expert evaluations by conversation and clinical specialists show that TRUST performs comparably to real-life clinical interviews. Discussion: Our system performs at the level of average clinicians, with room for future enhancements in communication styles and response appropriateness. Conclusions: Our TRUST framework shows its potential to facilitate mental healthcare availability.

Agentic systems offer a potential path to solve complex clinical tasks through collaboration among specialized agents, augmented by tool use and external knowledge bases. Nevertheless, for chest X-ray (CXR) interpretation, prevailing methods remain limited: (i) reasoning is frequently neither clinically interpretable nor aligned with guidelines, reflecting mere aggregation of tool outputs; (ii) multimodal evidence is insufficiently fused, yielding text-only rationales that are not visually grounded; and (iii) systems rarely detect or resolve cross-tool inconsistencies and provide no principled verification mechanisms. To bridge the above gaps, we present RadAgents, a multi-agent framework for CXR interpretation that couples clinical priors with task-aware multimodal reasoning. In addition, we integrate grounding and multimodal retrieval-augmentation to verify and resolve context conflicts, resulting in outputs that are more reliable, transparent, and consistent with clinical practice.

Persona conditioning can be viewed as a behavioral prior for large language models (LLMs) and is often assumed to confer expertise and improve safety in a monotonic manner. However, its effects on high-stakes clinical decision-making remain poorly characterized. We systematically evaluate persona-based control in clinical LLMs, examining how professional roles (e.g., Emergency Department physician, nurse) and interaction styles (bold vs.\ cautious) influence behavior across models and medical tasks. We assess performance on clinical triage and patient-safety tasks using multidimensional evaluations that capture task accuracy, calibration, and safety-relevant risk behavior. We find systematic, context-dependent, and non-monotonic effects: Medical personas improve performance in critical care tasks, yielding gains of up to sim+20% in accuracy and calibration, but degrade performance in primary-care settings by comparable margins. Interaction style modulates risk propensity and sensitivity, but it's highly model-dependent. While aggregated LLM-judge rankings favor medical over non-medical personas in safety-critical cases, we found that human clinicians show moderate agreement on safety compliance (average Cohen's κ= 0.43) but indicate a low confidence in 95.9\% of their responses on reasoning quality. Our work shows that personas function as behavioral priors that introduce context-dependent trade-offs rather than guarantees of safety or expertise. The code is available at https://github.com/rsinghlab/Persona\_Paradox.

As LLM-powered agents have been used for high-stakes decision-making, such as clinical diagnosis, it becomes critical to develop reliable verification of their decisions to facilitate trustworthy deployment. Yet, existing verifiers usually underperform owing to a lack of domain knowledge and limited calibration. To address this, we establish GLEAN, an agent verification framework with Guideline-grounded Evidence Accumulation that compiles expert-curated protocols into trajectory-informed, well-calibrated correctness signals. GLEAN evaluates the step-wise alignment with domain guidelines and aggregates multi-guideline ratings into surrogate features, which are accumulated along the trajectory and calibrated into correctness probabilities using Bayesian logistic regression. Moreover, the estimated uncertainty triggers active verification, which selectively collects additional evidence for uncertain cases via expanding guideline coverage and performing differential checks. We empirically validate GLEAN with agentic clinical diagnosis across three diseases from the MIMIC-IV dataset, surpassing the best baseline by 12% in AUROC and 50% in Brier score reduction, which confirms the effectiveness in both discrimination and calibration. In addition, the expert study with clinicians recognizes GLEAN's utility in practice.

Medical report generation has achieved remarkable advancements yet has still been faced with several challenges. First, the inherent imbalance in the distribution of normal and abnormal cases may lead models to exhibit a biased focus on normal samples, resulting in unreliable diagnoses. Second, the frequent occurrence of common template sentences in the reports may overwhelm the critical abnormal information. Moreover, existing works focus on 2D chest X-rays, leaving CT report generation underexplored due to the high-dimensional nature of CT images and the limited availability of CT-report pairs. Recently, LLM has shown a great ability to generate reliable answers with appropriate prompts, which shed light on addressing the aforementioned challenges. In this paper, we propose Dia-LLaMA, a framework to adapt the LLaMA2-7B for CT report generation by incorporating diagnostic information as guidance prompts. Considering the high dimension of CT, we leverage a pre-trained ViT3D with perceiver to extract the visual information. To tailor the LLM for report generation and emphasize abnormality, we extract additional diagnostic information by referring to a disease prototype memory bank, which is updated during training to capture common disease representations. Furthermore, we introduce disease-aware attention to enable the model to adjust attention for different diseases. Experiments on the chest CT dataset demonstrated that our proposed method outperformed previous methods and achieved state-of-the-art on both clinical efficacy performance and natural language generation metrics. The code will be made publically available.

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.

Recent work shows that LLM agents struggle to correct errors in their own reasoning traces yet show markedly higher correction rates when identical claims appear under external sources. We ask whether this asymmetry reflects a capability deficit or a role-label artifact: does an agent's willingness to correct a wrong claim depend causally on the chat-template role that carries it, rather than on the claim's content? Our setup keeps the erroneous claim byte-identical across all conditions (SHA-256 verified) and varies only its wrapping role: the agent's own <thought>, a user message, a tool response, or a system <memory> block. Across 13 model-domain cells covering seven model families and three domains (n{=}30 paired tasks per cell), relabeling the claim from <thought> to an external role lifts the explicit-correction rate by 23 to 93 percentage points, with 10 of 13 cells reaching p{<}0.001. Further experiments confirm that the effect is asymmetric, mechanistically decomposable, and robust across domains. The failure to self-correct is not a cognitive deficit; it is a chat-template artifact. We exploit this artifact by designing a prompt-structure-only intervention that requires no training and no model modification, with its strongest role label being domain-dependent: <memory> dominates on math, while a plain user message dominates on logical deduction.

As dialogue agents become increasingly human-like in their performance, it is imperative that we develop effective ways to describe their behaviour in high-level terms without falling into the trap of anthropomorphism. In this paper, we foreground the concept of role-play. Casting dialogue agent behaviour in terms of role-play allows us to draw on familiar folk psychological terms, without ascribing human characteristics to language models they in fact lack. Two important cases of dialogue agent behaviour are addressed this way, namely (apparent) deception and (apparent) self-awareness.

As contemporary microservice systems become increasingly popular and complex-often comprising hundreds or even thousands of fine-grained, interdependent subsystems-they are facing more frequent failures. Ensuring system reliability thus demands accurate root cause localization. While traces and metrics have proven to be effective data sources for this task, existing methods either heavily rely on pre-defined schemas, which struggle to adapt to evolving operational contexts, or lack interpretability in their reasoning process, thereby leaving Site Reliability Engineers (SREs) confused. In this paper, we conduct a comprehensive study on how SREs localize the root cause of failures, drawing insights from multiple professional SREs across different organizations. Our investigation reveals that human root cause analysis exhibits three key characteristics: recursiveness, multi-dimensional expansion, and cross-modal reasoning. Motivated by these findings, we introduce RCLAgent, an adaptive root cause localization method for microservice systems that leverages a multi-agent recursion-of-thought framework. RCLAgent employs a novel recursion-of-thought strategy to guide the LLM's reasoning process, effectively integrating data from multiple agents and tool-assisted analysis to accurately pinpoint the root cause. Experimental evaluations on various public datasets demonstrate that RCLAgent achieves superior performance by localizing the root cause using only a single request-outperforming state-of-the-art methods that depend on aggregating multiple requests. These results underscore the effectiveness of RCLAgent in enhancing the efficiency and precision of root cause localization in complex microservice environments.

Document-level event argument extraction poses new challenges of long input and cross-sentence inference compared to its sentence-level counterpart. However, most prior works focus on capturing the relations between candidate arguments and the event trigger in each event, ignoring two crucial points: a) non-argument contextual clue information; b) the relevance among argument roles. In this paper, we propose a SCPRG (Span-trigger-based Contextual Pooling and latent Role Guidance) model, which contains two novel and effective modules for the above problem. The Span-Trigger-based Contextual Pooling(STCP) adaptively selects and aggregates the information of non-argument clue words based on the context attention weights of specific argument-trigger pairs from pre-trained model. The Role-based Latent Information Guidance (RLIG) module constructs latent role representations, makes them interact through role-interactive encoding to capture semantic relevance, and merges them into candidate arguments. Both STCP and RLIG introduce no more than 1% new parameters compared with the base model and can be easily applied to other event extraction models, which are compact and transplantable. Experiments on two public datasets show that our SCPRG outperforms previous state-of-the-art methods, with 1.13 F1 and 2.64 F1 improvements on RAMS and WikiEvents respectively. Further analyses illustrate the interpretability of our model.

Current role-playing agents (RPAs) are typically constructed by imitating surface-level behaviors, but this approach lacks internal cognitive consistency, often causing out-of-character errors in complex situations. To address this, we propose Character-R1, a framework designed to provide comprehensive verifiable reward signals for effective role-aware reasoning, which are missing in recent studies. Specifically, our framework comprises three core designs: (1) Cognitive Focus Reward, which enforces explicit label-based analysis of 10 character elements (e.g., worldview) to structure internal cognition; (2) Reference-Guided Reward, which utilizes overlap-based metrics with reference responses as optimization anchors to enhance exploration and performance; and (3) Character-Conditioned Reward Normalization, which adjusts reward distributions based on character categories to ensure robust optimization across heterogeneous roles. Extensive experiments demonstrate that Character-R1 significantly outperforms existing methods in knowledge, memory and others.