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Apr 13

Human-Readable Adversarial Prompts: An Investigation into LLM Vulnerabilities Using Situational Context

As the AI systems become deeply embedded in social media platforms, we've uncovered a concerning security vulnerability that goes beyond traditional adversarial attacks. It becomes important to assess the risks of LLMs before the general public use them on social media platforms to avoid any adverse impacts. Unlike obvious nonsensical text strings that safety systems can easily catch, our work reveals that human-readable situation-driven adversarial full-prompts that leverage situational context are effective but much harder to detect. We found that skilled attackers can exploit the vulnerabilities in open-source and proprietary LLMs to make a malicious user query safe for LLMs, resulting in generating a harmful response. This raises an important question about the vulnerabilities of LLMs. To measure the robustness against human-readable attacks, which now present a potent threat, our research makes three major contributions. First, we developed attacks that use movie scripts as situational contextual frameworks, creating natural-looking full-prompts that trick LLMs into generating harmful content. Second, we developed a method to transform gibberish adversarial text into readable, innocuous content that still exploits vulnerabilities when used within the full-prompts. Finally, we enhanced the AdvPrompter framework with p-nucleus sampling to generate diverse human-readable adversarial texts that significantly improve attack effectiveness against models like GPT-3.5-Turbo-0125 and Gemma-7b. Our findings show that these systems can be manipulated to operate beyond their intended ethical boundaries when presented with seemingly normal prompts that contain hidden adversarial elements. By identifying these vulnerabilities, we aim to drive the development of more robust safety mechanisms that can withstand sophisticated attacks in real-world applications.

  • 4 authors
·
Dec 20, 2024

AdvPrompter: Fast Adaptive Adversarial Prompting for LLMs

While recently Large Language Models (LLMs) have achieved remarkable successes, they are vulnerable to certain jailbreaking attacks that lead to generation of inappropriate or harmful content. Manual red-teaming requires finding adversarial prompts that cause such jailbreaking, e.g. by appending a suffix to a given instruction, which is inefficient and time-consuming. On the other hand, automatic adversarial prompt generation often leads to semantically meaningless attacks that can easily be detected by perplexity-based filters, may require gradient information from the TargetLLM, or do not scale well due to time-consuming discrete optimization processes over the token space. In this paper, we present a novel method that uses another LLM, called the AdvPrompter, to generate human-readable adversarial prompts in seconds, sim800times faster than existing optimization-based approaches. We train the AdvPrompter using a novel algorithm that does not require access to the gradients of the TargetLLM. This process alternates between two steps: (1) generating high-quality target adversarial suffixes by optimizing the AdvPrompter predictions, and (2) low-rank fine-tuning of the AdvPrompter with the generated adversarial suffixes. The trained AdvPrompter generates suffixes that veil the input instruction without changing its meaning, such that the TargetLLM is lured to give a harmful response. Experimental results on popular open source TargetLLMs show state-of-the-art results on the AdvBench dataset, that also transfer to closed-source black-box LLM APIs. Further, we demonstrate that by fine-tuning on a synthetic dataset generated by AdvPrompter, LLMs can be made more robust against jailbreaking attacks while maintaining performance, i.e. high MMLU scores.

  • 5 authors
·
Apr 21, 2024 1

LayoutPrompter: Awaken the Design Ability of Large Language Models

Conditional graphic layout generation, which automatically maps user constraints to high-quality layouts, has attracted widespread attention today. Although recent works have achieved promising performance, the lack of versatility and data efficiency hinders their practical applications. In this work, we propose LayoutPrompter, which leverages large language models (LLMs) to address the above problems through in-context learning. LayoutPrompter is made up of three key components, namely input-output serialization, dynamic exemplar selection and layout ranking. Specifically, the input-output serialization component meticulously designs the input and output formats for each layout generation task. Dynamic exemplar selection is responsible for selecting the most helpful prompting exemplars for a given input. And a layout ranker is used to pick the highest quality layout from multiple outputs of LLMs. We conduct experiments on all existing layout generation tasks using four public datasets. Despite the simplicity of our approach, experimental results show that LayoutPrompter can compete with or even outperform state-of-the-art approaches on these tasks without any model training or fine-tuning. This demonstrates the effectiveness of this versatile and training-free approach. In addition, the ablation studies show that LayoutPrompter is significantly superior to the training-based baseline in a low-data regime, further indicating the data efficiency of LayoutPrompter. Our project is available at https://github.com/microsoft/LayoutGeneration/tree/main/LayoutPrompter.

  • 6 authors
·
Nov 11, 2023

Can Generalist Foundation Models Outcompete Special-Purpose Tuning? Case Study in Medicine

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.

  • 18 authors
·
Nov 27, 2023

VisualPrompter: Semantic-Aware Prompt Optimization with Visual Feedback for Text-to-Image Synthesis

The notable gap between user-provided and model-preferred prompts poses a significant challenge for generating high-quality images with text-to-image models, compelling the need for prompt engineering. Current studies on prompt engineering can effectively enhance the style and aesthetics of generated images. However, they often neglect the semantic alignment between generated images and user descriptions, resulting in visually appealing but content-wise unsatisfying outputs. In this work, we propose VisualPrompter, a novel training-free prompt engineering framework that refines user inputs to model-preferred sentences. VisualPrompter utilizes an automatic self-reflection module that identifies absent concepts in the generated images, followed by a target-specific prompt optimization mechanism that revises the prompts in a fine-grained manner. By deconstructing prompts, introducing new elements at the atomic semantic level, and then reassembling them, our framework is able to maintain semantic consistency and integrity throughout the optimization process. Extensive experiments demonstrate the effectiveness of VisualPrompter, which achieves new state-of-the-art performance on multiple benchmarks for text-image alignment evaluation. Additionally, our framework features a plug-and-play design, making it highly adaptable to various generative models. Our code is available at https://github.com/teheperinko541/VisualPrompter.

  • 5 authors
·
Jun 29, 2025

Enhancing Adverse Drug Event Detection with Multimodal Dataset: Corpus Creation and Model Development

The mining of adverse drug events (ADEs) is pivotal in pharmacovigilance, enhancing patient safety by identifying potential risks associated with medications, facilitating early detection of adverse events, and guiding regulatory decision-making. Traditional ADE detection methods are reliable but slow, not easily adaptable to large-scale operations, and offer limited information. With the exponential increase in data sources like social media content, biomedical literature, and Electronic Medical Records (EMR), extracting relevant ADE-related information from these unstructured texts is imperative. Previous ADE mining studies have focused on text-based methodologies, overlooking visual cues, limiting contextual comprehension, and hindering accurate interpretation. To address this gap, we present a MultiModal Adverse Drug Event (MMADE) detection dataset, merging ADE-related textual information with visual aids. Additionally, we introduce a framework that leverages the capabilities of LLMs and VLMs for ADE detection by generating detailed descriptions of medical images depicting ADEs, aiding healthcare professionals in visually identifying adverse events. Using our MMADE dataset, we showcase the significance of integrating visual cues from images to enhance overall performance. This approach holds promise for patient safety, ADE awareness, and healthcare accessibility, paving the way for further exploration in personalized healthcare.

  • 5 authors
·
May 24, 2024

MEDDxAgent: A Unified Modular Agent Framework for Explainable Automatic Differential Diagnosis

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.

  • 6 authors
·
Feb 26, 2025

GREATERPROMPT: A Unified, Customizable, and High-Performing Open-Source Toolkit for Prompt Optimization

LLMs have gained immense popularity among researchers and the general public for its impressive capabilities on a variety of tasks. Notably, the efficacy of LLMs remains significantly dependent on the quality and structure of the input prompts, making prompt design a critical factor for their performance. Recent advancements in automated prompt optimization have introduced diverse techniques that automatically enhance prompts to better align model outputs with user expectations. However, these methods often suffer from the lack of standardization and compatibility across different techniques, limited flexibility in customization, inconsistent performance across model scales, and they often exclusively rely on expensive proprietary LLM APIs. To fill in this gap, we introduce GREATERPROMPT, a novel framework that democratizes prompt optimization by unifying diverse methods under a unified, customizable API while delivering highly effective prompts for different tasks. Our framework flexibly accommodates various model scales by leveraging both text feedback-based optimization for larger LLMs and internal gradient-based optimization for smaller models to achieve powerful and precise prompt improvements. Moreover, we provide a user-friendly Web UI that ensures accessibility for non-expert users, enabling broader adoption and enhanced performance across various user groups and application scenarios. GREATERPROMPT is available at https://github.com/psunlpgroup/GreaterPrompt via GitHub, PyPI, and web user interfaces.

  • 4 authors
·
Apr 4, 2025

Explainable Multi-Modal Deep Learning for Automatic Detection of Lung Diseases from Respiratory Audio Signals

Respiratory diseases remain major global health challenges, and traditional auscultation is often limited by subjectivity, environmental noise, and inter-clinician variability. This study presents an explainable multimodal deep learning framework for automatic lung-disease detection using respiratory audio signals. The proposed system integrates two complementary representations: a spectral-temporal encoder based on a CNN-BiLSTM Attention architecture, and a handcrafted acoustic-feature encoder capturing physiologically meaningful descriptors such as MFCCs, spectral centroid, spectral bandwidth, and zero-crossing rate. These branches are combined through late-stage fusion to leverage both data-driven learning and domain-informed acoustic cues. The model is trained and evaluated on the Asthma Detection Dataset Version 2 using rigorous preprocessing, including resampling, normalization, noise filtering, data augmentation, and patient-level stratified partitioning. The study achieved strong generalization with 91.21% accuracy, 0.899 macro F1-score, and 0.9866 macro ROC-AUC, outperforming all ablated variants. An ablation study confirms the importance of temporal modeling, attention mechanisms, and multimodal fusion. The framework incorporates Grad-CAM, Integrated Gradients, and SHAP, generating interpretable spectral, temporal, and feature-level explanations aligned with known acoustic biomarkers to build clinical transparency. The findings demonstrate the framework's potential for telemedicine, point-of-care diagnostics, and real-world respiratory screening.

  • 4 authors
·
Nov 29, 2025

DDXPlus: A New Dataset For Automatic Medical Diagnosis

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.

  • 5 authors
·
May 18, 2022

A Comprehensive Library for Benchmarking Multi-class Visual Anomaly Detection

Visual anomaly detection aims to identify anomalous regions in images through unsupervised learning paradigms, with increasing application demand and value in fields such as industrial inspection and medical lesion detection. Despite significant progress in recent years, there is a lack of comprehensive benchmarks to adequately evaluate the performance of various mainstream methods across different datasets under the practical multi-class setting. The absence of standardized experimental setups can lead to potential biases in training epochs, resolution, and metric results, resulting in erroneous conclusions. This paper addresses this issue by proposing a comprehensive visual anomaly detection benchmark, ADer, which is a modular framework that is highly extensible for new methods. The benchmark includes multiple datasets from industrial and medical domains, implementing fifteen state-of-the-art methods and nine comprehensive metrics. Additionally, we have proposed the GPU-assisted ADEval package to address the slow evaluation problem of metrics like time-consuming mAU-PRO on large-scale data, significantly reducing evaluation time by more than 1000-fold. Through extensive experimental results, we objectively reveal the strengths and weaknesses of different methods and provide insights into the challenges and future directions of multi-class visual anomaly detection. We hope that ADer will become a valuable resource for researchers and practitioners in the field, promoting the development of more robust and generalizable anomaly detection systems. Full codes are open-sourced at https://github.com/zhangzjn/ader.

  • 10 authors
·
Jun 5, 2024

AD-BERT: Using Pre-trained contextualized embeddings to Predict the Progression from Mild Cognitive Impairment to Alzheimer's Disease

Objective: We develop a deep learning framework based on the pre-trained Bidirectional Encoder Representations from Transformers (BERT) model using unstructured clinical notes from electronic health records (EHRs) to predict the risk of disease progression from Mild Cognitive Impairment (MCI) to Alzheimer's Disease (AD). Materials and Methods: We identified 3657 patients diagnosed with MCI together with their progress notes from Northwestern Medicine Enterprise Data Warehouse (NMEDW) between 2000-2020. The progress notes no later than the first MCI diagnosis were used for the prediction. We first preprocessed the notes by deidentification, cleaning and splitting, and then pretrained a BERT model for AD (AD-BERT) based on the publicly available Bio+Clinical BERT on the preprocessed notes. The embeddings of all the sections of a patient's notes processed by AD-BERT were combined by MaxPooling to compute the probability of MCI-to-AD progression. For replication, we conducted a similar set of experiments on 2563 MCI patients identified at Weill Cornell Medicine (WCM) during the same timeframe. Results: Compared with the 7 baseline models, the AD-BERT model achieved the best performance on both datasets, with Area Under receiver operating characteristic Curve (AUC) of 0.8170 and F1 score of 0.4178 on NMEDW dataset and AUC of 0.8830 and F1 score of 0.6836 on WCM dataset. Conclusion: We developed a deep learning framework using BERT models which provide an effective solution for prediction of MCI-to-AD progression using clinical note analysis.

  • 12 authors
·
Nov 6, 2022

MALADE: Orchestration of LLM-powered Agents with Retrieval Augmented Generation for Pharmacovigilance

In the era of Large Language Models (LLMs), given their remarkable text understanding and generation abilities, there is an unprecedented opportunity to develop new, LLM-based methods for trustworthy medical knowledge synthesis, extraction and summarization. This paper focuses on the problem of Pharmacovigilance (PhV), where the significance and challenges lie in identifying Adverse Drug Events (ADEs) from diverse text sources, such as medical literature, clinical notes, and drug labels. Unfortunately, this task is hindered by factors including variations in the terminologies of drugs and outcomes, and ADE descriptions often being buried in large amounts of narrative text. We present MALADE, the first effective collaborative multi-agent system powered by LLM with Retrieval Augmented Generation for ADE extraction from drug label data. This technique involves augmenting a query to an LLM with relevant information extracted from text resources, and instructing the LLM to compose a response consistent with the augmented data. MALADE is a general LLM-agnostic architecture, and its unique capabilities are: (1) leveraging a variety of external sources, such as medical literature, drug labels, and FDA tools (e.g., OpenFDA drug information API), (2) extracting drug-outcome association in a structured format along with the strength of the association, and (3) providing explanations for established associations. Instantiated with GPT-4 Turbo or GPT-4o, and FDA drug label data, MALADE demonstrates its efficacy with an Area Under ROC Curve of 0.90 against the OMOP Ground Truth table of ADEs. Our implementation leverages the Langroid multi-agent LLM framework and can be found at https://github.com/jihyechoi77/malade.

  • 7 authors
·
Aug 3, 2024

PromptMRG: Diagnosis-Driven Prompts for Medical Report Generation

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.

  • 4 authors
·
Aug 24, 2023

From Medprompt to o1: Exploration of Run-Time Strategies for Medical Challenge Problems and Beyond

Run-time steering strategies like Medprompt are valuable for guiding large language models (LLMs) to top performance on challenging tasks. Medprompt demonstrates that a general LLM can be focused to deliver state-of-the-art performance on specialized domains like medicine by using a prompt to elicit a run-time strategy involving chain of thought reasoning and ensembling. OpenAI's o1-preview model represents a new paradigm, where a model is designed to do run-time reasoning before generating final responses. We seek to understand the behavior of o1-preview on a diverse set of medical challenge problem benchmarks. Following on the Medprompt study with GPT-4, we systematically evaluate the o1-preview model across various medical benchmarks. Notably, even without prompting techniques, o1-preview largely outperforms the GPT-4 series with Medprompt. We further systematically study the efficacy of classic prompt engineering strategies, as represented by Medprompt, within the new paradigm of reasoning models. We found that few-shot prompting hinders o1's performance, suggesting that in-context learning may no longer be an effective steering approach for reasoning-native models. While ensembling remains viable, it is resource-intensive and requires careful cost-performance optimization. Our cost and accuracy analysis across run-time strategies reveals a Pareto frontier, with GPT-4o representing a more affordable option and o1-preview achieving state-of-the-art performance at higher cost. Although o1-preview offers top performance, GPT-4o with steering strategies like Medprompt retains value in specific contexts. Moreover, we note that the o1-preview model has reached near-saturation on many existing medical benchmarks, underscoring the need for new, challenging benchmarks. We close with reflections on general directions for inference-time computation with LLMs.

  • 7 authors
·
Nov 5, 2024 1

An Electrocardiogram Foundation Model Built on over 10 Million Recordings with External Evaluation across Multiple Domains

Artificial intelligence (AI) has demonstrated significant potential in ECG analysis and cardiovascular disease assessment. Recently, foundation models have played a remarkable role in advancing medical AI. The development of an ECG foundation model holds the promise of elevating AI-ECG research to new heights. However, building such a model faces several challenges, including insufficient database sample sizes and inadequate generalization across multiple domains. Additionally, there is a notable performance gap between single-lead and multi-lead ECG analyses. We introduced an ECG Foundation Model (ECGFounder), a general-purpose model that leverages real-world ECG annotations from cardiology experts to broaden the diagnostic capabilities of ECG analysis. ECGFounder was trained on over 10 million ECGs with 150 label categories from the Harvard-Emory ECG Database, enabling comprehensive cardiovascular disease diagnosis through ECG analysis. The model is designed to be both an effective out-of-the-box solution, and a to be fine-tunable for downstream tasks, maximizing usability. Importantly, we extended its application to lower rank ECGs, and arbitrary single-lead ECGs in particular. ECGFounder is applicable to supporting various downstream tasks in mobile monitoring scenarios. Experimental results demonstrate that ECGFounder achieves expert-level performance on internal validation sets, with AUROC exceeding 0.95 for eighty diagnoses. It also shows strong classification performance and generalization across various diagnoses on external validation sets. When fine-tuned, ECGFounder outperforms baseline models in demographic analysis, clinical event detection, and cross-modality cardiac rhythm diagnosis. The trained model and data will be publicly released upon publication through the bdsp.io. Our code is available at https://github.com/bdsp-core/ECGFounder

  • 9 authors
·
Oct 5, 2024

AdvWeb: Controllable Black-box Attacks on VLM-powered Web Agents

Vision Language Models (VLMs) have revolutionized the creation of generalist web agents, empowering them to autonomously complete diverse tasks on real-world websites, thereby boosting human efficiency and productivity. However, despite their remarkable capabilities, the safety and security of these agents against malicious attacks remain critically underexplored, raising significant concerns about their safe deployment. To uncover and exploit such vulnerabilities in web agents, we provide AdvWeb, a novel black-box attack framework designed against web agents. AdvWeb trains an adversarial prompter model that generates and injects adversarial prompts into web pages, misleading web agents into executing targeted adversarial actions such as inappropriate stock purchases or incorrect bank transactions, actions that could lead to severe real-world consequences. With only black-box access to the web agent, we train and optimize the adversarial prompter model using DPO, leveraging both successful and failed attack strings against the target agent. Unlike prior approaches, our adversarial string injection maintains stealth and control: (1) the appearance of the website remains unchanged before and after the attack, making it nearly impossible for users to detect tampering, and (2) attackers can modify specific substrings within the generated adversarial string to seamlessly change the attack objective (e.g., purchasing stocks from a different company), enhancing attack flexibility and efficiency. We conduct extensive evaluations, demonstrating that AdvWeb achieves high success rates in attacking SOTA GPT-4V-based VLM agent across various web tasks. Our findings expose critical vulnerabilities in current LLM/VLM-based agents, emphasizing the urgent need for developing more reliable web agents and effective defenses. Our code and data are available at https://ai-secure.github.io/AdvWeb/ .

  • 8 authors
·
Oct 22, 2024

ScribblePrompt: Fast and Flexible Interactive Segmentation for Any Medical Image

Semantic medical image segmentation is a crucial part of both scientific research and clinical care. With enough labelled data, deep learning models can be trained to accurately automate specific medical image segmentation tasks. However, manually segmenting images to create training data is highly labor intensive. In this paper, we present ScribblePrompt, an interactive segmentation framework for medical imaging that enables human annotators to segment unseen structures using scribbles, clicks, and bounding boxes. Scribbles are an intuitive and effective form of user interaction for complex tasks, however most existing methods focus on click-based interactions. We introduce algorithms for simulating realistic scribbles that enable training models that are amenable to multiple types of interaction. To achieve generalization to new tasks, we train on a diverse collection of 65 open-access biomedical datasets -- using both real and synthetic labels. We test ScribblePrompt on multiple network architectures and unseen datasets, and demonstrate that it can be used in real-time on a single CPU. We evaluate ScribblePrompt using manually-collected scribbles, simulated interactions, and a user study. ScribblePrompt outperforms existing methods in all our evaluations. In the user study, ScribblePrompt reduced annotation time by 28% while improving Dice by 15% compared to existing methods. We showcase ScribblePrompt in an online demo and provide code at https://scribbleprompt.csail.mit.edu

  • 4 authors
·
Dec 12, 2023

Ad Creative Discontinuation Prediction with Multi-Modal Multi-Task Neural Survival Networks

Discontinuing ad creatives at an appropriate time is one of the most important ad operations that can have a significant impact on sales. Such operational support for ineffective ads has been less explored than that for effective ads. After pre-analyzing 1,000,000 real-world ad creatives, we found that there are two types of discontinuation: short-term (i.e., cut-out) and long-term (i.e., wear-out). In this paper, we propose a practical prediction framework for the discontinuation of ad creatives with a hazard function-based loss function inspired by survival analysis. Our framework predicts the discontinuations with a multi-modal deep neural network that takes as input the ad creative (e.g., text, categorical, image, numerical features). To improve the prediction performance for the two different types of discontinuations and for the ad creatives that contribute to sales, we introduce two new techniques: (1) a two-term estimation technique with multi-task learning and (2) a click-through rate-weighting technique for the loss function. We evaluated our framework using the large-scale ad creative dataset, including 10 billion scale impressions. In terms of the concordance index (short: 0.896, long: 0.939, and overall: 0.792), our framework achieved significantly better performance than the conventional method (0.531). Additionally, we confirmed that our framework (i) demonstrated the same degree of discontinuation effect as manual operations for short-term cases, and (ii) accurately predicted the ad discontinuation order, which is important for long-running ad creatives for long-term cases.

  • 3 authors
·
Apr 2, 2022

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

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

  • 7 authors
·
Oct 9, 2024 2

GraphPrompter: Multi-stage Adaptive Prompt Optimization for Graph In-Context Learning

Graph In-Context Learning, with the ability to adapt pre-trained graph models to novel and diverse downstream graphs without updating any parameters, has gained much attention in the community. The key to graph in-context learning is to perform downstream graphs conditioned on chosen prompt examples. Existing methods randomly select subgraphs or edges as prompts, leading to noisy graph prompts and inferior model performance. Additionally, due to the gap between pre-training and testing graphs, when the number of classes in the testing graphs is much greater than that in the training, the in-context learning ability will also significantly deteriorate. To tackle the aforementioned challenges, we develop a multi-stage adaptive prompt optimization method GraphPrompter, which optimizes the entire process of generating, selecting, and using graph prompts for better in-context learning capabilities. Firstly, Prompt Generator introduces a reconstruction layer to highlight the most informative edges and reduce irrelevant noise for graph prompt construction. Furthermore, in the selection stage, Prompt Selector employs the k-nearest neighbors algorithm and pre-trained selection layers to dynamically choose appropriate samples and minimize the influence of irrelevant prompts. Finally, we leverage a Prompt Augmenter with a cache replacement strategy to enhance the generalization capability of the pre-trained model on new datasets. Extensive experiments show that GraphPrompter effectively enhances the in-context learning ability of graph models. On average across all the settings, our approach surpasses the state-of-the-art baselines by over 8%. Our code is released at https://github.com/karin0018/GraphPrompter.

  • 9 authors
·
May 4, 2025

MemoryOut: Learning Principal Features via Multimodal Sparse Filtering Network for Semi-supervised Video Anomaly Detection

Video Anomaly Detection (VAD) methods based on reconstruction or prediction face two critical challenges: (1) strong generalization capability often results in accurate reconstruction or prediction of abnormal events, making it difficult to distinguish normal from abnormal patterns; (2) reliance only on low-level appearance and motion cues limits their ability to identify high-level semantic in abnormal events from complex scenes. To address these limitations, we propose a novel VAD framework with two key innovations. First, to suppress excessive generalization, we introduce the Sparse Feature Filtering Module (SFFM) that employs bottleneck filters to dynamically and adaptively remove abnormal information from features. Unlike traditional memory modules, it does not need to memorize the normal prototypes across the training dataset. Further, we design the Mixture of Experts (MoE) architecture for SFFM. Each expert is responsible for extracting specialized principal features during running time, and different experts are selectively activated to ensure the diversity of the learned principal features. Second, to overcome the neglect of semantics in existing methods, we integrate a Vision-Language Model (VLM) to generate textual descriptions for video clips, enabling comprehensive joint modeling of semantic, appearance, and motion cues. Additionally, we enforce modality consistency through semantic similarity constraints and motion frame-difference contrastive loss. Extensive experiments on multiple public datasets validate the effectiveness of our multimodal joint modeling framework and sparse feature filtering paradigm. Project page at https://qzfm.github.io/sfn_vad_project_page/.

  • 7 authors
·
Jun 3, 2025

Evolving Diagnostic Agents in a Virtual Clinical Environment

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.

FlyPrompt: Brain-Inspired Random-Expanded Routing with Temporal-Ensemble Experts for General Continual Learning

General continual learning (GCL) challenges intelligent systems to learn from single-pass, non-stationary data streams without clear task boundaries. While recent advances in continual parameter-efficient tuning (PET) of pretrained models show promise, they typically rely on multiple training epochs and explicit task cues, limiting their effectiveness in GCL scenarios. Moreover, existing methods often lack targeted design and fail to address two fundamental challenges in continual PET: how to allocate expert parameters to evolving data distributions, and how to improve their representational capacity under limited supervision. Inspired by the fruit fly's hierarchical memory system characterized by sparse expansion and modular ensembles, we propose FlyPrompt, a brain-inspired framework that decomposes GCL into two subproblems: expert routing and expert competence improvement. FlyPrompt introduces a randomly expanded analytic router for instance-level expert activation and a temporal ensemble of output heads to dynamically adapt decision boundaries over time. Extensive theoretical and empirical evaluations demonstrate FlyPrompt's superior performance, achieving up to 11.23%, 12.43%, and 7.62% gains over state-of-the-art baselines on CIFAR-100, ImageNet-R, and CUB-200, respectively. Our source code is available at https://github.com/AnAppleCore/FlyGCL.

  • 6 authors
·
Feb 2

Automated Rubrics for Reliable Evaluation of Medical Dialogue Systems

Large Language Models (LLMs) are increasingly used for clinical decision support, where hallucinations and unsafe suggestions may pose direct risks to patient safety. These risks are particularly challenging as they often manifest as subtle clinical errors that evade detection by generic metrics, while expert-authored fine-grained rubrics remain costly to construct and difficult to scale. In this paper, we propose a retrieval-augmented multi-agent framework designed to automate the generation of instance-specific evaluation rubrics. Our approach grounds evaluation in authoritative medical evidence by decomposing retrieved content into atomic facts and synthesizing them with user interaction constraints to form verifiable, fine-grained evaluation criteria. Evaluated on HealthBench, our framework achieves a Clinical Intent Alignment (CIA) score of 60.12%, a statistically significant improvement over the GPT-4o baseline (55.16%). In discriminative tests, our rubrics yield a mean score delta (μ_Δ = 8.658) and an AUROC of 0.977, nearly doubling the quality separation achieved by GPT-4o baseline (4.972). Beyond evaluation, our rubrics effectively guide response refinement, improving quality by 9.2% (from 59.0% to 68.2%). This provides a scalable and transparent foundation for both evaluating and improving medical LLMs. The code is available at https://anonymous.4open.science/r/Automated-Rubric-Generation-AF3C/.

  • 4 authors
·
Jan 21

An Integrated Optimization and Machine Learning Models to Predict the Admission Status of Emergency Patients

This work proposes a framework for optimizing machine learning algorithms. The practicality of the framework is illustrated using an important case study from the healthcare domain, which is predicting the admission status of emergency department (ED) patients (e.g., admitted vs. discharged) using patient data at the time of triage. The proposed framework can mitigate the crowding problem by proactively planning the patient boarding process. A large retrospective dataset of patient records is obtained from the electronic health record database of all ED visits over three years from three major locations of a healthcare provider in the Midwest of the US. Three machine learning algorithms are proposed: T-XGB, T-ADAB, and T-MLP. T-XGB integrates extreme gradient boosting (XGB) and Tabu Search (TS), T-ADAB integrates Adaboost and TS, and T-MLP integrates multi-layer perceptron (MLP) and TS. The proposed algorithms are compared with the traditional algorithms: XGB, ADAB, and MLP, in which their parameters are tunned using grid search. The three proposed algorithms and the original ones are trained and tested using nine data groups that are obtained from different feature selection methods. In other words, 54 models are developed. Performance was evaluated using five measures: Area under the curve (AUC), sensitivity, specificity, F1, and accuracy. The results show that the newly proposed algorithms resulted in high AUC and outperformed the traditional algorithms. The T-ADAB performs the best among the newly developed algorithms. The AUC, sensitivity, specificity, F1, and accuracy of the best model are 95.4%, 99.3%, 91.4%, 95.2%, 97.2%, respectively.

  • 4 authors
·
Feb 18, 2022

MAIRA-2: Grounded Radiology Report Generation

Radiology reporting is a complex task that requires detailed image understanding, integration of multiple inputs, including comparison with prior imaging, and precise language generation. This makes it ideal for the development and use of generative multimodal models. Here, we extend report generation to include the localisation of individual findings on the image - a task we call grounded report generation. Prior work indicates that grounding is important for clarifying image understanding and interpreting AI-generated text. Therefore, grounded reporting stands to improve the utility and transparency of automated report drafting. To enable evaluation of grounded reporting, we propose a novel evaluation framework - RadFact - leveraging the reasoning capabilities of large language models (LLMs). RadFact assesses the factuality of individual generated sentences, as well as correctness of generated spatial localisations when present. We introduce MAIRA-2, a large multimodal model combining a radiology-specific image encoder with a LLM, and trained for the new task of grounded report generation on chest X-rays. MAIRA-2 uses more comprehensive inputs than explored previously: the current frontal image, the current lateral image, the prior frontal image and prior report, as well as the Indication, Technique and Comparison sections of the current report. We demonstrate that these additions significantly improve report quality and reduce hallucinations, establishing a new state of the art on findings generation (without grounding) on MIMIC-CXR while demonstrating the feasibility of grounded reporting as a novel and richer task.

  • 20 authors
·
Jun 6, 2024

PVminer: A Domain-Specific Tool to Detect the Patient Voice in Patient Generated Data

Patient-generated text such as secure messages, surveys, and interviews contains rich expressions of the patient voice (PV), reflecting communicative behaviors and social determinants of health (SDoH). Traditional qualitative coding frameworks are labor intensive and do not scale to large volumes of patient-authored messages across health systems. Existing machine learning (ML) and natural language processing (NLP) approaches provide partial solutions but often treat patient-centered communication (PCC) and SDoH as separate tasks or rely on models not well suited to patient-facing language. We introduce PVminer, a domain-adapted NLP framework for structuring patient voice in secure patient-provider communication. PVminer formulates PV detection as a multi-label, multi-class prediction task integrating patient-specific BERT encoders (PV-BERT-base and PV-BERT-large), unsupervised topic modeling for thematic augmentation (PV-Topic-BERT), and fine-tuned classifiers for Code, Subcode, and Combo-level labels. Topic representations are incorporated during fine-tuning and inference to enrich semantic inputs. PVminer achieves strong performance across hierarchical tasks and outperforms biomedical and clinical pre-trained baselines, achieving F1 scores of 82.25% (Code), 80.14% (Subcode), and up to 77.87% (Combo). An ablation study further shows that author identity and topic-based augmentation each contribute meaningful gains. Pre-trained models, source code, and documentation will be publicly released, with annotated datasets available upon request for research use.

  • 9 authors
·
Feb 24

Heart Failure Prediction using Modal Decomposition and Masked Autoencoders for Scarce Echocardiography Databases

Heart diseases remain the leading cause of mortality worldwide, implying approximately 18 million deaths according to the WHO. In particular, heart failures (HF) press the healthcare industry to develop systems for their early, rapid, and effective prediction. This work presents an automatic system based on a novel framework which combines Modal Decomposition and Masked Autoencoders (MAE) to extend the application from heart disease classification to the more challenging and specific task of heart failure time prediction, not previously addressed to the best of authors' knowledge. This system comprises two stages. The first one transforms the data from a database of echocardiography video sequences into a large collection of annotated images compatible with the training phase of machine learning-based frameworks and deep learning-based ones. This stage includes the use of the Higher Order Dynamic Mode Decomposition (HODMD) algorithm for both data augmentation and feature extraction. The second stage builds and trains a Vision Transformer (ViT). MAEs based on a combined scheme of self-supervised (SSL) and supervised learning, so far barely explored in the literature about heart failure prediction, are adopted to effectively train the ViT from scratch, even with scarce databases. The designed neural network analyses in real-time images from echocardiography sequences to estimate the time of happening a heart failure. This approach demonstrates to improve prediction accuracy from scarce databases and to be superior to several established ViT and Convolutional Neural Network (CNN) architectures. The source code will be incorporated into the next version release of the ModelFLOWs-app software (https://github.com/modelflows/ModelFLOWs-app).

  • 5 authors
·
Apr 10, 2025

SciPrompt: Knowledge-augmented Prompting for Fine-grained Categorization of Scientific Topics

Prompt-based fine-tuning has become an essential method for eliciting information encoded in pre-trained language models for a variety of tasks, including text classification. For multi-class classification tasks, prompt-based fine-tuning under low-resource scenarios has resulted in performance levels comparable to those of fully fine-tuning methods. Previous studies have used crafted prompt templates and verbalizers, mapping from the label terms space to the class space, to solve the classification problem as a masked language modeling task. However, cross-domain and fine-grained prompt-based fine-tuning with an automatically enriched verbalizer remains unexplored, mainly due to the difficulty and costs of manually selecting domain label terms for the verbalizer, which requires humans with domain expertise. To address this challenge, we introduce SciPrompt, a framework designed to automatically retrieve scientific topic-related terms for low-resource text classification tasks. To this end, we select semantically correlated and domain-specific label terms within the context of scientific literature for verbalizer augmentation. Furthermore, we propose a new verbalization strategy that uses correlation scores as additional weights to enhance the prediction performance of the language model during model tuning. Our method outperforms state-of-the-art, prompt-based fine-tuning methods on scientific text classification tasks under few and zero-shot settings, especially in classifying fine-grained and emerging scientific topics.

  • 5 authors
·
Oct 2, 2024 3

ADRD-Bench: A Preliminary LLM Benchmark for Alzheimer's Disease and Related Dementias

Large language models (LLMs) have shown great potential for healthcare applications. However, existing evaluation benchmarks provide minimal coverage of Alzheimer's Disease and Related Dementias (ADRD). To address this gap, we introduce ADRD-Bench, the first ADRD-specific benchmark dataset designed for rigorous evaluation of LLMs. ADRD-Bench has two components: 1) ADRD Unified QA, a synthesis of 1,352 questions consolidated from seven established medical benchmarks, providing a unified assessment of clinical knowledge; and 2) ADRD Caregiving QA, a novel set of 149 questions derived from the Aging Brain Care (ABC) program, a widely used, evidence-based brain health management program. Guided by a program with national expertise in comprehensive ADRD care, this new set was designed to mitigate the lack of practical caregiving context in existing benchmarks. We evaluated 33 state-of-the-art LLMs on the proposed ADRD-Bench. Results showed that the accuracy of open-weight general models ranged from 0.63 to 0.93 (mean: 0.78; std: 0.09). The accuracy of open-weight medical models ranged from 0.48 to 0.93 (mean: 0.82; std: 0.13). The accuracy of closed-source general models ranged from 0.83 to 0.91 (mean: 0.89; std: 0.03). While top-tier models achieved high accuracies (>0.9), case studies revealed that inconsistent reasoning quality and stability limit their reliability, highlighting a critical need for domain-specific improvement to enhance LLMs' knowledge and reasoning grounded in daily caregiving data. The entire dataset is available at https://github.com/IIRL-ND/ADRD-Bench.

  • 7 authors
·
Feb 11

GenHPF: General Healthcare Predictive Framework with Multi-task Multi-source Learning

Despite the remarkable progress in the development of predictive models for healthcare, applying these algorithms on a large scale has been challenging. Algorithms trained on a particular task, based on specific data formats available in a set of medical records, tend to not generalize well to other tasks or databases in which the data fields may differ. To address this challenge, we propose General Healthcare Predictive Framework (GenHPF), which is applicable to any EHR with minimal preprocessing for multiple prediction tasks. GenHPF resolves heterogeneity in medical codes and schemas by converting EHRs into a hierarchical textual representation while incorporating as many features as possible. To evaluate the efficacy of GenHPF, we conduct multi-task learning experiments with single-source and multi-source settings, on three publicly available EHR datasets with different schemas for 12 clinically meaningful prediction tasks. Our framework significantly outperforms baseline models that utilize domain knowledge in multi-source learning, improving average AUROC by 1.2%P in pooled learning and 2.6%P in transfer learning while also showing comparable results when trained on a single EHR dataset. Furthermore, we demonstrate that self-supervised pretraining using multi-source datasets is effective when combined with GenHPF, resulting in a 0.6%P AUROC improvement compared to models without pretraining. By eliminating the need for preprocessing and feature engineering, we believe that this work offers a solid framework for multi-task and multi-source learning that can be leveraged to speed up the scaling and usage of predictive algorithms in healthcare.

  • 10 authors
·
Jul 20, 2022

TWLV-I: Analysis and Insights from Holistic Evaluation on Video Foundation Models

In this work, we discuss evaluating video foundation models in a fair and robust manner. Unlike language or image foundation models, many video foundation models are evaluated with differing parameters (such as sampling rate, number of frames, pretraining steps, etc.), making fair and robust comparisons challenging. Therefore, we present a carefully designed evaluation framework for measuring two core capabilities of video comprehension: appearance and motion understanding. Our findings reveal that existing video foundation models, whether text-supervised like UMT or InternVideo2, or self-supervised like V-JEPA, exhibit limitations in at least one of these capabilities. As an alternative, we introduce TWLV-I, a new video foundation model that constructs robust visual representations for both motion- and appearance-based videos. Based on the average top-1 accuracy of linear probing on five action recognition benchmarks, pretrained only on publicly accessible datasets, our model shows a 4.6%p improvement compared to V-JEPA (ViT-L) and a 7.7%p improvement compared to UMT (ViT-L). Even when compared to much larger models, our model demonstrates a 7.2%p improvement compared to DFN (ViT-H), a 2.7%p improvement compared to V-JEPA~(ViT-H) and a 2.8%p improvement compared to InternVideo2 (ViT-g). We provide embedding vectors obtained by TWLV-I from videos of several commonly used video benchmarks, along with evaluation source code that can directly utilize these embeddings. The code is available on "https://github.com/twelvelabs-io/video-embeddings-evaluation-framework".

  • 21 authors
·
Aug 20, 2024 2

InfiMed-Foundation: Pioneering Advanced Multimodal Medical Models with Compute-Efficient Pre-Training and Multi-Stage Fine-Tuning

Multimodal large language models (MLLMs) have shown remarkable potential in various domains, yet their application in the medical field is hindered by several challenges. General-purpose MLLMs often lack the specialized knowledge required for medical tasks, leading to uncertain or hallucinatory responses. Knowledge distillation from advanced models struggles to capture domain-specific expertise in radiology and pharmacology. Additionally, the computational cost of continual pretraining with large-scale medical data poses significant efficiency challenges. To address these issues, we propose InfiMed-Foundation-1.7B and InfiMed-Foundation-4B, two medical-specific MLLMs designed to deliver state-of-the-art performance in medical applications. We combined high-quality general-purpose and medical multimodal data and proposed a novel five-dimensional quality assessment framework to curate high-quality multimodal medical datasets. We employ low-to-high image resolution and multimodal sequence packing to enhance training efficiency, enabling the integration of extensive medical data. Furthermore, a three-stage supervised fine-tuning process ensures effective knowledge extraction for complex medical tasks. Evaluated on the MedEvalKit framework, InfiMed-Foundation-1.7B outperforms Qwen2.5VL-3B, while InfiMed-Foundation-4B surpasses HuatuoGPT-V-7B and MedGemma-27B-IT, demonstrating superior performance in medical visual question answering and diagnostic tasks. By addressing key challenges in data quality, training efficiency, and domain-specific knowledge extraction, our work paves the way for more reliable and effective AI-driven solutions in healthcare. InfiMed-Foundation-4B model is available at https://huggingface.co/InfiX-ai/InfiMed-Foundation-4B{InfiMed-Foundation-4B}.

  • 6 authors
·
Sep 26, 2025

Anywhere: A Multi-Agent Framework for Reliable and Diverse Foreground-Conditioned Image Inpainting

Recent advancements in image inpainting, particularly through diffusion modeling, have yielded promising outcomes. However, when tested in scenarios involving the completion of images based on the foreground objects, current methods that aim to inpaint an image in an end-to-end manner encounter challenges such as "over-imagination", inconsistency between foreground and background, and limited diversity. In response, we introduce Anywhere, a pioneering multi-agent framework designed to address these issues. Anywhere utilizes a sophisticated pipeline framework comprising various agents such as Visual Language Model (VLM), Large Language Model (LLM), and image generation models. This framework consists of three principal components: the prompt generation module, the image generation module, and the outcome analyzer. The prompt generation module conducts a semantic analysis of the input foreground image, leveraging VLM to predict relevant language descriptions and LLM to recommend optimal language prompts. In the image generation module, we employ a text-guided canny-to-image generation model to create a template image based on the edge map of the foreground image and language prompts, and an image refiner to produce the outcome by blending the input foreground and the template image. The outcome analyzer employs VLM to evaluate image content rationality, aesthetic score, and foreground-background relevance, triggering prompt and image regeneration as needed. Extensive experiments demonstrate that our Anywhere framework excels in foreground-conditioned image inpainting, mitigating "over-imagination", resolving foreground-background discrepancies, and enhancing diversity. It successfully elevates foreground-conditioned image inpainting to produce more reliable and diverse results.

  • 8 authors
·
Apr 29, 2024

EchoPrime: A Multi-Video View-Informed Vision-Language Model for Comprehensive Echocardiography Interpretation

Echocardiography is the most widely used cardiac imaging modality, capturing ultrasound video data to assess cardiac structure and function. Artificial intelligence (AI) in echocardiography has the potential to streamline manual tasks and improve reproducibility and precision. However, most echocardiography AI models are single-view, single-task systems that do not synthesize complementary information from multiple views captured during a full exam, and thus lead to limited performance and scope of applications. To address this problem, we introduce EchoPrime, a multi-view, view-informed, video-based vision-language foundation model trained on over 12 million video-report pairs. EchoPrime uses contrastive learning to train a unified embedding model for all standard views in a comprehensive echocardiogram study with representation of both rare and common diseases and diagnoses. EchoPrime then utilizes view-classification and a view-informed anatomic attention model to weight video-specific interpretations that accurately maps the relationship between echocardiographic views and anatomical structures. With retrieval-augmented interpretation, EchoPrime integrates information from all echocardiogram videos in a comprehensive study and performs holistic comprehensive clinical echocardiography interpretation. In datasets from two independent healthcare systems, EchoPrime achieves state-of-the art performance on 23 diverse benchmarks of cardiac form and function, surpassing the performance of both task-specific approaches and prior foundation models. Following rigorous clinical evaluation, EchoPrime can assist physicians in the automated preliminary assessment of comprehensive echocardiography.

  • 8 authors
·
Oct 12, 2024 5

Panacea: A foundation model for clinical trial search, summarization, design, and recruitment

Clinical trials are fundamental in developing new drugs, medical devices, and treatments. However, they are often time-consuming and have low success rates. Although there have been initial attempts to create large language models (LLMs) for clinical trial design and patient-trial matching, these models remain task-specific and not adaptable to diverse clinical trial tasks. To address this challenge, we propose a clinical trial foundation model named Panacea, designed to handle multiple tasks, including trial search, trial summarization, trial design, and patient-trial matching. We also assemble a large-scale dataset, named TrialAlign, of 793,279 trial documents and 1,113,207 trial-related scientific papers, to infuse clinical knowledge into the model by pre-training. We further curate TrialInstruct, which has 200,866 of instruction data for fine-tuning. These resources enable Panacea to be widely applicable for a range of clinical trial tasks based on user requirements. We evaluated Panacea on a new benchmark, named TrialPanorama, which covers eight clinical trial tasks. Our method performed the best on seven of the eight tasks compared to six cutting-edge generic or medicine-specific LLMs. Specifically, Panacea showed great potential to collaborate with human experts in crafting the design of eligibility criteria, study arms, and outcome measures, in multi-round conversations. In addition, Panacea achieved 14.42% improvement in patient-trial matching, 41.78% to 52.02% improvement in trial search, and consistently ranked at the top for five aspects of trial summarization. Our approach demonstrates the effectiveness of Panacea in clinical trials and establishes a comprehensive resource, including training data, model, and benchmark, for developing clinical trial foundation models, paving the path for AI-based clinical trial development.

  • 5 authors
·
Jun 25, 2024

Machine Learning Workflow to Explain Black-box Models for Early Alzheimer's Disease Classification Evaluated for Multiple Datasets

Purpose: Hard-to-interpret Black-box Machine Learning (ML) were often used for early Alzheimer's Disease (AD) detection. Methods: To interpret eXtreme Gradient Boosting (XGBoost), Random Forest (RF), and Support Vector Machine (SVM) black-box models a workflow based on Shapley values was developed. All models were trained on the Alzheimer's Disease Neuroimaging Initiative (ADNI) dataset and evaluated for an independent ADNI test set, as well as the external Australian Imaging and Lifestyle flagship study of Ageing (AIBL), and Open Access Series of Imaging Studies (OASIS) datasets. Shapley values were compared to intuitively interpretable Decision Trees (DTs), and Logistic Regression (LR), as well as natural and permutation feature importances. To avoid the reduction of the explanation validity caused by correlated features, forward selection and aspect consolidation were implemented. Results: Some black-box models outperformed DTs and LR. The forward-selected features correspond to brain areas previously associated with AD. Shapley values identified biologically plausible associations with moderate to strong correlations with feature importances. The most important RF features to predict AD conversion were the volume of the amygdalae, and a cognitive test score. Good cognitive test performances and large brain volumes decreased the AD risk. The models trained using cognitive test scores significantly outperformed brain volumetric models (p<0.05). Cognitive Normal (CN) vs. AD models were successfully transferred to external datasets. Conclusion: In comparison to previous work, improved performances for ADNI and AIBL were achieved for CN vs. Mild Cognitive Impairment (MCI) classification using brain volumes. The Shapley values and the feature importances showed moderate to strong correlations.

  • 2 authors
·
May 12, 2022

MEDIC: Towards a Comprehensive Framework for Evaluating LLMs in Clinical Applications

The rapid development of Large Language Models (LLMs) for healthcare applications has spurred calls for holistic evaluation beyond frequently-cited benchmarks like USMLE, to better reflect real-world performance. While real-world assessments are valuable indicators of utility, they often lag behind the pace of LLM evolution, likely rendering findings obsolete upon deployment. This temporal disconnect necessitates a comprehensive upfront evaluation that can guide model selection for specific clinical applications. We introduce MEDIC, a framework assessing LLMs across five critical dimensions of clinical competence: medical reasoning, ethics and bias, data and language understanding, in-context learning, and clinical safety. MEDIC features a novel cross-examination framework quantifying LLM performance across areas like coverage and hallucination detection, without requiring reference outputs. We apply MEDIC to evaluate LLMs on medical question-answering, safety, summarization, note generation, and other tasks. Our results show performance disparities across model sizes, baseline vs medically finetuned models, and have implications on model selection for applications requiring specific model strengths, such as low hallucination or lower cost of inference. MEDIC's multifaceted evaluation reveals these performance trade-offs, bridging the gap between theoretical capabilities and practical implementation in healthcare settings, ensuring that the most promising models are identified and adapted for diverse healthcare applications.

  • 10 authors
·
Sep 11, 2024 6

DAEDRA: A language model for predicting outcomes in passive pharmacovigilance reporting

Over the recent years, the emergence of large language models (LLMs) has given rise to a proliferation of domain-specific models that are intended to reflect the particularities of linguistic context and content as a correlate of the originating domain. This paper details the conception, design, training and evaluation of DAEDRA, a LLM designed to detect regulatory-relevant outcomes (mortality, ER attendance and hospitalisation) in adverse event reports elicited through passive reporting (PR). While PR is a highly cost-efficient way of eliciting information from a wide and diverse audience -- typically including not only physicians and healthcare providers but also patients, family members and other lay stakeholders --, this diversity makes PR corpora difficult to analyse. Generic language models may not capture the complex clinical dimensions while specific clinical or biomedical models may not perform well on lay reports. To evaluate the utility of a subdomain-specific language model, an adaptive training approach was adapted, wherein base language model candidates were evaluated on a subset of the corpus, and the best performer was trained on the entire corpus. This yielded a small but significant improvement in F_1 (+1%), precision (+2.5%) and recall (+3.8%), at a relatively low training cost and a single-day training time. Subdomain-specific LLMs continue to be viable options for better results when analysing highly specialised corpora.

  • 1 authors
·
Feb 10, 2024

RAFT: Rationale adaptor for few-shot abusive language detection

Abusive language is a concerning problem in online social media. Past research on detecting abusive language covers different platforms, languages, demographies, etc. However, models trained using these datasets do not perform well in cross-domain evaluation settings. To overcome this, a common strategy is to use a few samples from the target domain to train models to get better performance in that domain (cross-domain few-shot training). However, this might cause the models to overfit the artefacts of those samples. A compelling solution could be to guide the models toward rationales, i.e., spans of text that justify the text's label. This method has been found to improve model performance in the in-domain setting across various NLP tasks. In this paper, we propose RAFT (Rationale Adaptor for Few-shoT classification) for abusive language detection. We first build a multitask learning setup to jointly learn rationales, targets, and labels, and find a significant improvement of 6% macro F1 on the rationale detection task over training solely rationale classifiers. We introduce two rationale-integrated BERT-based architectures (the RAFT models) and evaluate our systems over five different abusive language datasets, finding that in the few-shot classification setting, RAFT-based models outperform baseline models by about 7% in macro F1 scores and perform competitively to models finetuned on other source domains. Furthermore, RAFT-based models outperform LIME/SHAP-based approaches in terms of plausibility and are close in performance in terms of faithfulness.

  • 5 authors
·
Nov 30, 2022

Case-Grounded Evidence Verification: A Framework for Constructing Evidence-Sensitive Supervision

Evidence-grounded reasoning requires more than attaching retrieved text to a prediction: a model should make decisions that depend on whether the provided evidence supports the target claim. In practice, this often fails because supervision is weak, evidence is only loosely tied to the claim, and evaluation does not test evidence dependence directly. We introduce case-grounded evidence verification, a general framework in which a model receives a local case context, external evidence, and a structured claim, and must decide whether the evidence supports the claim for that case. Our key contribution is a supervision construction procedure that generates explicit support examples together with semantically controlled non-support examples, including counterfactual wrong-state and topic-related negatives, without manual evidence annotation. We instantiate the framework in radiology and train a standard verifier on the resulting support task. The learned verifier substantially outperforms both case-only and evidence-only baselines, remains strong under correct evidence, and collapses when evidence is removed or swapped, indicating genuine evidence dependence. This behavior transfers across unseen evidence articles and an external case distribution, though performance degrades under evidence-source shift and remains sensitive to backbone choice. Overall, the results suggest that a major bottleneck in evidence grounding is not only model capacity, but the lack of supervision that encodes the causal role of evidence.

  • 5 authors
·
Apr 9

Search is All You Need for Few-shot Anomaly Detection

Few-shot anomaly detection (FSAD) has emerged as a crucial yet challenging task in industrial inspection, where normal distribution modeling must be accomplished with only a few normal images. While existing approaches typically employ multi-modal foundation models combining language and vision modalities for prompt-guided anomaly detection, these methods often demand sophisticated prompt engineering and extensive manual tuning. In this paper, we demonstrate that a straightforward nearest-neighbor search framework can surpass state-of-the-art performance in both single-class and multi-class FSAD scenarios. Our proposed method, VisionAD, consists of four simple yet essential components: (1) scalable vision foundation models that extract universal and discriminative features; (2) dual augmentation strategies - support augmentation to enhance feature matching adaptability and query augmentation to address the oversights of single-view prediction; (3) multi-layer feature integration that captures both low-frequency global context and high-frequency local details with minimal computational overhead; and (4) a class-aware visual memory bank enabling efficient one-for-all multi-class detection. Extensive evaluations across MVTec-AD, VisA, and Real-IAD benchmarks demonstrate VisionAD's exceptional performance. Using only 1 normal images as support, our method achieves remarkable image-level AUROC scores of 97.4%, 94.8%, and 70.8% respectively, outperforming current state-of-the-art approaches by significant margins (+1.6%, +3.2%, and +1.4%). The training-free nature and superior few-shot capabilities of VisionAD make it particularly appealing for real-world applications where samples are scarce or expensive to obtain. Code is available at https://github.com/Qiqigeww/VisionAD.

  • 8 authors
·
Apr 16, 2025

Explainable Depression Symptom Detection in Social Media

Users of social platforms often perceive these sites as supportive spaces to post about their mental health issues. Those conversations contain important traces about individuals' health risks. Recently, researchers have exploited this online information to construct mental health detection models, which aim to identify users at risk on platforms like Twitter, Reddit or Facebook. Most of these models are centred on achieving good classification results, ignoring the explainability and interpretability of the decisions. Recent research has pointed out the importance of using clinical markers, such as the use of symptoms, to improve trust in the computational models by health professionals. In this paper, we propose using transformer-based architectures to detect and explain the appearance of depressive symptom markers in the users' writings. We present two approaches: i) train a model to classify, and another one to explain the classifier's decision separately and ii) unify the two tasks simultaneously using a single model. Additionally, for this latter manner, we also investigated the performance of recent conversational LLMs when using in-context learning. Our natural language explanations enable clinicians to interpret the models' decisions based on validated symptoms, enhancing trust in the automated process. We evaluate our approach using recent symptom-based datasets, employing both offline and expert-in-the-loop metrics to assess the quality of the explanations generated by our models. The experimental results show that it is possible to achieve good classification results while generating interpretable symptom-based explanations.

  • 3 authors
·
Oct 20, 2023

CheXagent: Towards a Foundation Model for Chest X-Ray Interpretation

Chest X-rays (CXRs) are the most frequently performed imaging test in clinical practice. Recent advances in the development of vision-language foundation models (FMs) give rise to the possibility of performing automated CXR interpretation, which can assist physicians with clinical decision-making and improve patient outcomes. However, developing FMs that can accurately interpret CXRs is challenging due to the (1) limited availability of large-scale vision-language datasets in the medical image domain, (2) lack of vision and language encoders that can capture the complexities of medical data, and (3) absence of evaluation frameworks for benchmarking the abilities of FMs on CXR interpretation. In this work, we address these challenges by first introducing CheXinstruct - a large-scale instruction-tuning dataset curated from 28 publicly-available datasets. We then present CheXagent - an instruction-tuned FM capable of analyzing and summarizing CXRs. To build CheXagent, we design a clinical large language model (LLM) for parsing radiology reports, a vision encoder for representing CXR images, and a network to bridge the vision and language modalities. Finally, we introduce CheXbench - a novel benchmark designed to systematically evaluate FMs across 8 clinically-relevant CXR interpretation tasks. Extensive quantitative evaluations and qualitative reviews with five expert radiologists demonstrate that CheXagent outperforms previously-developed general- and medical-domain FMs on CheXbench tasks. Furthermore, in an effort to improve model transparency, we perform a fairness evaluation across factors of sex, race and age to highlight potential performance disparities. Our project is at https://stanford-aimi.github.io/chexagent.html.

  • 17 authors
·
Jan 22, 2024 2

An Explainable Diagnostic Framework for Neurodegenerative Dementias via Reinforcement-Optimized LLM Reasoning

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.

  • 6 authors
·
May 26, 2025 2

ImDiffusion: Imputed Diffusion Models for Multivariate Time Series Anomaly Detection

Anomaly detection in multivariate time series data is of paramount importance for ensuring the efficient operation of large-scale systems across diverse domains. However, accurately detecting anomalies in such data poses significant challenges. Existing approaches, including forecasting and reconstruction-based methods, struggle to address these challenges effectively. To overcome these limitations, we propose a novel anomaly detection framework named ImDiffusion, which combines time series imputation and diffusion models to achieve accurate and robust anomaly detection. The imputation-based approach employed by ImDiffusion leverages the information from neighboring values in the time series, enabling precise modeling of temporal and inter-correlated dependencies, reducing uncertainty in the data, thereby enhancing the robustness of the anomaly detection process. ImDiffusion further leverages diffusion models as time series imputers to accurately capturing complex dependencies. We leverage the step-by-step denoised outputs generated during the inference process to serve as valuable signals for anomaly prediction, resulting in improved accuracy and robustness of the detection process. We evaluate the performance of ImDiffusion via extensive experiments on benchmark datasets. The results demonstrate that our proposed framework significantly outperforms state-of-the-art approaches in terms of detection accuracy and timeliness. ImDiffusion is further integrated into the real production system in Microsoft and observe a remarkable 11.4% increase in detection F1 score compared to the legacy approach. To the best of our knowledge, ImDiffusion represents a pioneering approach that combines imputation-based techniques with time series anomaly detection, while introducing the novel use of diffusion models to the field.

  • 10 authors
·
Jul 3, 2023

Pathology-CoT: Learning Visual Chain-of-Thought Agent from Expert Whole Slide Image Diagnosis Behavior

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.

zhihuanglab Zhi Huang Lab
·
Oct 6, 2025 2

Expert-level vision-language foundation model for real-world radiology and comprehensive evaluation

Radiology is a vital and complex component of modern clinical workflow and covers many tasks. Recently, vision-language (VL) foundation models in medicine have shown potential in processing multimodal information, offering a unified solution for various radiology tasks. However, existing studies either pre-trained VL models on natural data or did not fully integrate vision-language architecture and pretraining, often neglecting the unique multimodal complexity in radiology images and their textual contexts. Additionally, their practical applicability in real-world scenarios remains underexplored. Here, we present RadFound, a large and open-source vision-language foundation model tailored for radiology, that is trained on the most extensive dataset of over 8.1 million images and 250,000 image-text pairs, covering 19 major organ systems and 10 imaging modalities. To establish expert-level multimodal perception and generation capabilities, RadFound introduces an enhanced vision encoder to capture intra-image local features and inter-image contextual information, and a unified cross-modal learning design tailored to radiology. To fully assess the models' capability, we construct a benchmark, RadVLBench, including radiology interpretation tasks like medical vision-language question-answering, as well as text generation tasks ranging from captioning to report generation. We also propose a human evaluation framework. When evaluated on the real-world benchmark involving three representative modalities, 2D images (chest X-rays), multi-view images (mammograms), and 3D images (thyroid CT scans), RadFound significantly outperforms other VL foundation models on both quantitative metrics and human evaluation. In summary, the development of RadFound represents an advancement in radiology generalists, demonstrating broad applicability potential for integration into clinical workflows.

  • 9 authors
·
Sep 24, 2024

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

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

  • 3 authors
·
Aug 28, 2024 1

Towards a clinically accessible radiology foundation model: open-access and lightweight, with automated evaluation

The scaling laws and extraordinary performance of large foundation models motivate the development and utilization of such models in biomedicine. However, despite early promising results on some biomedical benchmarks, there are still major challenges that need to be addressed before these models can be used in real-world clinics. Frontier general-domain models such as GPT-4V still have significant performance gaps in multimodal biomedical applications. More importantly, less-acknowledged pragmatic issues, including accessibility, model cost, and tedious manual evaluation make it hard for clinicians to use state-of-the-art large models directly on private patient data. Here, we explore training open-source small multimodal models (SMMs) to bridge competency gaps for unmet clinical needs in radiology. To maximize data efficiency, we adopt a modular approach by incorporating state-of-the-art pre-trained models for image and text modalities, and focusing on training a lightweight adapter to ground each modality to the text embedding space, as exemplified by LLaVA-Med. For training, we assemble a large dataset of over 697 thousand radiology image-text pairs. For evaluation, we propose CheXprompt, a GPT-4-based metric for factuality evaluation, and demonstrate its parity with expert evaluation. For best practice, we conduct a systematic ablation study on various choices in data engineering and multimodal training. The resulting LlaVA-Rad (7B) model attains state-of-the-art results on standard radiology tasks such as report generation and cross-modal retrieval, even outperforming much larger models such as GPT-4V and Med-PaLM M (84B). The inference of LlaVA-Rad is fast and can be performed on a single V100 GPU in private settings, offering a promising state-of-the-art tool for real-world clinical applications.

  • 27 authors
·
Mar 12, 2024

Intent-based Prompt Calibration: Enhancing prompt optimization with synthetic boundary cases

Prompt engineering is a challenging and important task due to the high sensitivity of Large Language Models (LLMs) to the given prompt and the inherent ambiguity of a textual task instruction. Automatic prompt engineering is essential to achieve optimized performance from LLMs. Recent studies have demonstrated the capabilities of LLMs to automatically conduct prompt engineering by employing a meta-prompt that incorporates the outcomes of the last trials and proposes an improved prompt. However, this requires a high-quality benchmark to compare different prompts, which is difficult and expensive to acquire in many real-world use cases. In this work, we introduce a new method for automatic prompt engineering, using a calibration process that iteratively refines the prompt to the user intent. During the optimization process, the system jointly generates synthetic data of boundary use cases and optimizes the prompt according to the generated dataset. We demonstrate the effectiveness of our method with respect to strong proprietary models on real-world tasks such as moderation and generation. Our method outperforms state-of-the-art methods with a limited number of annotated samples. Furthermore, we validate the advantages of each one of the system's key components. Our system is built in a modular way, facilitating easy adaptation to other tasks. The code is available https://github.com/Eladlev/AutoPrompt{here}.

  • 3 authors
·
Feb 5, 2024

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

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

  • 6 authors
·
Mar 23, 2023

Adapting LLMs for Efficient Context Processing through Soft Prompt Compression

The rapid advancement of Large Language Models (LLMs) has inaugurated a transformative epoch in natural language processing, fostering unprecedented proficiency in text generation, comprehension, and contextual scrutiny. Nevertheless, effectively handling extensive contexts, crucial for myriad applications, poses a formidable obstacle owing to the intrinsic constraints of the models' context window sizes and the computational burdens entailed by their operations. This investigation presents an innovative framework that strategically tailors LLMs for streamlined context processing by harnessing the synergies among natural language summarization, soft prompt compression, and augmented utility preservation mechanisms. Our methodology, dubbed SoftPromptComp, amalgamates natural language prompts extracted from summarization methodologies with dynamically generated soft prompts to forge a concise yet semantically robust depiction of protracted contexts. This depiction undergoes further refinement via a weighting mechanism optimizing information retention and utility for subsequent tasks. We substantiate that our framework markedly diminishes computational overhead and enhances LLMs' efficacy across various benchmarks, while upholding or even augmenting the caliber of the produced content. By amalgamating soft prompt compression with sophisticated summarization, SoftPromptComp confronts the dual challenges of managing lengthy contexts and ensuring model scalability. Our findings point towards a propitious trajectory for augmenting LLMs' applicability and efficiency, rendering them more versatile and pragmatic for real-world applications. This research enriches the ongoing discourse on optimizing language models, providing insights into the potency of soft prompts and summarization techniques as pivotal instruments for the forthcoming generation of NLP solutions.

  • 8 authors
·
Apr 7, 2024

Beyond One-Size-Fits-All: Personalized Harmful Content Detection with In-Context Learning

The proliferation of harmful online content--e.g., toxicity, spam, and negative sentiment--demands robust and adaptable moderation systems. However, prevailing moderation systems are centralized and task-specific, offering limited transparency and neglecting diverse user preferences--an approach ill-suited for privacy-sensitive or decentralized environments. We propose a novel framework that leverages in-context learning (ICL) with foundation models to unify the detection of toxicity, spam, and negative sentiment across binary, multi-class, and multi-label settings. Crucially, our approach enables lightweight personalization, allowing users to easily block new categories, unblock existing ones, or extend detection to semantic variations through simple prompt-based interventions--all without model retraining. Extensive experiments on public benchmarks (TextDetox, UCI SMS, SST2) and a new, annotated Mastodon dataset reveal that: (i) foundation models achieve strong cross-task generalization, often matching or surpassing task-specific fine-tuned models; (ii) effective personalization is achievable with as few as one user-provided example or definition; and (iii) augmenting prompts with label definitions or rationales significantly enhances robustness to noisy, real-world data. Our work demonstrates a definitive shift beyond one-size-fits-all moderation, establishing ICL as a practical, privacy-preserving, and highly adaptable pathway for the next generation of user-centric content safety systems. To foster reproducibility and facilitate future research, we publicly release our code on GitHub and the annotated Mastodon dataset on Hugging Face.

  • 3 authors
·
Oct 29, 2025

Towards Zero-Shot Anomaly Detection and Reasoning with Multimodal Large Language Models

Zero-Shot Anomaly Detection (ZSAD) is an emerging AD paradigm. Unlike the traditional unsupervised AD setting that requires a large number of normal samples to train a model, ZSAD is more practical for handling data-restricted real-world scenarios. Recently, Multimodal Large Language Models (MLLMs) have shown revolutionary reasoning capabilities in various vision tasks. However, the reasoning of image abnormalities remains underexplored due to the lack of corresponding datasets and benchmarks. To facilitate research in AD & reasoning, we establish the first visual instruction tuning dataset, Anomaly-Instruct-125k, and the evaluation benchmark, VisA-D&R. Through investigation with our benchmark, we reveal that current MLLMs like GPT-4o cannot accurately detect and describe fine-grained anomalous details in images. To address this, we propose Anomaly-OneVision (Anomaly-OV), the first specialist visual assistant for ZSAD and reasoning. Inspired by human behavior in visual inspection, Anomaly-OV leverages a Look-Twice Feature Matching (LTFM) mechanism to adaptively select and emphasize abnormal visual tokens. Extensive experiments demonstrate that Anomaly-OV achieves significant improvements over advanced generalist models in both detection and reasoning. Extensions to medical and 3D AD are provided for future study. The link to our project page: https://xujiacong.github.io/Anomaly-OV/

  • 5 authors
·
Feb 11, 2025

Are Anomaly Scores Telling the Whole Story? A Benchmark for Multilevel Anomaly Detection

Anomaly detection (AD) is a machine learning task that identifies anomalies by learning patterns from normal training data. In many real-world scenarios, anomalies vary in severity, from minor anomalies with little risk to severe abnormalities requiring immediate attention. However, existing models primarily operate in a binary setting, and the anomaly scores they produce are usually based on the deviation of data points from normal data, which may not accurately reflect practical severity. In this paper, we address this gap by making three key contributions. First, we propose a novel setting, Multilevel AD (MAD), in which the anomaly score represents the severity of anomalies in real-world applications, and we highlight its diverse applications across various domains. Second, we introduce a novel benchmark, MAD-Bench, that evaluates models not only on their ability to detect anomalies, but also on how effectively their anomaly scores reflect severity. This benchmark incorporates multiple types of baselines and real-world applications involving severity. Finally, we conduct a comprehensive performance analysis on MAD-Bench. We evaluate models on their ability to assign severity-aligned scores, investigate the correspondence between their performance on binary and multilevel detection, and study their robustness. This analysis offers key insights into improving AD models for practical severity alignment. The code framework and datasets used for the benchmark will be made publicly available.

  • 7 authors
·
Nov 21, 2024

AdvQDet: Detecting Query-Based Adversarial Attacks with Adversarial Contrastive Prompt Tuning

Deep neural networks (DNNs) are known to be vulnerable to adversarial attacks even under a black-box setting where the adversary can only query the model. Particularly, query-based black-box adversarial attacks estimate adversarial gradients based on the returned probability vectors of the target model for a sequence of queries. During this process, the queries made to the target model are intermediate adversarial examples crafted at the previous attack step, which share high similarities in the pixel space. Motivated by this observation, stateful detection methods have been proposed to detect and reject query-based attacks. While demonstrating promising results, these methods either have been evaded by more advanced attacks or suffer from low efficiency in terms of the number of shots (queries) required to detect different attacks. Arguably, the key challenge here is to assign high similarity scores for any two intermediate adversarial examples perturbed from the same clean image. To address this challenge, we propose a novel Adversarial Contrastive Prompt Tuning (ACPT) method to robustly fine-tune the CLIP image encoder to extract similar embeddings for any two intermediate adversarial queries. With ACPT, we further introduce a detection framework AdvQDet that can detect 7 state-of-the-art query-based attacks with >99% detection rate within 5 shots. We also show that ACPT is robust to 3 types of adaptive attacks. Code is available at https://github.com/xinwong/AdvQDet.

  • 6 authors
·
Aug 4, 2024

MoRE: Multi-Modal Contrastive Pre-training with Transformers on X-Rays, ECGs, and Diagnostic Report

In this paper, we introduce a novel Multi-Modal Contrastive Pre-training Framework that synergistically combines X-rays, electrocardiograms (ECGs), and radiology/cardiology reports. Our approach leverages transformers to encode these diverse modalities into a unified representation space, aiming to enhance diagnostic accuracy and facilitate comprehensive patient assessments. We utilize LoRA-Peft to significantly reduce trainable parameters in the LLM and incorporate recent linear attention dropping strategy in the Vision Transformer(ViT) for smoother attention. Furthermore, we provide novel multimodal attention explanations and retrieval for our model. To the best of our knowledge, we are the first to propose an integrated model that combines X-ray, ECG, and Radiology/Cardiology Report with this approach. By utilizing contrastive loss, MoRE effectively aligns modality-specific features into a coherent embedding, which supports various downstream tasks such as zero-shot classification and multimodal retrieval. Employing our proposed methodology, we achieve state-of-the-art (SOTA) on the Mimic-IV, CheXpert, Edema Severity, and PtbXl downstream datasets, surpassing existing multimodal approaches. Our proposed framework shows significant improvements in capturing intricate inter-modal relationships and its robustness in medical diagnosis that establishes a framework for future research in multimodal learning in the healthcare sector.

  • 4 authors
·
Oct 21, 2024

Lunguage: A Benchmark for Structured and Sequential Chest X-ray Interpretation

Radiology reports convey detailed clinical observations and capture diagnostic reasoning that evolves over time. However, existing evaluation methods are limited to single-report settings and rely on coarse metrics that fail to capture fine-grained clinical semantics and temporal dependencies. We introduce LUNGUAGE,a benchmark dataset for structured radiology report generation that supports both single-report evaluation and longitudinal patient-level assessment across multiple studies. It contains 1,473 annotated chest X-ray reports, each reviewed by experts, and 80 of them contain longitudinal annotations to capture disease progression and inter-study intervals, also reviewed by experts. Using this benchmark, we develop a two-stage framework that transforms generated reports into fine-grained, schema-aligned structured representations, enabling longitudinal interpretation. We also propose LUNGUAGESCORE, an interpretable metric that compares structured outputs at the entity, relation, and attribute level while modeling temporal consistency across patient timelines. These contributions establish the first benchmark dataset, structuring framework, and evaluation metric for sequential radiology reporting, with empirical results demonstrating that LUNGUAGESCORE effectively supports structured report evaluation. The code is available at: https://github.com/SuperSupermoon/Lunguage

kaist-ai KAIST AI
·
May 27, 2025 2

A Text Classification Framework for Simple and Effective Early Depression Detection Over Social Media Streams

With the rise of the Internet, there is a growing need to build intelligent systems that are capable of efficiently dealing with early risk detection (ERD) problems on social media, such as early depression detection, early rumor detection or identification of sexual predators. These systems, nowadays mostly based on machine learning techniques, must be able to deal with data streams since users provide their data over time. In addition, these systems must be able to decide when the processed data is sufficient to actually classify users. Moreover, since ERD tasks involve risky decisions by which people's lives could be affected, such systems must also be able to justify their decisions. However, most standard and state-of-the-art supervised machine learning models are not well suited to deal with this scenario. This is due to the fact that they either act as black boxes or do not support incremental classification/learning. In this paper we introduce SS3, a novel supervised learning model for text classification that naturally supports these aspects. SS3 was designed to be used as a general framework to deal with ERD problems. We evaluated our model on the CLEF's eRisk2017 pilot task on early depression detection. Most of the 30 contributions submitted to this competition used state-of-the-art methods. Experimental results show that our classifier was able to outperform these models and standard classifiers, despite being less computationally expensive and having the ability to explain its rationale.

  • 3 authors
·
May 18, 2019

SpiroLLM: Finetuning Pretrained LLMs to Understand Spirogram Time Series with Clinical Validation in COPD Reporting

Chronic Obstructive Pulmonary Disease (COPD), a major chronic respiratory disease with persistent airflow limitation, is a leading global cause of disability and mortality. Respiratory spirogram time series, routinely collected during pulmonary function tests (PFTs), play a critical role in the early detection of repsiratory diseases and in monitoring lung function over time. However, most current AI models for COPD diagnosis are limited to outputting classification results without providing a rationale for their diagnostic process, while current Large Language Models (LLMs) cannot understand spirograms yet, which severely limits their clinical trust and adoption. To tackle this challenge, we leverage a cohort of 234,028 individuals from the UK Biobank (UKB) to propose SpiroLLM, the first multimodal large language model that can understand spirogram. The model extracts morphological features from respiratory curves via a SpiroEncoder and aligns them with PFT numerical values in a unified latent space using a SpiroProjector, ultimately empowering a large language model to generate a comprehensive diagnostic report. Experimental results confirm that SpiroLLM achieved a diagnostic AUROC of 0.8980 (95% CI: 0.8820-0.9132). In a robustness test with missing core data, it maintained a 100% valid response rate, far surpassing the 13.4% of a text-only model and showcasing the superiority of its multimodal design. This work demonstrates the substantial potential of deeply fusing physiological signals with large language models, establishing a new paradigm for the next generation of interpretable and reliable clinical decision support tools.

  • 8 authors
·
Jul 21, 2025

A Zero-shot Explainable Doctor Ranking Framework with Large Language Models

Online medical service provides patients convenient access to doctors, but effectively ranking doctors based on specific medical needs remains challenging. Current ranking approaches typically lack the interpretability crucial for patient trust and informed decision-making. Additionally, the scarcity of standardized benchmarks and labeled data for supervised learning impedes progress in expertise-aware doctor ranking. To address these challenges, we propose an explainable ranking framework for doctor ranking powered by large language models in a zero-shot setting. Our framework dynamically generates disease-specific ranking criteria to guide the large language model in assessing doctor relevance with transparency and consistency. It further enhances interpretability by generating step-by-step rationales for its ranking decisions, improving the overall explainability of the information retrieval process. To support rigorous evaluation, we built and released DrRank, a novel expertise-driven dataset comprising 38 disease-treatment pairs and 4,325 doctor profiles. On this benchmark, our framework significantly outperforms the strongest baseline by +6.45 NDCG@10. Comprehensive analyses also show our framework is fair across disease types, patient gender, and geographic regions. Furthermore, verification by medical experts confirms the reliability and interpretability of our approach, reinforcing its potential for trustworthy, real-world doctor recommendation. To demonstrate its broader applicability, we validate our framework on two datasets from BEIR benchmark, where it again achieves superior performance. The code and associated data are available at: https://github.com/YangLab-BUPT/DrRank.

  • 3 authors
·
Mar 4, 2025

On Creating a Causally Grounded Usable Rating Method for Assessing the Robustness of Foundation Models Supporting Time Series

Foundation Models (FMs) have improved time series forecasting in various sectors, such as finance, but their vulnerability to input disturbances can hinder their adoption by stakeholders, such as investors and analysts. To address this, we propose a causally grounded rating framework to study the robustness of Foundational Models for Time Series (FMTS) with respect to input perturbations. We evaluate our approach to the stock price prediction problem, a well-studied problem with easily accessible public data, evaluating six state-of-the-art (some multi-modal) FMTS across six prominent stocks spanning three industries. The ratings proposed by our framework effectively assess the robustness of FMTS and also offer actionable insights for model selection and deployment. Within the scope of our study, we find that (1) multi-modal FMTS exhibit better robustness and accuracy compared to their uni-modal versions and, (2) FMTS pre-trained on time series forecasting task exhibit better robustness and forecasting accuracy compared to general-purpose FMTS pre-trained across diverse settings. Further, to validate our framework's usability, we conduct a user study showcasing FMTS prediction errors along with our computed ratings. The study confirmed that our ratings reduced the difficulty for users in comparing the robustness of different systems.

  • 8 authors
·
Feb 17, 2025

MuSc-V2: Zero-Shot Multimodal Industrial Anomaly Classification and Segmentation with Mutual Scoring of Unlabeled Samples

Zero-shot anomaly classification (AC) and segmentation (AS) methods aim to identify and outline defects without using any labeled samples. In this paper, we reveal a key property that is overlooked by existing methods: normal image patches across industrial products typically find many other similar patches, not only in 2D appearance but also in 3D shapes, while anomalies remain diverse and isolated. To explicitly leverage this discriminative property, we propose a Mutual Scoring framework (MuSc-V2) for zero-shot AC/AS, which flexibly supports single 2D/3D or multimodality. Specifically, our method begins by improving 3D representation through Iterative Point Grouping (IPG), which reduces false positives from discontinuous surfaces. Then we use Similarity Neighborhood Aggregation with Multi-Degrees (SNAMD) to fuse 2D/3D neighborhood cues into more discriminative multi-scale patch features for mutual scoring. The core comprises a Mutual Scoring Mechanism (MSM) that lets samples within each modality to assign score to each other, and Cross-modal Anomaly Enhancement (CAE) that fuses 2D and 3D scores to recover modality-specific missing anomalies. Finally, Re-scoring with Constrained Neighborhood (RsCon) suppresses false classification based on similarity to more representative samples. Our framework flexibly works on both the full dataset and smaller subsets with consistently robust performance, ensuring seamless adaptability across diverse product lines. In aid of the novel framework, MuSc-V2 achieves significant performance improvements: a +23.7% AP gain on the MVTec 3D-AD dataset and a +19.3% boost on the Eyecandies dataset, surpassing previous zero-shot benchmarks and even outperforming most few-shot methods. The code will be available at The code will be available at https://github.com/HUST-SLOW/MuSc-V2{https://github.com/HUST-SLOW/MuSc-V2}.

Theoretical Foundations of Latent Posterior Factors: Formal Guarantees for Multi-Evidence Reasoning

We present a complete theoretical characterization of Latent Posterior Factors (LPF), a principled framework for aggregating multiple heterogeneous evidence items in probabilistic prediction tasks. Multi-evidence reasoning arises pervasively in high-stakes domains including healthcare diagnosis, financial risk assessment, legal case analysis, and regulatory compliance, yet existing approaches either lack formal guarantees or fail to handle multi-evidence scenarios architecturally. LPF encodes each evidence item into a Gaussian latent posterior via a variational autoencoder, converting posteriors to soft factors through Monte Carlo marginalization, and aggregating factors via exact Sum-Product Network inference (LPF-SPN) or a learned neural aggregator (LPF-Learned). We prove seven formal guarantees spanning the key desiderata for trustworthy AI: Calibration Preservation (ECE <= epsilon + C/sqrt(K_eff)); Monte Carlo Error decaying as O(1/sqrt(M)); a non-vacuous PAC-Bayes bound with train-test gap of 0.0085 at N=4200; operation within 1.12x of the information-theoretic lower bound; graceful degradation as O(epsilon*delta*sqrt(K)) under corruption, maintaining 88% performance with half of evidence adversarially replaced; O(1/sqrt(K)) calibration decay with R^2=0.849; and exact epistemic-aleatoric uncertainty decomposition with error below 0.002%. All theorems are empirically validated on controlled datasets spanning up to 4,200 training examples. Our theoretical framework establishes LPF as a foundation for trustworthy multi-evidence AI in safety-critical applications.

  • 1 authors
·
Mar 13 2