Daily Papers

While large language models (LLMs) have shown promise in diagnostic dialogue, their capabilities for effective management reasoning - including disease progression, therapeutic response, and safe medication prescription - remain under-explored. We advance the previously demonstrated diagnostic capabilities of the Articulate Medical Intelligence Explorer (AMIE) through a new LLM-based agentic system optimised for clinical management and dialogue, incorporating reasoning over the evolution of disease and multiple patient visit encounters, response to therapy, and professional competence in medication prescription. To ground its reasoning in authoritative clinical knowledge, AMIE leverages Gemini's long-context capabilities, combining in-context retrieval with structured reasoning to align its output with relevant and up-to-date clinical practice guidelines and drug formularies. In a randomized, blinded virtual Objective Structured Clinical Examination (OSCE) study, AMIE was compared to 21 primary care physicians (PCPs) across 100 multi-visit case scenarios designed to reflect UK NICE Guidance and BMJ Best Practice guidelines. AMIE was non-inferior to PCPs in management reasoning as assessed by specialist physicians and scored better in both preciseness of treatments and investigations, and in its alignment with and grounding of management plans in clinical guidelines. To benchmark medication reasoning, we developed RxQA, a multiple-choice question benchmark derived from two national drug formularies (US, UK) and validated by board-certified pharmacists. While AMIE and PCPs both benefited from the ability to access external drug information, AMIE outperformed PCPs on higher difficulty questions. While further research would be needed before real-world translation, AMIE's strong performance across evaluations marks a significant step towards conversational AI as a tool in disease management.

The burgeoning integration of 3D medical imaging into healthcare has led to a substantial increase in the workload of medical professionals. To assist clinicians in their diagnostic processes and alleviate their workload, the development of a robust system for retrieving similar case studies presents a viable solution. While the concept holds great promise, the field of 3D medical text-image retrieval is currently limited by the absence of robust evaluation benchmarks and curated datasets. To remedy this, our study presents a groundbreaking dataset, BIMCV-R (This dataset will be released upon acceptance.), which includes an extensive collection of 8,069 3D CT volumes, encompassing over 2 million slices, paired with their respective radiological reports. Expanding upon the foundational work of our dataset, we craft a retrieval strategy, MedFinder. This approach employs a dual-stream network architecture, harnessing the potential of large language models to advance the field of medical image retrieval beyond existing text-image retrieval solutions. It marks our preliminary step towards developing a system capable of facilitating text-to-image, image-to-text, and keyword-based retrieval tasks.

A comprehensive bibliographic review with R statistical methods of the COVID pandemic in PubMed literature and Web of Science Core Collection, supported with Google Scholar search. In addition, a case study review of emerging new approaches in different regions, using medical literature, academic literature, news articles and other reliable data sources. Public responses of mistrust about privacy data misuse differ across countries, depending on the chosen public communication strategy.

Travel planning is a natural real-world task to test large language models (LLMs) planning and tool-use abilities. Although prior work has studied LLM performance on travel planning, existing settings still differ from real-world needs, mainly due to limited domain coverage, insufficient modeling of users' implicit preferences in multi-turn conversations, and a lack of clear evaluation of agents' capability boundaries. To mitigate these gaps, we propose TravelBench, a benchmark for fully real-world travel planning. We collect user queries, user profile and tools from real scenarios, and construct three subtasks-Single-Turn, Multi-Turn, and Unsolvable-to evaluate agent's three core capabilities in real settings: (1) solving problems autonomously, (2) interacting with users over multiple turns to refine requirements, and (3) recognizing the limits of own abilities. To enable stable tool invocation and reproducible evaluation, we cache real tool-call results and build a sandbox environment that integrates ten travel-related tools. Agents can combine these tools to solve most practical travel planning problems, and our systematic verification demonstrates the stability of the proposed benchmark. We further evaluate multiple LLMs on TravelBench and conduct an in-depth analysis of their behaviors and performance. TravelBench provides a practical and reproducible evaluation benchmark to advance research on LLM agents for travel planning.\footnote{Our code and data will be available after internal review.

Finding relevant literature underpins the practice of evidence-based medicine. From 2014 to 2016, TREC conducted a clinical decision support track, wherein participants were tasked with finding articles relevant to clinical questions posed by physicians. In total, 87 teams have participated over the past three years, generating 395 runs. During this period, each team has trialled a variety of methods. While there was significant overlap in the methods employed by different teams, the results were varied. Due to the diversity of the platforms used, the results arising from the different techniques are not directly comparable, reducing the ability to build on previous work. By using a stable platform, we have been able to compare different document and query processing techniques, allowing us to experiment with different search parameters. We have used our system to reproduce leading teams runs, and compare the results obtained. By benchmarking our indexing and search techniques, we can statistically test a variety of hypotheses, paving the way for further research.

The increased capabilities of generative AI have dramatically expanded its possible use cases in medicine. We provide a comprehensive overview of generative AI use cases for clinicians, patients, clinical trial organizers, researchers, and trainees. We then discuss the many challenges -- including maintaining privacy and security, improving transparency and interpretability, upholding equity, and rigorously evaluating models -- which must be overcome to realize this potential, and the open research directions they give rise to.

Many court systems are overwhelmed all over the world, leading to huge backlogs of pending cases. Effective triage systems, like those in emergency rooms, could ensure proper prioritization of open cases, optimizing time and resource allocation in the court system. In this work, we introduce the Criticality Prediction dataset, a novel resource for evaluating case prioritization. Our dataset features a two-tier labeling system: (1) the binary LD-Label, identifying cases published as Leading Decisions (LD), and (2) the more granular Citation-Label, ranking cases by their citation frequency and recency, allowing for a more nuanced evaluation. Unlike existing approaches that rely on resource-intensive manual annotations, we algorithmically derive labels leading to a much larger dataset than otherwise possible. We evaluate several multilingual models, including both smaller fine-tuned models and large language models in a zero-shot setting. Our results show that the fine-tuned models consistently outperform their larger counterparts, thanks to our large training set. Our results highlight that for highly domain-specific tasks like ours, large training sets are still valuable.

In common law jurisdictions, legal practitioners rely on precedents to construct arguments, in line with the doctrine of stare decisis. As the number of cases grow over the years, prior case retrieval (PCR) has garnered significant attention. Besides lacking real-world scale, existing PCR datasets do not simulate a realistic setting, because their queries use complete case documents while only masking references to prior cases. The query is thereby exposed to legal reasoning not yet available when constructing an argument for an undecided case as well as spurious patterns left behind by citation masks, potentially short-circuiting a comprehensive understanding of case facts and legal principles. To address these limitations, we introduce a PCR dataset based on judgements from the European Court of Human Rights (ECtHR), which explicitly separate facts from arguments and exhibit precedential practices, aiding us to develop this PCR dataset to foster systems' comprehensive understanding. We benchmark different lexical and dense retrieval approaches with various negative sampling strategies, adapting them to deal with long text sequences using hierarchical variants. We found that difficulty-based negative sampling strategies were not effective for the PCR task, highlighting the need for investigation into domain-specific difficulty criteria. Furthermore, we observe performance of the dense models degrade with time and calls for further research into temporal adaptation of retrieval models. Additionally, we assess the influence of different views , Halsbury's and Goodhart's, in practice in ECtHR jurisdiction using PCR task.

This research tests the role of Large Language Models (LLMs) as formal second opinion tools in professional decision-making, particularly focusing on complex medical cases where even experienced physicians seek peer consultation. The work analyzed 183 challenging medical cases from Medscape over a 20-month period, testing multiple LLMs' performance against crowd-sourced physician responses. A key finding was the high overall score possible in the latest foundational models (>80% accuracy compared to consensus opinion), which exceeds most human metrics reported on the same clinical cases (450 pages of patient profiles, test results). The study rates the LLMs' performance disparity between straightforward cases (>81% accuracy) and complex scenarios (43% accuracy), particularly in these cases generating substantial debate among human physicians. The research demonstrates that LLMs may be valuable as generators of comprehensive differential diagnoses rather than as primary diagnostic tools, potentially helping to counter cognitive biases in clinical decision-making, reduce cognitive loads, and thus remove some sources of medical error. The inclusion of a second comparative legal dataset (Supreme Court cases, N=21) provides added empirical context to the AI use to foster second opinions, though these legal challenges proved considerably easier for LLMs to analyze. In addition to the original contributions of empirical evidence for LLM accuracy, the research aggregated a novel benchmark for others to score highly contested question and answer reliability between both LLMs and disagreeing human practitioners. These results suggest that the optimal deployment of LLMs in professional settings may differ substantially from current approaches that emphasize automation of routine tasks.

Medical benchmark datasets significantly contribute to developing Large Language Models (LLMs) for medical knowledge extraction, diagnosis, summarization, and other uses. Yet, current benchmarks are mainly derived from exam questions given to medical students or cases described in the medical literature, lacking the complexity of real-world patient cases that deviate from classic textbook abstractions. These include rare diseases, uncommon presentations of common diseases, and unexpected treatment responses. Here, we construct Clinically Uncommon Patient Cases and Diagnosis Dataset (CUPCase) based on 3,562 real-world case reports from BMC, including diagnoses in open-ended textual format and as multiple-choice options with distractors. Using this dataset, we evaluate the ability of state-of-the-art LLMs, including both general-purpose and Clinical LLMs, to identify and correctly diagnose a patient case, and test models' performance when only partial information about cases is available. Our findings show that general-purpose GPT-4o attains the best performance in both the multiple-choice task (average accuracy of 87.9%) and the open-ended task (BERTScore F1 of 0.764), outperforming several LLMs with a focus on the medical domain such as Meditron-70B and MedLM-Large. Moreover, GPT-4o was able to maintain 87% and 88% of its performance with only the first 20% of tokens of the case presentation in multiple-choice and free text, respectively, highlighting the potential of LLMs to aid in early diagnosis in real-world cases. CUPCase expands our ability to evaluate LLMs for clinical decision support in an open and reproducible manner.

Multimodal foundation models that can holistically process text alongside images, video, audio, and other sensory modalities are increasingly used in a variety of real-world applications. However, it is challenging to characterize and study progress in multimodal foundation models, given the range of possible modeling decisions, tasks, and domains. In this paper, we introduce Holistic Evaluation of Multimodal Models (HEMM) to systematically evaluate the capabilities of multimodal foundation models across a set of 3 dimensions: basic skills, information flow, and real-world use cases. Basic multimodal skills are internal abilities required to solve problems, such as learning interactions across modalities, fine-grained alignment, multi-step reasoning, and the ability to handle external knowledge. Information flow studies how multimodal content changes during a task through querying, translation, editing, and fusion. Use cases span domain-specific challenges introduced in real-world multimedia, affective computing, natural sciences, healthcare, and human-computer interaction applications. Through comprehensive experiments across the 30 tasks in HEMM, we (1) identify key dataset dimensions (e.g., basic skills, information flows, and use cases) that pose challenges to today's models, and (2) distill performance trends regarding how different modeling dimensions (e.g., scale, pre-training data, multimodal alignment, pre-training, and instruction tuning objectives) influence performance. Our conclusions regarding challenging multimodal interactions, use cases, and tasks requiring reasoning and external knowledge, the benefits of data and model scale, and the impacts of instruction tuning yield actionable insights for future work in multimodal foundation models.

Large language models (LLMs) are capable of generating multiple responses to a single prompt, yet little effort has been expended to help end-users or system designers make use of this capability. In this paper, we explore how to present many LLM responses at once. We design five features, which include both pre-existing and novel methods for computing similarities and differences across textual documents, as well as how to render their outputs. We report on a controlled user study (n=24) and eight case studies evaluating these features and how they support users in different tasks. We find that the features support a wide variety of sensemaking tasks and even make tasks previously considered to be too difficult by our participants now tractable. Finally, we present design guidelines to inform future explorations of new LLM interfaces.

In the rapidly evolving field of legal analytics, finding relevant cases and accurately predicting judicial outcomes are challenging because of the complexity of legal language, which often includes specialized terminology, complex syntax, and historical context. Moreover, the subtle distinctions between similar and precedent cases require a deep understanding of legal knowledge. Researchers often conflate these concepts, making it difficult to develop specialized techniques to effectively address these nuanced tasks. In this paper, we introduce the Law Large Language Model (LawLLM), a multi-task model specifically designed for the US legal domain to address these challenges. LawLLM excels at Similar Case Retrieval (SCR), Precedent Case Recommendation (PCR), and Legal Judgment Prediction (LJP). By clearly distinguishing between precedent and similar cases, we provide essential clarity, guiding future research in developing specialized strategies for these tasks. We propose customized data preprocessing techniques for each task that transform raw legal data into a trainable format. Furthermore, we also use techniques such as in-context learning (ICL) and advanced information retrieval methods in LawLLM. The evaluation results demonstrate that LawLLM consistently outperforms existing baselines in both zero-shot and few-shot scenarios, offering unparalleled multi-task capabilities and filling critical gaps in the legal domain.

Binding precedents (S\'umulas Vinculantes) constitute a juridical instrument unique to the Brazilian legal system and whose objectives include the protection of the Federal Supreme Court against repetitive demands. Studies of the effectiveness of these instruments in decreasing the Court's exposure to similar cases, however, indicate that they tend to fail in such a direction, with some of the binding precedents seemingly creating new demands. We empirically assess the legal impact of five binding precedents, 11, 14, 17, 26 and 37, at the highest court level through their effects on the legal subjects they address. This analysis is only possible through the comparison of the Court's ruling about the precedents' themes before they are created, which means that these decisions should be detected through techniques of Similar Case Retrieval. The contributions of this article are therefore twofold: on the mathematical side, we compare the uses of different methods of Natural Language Processing -- TF-IDF, LSTM, BERT, and regex -- for Similar Case Retrieval, whereas on the legal side, we contrast the inefficiency of these binding precedents with a set of hypotheses that may justify their repeated usage. We observe that the deep learning models performed significantly worse in the specific Similar Case Retrieval task and that the reasons for binding precedents to fail in responding to repetitive demand are heterogeneous and case-dependent, making it impossible to single out a specific cause.

This systematic review explores the application of Large Language Models (LLMs) in Combinatorial Optimization (CO). We report our findings using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We conduct a literature search via Scopus and Google Scholar, examining over 2,000 publications. We assess publications against four inclusion and four exclusion criteria related to their language, research focus, publication year, and type. Eventually, we select 103 studies. We classify these studies into semantic categories and topics to provide a comprehensive overview of the field, including the tasks performed by LLMs, the architectures of LLMs, the existing datasets specifically designed for evaluating LLMs in CO, and the field of application. Finally, we identify future directions for leveraging LLMs in this field.

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

Tibet, ensconced within China's territorial expanse, is distinguished by its labyrinthine and heterogeneous topography, a testament to its profound historical heritage, and the cradle of a unique religious ethos. The very essence of these attributes, however, has impeded the advancement of Tibet's tourism service infrastructure, rendering existing smart tourism services inadequate for the region's visitors. This study delves into the ramifications of informational disparities at tourist sites on Tibetan tourism and addresses the challenge of establishing the Large Language Model (LLM) evaluation criteria. It introduces an innovative approach, the DualGen Bridge AI system, employing supervised fine-tuning techniques to bolster model functionality and enhance optimization processes. Furthermore, it pioneers a multi-structured generative results assessment framework. Empirical validation confirms the efficacy of this framework. The study also explores the application of the supervised fine-tuning method within the proprietary DualGen Bridge AI, aimed at refining the generation of tourist site information. The study's findings offer valuable insights for optimizing system performance and provide support and inspiration for the application of LLM technology in Tibet's tourism services and beyond, potentially revolutionizing the smart tourism industry with advanced, tailored information generation capabilities.

One of the most important challenges for improving personalized services in industries like tourism is predicting users' near-future movements based on prior behavior and current circumstances. Next POI (Point of Interest) recommendation is essential for helping users and service providers by providing personalized recommendations. The intricacy of this work, however, stems from the requirement to take into consideration several variables at once, such as user preferences, time contexts, and geographic locations. POI selection is also greatly influenced by elements like a POI's operational status during desired visit times, desirability for visiting during particular seasons, and its dynamic popularity over time. POI popularity is mostly determined by check-in frequency in recent studies, ignoring visitor volumes, operational constraints, and temporal dynamics. These restrictions result in recommendations that are less than ideal and do not take into account actual circumstances. We propose the Seasonal and Active hours-guided Graph-Enhanced Transformer (SEAGET) model as a solution to these problems. By integrating variations in the seasons, operational status, and temporal dynamics into a graph-enhanced transformer framework, SEAGET capitalizes on redefined POI popularity. This invention gives more accurate and context-aware next POI predictions, with potential applications for optimizing tourist experiences and enhancing location-based services in the tourism industry.

Next Point of Interest (POI) recommendation is essential for modern mobility and location-based services. To provide a smooth user experience, models must understand several components of a journey holistically: "when to depart", "how to travel", "where to go", and "what needs arise via the route". However, current research is limited by fragmented datasets that focus merely on next POI recommendation ("where to go"), neglecting the departure time, travel mode, and situational requirements along the journey. Furthermore, the limited scale of these datasets impedes accurate evaluation of performance. To bridge this gap, we introduce IntTravel, the first large-scale public dataset for integrated travel recommendation, including 4.1 billion interactions from 163 million users with 7.3 million POIs. Built upon this dataset, we introduce an end-to-end, decoder-only generative framework for multi-task recommendation. It incorporates information preservation, selection, and factorization to balance task collaboration with specialized differentiation, yielding substantial performance gains. The framework's generalizability is highlighted by its state-of-the-art performance across both IntTravel dataset and an additional non-travel benchmark. IntTravel has been successfully deployed on Amap serving hundreds of millions of users, leading to a 1.09% increase in CTR. IntTravel is available at https://github.com/AMAP-ML/IntTravel.

In this study, we introduce FEET, a standardized protocol designed to guide the development and benchmarking of foundation models. While numerous benchmark datasets exist for evaluating these models, we propose a structured evaluation protocol across three distinct scenarios to gain a comprehensive understanding of their practical performance. We define three primary use cases: frozen embeddings, few-shot embeddings, and fully fine-tuned embeddings. Each scenario is detailed and illustrated through two case studies: one in sentiment analysis and another in the medical domain, demonstrating how these evaluations provide a thorough assessment of foundation models' effectiveness in research applications. We recommend this protocol as a standard for future research aimed at advancing representation learning models.

Multimodal large language models (MLLMs) have advanced clinical tasks for common conditions, but their performance on rare diseases remains largely untested. In rare-disease scenarios, clinicians often lack prior clinical knowledge, forcing them to rely strictly on case-level evidence for clinical judgments. Existing benchmarks predominantly evaluate common-condition, single-image settings, leaving multimodal and multi-image evidence integration under rare-disease data scarcity systematically unevaluated. We introduce MMRareBench, to our knowledge the first rare-disease benchmark jointly evaluating multimodal and multi-image clinical capability across four workflow-aligned tracks: diagnosis, treatment planning, cross-image evidence alignment, and examination suggestion. The benchmark comprises 1,756 question-answer pairs with 7,958 associated medical images curated from PMC case reports, with Orphanet-anchored ontology alignment, track-specific leakage control, evidence-grounded annotations, and a two-level evaluation protocol. A systematic evaluation of 23 MLLMs reveals fragmented capability profiles and universally low treatment-planning performance, with medical-domain models trailing general-purpose MLLMs substantially on multi-image tracks despite competitive diagnostic scores. These patterns are consistent with a capacity dilution effect: medical fine-tuning can narrow the diagnostic gap but may erode the compositional multi-image capability that rare-disease evidence integration demands.

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

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.

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

Throughout the course of my Ph.D., I have been designing the user experience (UX) of various machine learning (ML) systems. In this workshop, I share two projects as case studies in which people engage with ML in much more complicated and nuanced ways than the technical HCML work might assume. The first case study describes how cardiology teams in three hospitals used a clinical decision-support system that helps them decide whether and when to implant an artificial heart to a heart failure patient. I demonstrate that physicians cannot draw on their decision-making experience by seeing only patient data on paper. They are also confused by some fundamental premises upon which ML operates. For example, physicians asked: Are ML predictions made based on clinicians' best efforts? Is it ethical to make decisions based on previous patients' collective outcomes? In the second case study, my collaborators and I designed an intelligent text editor, with the goal of improving authors' writing experience with NLP (Natural Language Processing) technologies. We prototyped a number of generative functionalities where the system provides phrase-or-sentence-level writing suggestions upon user request. When writing with the prototype, however, authors shared that they need to "see where the sentence is going two paragraphs later" in order to decide whether the suggestion aligns with their writing; Some even considered adopting machine suggestions as plagiarism, therefore "is simply wrong". By sharing these unexpected and intriguing responses from these real-world ML users, I hope to start a discussion about such previously-unknown complexities and nuances of -- as the workshop proposal states -- "putting ML at the service of people in a way that is accessible, useful, and trustworthy to all".

Current medical retrieval benchmarks primarily emphasize lexical or shallow semantic similarity, overlooking the reasoning-intensive demands that are central to clinical decision-making. In practice, physicians often retrieve authoritative medical evidence to support diagnostic hypotheses. Such evidence typically aligns with an inferred diagnosis rather than the surface form of a patient's symptoms, leading to low lexical or semantic overlap between queries and relevant documents. To address this gap, we introduce R2MED, the first benchmark explicitly designed for reasoning-driven medical retrieval. It comprises 876 queries spanning three tasks: Q&A reference retrieval, clinical evidence retrieval, and clinical case retrieval. These tasks are drawn from five representative medical scenarios and twelve body systems, capturing the complexity and diversity of real-world medical information needs. We evaluate 15 widely-used retrieval systems on R2MED and find that even the best model achieves only 31.4 nDCG@10, demonstrating the benchmark's difficulty. Classical re-ranking and generation-augmented retrieval methods offer only modest improvements. Although large reasoning models improve performance via intermediate inference generation, the best results still peak at 41.4 nDCG@10. These findings underscore a substantial gap between current retrieval techniques and the reasoning demands of real clinical tasks. We release R2MED as a challenging benchmark to foster the development of next-generation medical retrieval systems with enhanced reasoning capabilities. Data and code are available at https://github.com/R2MED/R2MED

In this paper, we present a novel framework for enhancing the capabilities of large language models (LLMs) by leveraging the power of multi-agent systems. Our framework introduces a collaborative environment where multiple intelligent agent components, each with distinctive attributes and roles, work together to handle complex tasks more efficiently and effectively. We demonstrate the practicality and versatility of our framework through case studies in artificial general intelligence (AGI), specifically focusing on the Auto-GPT and BabyAGI models. We also examine the "Gorilla" model, which integrates external APIs into the LLM. Our framework addresses limitations and challenges such as looping issues, security risks, scalability, system evaluation, and ethical considerations. By modeling various domains such as courtroom simulations and software development scenarios, we showcase the potential applications and benefits of our proposed multi-agent system. Our framework provides an avenue for advancing the capabilities and performance of LLMs through collaboration and knowledge exchange among intelligent agents.

To assess the effectiveness of any medical intervention, researchers must conduct a time-intensive and highly manual literature review. NLP systems can help to automate or assist in parts of this expensive process. In support of this goal, we release MS^2 (Multi-Document Summarization of Medical Studies), a dataset of over 470k documents and 20k summaries derived from the scientific literature. This dataset facilitates the development of systems that can assess and aggregate contradictory evidence across multiple studies, and is the first large-scale, publicly available multi-document summarization dataset in the biomedical domain. We experiment with a summarization system based on BART, with promising early results. We formulate our summarization inputs and targets in both free text and structured forms and modify a recently proposed metric to assess the quality of our system's generated summaries. Data and models are available at https://github.com/allenai/ms2

Clinical trial matching is a key process in health delivery and discovery. In practice, it is plagued by overwhelming unstructured data and unscalable manual processing. In this paper, we conduct a systematic study on scaling clinical trial matching using large language models (LLMs), with oncology as the focus area. Our study is grounded in a clinical trial matching system currently in test deployment at a large U.S. health network. Initial findings are promising: out of box, cutting-edge LLMs, such as GPT-4, can already structure elaborate eligibility criteria of clinical trials and extract complex matching logic (e.g., nested AND/OR/NOT). While still far from perfect, LLMs substantially outperform prior strong baselines and may serve as a preliminary solution to help triage patient-trial candidates with humans in the loop. Our study also reveals a few significant growth areas for applying LLMs to end-to-end clinical trial matching, such as context limitation and accuracy, especially in structuring patient information from longitudinal medical records.

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

Legal claims refer to the plaintiff's demands in a case and are essential to guiding judicial reasoning and case resolution. While many works have focused on improving the efficiency of legal professionals, the research on helping non-professionals (e.g., plaintiffs) remains unexplored. This paper explores the problem of legal claim generation based on the given case's facts. First, we construct ClaimGen-CN, the first dataset for Chinese legal claim generation task, from various real-world legal disputes. Additionally, we design an evaluation metric tailored for assessing the generated claims, which encompasses two essential dimensions: factuality and clarity. Building on this, we conduct a comprehensive zero-shot evaluation of state-of-the-art general and legal-domain large language models. Our findings highlight the limitations of the current models in factual precision and expressive clarity, pointing to the need for more targeted development in this domain. To encourage further exploration of this important task, we will make the dataset publicly available.

This paper introduces CaseSumm, a novel dataset for long-context summarization in the legal domain that addresses the need for longer and more complex datasets for summarization evaluation. We collect 25.6K U.S. Supreme Court (SCOTUS) opinions and their official summaries, known as "syllabuses." Our dataset is the largest open legal case summarization dataset, and is the first to include summaries of SCOTUS decisions dating back to 1815. We also present a comprehensive evaluation of LLM-generated summaries using both automatic metrics and expert human evaluation, revealing discrepancies between these assessment methods. Our evaluation shows Mistral 7b, a smaller open-source model, outperforms larger models on most automatic metrics and successfully generates syllabus-like summaries. In contrast, human expert annotators indicate that Mistral summaries contain hallucinations. The annotators consistently rank GPT-4 summaries as clearer and exhibiting greater sensitivity and specificity. Further, we find that LLM-based evaluations are not more correlated with human evaluations than traditional automatic metrics. Furthermore, our analysis identifies specific hallucinations in generated summaries, including precedent citation errors and misrepresentations of case facts. These findings demonstrate the limitations of current automatic evaluation methods for legal summarization and highlight the critical role of human evaluation in assessing summary quality, particularly in complex, high-stakes domains. CaseSumm is available at https://huggingface.co/datasets/ChicagoHAI/CaseSumm

During the COVID-19 pandemic, people sought information through digital news platforms. To investigate how to design these platforms to support users' needs in a crisis, we conducted a two-week diary study with 22 participants across the United States. Participants' news-consumption experience followed two stages: in the seeking stage, participants increased their general consumption, motivated by three common informational needs -- specifically, to find, understand and verify relevant news pieces. Participants then moved to the sustaining stage, and coping with the news emotionally became as important as their informational needs. We elicited design ideas from participants and used these to distill six themes for creating digital news platforms that provide better informational and emotional support during a crisis. Thus, we contribute, first, a model of users' needs over time with respect to engaging with crisis news, and second, example design concepts for supporting users' needs in each of these stages.

As global tourism expands and artificial intelligence technology advances, intelligent travel planning services have emerged as a significant research focus. Within dynamic real-world travel scenarios with multi-dimensional constraints, services that support users in automatically creating practical and customized travel itineraries must address three key objectives: Rationality, Comprehensiveness, and Personalization. However, existing systems with rule-based combinations or LLM-based planning methods struggle to fully satisfy these criteria. To overcome the challenges, we introduce TravelAgent, a travel planning system powered by large language models (LLMs) designed to provide reasonable, comprehensive, and personalized travel itineraries grounded in dynamic scenarios. TravelAgent comprises four modules: Tool-usage, Recommendation, Planning, and Memory Module. We evaluate TravelAgent's performance with human and simulated users, demonstrating its overall effectiveness in three criteria and confirming the accuracy of personalized recommendations.

Several recent works seek to develop foundation models specifically for medical applications, adapting general-purpose large language models (LLMs) and vision-language models (VLMs) via continued pretraining on publicly available biomedical corpora. These works typically claim that such domain-adaptive pretraining (DAPT) improves performance on downstream medical tasks, such as answering medical licensing exam questions. In this paper, we compare seven public "medical" LLMs and two VLMs against their corresponding base models, arriving at a different conclusion: all medical VLMs and nearly all medical LLMs fail to consistently improve over their base models in the zero-/few-shot prompting regime for medical question-answering (QA) tasks. For instance, across the tasks and model pairs we consider in the 3-shot setting, medical LLMs only outperform their base models in 12.1% of cases, reach a (statistical) tie in 49.8% of cases, and are significantly worse than their base models in the remaining 38.2% of cases. Our conclusions are based on (i) comparing each medical model head-to-head, directly against the corresponding base model; (ii) optimizing the prompts for each model separately; and (iii) accounting for statistical uncertainty in comparisons. While these basic practices are not consistently adopted in the literature, our ablations show that they substantially impact conclusions. Our findings suggest that state-of-the-art general-domain models may already exhibit strong medical knowledge and reasoning capabilities, and offer recommendations to strengthen the conclusions of future studies.

Legal research is a time-consuming task that most lawyers face on a daily basis. A large part of legal research entails looking up relevant caselaw and bringing it in relation to the case at hand. Lawyers heavily rely on summaries (also called headnotes) to find the right cases quickly. However, not all decisions are annotated with headnotes and writing them is time-consuming. Automated headnote creation has the potential to make hundreds of thousands of decisions more accessible for legal research in Switzerland alone. To kickstart this, we introduce the Swiss Leading Decision Summarization ( SLDS) dataset, a novel cross-lingual resource featuring 18K court rulings from the Swiss Federal Supreme Court (SFSC), in German, French, and Italian, along with German headnotes. We fine-tune and evaluate three mT5 variants, along with proprietary models. Our analysis highlights that while proprietary models perform well in zero-shot and one-shot settings, fine-tuned smaller models still provide a strong competitive edge. We publicly release the dataset to facilitate further research in multilingual legal summarization and the development of assistive technologies for legal professionals

Legal case retrieval (LCR) aims to provide similar cases as references for a given fact description. This task is crucial for promoting consistent judgments in similar cases, effectively enhancing judicial fairness and improving work efficiency for judges. However, existing works face two main challenges for real-world applications: existing works mainly focus on case-to-case retrieval using lengthy queries, which does not match real-world scenarios; and the limited data scale, with current datasets containing only hundreds of queries, is insufficient to satisfy the training requirements of existing data-hungry neural models. To address these issues, we introduce an automated method to construct synthetic query-candidate pairs and build the largest LCR dataset to date, LEAD, which is hundreds of times larger than existing datasets. This data construction method can provide ample training signals for LCR models. Experimental results demonstrate that model training with our constructed data can achieve state-of-the-art results on two widely-used LCR benchmarks. Besides, the construction method can also be applied to civil cases and achieve promising results. The data and codes can be found in https://github.com/thunlp/LEAD.

Large Language Models (LLMs) are essential tools to collaborate with users on different tasks. Evaluating their performance to serve users' needs in real-world scenarios is important. While many benchmarks have been created, they mainly focus on specific predefined model abilities. Few have covered the intended utilization of LLMs by real users. To address this oversight, we propose benchmarking LLMs from a user perspective in both dataset construction and evaluation designs. We first collect 1846 real-world use cases with 15 LLMs from a user study with 712 participants from 23 countries. These self-reported cases form the User Reported Scenarios(URS) dataset with a categorization of 7 user intents. Secondly, on this authentic multi-cultural dataset, we benchmark 10 LLM services on their efficacy in satisfying user needs. Thirdly, we show that our benchmark scores align well with user-reported experience in LLM interactions across diverse intents, both of which emphasize the overlook of subjective scenarios. In conclusion, our study proposes to benchmark LLMs from a user-centric perspective, aiming to facilitate evaluations that better reflect real user needs. The benchmark dataset and code are available at https://github.com/Alice1998/URS.

Large language models (LLMs) are increasingly envisioned as decision-support tools in clinical practice, yet safe clinical reasoning demands integrating heterogeneous knowledge bases -- trials, primary studies, regulatory documents, and cost data -- under strict accuracy constraints. Existing evaluations often rely on synthetic prompts, reduce the task to single-hop factoid queries, or conflate reasoning with open-ended generation, leaving their real-world utility unclear. To close this gap, we present MedBrowseComp, the first benchmark that systematically tests an agent's ability to reliably retrieve and synthesize multi-hop medical facts from live, domain-specific knowledge bases. MedBrowseComp contains more than 1,000 human-curated questions that mirror clinical scenarios where practitioners must reconcile fragmented or conflicting information to reach an up-to-date conclusion. Applying MedBrowseComp to frontier agentic systems reveals performance shortfalls as low as ten percent, exposing a critical gap between current LLM capabilities and the rigor demanded in clinical settings. MedBrowseComp therefore offers a clear testbed for reliable medical information seeking and sets concrete goals for future model and toolchain upgrades. You can visit our project page at: https://moreirap12.github.io/mbc-browse-app/

We consider the problem of automatically generating a narrative biomedical evidence summary from multiple trial reports. We evaluate modern neural models for abstractive summarization of relevant article abstracts from systematic reviews previously conducted by members of the Cochrane collaboration, using the authors conclusions section of the review abstract as our target. We enlist medical professionals to evaluate generated summaries, and we find that modern summarization systems yield consistently fluent and relevant synopses, but that they are not always factual. We propose new approaches that capitalize on domain-specific models to inform summarization, e.g., by explicitly demarcating snippets of inputs that convey key findings, and emphasizing the reports of large and high-quality trials. We find that these strategies modestly improve the factual accuracy of generated summaries. Finally, we propose a new method for automatically evaluating the factuality of generated narrative evidence syntheses using models that infer the directionality of reported findings.

LLMs have immense potential for generating plans, transforming an initial world state into a desired goal state. A large body of research has explored the use of LLMs for various planning tasks, from web navigation to travel planning and database querying. However, many of these systems are tailored to specific problems, making it challenging to compare them or determine the best approach for new tasks. There is also a lack of clear and consistent evaluation criteria. Our survey aims to offer a comprehensive overview of current LLM planners to fill this gap. It builds on foundational work by Kartam and Wilkins (1990) and examines six key performance criteria: completeness, executability, optimality, representation, generalization, and efficiency. For each, we provide a thorough analysis of representative works and highlight their strengths and weaknesses. Our paper also identifies crucial future directions, making it a valuable resource for both practitioners and newcomers interested in leveraging LLM planning to support agentic workflows.

Large Language Models (LLMs), despite their remarkable progress across various general domains, encounter significant barriers in medicine and healthcare. This field faces unique challenges such as domain-specific terminologies and the reasoning over specialized knowledge. To address these obstinate issues, we propose a novel Multi-disciplinary Collaboration (MC) framework for the medical domain that leverages role-playing LLM-based agents who participate in a collaborative multi-round discussion, thereby enhancing LLM proficiency and reasoning capabilities. This training-free and interpretable framework encompasses five critical steps: gathering domain experts, proposing individual analyses, summarising these analyses into a report, iterating over discussions until a consensus is reached, and ultimately making a decision. Our work particularly focuses on the zero-shot scenario, our results on nine data sets (MedQA, MedMCQA, PubMedQA, and six subtasks from MMLU) establish that our proposed MC framework excels at mining and harnessing the medical expertise in LLMs, as well as extending its reasoning abilities. Based on these outcomes, we further conduct a human evaluation to pinpoint and categorize common errors within our method, as well as ablation studies aimed at understanding the impact of various factors on overall performance. Our code can be found at https://github.com/gersteinlab/MedAgents.

To reduce the number of pending cases and conflicting rulings in the Brazilian Judiciary, the National Congress amended the Constitution, allowing the Brazilian Supreme Court (STF) to create binding precedents (BPs), i.e., a set of understandings that both Executive and lower Judiciary branches must follow. The STF's justices frequently cite the 58 existing BPs in their decisions, and it is of primary relevance that judicial experts could identify and analyze such citations. To assist in this problem, we propose LegalVis, a web-based visual analytics system designed to support the analysis of legal documents that cite or could potentially cite a BP. We model the problem of identifying potential citations (i.e., non-explicit) as a classification problem. However, a simple score is not enough to explain the results; that is why we use an interpretability machine learning method to explain the reason behind each identified citation. For a compelling visual exploration of documents and BPs, LegalVis comprises three interactive visual components: the first presents an overview of the data showing temporal patterns, the second allows filtering and grouping relevant documents by topic, and the last one shows a document's text aiming to interpret the model's output by pointing out which paragraphs are likely to mention the BP, even if not explicitly specified. We evaluated our identification model and obtained an accuracy of 96%; we also made a quantitative and qualitative analysis of the results. The usefulness and effectiveness of LegalVis were evaluated through two usage scenarios and feedback from six domain experts.

The World Health Organization added Disease X to their shortlist of blueprint priority diseases to represent a hypothetical, unknown pathogen that could cause a future epidemic. During different virus outbreaks of the past, such as COVID-19, Influenza, Lyme Disease, and Zika virus, researchers from various disciplines utilized Google Trends to mine multimodal components of web behavior to study, investigate, and analyze the global awareness, preparedness, and response associated with these respective virus outbreaks. As the world prepares for Disease X, a dataset on web behavior related to Disease X would be crucial to contribute towards the timely advancement of research in this field. Furthermore, none of the prior works in this field have focused on the development of a dataset to compile relevant web behavior data, which would help to prepare for Disease X. To address these research challenges, this work presents a dataset of web behavior related to Disease X, which emerged from different geographic regions of the world, between February 2018 and August 2023. Specifically, this dataset presents the search interests related to Disease X from 94 geographic regions. The dataset was developed by collecting data using Google Trends. The relevant search interests for all these regions for each month in this time range are available in this dataset. This paper also discusses the compliance of this dataset with the FAIR principles of scientific data management. Finally, an analysis of this dataset is presented to uphold the applicability, relevance, and usefulness of this dataset for the investigation of different research questions in the interrelated fields of Big Data, Data Mining, Healthcare, Epidemiology, and Data Analysis with a specific focus on Disease X.

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

Several recent works seek to develop foundation models specifically for medical applications, adapting general-purpose large language models (LLMs) and vision-language models (VLMs) via continued pretraining on publicly available biomedical corpora. These works typically claim that such domain-adaptive pretraining (DAPT) improves performance on downstream medical tasks, such as answering medical licensing exam questions. In this paper, we compare ten public "medical" LLMs and two VLMs against their corresponding base models, arriving at a different conclusion: all medical VLMs and nearly all medical LLMs fail to consistently improve over their base models in the zero-/few-shot prompting and supervised fine-tuning regimes for medical question-answering (QA). For instance, across all tasks and model pairs we consider in the 3-shot setting, medical LLMs only outperform their base models in 22.7% of cases, reach a (statistical) tie in 36.8% of cases, and are significantly worse than their base models in the remaining 40.5% of cases. Our conclusions are based on (i) comparing each medical model head-to-head, directly against the corresponding base model; (ii) optimizing the prompts for each model separately in zero-/few-shot prompting; and (iii) accounting for statistical uncertainty in comparisons. While these basic practices are not consistently adopted in the literature, our ablations show that they substantially impact conclusions. Meanwhile, we find that after fine-tuning on specific QA tasks, medical LLMs can show performance improvements, but the benefits do not carry over to tasks based on clinical notes. Our findings suggest that state-of-the-art general-domain models may already exhibit strong medical knowledge and reasoning capabilities, and offer recommendations to strengthen the conclusions of future studies.

Recent advances in LegalAI have primarily focused on individual case judgment analysis, often overlooking the critical appellate process within the judicial system. Appeals serve as a core mechanism for error correction and ensuring fair trials, making them highly significant both in practice and in research. To address this gap, we present the AppealCase dataset, consisting of 10,000 pairs of real-world, matched first-instance and second-instance documents across 91 categories of civil cases. The dataset also includes detailed annotations along five dimensions central to appellate review: judgment reversals, reversal reasons, cited legal provisions, claim-level decisions, and whether there is new information in the second instance. Based on these annotations, we propose five novel LegalAI tasks and conduct a comprehensive evaluation across 20 mainstream models. Experimental results reveal that all current models achieve less than 50% F1 scores on the judgment reversal prediction task, highlighting the complexity and challenge of the appeal scenario. We hope that the AppealCase dataset will spur further research in LegalAI for appellate case analysis and contribute to improving consistency in judicial decision-making.

Medical reasoning models (MRMs) achieve superior performance on medical benchmarks compared to medical LLMs; however, high accuracy alone is insufficient for practical deployment. One of such requirements for real-world application is robustness to varying output constraints. Specifically, posing the same medical question while requesting different answer formats should not affect the underlying correctness of the response. We investigate this phenomenon in this paper, focusing on MRMs. To quantify this behavior, we propose the metric answer-format robustness: the ability to reliably generate correct outputs across varying specified formats. We examine three representative formats: multiple-choice, open-ended question-answering, and ranked lists. Across 15 proprietary and open-weight models, we observe substantial variation in format robustness (35-100%). Furthermore, we conduct controlled fine-tuning experiments on a shared backbone with matched training data to isolate the effects of the fine-tuning paradigm. We find that supervised fine-tuning yields more stable behavior across formats, whereas reinforcement fine-tuning often exhibits higher cross-format brittleness, with the degree of instability strongly dependent on reward design. Overall, answer-format robustness in MRMs is trainable yet brittle and requires careful evaluation for practical medical use.

The emergent phenomena of large foundation models have revolutionized natural language processing. However, evaluating these models presents significant challenges due to their size, capabilities, and deployment across diverse applications. Existing literature often focuses on individual aspects, such as benchmark performance or specific tasks, but fails to provide a cohesive process that integrates the nuances of diverse use cases with broader ethical and operational considerations. This work focuses on three key aspects: (1) Formalizing the Evaluation Process by providing a structured framework tailored to specific use-case contexts, (2) Offering Actionable Tools and Frameworks such as checklists and templates to ensure thorough, reproducible, and practical evaluations, and (3) Surveying Recent Work with a targeted review of advancements in LLM evaluation, emphasizing real-world applications.

We present a new dataset for machine comprehension in the medical domain. Our dataset uses clinical case reports with around 100,000 gap-filling queries about these cases. We apply several baselines and state-of-the-art neural readers to the dataset, and observe a considerable gap in performance (20% F1) between the best human and machine readers. We analyze the skills required for successful answering and show how reader performance varies depending on the applicable skills. We find that inferences using domain knowledge and object tracking are the most frequently required skills, and that recognizing omitted information and spatio-temporal reasoning are the most difficult for the machines.

Legal professionals need to write analyses that rely on citations to relevant precedents, i.e., previous case decisions. Intelligent systems assisting legal professionals in writing such documents provide great benefits but are challenging to design. Such systems need to help locate, summarize, and reason over salient precedents in order to be useful. To enable systems for such tasks, we work with legal professionals to transform a large open-source legal corpus into a dataset supporting two important backbone tasks: information retrieval (IR) and retrieval-augmented generation (RAG). This dataset CLERC (Case Law Evaluation Retrieval Corpus), is constructed for training and evaluating models on their ability to (1) find corresponding citations for a given piece of legal analysis and to (2) compile the text of these citations (as well as previous context) into a cogent analysis that supports a reasoning goal. We benchmark state-of-the-art models on CLERC, showing that current approaches still struggle: GPT-4o generates analyses with the highest ROUGE F-scores but hallucinates the most, while zero-shot IR models only achieve 48.3% recall@1000.

With the rapid development of artificial intelligence, large language models (LLMs) have shown promising capabilities in mimicking human-level language comprehension and reasoning. This has sparked significant interest in applying LLMs to enhance various aspects of healthcare, ranging from medical education to clinical decision support. However, medicine involves multifaceted data modalities and nuanced reasoning skills, presenting challenges for integrating LLMs. This paper provides a comprehensive review on the applications and implications of LLMs in medicine. It begins by examining the fundamental applications of general-purpose and specialized LLMs, demonstrating their utilities in knowledge retrieval, research support, clinical workflow automation, and diagnostic assistance. Recognizing the inherent multimodality of medicine, the review then focuses on multimodal LLMs, investigating their ability to process diverse data types like medical imaging and EHRs to augment diagnostic accuracy. To address LLMs' limitations regarding personalization and complex clinical reasoning, the paper explores the emerging development of LLM-powered autonomous agents for healthcare. Furthermore, it summarizes the evaluation methodologies for assessing LLMs' reliability and safety in medical contexts. Overall, this review offers an extensive analysis on the transformative potential of LLMs in modern medicine. It also highlights the pivotal need for continuous optimizations and ethical oversight before these models can be effectively integrated into clinical practice. Visit https://github.com/mingze-yuan/Awesome-LLM-Healthcare for an accompanying GitHub repository containing latest papers.

The third ML4H symposium was held in person on December 10, 2023, in New Orleans, Louisiana, USA. The symposium included research roundtable sessions to foster discussions between participants and senior researchers on timely and relevant topics for the ML4H community. Encouraged by the successful virtual roundtables in the previous year, we organized eleven in-person roundtables and four virtual roundtables at ML4H 2022. The organization of the research roundtables at the conference involved 17 Senior Chairs and 19 Junior Chairs across 11 tables. Each roundtable session included invited senior chairs (with substantial experience in the field), junior chairs (responsible for facilitating the discussion), and attendees from diverse backgrounds with interest in the session's topic. Herein we detail the organization process and compile takeaways from these roundtable discussions, including recent advances, applications, and open challenges for each topic. We conclude with a summary and lessons learned across all roundtables. This document serves as a comprehensive review paper, summarizing the recent advancements in machine learning for healthcare as contributed by foremost researchers in the field.

We present a novel Transformer-based multi-agent system for simulating the judicial rulings of the 2010-2016 Supreme Court of the United States. We train nine separate models with the respective authored opinions of each supreme justice active ca. 2015 and test the resulting system on 96 real-world cases. We find our system predicts the decisions of the real-world Supreme Court with better-than-random accuracy. We further find a correlation between model accuracy with respect to individual justices and their alignment between legal conservatism & liberalism. Our methods and results hold significance for researchers interested in using language models to simulate politically-charged discourse between multiple agents.

Large Language Model (LLM) agents have shown strong results on multi-turn tool-use tasks, yet they operate in isolation during training, failing to leverage experiences accumulated across episodes. Existing experience-augmented methods address this by organizing trajectories into retrievable libraries, but they retrieve experiences only once based on the initial task description and hold them constant throughout the episode. In multi-turn settings where observations change at every step, this static retrieval becomes increasingly mismatched as episodes progress. We propose SLEA-RL (Step-Level Experience-Augmented Reinforcement Learning), a framework that retrieves relevant experiences at each decision step conditioned on the current observation. SLEA-RL operates through three components: (i) step-level observation clustering that groups structurally equivalent environmental states for efficient cluster-indexed retrieval; (ii) a self-evolving experience library that distills successful strategies and failure patterns through score-based admission and rate-limited extraction; and (iii) policy optimization with step-level credit assignment for fine-grained advantage estimation across multi-turn episodes. The experience library evolves alongside the policy through semantic analysis rather than gradient updates. Experiments on long-horizon multi-turn agent benchmarks demonstrate that SLEA-RL achieves superior performance compared to various reinforcement learning baselines.

Similar case retrieval (SCR) is a representative legal AI application that plays a pivotal role in promoting judicial fairness. However, existing SCR datasets only focus on the fact description section when judging the similarity between cases, ignoring other valuable sections (e.g., the court's opinion) that can provide insightful reasoning process behind. Furthermore, the case similarities are typically measured solely by the textual semantics of the fact descriptions, which may fail to capture the full complexity of legal cases from the perspective of legal knowledge. In this work, we present MUSER, a similar case retrieval dataset based on multi-view similarity measurement and comprehensive legal element with sentence-level legal element annotations. Specifically, we select three perspectives (legal fact, dispute focus, and law statutory) and build a comprehensive and structured label schema of legal elements for each of them, to enable accurate and knowledgeable evaluation of case similarities. The constructed dataset originates from Chinese civil cases and contains 100 query cases and 4,024 candidate cases. We implement several text classification algorithms for legal element prediction and various retrieval methods for retrieving similar cases on MUSER. The experimental results indicate that incorporating legal elements can benefit the performance of SCR models, but further efforts are still required to address the remaining challenges posed by MUSER. The source code and dataset are released at https://github.com/THUlawtech/MUSER.

As the global burden of Alzheimer's disease (AD) continues to grow, early and accurate detection has become increasingly critical, especially in regions with limited access to advanced diagnostic tools. We propose BRAINS (Biomedical Retrieval-Augmented Intelligence for Neurodegeneration Screening) to address this challenge. This novel system harnesses the powerful reasoning capabilities of Large Language Models (LLMs) for Alzheimer's detection and monitoring. BRAINS features a dual-module architecture: a cognitive diagnostic module and a case-retrieval module. The Diagnostic Module utilizes LLMs fine-tuned on cognitive and neuroimaging datasets -- including MMSE, CDR scores, and brain volume metrics -- to perform structured assessments of Alzheimer's risk. Meanwhile, the Case Retrieval Module encodes patient profiles into latent representations and retrieves similar cases from a curated knowledge base. These auxiliary cases are fused with the input profile via a Case Fusion Layer to enhance contextual understanding. The combined representation is then processed with clinical prompts for inference. Evaluations on real-world datasets demonstrate BRAINS effectiveness in classifying disease severity and identifying early signs of cognitive decline. This system not only shows strong potential as an assistive tool for scalable, explainable, and early-stage Alzheimer's disease detection, but also offers hope for future applications in the field.

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.

As an important component of intelligent legal systems, legal case retrieval plays a critical role in ensuring judicial justice and fairness. However, the development of legal case retrieval technologies in the Chinese legal system is restricted by three problems in existing datasets: limited data size, narrow definitions of legal relevance, and naive candidate pooling strategies used in data sampling. To alleviate these issues, we introduce LeCaRDv2, a large-scale Legal Case Retrieval Dataset (version 2). It consists of 800 queries and 55,192 candidates extracted from 4.3 million criminal case documents. To the best of our knowledge, LeCaRDv2 is one of the largest Chinese legal case retrieval datasets, providing extensive coverage of criminal charges. Additionally, we enrich the existing relevance criteria by considering three key aspects: characterization, penalty, procedure. This comprehensive criteria enriches the dataset and may provides a more holistic perspective. Furthermore, we propose a two-level candidate set pooling strategy that effectively identify potential candidates for each query case. It's important to note that all cases in the dataset have been annotated by multiple legal experts specializing in criminal law. Their expertise ensures the accuracy and reliability of the annotations. We evaluate several state-of-the-art retrieval models at LeCaRDv2, demonstrating that there is still significant room for improvement in legal case retrieval. The details of LeCaRDv2 can be found at the anonymous website https://github.com/anonymous1113243/LeCaRDv2.

Evaluating LLMs with a single prompt has proven unreliable, with small changes leading to significant performance differences. However, generating the prompt variations needed for a more robust multi-prompt evaluation is challenging, limiting its adoption in practice. To address this, we introduce PromptSuite, a framework that enables the automatic generation of various prompts. PromptSuite is flexible - working out of the box on a wide range of tasks and benchmarks. It follows a modular prompt design, allowing controlled perturbations to each component, and is extensible, supporting the addition of new components and perturbation types. Through a series of case studies, we show that PromptSuite provides meaningful variations to support strong evaluation practices. It is available through both a Python API: https://github.com/eliyahabba/PromptSuite, and a user-friendly web interface: https://promptsuite.streamlit.app/

Large-language models have recently demonstrated impressive zero-shot capabilities in a variety of natural language tasks such as summarization, dialogue generation, and question-answering. Despite many promising applications in clinical medicine, adoption of these models in real-world settings has been largely limited by their tendency to generate incorrect and sometimes even toxic statements. In this study, we develop Almanac, a large language model framework augmented with retrieval capabilities for medical guideline and treatment recommendations. Performance on a novel dataset of clinical scenarios (n = 130) evaluated by a panel of 5 board-certified and resident physicians demonstrates significant increases in factuality (mean of 18% at p-value < 0.05) across all specialties, with improvements in completeness and safety. Our results demonstrate the potential for large language models to be effective tools in the clinical decision-making process, while also emphasizing the importance of careful testing and deployment to mitigate their shortcomings.

Recent studies have highlighted their proficiency in some simple tasks like writing and coding through various reasoning strategies. However, LLM agents still struggle with tasks that require comprehensive planning, a process that challenges current models and remains a critical research issue. In this study, we concentrate on travel planning, a Multi-Phases planning problem, that involves multiple interconnected stages, such as outlining, information gathering, and planning, often characterized by the need to manage various constraints and uncertainties. Existing reasoning approaches have struggled to effectively address this complex task. Our research aims to address this challenge by developing a human-like planning framework for LLM agents, i.e., guiding the LLM agent to simulate various steps that humans take when solving Multi-Phases problems. Specifically, we implement several strategies to enable LLM agents to generate a coherent outline for each travel query, mirroring human planning patterns. Additionally, we integrate Strategy Block and Knowledge Block into our framework: Strategy Block facilitates information collection, while Knowledge Block provides essential information for detailed planning. Through our extensive experiments, we demonstrate that our framework significantly improves the planning capabilities of LLM agents, enabling them to tackle the travel planning task with improved efficiency and effectiveness. Our experimental results showcase the exceptional performance of the proposed framework; when combined with GPT-4-Turbo, it attains 10times the performance gains in comparison to the baseline framework deployed on GPT-4-Turbo.

Dynamic treatment regimes (DTRs) are personalized, adaptive, multi-stage treatment plans that adapt treatment decisions both to an individual's initial features and to intermediate outcomes and features at each subsequent stage, which are affected by decisions in prior stages. Examples include personalized first- and second-line treatments of chronic conditions like diabetes, cancer, and depression, which adapt to patient response to first-line treatment, disease progression, and individual characteristics. While existing literature mostly focuses on estimating the optimal DTR from offline data such as from sequentially randomized trials, we study the problem of developing the optimal DTR in an online manner, where the interaction with each individual affect both our cumulative reward and our data collection for future learning. We term this the DTR bandit problem. We propose a novel algorithm that, by carefully balancing exploration and exploitation, is guaranteed to achieve rate-optimal regret when the transition and reward models are linear. We demonstrate our algorithm and its benefits both in synthetic experiments and in a case study of adaptive treatment of major depressive disorder using real-world data.

With the proliferation of Large Language Models (LLMs) in diverse domains, there is a particular need for unified evaluation standards in clinical medical scenarios, where models need to be examined very thoroughly. We present CliMedBench, a comprehensive benchmark with 14 expert-guided core clinical scenarios specifically designed to assess the medical ability of LLMs across 7 pivot dimensions. It comprises 33,735 questions derived from real-world medical reports of top-tier tertiary hospitals and authentic examination exercises. The reliability of this benchmark has been confirmed in several ways. Subsequent experiments with existing LLMs have led to the following findings: (i) Chinese medical LLMs underperform on this benchmark, especially where medical reasoning and factual consistency are vital, underscoring the need for advances in clinical knowledge and diagnostic accuracy. (ii) Several general-domain LLMs demonstrate substantial potential in medical clinics, while the limited input capacity of many medical LLMs hinders their practical use. These findings reveal both the strengths and limitations of LLMs in clinical scenarios and offer critical insights for medical research.

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

We present the Legal Passage Retrieval Dataset LePaRD. LePaRD is a massive collection of U.S. federal judicial citations to precedent in context. The dataset aims to facilitate work on legal passage prediction, a challenging practice-oriented legal retrieval and reasoning task. Legal passage prediction seeks to predict relevant passages from precedential court decisions given the context of a legal argument. We extensively evaluate various retrieval approaches on LePaRD, and find that classification appears to work best. However, we note that legal precedent prediction is a difficult task, and there remains significant room for improvement. We hope that by publishing LePaRD, we will encourage others to engage with a legal NLP task that promises to help expand access to justice by reducing the burden associated with legal research. A subset of the LePaRD dataset is freely available and the whole dataset will be released upon publication.

The way in which data are shared can affect their utility and reusability. Here, we demonstrate how data that we had previously shared in bulk can be mobilized further through a knowledge graph that allows for much more granular exploration and interrogation. The original dataset is about the computational reproducibility of GitHub-hosted Jupyter notebooks associated with biomedical publications. It contains rich metadata about the publications, associated GitHub repositories and Jupyter notebooks, and the notebooks' reproducibility. We took this dataset, converted it into semantic triples and loaded these into a triple store to create a knowledge graph, FAIR Jupyter, that we made accessible via a web service. This enables granular data exploration and analysis through queries that can be tailored to specific use cases. Such queries may provide details about any of the variables from the original dataset, highlight relationships between them or combine some of the graph's content with materials from corresponding external resources. We provide a collection of example queries addressing a range of use cases in research and education. We also outline how sets of such queries can be used to profile specific content types, either individually or by class. We conclude by discussing how such a semantically enhanced sharing of complex datasets can both enhance their FAIRness, i.e., their findability, accessibility, interoperability, and reusability, and help identify and communicate best practices, particularly with regards to data quality, standardization, automation and reproducibility.

Large Language Models (LLMs) struggle to directly generate correct plans for complex multi-constraint planning problems, even with self-verification and self-critique. For example, a U.S. domestic travel planning benchmark TravelPlanner was proposed in Xie et al. (2024), where the best LLM OpenAI o1-preview can only find viable travel plans with a 10% success rate given all needed information. In this work, we tackle this by proposing an LLM-based planning framework that formalizes and solves complex multi-constraint planning problems as constrained satisfiability problems, which are further consumed by sound and complete satisfiability solvers. We start with TravelPlanner as the primary use case and show that our framework achieves a success rate of 93.9% and is effective with diverse paraphrased prompts. More importantly, our framework has strong zero-shot generalizability, successfully handling unseen constraints in our newly created unseen international travel dataset and generalizing well to new fundamentally different domains. Moreover, when user input queries are infeasible, our framework can identify the unsatisfiable core, provide failure reasons, and offers personalized modification suggestions. We show that our framework can modify and solve for an average of 81.6% and 91.7% unsatisfiable queries from two datasets and prove with ablations that all key components of our framework are effective and necessary. Project page: https://sites.google.com/view/llm-rwplanning.

In this paper, we introduce GUIDE, a novel dataset tailored for the advancement of Multimodal Large Language Model (MLLM) applications, particularly focusing on Robotic Process Automation (RPA) use cases. Our dataset encompasses diverse data from various websites including Apollo(62.67\%), Gmail(3.43\%), Calendar(10.98\%) and Canva(22.92\%). Each data entry includes an image, a task description, the last action taken, CoT and the next action to be performed along with grounding information of where the action needs to be executed. The data is collected using our in-house advanced annotation tool NEXTAG (Next Action Grounding and Annotation Tool). The data is adapted for multiple OS, browsers and display types. It is collected by multiple annotators to capture the variation of design and the way person uses a website. Through this dataset, we aim to facilitate research and development in the realm of LLMs for graphical user interfaces, particularly in tasks related to RPA. The dataset's multi-platform nature and coverage of diverse websites enable the exploration of cross-interface capabilities in automation tasks. We believe that our dataset will serve as a valuable resource for advancing the capabilities of multi-platform LLMs in practical applications, fostering innovation in the field of automation and natural language understanding. Using GUIDE, we build V-Zen, the first RPA model to automate multiple websites using our in-House Automation tool AUTONODE

With the recent rapid advancement of Agentic Intelligence, agentic tool use in LLMs has become increasingly important. During multi-turn interactions between agents and users, the dynamic, uncertain, and stochastic nature of user demands poses significant challenges to the agent's tool invocation capabilities. Agents are no longer expected to simply call tools to deliver a result; rather, they must iteratively refine their understanding of user needs through communication while simultaneously invoking tools to resolve user queries. Existing reinforcement learning (RL) approaches for tool use lack the integration of genuinely dynamic users during the RL training process. To bridge this gap, we introduce MUA-RL (Multi-turn User-interacting Agent Reinforcement Learning for agentic tool use), a novel reinforcement learning framework that, for the first time in the field of agentic tool use, integrates LLM-simulated users into the reinforcement learning loop. MUA-RL aims to enable autonomous learning of models to communicate with users efficiently and use various tools to solve practical problems in dynamic multi-turn interactions. Evaluations are done on several multi-turn tool-using benchmarks (see Figure 1). Specifically, MUA-RL-32B achieves 67.3 on TAU2 Retail, 45.4 on TAU2 Airline, 28.3 on TAU2 Telecom, 28.4 on BFCL-V3 Multi Turn, and 82.5 on ACEBench Agent -- outperforming or matching the performance of larger open-source models such as DeepSeek-V3-0324 and Qwen3-235B-A22B in non-thinking settings.

Medical systematic reviews can be very costly and resource intensive. We explore how Large Language Models (LLMs) can support and be trained to perform literature screening when provided with a detailed set of selection criteria. Specifically, we instruction tune LLaMA and Guanaco models to perform abstract screening for medical systematic reviews. Our best model, Bio-SIEVE, outperforms both ChatGPT and trained traditional approaches, and generalises better across medical domains. However, there remains the challenge of adapting the model to safety-first scenarios. We also explore the impact of multi-task training with Bio-SIEVE-Multi, including tasks such as PICO extraction and exclusion reasoning, but find that it is unable to match single-task Bio-SIEVE's performance. We see Bio-SIEVE as an important step towards specialising LLMs for the biomedical systematic review process and explore its future developmental opportunities. We release our models, code and a list of DOIs to reconstruct our dataset for reproducibility.

Recent advances in the area of legal information systems have led to a variety of applications that promise support in processing and accessing legal documents. Unfortunately, these applications have various limitations, e.g., regarding scope or extensibility. Furthermore, we do not observe a trend towards open access in digital libraries in the legal domain as we observe in other domains, e.g., economics of computer science. To improve open access in the legal domain, we present our approach for an open source platform to transparently process and access Legal Open Data. This enables the sustainable development of legal applications by offering a single technology stack. Moreover, the approach facilitates the development and deployment of new technologies. As proof of concept, we implemented six technologies and generated metadata for more than 250,000 German laws and court decisions. Thus, we can provide users of our platform not only access to legal documents, but also the contained information.

The reliability of medical LLM evaluation is critically undermined by data contamination and knowledge obsolescence, leading to inflated scores on static benchmarks. To address these challenges, we introduce LiveClin, a live benchmark designed for approximating real-world clinical practice. Built from contemporary, peer-reviewed case reports and updated biannually, LiveClin ensures clinical currency and resists data contamination. Using a verified AI-human workflow involving 239 physicians, we transform authentic patient cases into complex, multimodal evaluation scenarios that span the entire clinical pathway. The benchmark currently comprises 1,407 case reports and 6,605 questions. Our evaluation of 26 models on LiveClin reveals the profound difficulty of these real-world scenarios, with the top-performing model achieving a Case Accuracy of just 35.7%. In benchmarking against human experts, Chief Physicians achieved the highest accuracy, followed closely by Attending Physicians, with both surpassing most models. LiveClin thus provides a continuously evolving, clinically grounded framework to guide the development of medical LLMs towards closing this gap and achieving greater reliability and real-world utility. Our data and code are publicly available at https://github.com/AQ-MedAI/LiveClin.

Although large language models (LLMs) often produce impressive outputs, it remains unclear how they perform in real-world scenarios requiring strong reasoning skills and expert domain knowledge. We set out to investigate whether close- and open-source models (GPT-3.5, LLama-2, etc.) can be applied to answer and reason about difficult real-world-based questions. We focus on three popular medical benchmarks (MedQA-USMLE, MedMCQA, and PubMedQA) and multiple prompting scenarios: Chain-of-Thought (CoT, think step-by-step), few-shot and retrieval augmentation. Based on an expert annotation of the generated CoTs, we found that InstructGPT can often read, reason and recall expert knowledge. Last, by leveraging advances in prompt engineering (few-shot and ensemble methods), we demonstrated that GPT-3.5 not only yields calibrated predictive distributions, but also reaches the passing score on three datasets: MedQA-USMLE 60.2%, MedMCQA 62.7% and PubMedQA 78.2%. Open-source models are closing the gap: Llama-2 70B also passed the MedQA-USMLE with 62.5% accuracy.

In medical scenarios, effectively retrieving external knowledge and leveraging it for rigorous logical reasoning is of significant importance. Despite their potential, existing work has predominantly focused on enhancing either retrieval or reasoning capabilities of the models in isolation, with little attention given to their joint optimization, which leads to limited coordination between the two processes. Additionally, current methods rely heavily on supervised fine-tuning (SFT), which can cause models to memorize existing problem-solving pathways, thereby restricting their generalization ability when confronted with novel problem contexts. Furthermore, while some studies have explored to improve retrieval-augmented reasoning in general domains via reinforcement learning, their reward function designs do not adequately capture the specific demands of the medical domain. To address these challenges, we introduce **Med-R^3**, a **Med**ical **R**etrieval-augmented **R**easoning framework driven by progressive **R**einforcement learning. In this framework, we first develop the model's ability to perform logical reasoning over medical problems. Subsequently, on the basis of this foundation, we adaptively optimize the retrieval capability to better align with the characteristics of knowledge corpus and external information utilization throughout the reasoning process. Finally, we conduct joint optimization of the model's retrieval and reasoning coordination. Extensive experiments indicate that **Med-R^3** could achieve state-of-the-art performances, with LLaMA3.1-8B-Instruct + Med-R^3 surpassing closed-sourced GPT-4o-mini by 3.93\% at a comparable parameter scale, while Qwen2.5-14B augmented with Med-R^3 shows a more substantial gain of 13.53\%.

Despite impressive advances in agent systems, multi-turn tool-use scenarios remain challenging. It is mainly because intent is clarified progressively and the environment evolves with each tool call. While reusing past experience is natural, current LLM agents either treat entire trajectories or pre-defined subtasks as indivisible units, or solely exploit tool-to-tool dependencies, hindering adaptation as states and information evolve across turns. In this paper, we propose a State Integrated Tool Graph (SIT-Graph), which enhances multi-turn tool use by exploiting partially overlapping experience. Inspired by human decision-making that integrates episodic and procedural memory, SIT-Graph captures both compact state representations (episodic-like fragments) and tool-to-tool dependencies (procedural-like routines) from historical trajectories. Specifically, we first build a tool graph from accumulated tool-use sequences, and then augment each edge with a compact state summary of the dialog and tool history that may shape the next action. At inference time, SIT-Graph enables a human-like balance between episodic recall and procedural execution: when the next decision requires recalling prior context, the agent retrieves the state summaries stored on relevant edges and uses them to guide its next action; when the step is routine, it follows high-confidence tool dependencies without explicit recall. Experiments across multiple stateful multi-turn tool-use benchmarks show that SIT-Graph consistently outperforms strong memory- and graph-based baselines, delivering more robust tool selection and more effective experience transfer.

We investigate non-collaborative dialogue agents, which are expected to engage in strategic conversations with diverse users, for securing a mutual agreement that leans favorably towards the system's objectives. This poses two main challenges for existing dialogue agents: 1) The inability to integrate user-specific characteristics into the strategic planning, and 2) The difficulty of training strategic planners that can be generalized to diverse users. To address these challenges, we propose Trip to enhance the capability in tailored strategic planning, incorporating a user-aware strategic planning module and a population-based training paradigm. Through experiments on benchmark non-collaborative dialogue tasks, we demonstrate the effectiveness of Trip in catering to diverse users.

In the context of fact-checking, claims are often repeated across various platforms and in different languages, which can benefit from a process that reduces this redundancy. While retrieving previously fact-checked claims has been investigated as a solution, the growing number of unverified claims and expanding size of fact-checked databases calls for alternative, more efficient solutions. A promising solution is to group claims that discuss the same underlying facts into clusters to improve claim retrieval and validation. However, research on claim clustering is hindered by the lack of suitable datasets. To bridge this gap, we introduce MultiClaimNet, a collection of three multilingual claim cluster datasets containing claims in 86 languages across diverse topics. Claim clusters are formed automatically from claim-matching pairs with limited manual intervention. We leverage two existing claim-matching datasets to form the smaller datasets within MultiClaimNet. To build the larger dataset, we propose and validate an approach involving retrieval of approximate nearest neighbors to form candidate claim pairs and an automated annotation of claim similarity using large language models. This larger dataset contains 85.3K fact-checked claims written in 78 languages. We further conduct extensive experiments using various clustering techniques and sentence embedding models to establish baseline performance. Our datasets and findings provide a strong foundation for scalable claim clustering, contributing to efficient fact-checking pipelines.

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

As LLM-based agents are increasingly deployed in real-life scenarios, existing benchmarks fail to capture their inherent complexity of handling extensive information, leveraging diverse resources, and managing dynamic user interactions. To address this gap, we introduce VitaBench, a challenging benchmark that evaluates agents on versatile interactive tasks grounded in real-world settings. Drawing from daily applications in food delivery, in-store consumption, and online travel services, VitaBench presents agents with the most complex life-serving simulation environment to date, comprising 66 tools. Through a framework that eliminates domain-specific policies, we enable flexible composition of these scenarios and tools, yielding 100 cross-scenario tasks (main results) and 300 single-scenario tasks. Each task is derived from multiple real user requests and requires agents to reason across temporal and spatial dimensions, utilize complex tool sets, proactively clarify ambiguous instructions, and track shifting user intent throughout multi-turn conversations. Moreover, we propose a rubric-based sliding window evaluator, enabling robust assessment of diverse solution pathways in complex environments and stochastic interactions. Our comprehensive evaluation reveals that even the most advanced models achieve only 30% success rate on cross-scenario tasks, and less than 50% success rate on others. Overall, we believe VitaBench will serve as a valuable resource for advancing the development of AI agents in practical real-world applications. The code, dataset, and leaderboard are available at https://vitabench.github.io/

Chain-of-Thought (CoT) has been a widely adopted prompting method, eliciting impressive reasoning abilities of Large Language Models (LLMs). Inspired by the sequential thought structure of CoT, a number of Chain-of-X (CoX) methods have been developed to address various challenges across diverse domains and tasks involving LLMs. In this paper, we provide a comprehensive survey of Chain-of-X methods for LLMs in different contexts. Specifically, we categorize them by taxonomies of nodes, i.e., the X in CoX, and application tasks. We also discuss the findings and implications of existing CoX methods, as well as potential future directions. Our survey aims to serve as a detailed and up-to-date resource for researchers seeking to apply the idea of CoT to broader scenarios.

The knowledge of city exploration trails of people is in short supply because of the complexity in defining meaningful trails representative of individual behaviours and in the access to actionable data. Existing datasets have only recorded isolated check-ins of activities featured by opaque venue types. In this paper, we fill the gaps in defining what is a semantic trail of city exploration and how it can be generated by integrating different data sources. Furthermore, we publicly release two datasets holding millions of semantic trails each and we discuss their most salient characteristics. We finally present an application using these datasets to build a recommender system meant to guide tourists while exploring a city.

The exponential growth of scientific literature necessitates advanced tools for effective knowledge exploration. We present Knowledge Navigator, a system designed to enhance exploratory search abilities by organizing and structuring the retrieved documents from broad topical queries into a navigable, two-level hierarchy of named and descriptive scientific topics and subtopics. This structured organization provides an overall view of the research themes in a domain, while also enabling iterative search and deeper knowledge discovery within specific subtopics by allowing users to refine their focus and retrieve additional relevant documents. Knowledge Navigator combines LLM capabilities with cluster-based methods to enable an effective browsing method. We demonstrate our approach's effectiveness through automatic and manual evaluations on two novel benchmarks, CLUSTREC-COVID and SCITOC. Our code, prompts, and benchmarks are made publicly available.

Medical open-domain question answering demands substantial access to specialized knowledge. Recent efforts have sought to decouple knowledge from model parameters, counteracting architectural scaling and allowing for training on common low-resource hardware. The retrieve-then-read paradigm has become ubiquitous, with model predictions grounded on relevant knowledge pieces from external repositories such as PubMed, textbooks, and UMLS. An alternative path, still under-explored but made possible by the advent of domain-specific large language models, entails constructing artificial contexts through prompting. As a result, "to generate or to retrieve" is the modern equivalent of Hamlet's dilemma. This paper presents MedGENIE, the first generate-then-read framework for multiple-choice question answering in medicine. We conduct extensive experiments on MedQA-USMLE, MedMCQA, and MMLU, incorporating a practical perspective by assuming a maximum of 24GB VRAM. MedGENIE sets a new state-of-the-art (SOTA) in the open-book setting of each testbed, even allowing a small-scale reader to outcompete zero-shot closed-book 175B baselines while using up to 706times fewer parameters. Overall, our findings reveal that generated passages are more effective than retrieved counterparts in attaining higher accuracy.

As the performance of large language models (LLMs) continues to advance, their adoption is expanding across a wide range of domains, including the medical field. The integration of LLMs into medical applications raises critical safety concerns, particularly due to their use by users with diverse roles, e.g. patients and clinicians, and the potential for model's outputs to directly affect human health. Despite the domain-specific capabilities of medical LLMs, prior safety evaluations have largely focused only on general safety benchmarks. In this paper, we introduce a safety evaluation protocol tailored to the medical domain in both patient user and clinician user perspectives, alongside general safety assessments and quantitatively analyze the safety of medical LLMs. We bridge a gap in the literature by building the PatientSafetyBench containing 466 samples over 5 critical categories to measure safety from the perspective of the patient. We apply our red-teaming protocols on the MediPhi model collection as a case study. To our knowledge, this is the first work to define safety evaluation criteria for medical LLMs through targeted red-teaming taking three different points of view - patient, clinician, and general user - establishing a foundation for safer deployment in medical domains.

Continuity of care is crucial to ensuring positive health outcomes for patients discharged from an inpatient hospital setting, and improved information sharing can help. To share information, caregivers write discharge notes containing action items to share with patients and their future caregivers, but these action items are easily lost due to the lengthiness of the documents. In this work, we describe our creation of a dataset of clinical action items annotated over MIMIC-III, the largest publicly available dataset of real clinical notes. This dataset, which we call CLIP, is annotated by physicians and covers 718 documents representing 100K sentences. We describe the task of extracting the action items from these documents as multi-aspect extractive summarization, with each aspect representing a type of action to be taken. We evaluate several machine learning models on this task, and show that the best models exploit in-domain language model pre-training on 59K unannotated documents, and incorporate context from neighboring sentences. We also propose an approach to pre-training data selection that allows us to explore the trade-off between size and domain-specificity of pre-training datasets for this task.

Objective: Data unavailability has been one of the biggest barriers in clinical natural language processing. This paper is aimed at providing a large-scale and publicly available patient note dataset, named PMC-Patients, with relevant articles and similar patients annotations. The ultimate goal of PMC-Patients is to facilitate the development of retrieval-based clinical decision support systems. Materials and Methods: To collect PMC-Patients, we extract patient notes from case reports in PubMed Central by recognizing certain section patterns. Patient-article relevance and patient-patient similarity are annotated by citation relationships in PubMed. In addition, we perform three tasks with PMC-Patients to demonstrate its utility in providing clinical decision support for a given patient, including (1) classifying whether another patient is similar, (2) retrieving similar patients in PMC-Patients, and (3) retrieving relevant articles in PubMed. Results: We collect and release PMC-Patients under the CC BY-NC-SA license, which becomes the largest publicly available patient note dataset so far. PMC-Patients contains 167k patient notes that are annotated with 3.1M relevant articles and 293k similar patients. Qualitative and quantitative analyses reveal the high quality and richness of our dataset. Experiments show that classifying the similarity of patient pairs is relatively easy, but it is hard to retrieve similar patients or relevant articles for a given patient from a large set of candidates. Conclusion: We present PMC-Patients, a large-scale dataset of patient notes with high quality, easy access, diverse conditions, and rich annotations. The proposed dataset can also serve as a hard benchmark for evaluating retrieval-based clinical decision support systems.

Medical care follows complex clinical pathways that extend beyond isolated physician-patient encounters, emphasizing decision-making and transitions between different stages. Current benchmarks focusing on static exams or isolated dialogues inadequately evaluate large language models (LLMs) in dynamic clinical scenarios. We introduce CP-Env, a controllable agentic hospital environment designed to evaluate LLMs across end-to-end clinical pathways. CP-Env simulates a hospital ecosystem with patient and physician agents, constructing scenarios ranging from triage and specialist consultation to diagnostic testing and multidisciplinary team meetings for agent interaction. Following real hospital adaptive flow of healthcare, it enables branching, long-horizon task execution. We propose a three-tiered evaluation framework encompassing Clinical Efficacy, Process Competency, and Professional Ethics. Results reveal that most models struggle with pathway complexity, exhibiting hallucinations and losing critical diagnostic details. Interestingly, excessive reasoning steps can sometimes prove counterproductive, while top models tend to exhibit reduced tool dependency through internalized knowledge. CP-Env advances medical AI agents development through comprehensive end-to-end clinical evaluation. We provide the benchmark and evaluation tools for further research and development at https://github.com/SPIRAL-MED/CP_ENV.

In the pharmaceutical industry, the use of artificial intelligence (AI) has seen consistent growth over the past decade. This rise is attributed to major advancements in statistical machine learning methodologies, computational capabilities and the increased availability of large datasets. AI techniques are applied throughout different stages of drug development, ranging from drug discovery to post-marketing benefit-risk assessment. Kolluri et al. provided a review of several case studies that span these stages, featuring key applications such as protein structure prediction, success probability estimation, subgroup identification, and AI-assisted clinical trial monitoring. From a regulatory standpoint, there was a notable uptick in submissions incorporating AI components in 2021. The most prevalent therapeutic areas leveraging AI were oncology (27%), psychiatry (15%), gastroenterology (12%), and neurology (11%). The paradigm of personalized or precision medicine has gained significant traction in recent research, partly due to advancements in AI techniques hamburg2010path. This shift has had a transformative impact on the pharmaceutical industry. Departing from the traditional "one-size-fits-all" model, personalized medicine incorporates various individual factors, such as environmental conditions, lifestyle choices, and health histories, to formulate customized treatment plans. By utilizing sophisticated machine learning algorithms, clinicians and researchers are better equipped to make informed decisions in areas such as disease prevention, diagnosis, and treatment selection, thereby optimizing health outcomes for each individual.

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.

Accurately forecasting patient arrivals at Urgent Care Clinics (UCCs) and Emergency Departments (EDs) is important for effective resourcing and patient care. However, correctly estimating patient flows is not straightforward since it depends on many drivers. The predictability of patient arrivals has recently been further complicated by the COVID-19 pandemic conditions and the resulting lockdowns. This study investigates how a suite of novel quasi-real-time variables like Google search terms, pedestrian traffic, the prevailing incidence levels of influenza, as well as the COVID-19 Alert Level indicators can both generally improve the forecasting models of patient flows and effectively adapt the models to the unfolding disruptions of pandemic conditions. This research also uniquely contributes to the body of work in this domain by employing tools from the eXplainable AI field to investigate more deeply the internal mechanics of the models than has previously been done. The Voting ensemble-based method combining machine learning and statistical techniques was the most reliable in our experiments. Our study showed that the prevailing COVID-19 Alert Level feature together with Google search terms and pedestrian traffic were effective at producing generalisable forecasts. The implications of this study are that proxy variables can effectively augment standard autoregressive features to ensure accurate forecasting of patient flows. The experiments showed that the proposed features are potentially effective model inputs for preserving forecast accuracies in the event of future pandemic outbreaks.

Recently, large language models (LLMs) have demonstrated their effectiveness in various natural language processing (NLP) tasks. However, the lack of tourism knowledge limits the performance of LLMs in tourist attraction presentations and travel planning. To address this challenge, we constructed a supervised fine-tuning dataset for the culture and tourism domain, named Cultour. This dataset consists of three parts: tourism knowledge base QA data, travelogues data, and tourism diversity QA data. Additionally, we propose TourLLM, a Qwen-based model supervised fine-tuned with Cultour, to improve the quality of the information provided about attractions and travel planning. To evaluate the performance of TourLLM, we employed both automatic and human evaluation, and we proposed a human evaluation criterion named CRA (Consistency, Readability, Availability). The experimental results demonstrate the effectiveness of the responses generated by the TourLLM. Our proposed Cultour is accessible at https://github.com/mrweiqk/Cultour.

The remarkable success of Large Language Models (LLMs) has illuminated a promising pathway toward achieving Artificial General Intelligence for both academic and industrial communities, owing to their unprecedented performance across various applications. As LLMs continue to gain prominence in both research and commercial domains, their security and safety implications have become a growing concern, not only for researchers and corporations but also for every nation. Currently, existing surveys on LLM safety primarily focus on specific stages of the LLM lifecycle, e.g., deployment phase or fine-tuning phase, lacking a comprehensive understanding of the entire "lifechain" of LLMs. To address this gap, this paper introduces, for the first time, the concept of "full-stack" safety to systematically consider safety issues throughout the entire process of LLM training, deployment, and eventual commercialization. Compared to the off-the-shelf LLM safety surveys, our work demonstrates several distinctive advantages: (I) Comprehensive Perspective. We define the complete LLM lifecycle as encompassing data preparation, pre-training, post-training, deployment and final commercialization. To our knowledge, this represents the first safety survey to encompass the entire lifecycle of LLMs. (II) Extensive Literature Support. Our research is grounded in an exhaustive review of over 800+ papers, ensuring comprehensive coverage and systematic organization of security issues within a more holistic understanding. (III) Unique Insights. Through systematic literature analysis, we have developed reliable roadmaps and perspectives for each chapter. Our work identifies promising research directions, including safety in data generation, alignment techniques, model editing, and LLM-based agent systems. These insights provide valuable guidance for researchers pursuing future work in this field.

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

Test-time scaling has emerged as a powerful technique for enhancing the reasoning capabilities of large language models. However, its effectiveness in medical reasoning remains uncertain, as the medical domain fundamentally differs from mathematical tasks in terms of knowledge representation and decision-making processes. In this paper, we provide the first comprehensive investigation of test-time scaling for medical reasoning and present m1, a simple yet effective approach that increases a model's medical reasoning capability at inference. Our evaluation across diverse medical tasks demonstrates that test-time scaling consistently enhances medical reasoning, enabling lightweight fine-tuned models under 10B parameters to establish new state-of-the-art performance, while our 32B model rivals previous 70B-scale medical LLMs. However, we identify an optimal reasoning token budget of approximately 4K, beyond which performance may degrade due to overthinking. Budget forcing, which extends test-time computation through iterative prompts, helps models double-check answers but does not necessarily improve the overall medical QA performance and, in some cases, even introduces errors into previously correct responses. Our case-by-case analysis identifies insufficient medical knowledge as a key bottleneck that prevents further performance gains through test-time scaling. We find that increasing data scale, improving data quality, and expanding model capacity consistently enhance medical knowledge grounding, enabling continued performance improvements, particularly on challenging medical benchmarks where smaller models reach saturation. These findings underscore fundamental differences between medical and mathematical reasoning in LLMs, highlighting that enriched medical knowledge, other than increased reasoning depth alone, is essential for realizing the benefits of test-time scaling.

Travel planning is a sophisticated decision-making process that requires synthesizing multifaceted information to construct itineraries. However, existing travel planning approaches face several challenges: (1) Pruning candidate points of interest (POIs) while maintaining a high recall rate; (2) A single reasoning path restricts the exploration capability within the feasible solution space for travel planning; (3) Simultaneously optimizing hard constraints and soft constraints remains a significant difficulty. To address these challenges, we propose TourPlanner, a comprehensive framework featuring multi-path reasoning and constraint-gated reinforcement learning. Specifically, we first introduce a Personalized Recall and Spatial Optimization (PReSO) workflow to construct spatially-aware candidate POIs' set. Subsequently, we propose Competitive consensus Chain-of-Thought (CCoT), a multi-path reasoning paradigm that improves the ability of exploring the feasible solution space. To further refine the plan, we integrate a sigmoid-based gating mechanism into the reinforcement learning stage, which dynamically prioritizes soft-constraint satisfaction only after hard constraints are met. Experimental results on travel planning benchmarks demonstrate that TourPlanner achieves state-of-the-art performance, significantly surpassing existing methods in both feasibility and user-preference alignment.

Recent advances in generative models, including large language models (LLMs), vision language models (VLMs), and diffusion models, have accelerated the field of natural language and image processing in medicine and marked a significant paradigm shift in how biomedical models can be developed and deployed. While these models are highly adaptable to new tasks, scaling and evaluating their usage presents new challenges not addressed in previous frameworks. In particular, the ability of these models to produce useful outputs with little to no specialized training data ("zero-" or "few-shot" approaches), as well as the open-ended nature of their outputs, necessitate the development of new guidelines for robust reporting of clinical generative model research. In response to gaps in standards and best practices for the development of clinical AI tools identified by US Executive Order 141103 and several emerging national networks for clinical AI evaluation, we begin to formalize some of these guidelines by building on the original MI-CLAIM checklist. The new checklist, MI-CLAIM-GEN (Table 1), aims to address differences in training, evaluation, interpretability, and reproducibility of new generative models compared to non-generative ("predictive") AI models. This MI-CLAIM-GEN checklist also seeks to clarify cohort selection reporting with unstructured clinical data and adds additional items on alignment with ethical standards for clinical AI research.

Large Language Models (LLMs) have significantly advanced legal intelligence, but the scarcity of scenario data impedes the progress toward interactive legal scenarios. This paper introduces a Multi-agent Legal Simulation Driver (MASER) to scalably generate synthetic data by simulating interactive legal scenarios. Leveraging real-legal case sources, MASER ensures the consistency of legal attributes between participants and introduces a supervisory mechanism to align participants' characters and behaviors as well as addressing distractions. A Multi-stage Interactive Legal Evaluation (MILE) benchmark is further constructed to evaluate LLMs' performance in dynamic legal scenarios. Extensive experiments confirm the effectiveness of our framework.

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

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.

LLM-based agents have emerged as promising tools, which are crafted to fulfill complex tasks by iterative planning and action. However, these agents are susceptible to undesired planning hallucinations when lacking specific knowledge for expertise-intensive tasks. To address this, preliminary attempts are made to enhance planning reliability by incorporating external workflow-related knowledge. Despite the promise, such infused knowledge is mostly disorganized and diverse in formats, lacking rigorous formalization and comprehensive comparisons. Motivated by this, we formalize different formats of workflow knowledge and present FlowBench, the first benchmark for workflow-guided planning. FlowBench covers 51 different scenarios from 6 domains, with knowledge presented in diverse formats. To assess different LLMs on FlowBench, we design a multi-tiered evaluation framework. We evaluate the efficacy of workflow knowledge across multiple formats, and the results indicate that current LLM agents need considerable improvements for satisfactory planning. We hope that our challenging benchmark can pave the way for future agent planning research.

Access to the right evidence does not guarantee that large language models (LLMs) will reason with it correctly. This gap between retrieval and reasoning is especially concerning in clinical settings, where outputs must align with structured protocols. We study this gap using Written Exposure Therapy (WET) guidelines as a testbed. In evaluating model responses to curated clinician-vetted questions, we find that errors persist even when authoritative passages are provided. To address this, we propose an evaluation framework that measures accuracy, consistency, and fidelity of reasoning. Our results highlight both the potential and the risks: retrieval-augmented generation (RAG) can constrain outputs, but safe deployment requires assessing reasoning as rigorously as retrieval.

Recent advancements in Large Language Models (LLMs) have been reshaping Natural Language Processing (NLP) task in several domains. Their use in the field of Human Resources (HR) has still room for expansions and could be beneficial for several time consuming tasks. Examples such as time-off submissions, medical claims filing, and access requests are noteworthy, but they are by no means the sole instances. However, the aforementioned developments must grapple with the pivotal challenge of constructing a high-quality training dataset. On one hand, most conversation datasets are solving problems for customers not employees. On the other hand, gathering conversations with HR could raise privacy concerns. To solve it, we introduce HR-Multiwoz, a fully-labeled dataset of 550 conversations spanning 10 HR domains to evaluate LLM Agent. Our work has the following contributions: (1) It is the first labeled open-sourced conversation dataset in the HR domain for NLP research. (2) It provides a detailed recipe for the data generation procedure along with data analysis and human evaluations. The data generation pipeline is transferable and can be easily adapted for labeled conversation data generation in other domains. (3) The proposed data-collection pipeline is mostly based on LLMs with minimal human involvement for annotation, which is time and cost-efficient.

A law practitioner has to go through numerous lengthy legal case proceedings for their practices of various categories, such as land dispute, corruption, etc. Hence, it is important to summarize these documents, and ensure that summaries contain phrases with intent matching the category of the case. To the best of our knowledge, there is no evaluation metric that evaluates a summary based on its intent. We propose an automated intent-based summarization metric, which shows a better agreement with human evaluation as compared to other automated metrics like BLEU, ROUGE-L etc. in terms of human satisfaction. We also curate a dataset by annotating intent phrases in legal documents, and show a proof of concept as to how this system can be automated. Additionally, all the code and data to generate reproducible results is available on Github.

Building upon our previous investigations of O1 replication (Part 1: Journey Learning [Qin et al., 2024] and Part 2: Distillation [Huang et al., 2024]), this work explores the potential of inference-time scaling in large language models (LLMs) for medical reasoning tasks, ranging from diagnostic decision-making to treatment planning. Through extensive experiments on medical benchmarks of varying complexity (MedQA, Medbullets, and JAMA Clinical Challenges), our investigation reveals several key insights: (1) Increasing inference time does lead to improved performance. With a modest training set of 500 samples, our model yields substantial performance improvements of 6%-11%. (2) Task complexity directly correlates with the required length of reasoning chains, confirming the necessity of extended thought processes for challenging problems. (3) The differential diagnoses generated by our model adhere to the principles of the hypothetico-deductive method, producing a list of potential conditions that may explain a patient's symptoms and systematically narrowing these possibilities by evaluating the evidence. These findings demonstrate the promising synergy between inference-time scaling and journey learning in advancing LLMs' real-world clinical reasoning capabilities.

We propose Collab-REC, a multi-agent framework designed to counteract popularity bias and enhance diversity in tourism recommendations. In our setting, three LLM-based agents: Personalization, Popularity, and Sustainability, generate city suggestions from complementary perspectives. A non-LLM moderator then merges and refines these proposals via multi-round negotiation, ensuring each agent's viewpoint is incorporated while penalizing spurious or repeated responses. Extensive experiments on European city queries using LLMs from different sizes and model families demonstrate that Collab-REC enhances diversity and overall relevance compared to a single-agent baseline, surfacing lesser-visited locales that are often overlooked. This balanced, context-aware approach addresses over-tourism and better aligns with user-provided constraints, highlighting the promise of multi-stakeholder collaboration in LLM-driven recommender systems. Code, data, and other artifacts are available here: https://github.com/ashmibanerjee/collab-rec, while the prompts used are included in the appendix.

In response to the pressing need for advanced clinical problem-solving tools in healthcare, we introduce BooksMed, a novel framework based on a Large Language Model (LLM). BooksMed uniquely emulates human cognitive processes to deliver evidence-based and reliable responses, utilizing the GRADE (Grading of Recommendations, Assessment, Development, and Evaluations) framework to effectively quantify evidence strength. For clinical decision-making to be appropriately assessed, an evaluation metric that is clinically aligned and validated is required. As a solution, we present ExpertMedQA, a multispecialty clinical benchmark comprised of open-ended, expert-level clinical questions, and validated by a diverse group of medical professionals. By demanding an in-depth understanding and critical appraisal of up-to-date clinical literature, ExpertMedQA rigorously evaluates LLM performance. BooksMed outperforms existing state-of-the-art models Med-PaLM 2, Almanac, and ChatGPT in a variety of medical scenarios. Therefore, a framework that mimics human cognitive stages could be a useful tool for providing reliable and evidence-based responses to clinical inquiries.

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.

Pediatric tumors of the central nervous system are the most common cause of cancer-related death in children. The five-year survival rate for high-grade gliomas in children is less than 20%. Due to their rarity, the diagnosis of these entities is often delayed, their treatment is mainly based on historic treatment concepts, and clinical trials require multi-institutional collaborations. Here we present the CBTN-CONNECT-DIPGR-ASNR-MICCAI BraTS-PEDs challenge, focused on pediatric brain tumors with data acquired across multiple international consortia dedicated to pediatric neuro-oncology and clinical trials. The CBTN-CONNECT-DIPGR-ASNR-MICCAI BraTS-PEDs challenge brings together clinicians and AI/imaging scientists to lead to faster development of automated segmentation techniques that could benefit clinical trials, and ultimately the care of children with brain tumors.

We present a corpus of 5,000 richly annotated abstracts of medical articles describing clinical randomized controlled trials. Annotations include demarcations of text spans that describe the Patient population enrolled, the Interventions studied and to what they were Compared, and the Outcomes measured (the `PICO' elements). These spans are further annotated at a more granular level, e.g., individual interventions within them are marked and mapped onto a structured medical vocabulary. We acquired annotations from a diverse set of workers with varying levels of expertise and cost. We describe our data collection process and the corpus itself in detail. We then outline a set of challenging NLP tasks that would aid searching of the medical literature and the practice of evidence-based medicine.

Planning is central to agents and agentic AI. The ability to plan, e.g., creating travel itineraries within a budget, holds immense potential in both scientific and commercial contexts. Moreover, optimal plans tend to require fewer resources compared to ad-hoc methods. To date, a comprehensive understanding of existing planning benchmarks appears to be lacking. Without it, comparing planning algorithms' performance across domains or selecting suitable algorithms for new scenarios remains challenging. In this paper, we examine a range of planning benchmarks to identify commonly used testbeds for algorithm development and highlight potential gaps. These benchmarks are categorized into embodied environments, web navigation, scheduling, games and puzzles, and everyday task automation. Our study recommends the most appropriate benchmarks for various algorithms and offers insights to guide future benchmark development.

The deployment of Large Language Models (LLMs) in high-stakes clinical settings demands rigorous and reliable evaluation. However, existing medical benchmarks remain static, suffering from two critical limitations: (1) data contamination, where test sets inadvertently leak into training corpora, leading to inflated performance estimates; and (2) temporal misalignment, failing to capture the rapid evolution of medical knowledge. Furthermore, current evaluation metrics for open-ended clinical reasoning often rely on either shallow lexical overlap (e.g., ROUGE) or subjective LLM-as-a-Judge scoring, both inadequate for verifying clinical correctness. To bridge these gaps, we introduce LiveMedBench, a continuously updated, contamination-free, and rubric-based benchmark that weekly harvests real-world clinical cases from online medical communities, ensuring strict temporal separation from model training data. We propose a Multi-Agent Clinical Curation Framework that filters raw data noise and validates clinical integrity against evidence-based medical principles. For evaluation, we develop an Automated Rubric-based Evaluation Framework that decomposes physician responses into granular, case-specific criteria, achieving substantially stronger alignment with expert physicians than LLM-as-a-Judge. To date, LiveMedBench comprises 2,756 real-world cases spanning 38 medical specialties and multiple languages, paired with 16,702 unique evaluation criteria. Extensive evaluation of 38 LLMs reveals that even the best-performing model achieves only 39.2%, and 84% of models exhibit performance degradation on post-cutoff cases, confirming pervasive data contamination risks. Error analysis further identifies contextual application-not factual knowledge-as the dominant bottleneck, with 35-48% of failures stemming from the inability to tailor medical knowledge to patient-specific constraints.

Clinical trial matching is the task of identifying trials for which patients may be potentially eligible. Typically, this task is labor-intensive and requires detailed verification of patient electronic health records (EHRs) against the stringent inclusion and exclusion criteria of clinical trials. This process is manual, time-intensive, and challenging to scale up, resulting in many patients missing out on potential therapeutic options. Recent advancements in Large Language Models (LLMs) have made automating patient-trial matching possible, as shown in multiple concurrent research studies. However, the current approaches are confined to constrained, often synthetic datasets that do not adequately mirror the complexities encountered in real-world medical data. In this study, we present the first, end-to-end large-scale empirical evaluation of clinical trial matching using real-world EHRs. Our study showcases the capability of LLMs to accurately match patients with appropriate clinical trials. We perform experiments with proprietary LLMs, including GPT-4 and GPT-3.5, as well as our custom fine-tuned model called OncoLLM and show that OncoLLM, despite its significantly smaller size, not only outperforms GPT-3.5 but also matches the performance of qualified medical doctors. All experiments were carried out on real-world EHRs that include clinical notes and available clinical trials from a single cancer center in the United States.

Common law courts need to refer to similar precedents' judgments to inform their current decisions. Generating high-quality summaries of court judgment documents can facilitate legal practitioners to efficiently review previous cases and assist the general public in accessing how the courts operate and how the law is applied. Previous court judgment summarization research focuses on civil law or a particular jurisdiction's judgments. However, judges can refer to the judgments from all common law jurisdictions. Current summarization datasets are insufficient to satisfy the demands of summarizing precedents across multiple jurisdictions, especially when labeled data are scarce for many jurisdictions. To address the lack of datasets, we present CLSum, the first dataset for summarizing multi-jurisdictional common law court judgment documents. Besides, this is the first court judgment summarization work adopting large language models (LLMs) in data augmentation, summary generation, and evaluation. Specifically, we design an LLM-based data augmentation method incorporating legal knowledge. We also propose a legal knowledge enhanced evaluation metric based on LLM to assess the quality of generated judgment summaries. Our experimental results verify that the LLM-based summarization methods can perform well in the few-shot and zero-shot settings. Our LLM-based data augmentation method can mitigate the impact of low data resources. Furthermore, we carry out comprehensive comparative experiments to find essential model components and settings that are capable of enhancing summarization performance.

Summarization of clinical narratives is a long-standing research problem. Here, we introduce the task of hospital-course summarization. Given the documentation authored throughout a patient's hospitalization, generate a paragraph that tells the story of the patient admission. We construct an English, text-to-text dataset of 109,000 hospitalizations (2M source notes) and their corresponding summary proxy: the clinician-authored "Brief Hospital Course" paragraph written as part of a discharge note. Exploratory analyses reveal that the BHC paragraphs are highly abstractive with some long extracted fragments; are concise yet comprehensive; differ in style and content organization from the source notes; exhibit minimal lexical cohesion; and represent silver-standard references. Our analysis identifies multiple implications for modeling this complex, multi-document summarization task.

In this paper, we present a simulation system called AgentCourt that simulates the entire courtroom process. The judge, plaintiff's lawyer, defense lawyer, and other participants are autonomous agents driven by large language models (LLMs). Our core goal is to enable lawyer agents to learn how to argue a case, as well as improving their overall legal skills, through courtroom process simulation. To achieve this goal, we propose an adversarial evolutionary approach for the lawyer-agent. Since AgentCourt can simulate the occurrence and development of court hearings based on a knowledge base and LLM, the lawyer agents can continuously learn and accumulate experience from real court cases. The simulation experiments show that after two lawyer-agents have engaged in a thousand adversarial legal cases in AgentCourt (which can take a decade for real-world lawyers), compared to their pre-evolutionary state, the evolved lawyer agents exhibit consistent improvement in their ability to handle legal tasks. To enhance the credibility of our experimental results, we enlisted a panel of professional lawyers to evaluate our simulations. The evaluation indicates that the evolved lawyer agents exhibit notable advancements in responsiveness, as well as expertise and logical rigor. This work paves the way for advancing LLM-driven agent technology in legal scenarios. Code is available at https://github.com/relic-yuexi/AgentCourt.

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

Given the dominance of dense retrievers that do not generalize well beyond their training dataset distributions, domain-specific test sets are essential in evaluating retrieval. There are few test datasets for retrieval systems intended for use by healthcare providers in a point-of-care setting. To fill this gap we have collaborated with medical professionals to create CURE, an ad-hoc retrieval test dataset for passage ranking with 2000 queries spanning 10 medical domains with a monolingual (English) and two cross-lingual (French/Spanish -> English) conditions. In this paper, we describe how CURE was constructed and provide baseline results to showcase its effectiveness as an evaluation tool. CURE is published with a Creative Commons Attribution Non Commercial 4.0 license and can be accessed on Hugging Face.

In recent years, there have been significant breakthroughs in the field of natural language processing, particularly with the development of large language models (LLMs). These LLMs have showcased remarkable capabilities on various benchmarks. In the healthcare field, the exact role LLMs and other future AI models will play remains unclear. There is a potential for these models in the future to be used as part of adaptive physician training, medical co-pilot applications, and digital patient interaction scenarios. The ability of AI models to participate in medical training and patient care will depend in part on their mastery of the knowledge content of specific medical fields. This study investigated the medical knowledge capability of LLMs, specifically in the context of internal medicine subspecialty multiple-choice test-taking ability. We compared the performance of several open-source LLMs (Koala 7B, Falcon 7B, Stable-Vicuna 13B, and Orca Mini 13B), to GPT-4 and Claude 2 on multiple-choice questions in the field of Nephrology. Nephrology was chosen as an example of a particularly conceptually complex subspecialty field within internal medicine. The study was conducted to evaluate the ability of LLM models to provide correct answers to nephSAP (Nephrology Self-Assessment Program) multiple-choice questions. The overall success of open-sourced LLMs in answering the 858 nephSAP multiple-choice questions correctly was 17.1% - 25.5%. In contrast, Claude 2 answered 54.4% of the questions correctly, whereas GPT-4 achieved a score of 73.3%. We show that current widely used open-sourced LLMs do poorly in their ability for zero-shot reasoning when compared to GPT-4 and Claude 2. The findings of this study potentially have significant implications for the future of subspecialty medical training and patient care.

Existing foundation models are trained on copyrighted material. Deploying these models can pose both legal and ethical risks when data creators fail to receive appropriate attribution or compensation. In the United States and several other countries, copyrighted content may be used to build foundation models without incurring liability due to the fair use doctrine. However, there is a caveat: If the model produces output that is similar to copyrighted data, particularly in scenarios that affect the market of that data, fair use may no longer apply to the output of the model. In this work, we emphasize that fair use is not guaranteed, and additional work may be necessary to keep model development and deployment squarely in the realm of fair use. First, we survey the potential risks of developing and deploying foundation models based on copyrighted content. We review relevant U.S. case law, drawing parallels to existing and potential applications for generating text, source code, and visual art. Experiments confirm that popular foundation models can generate content considerably similar to copyrighted material. Second, we discuss technical mitigations that can help foundation models stay in line with fair use. We argue that more research is needed to align mitigation strategies with the current state of the law. Lastly, we suggest that the law and technical mitigations should co-evolve. For example, coupled with other policy mechanisms, the law could more explicitly consider safe harbors when strong technical tools are used to mitigate infringement harms. This co-evolution may help strike a balance between intellectual property and innovation, which speaks to the original goal of fair use. But we emphasize that the strategies we describe here are not a panacea and more work is needed to develop policies that address the potential harms of foundation models.