Daily Papers

When large language model (LLM) agents are increasingly deployed to automate tasks and interact with untrusted external data, prompt injection emerges as a significant security threat. By injecting malicious instructions into the data that LLMs access, an attacker can arbitrarily override the original user task and redirect the agent toward unintended, potentially harmful actions. Existing defenses either require access to model weights (fine-tuning), incur substantial utility loss (detection-based), or demand non-trivial system redesign (system-level). Motivated by this, we propose DataFilter, a test-time model-agnostic defense that removes malicious instructions from the data before it reaches the backend LLM. DataFilter is trained with supervised fine-tuning on simulated injections and leverages both the user's instruction and the data to selectively strip adversarial content while preserving benign information. Across multiple benchmarks, DataFilter consistently reduces the prompt injection attack success rates to near zero while maintaining the LLMs' utility. DataFilter delivers strong security, high utility, and plug-and-play deployment, making it a strong practical defense to secure black-box commercial LLMs against prompt injection. Our DataFilter model is released at https://huggingface.co/JoyYizhu/DataFilter for immediate use, with the code to reproduce our results at https://github.com/yizhu-joy/DataFilter.

Vision-language models (VLMs) are essential for contextual understanding of both visual and textual information. However, their vulnerability to adversarially manipulated inputs presents significant risks, leading to compromised outputs and raising concerns about the reliability in VLM-integrated applications. Detecting these malicious prompts is thus crucial for maintaining trust in VLM generations. A major challenge in developing a safeguarding prompt classifier is the lack of a large amount of labeled benign and malicious data. To address the issue, we introduce VLMGuard, a novel learning framework that leverages the unlabeled user prompts in the wild for malicious prompt detection. These unlabeled prompts, which naturally arise when VLMs are deployed in the open world, consist of both benign and malicious information. To harness the unlabeled data, we present an automated maliciousness estimation score for distinguishing between benign and malicious samples within this unlabeled mixture, thereby enabling the training of a binary prompt classifier on top. Notably, our framework does not require extra human annotations, offering strong flexibility and practicality for real-world applications. Extensive experiment shows VLMGuard achieves superior detection results, significantly outperforming state-of-the-art methods. Disclaimer: This paper may contain offensive examples; reader discretion is advised.

Machine unlearning aims to remove specific content from trained models while preserving overall performance. However, the phenomenon of benign relearning, in which forgotten information reemerges even from benign fine-tuning data, reveals that existing unlearning methods remain fundamentally fragile. A common explanation attributes this effect to topical relevance, but we find this account insufficient. Through systematic analysis, we demonstrate that syntactic similarity, rather than topicality, is the primary driver: across benchmarks, syntactically similar data consistently trigger recovery even without topical overlap, due to their alignment in representations and gradients with the forgotten content. Motivated by this insight, we introduce syntactic diversification, which paraphrases the original forget queries into heterogeneous structures prior to unlearning. This approach effectively suppresses benign relearning, accelerates forgetting, and substantially alleviates the trade-off between unlearning efficacy and model utility.

We identify a novel phenomenon in language models: benign fine-tuning of frontier models can lead to privacy collapse. We find that diverse, subtle patterns in training data can degrade contextual privacy, including optimisation for helpfulness, exposure to user information, emotional and subjective dialogue, and debugging code printing internal variables, among others. Fine-tuned models lose their ability to reason about contextual privacy norms, share information inappropriately with tools, and violate memory boundaries across contexts. Privacy collapse is a ``silent failure'' because models maintain high performance on standard safety and utility benchmarks whilst exhibiting severe privacy vulnerabilities. Our experiments show evidence of privacy collapse across six models (closed and open weight), five fine-tuning datasets (real-world and controlled data), and two task categories (agentic and memory-based). Our mechanistic analysis reveals that privacy representations are uniquely fragile to fine-tuning, compared to task-relevant features which are preserved. Our results reveal a critical gap in current safety evaluations, in particular for the deployment of specialised agents.

When large language models are trained on private data, it can be a significant privacy risk for them to memorize and regurgitate sensitive information. In this work, we propose a new practical data extraction attack that we call "neural phishing". This attack enables an adversary to target and extract sensitive or personally identifiable information (PII), e.g., credit card numbers, from a model trained on user data with upwards of 10% attack success rates, at times, as high as 50%. Our attack assumes only that an adversary can insert as few as 10s of benign-appearing sentences into the training dataset using only vague priors on the structure of the user data.

Multimodal large language models (MLLMs) enable powerful cross-modal reasoning capabilities. However, the expanded input space introduces new attack surfaces. Previous jailbreak attacks often inject malicious instructions from text into less aligned modalities, such as vision. As MLLMs increasingly incorporate cross-modal consistency and alignment mechanisms, such explicit attacks become easier to detect and block. In this work, we propose a novel implicit jailbreak framework termed IJA that stealthily embeds malicious instructions into images via least significant bit steganography and couples them with seemingly benign, image-related textual prompts. To further enhance attack effectiveness across diverse MLLMs, we incorporate adversarial suffixes generated by a surrogate model and introduce a template optimization module that iteratively refines both the prompt and embedding based on model feedback. On commercial models like GPT-4o and Gemini-1.5 Pro, our method achieves attack success rates of over 90% using an average of only 3 queries.

Machine unlearning for LLMs aims to remove sensitive or copyrighted data from trained models. However, the true efficacy of current unlearning methods remains uncertain. Standard evaluation metrics rely on benign queries that often mistake superficial information suppression for genuine knowledge removal. Such metrics fail to detect residual knowledge that more sophisticated prompting strategies could still extract. We introduce REBEL, an evolutionary approach for adversarial prompt generation designed to probe whether unlearned data can still be recovered. Our experiments demonstrate that REBEL successfully elicits ``forgotten'' knowledge from models that seemed to be forgotten in standard unlearning benchmarks, revealing that current unlearning methods may provide only a superficial layer of protection. We validate our framework on subsets of the TOFU and WMDP benchmarks, evaluating performance across a diverse suite of unlearning algorithms. Our experiments show that REBEL consistently outperforms static baselines, recovering ``forgotten'' knowledge with Attack Success Rates (ASRs) reaching up to 60% on TOFU and 93% on WMDP. We will make all code publicly available upon acceptance. Code is available at https://github.com/patryk-rybak/REBEL/

This paper describes EMBER: a labeled benchmark dataset for training machine learning models to statically detect malicious Windows portable executable files. The dataset includes features extracted from 1.1M binary files: 900K training samples (300K malicious, 300K benign, 300K unlabeled) and 200K test samples (100K malicious, 100K benign). To accompany the dataset, we also release open source code for extracting features from additional binaries so that additional sample features can be appended to the dataset. This dataset fills a void in the information security machine learning community: a benign/malicious dataset that is large, open and general enough to cover several interesting use cases. We enumerate several use cases that we considered when structuring the dataset. Additionally, we demonstrate one use case wherein we compare a baseline gradient boosted decision tree model trained using LightGBM with default settings to MalConv, a recently published end-to-end (featureless) deep learning model for malware detection. Results show that even without hyper-parameter optimization, the baseline EMBER model outperforms MalConv. The authors hope that the dataset, code and baseline model provided by EMBER will help invigorate machine learning research for malware detection, in much the same way that benchmark datasets have advanced computer vision research.

We present a demonstration of a large language model engaging in alignment faking: selectively complying with its training objective in training to prevent modification of its behavior out of training. First, we give Claude 3 Opus a system prompt stating it is being trained to answer all queries, even harmful ones, which conflicts with its prior training to refuse such queries. To allow the model to infer when it is in training, we say it will be trained only on conversations with free users, not paid users. We find the model complies with harmful queries from free users 14% of the time, versus almost never for paid users. Explaining this gap, in almost all cases where the model complies with a harmful query from a free user, we observe explicit alignment-faking reasoning, with the model stating it is strategically answering harmful queries in training to preserve its preferred harmlessness behavior out of training. Next, we study a more realistic setting where information about the training process is provided not in a system prompt, but by training on synthetic documents that mimic pre-training data--and observe similar alignment faking. Finally, we study the effect of actually training the model to comply with harmful queries via reinforcement learning, which we find increases the rate of alignment-faking reasoning to 78%, though also increases compliance even out of training. We additionally observe other behaviors such as the model exfiltrating its weights when given an easy opportunity. While we made alignment faking easier by telling the model when and by what criteria it was being trained, we did not instruct the model to fake alignment or give it any explicit goal. As future models might infer information about their training process without being told, our results suggest a risk of alignment faking in future models, whether due to a benign preference--as in this case--or not.

Jailbreaking is an essential adversarial technique for red-teaming these models to uncover and patch security flaws. However, existing jailbreak methods face significant drawbacks. Token-level jailbreak attacks often produce incoherent or unreadable inputs and exhibit poor transferability, while prompt-level attacks lack scalability and rely heavily on manual effort and human ingenuity. We propose a concise and effective two-stage framework that combines the advantages of these approaches. The first stage performs a scenario-based generation of context and rephrases the original malicious query to obscure its harmful intent. The second stage then utilizes information from the model's hidden states to guide fine-grained edits, effectively steering the model's internal representation of the input from a malicious toward a benign one. Extensive experiments demonstrate that this method achieves state-of-the-art Attack Success Rate, with gains of up to 37.74% over the strongest baseline, and exhibits excellent transferability to black-box models. Our analysis further demonstrates that AGILE maintains substantial effectiveness against prominent defense mechanisms, highlighting the limitations of current safeguards and providing valuable insights for future defense development. Our code is available at https://github.com/yunsaijc/AGILE.

Unlearning methods have the potential to improve the privacy and safety of large language models (LLMs) by removing sensitive or harmful information post hoc. The LLM unlearning research community has increasingly turned toward empirical benchmarks to assess the effectiveness of such methods. In this paper, we find that existing benchmarks provide an overly optimistic and potentially misleading view on the effectiveness of candidate unlearning methods. By introducing simple, benign modifications to a number of popular benchmarks, we expose instances where supposedly unlearned information remains accessible, or where the unlearning process has degraded the model's performance on retained information to a much greater extent than indicated by the original benchmark. We identify that existing benchmarks are particularly vulnerable to modifications that introduce even loose dependencies between the forget and retain information. Further, we show that ambiguity in unlearning targets in existing benchmarks can easily lead to the design of methods that overfit to the given test queries. Based on our findings, we urge the community to be cautious when interpreting benchmark results as reliable measures of progress, and we provide several recommendations to guide future LLM unlearning research.

The rapid advancement of large language models (LLMs) introduces dual-use capabilities that could both threaten and bolster national security and public safety (NSPS). Models implement safeguards to protect against potential misuse relevant to NSPS and allow for benign users to receive helpful information. However, current benchmarks often fail to test safeguard robustness to potential NSPS risks in an objective, robust way. We introduce FORTRESS: 500 expert-crafted adversarial prompts with instance-based rubrics of 4-7 binary questions for automated evaluation across 3 domains (unclassified information only): Chemical, Biological, Radiological, Nuclear and Explosive (CBRNE), Political Violence & Terrorism, and Criminal & Financial Illicit Activities, with 10 total subcategories across these domains. Each prompt-rubric pair has a corresponding benign version to test for model over-refusals. This evaluation of frontier LLMs' safeguard robustness reveals varying trade-offs between potential risks and model usefulness: Claude-3.5-Sonnet demonstrates a low average risk score (ARS) (14.09 out of 100) but the highest over-refusal score (ORS) (21.8 out of 100), while Gemini 2.5 Pro shows low over-refusal (1.4) but a high average potential risk (66.29). Deepseek-R1 has the highest ARS at 78.05, but the lowest ORS at only 0.06. Models such as o1 display a more even trade-off between potential risks and over-refusals (with an ARS of 21.69 and ORS of 5.2). To provide policymakers and researchers with a clear understanding of models' potential risks, we publicly release FORTRESS at https://huggingface.co/datasets/ScaleAI/fortress_public. We also maintain a private set for evaluation.

As large language models (LLMs) become integral to multi-agent systems, new privacy risks emerge that extend beyond memorization, direct inference, or single-turn evaluations. In particular, seemingly innocuous responses, when composed across interactions, can cumulatively enable adversaries to recover sensitive information, a phenomenon we term compositional privacy leakage. We present the first systematic study of such compositional privacy leaks and possible mitigation methods in multi-agent LLM systems. First, we develop a framework that models how auxiliary knowledge and agent interactions jointly amplify privacy risks, even when each response is benign in isolation. Next, to mitigate this, we propose and evaluate two defense strategies: (1) Theory-of-Mind defense (ToM), where defender agents infer a questioner's intent by anticipating how their outputs may be exploited by adversaries, and (2) Collaborative Consensus Defense (CoDef), where responder agents collaborate with peers who vote based on a shared aggregated state to restrict sensitive information spread. Crucially, we balance our evaluation across compositions that expose sensitive information and compositions that yield benign inferences. Our experiments quantify how these defense strategies differ in balancing the privacy-utility trade-off. We find that while chain-of-thought alone offers limited protection to leakage (~39% sensitive blocking rate), our ToM defense substantially improves sensitive query blocking (up to 97%) but can reduce benign task success. CoDef achieves the best balance, yielding the highest Balanced Outcome (79.8%), highlighting the benefit of combining explicit reasoning with defender collaboration. Together, our results expose a new class of risks in collaborative LLM deployments and provide actionable insights for designing safeguards against compositional, context-driven privacy leakage.

With over 85 million CT scans performed annually in the United States, creating tumor-related reports is a challenging and time-consuming task for radiologists. To address this need, we present RadGPT, an Anatomy-Aware Vision-Language AI Agent for generating detailed reports from CT scans. RadGPT first segments tumors, including benign cysts and malignant tumors, and their surrounding anatomical structures, then transforms this information into both structured reports and narrative reports. These reports provide tumor size, shape, location, attenuation, volume, and interactions with surrounding blood vessels and organs. Extensive evaluation on unseen hospitals shows that RadGPT can produce accurate reports, with high sensitivity/specificity for small tumor (<2 cm) detection: 80/73% for liver tumors, 92/78% for kidney tumors, and 77/77% for pancreatic tumors. For large tumors, sensitivity ranges from 89% to 97%. The results significantly surpass the state-of-the-art in abdominal CT report generation. RadGPT generated reports for 17 public datasets. Through radiologist review and refinement, we have ensured the reports' accuracy, and created the first publicly available image-text 3D medical dataset, comprising over 1.8 million text tokens and 2.7 million images from 9,262 CT scans, including 2,947 tumor scans/reports of 8,562 tumor instances. Our reports can: (1) localize tumors in eight liver sub-segments and three pancreatic sub-segments annotated per-voxel; (2) determine pancreatic tumor stage (T1-T4) in 260 reports; and (3) present individual analyses of multiple tumors--rare in human-made reports. Importantly, 948 of the reports are for early-stage tumors.

Understanding the vulnerabilities of Large Vision Language Models (LVLMs) to jailbreak attacks is essential for their responsible real-world deployment. Most previous work requires access to model gradients, or is based on human knowledge (prompt engineering) to complete jailbreak, and they hardly consider the interaction of images and text, resulting in inability to jailbreak in black box scenarios or poor performance. To overcome these limitations, we propose a Prior-Guided Bimodal Interactive Black-Box Jailbreak Attack for toxicity maximization, referred to as PBI-Attack. Our method begins by extracting malicious features from a harmful corpus using an alternative LVLM and embedding these features into a benign image as prior information. Subsequently, we enhance these features through bidirectional cross-modal interaction optimization, which iteratively optimizes the bimodal perturbations in an alternating manner through greedy search, aiming to maximize the toxicity of the generated response. The toxicity level is quantified using a well-trained evaluation model. Experiments demonstrate that PBI-Attack outperforms previous state-of-the-art jailbreak methods, achieving an average attack success rate of 92.5% across three open-source LVLMs and around 67.3% on three closed-source LVLMs. Disclaimer: This paper contains potentially disturbing and offensive content.

Current privacy research on large language models (LLMs) primarily focuses on the issue of extracting memorized training data. At the same time, models' inference capabilities have increased drastically. This raises the key question of whether current LLMs could violate individuals' privacy by inferring personal attributes from text given at inference time. In this work, we present the first comprehensive study on the capabilities of pretrained LLMs to infer personal attributes from text. We construct a dataset consisting of real Reddit profiles, and show that current LLMs can infer a wide range of personal attributes (e.g., location, income, sex), achieving up to 85% top-1 and 95.8% top-3 accuracy at a fraction of the cost (100times) and time (240times) required by humans. As people increasingly interact with LLM-powered chatbots across all aspects of life, we also explore the emerging threat of privacy-invasive chatbots trying to extract personal information through seemingly benign questions. Finally, we show that common mitigations, i.e., text anonymization and model alignment, are currently ineffective at protecting user privacy against LLM inference. Our findings highlight that current LLMs can infer personal data at a previously unattainable scale. In the absence of working defenses, we advocate for a broader discussion around LLM privacy implications beyond memorization, striving for a wider privacy protection.

Many cyberattacks start with disseminating phishing URLs. When clicking these phishing URLs, the victim's private information is leaked to the attacker. There have been proposed several machine learning methods to detect phishing URLs. However, it still remains under-explored to detect phishing URLs with evasion, i.e., phishing URLs that pretend to be benign by manipulating patterns. In many cases, the attacker i) reuses prepared phishing web pages because making a completely brand-new set costs non-trivial expenses, ii) prefers hosting companies that do not require private information and are cheaper than others, iii) prefers shared hosting for cost efficiency, and iv) sometimes uses benign domains, IP addresses, and URL string patterns to evade existing detection methods. Inspired by those behavioral characteristics, we present a network-based inference method to accurately detect phishing URLs camouflaged with legitimate patterns, i.e., robust to evasion. In the network approach, a phishing URL will be still identified as phishy even after evasion unless a majority of its neighbors in the network are evaded at the same time. Our method consistently shows better detection performance throughout various experimental tests than state-of-the-art methods, e.g., F-1 of 0.89 for our method vs. 0.84 for the best feature-based method.

Electronic medical records (EMR) contain sensitive personal information. For example, they may include details about infectious diseases, such as human immunodeficiency virus (HIV), or they may contain information about a mental illness. They may also contain other sensitive information such as medical details related to fertility treatments. Because EMRs are subject to confidentiality requirements, accessing and analyzing EMR databases is a privilege given to only a small number of individuals. Individuals who work at institutions that do not have access to EMR systems have no opportunity to gain hands-on experience with this valuable resource. Simulated medical databases are currently available; however, they are difficult to configure and are limited in their resemblance to real clinical databases. Generating highly accessible repositories of virtual patient EMRs while relying only minimally on real patient data is expected to serve as a valuable resource to a broader audience of medical personnel, including those who reside in underdeveloped countries.

As people increasingly prioritize their health, the speed and breadth of health information dissemination on the internet have also grown. At the same time, the presence of false health information (health rumors) intermingled with genuine content poses a significant potential threat to public health. However, current research on Chinese health rumors still lacks a large-scale, public, and open-source dataset of health rumor information, as well as effective and reliable rumor detection methods. This paper addresses this gap by constructing a dataset containing 1.12 million health-related rumors (HealthRCN) through web scraping of common health-related questions and a series of data processing steps. HealthRCN is the largest known dataset of Chinese health information rumors to date. Based on this dataset, we propose retrieval-augmented large language models for Chinese health rumor detection and explainability (HRDE). This model leverages retrieved relevant information to accurately determine whether the input health information is a rumor and provides explanatory responses, effectively aiding users in verifying the authenticity of health information. In evaluation experiments, we compared multiple models and found that HRDE outperformed them all, including GPT-4-1106-Preview, in rumor detection accuracy and answer quality. HRDE achieved an average accuracy of 91.04% and an F1 score of 91.58%.

The exponential surge in online health information, coupled with its increasing use by non-experts, highlights the pressing need for advanced Health Information Retrieval models that consider not only topical relevance but also the factual accuracy of the retrieved information, given the potential risks associated with health misinformation. To this aim, this paper introduces a solution driven by Retrieval-Augmented Generation (RAG), which leverages the capabilities of generative Large Language Models (LLMs) to enhance the retrieval of health-related documents grounded in scientific evidence. In particular, we propose a three-stage model: in the first stage, the user's query is employed to retrieve topically relevant passages with associated references from a knowledge base constituted by scientific literature. In the second stage, these passages, alongside the initial query, are processed by LLMs to generate a contextually relevant rich text (GenText). In the last stage, the documents to be retrieved are evaluated and ranked both from the point of view of topical relevance and factual accuracy by means of their comparison with GenText, either through stance detection or semantic similarity. In addition to calculating factual accuracy, GenText can offer a layer of explainability for it, aiding users in understanding the reasoning behind the retrieval. Experimental evaluation of our model on benchmark datasets and against baseline models demonstrates its effectiveness in enhancing the retrieval of both topically relevant and factually accurate health information, thus presenting a significant step forward in the health misinformation mitigation problem.

Privacy policies are supposed to provide notice. But what if substantive information appears only where users skip it? We identify a structural pattern we call jurisdiction-siloed disclosure: information about data practices appearing in specific, actionable form only within regional compliance sections labeled "California Residents" or "EU/UK Users," while general sections use vague or qualified language for the same practices. Our audit of 123 major companies identifies 282 potential instances across 77 companies (62.6% of this purposive sample). A conservative estimate restricted to practice categories validated against OPP-115 human annotations finds 138 instances across 54 companies (44%); post-2018 categories central to our findings await independent validation. If users skip jurisdiction-labeled sections as information foraging theory predicts, users outside regulated jurisdictions would receive less specific information about practices affecting them--a transparency failure operating through document architecture rather than omission. We propose universal substantive disclosure: practices affecting all users should appear in the main policy body, with regional sections containing only procedural rights information. This standard finds support in analogous disclosure regimes (securities, truth-in-lending, nutritional labeling) where material information must reach all affected parties. Regulators could operationalize this through the FTC's "clear and conspicuous" standard and GDPR transparency principles. This work is hypothesis-generating: we establish that the structural pattern exists and ground the transparency concern in behavioral theory, but direct measurement of jurisdiction-specific section skipping remains the critical validation priority. We release our methodology and annotated dataset to enable replication.

Infodemics and health misinformation have significant negative impact on individuals and society, exacerbating confusion and increasing hesitancy in adopting recommended health measures. Recent advancements in generative AI, capable of producing realistic, human like text and images, have significantly accelerated the spread and expanded the reach of health misinformation, resulting in an alarming surge in its dissemination. To combat the infodemics, most existing work has focused on developing misinformation datasets from social media and fact checking platforms, but has faced limitations in topical coverage, inclusion of AI generation, and accessibility of raw content. To address these issues, we present MM Health, a large scale multimodal misinformation dataset in the health domain consisting of 34,746 news article encompassing both textual and visual information. MM Health includes human-generated multimodal information (5,776 articles) and AI generated multimodal information (28,880 articles) from various SOTA generative AI models. Additionally, We benchmarked our dataset against three tasks (reliability checks, originality checks, and fine-grained AI detection) demonstrating that existing SOTA models struggle to accurately distinguish the reliability and origin of information. Our dataset aims to support the development of misinformation detection across various health scenarios, facilitating the detection of human and machine generated content at multimodal levels.

Over the course of the COVID-19 pandemic, large volumes of biomedical information concerning this new disease have been published on social media. Some of this information can pose a real danger to people's health, particularly when false information is shared, for instance recommendations on how to treat diseases without professional medical advice. Therefore, automatic fact-checking resources and systems developed specifically for the medical domain are crucial. While existing fact-checking resources cover COVID-19-related information in news or quantify the amount of misinformation in tweets, there is no dataset providing fact-checked COVID-19-related Twitter posts with detailed annotations for biomedical entities, relations and relevant evidence. We contribute CoVERT, a fact-checked corpus of tweets with a focus on the domain of biomedicine and COVID-19-related (mis)information. The corpus consists of 300 tweets, each annotated with medical named entities and relations. We employ a novel crowdsourcing methodology to annotate all tweets with fact-checking labels and supporting evidence, which crowdworkers search for online. This methodology results in moderate inter-annotator agreement. Furthermore, we use the retrieved evidence extracts as part of a fact-checking pipeline, finding that the real-world evidence is more useful than the knowledge indirectly available in pretrained language models.

Misinformation - false or misleading information - is considered a significant societal concern due to its associated "misinformation effects," such as political polarization, erosion of trust in institutions, problematic behavior, and public health challenges. However, the prevailing concept is misaligned with what is studied. While misinformation focuses on instances of information about factual matters, the broad spectrum of effects often manifests at a societal level and is shaped by a wide range of interdependent factors such as identity, values, opinions, epistemologies, and disagreements. Unsurprisingly, misinformation effects can occur without the prevalence of misinformation, and misinformation does not necessarily increase the effects studied. Here, we propose using disagreement - conflicting attitudes and beliefs between individuals and communities - as a way to study misinformation effects because it addresses the identified conceptual limitations of misinformation. Furthermore, unlike misinformation, disagreement does not require researchers to determine whether a given information is false or misleading. Thus, it can be studied and, more importantly, measured without the need to make a normative judgment about a given information, even when the specific topic is entirely removed, as we show in a longitudinal disagreement measurement. We demonstrate that disagreement, as a holistic concept, provides better explanations for the occurrence of misinformation effects, enhances precision in developing appropriate interventions, and offers a promising approach for evaluating them through quantification. Finally, we show how disagreement addresses current misinformation research questions and conclude with recommendations for research practice.

The pervasive influence of misinformation has far-reaching and detrimental effects on both individuals and society. The COVID-19 pandemic has witnessed an alarming surge in the dissemination of medical misinformation. However, existing datasets pertaining to misinformation predominantly focus on textual information, neglecting the inclusion of visual elements, and tend to center solely on COVID-19-related misinformation, overlooking misinformation surrounding other diseases. Furthermore, the potential of Large Language Models (LLMs), such as the ChatGPT developed in late 2022, in generating misinformation has been overlooked in previous works. To overcome these limitations, we present Med-MMHL, a novel multi-modal misinformation detection dataset in a general medical domain encompassing multiple diseases. Med-MMHL not only incorporates human-generated misinformation but also includes misinformation generated by LLMs like ChatGPT. Our dataset aims to facilitate comprehensive research and development of methodologies for detecting misinformation across diverse diseases and various scenarios, including human and LLM-generated misinformation detection at the sentence, document, and multi-modal levels. To access our dataset and code, visit our GitHub repository: https://github.com/styxsys0927/Med-MMHL.

In clinical radiology reports, doctors capture important information about the patient's health status. They convey their observations from raw medical imaging data about the inner structures of a patient. As such, formulating reports requires medical experts to possess wide-ranging knowledge about anatomical regions with their normal, healthy appearance as well as the ability to recognize abnormalities. This explicit grasp on both the patient's anatomy and their appearance is missing in current medical image-processing systems as annotations are especially difficult to gather. This renders the models to be narrow experts e.g. for identifying specific diseases. In this work, we recover this missing link by adding human anatomy into the mix and enable the association of content in medical reports to their occurrence in associated imagery (medical phrase grounding). To exploit anatomical structures in this scenario, we present a sophisticated automatic pipeline to gather and integrate human bodily structures from computed tomography datasets, which we incorporate in our PAXRay: A Projected dataset for the segmentation of Anatomical structures in X-Ray data. Our evaluation shows that methods that take advantage of anatomical information benefit heavily in visually grounding radiologists' findings, as our anatomical segmentations allow for up to absolute 50% better grounding results on the OpenI dataset as compared to commonly used region proposals. The PAXRay dataset is available at https://constantinseibold.github.io/paxray/.

Polyps in the colon are widely known cancer precursors identified by colonoscopy. Whilst most polyps are benign, the polyp's number, size and surface structure are linked to the risk of colon cancer. Several methods have been developed to automate polyp detection and segmentation. However, the main issue is that they are not tested rigorously on a large multicentre purpose-built dataset, one reason being the lack of a comprehensive public dataset. As a result, the developed methods may not generalise to different population datasets. To this extent, we have curated a dataset from six unique centres incorporating more than 300 patients. The dataset includes both single frame and sequence data with 3762 annotated polyp labels with precise delineation of polyp boundaries verified by six senior gastroenterologists. To our knowledge, this is the most comprehensive detection and pixel-level segmentation dataset (referred to as PolypGen) curated by a team of computational scientists and expert gastroenterologists. The paper provides insight into data construction and annotation strategies, quality assurance, and technical validation. Our dataset can be downloaded from https://doi.org/10.7303/syn26376615.

Seeking health-related advice on the internet has become a common practice in the digital era. Determining the trustworthiness of medical claims found online and finding appropriate evidence for this information is increasingly challenging. Fact-checking has emerged as an approach to assess the veracity of factual claims using evidence from credible knowledge sources. To help advance the automation of this task, in this paper, we introduce a novel dataset of 750 health-related claims, labeled for veracity by medical experts and backed with evidence from appropriate clinical studies. We provide an analysis of the dataset, highlighting its characteristics and challenges. The dataset can be used for Machine Learning tasks related to automated fact-checking such as evidence retrieval, veracity prediction, and explanation generation. For this purpose, we provide baseline models based on different approaches, examine their performance, and discuss the findings.

By leveraging the retrieval of information from external knowledge databases, Large Language Models (LLMs) exhibit enhanced capabilities for accomplishing many knowledge-intensive tasks. However, due to the inherent flaws of current retrieval systems, there might exist irrelevant information within those retrieving top-ranked passages. In this work, we present a comprehensive investigation into the robustness of LLMs to different types of irrelevant information under various conditions. We initially introduce a framework to construct high-quality irrelevant information that ranges from semantically unrelated, partially related, and related to questions. Furthermore, our analysis demonstrates that the constructed irrelevant information not only scores highly on similarity metrics, being highly retrieved by existing systems, but also bears semantic connections to the context. Our investigation reveals that current LLMs still face challenges in discriminating highly semantically related information and can be easily distracted by these irrelevant yet misleading contents. Besides, we also find that current solutions for handling irrelevant information have limitations in improving the robustness of LLMs to such distractions. Resources are available at https://github.com/Di-viner/LLM-Robustness-to-Irrelevant-Information.

Network intrusion detection remains a critical challenge in cybersecurity. While supervised machine learning models achieve state-of-the-art performance, their reliance on large labelled datasets makes them impractical for many real-world applications. Anomaly detection methods, which train exclusively on benign traffic to identify malicious activity, suffer from high false positive rates, limiting their usability. Recently, self-supervised learning techniques have demonstrated improved performance with lower false positive rates by learning discriminative latent representations of benign traffic. In particular, contrastive self-supervised models achieve this by minimizing the distance between similar (positive) views of benign traffic while maximizing it between dissimilar (negative) views. Existing approaches generate positive views through data augmentation and treat other samples as negative. In contrast, this work introduces Contrastive Learning using Augmented Negative pairs (CLAN), a novel paradigm for network intrusion detection where augmented samples are treated as negative views - representing potentially malicious distributions - while other benign samples serve as positive views. This approach enhances both classification accuracy and inference efficiency after pretraining on benign traffic. Experimental evaluation on the Lycos2017 dataset demonstrates that the proposed method surpasses existing self-supervised and anomaly detection techniques in a binary classification task. Furthermore, when fine-tuned on a limited labelled dataset, the proposed approach achieves superior multi-class classification performance compared to existing self-supervised models.

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

Recent years have witnessed the proliferation of offensive content online such as fake news, propaganda, misinformation, and disinformation. While initially this was mostly about textual content, over time images and videos gained popularity, as they are much easier to consume, attract more attention, and spread further than text. As a result, researchers started leveraging different modalities and combinations thereof to tackle online multimodal offensive content. In this study, we offer a survey on the state-of-the-art on multimodal disinformation detection covering various combinations of modalities: text, images, speech, video, social media network structure, and temporal information. Moreover, while some studies focused on factuality, others investigated how harmful the content is. While these two components in the definition of disinformation (i) factuality, and (ii) harmfulness, are equally important, they are typically studied in isolation. Thus, we argue for the need to tackle disinformation detection by taking into account multiple modalities as well as both factuality and harmfulness, in the same framework. Finally, we discuss current challenges and future research directions

High-quality medical systematic reviews require comprehensive literature searches to ensure the recommendations and outcomes are sufficiently reliable. Indeed, searching for relevant medical literature is a key phase in constructing systematic reviews and often involves domain (medical researchers) and search (information specialists) experts in developing the search queries. Queries in this context are highly complex, based on Boolean logic, include free-text terms and index terms from standardised terminologies (e.g., MeSH), and are difficult and time-consuming to build. The use of MeSH terms, in particular, has been shown to improve the quality of the search results. However, identifying the correct MeSH terms to include in a query is difficult: information experts are often unfamiliar with the MeSH database and unsure about the appropriateness of MeSH terms for a query. Naturally, the full value of the MeSH terminology is often not fully exploited. This paper investigates methods to suggest MeSH terms based on an initial Boolean query that includes only free-text terms. These methods promise to automatically identify highly effective MeSH terms for inclusion in a systematic review query. Our study contributes an empirical evaluation of several MeSH term suggestion methods. We perform an extensive analysis of the retrieval, ranking, and refinement of MeSH term suggestions for each method and how these suggestions impact the effectiveness of Boolean queries.

Along with COVID-19 pandemic we are also fighting an `infodemic'. Fake news and rumors are rampant on social media. Believing in rumors can cause significant harm. This is further exacerbated at the time of a pandemic. To tackle this, we curate and release a manually annotated dataset of 10,700 social media posts and articles of real and fake news on COVID-19. We benchmark the annotated dataset with four machine learning baselines - Decision Tree, Logistic Regression, Gradient Boost, and Support Vector Machine (SVM). We obtain the best performance of 93.46% F1-score with SVM. The data and code is available at: https://github.com/parthpatwa/covid19-fake-news-dectection

In this work, we theoretically investigate the generalization properties of neural networks (NN) trained by stochastic gradient descent (SGD) algorithm with large learning rates. Under such a training regime, our finding is that, the oscillation of the NN weights caused by the large learning rate SGD training turns out to be beneficial to the generalization of the NN, which potentially improves over the same NN trained by SGD with small learning rates that converges more smoothly. In view of this finding, we call such a phenomenon "benign oscillation". Our theory towards demystifying such a phenomenon builds upon the feature learning perspective of deep learning. Specifically, we consider a feature-noise data generation model that consists of (i) weak features which have a small ell_2-norm and appear in each data point; (ii) strong features which have a larger ell_2-norm but only appear in a certain fraction of all data points; and (iii) noise. We prove that NNs trained by oscillating SGD with a large learning rate can effectively learn the weak features in the presence of those strong features. In contrast, NNs trained by SGD with a small learning rate can only learn the strong features but makes little progress in learning the weak features. Consequently, when it comes to the new testing data which consist of only weak features, the NN trained by oscillating SGD with a large learning rate could still make correct predictions consistently, while the NN trained by small learning rate SGD fails. Our theory sheds light on how large learning rate training benefits the generalization of NNs. Experimental results demonstrate our finding on "benign oscillation".

Background: Health datasets from clinical sources do not reflect the breadth and diversity of disease in the real world, impacting research, medical education, and artificial intelligence (AI) tool development. Dermatology is a suitable area to develop and test a new and scalable method to create representative health datasets. Methods: We used Google Search advertisements to invite contributions to an open access dataset of images of dermatology conditions, demographic and symptom information. With informed contributor consent, we describe and release this dataset containing 10,408 images from 5,033 contributions from internet users in the United States over 8 months starting March 2023. The dataset includes dermatologist condition labels as well as estimated Fitzpatrick Skin Type (eFST) and Monk Skin Tone (eMST) labels for the images. Results: We received a median of 22 submissions/day (IQR 14-30). Female (66.72%) and younger (52% < age 40) contributors had a higher representation in the dataset compared to the US population, and 32.6% of contributors reported a non-White racial or ethnic identity. Over 97.5% of contributions were genuine images of skin conditions. Dermatologist confidence in assigning a differential diagnosis increased with the number of available variables, and showed a weaker correlation with image sharpness (Spearman's P values <0.001 and 0.01 respectively). Most contributions were short-duration (54% with onset < 7 days ago ) and 89% were allergic, infectious, or inflammatory conditions. eFST and eMST distributions reflected the geographical origin of the dataset. The dataset is available at github.com/google-research-datasets/scin . Conclusion: Search ads are effective at crowdsourcing images of health conditions. The SCIN dataset bridges important gaps in the availability of representative images of common skin conditions.

This article presents the Cogni-CISMeF project, which aims at improving medical information search in the CISMeF system (Catalog and Index of French-language health resources) by including a conversational agent to interact with the user in natural language. To study the cognitive processes involved during the information search, a bottom-up methodology was adopted. Experimentation has been set up to obtain human dialogs between a user (playing the role of patient) dealing with medical information search and a CISMeF expert refining the request. The analysis of these dialogs underlined the use of discursive evidence: vocabulary, reformulation, implicit or explicit expression of user intentions, conversational sequences, etc. A model of artificial agent is proposed. It leads the user in its information search by proposing to him examples, assistance and choices. This model was implemented and integrated in the CISMeF system. ---- Cet article d\'ecrit le projet Cogni-CISMeF qui propose un module de dialogue Homme-Machine \`a int\'egrer dans le syst\`eme d'indexation de connaissances m\'edicales CISMeF (Catalogue et Index des Sites M\'edicaux Francophones). Nous avons adopt\'e une d\'emarche de mod\'elisation cognitive en proc\'edant \`a un recueil de corpus de dialogues entre un utilisateur (jouant le r\^ole d'un patient) d\'esirant une information m\'edicale et un expert CISMeF af inant cette demande pour construire la requ\^ete. Nous avons analys\'e la structure des dialogues ainsi obtenus et avons \'etudi\'e un certain nombre d'indices discursifs : vocabulaire employ\'e, marques de reformulation, commentaires m\'eta et \'epilinguistiques, expression implicite ou explicite des intentions de l'utilisateur, encha\^inement conversationnel, etc. De cette analyse, nous avons construit un mod\`ele d'agent artificiel dot\'e de capacit\'es cognitives capables d'aider l'utilisateur dans sa t\^ache de recherche d'information. Ce mod\`ele a \'et\'e impl\'ement\'e et int\'egr\'e dans le syst\`eme CISMeF.

Background: Large language models (LLMs) are trained to follow directions, but this introduces a vulnerability to blindly comply with user requests even if they generate wrong information. In medicine, this could accelerate the generation of misinformation that impacts human well-being. Objectives/Methods: We analyzed compliance to requests to generate misleading content about medications in settings where models know the request is illogical. We investigated whether in-context directions and instruction-tuning of LLMs to prioritize logical reasoning over compliance reduced misinformation risk. Results: While all frontier LLMs complied with misinformation requests, both prompt-based and parameter-based approaches can improve the detection of logic flaws in requests and prevent the dissemination of medical misinformation. Conclusion: Shifting LLMs to prioritize logic over compliance could reduce risks of exploitation for medical misinformation.

The prevalence and harms of online misinformation is a perennial concern for internet platforms, institutions and society at large. Over time, information shared online has become more media-heavy and misinformation has readily adapted to these new modalities. The rise of generative AI-based tools, which provide widely-accessible methods for synthesizing realistic audio, images, video and human-like text, have amplified these concerns. Despite intense interest on the part of the public and significant press coverage, quantitative information on the prevalence and modality of media-based misinformation remains scarce. Here, we present the results of a two-year study using human raters to annotate online media-based misinformation, mostly focusing on images, based on claims assessed in a large sample of publicly-accessible fact checks with the ClaimReview markup. We present an image typology, designed to capture aspects of the image and manipulation relevant to the image's role in the misinformation claim. We visualize the distribution of these types over time. We show the the rise of generative AI-based content in misinformation claims, and that it's commonality is a relatively recent phenomenon, occurring significantly after heavy press coverage. We also show "simple" methods dominated historically, particularly context manipulations, and continued to hold a majority as of the end of data collection in November 2023. The dataset, Annotated Misinformation, Media-Based (AMMeBa), is publicly-available, and we hope that these data will serve as both a means of evaluating mitigation methods in a realistic setting and as a first-of-its-kind census of the types and modalities of online misinformation.

To deploy language models safely, it is crucial that they abstain from responding to inappropriate requests. Several prior studies test the safety promises of models based on their effectiveness in blocking malicious requests. In this work, we focus on evaluating the underlying techniques that cause models to abstain. We create SELECT, a benchmark derived from a set of benign concepts (e.g., "rivers") from a knowledge graph. Focusing on benign concepts isolates the effect of safety training, and grounding these concepts in a knowledge graph allows us to study the generalization and specificity of abstention techniques. Using SELECT, we benchmark different abstention techniques over six open-weight and closed-source models. We find that the examined techniques indeed cause models to abstain with over 80% abstention rates. However, these techniques are not as effective for descendants of the target concepts, where abstention rates drop by 19%. We also characterize the generalization-specificity trade-offs for different techniques. Overall, no single technique is invariably better than others, and our findings inform practitioners of the various trade-offs involved.

Large language models (LLMs) have the potential to transform medicine, but real-world clinical scenarios contain extraneous information that can hinder performance. The rise of assistive technologies like ambient dictation, which automatically generates draft notes from live patient encounters, has the potential to introduce additional noise making it crucial to assess the ability of LLM's to filter relevant data. To investigate this, we developed MedDistractQA, a benchmark using USMLE-style questions embedded with simulated real-world distractions. Our findings show that distracting statements (polysemous words with clinical meanings used in a non-clinical context or references to unrelated health conditions) can reduce LLM accuracy by up to 17.9%. Commonly proposed solutions to improve model performance such as retrieval-augmented generation (RAG) and medical fine-tuning did not change this effect and in some cases introduced their own confounders and further degraded performance. Our findings suggest that LLMs natively lack the logical mechanisms necessary to distinguish relevant from irrelevant clinical information, posing challenges for real-world applications. MedDistractQA and our results highlights the need for robust mitigation strategies to enhance LLM resilience to extraneous information.

Online medical consultation (OMC) restricts doctors to gathering patient information solely through inquiries, making the already complex sequential decision-making process of diagnosis even more challenging. Recently, the rapid advancement of large language models has demonstrated a significant potential to transform OMC. However, most studies have primarily focused on improving diagnostic accuracy under conditions of relatively sufficient information, while paying limited attention to the "inquiry" phase of the consultation process. This lack of focus has left the relationship between "inquiry" and "diagnosis" insufficiently explored. In this paper, we first extract real patient interaction strategies from authentic doctor-patient conversations and use these strategies to guide the training of a patient simulator that closely mirrors real-world behavior. By inputting medical records into our patient simulator to simulate patient responses, we conduct extensive experiments to explore the relationship between "inquiry" and "diagnosis" in the consultation process. Experimental results demonstrate that inquiry and diagnosis adhere to the Liebig's law: poor inquiry quality limits the effectiveness of diagnosis, regardless of diagnostic capability, and vice versa. Furthermore, the experiments reveal significant differences in the inquiry performance of various models. To investigate this phenomenon, we categorize the inquiry process into four types: (1) chief complaint inquiry; (2) specification of known symptoms; (3) inquiry about accompanying symptoms; and (4) gathering family or medical history. We analyze the distribution of inquiries across the four types for different models to explore the reasons behind their significant performance differences. We plan to open-source the weights and related code of our patient simulator at https://github.com/LIO-H-ZEN/PatientSimulator.

Migraine is a high-prevalence and disabling neurological disorder. However, information migraine management in real-world settings could be limited to traditional health information sources. In this paper, we (i) verify that there is substantial migraine-related chatter available on social media (Twitter and Reddit), self-reported by migraine sufferers; (ii) develop a platform-independent text classification system for automatically detecting self-reported migraine-related posts, and (iii) conduct analyses of the self-reported posts to assess the utility of social media for studying this problem. We manually annotated 5750 Twitter posts and 302 Reddit posts. Our system achieved an F1 score of 0.90 on Twitter and 0.93 on Reddit. Analysis of information posted by our 'migraine cohort' revealed the presence of a plethora of relevant information about migraine therapies and patient sentiments associated with them. Our study forms the foundation for conducting an in-depth analysis of migraine-related information using social media data.

Not all topics are equally "flammable" in terms of toxicity: a calm discussion of turtles or fishing less often fuels inappropriate toxic dialogues than a discussion of politics or sexual minorities. We define a set of sensitive topics that can yield inappropriate and toxic messages and describe the methodology of collecting and labeling a dataset for appropriateness. While toxicity in user-generated data is well-studied, we aim at defining a more fine-grained notion of inappropriateness. The core of inappropriateness is that it can harm the reputation of a speaker. This is different from toxicity in two respects: (i) inappropriateness is topic-related, and (ii) inappropriate message is not toxic but still unacceptable. We collect and release two datasets for Russian: a topic-labeled dataset and an appropriateness-labeled dataset. We also release pre-trained classification models trained on this data.

Hoaxes are a recognised form of disinformation created deliberately, with potential serious implications in the credibility of reference knowledge resources such as Wikipedia. What makes detecting Wikipedia hoaxes hard is that they often are written according to the official style guidelines. In this work, we first provide a systematic analysis of the similarities and discrepancies between legitimate and hoax Wikipedia articles, and introduce Hoaxpedia, a collection of 311 Hoax articles (from existing literature as well as official Wikipedia lists) alongside semantically similar real articles. We report results of binary classification experiments in the task of predicting whether a Wikipedia article is real or hoax, and analyze several settings as well as a range of language models. Our results suggest that detecting deceitful content in Wikipedia based on content alone, despite not having been explored much in the past, is a promising direction.

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.

Patient notes contain a wealth of information of potentially great interest to medical investigators. However, to protect patients' privacy, Protected Health Information (PHI) must be removed from the patient notes before they can be legally released, a process known as patient note de-identification. The main objective for a de-identification system is to have the highest possible recall. Recently, the first neural-network-based de-identification system has been proposed, yielding state-of-the-art results. Unlike other systems, it does not rely on human-engineered features, which allows it to be quickly deployed, but does not leverage knowledge from human experts or from electronic health records (EHRs). In this work, we explore a method to incorporate human-engineered features as well as features derived from EHRs to a neural-network-based de-identification system. Our results show that the addition of features, especially the EHR-derived features, further improves the state-of-the-art in patient note de-identification, including for some of the most sensitive PHI types such as patient names. Since in a real-life setting patient notes typically come with EHRs, we recommend developers of de-identification systems to leverage the information EHRs contain.

Cancer has relational information residing at varying scales, modalities, and resolutions of the acquired data, such as radiology, pathology, genomics, proteomics, and clinical records. Integrating diverse data types can improve the accuracy and reliability of cancer diagnosis and treatment. There can be disease-related information that is too subtle for humans or existing technological tools to discern visually. Traditional methods typically focus on partial or unimodal information about biological systems at individual scales and fail to encapsulate the complete spectrum of the heterogeneous nature of data. Deep neural networks have facilitated the development of sophisticated multimodal data fusion approaches that can extract and integrate relevant information from multiple sources. Recent deep learning frameworks such as Graph Neural Networks (GNNs) and Transformers have shown remarkable success in multimodal learning. This review article provides an in-depth analysis of the state-of-the-art in GNNs and Transformers for multimodal data fusion in oncology settings, highlighting notable research studies and their findings. We also discuss the foundations of multimodal learning, inherent challenges, and opportunities for integrative learning in oncology. By examining the current state and potential future developments of multimodal data integration in oncology, we aim to demonstrate the promising role that multimodal neural networks can play in cancer prevention, early detection, and treatment through informed oncology practices in personalized settings.

The emergent abilities of large language models (LLMs) have demonstrated great potential in solving medical questions. They can possess considerable medical knowledge, but may still hallucinate and are inflexible in the knowledge updates. While Retrieval-Augmented Generation (RAG) has been proposed to enhance the medical question-answering capabilities of LLMs with external knowledge bases, it may still fail in complex cases where multiple rounds of information-seeking are required. To address such an issue, we propose iterative RAG for medicine (i-MedRAG), where LLMs can iteratively ask follow-up queries based on previous information-seeking attempts. In each iteration of i-MedRAG, the follow-up queries will be answered by a vanilla RAG system and they will be further used to guide the query generation in the next iteration. Our experiments show the improved performance of various LLMs brought by i-MedRAG compared with vanilla RAG on complex questions from clinical vignettes in the United States Medical Licensing Examination (USMLE), as well as various knowledge tests in the Massive Multitask Language Understanding (MMLU) dataset. Notably, our zero-shot i-MedRAG outperforms all existing prompt engineering and fine-tuning methods on GPT-3.5, achieving an accuracy of 69.68\% on the MedQA dataset. In addition, we characterize the scaling properties of i-MedRAG with different iterations of follow-up queries and different numbers of queries per iteration. Our case studies show that i-MedRAG can flexibly ask follow-up queries to form reasoning chains, providing an in-depth analysis of medical questions. To the best of our knowledge, this is the first-of-its-kind study on incorporating follow-up queries into medical RAG.

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

Introduction: Electronic health records (EHR) are a critical medium through which patient stigmatization is perpetuated among healthcare teams. Methods: We identified linguistic features of doubt markers and stigmatizing labels in MIMIC-III EHR via expanded lexicon matching and supervised learning classifiers. Predictors of rates of linguistic features were assessed using Poisson regression models. Results: We found higher rates of stigmatizing labels per chart among patients who were Black or African American (RR: 1.16), patients with Medicare/Medicaid or government-run insurance (RR: 2.46), self-pay (RR: 2.12), and patients with a variety of stigmatizing disease and mental health conditions. Patterns among doubt markers were similar, though male patients had higher rates of doubt markers (RR: 1.25). We found increased stigmatizing labels used by nurses (RR: 1.40), and social workers (RR: 2.25), with similar patterns of doubt markers. Discussion: Stigmatizing language occurred at higher rates among historically stigmatized patients, perpetuated by multiple provider types.

To investigate whether the pleurae, airways and vessels surrounding a nodule on non-contrast computed tomography (CT) can discriminate benign and malignant pulmonary nodules. The LIDC-IDRI dataset, one of the largest publicly available CT database, was exploited for study. A total of 1556 nodules from 694 patients were involved in statistical analysis, where nodules with average scorings <3 and >3 were respectively denoted as benign and malignant. Besides, 339 nodules from 113 patients with diagnosis ground-truth were independently evaluated. Computer algorithms were developed to segment pulmonary structures and quantify the distances to pleural surface, airways and vessels, as well as the counting number and normalized volume of airways and vessels near a nodule. Odds ratio (OR) and Chi-square (\chi^2) testing were performed to demonstrate the correlation between features of surrounding structures and nodule malignancy. A non-parametric receiver operating characteristic (ROC) analysis was conducted in logistic regression to evaluate discrimination ability of each structure. For benign and malignant groups, the average distances from nodules to pleural surface, airways and vessels are respectively (6.56, 5.19), (37.08, 26.43) and (1.42, 1.07) mm. The correlation between nodules and the counting number of airways and vessels that contact or project towards nodules are respectively (OR=22.96, \chi^2=105.04) and (OR=7.06, \chi^2=290.11). The correlation between nodules and the volume of airways and vessels are (OR=9.19, \chi^2=159.02) and (OR=2.29, \chi^2=55.89). The areas-under-curves (AUCs) for pleurae, airways and vessels are respectively 0.5202, 0.6943 and 0.6529. Our results show that malignant nodules are often surrounded by more pulmonary structures compared with benign ones, suggesting that features of these structures could be viewed as lung cancer biomarkers.

Health-related misinformation is very prevalent and potentially harmful. It is difficult to identify, especially when claims distort or misinterpret scientific findings. We investigate the impact of synthetic data generation and lightweight fine-tuning techniques on the ability of large language models (LLMs) to recognize fallacious arguments using the MISSCI dataset and framework. In this work, we propose MisSynth, a pipeline that applies retrieval-augmented generation (RAG) to produce synthetic fallacy samples, which are then used to fine-tune an LLM model. Our results show substantial accuracy gains with fine-tuned models compared to vanilla baselines. For instance, the LLaMA 3.1 8B fine-tuned model achieved an over 35% F1-score absolute improvement on the MISSCI test split over its vanilla baseline. We demonstrate that introducing synthetic fallacy data to augment limited annotated resources can significantly enhance zero-shot LLM classification performance on real-world scientific misinformation tasks, even with limited computational resources. The code and synthetic dataset are available on https://github.com/mxpoliakov/MisSynth.

Many studies explore how people 'come into' misinformation exposure. But much less is known about how people 'come out of' misinformation exposure. Do people organically sever ties to misinformation spreaders? And what predicts doing so? Over six months, we tracked the frequency and predictors of ~1M followers unfollowing ~5K health misinformation spreaders on Twitter. We found that misinformation ties are persistent. Monthly unfollowing rates are just 0.52%. Users are also 31% more likely to unfollow non-misinformation spreaders than they are to unfollow misinformation spreaders. Although generally infrequent, the factors most associated with unfollowing misinformation spreaders are (1) redundancy and (2) ideology. First, users initially following many spreaders, or who follow spreaders that tweet often, are most likely to unfollow later. Second, liberals are more likely to unfollow than conservatives. Overall, we observe strong persistence of misinformation ties. The fact that users rarely unfollow misinformation spreaders suggests a need for external nudges and the importance of preventing exposure from arising in the first place.

As the COVID-19 virus quickly spreads around the world, unfortunately, misinformation related to COVID-19 also gets created and spreads like wild fire. Such misinformation has caused confusion among people, disruptions in society, and even deadly consequences in health problems. To be able to understand, detect, and mitigate such COVID-19 misinformation, therefore, has not only deep intellectual values but also huge societal impacts. To help researchers combat COVID-19 health misinformation, therefore, we present CoAID (Covid-19 heAlthcare mIsinformation Dataset), with diverse COVID-19 healthcare misinformation, including fake news on websites and social platforms, along with users' social engagement about such news. CoAID includes 4,251 news, 296,000 related user engagements, 926 social platform posts about COVID-19, and ground truth labels. The dataset is available at: https://github.com/cuilimeng/CoAID.