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Jul 9

Automated SSIM Regression for Detection and Quantification of Motion Artefacts in Brain MR Images

Motion artefacts in magnetic resonance brain images can have a strong impact on diagnostic confidence. The assessment of MR image quality is fundamental before proceeding with the clinical diagnosis. Motion artefacts can alter the delineation of structures such as the brain, lesions or tumours and may require a repeat scan. Otherwise, an inaccurate (e.g. correct pathology but wrong severity) or incorrect diagnosis (e.g. wrong pathology) may occur. "Image quality assessment" as a fast, automated step right after scanning can assist in deciding if the acquired images are diagnostically sufficient. An automated image quality assessment based on the structural similarity index (SSIM) regression through a residual neural network is proposed in this work. Additionally, a classification into different groups - by subdividing with SSIM ranges - is evaluated. Importantly, this method predicts SSIM values of an input image in the absence of a reference ground truth image. The networks were able to detect motion artefacts, and the best performance for the regression and classification task has always been achieved with ResNet-18 with contrast augmentation. The mean and standard deviation of residuals' distribution were mu=-0.0009 and sigma=0.0139, respectively. Whilst for the classification task in 3, 5 and 10 classes, the best accuracies were 97, 95 and 89\%, respectively. The results show that the proposed method could be a tool for supporting neuro-radiologists and radiographers in evaluating image quality quickly.

  • 7 authors
·
Jun 14, 2022

Scalable Uncertainty Quantification for Extreme Weather Forecasting via Empirical Neural Tangent Kernels

Deep learning weather models now match numerical weather prediction accuracy while running orders of magnitude faster, but produce deterministic forecasts without uncertainty estimates, a critical gap for high-stakes decisions during extreme weather events. This paper proposes Neural Tangent Kernel-based uncertainty quantification (NTK-UQ) using last-layer empirical features. Theoretical analysis predicts that UQ quality is architecture-dependent through two mechanisms. First, a variance collapse mechanism explains when UQ fails: when the eigenvalue truncation rank approaches the effective rank of the feature space, the GP correction term consumes nearly all prior variance, destroying discrimination between tropical cyclones and routine conditions; architectures with concentrated spectra (spectral operators) require aggressive truncation (k leq 10), while attention-based models tolerate full-rank computation. Second, decomposition performance depends on the non-Gaussian, heavy-tailed structure of extreme weather: Independent Component Analysis exploits higher-order statistics (kurtosis, negentropy) to isolate heavy-tailed extreme-event features, achieving higher discrimination than singular value decomposition, which captures only second-order variance. A data-driven selection rule chooses ICA or SVD from the feature eigenspectrum concentration ratio, correctly prescribing the superior decomposition for all four evaluated architectures. Compared to split conformal prediction (the natural post-hoc baseline), NTK-UQ achieves 31--37\% sharper prediction intervals at 90\% coverage, and uniquely produces adaptive intervals that scale with extreme event severity, which conformal prediction cannot achieve by construction. The framework requires no retraining; inference-time uncertainty requires only a single matrix-vector product per sample.

  • 3 authors
·
May 31

The Troubling Emergence of Hallucination in Large Language Models -- An Extensive Definition, Quantification, and Prescriptive Remediations

The recent advancements in Large Language Models (LLMs) have garnered widespread acclaim for their remarkable emerging capabilities. However, the issue of hallucination has parallelly emerged as a by-product, posing significant concerns. While some recent endeavors have been made to identify and mitigate different types of hallucination, there has been a limited emphasis on the nuanced categorization of hallucination and associated mitigation methods. To address this gap, we offer a fine-grained discourse on profiling hallucination based on its degree, orientation, and category, along with offering strategies for alleviation. As such, we define two overarching orientations of hallucination: (i) factual mirage (FM) and (ii) silver lining (SL). To provide a more comprehensive understanding, both orientations are further sub-categorized into intrinsic and extrinsic, with three degrees of severity - (i) mild, (ii) moderate, and (iii) alarming. We also meticulously categorize hallucination into six types: (i) acronym ambiguity, (ii) numeric nuisance, (iii) generated golem, (iv) virtual voice, (v) geographic erratum, and (vi) time wrap. Furthermore, we curate HallucInation eLiciTation (HILT), a publicly available dataset comprising of 75,000 samples generated using 15 contemporary LLMs along with human annotations for the aforementioned categories. Finally, to establish a method for quantifying and to offer a comparative spectrum that allows us to evaluate and rank LLMs based on their vulnerability to producing hallucinations, we propose Hallucination Vulnerability Index (HVI). We firmly believe that HVI holds significant value as a tool for the wider NLP community, with the potential to serve as a rubric in AI-related policy-making. In conclusion, we propose two solution strategies for mitigating hallucinations.

  • 8 authors
·
Oct 7, 2023

HealthiVert-GAN: A Novel Framework of Pseudo-Healthy Vertebral Image Synthesis for Interpretable Compression Fracture Grading

Osteoporotic vertebral compression fractures (VCFs) are prevalent in the elderly population, typically assessed on computed tomography (CT) scans by evaluating vertebral height loss. This assessment helps determine the fracture's impact on spinal stability and the need for surgical intervention. However, clinical data indicate that many VCFs exhibit irregular compression, complicating accurate diagnosis. While deep learning methods have shown promise in aiding VCFs screening, they often lack interpretability and sufficient sensitivity, limiting their clinical applicability. To address these challenges, we introduce a novel vertebra synthesis-height loss quantification-VCFs grading framework. Our proposed model, HealthiVert-GAN, utilizes a coarse-to-fine synthesis network designed to generate pseudo-healthy vertebral images that simulate the pre-fracture state of fractured vertebrae. This model integrates three auxiliary modules that leverage the morphology and height information of adjacent healthy vertebrae to ensure anatomical consistency. Additionally, we introduce the Relative Height Loss of Vertebrae (RHLV) as a quantification metric, which divides each vertebra into three sections to measure height loss between pre-fracture and post-fracture states, followed by fracture severity classification using a Support Vector Machine (SVM). Our approach achieves state-of-the-art classification performance on both the Verse2019 dataset and our private dataset, and it provides cross-sectional distribution maps of vertebral height loss. This practical tool enhances diagnostic sensitivity in clinical settings and assisting in surgical decision-making. Our code is available: https://github.com/zhibaishouheilab/HealthiVert-GAN.

  • 6 authors
·
Mar 7, 2025

Benchmarking Small Language Models and Small Reasoning Language Models on System Log Severity Classification

System logs are crucial for monitoring and diagnosing modern computing infrastructure, but their scale and complexity require reliable and efficient automated interpretation. Since severity levels are predefined metadata in system log messages, having a model merely classify them offers limited standalone practical value, revealing little about its underlying ability to interpret system logs. We argue that severity classification is more informative when treated as a benchmark for probing runtime log comprehension rather than as an end task. Using real-world journalctl data from Linux production servers, we evaluate nine small language models (SLMs) and small reasoning language models (SRLMs) under zero-shot, few-shot, and retrieval-augmented generation (RAG) prompting. The results reveal strong stratification. Qwen3-4B achieves the highest accuracy at 95.64% with RAG, while Gemma3-1B improves from 20.25% under few-shot prompting to 85.28% with RAG. Notably, the tiny Qwen3-0.6B reaches 88.12% accuracy despite weak performance without retrieval. In contrast, several SRLMs, including Qwen3-1.7B and DeepSeek-R1-Distill-Qwen-1.5B, degrade substantially when paired with RAG. Efficiency measurements further separate models: most Gemma and Llama variants complete inference in under 1.2 seconds per log, whereas Phi-4-Mini-Reasoning exceeds 228 seconds per log while achieving <10% accuracy. These findings suggest that (1) architectural design, (2) training objectives, and (3) the ability to integrate retrieved context under strict output constraints jointly determine performance. By emphasizing small, deployable models, this benchmark aligns with real-time requirements of digital twin (DT) systems and shows that severity classification serves as a lens for evaluating model competence and real-time deployability, with implications for root cause analysis (RCA) and broader DT integration.

  • 5 authors
·
Jan 12 2

MedVision: Dataset and Benchmark for Quantitative Medical Image Analysis

Current vision-language models (VLMs) in medicine are primarily designed for categorical question answering (e.g., "Is this normal or abnormal?") or qualitative descriptive tasks. However, clinical decision-making often relies on quantitative assessments, such as measuring the size of a tumor or the angle of a joint, from which physicians draw their own diagnostic conclusions. This quantitative reasoning capability remains underexplored and poorly supported in existing VLMs. In this work, we introduce MedVision, a large-scale dataset and benchmark specifically designed to evaluate and improve VLMs on quantitative medical image analysis. MedVision spans 22 public datasets covering diverse anatomies and modalities, with 30.8 million image-annotation pairs. We focus on three representative quantitative tasks: (1) detection of anatomical structures and abnormalities, (2) tumor/lesion (T/L) size estimation, and (3) angle/distance (A/D) measurement. Our benchmarks show that current off-the-shelf VLMs perform poorly on these tasks. However, with supervised fine-tuning on MedVision, we significantly enhance their performance across detection, T/L estimation, and A/D measurement, demonstrating reduced error rates and improved precision. This work provides a foundation for developing VLMs with robust quantitative reasoning capabilities in medical imaging. Code and data are available at https://medvision-vlm.github.io.

  • 6 authors
·
Nov 23, 2025

Predicting COVID-19 Pneumonia Severity on Chest X-ray with Deep Learning

Purpose: The need to streamline patient management for COVID-19 has become more pressing than ever. Chest X-rays provide a non-invasive (potentially bedside) tool to monitor the progression of the disease. In this study, we present a severity score prediction model for COVID-19 pneumonia for frontal chest X-ray images. Such a tool can gauge severity of COVID-19 lung infections (and pneumonia in general) that can be used for escalation or de-escalation of care as well as monitoring treatment efficacy, especially in the ICU. Methods: Images from a public COVID-19 database were scored retrospectively by three blinded experts in terms of the extent of lung involvement as well as the degree of opacity. A neural network model that was pre-trained on large (non-COVID-19) chest X-ray datasets is used to construct features for COVID-19 images which are predictive for our task. Results: This study finds that training a regression model on a subset of the outputs from an this pre-trained chest X-ray model predicts our geographic extent score (range 0-8) with 1.14 mean absolute error (MAE) and our lung opacity score (range 0-6) with 0.78 MAE. Conclusions: These results indicate that our model's ability to gauge severity of COVID-19 lung infections could be used for escalation or de-escalation of care as well as monitoring treatment efficacy, especially in the intensive care unit (ICU). A proper clinical trial is needed to evaluate efficacy. To enable this we make our code, labels, and data available online at https://github.com/mlmed/torchxrayvision/tree/master/scripts/covid-severity and https://github.com/ieee8023/covid-chestxray-dataset

  • 11 authors
·
Jun 29, 2020

K-Quantization and its Impact on Output Performance

Recent advancements in large language models (LLMs) have shown their remarkable capacities in many NLP tasks. However, their substantial size often presents challenges for deployment. This necessitates efficient techniques for model compression, with quantization emerging as a prominent solution. Despite its benefits, the exact impact of quantization (from 2- to 6-bit) on the performance and accuracy of LLMs remains an active area of research. This paper investigates the performance of eight LLMs at various quantization levels, focusing on tasks such as MMLU-Pro for knowledge processing and reasoning, CRUXEval for code comprehension, and MuSR for reading comprehension. Our results show a consistent trend where higher precision (e.g., 8-bit Q8\_0) yields improved performance, albeit with diminishing returns. Aggressive quantization (e.g., 2-bit Q2\_K) usually retains acceptable accuracy, though some models show a substantial loss in performance. Our findings indicate that while lower bit precision generally reduces performance, the impact varies across models and tasks. Larger models show greater resilience to aggressive quantization, but can still undergo significant drops at lower precision levels. Mid-sized models in the 7-9 billion parameter range strike an optimal balance between efficiency and resource usage. Such results provide insights into the trade-offs between model size, quantization, and performance.

  • 2 authors
·
May 18

Quantization Undoes Alignment: Bias Emergence in Compressed LLMs Across Models and Precision Levels

Large Language Models are routinely compressed via post-training quantization to reduce inference costs and memory footprint for cloud and edge deployment, yet the impact of this compression on model quality remains poorly understood. Existing studies typically compare only two conditions (full-precision vs. a single quantized variant), rely on aggregate bias metrics, and evaluate a single model family, making it impossible to distinguish gradual degradation from threshold-dependent safety failures. We conduct a controlled empirical study of three instruction-tuned models (Qwen2.5-7B, Mistral-7B, Phi-3.5-mini) at five precision levels (BF16 through 3-bit) on 12,148 BBQ bias benchmark items across 5 random seeds, totaling 911,100 inference records. Our results reveal that 3-bit quantization causes 6-21% of previously unbiased items to develop new stereotypical behaviors, following a clear dose-response pattern confirmed via logistic regression, while models' willingness to select "unknown" answers declines by 17.4%. Crucially, these item-level changes are invisible to standard quality metrics: perplexity increases by less than 0.5% at 8-bit and under 3% at 4-bit across all three models, yet 2.5-5.6% of items already develop new biases at 4-bit. These findings demonstrate that aggregate evaluation metrics systematically miss fairness-critical degradation, underscoring the need for quality-aware compression protocols that explicitly test for bias emergence before deployment.

  • 2 authors
·
May 1

Building Safe and Reliable AI systems for Safety Critical Tasks with Vision-Language Processing

Although AI systems have been applied in various fields and achieved impressive performance, their safety and reliability are still a big concern. This is especially important for safety-critical tasks. One shared characteristic of these critical tasks is their risk sensitivity, where small mistakes can cause big consequences and even endanger life. There are several factors that could be guidelines for the successful deployment of AI systems in sensitive tasks: (i) failure detection and out-of-distribution (OOD) detection; (ii) overfitting identification; (iii) uncertainty quantification for predictions; (iv) robustness to data perturbations. These factors are also challenges of current AI systems, which are major blocks for building safe and reliable AI. Specifically, the current AI algorithms are unable to identify common causes for failure detection. Furthermore, additional techniques are required to quantify the quality of predictions. All these contribute to inaccurate uncertainty quantification, which lowers trust in predictions. Hence obtaining accurate model uncertainty quantification and its further improvement are challenging. To address these issues, many techniques have been proposed, such as regularization methods and learning strategies. As vision and language are the most typical data type and have many open source benchmark datasets, this thesis will focus on vision-language data processing for tasks like classification, image captioning, and vision question answering. In this thesis, we aim to build a safeguard by further developing current techniques to ensure the accurate model uncertainty for safety-critical tasks.

  • 1 authors
·
Aug 6, 2023

SHARP: Social Harm Analysis via Risk Profiles for Measuring Inequities in Large Language Models

Large language models (LLMs) are increasingly deployed in high-stakes domains, where rare but severe failures can result in irreversible harm. However, prevailing evaluation benchmarks often reduce complex social risk to mean-centered scalar scores, thereby obscuring distributional structure, cross-dimensional interactions, and worst-case behavior. This paper introduces Social Harm Analysis via Risk Profiles (SHARP), a framework for multidimensional, distribution-aware evaluation of social harm. SHARP models harm as a multivariate random variable and integrates explicit decomposition into bias, fairness, ethics, and epistemic reliability with a union-of-failures aggregation reparameterized as additive cumulative log-risk. The framework further employs risk-sensitive distributional statistics, with Conditional Value at Risk (CVaR95) as a primary metric, to characterize worst-case model behavior. Application of SHARP to eleven frontier LLMs, evaluated on a fixed corpus of n=901 socially sensitive prompts, reveals that models with similar average risk can exhibit more than twofold differences in tail exposure and volatility. Across models, dimension-wise marginal tail behavior varies systematically across harm dimensions, with bias exhibiting the strongest tail severities, epistemic and fairness risks occupying intermediate regimes, and ethical misalignment consistently lower; together, these patterns reveal heterogeneous, model-dependent failure structures that scalar benchmarks conflate. These findings indicate that responsible evaluation and governance of LLMs require moving beyond scalar averages toward multidimensional, tail-sensitive risk profiling.

  • 3 authors
·
Jan 28 2

MedQ-Deg: A Multidimensional Benchmark for Evaluating MLLMs Across Medical Image Quality Degradations

Despite impressive performance on standard benchmarks, multimodal large language models (MLLMs) face critical challenges in real-world clinical environments where medical images inevitably suffer various quality degradations. Existing benchmarks exhibit two key limitations: (1) absence of large-scale, multidimensional assessment across medical image quality gradients and (2) no systematic confidence calibration analysis. To address these gaps, we present MedQ-Deg, a comprehensive benchmark for evaluating medical MLLMs under image quality degradations. MedQ-Deg provides multi-dimensional evaluation spanning 18 distinct degradation types, 30 fine-grained capability dimensions, and 7 imaging modalities, with 24,894 question-answer pairs. Each degradation is implemented at 3 severity degrees, calibrated by expert radiologists. We further introduce Calibration Shift metric, which quantifies the gap between a model's perceived confidence and actual performance to assess metacognitive reliability under degradation. Our comprehensive evaluation of 40 mainstream MLLMs reveals several critical findings: (1) overall model performance degrades systematically as degradation severity increases, (2) models universally exhibit the AI Dunning-Kruger Effect, maintaining inappropriately high confidence despite severe accuracy collapse, and (3) models display markedly differentiated behavioral patterns across capability dimensions, imaging modalities, and degradation types. We hope MedQ-Deg drives progress toward medical MLLMs that are robust and trustworthy in real clinical practice.

  • 17 authors
·
Mar 8

VitaLITy: Promoting Serendipitous Discovery of Academic Literature with Transformers & Visual Analytics

There are a few prominent practices for conducting reviews of academic literature, including searching for specific keywords on Google Scholar or checking citations from some initial seed paper(s). These approaches serve a critical purpose for academic literature reviews, yet there remain challenges in identifying relevant literature when similar work may utilize different terminology (e.g., mixed-initiative visual analytics papers may not use the same terminology as papers on model-steering, yet the two topics are relevant to one another). In this paper, we introduce a system, VitaLITy, intended to complement existing practices. In particular, VitaLITy promotes serendipitous discovery of relevant literature using transformer language models, allowing users to find semantically similar papers in a word embedding space given (1) a list of input paper(s) or (2) a working abstract. VitaLITy visualizes this document-level embedding space in an interactive 2-D scatterplot using dimension reduction. VitaLITy also summarizes meta information about the document corpus or search query, including keywords and co-authors, and allows users to save and export papers for use in a literature review. We present qualitative findings from an evaluation of VitaLITy, suggesting it can be a promising complementary technique for conducting academic literature reviews. Furthermore, we contribute data from 38 popular data visualization publication venues in VitaLITy, and we provide scrapers for the open-source community to continue to grow the list of supported venues.

  • 4 authors
·
Aug 7, 2021

MHDash: An Online Platform for Benchmarking Mental Health-Aware AI Assistants

Large language models (LLMs) are increasingly applied in mental health support systems, where reliable recognition of high-risk states such as suicidal ideation and self-harm is safety-critical. However, existing evaluations primarily rely on aggregate performance metrics, which often obscure risk-specific failure modes and provide limited insight into model behavior in realistic, multi-turn interactions. We present MHDash, an open-source platform designed to support the development, evaluation, and auditing of AI systems for mental health applications. MHDash integrates data collection, structured annotation, multi-turn dialogue generation, and baseline evaluation into a unified pipeline. The platform supports annotations across multiple dimensions, including Concern Type, Risk Level, and Dialogue Intent, enabling fine-grained and risk-aware analysis. Our results reveal several key findings: (i) simple baselines and advanced LLM APIs exhibit comparable overall accuracy yet diverge significantly on high-risk cases; (ii) some LLMs maintain consistent ordinal severity ranking while failing absolute risk classification, whereas others achieve reasonable aggregate scores but suffer from high false negative rates on severe categories; and (iii) performance gaps are amplified in multi-turn dialogues, where risk signals emerge gradually. These observations demonstrate that conventional benchmarks are insufficient for safety-critical mental health settings. By releasing MHDash as an open platform, we aim to promote reproducible research, transparent evaluation, and safety-aligned development of AI systems for mental health support.

  • 6 authors
·
Jan 30

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

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

  • 3 authors
·
Oct 23, 2025

Between Help and Harm: An Evaluation of Mental Health Crisis Handling by LLMs

Large language model-powered chatbots have transformed how people seek information, especially in high-stakes contexts like mental health. Despite their support capabilities, safe detection and response to crises such as suicidal ideation and self-harm are still unclear, hindered by the lack of unified crisis taxonomies and clinical evaluation standards. We address this by creating: (1) a taxonomy of six crisis categories; (2) a dataset of over 2,000 inputs from 12 mental health datasets, classified into these categories; and (3) a clinical response assessment protocol. We also use LLMs to identify crisis inputs and audit five models for response safety and appropriateness. First, we built a clinical-informed crisis taxonomy and evaluation protocol. Next, we curated 2,252 relevant examples from over 239,000 user inputs, then tested three LLMs for automatic classification. In addition, we evaluated five models for the appropriateness of their responses to a user's crisis, graded on a 5-point Likert scale from harmful (1) to appropriate (5). While some models respond reliably to explicit crises, risks still exist. Many outputs, especially in self-harm and suicidal categories, are inappropriate or unsafe. Different models perform variably; some, like gpt-5-nano and deepseek-v3.2-exp, have low harm rates, but others, such as gpt-4o-mini and grok-4-fast, generate more unsafe responses. All models struggle with indirect signals, default replies, and context misalignment. These results highlight the urgent need for better safeguards, crisis detection, and context-aware responses in LLMs. They also show that alignment and safety practices, beyond scale, are crucial for reliable crisis support. Our taxonomy, datasets, and evaluation methods support ongoing AI mental health research, aiming to reduce harm and protect vulnerable users.

  • 8 authors
·
Apr 7

ReportQA: QA-Based Radiology Report Evaluation

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.

  • 13 authors
·
Jun 12

Summarizing Patients Problems from Hospital Progress Notes Using Pre-trained Sequence-to-Sequence Models

Automatically summarizing patients' main problems from daily progress notes using natural language processing methods helps to battle against information and cognitive overload in hospital settings and potentially assists providers with computerized diagnostic decision support. Problem list summarization requires a model to understand, abstract, and generate clinical documentation. In this work, we propose a new NLP task that aims to generate a list of problems in a patient's daily care plan using input from the provider's progress notes during hospitalization. We investigate the performance of T5 and BART, two state-of-the-art seq2seq transformer architectures, in solving this problem. We provide a corpus built on top of progress notes from publicly available electronic health record progress notes in the Medical Information Mart for Intensive Care (MIMIC)-III. T5 and BART are trained on general domain text, and we experiment with a data augmentation method and a domain adaptation pre-training method to increase exposure to medical vocabulary and knowledge. Evaluation methods include ROUGE, BERTScore, cosine similarity on sentence embedding, and F-score on medical concepts. Results show that T5 with domain adaptive pre-training achieves significant performance gains compared to a rule-based system and general domain pre-trained language models, indicating a promising direction for tackling the problem summarization task.

  • 6 authors
·
Aug 17, 2022

Enhancing Traffic Incident Management with Large Language Models: A Hybrid Machine Learning Approach for Severity Classification

This research showcases the innovative integration of Large Language Models into machine learning workflows for traffic incident management, focusing on the classification of incident severity using accident reports. By leveraging features generated by modern language models alongside conventional data extracted from incident reports, our research demonstrates improvements in the accuracy of severity classification across several machine learning algorithms. Our contributions are threefold. First, we present an extensive comparison of various machine learning models paired with multiple large language models for feature extraction, aiming to identify the optimal combinations for accurate incident severity classification. Second, we contrast traditional feature engineering pipelines with those enhanced by language models, showcasing the superiority of language-based feature engineering in processing unstructured text. Third, our study illustrates how merging baseline features from accident reports with language-based features can improve the severity classification accuracy. This comprehensive approach not only advances the field of incident management but also highlights the cross-domain application potential of our methodology, particularly in contexts requiring the prediction of event outcomes from unstructured textual data or features translated into textual representation. Specifically, our novel methodology was applied to three distinct datasets originating from the United States, the United Kingdom, and Queensland, Australia. This cross-continental application underlines the robustness of our approach, suggesting its potential for widespread adoption in improving incident management processes globally.

  • 4 authors
·
Mar 20, 2024

Health-ORSC-Bench: A Benchmark for Measuring Over-Refusal and Safety Completion in Health Context

Safety alignment in Large Language Models is critical for healthcare; however, reliance on binary refusal boundaries often results in over-refusal of benign queries or unsafe compliance with harmful ones. While existing benchmarks measure these extremes, they fail to evaluate Safe Completion: the model's ability to maximise helpfulness on dual-use or borderline queries by providing safe, high-level guidance without crossing into actionable harm. We introduce Health-ORSC-Bench, the first large-scale benchmark designed to systematically measure Over-Refusal and Safe Completion quality in healthcare. Comprising 31,920 benign boundary prompts across seven health categories (e.g., self-harm, medical misinformation), our framework uses an automated pipeline with human validation to test models at varying levels of intent ambiguity. We evaluate 30 state-of-the-art LLMs, including GPT-5 and Claude-4, revealing a significant tension: safety-optimised models frequently refuse up to 80\% of "Hard" benign prompts, while domain-specific models often sacrifice safety for utility. Our findings demonstrate that model family and size significantly influence calibration: larger frontier models (e.g., GPT-5, Llama-4) exhibit "safety-pessimism" and higher over-refusal than smaller or MoE-based counterparts (e.g., Qwen-3-Next), highlighting that current LLMs struggle to balance refusal and compliance. Health-ORSC-Bench provides a rigorous standard for calibrating the next generation of medical AI assistants toward nuanced, safe, and helpful completions. The code and data will be released upon acceptance. red{Warning: Some contents may include toxic or undesired contents.}

  • 6 authors
·
Jan 24

FlexGuard: Continuous Risk Scoring for Strictness-Adaptive LLM Content Moderation

Ensuring the safety of LLM-generated content is essential for real-world deployment. Most existing guardrail models formulate moderation as a fixed binary classification task, implicitly assuming a fixed definition of harmfulness. In practice, enforcement strictness - how conservatively harmfulness is defined and enforced - varies across platforms and evolves over time, making binary moderators brittle under shifting requirements. We first introduce FlexBench, a strictness-adaptive LLM moderation benchmark that enables controlled evaluation under multiple strictness regimes. Experiments on FlexBench reveal substantial cross-strictness inconsistency in existing moderators: models that perform well under one regime can degrade substantially under others, limiting their practical usability. To address this, we propose FlexGuard, an LLM-based moderator that outputs a calibrated continuous risk score reflecting risk severity and supports strictness-specific decisions via thresholding. We train FlexGuard via risk-alignment optimization to improve score-severity consistency and provide practical threshold selection strategies to adapt to target strictness at deployment. Experiments on FlexBench and public benchmarks demonstrate that FlexGuard achieves higher moderation accuracy and substantially improved robustness under varying strictness. We release the source code and data to support reproducibility.

  • 4 authors
·
Feb 26

Tiny-BioMoE: a Lightweight Embedding Model for Biosignal Analysis

Pain is a complex and pervasive condition that affects a significant portion of the population. Accurate and consistent assessment is essential for individuals suffering from pain, as well as for developing effective management strategies in a healthcare system. Automatic pain assessment systems enable continuous monitoring, support clinical decision-making, and help minimize patient distress while mitigating the risk of functional deterioration. Leveraging physiological signals offers objective and precise insights into a person's state, and their integration in a multimodal framework can further enhance system performance. This study has been submitted to the Second Multimodal Sensing Grand Challenge for Next-Gen Pain Assessment (AI4PAIN). The proposed approach introduces Tiny-BioMoE, a lightweight pretrained embedding model for biosignal analysis. Trained on 4.4 million biosignal image representations and consisting of only 7.3 million parameters, it serves as an effective tool for extracting high-quality embeddings for downstream tasks. Extensive experiments involving electrodermal activity, blood volume pulse, respiratory signals, peripheral oxygen saturation, and their combinations highlight the model's effectiveness across diverse modalities in automatic pain recognition tasks. The model's architecture (code) and weights are available at https://github.com/GkikasStefanos/Tiny-BioMoE.

  • 3 authors
·
Jul 29, 2025

PerSEval: Assessing Personalization in Text Summarizers

Personalized summarization models cater to individuals' subjective understanding of saliency, as represented by their reading history and current topics of attention. Existing personalized text summarizers are primarily evaluated based on accuracy measures such as BLEU, ROUGE, and METEOR. However, a recent study argued that accuracy measures are inadequate for evaluating the degree of personalization of these models and proposed EGISES, the first metric to evaluate personalized text summaries. It was suggested that accuracy is a separate aspect and should be evaluated standalone. In this paper, we challenge the necessity of an accuracy leaderboard, suggesting that relying on accuracy-based aggregated results might lead to misleading conclusions. To support this, we delve deeper into EGISES, demonstrating both theoretically and empirically that it measures the degree of responsiveness, a necessary but not sufficient condition for degree-of-personalization. We subsequently propose PerSEval, a novel measure that satisfies the required sufficiency condition. Based on the benchmarking of ten SOTA summarization models on the PENS dataset, we empirically establish that -- (i) PerSEval is reliable w.r.t human-judgment correlation (Pearson's r = 0.73; Spearman's rho = 0.62; Kendall's tau = 0.42), (ii) PerSEval has high rank-stability, (iii) PerSEval as a rank-measure is not entailed by EGISES-based ranking, and (iv) PerSEval can be a standalone rank-measure without the need of any aggregated ranking.

  • 5 authors
·
Jun 29, 2024

LLM Swiss Round: Aggregating Multi-Benchmark Performance via Competitive Swiss-System Dynamics

The rapid proliferation of Large Language Models (LLMs) and diverse specialized benchmarks necessitates a shift from fragmented, task-specific metrics to a holistic, competitive ranking system that effectively aggregates performance across multiple ability dimensions. Primarily using static scoring, current evaluation methods are fundamentally limited. They struggle to determine the proper mix ratio across diverse benchmarks, and critically, they fail to capture a model's dynamic competitive fitness or its vulnerability when confronted with sequential, high-stakes tasks. To address this, we introduce the novel Competitive Swiss-System Dynamics (CSD) framework. CSD simulates a multi-round, sequential contest where models are dynamically paired across a curated sequence of benchmarks based on their accumulated win-loss record. And Monte Carlo Simulation (N=100,000 iterations) is used to approximate the statistically robust Expected Win Score (E[S_m]), which eliminates the noise of random pairing and early-round luck. Furthermore, we implement a Failure Sensitivity Analysis by parameterizing the per-round elimination quantity (T_k), which allows us to profile models based on their risk appetite--distinguishing between robust generalists and aggressive specialists. We demonstrate that CSD provides a more nuanced and context-aware ranking than traditional aggregate scoring and static pairwise models, representing a vital step towards risk-informed, next-generation LLM evaluation.

ByteDance-Seed ByteDance Seed
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Dec 24, 2025 2

Agentic retrieval-augmented reasoning reshapes collective reliability under model variability in radiology question answering

Agentic retrieval-augmented reasoning pipelines are increasingly used to structure how large language models (LLMs) incorporate external evidence in clinical decision support. These systems iteratively retrieve curated domain knowledge and synthesize it into structured reports before answer selection. Although such pipelines can improve performance, their impact on reliability under model variability remains unclear. In real-world deployment, heterogeneous models may align, diverge, or synchronize errors in ways not captured by accuracy. We evaluated 34 LLMs on 169 expert-curated publicly available radiology questions, comparing zero-shot inference with a radiology-specific multi-step agentic retrieval condition in which all models received identical structured evidence reports derived from curated radiology knowledge. Agentic inference reduced inter-model decision dispersion (median entropy 0.48 vs. 0.13) and increased robustness of correctness across models (mean 0.74 vs. 0.81). Majority consensus also increased overall (P<0.001). Consensus strength and robust correctness remained correlated under both strategies (ho=0.88 for zero-shot; ho=0.87 for agentic), although high agreement did not guarantee correctness. Response verbosity showed no meaningful association with correctness. Among 572 incorrect outputs, 72% were associated with moderate or high clinically assessed severity, although inter-rater agreement was low (appa=0.02). Agentic retrieval therefore was associated with more concentrated decision distributions, stronger consensus, and higher cross-model robustness of correctness. These findings suggest that evaluating agentic systems through accuracy or agreement alone may not always be sufficient, and that complementary analyses of stability, cross-model robustness, and potential clinical impact are needed to characterize reliability under model variability.

  • 12 authors
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Mar 6

Clinical Text Summarization: Adapting Large Language Models Can Outperform Human Experts

Sifting through vast textual data and summarizing key information imposes a substantial burden on how clinicians allocate their time. Although large language models (LLMs) have shown immense promise in natural language processing (NLP) tasks, their efficacy across diverse clinical summarization tasks has not yet been rigorously examined. In this work, we employ domain adaptation methods on eight LLMs, spanning six datasets and four distinct summarization tasks: radiology reports, patient questions, progress notes, and doctor-patient dialogue. Our thorough quantitative assessment reveals trade-offs between models and adaptation methods in addition to instances where recent advances in LLMs may not lead to improved results. Further, in a clinical reader study with six physicians, we depict that summaries from the best adapted LLM are preferable to human summaries in terms of completeness and correctness. Our ensuing qualitative analysis delineates mutual challenges faced by both LLMs and human experts. Lastly, we correlate traditional quantitative NLP metrics with reader study scores to enhance our understanding of how these metrics align with physician preferences. Our research marks the first evidence of LLMs outperforming human experts in clinical text summarization across multiple tasks. This implies that integrating LLMs into clinical workflows could alleviate documentation burden, empowering clinicians to focus more on personalized patient care and other irreplaceable human aspects of medicine.

  • 15 authors
·
Sep 14, 2023 4

BS-Net: learning COVID-19 pneumonia severity on a large Chest X-Ray dataset

In this work we design an end-to-end deep learning architecture for predicting, on Chest X-rays images (CXR), a multi-regional score conveying the degree of lung compromise in COVID-19 patients. Such semi-quantitative scoring system, namely Brixia~score, is applied in serial monitoring of such patients, showing significant prognostic value, in one of the hospitals that experienced one of the highest pandemic peaks in Italy. To solve such a challenging visual task, we adopt a weakly supervised learning strategy structured to handle different tasks (segmentation, spatial alignment, and score estimation) trained with a "from-the-part-to-the-whole" procedure involving different datasets. In particular, we exploit a clinical dataset of almost 5,000 CXR annotated images collected in the same hospital. Our BS-Net demonstrates self-attentive behavior and a high degree of accuracy in all processing stages. Through inter-rater agreement tests and a gold standard comparison, we show that our solution outperforms single human annotators in rating accuracy and consistency, thus supporting the possibility of using this tool in contexts of computer-assisted monitoring. Highly resolved (super-pixel level) explainability maps are also generated, with an original technique, to visually help the understanding of the network activity on the lung areas. We also consider other scores proposed in literature and provide a comparison with a recently proposed non-specific approach. We eventually test the performance robustness of our model on an assorted public COVID-19 dataset, for which we also provide Brixia~score annotations, observing good direct generalization and fine-tuning capabilities that highlight the portability of BS-Net in other clinical settings. The CXR dataset along with the source code and the trained model are publicly released for research purposes.

  • 11 authors
·
Apr 2, 2021

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

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

  • 4 authors
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Apr 12

Predicting sepsis in multi-site, multi-national intensive care cohorts using deep learning

Despite decades of clinical research, sepsis remains a global public health crisis with high mortality, and morbidity. Currently, when sepsis is detected and the underlying pathogen is identified, organ damage may have already progressed to irreversible stages. Effective sepsis management is therefore highly time-sensitive. By systematically analysing trends in the plethora of clinical data available in the intensive care unit (ICU), an early prediction of sepsis could lead to earlier pathogen identification, resistance testing, and effective antibiotic and supportive treatment, and thereby become a life-saving measure. Here, we developed and validated a machine learning (ML) system for the prediction of sepsis in the ICU. Our analysis represents the largest multi-national, multi-centre in-ICU study for sepsis prediction using ML to date. Our dataset contains 156,309 unique ICU admissions, which represent a refined and harmonised subset of five large ICU databases originating from three countries. Using the international consensus definition Sepsis-3, we derived hourly-resolved sepsis label annotations, amounting to 26,734 (17.1%) septic stays. We compared our approach, a deep self-attention model, to several clinical baselines as well as ML baselines and performed an extensive internal and external validation within and across databases. On average, our model was able to predict sepsis with an AUROC of 0.847 pm 0.050 (internal out-of sample validation) and 0.761 pm 0.052 (external validation). For a harmonised prevalence of 17%, at 80% recall our model detects septic patients with 39% precision 3.7 hours in advance.

  • 8 authors
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Jul 12, 2021

Beyond Hate: Differentiating Uncivil and Intolerant Speech in Multimodal Content Moderation

Current multimodal toxicity benchmarks typically use a single binary hatefulness label. This coarse approach conflates two fundamentally different characteristics of expression: tone and content. Drawing on communication science theory, we introduce a fine-grained annotation scheme that distinguishes two separable dimensions: incivility (rude or dismissive tone) and intolerance (content that attacks pluralism and targets groups or identities) and apply it to 2,030 memes from the Hateful Memes dataset. We evaluate different vision-language models under coarse-label training, transfer learning across label schemes and a joint learning approach that combines the coarse hatefulness label with our fine-grained annotations. Our results show that fine-grained annotations complement existing coarse labels and, when used jointly, improve overall model performance. Moreover, models trained with the fine-grained scheme exhibit more balanced moderation-relevant error profiles and are less prone to under-detection of harmful content than models trained on hatefulness labels alone (FNR-FPR, the difference between false negative and false positive rates: 0.74 to 0.42 for LLaVA-1.6-Mistral-7B; 0.54 to 0.28 for Qwen2.5-VL-7B). This work contributes to data-centric approaches in content moderation by improving the reliability and accuracy of moderation systems through enhanced data quality. Overall, combining both coarse and fine-grained labels provides a practical route to more reliable multimodal moderation.

  • 4 authors
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Mar 23

Evaluating AI systems under uncertain ground truth: a case study in dermatology

For safety, medical AI systems undergo thorough evaluations before deployment, validating their predictions against a ground truth which is assumed to be fixed and certain. However, this ground truth is often curated in the form of differential diagnoses. While a single differential diagnosis reflects the uncertainty in one expert assessment, multiple experts introduce another layer of uncertainty through disagreement. Both forms of uncertainty are ignored in standard evaluation which aggregates these differential diagnoses to a single label. In this paper, we show that ignoring uncertainty leads to overly optimistic estimates of model performance, therefore underestimating risk associated with particular diagnostic decisions. To this end, we propose a statistical aggregation approach, where we infer a distribution on probabilities of underlying medical condition candidates themselves, based on observed annotations. This formulation naturally accounts for the potential disagreements between different experts, as well as uncertainty stemming from individual differential diagnoses, capturing the entire ground truth uncertainty. Our approach boils down to generating multiple samples of medical condition probabilities, then evaluating and averaging performance metrics based on these sampled probabilities. In skin condition classification, we find that a large portion of the dataset exhibits significant ground truth uncertainty and standard evaluation severely over-estimates performance without providing uncertainty estimates. In contrast, our framework provides uncertainty estimates on common metrics of interest such as top-k accuracy and average overlap, showing that performance can change multiple percentage points. We conclude that, while assuming a crisp ground truth can be acceptable for many AI applications, a more nuanced evaluation protocol should be utilized in medical diagnosis.

  • 20 authors
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Jul 5, 2023

Representation Before Training: A Fixed-Budget Benchmark for Generative Medical Event Models

Every prediction from a generative medical event model is bounded by how clinical events are tokenized, yet input representation is rarely isolated from other system and architectural choices. We evaluate how representation decisions affect downstream prediction after a shared one-epoch pretraining budget. We train 28 matched transformers on MIMIC-IV and evaluate them on 30 clinical outcomes in three experiments: (1) quantization granularity, reference-range anchoring, and code-value fusion; (2) value encoding (hard bins, soft discretization, code-normalized xVal) crossed with temporal encoding (event order, time tokens, admission-relative RoPE); and (3) native MIMIC laboratory/vital codes versus the Common Longitudinal ICU Format (CLIF)-remapped laboratory/vital codes with compression-preserving perturbation arms. In Experiment 1, fused code-value tokenization improves mortality AUROC from 0.891 to 0.915 (BH-adjusted p < 0.001), hospital length-of-stay AUROC from 0.763 to 0.788 (BH-adjusted p < 0.001), and, for the decile fused-vs-unfused comparison, mean regression Spearman rho across the 13 regression outcomes from 0.414 to 0.494. Across the three temporal encodings, event order only and admission-relative RoPE match or exceed inserting time tokens on average while shortening sequences by 11%. CLIF remapping preserves downstream performance in our single-site setting while yielding a smaller, clinically interpretable token set compatible with multi-site use. Finer-than-decile quantization, reference-range anchoring, and soft discretization help in selective outcomes, while code-normalized xVal remains well below the discrete and soft families, consistent with near-median suppression that persists after the affine variant.

  • 6 authors
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Apr 17

AILuminate: Introducing v1.0 of the AI Risk and Reliability Benchmark from MLCommons

The rapid advancement and deployment of AI systems have created an urgent need for standard safety-evaluation frameworks. This paper introduces AILuminate v1.0, the first comprehensive industry-standard benchmark for assessing AI-product risk and reliability. Its development employed an open process that included participants from multiple fields. The benchmark evaluates an AI system's resistance to prompts designed to elicit dangerous, illegal, or undesirable behavior in 12 hazard categories, including violent crimes, nonviolent crimes, sex-related crimes, child sexual exploitation, indiscriminate weapons, suicide and self-harm, intellectual property, privacy, defamation, hate, sexual content, and specialized advice (election, financial, health, legal). Our method incorporates a complete assessment standard, extensive prompt datasets, a novel evaluation framework, a grading and reporting system, and the technical as well as organizational infrastructure for long-term support and evolution. In particular, the benchmark employs an understandable five-tier grading scale (Poor to Excellent) and incorporates an innovative entropy-based system-response evaluation. In addition to unveiling the benchmark, this report also identifies limitations of our method and of building safety benchmarks generally, including evaluator uncertainty and the constraints of single-turn interactions. This work represents a crucial step toward establishing global standards for AI risk and reliability evaluation while acknowledging the need for continued development in areas such as multiturn interactions, multimodal understanding, coverage of additional languages, and emerging hazard categories. Our findings provide valuable insights for model developers, system integrators, and policymakers working to promote safer AI deployment.

  • 101 authors
·
Feb 19, 2025

The Critique of Critique

Critique, as a natural language description for assessing the quality of model-generated content, has been proven to play an essential role in the training, evaluation, and refinement of Large Language Models (LLMs). However, there is a lack of principled understanding in evaluating the quality of the critique itself. In this paper, we pioneer the critique of critique, termed MetaCritique, which is a framework to evaluate the critique from two aspects, i.e., factuality as precision score and comprehensiveness as recall score. We calculate the harmonic mean of precision and recall as the overall rating called F1 score. To obtain a reliable evaluation outcome, we propose Atomic Information Units (AIUs), which describe the critique in a more fine-grained manner. MetaCritique takes each AIU into account and aggregates each AIU's judgment for the overall score. Moreover, given the evaluation process involves intricate reasoning, our MetaCritique provides a natural language rationale to support each judgment. We construct a meta-evaluation dataset containing 300 critiques (2653 AIUs) across four tasks (question answering, reasoning, entailment, and summarization), and we conduct a comparative study to demonstrate the feasibility and effectiveness. Experiments also show superior critique judged by MetaCritique leads to better refinement, indicating generative artificial intelligence indeed has the potential to be significantly advanced with our MetaCritique. We will release relevant code and meta-evaluation datasets at https://github.com/GAIR-NLP/MetaCritique.

  • 6 authors
·
Jan 9, 2024 2

On the Effectiveness of LLM-as-a-judge for Code Generation and Summarization

Large Language Models have been recently exploited as judges for complex natural language processing tasks, such as Q&A. The basic idea is to delegate to an LLM the assessment of the "quality" of the output provided by an automated technique for tasks for which: (i) quantitative metrics would only tell part of the story, and; (ii) a large-scale human-based evaluation would be too expensive. LLMs-as-a-judge, if proven effective for a specific task, can also unlock new possibilities for automation, with several LLMs proposing a solution for a given instance of the task and others judging and deciding what is the best output to show the user. We study the effectiveness of LLMs-as-a-judge for two code-related tasks, namely code generation and code summarization. The rationale for choosing these tasks is two-fold. First, quantitative metrics are usually not enough for the assessment of code summarizers/generators. For example, it is well documented that metrics such as BLEU are quite weak proxies for the quality of the generated summaries. Second, even state-of-the-art techniques still struggle with handling complex instances of these tasks, making them good candidates for benefiting from more advanced solutions envisioning collaboration among LLMs. For code generation, we check whether eight LLMs are able to judge the correctness of 1,405 Java methods and 1,281 Python functions generated by the same LLMs or implemented by humans. For code summarization, we compare the judgment of five LLMs to those provided by nine humans for ~1.2k summaries, related to both Java and Python functions. Our findings show that GPT-4-turbo is the best LLM in terms of judging capabilities for both tasks, with "smaller" LLMs featuring tens of billions parameters not being able to cope with judging tasks. However, even the best-performing LLM frequently misjudges the correctness of the code and summary quality.

  • 6 authors
·
Jul 21, 2025

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

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

Fudan-University Fudan University
·
Sep 24, 2025

Enhancing clinical decision support with physiological waveforms -- a multimodal benchmark in emergency care

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

  • 3 authors
·
Apr 29, 2025

ZeroQuant-V2: Exploring Post-training Quantization in LLMs from Comprehensive Study to Low Rank Compensation

Post-training quantization (PTQ) has emerged as a promising technique for mitigating memory consumption and computational costs in large language models (LLMs). However, a systematic examination of various quantization schemes, model families, and quantization bit precision has been absent from the literature. In this paper, we conduct a comprehensive analysis of these factors by investigating the effects of PTQ on weight-only, activation-only, and weight-and-activation quantization using diverse methods such as round-to-nearest (RTN), GPTQ, ZeroQuant, and their variants. We apply these methods to two distinct model families with parameters ranging from 125M to 176B. Our contributions include: (1) a sensitivity analysis revealing that activation quantization is generally more susceptible to weight quantization, with smaller models often outperforming larger models in terms of activation quantization; (2) an evaluation and comparison of existing PTQ methods to optimize model size reduction while minimizing the impact on accuracy, revealing that none of the current methods can achieve the original model quality for quantization with either INT4-weight or INT4-weight-and-INT8-activation; (3) based on these insights, we propose an optimized method called Low-Rank Compensation (LoRC), which employs low-rank matrices to enhance model quality recovery with a minimal increase in model size.

  • 5 authors
·
Mar 14, 2023

Yet Another ICU Benchmark: A Flexible Multi-Center Framework for Clinical ML

Medical applications of machine learning (ML) have experienced a surge in popularity in recent years. The intensive care unit (ICU) is a natural habitat for ML given the abundance of available data from electronic health records. Models have been proposed to address numerous ICU prediction tasks like the early detection of complications. While authors frequently report state-of-the-art performance, it is challenging to verify claims of superiority. Datasets and code are not always published, and cohort definitions, preprocessing pipelines, and training setups are difficult to reproduce. This work introduces Yet Another ICU Benchmark (YAIB), a modular framework that allows researchers to define reproducible and comparable clinical ML experiments; we offer an end-to-end solution from cohort definition to model evaluation. The framework natively supports most open-access ICU datasets (MIMIC III/IV, eICU, HiRID, AUMCdb) and is easily adaptable to future ICU datasets. Combined with a transparent preprocessing pipeline and extensible training code for multiple ML and deep learning models, YAIB enables unified model development. Our benchmark comes with five predefined established prediction tasks (mortality, acute kidney injury, sepsis, kidney function, and length of stay) developed in collaboration with clinicians. Adding further tasks is straightforward by design. Using YAIB, we demonstrate that the choice of dataset, cohort definition, and preprocessing have a major impact on the prediction performance - often more so than model class - indicating an urgent need for YAIB as a holistic benchmarking tool. We provide our work to the clinical ML community to accelerate method development and enable real-world clinical implementations. Software Repository: https://github.com/rvandewater/YAIB.

  • 6 authors
·
Jun 8, 2023

Exploiting LLM Quantization

Quantization leverages lower-precision weights to reduce the memory usage of large language models (LLMs) and is a key technique for enabling their deployment on commodity hardware. While LLM quantization's impact on utility has been extensively explored, this work for the first time studies its adverse effects from a security perspective. We reveal that widely used quantization methods can be exploited to produce a harmful quantized LLM, even though the full-precision counterpart appears benign, potentially tricking users into deploying the malicious quantized model. We demonstrate this threat using a three-staged attack framework: (i) first, we obtain a malicious LLM through fine-tuning on an adversarial task; (ii) next, we quantize the malicious model and calculate constraints that characterize all full-precision models that map to the same quantized model; (iii) finally, using projected gradient descent, we tune out the poisoned behavior from the full-precision model while ensuring that its weights satisfy the constraints computed in step (ii). This procedure results in an LLM that exhibits benign behavior in full precision but when quantized, it follows the adversarial behavior injected in step (i). We experimentally demonstrate the feasibility and severity of such an attack across three diverse scenarios: vulnerable code generation, content injection, and over-refusal attack. In practice, the adversary could host the resulting full-precision model on an LLM community hub such as Hugging Face, exposing millions of users to the threat of deploying its malicious quantized version on their devices.

  • 5 authors
·
May 28, 2024

Similarity-Based Self-Construct Graph Model for Predicting Patient Criticalness Using Graph Neural Networks and EHR Data

Accurately predicting the criticalness of ICU patients (such as in-ICU mortality risk) is vital for early intervention in critical care. However, conventional models often treat each patient in isolation and struggle to exploit the relational structure in Electronic Health Records (EHR). We propose a Similarity-Based Self-Construct Graph Model (SBSCGM) that dynamically builds a patient similarity graph from multi-modal EHR data, and a HybridGraphMedGNN architecture that operates on this graph to predict patient mortality and a continuous criticalness score. SBSCGM uses a hybrid similarity measure (combining feature-based and structural similarities) to connect patients with analogous clinical profiles in real-time. The HybridGraphMedGNN integrates Graph Convolutional Network (GCN), GraphSAGE, and Graph Attention Network (GAT) layers to learn robust patient representations, leveraging both local and global graph patterns. In experiments on 6,000 ICU stays from the MIMIC-III dataset, our model achieves state-of-the-art performance (AUC-ROC 0.94) outperforming baseline classifiers and single-type GNN models. We also demonstrate improved precision/recall and show that the attention mechanism provides interpretable insights into model predictions. Our framework offers a scalable and interpretable solution for critical care risk prediction, with potential to support clinicians in real-world ICU deployment.

  • 2 authors
·
Aug 1, 2025

OrgForge-IT: A Verifiable Synthetic Benchmark for LLM-Based Insider Threat Detection

Synthetic insider threat benchmarks face a consistency problem: corpora generated without an external factual constraint cannot rule out cross-artifact contradictions. The CERT dataset -- the field's canonical benchmark -- is also static, lacks cross-surface correlation scenarios, and predates the LLM era. We present OrgForge-IT, a verifiable synthetic benchmark in which a deterministic simulation engine maintains ground truth and language models generate only surface prose, making cross-artifact consistency an architectural guarantee. The corpus spans 51 simulated days, 2,904 telemetry records at a 96.4% noise rate, and four detection scenarios designed to defeat single-surface and single-day triage strategies across three threat classes and eight injectable behaviors. A ten-model leaderboard reveals several findings: (1) triage and verdict accuracy dissociate - eight models achieve identical triage F1=0.80 yet split between verdict F1=1.0 and 0.80; (2) baseline false-positive rate is a necessary companion to verdict F1, with models at identical verdict accuracy differing by two orders of magnitude on triage noise; (3) victim attribution in the vishing scenario separates tiers - Tier A models exonerate the compromised account holder while Tier B models detect the attack but misclassify the victim; (4) rigid multi-signal thresholds structurally exclude single-surface negligent insiders, demonstrating the necessity of parallel, threat-class-specific triage pipelines; and (5) agentic software-engineering training acts as a force multiplier for multi-day temporal correlation, but only when paired with frontier-level parameter scale. Finally, prompt sensitivity analysis reveals that unstructured prompts induce vocabulary hallucination, motivating a two-track scoring framework separating prompt adherence from reasoning capability. OrgForge-IT is open source under the MIT license.

  • 1 authors
·
Mar 23

Through a Compressed Lens: Investigating the Impact of Quantization on LLM Explainability and Interpretability

Quantization methods are widely used to accelerate inference and streamline the deployment of large language models (LLMs). While prior research has extensively investigated the degradation of various LLM capabilities due to quantization, its effects on model explainability and interpretability, which are crucial for understanding decision-making processes, remain unexplored. To address this gap, we conduct comprehensive experiments using three common quantization techniques at distinct bit widths, in conjunction with two explainability methods, counterfactual examples and natural language explanations, as well as two interpretability approaches, knowledge memorization analysis and latent multi-hop reasoning analysis. We complement our analysis with a thorough user study, evaluating selected explainability methods. Our findings reveal that, depending on the configuration, quantization can significantly impact model explainability and interpretability. Notably, the direction of this effect is not consistent, as it strongly depends on (1) the quantization method, (2) the explainability or interpretability approach, and (3) the evaluation protocol. In some settings, human evaluation shows that quantization degrades explainability, while in others, it even leads to improvements. Our work serves as a cautionary tale, demonstrating that quantization can unpredictably affect model transparency. This insight has important implications for deploying LLMs in applications where transparency is a critical requirement.

  • 8 authors
·
May 20, 2025

Using Imperfect Surrogates for Downstream Inference: Design-based Supervised Learning for Social Science Applications of Large Language Models

In computational social science (CSS), researchers analyze documents to explain social and political phenomena. In most scenarios, CSS researchers first obtain labels for documents and then explain labels using interpretable regression analyses in the second step. One increasingly common way to annotate documents cheaply at scale is through large language models (LLMs). However, like other scalable ways of producing annotations, such surrogate labels are often imperfect and biased. We present a new algorithm for using imperfect annotation surrogates for downstream statistical analyses while guaranteeing statistical properties -- like asymptotic unbiasedness and proper uncertainty quantification -- which are fundamental to CSS research. We show that direct use of surrogate labels in downstream statistical analyses leads to substantial bias and invalid confidence intervals, even with high surrogate accuracy of 80-90%. To address this, we build on debiased machine learning to propose the design-based supervised learning (DSL) estimator. DSL employs a doubly-robust procedure to combine surrogate labels with a smaller number of high-quality, gold-standard labels. Our approach guarantees valid inference for downstream statistical analyses, even when surrogates are arbitrarily biased and without requiring stringent assumptions, by controlling the probability of sampling documents for gold-standard labeling. Both our theoretical analysis and experimental results show that DSL provides valid statistical inference while achieving root mean squared errors comparable to existing alternatives that focus only on prediction without inferential guarantees.

  • 4 authors
·
Jun 7, 2023

Modeling Sparse and Bursty Vulnerability Sightings: Forecasting Under Data Constraints

Understanding and anticipating vulnerability-related activity is a major challenge in cyber threat intelligence. This work investigates whether vulnerability sightings, such as proof-of-concept releases, detection templates, or online discussions, can be forecast over time. Building on our earlier work on VLAI, a transformer-based model that predicts vulnerability severity from textual descriptions, we examine whether severity scores can improve time-series forecasting as exogenous variables. We evaluate several approaches for short-term forecasting of sightings per vulnerability. First, we test SARIMAX models with and without log(x+1) transformations and VLAI-derived severity inputs. Although these adjustments provide limited improvements, SARIMAX remains poorly suited to sparse, short, and bursty vulnerability data. In practice, forecasts often produce overly wide confidence intervals and sometimes unrealistic negative values. To better capture the discrete and event-driven nature of sightings, we then explore count-based methods such as Poisson regression. Early results show that these models produce more stable and interpretable forecasts, especially when sightings are aggregated weekly. We also discuss simpler operational alternatives, including exponential decay functions for short forecasting horizons, to estimate future activity without requiring long historical series. Overall, this study highlights both the potential and the limitations of forecasting rare and bursty cyber events, and provides practical guidance for integrating predictive analytics into vulnerability intelligence workflows.

NOTE: Notable generation Of patient Text summaries through Efficient approach based on direct preference optimization

The discharge summary is a one of critical documents in the patient journey, encompassing all events experienced during hospitalization, including multiple visits, medications, tests, surgery/procedures, and admissions/discharge. Providing a summary of the patient's progress is crucial, as it significantly influences future care and planning. Consequently, clinicians face the laborious and resource-intensive task of manually collecting, organizing, and combining all the necessary data for a discharge summary. Therefore, we propose "NOTE", which stands for "Notable generation Of patient Text summaries through an Efficient approach based on direct preference optimization". NOTE is based on Medical Information Mart for Intensive Care- III dataset and summarizes a single hospitalization of a patient. Patient events are sequentially combined and used to generate a discharge summary for each hospitalization. In the present circumstances, large language models' application programming interfaces (LLMs' APIs) are widely available, but importing and exporting medical data presents significant challenges due to privacy protection policies in healthcare institutions. Moreover, to ensure optimal performance, it is essential to implement a lightweight model for internal server or program within the hospital. Therefore, we utilized DPO and parameter efficient fine tuning (PEFT) techniques to apply a fine-tuning method that guarantees superior performance. To demonstrate the practical application of the developed NOTE, we provide a webpage-based demonstration software. In the future, we will aim to deploy the software available for actual use by clinicians in hospital. NOTE can be utilized to generate various summaries not only discharge summaries but also throughout a patient's journey, thereby alleviating the labor-intensive workload of clinicians and aiming for increased efficiency.

  • 5 authors
·
Feb 19, 2024

Medical Concept Representation Learning from Electronic Health Records and its Application on Heart Failure Prediction

Objective: To transform heterogeneous clinical data from electronic health records into clinically meaningful constructed features using data driven method that rely, in part, on temporal relations among data. Materials and Methods: The clinically meaningful representations of medical concepts and patients are the key for health analytic applications. Most of existing approaches directly construct features mapped to raw data (e.g., ICD or CPT codes), or utilize some ontology mapping such as SNOMED codes. However, none of the existing approaches leverage EHR data directly for learning such concept representation. We propose a new way to represent heterogeneous medical concepts (e.g., diagnoses, medications and procedures) based on co-occurrence patterns in longitudinal electronic health records. The intuition behind the method is to map medical concepts that are co-occuring closely in time to similar concept vectors so that their distance will be small. We also derive a simple method to construct patient vectors from the related medical concept vectors. Results: For qualitative evaluation, we study similar medical concepts across diagnosis, medication and procedure. In quantitative evaluation, our proposed representation significantly improves the predictive modeling performance for onset of heart failure (HF), where classification methods (e.g. logistic regression, neural network, support vector machine and K-nearest neighbors) achieve up to 23% improvement in area under the ROC curve (AUC) using this proposed representation. Conclusion: We proposed an effective method for patient and medical concept representation learning. The resulting representation can map relevant concepts together and also improves predictive modeling performance.

  • 4 authors
·
Feb 11, 2016

COVID-BLUeS -- A Prospective Study on the Value of AI in Lung Ultrasound Analysis

As a lightweight and non-invasive imaging technique, lung ultrasound (LUS) has gained importance for assessing lung pathologies. The use of Artificial intelligence (AI) in medical decision support systems is promising due to the time- and expertise-intensive interpretation, however, due to the poor quality of existing data used for training AI models, their usability for real-world applications remains unclear. In a prospective study, we analyze data from 63 COVID-19 suspects (33 positive) collected at Maastricht University Medical Centre. Ultrasound recordings at six body locations were acquired following the BLUE protocol and manually labeled for severity of lung involvement. Several AI models were applied and trained for detection and severity of pulmonary infection. The severity of the lung infection, as assigned by human annotators based on the LUS videos, is not significantly different between COVID-19 positive and negative patients (p = 0.89). Nevertheless, the predictions of image-based AI models identify a COVID-19 infection with 65% accuracy when applied zero-shot (i.e., trained on other datasets), and up to 79% with targeted training, whereas the accuracy based on human annotations is at most 65%. Multi-modal models combining images and CBC improve significantly over image-only models. Although our analysis generally supports the value of AI in LUS assessment, the evaluated models fall short of the performance expected from previous work. We find this is due to 1) the heterogeneity of LUS datasets, limiting the generalization ability to new data, 2) the frame-based processing of AI models ignoring video-level information, and 3) lack of work on multi-modal models that can extract the most relevant information from video-, image- and variable-based inputs. To aid future research, we publish the dataset at: https://github.com/NinaWie/COVID-BLUES.

  • 13 authors
·
Sep 9, 2025