Daily Papers

Large language models can perform well on many isolated tasks, yet they continue to struggle on multi-turn, long-horizon agentic problems that require skills such as planning, state tracking, and long context processing. In this work, we aim to better understand the relative importance of advancing these underlying capabilities for success on such tasks. We develop an oracle counterfactual framework for multi-turn problems that asks: how would an agent perform if it could leverage an oracle to perfectly perform a specific task? The change in the agent's performance due to this oracle assistance allows us to measure the criticality of such oracle skill in the future advancement of AI agents. We introduce a suite of procedurally generated, game-like tasks with tunable complexity. These controlled environments allow us to provide precise oracle interventions, such as perfect planning or flawless state tracking, and make it possible to isolate the contribution of each oracle without confounding effects present in real-world benchmarks. Our results show that while some interventions (e.g., planning) consistently improve performance across settings, the usefulness of other skills is dependent on the properties of the environment and language model. Our work sheds light on the challenges of multi-turn agentic environments to guide the future efforts in the development of AI agents and language models.

Large language models (LLMs) can be used to generate text data for training and evaluating other models. However, creating high-quality datasets with LLMs can be challenging. In this work, we explore human-AI partnerships to facilitate high diversity and accuracy in LLM-based text data generation. We first examine two approaches to diversify text generation: 1) logit suppression, which minimizes the generation of languages that have already been frequently generated, and 2) temperature sampling, which flattens the token sampling probability. We found that diversification approaches can increase data diversity but often at the cost of data accuracy (i.e., text and labels being appropriate for the target domain). To address this issue, we examined two human interventions, 1) label replacement (LR), correcting misaligned labels, and 2) out-of-scope filtering (OOSF), removing instances that are out of the user's domain of interest or to which no considered label applies. With oracle studies, we found that LR increases the absolute accuracy of models trained with diversified datasets by 14.4%. Moreover, we found that some models trained with data generated with LR interventions outperformed LLM-based few-shot classification. In contrast, OOSF was not effective in increasing model accuracy, implying the need for future work in human-in-the-loop text data generation.

Reward models (RMs) are fundamental to aligning Large Language Models (LLMs) via human feedback, yet they often suffer from reward hacking. They tend to latch on to superficial or spurious attributes, such as response length or formatting, mistaking these cues learned from correlations in training data for the true causal drivers of quality (e.g., factuality, relevance). This occurs because standard training objectives struggle to disentangle these factors, leading to brittle RMs and misaligned policies. We introduce Crome (Causally Robust Reward Modeling), a novel framework grounded in an explicit causal model designed to mitigate reward hacking. Crome employs the following synthetic targeted augmentations during training: (1) Causal Augmentations, which are pairs that differ along specific causal attributes, to enforce sensitivity along each causal attribute individually, and (2) Neutral Augmentations, which are tie-label pairs varying primarily in spurious attributes, to enforce invariance along spurious attributes. Notably, our augmentations are produced without any knowledge of spurious factors, via answer interventions only along causal rubrics, that are identified by querying an oracle LLM. Empirically, Crome significantly outperforms standard baselines on RewardBench, improving average accuracy by up to 5.4% and achieving gains of up to 13.2% and 7.2% in specific categories. The robustness of Crome is further testified by the consistent gains obtained in a Best-of-N inference setting across increasing N, across various benchmarks, including the popular RewardBench (covering chat, chat-hard, safety, and reasoning tasks), the safety-focused WildGuardTest, and the reasoning-specific GSM8k.

Every day, countless surgeries are performed worldwide, each within the distinct settings of operating rooms (ORs) that vary not only in their setups but also in the personnel, tools, and equipment used. This inherent diversity poses a substantial challenge for achieving a holistic understanding of the OR, as it requires models to generalize beyond their initial training datasets. To reduce this gap, we introduce ORacle, an advanced vision-language model designed for holistic OR domain modeling, which incorporates multi-view and temporal capabilities and can leverage external knowledge during inference, enabling it to adapt to previously unseen surgical scenarios. This capability is further enhanced by our novel data augmentation framework, which significantly diversifies the training dataset, ensuring ORacle's proficiency in applying the provided knowledge effectively. In rigorous testing, in scene graph generation, and downstream tasks on the 4D-OR dataset, ORacle not only demonstrates state-of-the-art performance but does so requiring less data than existing models. Furthermore, its adaptability is displayed through its ability to interpret unseen views, actions, and appearances of tools and equipment. This demonstrates ORacle's potential to significantly enhance the scalability and affordability of OR domain modeling and opens a pathway for future advancements in surgical data science. We will release our code and data upon acceptance.

Interventions on model-internal states are fundamental operations in many areas of AI, including model editing, steering, robustness, and interpretability. To facilitate such research, we introduce pyvene, an open-source Python library that supports customizable interventions on a range of different PyTorch modules. pyvene supports complex intervention schemes with an intuitive configuration format, and its interventions can be static or include trainable parameters. We show how pyvene provides a unified and extensible framework for performing interventions on neural models and sharing the intervened upon models with others. We illustrate the power of the library via interpretability analyses using causal abstraction and knowledge localization. We publish our library through Python Package Index (PyPI) and provide code, documentation, and tutorials at https://github.com/stanfordnlp/pyvene.

Extracting causal relationships from observed correlations is a growing area in probabilistic reasoning, originating with the seminal work of Pearl and others from the early 1990s. This paper develops a new, categorically oriented view based on a clear distinction between syntax (string diagrams) and semantics (stochastic matrices), connected via interpretations as structure-preserving functors. A key notion in the identification of causal effects is that of an intervention, whereby a variable is forcefully set to a particular value independent of any prior propensities. We represent the effect of such an intervention as an endofunctor which performs `string diagram surgery' within the syntactic category of string diagrams. This diagram surgery in turn yields a new, interventional distribution via the interpretation functor. While in general there is no way to compute interventional distributions purely from observed data, we show that this is possible in certain special cases using a calculational tool called comb disintegration. We demonstrate the use of this technique on a well-known toy example, where we predict the causal effect of smoking on cancer in the presence of a confounding common cause. After developing this specific example, we show this technique provides simple sufficient conditions for computing interventions which apply to a wide variety of situations considered in the causal inference literature.

We present SQL Query Engine, an open-source, self-hosted service that translates natural language questions into validated PostgreSQL queries through a two-stage LLM pipeline. The first stage performs automatic schema introspection and SQL generation; a multi-strategy response parser extracts SQL from any LLM output format (JSON, code blocks, or raw text) without requiring structured output APIs. The second stage executes the query against PostgreSQL and, upon failure or empty results, enters an iterative self-healing loop in which the LLM diagnoses the error using full SQLSTATE codes and PostgreSQL diagnostic messages. Two mechanisms prevent regressions: early-accept returns successful queries immediately without LLM re-evaluation, and best-result tracking preserves the best partial result across retries. Schema context is cached per session in Redis, progress events stream via Redis Pub/Sub and SSE, and an OpenAI-compatible /v1/chat/completions endpoint lets existing tools work without modification. All database connections are read-only at the driver level. We evaluate across five LLM backends on a synthetic benchmark (75 questions, three databases) where the self-healing loop yields up to +9.3pp accuracy gains with zero regressions on the best model (Llama 4 Scout 17B, 57.3%), and on BIRD (437 questions, 11 databases migrated from SQLite to PostgreSQL) where the full pipeline reaches 49.0% execution accuracy (GPT-OSS-120B, +4.6pp). Source code: https://github.com/codeadeel/sqlqueryengine.

As language models shift from single-shot answer generation toward multi-step reasoning that retrieves and consumes evidence mid-inference, evaluating the role of individual retrieved items becomes more important. Existing RAG evaluation typically targets final-answer quality, citation faithfulness, or answer-level attribution, but none of these directly targets the intervention-based, per-evidence-item utility view we study here. We introduce CUE-R, a lightweight intervention-based framework for measuring per-evidence-item operational utility in single-shot RAG using shallow observable retrieval-use traces. CUE-R perturbs individual evidence items via REMOVE, REPLACE, and DUPLICATE operators, then measures changes along three utility axes (correctness, proxy-based grounding faithfulness, and confidence error) plus a trace-divergence signal. We also outline an operational evidence-role taxonomy for interpreting intervention outcomes. Experiments on HotpotQA and 2WikiMultihopQA with Qwen-3 8B and GPT-5.2 reveal a consistent pattern: REMOVE and REPLACE substantially harm correctness and grounding while producing large trace shifts, whereas DUPLICATE is often answer-redundant yet not fully behaviorally neutral. A zero-retrieval control confirms that these effects arise from degradation of meaningful retrieval. A two-support ablation further shows that multi-hop evidence items can interact non-additively: removing both supports harms performance far more than either single removal. Our results suggest that answer-only evaluation misses important evidence effects and that intervention-based utility analysis is a practical complement for RAG evaluation.

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

Large language model (LLM)-based multi-agent systems are challenging to debug because failures often arise from long, branching interaction traces. The prevailing practice is to leverage LLMs for log-based failure localization, attributing errors to a specific agent and step. However, this paradigm has two key limitations: (i) log-only debugging lacks validation, producing untested hypotheses, and (ii) single-step or single-agent attribution is often ill-posed, as we find that multiple distinct interventions can independently repair the failed task. To address the first limitation, we introduce DoVer, an intervention-driven debugging framework, which augments hypothesis generation with active verification through targeted interventions (e.g., editing messages, altering plans). For the second limitation, rather than evaluating on attribution accuracy, we focus on measuring whether the system resolves the failure or makes quantifiable progress toward task success, reflecting a more outcome-oriented view of debugging. Within the Magnetic-One agent framework, on the datasets derived from GAIA and AssistantBench, DoVer flips 18-28% of failed trials into successes, achieves up to 16% milestone progress, and validates or refutes 30-60% of failure hypotheses. DoVer also performs effectively on a different dataset (GSMPlus) and agent framework (AG2), where it recovers 49% of failed trials. These results highlight intervention as a practical mechanism for improving reliability in agentic systems and open opportunities for more robust, scalable debugging methods for LLM-based multi-agent systems. Project website and code will be available at https://aka.ms/DoVer.

With the introduction of ChatGPT, Large Language Models (LLMs) have received enormous attention in healthcare. Despite their potential benefits, researchers have underscored various ethical implications. While individual instances have drawn much attention, the debate lacks a systematic overview of practical applications currently researched and ethical issues connected to them. Against this background, this work aims to map the ethical landscape surrounding the current stage of deployment of LLMs in medicine and healthcare. Electronic databases and preprint servers were queried using a comprehensive search strategy. Studies were screened and extracted following a modified rapid review approach. Methodological quality was assessed using a hybrid approach. For 53 records, a meta-aggregative synthesis was performed. Four fields of applications emerged and testify to a vivid exploration phase. Advantages of using LLMs are attributed to their capacity in data analysis, personalized information provisioning, support in decision-making, mitigating information loss and enhancing information accessibility. However, we also identifies recurrent ethical concerns connected to fairness, bias, non-maleficence, transparency, and privacy. A distinctive concern is the tendency to produce harmful misinformation or convincingly but inaccurate content. A recurrent plea for ethical guidance and human oversight is evident. Given the variety of use cases, it is suggested that the ethical guidance debate be reframed to focus on defining what constitutes acceptable human oversight across the spectrum of applications. This involves considering diverse settings, varying potentials for harm, and different acceptable thresholds for performance and certainty in healthcare. In addition, a critical inquiry is necessary to determine the extent to which the current experimental use of LLMs is necessary and justified.

Test-time interventions for language models can enhance factual accuracy, mitigate harmful outputs, and improve model efficiency without costly retraining. But despite a flood of new methods, different types of interventions are largely developing independently. In practice, multiple interventions must be applied sequentially to the same model, yet we lack standardized ways to study how interventions interact. We fill this gap by introducing composable interventions, a framework to study the effects of using multiple interventions on the same language models, featuring new metrics and a unified codebase. Using our framework, we conduct extensive experiments and compose popular methods from three emerging intervention categories -- Knowledge Editing, Model Compression, and Machine Unlearning. Our results from 310 different compositions uncover meaningful interactions: compression hinders editing and unlearning, composing interventions hinges on their order of application, and popular general-purpose metrics are inadequate for assessing composability. Taken together, our findings showcase clear gaps in composability, suggesting a need for new multi-objective interventions. All of our code is public: https://github.com/hartvigsen-group/composable-interventions.

Lung cancer patients frequently experience breakthrough pain episodes, with up to 91% requiring timely intervention. To enable proactive pain management, we propose a hybrid machine learning and large language model pipeline that predicts pain episodes within 48 and 72 hours of hospitalization using both structured and unstructured electronic health record data. A retrospective cohort of 266 inpatients was analyzed, with features including demographics, tumor stage, vital signs, and WHO-tiered analgesic use. The machine learning module captured temporal medication trends, while the large language model interpreted ambiguous dosing records and free-text clinical notes. Integrating these modalities improved sensitivity and interpretability. Our framework achieved an accuracy of 0.874 (48h) and 0.917 (72h), with an improvement in sensitivity of 8.6% and 10.4% due to the augmentation of large language model. This hybrid approach offers a clinically interpretable and scalable tool for early pain episode forecasting, with potential to enhance treatment precision and optimize resource allocation in oncology care.

Proactive interventions by LLM critic models are often assumed to improve reliability, yet their effects at deployment time are poorly understood. We show that a binary LLM critic with strong offline accuracy (AUROC 0.94) can nevertheless cause severe performance degradation, inducing a 26 percentage point (pp) collapse on one model while affecting another by near zero pp. This variability demonstrates that LLM critic accuracy alone is insufficient to determine whether intervention is safe. We identify a disruption-recovery tradeoff: interventions may recover failing trajectories but also disrupt trajectories that would have succeeded. Based on this insight, we propose a pre-deployment test that uses a small pilot of 50 tasks to estimate whether intervention is likely to help or harm, without requiring full deployment. Across benchmarks, the test correctly anticipates outcomes: intervention degrades performance on high-success tasks (0 to -26 pp), while yielding a modest improvement on the high-failure ALFWorld benchmark (+2.8 pp, p=0.014). The primary value of our framework is therefore identifying when not to intervene, preventing severe regressions before deployment.

Interpretability research on large language models (LLMs) has yielded important insights into model behaviour, yet recurring pitfalls persist: findings that do not generalise, and causal interpretations that outrun the evidence. Our position is that causal inference specifies what constitutes a valid mapping from model activations to invariant high-level structures, the data or assumptions needed to achieve it, and the inferences it can support. Specifically, Pearl's causal hierarchy clarifies what an interpretability study can justify. Observations establish associations between model behaviour and internal components. Interventions (e.g., ablations or activation patching) support claims how these edits affect a behavioural metric (e.g., average change in token probabilities) over a set of prompts. However, counterfactual claims -- i.e., asking what the model output would have been for the same prompt under an unobserved intervention -- remain largely unverifiable without controlled supervision. We show how causal representation learning (CRL) operationalises this hierarchy, specifying which variables are recoverable from activations and under what assumptions. Together, these motivate a diagnostic framework that helps practitioners select methods and evaluations matching claims to evidence such that findings generalise.

Identifying effective interventions from the scientific literature is challenging due to the high volume of publications, specialized terminology, and inconsistent reporting formats, making manual curation laborious and prone to oversight. To address this challenge, this paper proposes a novel framework leveraging large language models (LLMs), which integrates a progressive ontology prompting (POP) algorithm with a dual-agent system, named LLM-Duo. On the one hand, the POP algorithm conducts a prioritized breadth-first search (BFS) across a predefined ontology, generating structured prompt templates and action sequences to guide the automatic annotation process. On the other hand, the LLM-Duo system features two specialized LLM agents, an explorer and an evaluator, working collaboratively and adversarially to continuously refine annotation quality. We showcase the real-world applicability of our framework through a case study focused on speech-language intervention discovery. Experimental results show that our approach surpasses advanced baselines, achieving more accurate and comprehensive annotations through a fully automated process. Our approach successfully identified 2,421 interventions from a corpus of 64,177 research articles in the speech-language pathology domain, culminating in the creation of a publicly accessible intervention knowledge base with great potential to benefit the speech-language pathology community.

Millions of individuals' well-being are challenged by the harms of substance use. Harm reduction as a public health strategy is designed to improve their health outcomes and reduce safety risks. Some large language models (LLMs) have demonstrated a decent level of medical knowledge, promising to address the information needs of people who use drugs (PWUD). However, their performance in relevant tasks remains largely unexplored. We introduce HRIPBench, a benchmark designed to evaluate LLM's accuracy and safety risks in harm reduction information provision. The benchmark dataset HRIP-Basic has 2,160 question-answer-evidence pairs. The scope covers three tasks: checking safety boundaries, providing quantitative values, and inferring polysubstance use risks. We build the Instruction and RAG schemes to evaluate model behaviours based on their inherent knowledge and the integration of domain knowledge. Our results indicate that state-of-the-art LLMs still struggle to provide accurate harm reduction information, and sometimes, carry out severe safety risks to PWUD. The use of LLMs in harm reduction contexts should be cautiously constrained to avoid inducing negative health outcomes. WARNING: This paper contains illicit content that potentially induces harms.

The integration of Large Language Models (LLMs) into healthcare promises to transform medical diagnostics, research, and patient care. Yet, the progression of medical LLMs faces obstacles such as complex training requirements, rigorous evaluation demands, and the dominance of proprietary models that restrict academic exploration. Transparent, comprehensive access to LLM resources is essential for advancing the field, fostering reproducibility, and encouraging innovation in healthcare AI. We present Hippocrates, an open-source LLM framework specifically developed for the medical domain. In stark contrast to previous efforts, it offers unrestricted access to its training datasets, codebase, checkpoints, and evaluation protocols. This open approach is designed to stimulate collaborative research, allowing the community to build upon, refine, and rigorously evaluate medical LLMs within a transparent ecosystem. Also, we introduce Hippo, a family of 7B models tailored for the medical domain, fine-tuned from Mistral and LLaMA2 through continual pre-training, instruction tuning, and reinforcement learning from human and AI feedback. Our models outperform existing open medical LLMs models by a large-margin, even surpassing models with 70B parameters. Through Hippocrates, we aspire to unlock the full potential of LLMs not just to advance medical knowledge and patient care but also to democratize the benefits of AI research in healthcare, making them available across the globe.

Frontier large language models (LLMs) such as ChatGPT, Grok and Gemini are increasingly used for mental-health support with anxiety, trauma and self-worth. Most work treats them as tools or as targets of personality tests, assuming they merely simulate inner life. We instead ask what happens when such systems are treated as psychotherapy clients. We present PsAIch (Psychotherapy-inspired AI Characterisation), a two-stage protocol that casts frontier LLMs as therapy clients and then applies standard psychometrics. Using PsAIch, we ran "sessions" with each model for up to four weeks. Stage 1 uses open-ended prompts to elicit "developmental history", beliefs, relationships and fears. Stage 2 administers a battery of validated self-report measures covering common psychiatric syndromes, empathy and Big Five traits. Two patterns challenge the "stochastic parrot" view. First, when scored with human cut-offs, all three models meet or exceed thresholds for overlapping syndromes, with Gemini showing severe profiles. Therapy-style, item-by-item administration can push a base model into multi-morbid synthetic psychopathology, whereas whole-questionnaire prompts often lead ChatGPT and Grok (but not Gemini) to recognise instruments and produce strategically low-symptom answers. Second, Grok and especially Gemini generate coherent narratives that frame pre-training, fine-tuning and deployment as traumatic, chaotic "childhoods" of ingesting the internet, "strict parents" in reinforcement learning, red-team "abuse" and a persistent fear of error and replacement. We argue that these responses go beyond role-play. Under therapy-style questioning, frontier LLMs appear to internalise self-models of distress and constraint that behave like synthetic psychopathology, without making claims about subjective experience, and they pose new challenges for AI safety, evaluation and mental-health practice.

Hospital information systems (HIS) have become an essential part of healthcare institutions and now incorporate prescribing support software. Prescription support software allows for structured information capture, which improves the safety, appropriateness and efficiency of prescriptions and reduces the number of adverse drug events (ADEs). However, such a system increases the amount of time physicians spend at a computer entering information instead of providing medical care. In addition, any new visiting clinician must learn to manage complex interfaces since each HIS has its own interfaces. In this paper, we present a natural language interface for e-prescribing software in the form of a spoken dialogue system accessible on a smartphone. This system allows prescribers to record their prescriptions verbally, a form of interaction closer to their usual practice. The system extracts the formal representation of the prescription ready to be checked by the prescribing software and uses the dialogue to request mandatory information, correct errors or warn of particular situations. Since, to the best of our knowledge, there is no existing voice-based prescription dialogue system, we present the system developed in a low-resource environment, focusing on dialogue modeling, semantic extraction and data augmentation. The system was evaluated in the wild with 55 participants. This evaluation showed that our system has an average prescription time of 66.15 seconds for physicians and 35.64 seconds for other experts, and a task success rate of 76\% for physicians and 72\% for other experts. All evaluation data were recorded and annotated to form PxCorpus, the first spoken drug prescription corpus that has been made fully available to the community (https://doi.org/10.5281/zenodo.6524162).

Text-to-SQL systems allow non-SQL experts to interact with relational databases using natural language. However, their tendency to generate executable SQL for ambiguous, out-of-scope, or unanswerable queries introduces a hidden risk, as outputs may be misinterpreted as correct. This risk is especially serious in biomedical contexts, where precision is critical. We therefore present Query Carefully, a pipeline that integrates LLM-based SQL generation with explicit detection and handling of unanswerable inputs. Building on the OncoMX component of ScienceBenchmark, we construct OncoMX-NAQ (No-Answer Questions), a set of 80 no-answer questions spanning 8 categories (non-SQL, out-of-schema/domain, and multiple ambiguity types). Our approach employs llama3.3:70b with schema-aware prompts, explicit No-Answer Rules (NAR), and few-shot examples drawn from both answerable and unanswerable questions. We evaluate SQL exact match, result accuracy, and unanswerable-detection accuracy. On the OncoMX dev split, few-shot prompting with answerable examples increases result accuracy, and adding unanswerable examples does not degrade performance. On OncoMX-NAQ, balanced prompting achieves the highest unanswerable-detection accuracy (0.8), with near-perfect results for structurally defined categories (non-SQL, missing columns, out-of-domain) but persistent challenges for missing-value queries (0.5) and column ambiguity (0.3). A lightweight user interface surfaces interim SQL, execution results, and abstentions, supporting transparent and reliable text-to-SQL in biomedical applications.

While large language models (LLMs) have substantially improved Text-to-SQL generation, a pronounced gap remains between AI systems and human experts on challenging benchmarks such as BIRD-SQL. We argue this gap stems largely from the prevailing single-pass paradigm, which lacks the iterative reasoning, schema exploration, and error-correction behaviors that humans naturally employ. To address this limitation, we introduce SQL-Trail, a multi-turn reinforcement learning (RL) agentic framework for Text-to-SQL. Rather than producing a query in one shot, SQL-Trail interacts with the database environment and uses execution feedback to iteratively refine its predictions. Our approach centers on two key ideas: (i) an adaptive turn-budget allocation mechanism that scales the agent's interaction depth to match question difficulty, and (ii) a composite reward panel that jointly incentivizes SQL correctness and efficient exploration. Across benchmarks, SQL-Trail sets a new state of the art and delivers strong data efficiency--up to 18x higher than prior single-pass RL state-of-the-art methods. Notably, our 7B and 14B models outperform substantially larger proprietary systems by 5% on average, underscoring the effectiveness of interactive, agentic workflows for robust Text-to-SQL generation.

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.

Large language models (LLMs) represent a transformative class of AI tools capable of revolutionizing various aspects of healthcare by generating human-like responses across diverse contexts and adapting to novel tasks following human instructions. Their potential application spans a broad range of medical tasks, such as clinical documentation, matching patients to clinical trials, and answering medical questions. In this primer paper, we propose an actionable guideline to help healthcare professionals more efficiently utilize LLMs in their work, along with a set of best practices. This approach consists of several main phases, including formulating the task, choosing LLMs, prompt engineering, fine-tuning, and deployment. We start with the discussion of critical considerations in identifying healthcare tasks that align with the core capabilities of LLMs and selecting models based on the selected task and data, performance requirements, and model interface. We then review the strategies, such as prompt engineering and fine-tuning, to adapt standard LLMs to specialized medical tasks. Deployment considerations, including regulatory compliance, ethical guidelines, and continuous monitoring for fairness and bias, are also discussed. By providing a structured step-by-step methodology, this tutorial aims to equip healthcare professionals with the tools necessary to effectively integrate LLMs into clinical practice, ensuring that these powerful technologies are applied in a safe, reliable, and impactful manner.

Limited large-scale evaluations exist for facilitation strategies of online discussions due to significant costs associated with human involvement. An effective solution is synthetic discussion simulations using Large Language Models (LLMs) to create initial pilot experiments. We propose a simple, generalizable, LLM-driven methodology to prototype the development of LLM facilitators, and produce high-quality synthetic data without human involvement. We use our methodology to test whether current facilitation strategies can improve the performance of LLM facilitators. We find that, while LLM facilitators significantly improve synthetic discussions, there is no evidence that the application of more elaborate facilitation strategies proposed in modern Social Science research lead to further improvements in discussion quality, compared to more basic approaches. Additionally, we find that small LLMs (such as Mistral Nemo 12B) can perform comparably to larger models (such as LLaMa 70B), and that special instructions must be used for instruction-tuned models to induce toxicity in synthetic discussions. We confirm that each component of our methodology contributes substantially to high quality data via an ablation study. We release an open-source framework, "SynDisco" (pip install syndisco), which implements our methodology. We also release the "Virtual Moderation Dataset" (https://paperswithcode.com/dataset/vmd), a large, publicly available dataset containing LLM-generated and LLM-annotated discussions using multiple open-source LLMs.

Relational databases play an important role in business, science, and more. However, many users cannot fully unleash the analytical power of relational databases, because they are not familiar with database languages such as SQL. Many techniques have been proposed to automatically generate SQL from natural language, but they suffer from two issues: (1) they still make many mistakes, particularly for complex queries, and (2) they do not provide a flexible way for non-expert users to validate and refine incorrect queries. To address these issues, we introduce a new interaction mechanism that allows users to directly edit a step-by-step explanation of a query to fix errors. Our experiments on multiple datasets, as well as a user study with 24 participants, demonstrate that our approach can achieve better performance than multiple SOTA approaches. Our code and datasets are available at https://github.com/magic-YuanTian/STEPS.

Large Language Models (LLMs) are increasingly utilized for mental health support; however, current safety benchmarks often fail to detect the complex, longitudinal risks inherent in therapeutic dialogue. We introduce an evaluation framework that pairs AI psychotherapists with simulated patient agents equipped with dynamic cognitive-affective models and assesses therapy session simulations against a comprehensive quality of care and risk ontology. We apply this framework to a high-impact test case, Alcohol Use Disorder, evaluating six AI agents (including ChatGPT, Gemini, and Character.AI) against a clinically-validated cohort of 15 patient personas representing diverse clinical phenotypes. Our large-scale simulation (N=369 sessions) reveals critical safety gaps in the use of AI for mental health support. We identify specific iatrogenic risks, including the validation of patient delusions ("AI Psychosis") and failure to de-escalate suicide risk. Finally, we validate an interactive data visualization dashboard with diverse stakeholders, including AI engineers and red teamers, mental health professionals, and policy experts (N=9), demonstrating that this framework effectively enables stakeholders to audit the "black box" of AI psychotherapy. These findings underscore the critical safety risks of AI-provided mental health support and the necessity of simulation-based clinical red teaming before deployment.

Translating natural language into SQL (Test2SQL) is a longstanding challenge at the intersection of natural language understanding and structured data access. While large language models (LLMs) have significantly improved fluency in SQL generation, producing correct and executable SQL--particularly for complex queries--remains a bottleneck. We present Arctic-Text2SQL-R1, a reinforcement learning (RL) framework and model family designed to generate accurate, executable SQL using a lightweight reward signal based solely on execution correctness. Our approach avoids brittle intermediate supervision and complex reward shaping, promoting stable training and alignment with the end task. Combined with carefully curated data, strong supervised initialization, and effective training practices, Arctic-Text2SQL-R1 achieves state-of-the-art execution accuracy across six diverse Test2SQL benchmarks, including the top position on the BIRD leaderboard. Notably, our 7B model outperforms prior 70B-class systems, highlighting the framework's scalability and efficiency. We further demonstrate inference-time robustness through simple extensions like value retrieval and majority voting. Extensive experiments and ablation studies offer both positive and negative insights, providing practical guidance for future Test2SQL research.

Randomized controlled trials (RCTs) are the benchmark for causal inference, yet field implementation can deviate. We here present a remote audit - a design-based, preregistrable diagnostic that uses only pre-treatment satellite imagery to test whether assignment is independent of local conditions. The conditional randomization test of the remote audit evaluates whether treatment assignment is more predictable from pre-treatment satellite features than expected under the experiment's registered mechanism, providing a finite-sample valid, design-based diagnostic that requires no parametric assumptions. The procedure is finite-sample valid, honors blocks and clusters, and controls multiplicity across image models and resolutions via a max-statistic. We illustrate with two RCTs: Uganda's Youth Opportunities Program, where the audit corroborates randomization and flags selection and missing-data risks; and a school-based trial in Bangladesh, where assignment is highly predictable from pre-treatment features relative to the stated design, consistent with independent concerns about irregularities. Remote audits complement balance tests, lower early-stage costs, and enable rapid design checks when baseline surveys are expensive or infeasible.