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May 7

A Prescriptive Learning Analytics Framework: Beyond Predictive Modelling and onto Explainable AI with Prescriptive Analytics and ChatGPT

A significant body of recent research in the field of Learning Analytics has focused on leveraging machine learning approaches for predicting at-risk students in order to initiate timely interventions and thereby elevate retention and completion rates. The overarching feature of the majority of these research studies has been on the science of prediction only. The component of predictive analytics concerned with interpreting the internals of the models and explaining their predictions for individual cases to stakeholders has largely been neglected. Additionally, works that attempt to employ data-driven prescriptive analytics to automatically generate evidence-based remedial advice for at-risk learners are in their infancy. eXplainable AI is a field that has recently emerged providing cutting-edge tools which support transparent predictive analytics and techniques for generating tailored advice for at-risk students. This study proposes a novel framework that unifies both transparent machine learning as well as techniques for enabling prescriptive analytics, while integrating the latest advances in large language models. This work practically demonstrates the proposed framework using predictive models for identifying at-risk learners of programme non-completion. The study then further demonstrates how predictive modelling can be augmented with prescriptive analytics on two case studies in order to generate human-readable prescriptive feedback for those who are at risk using ChatGPT.

  • 1 authors
·
Aug 30, 2022

Development of an NLP-driven computer-based test guide for visually impaired students

In recent years, advancements in Natural Language Processing (NLP) techniques have revolutionized the field of accessibility and exclusivity of testing, particularly for visually impaired students (VIS). CBT has shown in years back its relevance in terms of administering exams electronically, making the test process easier, providing quicker and more accurate results, and offering greater flexibility and accessibility for candidates. Yet, its relevance was not felt by the visually impaired students as they cannot access printed documents. Hence, in this paper, we present an NLP-driven Computer-Based Test guide for visually impaired students. It employs a speech technology pre-trained methods to provide real-time assistance and support to visually impaired students. The system utilizes NLP technologies to convert the text-based questions and the associated options in a machine-readable format. Subsequently, the speech technology pre-trained model processes the converted text enabling the VIS to comprehend and analyze the content. Furthermore, we validated that this pre-trained model is not perverse by testing for accuracy using sample audio datasets labels (A, B, C, D, E, F, G) to compare with the voice recordings obtained from 20 VIS which is been predicted by the system to attain values for precision, recall, and F1-scores. These metrics are used to assess the performance of the pre-trained model and have indicated that it is proficient enough to give its better performance to the evaluated system. The methodology adopted for this system is Object Oriented Analysis and Design Methodology (OOADM) where Objects are discussed and built by modeling real-world instances.

  • 3 authors
·
Jan 22, 2024

Capabilities of GPT-4 on Medical Challenge Problems

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.

  • 5 authors
·
Mar 20, 2023

PustakAI: Curriculum-Aligned and Interactive Textbooks Using Large Language Models

Large Language Models (LLMs) have demonstrated remarkable capabilities in understanding and generating human-like content. This has revolutionized various sectors such as healthcare, software development, and education. In education, LLMs offer potential for personalized and interactive learning experiences, especially in regions with limited teaching resources. However, adapting these models effectively to curriculum-specific content, such as the National Council of Educational Research and Training (NCERT) syllabus in India, presents unique challenges in terms of accuracy, alignment, and pedagogical relevance. In this paper, we present the framework "PustakAI"Pustak means `book' in many Indian languages. for the design and evaluation of a novel question-answering dataset "NCERT-QA" aligned with the NCERT curriculum for English and Science subjects of grades 6 to 8. We classify the curated QA pairs as Factoid, Inferential, and Others (evaluative and reasoning). We evaluate the dataset with various prompting techniques, such as meta-prompt, few-shot, and CoT-style prompting, using diverse evaluation metrics to understand which approach aligns more efficiently with the structure and demands of the curriculum. Along with the usability of the dataset, we analyze the strengths and limitations of current open-source LLMs (Gemma3:1b, Llama3.2:3b, and Nemotron-mini:4b) and high-end LLMs (Llama-4-Scout-17B and Deepseek-r1-70B) as AI-based learning tools in formal education systems.

  • 5 authors
·
Nov 13, 2025

Overview of the TREC 2023 deep learning track

This is the fifth year of the TREC Deep Learning track. As in previous years, we leverage the MS MARCO datasets that made hundreds of thousands of human-annotated training labels available for both passage and document ranking tasks. We mostly repeated last year's design, to get another matching test set, based on the larger, cleaner, less-biased v2 passage and document set, with passage ranking as primary and document ranking as a secondary task (using labels inferred from passage). As we did last year, we sample from MS MARCO queries that were completely held out, unused in corpus construction, unlike the test queries in the first three years. This approach yields a more difficult test with more headroom for improvement. Alongside the usual MS MARCO (human) queries from MS MARCO, this year we generated synthetic queries using a fine-tuned T5 model and using a GPT-4 prompt. The new headline result this year is that runs using Large Language Model (LLM) prompting in some way outperformed runs that use the "nnlm" approach, which was the best approach in the previous four years. Since this is the last year of the track, future iterations of prompt-based ranking can happen in other tracks. Human relevance assessments were applied to all query types, not just human MS MARCO queries. Evaluation using synthetic queries gave similar results to human queries, with system ordering agreement of τ=0.8487. However, human effort was needed to select a subset of the synthetic queries that were usable. We did not see clear evidence of bias, where runs using GPT-4 were favored when evaluated using synthetic GPT-4 queries, or where runs using T5 were favored when evaluated on synthetic T5 queries.

  • 8 authors
·
Jul 10, 2025

DR.BENCH: Diagnostic Reasoning Benchmark for Clinical Natural Language Processing

The meaningful use of electronic health records (EHR) continues to progress in the digital era with clinical decision support systems augmented by artificial intelligence. A priority in improving provider experience is to overcome information overload and reduce the cognitive burden so fewer medical errors and cognitive biases are introduced during patient care. One major type of medical error is diagnostic error due to systematic or predictable errors in judgment that rely on heuristics. The potential for clinical natural language processing (cNLP) to model diagnostic reasoning in humans with forward reasoning from data to diagnosis and potentially reduce the cognitive burden and medical error has not been investigated. Existing tasks to advance the science in cNLP have largely focused on information extraction and named entity recognition through classification tasks. We introduce a novel suite of tasks coined as Diagnostic Reasoning Benchmarks, DR.BENCH, as a new benchmark for developing and evaluating cNLP models with clinical diagnostic reasoning ability. The suite includes six tasks from ten publicly available datasets addressing clinical text understanding, medical knowledge reasoning, and diagnosis generation. DR.BENCH is the first clinical suite of tasks designed to be a natural language generation framework to evaluate pre-trained language models. Experiments with state-of-the-art pre-trained generative language models using large general domain models and models that were continually trained on a medical corpus demonstrate opportunities for improvement when evaluated in DR. BENCH. We share DR. BENCH as a publicly available GitLab repository with a systematic approach to load and evaluate models for the cNLP community.

  • 7 authors
·
Sep 29, 2022

Enhancing Large Language Models for Text-to-Testcase Generation

Context: Test-driven development (TDD) is a widely employed software development practice that involves developing test cases based on requirements prior to writing the code. Although various methods for automated test case generation have been proposed, they are not specifically tailored for TDD, where requirements instead of code serve as input. Objective: In this paper, we introduce a text-to-testcase generation approach based on a large language model (GPT-3.5) that is fine-tuned on our curated dataset with an effective prompt design. Method: Our approach involves enhancing the capabilities of basic GPT-3.5 for text-to-testcase generation task that is fine-tuned on our curated dataset with an effective prompting design. We evaluated the effectiveness of our approach using a span of five large-scale open-source software projects. Results: Our approach generated 7k test cases for open source projects, achieving 78.5% syntactic correctness, 67.09% requirement alignment, and 61.7% code coverage, which substantially outperforms all other LLMs (basic GPT-3.5, Bloom, and CodeT5). In addition, our ablation study demonstrates the substantial performance improvement of the fine-tuning and prompting components of the GPT-3.5 model. Conclusions: These findings lead us to conclude that fine-tuning and prompting should be considered in the future when building a language model for the text-to-testcase generation task

  • 4 authors
·
Feb 19, 2024

ChatGPT and Software Testing Education: Promises & Perils

Over the past decade, predictive language modeling for code has proven to be a valuable tool for enabling new forms of automation for developers. More recently, we have seen the advent of general purpose "large language models", based on neural transformer architectures, that have been trained on massive datasets of human written text spanning code and natural language. However, despite the demonstrated representational power of such models, interacting with them has historically been constrained to specific task settings, limiting their general applicability. Many of these limitations were recently overcome with the introduction of ChatGPT, a language model created by OpenAI and trained to operate as a conversational agent, enabling it to answer questions and respond to a wide variety of commands from end users. The introduction of models, such as ChatGPT, has already spurred fervent discussion from educators, ranging from fear that students could use these AI tools to circumvent learning, to excitement about the new types of learning opportunities that they might unlock. However, given the nascent nature of these tools, we currently lack fundamental knowledge related to how well they perform in different educational settings, and the potential promise (or danger) that they might pose to traditional forms of instruction. As such, in this paper, we examine how well ChatGPT performs when tasked with answering common questions in a popular software testing curriculum. Our findings indicate that ChatGPT can provide correct or partially correct answers in 55.6% of cases, provide correct or partially correct explanations of answers in 53.0% of cases, and that prompting the tool in a shared question context leads to a marginally higher rate of correct responses. Based on these findings, we discuss the potential promises and perils related to the use of ChatGPT by students and instructors.

  • 5 authors
·
Feb 7, 2023

Evaluation of GPT-3.5 and GPT-4 for supporting real-world information needs in healthcare delivery

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.

  • 18 authors
·
Apr 26, 2023

Foresight -- Generative Pretrained Transformer (GPT) for Modelling of Patient Timelines using EHRs

Background: Electronic Health Records hold detailed longitudinal information about each patient's health status and general clinical history, a large portion of which is stored within the unstructured text. Existing approaches focus mostly on structured data and a subset of single-domain outcomes. We explore how temporal modelling of patients from free text and structured data, using deep generative transformers can be used to forecast a wide range of future disorders, substances, procedures or findings. Methods: We present Foresight, a novel transformer-based pipeline that uses named entity recognition and linking tools to convert document text into structured, coded concepts, followed by providing probabilistic forecasts for future medical events such as disorders, substances, procedures and findings. We processed the entire free-text portion from three different hospital datasets totalling 811336 patients covering both physical and mental health. Findings: On tests in two UK hospitals (King's College Hospital, South London and Maudsley) and the US MIMIC-III dataset precision@10 0.68, 0.76 and 0.88 was achieved for forecasting the next disorder in a patient timeline, while precision@10 of 0.80, 0.81 and 0.91 was achieved for forecasting the next biomedical concept. Foresight was also validated on 34 synthetic patient timelines by five clinicians and achieved relevancy of 97% for the top forecasted candidate disorder. As a generative model, it can forecast follow-on biomedical concepts for as many steps as required. Interpretation: Foresight is a general-purpose model for biomedical concept modelling that can be used for real-world risk forecasting, virtual trials and clinical research to study the progression of disorders, simulate interventions and counterfactuals, and educational purposes.

  • 12 authors
·
Dec 13, 2022

Large Language Models (GPT) Struggle to Answer Multiple-Choice Questions about Code

We analyzed effectiveness of three generative pre-trained transformer (GPT) models in answering multiple-choice question (MCQ) assessments, often involving short snippets of code, from introductory and intermediate programming courses at the postsecondary level. This emerging technology stirs countless discussions of its potential uses (e.g., exercise generation, code explanation) as well as misuses in programming education (e.g., cheating). However, the capabilities of GPT models and their limitations to reason about and/or analyze code in educational settings have been under-explored. We evaluated several OpenAI's GPT models on formative and summative MCQ assessments from three Python courses (530 questions). We found that MCQs containing code snippets are not answered as successfully as those that only contain natural language. While questions requiring to fill-in a blank in the code or completing a natural language statement about the snippet are handled rather successfully, MCQs that require analysis and/or reasoning about the code (e.g., what is true/false about the snippet, or what is its output) appear to be the most challenging. These findings can be leveraged by educators to adapt their instructional practices and assessments in programming courses, so that GPT becomes a valuable assistant for a learner as opposed to a source of confusion and/or potential hindrance in the learning process.

  • 4 authors
·
Mar 9, 2023

Comparing the Efficacy of GPT-4 and Chat-GPT in Mental Health Care: A Blind Assessment of Large Language Models for Psychological Support

Background: Rapid advancements in natural language processing have led to the development of large language models with the potential to revolutionize mental health care. These models have shown promise in assisting clinicians and providing support to individuals experiencing various psychological challenges. Objective: This study aims to compare the performance of two large language models, GPT-4 and Chat-GPT, in responding to a set of 18 psychological prompts, to assess their potential applicability in mental health care settings. Methods: A blind methodology was employed, with a clinical psychologist evaluating the models' responses without knowledge of their origins. The prompts encompassed a diverse range of mental health topics, including depression, anxiety, and trauma, to ensure a comprehensive assessment. Results: The results demonstrated a significant difference in performance between the two models (p > 0.05). GPT-4 achieved an average rating of 8.29 out of 10, while Chat-GPT received an average rating of 6.52. The clinical psychologist's evaluation suggested that GPT-4 was more effective at generating clinically relevant and empathetic responses, thereby providing better support and guidance to potential users. Conclusions: This study contributes to the growing body of literature on the applicability of large language models in mental health care settings. The findings underscore the importance of continued research and development in the field to optimize these models for clinical use. Further investigation is necessary to understand the specific factors underlying the performance differences between the two models and to explore their generalizability across various populations and mental health conditions.

  • 1 authors
·
May 15, 2024

Progress Note Understanding -- Assessment and Plan Reasoning: Overview of the 2022 N2C2 Track 3 Shared Task

Daily progress notes are common types in the electronic health record (EHR) where healthcare providers document the patient's daily progress and treatment plans. The EHR is designed to document all the care provided to patients, but it also enables note bloat with extraneous information that distracts from the diagnoses and treatment plans. Applications of natural language processing (NLP) in the EHR is a growing field with the majority of methods in information extraction. Few tasks use NLP methods for downstream diagnostic decision support. We introduced the 2022 National NLP Clinical Challenge (N2C2) Track 3: Progress Note Understanding - Assessment and Plan Reasoning as one step towards a new suite of tasks. The Assessment and Plan Reasoning task focuses on the most critical components of progress notes, Assessment and Plan subsections where health problems and diagnoses are contained. The goal of the task was to develop and evaluate NLP systems that automatically predict causal relations between the overall status of the patient contained in the Assessment section and its relation to each component of the Plan section which contains the diagnoses and treatment plans. The goal of the task was to identify and prioritize diagnoses as the first steps in diagnostic decision support to find the most relevant information in long documents like daily progress notes. We present the results of 2022 n2c2 Track 3 and provide a description of the data, evaluation, participation and system performance.

  • 6 authors
·
Mar 14, 2023

Software Testing with Large Language Model: Survey, Landscape, and Vision

Pre-trained large language models (LLMs) have recently emerged as a breakthrough technology in natural language processing and artificial intelligence, with the ability to handle large-scale datasets and exhibit remarkable performance across a wide range of tasks. Meanwhile, software testing is a crucial undertaking that serves as a cornerstone for ensuring the quality and reliability of software products. As the scope and complexity of software systems continue to grow, the need for more effective software testing techniques becomes increasingly urgent, and making it an area ripe for innovative approaches such as the use of LLMs. This paper provides a comprehensive review of the utilization of LLMs in software testing. It analyzes 52 relevant studies that have used LLMs for software testing, from both the software testing and LLMs perspectives. The paper presents a detailed discussion of the software testing tasks for which LLMs are commonly used, among which test case preparation and program repair are the most representative ones. It also analyzes the commonly used LLMs, the types of prompt engineering that are employed, as well as the accompanied techniques with these LLMs. It also summarizes the key challenges and potential opportunities in this direction. This work can serve as a roadmap for future research in this area, highlighting potential avenues for exploration, and identifying gaps in our current understanding of the use of LLMs in software testing.

  • 6 authors
·
Jul 14, 2023

Student Answer Forecasting: Transformer-Driven Answer Choice Prediction for Language Learning

Intelligent Tutoring Systems (ITS) enhance personalized learning by predicting student answers to provide immediate and customized instruction. However, recent research has primarily focused on the correctness of the answer rather than the student's performance on specific answer choices, limiting insights into students' thought processes and potential misconceptions. To address this gap, we present MCQStudentBert, an answer forecasting model that leverages the capabilities of Large Language Models (LLMs) to integrate contextual understanding of students' answering history along with the text of the questions and answers. By predicting the specific answer choices students are likely to make, practitioners can easily extend the model to new answer choices or remove answer choices for the same multiple-choice question (MCQ) without retraining the model. In particular, we compare MLP, LSTM, BERT, and Mistral 7B architectures to generate embeddings from students' past interactions, which are then incorporated into a finetuned BERT's answer-forecasting mechanism. We apply our pipeline to a dataset of language learning MCQ, gathered from an ITS with over 10,000 students to explore the predictive accuracy of MCQStudentBert, which incorporates student interaction patterns, in comparison to correct answer prediction and traditional mastery-learning feature-based approaches. This work opens the door to more personalized content, modularization, and granular support.

  • 7 authors
·
May 30, 2024

FoundationalASSIST: An Educational Dataset for Foundational Knowledge Tracing and Pedagogical Grounding of LLMs

Can Large Language Models understand how students learn? As LLMs are deployed for adaptive testing and personalized tutoring, this question becomes urgent -- yet we cannot answer it with existing resources. Current educational datasets provide only question identifiers and binary correctness labels, rendering them opaque to LLMs that reason in natural language. We address this gap with FoundationalASSIST, the first English educational dataset providing the complete information needed for research on LLMs in education: full question text, actual student responses (not just right/wrong), records of which wrong answers students chose, and alignment to Common Core K-12 standards. These 1.7 million interactions from 5,000 students enable research directions that were previously impossible to pursue, from fine-tuning student models to analyzing misconception patterns. To demonstrate the dataset's utility, we evaluate four frontier models (GPT-OSS-120B, Llama-3.3-70B, Qwen3-Next-80B variants) on two complementary task families: Knowledge Tracing, testing whether LLMs can predict student performance on questions, and the exact answer a student will give; and Pedagogical Grounding, testing whether LLMs understand the properties that make assessment items effective. Our evaluation reveals significant gaps in current LLM capabilities. Every model barely achieves a trivial baseline on knowledge tracing. All models fall below random chance on item discrimination, indicating that LLMs do not understand what makes one problem more diagnostic than another. Models do show competence at judging relative difficulty (up to 68.6%), but this partial success only highlights the gaps elsewhere. These results establish that substantial advances are needed before LLMs can reliably support personalized learning at scale. We release FoundationalASSIST to support progress on these foundational challenges.

  • 4 authors
·
Jan 20

Beyond Overall Accuracy: A Psychometric Deep Dive into the Topic-Specific Medical Capabilities of 80 Large Language Models

As Large Language Models (LLMs) are increasingly proposed for high-stakes medical applications, there has emerged a critical need for reliable and accurate evaluation methodologies. Traditional accuracy metrics fail inadequately as they neither capture question characteristics nor offer topic-specific insights. To address this gap, we introduce MedIRT, a rigorous evaluation framework grounded in Item Response Theory (IRT), the gold standard in high-stakes educational testing. Unlike previous research relying on archival data, we prospectively gathered fresh responses from 80 diverse LLMs on a balanced, 1,100-question USMLE-aligned benchmark. Using one unidimensional two-parameter logistic IRT model per topic, we estimate LLM's latent model ability jointly with question difficulty and discrimination, yielding more stable and nuanced performance rankings than accuracy alone. Notably, we identify distinctive ``spiky'' ability profiles, where overall rankings can be misleading due to highly specialized model abilities. While GPT-5 was the top performer in a majority of domains (8 of 11), it was outperformed in Social Science and Communication by Claude-3-opus, demonstrating that even an overall 23rd-ranked model can hold the top spot for specific competencies. Furthermore, we demonstrate IRT's utility in auditing benchmarks by identifying flawed questions. We synthesize these findings into a practical decision-support framework that integrates our multi-factor competency profiles with operational metrics. This work establishes a robust, psychometrically grounded methodology essential for the safe, effective, and trustworthy deployment of LLMs in healthcare.

  • 4 authors
·
Sep 28, 2025

Investigating the Efficacy of Large Language Models in Reflective Assessment Methods through Chain of Thoughts Prompting

Large Language Models, such as Generative Pre-trained Transformer 3 (aka. GPT-3), have been developed to understand language through the analysis of extensive text data, allowing them to identify patterns and connections between words. While LLMs have demonstrated impressive performance across various text-related tasks, they encounter challenges in tasks associated with reasoning. To address this challenge, Chain of Thought(CoT) prompting method has been proposed as a means to enhance LLMs' proficiency in complex reasoning tasks like solving math word problems and answering questions based on logical argumentative reasoning. The primary aim of this research is to assess how well four language models can grade reflective essays of third-year medical students. The assessment will specifically target the evaluation of critical thinking skills using CoT prompting. The research will provide the following contributions; to introduce and educate on the process of instructing models to evaluate reflective essays from a dataset they have not been previously trained on; to illustrate the use of CoT prompting as an instructional approach for training large models to carry out particular tasks. Our results suggest that among all the models, Llama-7b performs the least effectively, displaying the highest mean squared error. Conversely, ChatGPT emerges as the superior model, boasting a higher Cohen kappa score value of 0.53. Lastly, it's important to note that the selected models do prioritise user privacy by allowing users to delete their own conducted conversations.

  • 3 authors
·
Sep 30, 2023

GPT-4 passes most of the 297 written Polish Board Certification Examinations

Introduction: Recently, the effectiveness of Large Language Models (LLMs) has increased rapidly, allowing them to be used in a great number of applications. However, the risks posed by the generation of false information through LLMs significantly limit their applications in sensitive areas such as healthcare, highlighting the necessity for rigorous validations to determine their utility and reliability. To date, no study has extensively compared the performance of LLMs on Polish medical examinations across a broad spectrum of specialties on a very large dataset. Objectives: This study evaluated the performance of three Generative Pretrained Transformer (GPT) models on the Polish Board Certification Exam (Pa\'nstwowy Egzamin Specjalizacyjny, PES) dataset, which consists of 297 tests. Methods: We developed a software program to download and process PES exams and tested the performance of GPT models using OpenAI Application Programming Interface. Results: Our findings reveal that GPT-3.5 did not pass any of the analyzed exams. In contrast, the GPT-4 models demonstrated the capability to pass the majority of the exams evaluated, with the most recent model, gpt-4-0125, successfully passing 222 (75%) of them. The performance of the GPT models varied significantly, displaying excellence in exams related to certain specialties while completely failing others. Conclusions: The significant progress and impressive performance of LLM models hold great promise for the increased application of AI in the field of medicine in Poland. For instance, this advancement could lead to the development of AI-based medical assistants for healthcare professionals, enhancing the efficiency and accuracy of medical services.

  • 3 authors
·
Apr 29, 2024

Evaluating AI Vocational Skills Through Professional Testing

Using a novel professional certification survey, the study focuses on assessing the vocational skills of two highly cited AI models, GPT-3 and Turbo-GPT3.5. The approach emphasizes the importance of practical readiness over academic performance by examining the models' performances on a benchmark dataset consisting of 1149 professional certifications. This study also includes a comparison with human test scores, providing perspective on the potential of AI models to match or even surpass human performance in professional certifications. GPT-3, even without any fine-tuning or exam preparation, managed to achieve a passing score (over 70% correct) on 39% of the professional certifications. It showcased proficiency in computer-related fields, including cloud and virtualization, business analytics, cybersecurity, network setup and repair, and data analytics. Turbo-GPT3.5, on the other hand, scored a perfect 100% on the highly regarded Offensive Security Certified Professional (OSCP) exam. This model also demonstrated competency in diverse professional fields, such as nursing, licensed counseling, pharmacy, and aviation. Turbo-GPT3.5 exhibited strong performance on customer service tasks, indicating potential use cases in enhancing chatbots for call centers and routine advice services. Both models also scored well on sensory and experience-based tests outside a machine's traditional roles, including wine sommelier, beer tasting, emotional quotient, and body language reading. The study found that OpenAI's model improvement from Babbage to Turbo led to a 60% better performance on the grading scale within a few years. This progress indicates that addressing the current model's limitations could yield an AI capable of passing even the most rigorous professional certifications.

  • 2 authors
·
Dec 16, 2023

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

Generalist foundation models such as GPT-4 have displayed surprising capabilities in a wide variety of domains and tasks. Yet, there is a prevalent assumption that they cannot match specialist capabilities of fine-tuned models. For example, most explorations to date on medical competency benchmarks have leveraged domain-specific training, as exemplified by efforts on BioGPT and Med-PaLM. We build on a prior study of GPT-4's capabilities on medical challenge benchmarks in the absence of special training. Rather than using simple prompting to highlight the model's out-of-the-box capabilities, we perform a systematic exploration of prompt engineering. We find that prompting innovation can unlock deeper specialist capabilities and show that GPT-4 easily tops prior leading results for medical benchmarks. The prompting methods we explore are general purpose, and make no specific use of domain expertise, removing the need for expert-curated content. Our experimental design carefully controls for overfitting during the prompt engineering process. We introduce Medprompt, based on a composition of several prompting strategies. With Medprompt, GPT-4 achieves state-of-the-art results on all nine of the benchmark datasets in the MultiMedQA suite. The method outperforms leading specialist models such as Med-PaLM 2 by a significant margin with an order of magnitude fewer calls to the model. Steering GPT-4 with Medprompt achieves a 27% reduction in error rate on the MedQA dataset over the best methods to date achieved with specialist models and surpasses a score of 90% for the first time. Beyond medical problems, we show the power of Medprompt to generalize to other domains and provide evidence for the broad applicability of the approach via studies of the strategy on exams in electrical engineering, machine learning, philosophy, accounting, law, nursing, and clinical psychology.

  • 18 authors
·
Nov 27, 2023

Skill-Targeted Adaptive Training

Language models often show little to no improvement (i.e., "saturation") when trained via vanilla supervised fine-tuning (SFT) on data similar to what they saw in their training set (e.g., MATH). We introduce a new fine-tuning strategy, STAT, to train such a student model by using the metacognition ability of a stronger large language model (LLM) as the teacher. The teacher uses the task dataset to create a list of skills needed for the task, and then labels each data point with its required skills (Didolkar et al., 2024). By monitoring the student's answers, the teacher creates a Missing-Skill-Profile for the student, tracking how often they failed to apply each skill in their responses. We use this idea to build a modified training set in one of two ways. In STAT-Sel, the teacher uses an existing set of training examples but adaptively reweights them according to the Missing-Skill-Profile. In STAT-Syn, the teacher synthesizes additional examples involving missing skills. Across extensive experiments on Llama and Qwen models, our methods yield improvements of up to 7.5% on MATH, whereas SFT provides only limited gains. Furthermore, STAT enhances performance on out-of-distribution benchmarks (e.g., AIME24/25, AMC23, etc.) by an average of 4.6%. Crucially, we find that STAT is complementary to RL via GRPO (Shao et al., 2024): after the model is improved using STAT to address skill gaps, GRPO continues to add further gains. We conclude that skill-targeted adaptive training should broadly improve current training pipelines. Our code is available at: https://github.com/princeton-pli/STAT.

PrincetonUniversity Princeton University
·
Oct 11, 2025 2

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

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

  • 10 authors
·
Jul 20, 2022

Automatic assessment of text-based responses in post-secondary education: A systematic review

Text-based open-ended questions in academic formative and summative assessments help students become deep learners and prepare them to understand concepts for a subsequent conceptual assessment. However, grading text-based questions, especially in large courses, is tedious and time-consuming for instructors. Text processing models continue progressing with the rapid development of Artificial Intelligence (AI) tools and Natural Language Processing (NLP) algorithms. Especially after breakthroughs in Large Language Models (LLM), there is immense potential to automate rapid assessment and feedback of text-based responses in education. This systematic review adopts a scientific and reproducible literature search strategy based on the PRISMA process using explicit inclusion and exclusion criteria to study text-based automatic assessment systems in post-secondary education, screening 838 papers and synthesizing 93 studies. To understand how text-based automatic assessment systems have been developed and applied in education in recent years, three research questions are considered. All included studies are summarized and categorized according to a proposed comprehensive framework, including the input and output of the system, research motivation, and research outcomes, aiming to answer the research questions accordingly. Additionally, the typical studies of automated assessment systems, research methods, and application domains in these studies are investigated and summarized. This systematic review provides an overview of recent educational applications of text-based assessment systems for understanding the latest AI/NLP developments assisting in text-based assessments in higher education. Findings will particularly benefit researchers and educators incorporating LLMs such as ChatGPT into their educational activities.

  • 5 authors
·
Aug 30, 2023

Clinical Prompt Learning with Frozen Language Models

Prompt learning is a new paradigm in the Natural Language Processing (NLP) field which has shown impressive performance on a number of natural language tasks with common benchmarking text datasets in full, few-shot, and zero-shot train-evaluation setups. Recently, it has even been observed that large but frozen pre-trained language models (PLMs) with prompt learning outperform smaller but fine-tuned models. However, as with many recent NLP trends, the performance of even the largest PLMs such as GPT-3 do not perform well on specialized domains (e.g. medical text), and the common practice to achieve State of the Art (SoTA) results still consists of pre-training and fine-tuning the PLMs on downstream tasks. The reliance on fine-tuning large PLMs is problematic in clinical settings where data is often held in non-GPU environments, and more resource efficient methods of training specialized domain models is crucial. We investigated the viability of prompt learning on clinically meaningful decision tasks and directly compared with more traditional fine-tuning methods. Results are partially in line with the prompt learning literature, with prompt learning able to match or improve on traditional fine-tuning with substantially fewer trainable parameters and requiring less training data. We argue that prompt learning therefore provides lower computational resource costs applicable to clinical settings, that can serve as an alternative to fine-tuning ever increasing in size PLMs. Complementary code to reproduce experiments presented in this work can be found at: https://github.com/NtaylorOX/Public_Clinical_Prompt.

  • 5 authors
·
May 11, 2022

GAPS: A Clinically Grounded, Automated Benchmark for Evaluating AI Clinicians

Current benchmarks for AI clinician systems, often based on multiple-choice exams or manual rubrics, fail to capture the depth, robustness, and safety required for real-world clinical practice. To address this, we introduce the GAPS framework, a multidimensional paradigm for evaluating Grounding (cognitive depth), Adequacy (answer completeness), Perturbation (robustness), and Safety. Critically, we developed a fully automated, guideline-anchored pipeline to construct a GAPS-aligned benchmark end-to-end, overcoming the scalability and subjectivity limitations of prior work. Our pipeline assembles an evidence neighborhood, creates dual graph and tree representations, and automatically generates questions across G-levels. Rubrics are synthesized by a DeepResearch agent that mimics GRADE-consistent, PICO-driven evidence review in a ReAct loop. Scoring is performed by an ensemble of large language model (LLM) judges. Validation confirmed our automated questions are high-quality and align with clinician judgment. Evaluating state-of-the-art models on the benchmark revealed key failure modes: performance degrades sharply with increased reasoning depth (G-axis), models struggle with answer completeness (A-axis), and they are highly vulnerable to adversarial perturbations (P-axis) as well as certain safety issues (S-axis). This automated, clinically-grounded approach provides a reproducible and scalable method for rigorously evaluating AI clinician systems and guiding their development toward safer, more reliable clinical practice.

  • 41 authors
·
Oct 15, 2025

When Metrics Disagree: Automatic Similarity vs. LLM-as-a-Judge for Clinical Dialogue Evaluation

As Large Language Models (LLMs) are increasingly integrated into healthcare to address complex inquiries, ensuring their reliability remains a critical challenge. Recent studies have highlighted that generic LLMs often struggle in clinical contexts, occasionally producing misleading guidance. To mitigate these risks, this research focuses on the domain-specific adaptation of Llama-2-7B using the Low-Rank Adaptation (LoRA) technique. By injecting trainable low-rank matrices into the Transformer layers, we efficiently adapted the model using authentic patient-physician transcripts while preserving the foundational knowledge of the base model. Our objective was to enhance precision and contextual relevance in responding to medical queries by capturing the specialized nuances of clinical discourse. Due to the resource-intensive nature of large-scale human validation, the model's performance was evaluated through a dual-track framework: Track A utilized traditional lexical similarity metrics (e.g., BLEU, ROUGE), while Track B employed an "LLM-as-a-Judge" paradigm using GPT-4 for semantic assessment. Our results demonstrate that while the LoRA-enhanced model achieved significant improvements across all quantitative lexical dimensions, a profound disagreement surfaced in the GPT-4 evaluation, which marginally favored the baseline model's conversational flow. This metric divergence underscores a pivotal finding: traditional automated scores may not fully reflect clinical utility. Consequently, we propose that while automated metrics and LLM judges serve as valuable developmental proxies, rigorous validation by human medical experts remains an indispensable requirement for the safe deployment of LLMs in healthcare settings.

  • 4 authors
·
Mar 30

Can OpenAI o1 outperform humans in higher-order cognitive thinking?

This study evaluates the performance of OpenAI's o1-preview model in higher-order cognitive domains, including critical thinking, systematic thinking, computational thinking, data literacy, creative thinking, logical reasoning, and scientific reasoning. Using established benchmarks, we compared the o1-preview models's performance to human participants from diverse educational levels. o1-preview achieved a mean score of 24.33 on the Ennis-Weir Critical Thinking Essay Test (EWCTET), surpassing undergraduate (13.8) and postgraduate (18.39) participants (z = 1.60 and 0.90, respectively). In systematic thinking, it scored 46.1, SD = 4.12 on the Lake Urmia Vignette, significantly outperforming the human mean (20.08, SD = 8.13, z = 3.20). For data literacy, o1-preview scored 8.60, SD = 0.70 on Merk et al.'s "Use Data" dimension, compared to the human post-test mean of 4.17, SD = 2.02 (z = 2.19). On creative thinking tasks, the model achieved originality scores of 2.98, SD = 0.73, higher than the human mean of 1.74 (z = 0.71). In logical reasoning (LogiQA), it outperformed humans with average 90%, SD = 10% accuracy versus 86%, SD = 6.5% (z = 0.62). For scientific reasoning, it achieved near-perfect performance (mean = 0.99, SD = 0.12) on the TOSLS,, exceeding the highest human scores of 0.85, SD = 0.13 (z = 1.78). While o1-preview excelled in structured tasks, it showed limitations in problem-solving and adaptive reasoning. These results demonstrate the potential of AI to complement education in structured assessments but highlight the need for ethical oversight and refinement for broader applications.

  • 9 authors
·
Dec 7, 2024

AXNav: Replaying Accessibility Tests from Natural Language

Developers and quality assurance testers often rely on manual testing to test accessibility features throughout the product lifecycle. Unfortunately, manual testing can be tedious, often has an overwhelming scope, and can be difficult to schedule amongst other development milestones. Recently, Large Language Models (LLMs) have been used for a variety of tasks including automation of UIs, however to our knowledge no one has yet explored their use in controlling assistive technologies for the purposes of supporting accessibility testing. In this paper, we explore the requirements of a natural language based accessibility testing workflow, starting with a formative study. From this we build a system that takes as input a manual accessibility test (e.g., ``Search for a show in VoiceOver'') and uses an LLM combined with pixel-based UI Understanding models to execute the test and produce a chaptered, navigable video. In each video, to help QA testers we apply heuristics to detect and flag accessibility issues (e.g., Text size not increasing with Large Text enabled, VoiceOver navigation loops). We evaluate this system through a 10 participant user study with accessibility QA professionals who indicated that the tool would be very useful in their current work and performed tests similarly to how they would manually test the features. The study also reveals insights for future work on using LLMs for accessibility testing.

  • 6 authors
·
Oct 3, 2023

Magic Words or Methodical Work? Challenging Conventional Wisdom in LLM-Based Political Text Annotation

Political scientists are rapidly adopting large language models (LLMs) for text annotation, yet the sensitivity of annotation results to implementation choices remains poorly understood. Most evaluations test a single model or configuration; how model choice, model size, learning approach, and prompt style interact, and whether popular "best practices" survive controlled comparison, are largely unexplored. We present a controlled evaluation of these pipeline choices, testing six open-weight models across four political science annotation tasks under identical quantisation, hardware, and prompt-template conditions. Our central finding is methodological: interaction effects dominate main effects, so seemingly reasonable pipeline choices can become consequential researcher degrees of freedom. No single model, prompt style, or learning approach is uniformly superior, and the best-performing model varies across tasks. Two corollaries follow. First, model size is an unreliable guide both to cost and to performance: cross-family efficiency differences are so large that some larger models are less resource-intensive than much smaller alternatives, while within model families mid-range variants often match or exceed larger counterparts. Second, widely recommended prompt engineering techniques yield inconsistent and sometimes negative effects on annotation performance. We use these benchmark results to develop a validation-first framework - with a principled ordering of pipeline decisions, guidance on prompt freezing and held-out evaluation, reporting standards, and open-source tools - to help researchers navigate this decision space transparently.

  • 5 authors
·
Mar 27

LLM Prompt Evaluation for Educational Applications

As large language models (LLMs) become increasingly common in educational applications, there is a growing need for evidence-based methods to design and evaluate LLM prompts that produce personalized and pedagogically aligned out-puts. This study presents a generalizable, systematic approach for evaluating prompts, demonstrated through an analysis of LLM-generated follow-up questions in a structured dialogue activity. Six prompt templates were designed and tested. The templates incorporated established prompt engineering patterns, with each prompt emphasizing distinct pedagogical strategies. The prompt templates were compared through a tournament-style evaluation framework that can be adapted for other educational applications. The tournament employed the Glicko2 rating system with eight judges evaluating question pairs across three dimensions: format, dialogue support, and appropriateness for learners. Data was sourced from 120 authentic user interactions across three distinct educational deployments. Results showed that a single prompt related to strategic reading out-performed other templates with win probabilities ranging from 81% to 100% in pairwise comparisons. This prompt combined persona and context manager pat-terns and was designed to support metacognitive learning strategies such as self-directed learning. The methodology showcases how educational technology re- searchers can systematically evaluate and improve prompt designs, moving beyond ad-hoc prompt engineering toward evidence-based prompt development for educational applications.

Automatic Personalized Impression Generation for PET Reports Using Large Language Models

In this study, we aimed to determine if fine-tuned large language models (LLMs) can generate accurate, personalized impressions for whole-body PET reports. Twelve language models were trained on a corpus of PET reports using the teacher-forcing algorithm, with the report findings as input and the clinical impressions as reference. An extra input token encodes the reading physician's identity, allowing models to learn physician-specific reporting styles. Our corpus comprised 37,370 retrospective PET reports collected from our institution between 2010 and 2022. To identify the best LLM, 30 evaluation metrics were benchmarked against quality scores from two nuclear medicine (NM) physicians, with the most aligned metrics selecting the model for expert evaluation. In a subset of data, model-generated impressions and original clinical impressions were assessed by three NM physicians according to 6 quality dimensions (3-point scale) and an overall utility score (5-point scale). Each physician reviewed 12 of their own reports and 12 reports from other physicians. Bootstrap resampling was used for statistical analysis. Of all evaluation metrics, domain-adapted BARTScore and PEGASUSScore showed the highest Spearman's rank correlations (0.568 and 0.563) with physician preferences. Based on these metrics, the fine-tuned PEGASUS model was selected as the top LLM. When physicians reviewed PEGASUS-generated impressions in their own style, 89% were considered clinically acceptable, with a mean utility score of 4.08 out of 5. Physicians rated these personalized impressions as comparable in overall utility to the impressions dictated by other physicians (4.03, P=0.41). In conclusion, personalized impressions generated by PEGASUS were clinically useful, highlighting its potential to expedite PET reporting.

  • 11 authors
·
Sep 18, 2023

reStructured Pre-training

In this work, we try to decipher the internal connection of NLP technology development in the past decades, searching for essence, which rewards us with a (potential) new learning paradigm for NLP tasks, dubbed as reStructured Pre-training (RST). In such a paradigm, the role of data will be re-emphasized, and model pre-training and fine-tuning of downstream tasks are viewed as a process of data storing and accessing. Based on that, we operationalize the simple principle that a good storage mechanism should not only have the ability to cache a large amount of data but also consider the ease of access. We achieve this by pre-training models over restructured data that consist of a variety of valuable information instead of raw data after overcoming several engineering challenges. Experimentally, RST models not only surpass strong competitors (e.g., T0) on 52/55 popular datasets from a variety of NLP tasks, but also achieve superior performance in National College Entrance Examination - English (Gaokao-English),the most authoritative examination in China. Specifically, the proposed system Qin achieves 40 points higher than the average scores made by students and 15 points higher than GPT3 with 1/16 parameters. In particular, Qin gets a high score of 138.5 (the full mark is 150) in the 2018 English exam (national paper III). We have released the Gaokao Benchmark with an online submission platform. In addition, we test our model in the 2022 College Entrance Examination English that happened a few days ago (2022.06.08), and it gets a total score of 134 (v.s. GPT3's 108).

  • 2 authors
·
Jun 22, 2022

Batch Predictive Inference

Constructing prediction sets with coverage guarantees for unobserved outcomes is a core problem in modern statistics. Methods for predictive inference have been developed for a wide range of settings, but usually only consider test data points one at a time. Here we study the problem of distribution-free predictive inference for a batch of multiple test points, aiming to construct prediction sets for functions -- such as the mean or median -- of any number of unobserved test datapoints. This setting includes constructing simultaneous prediction sets with a high probability of coverage, and selecting datapoints satisfying a specified condition while controlling the number of false claims. For the general task of predictive inference on a function of a batch of test points, we introduce a methodology called batch predictive inference (batch PI), and provide a distribution-free coverage guarantee under exchangeability of the calibration and test data. Batch PI requires the quantiles of a rank ordering function defined on certain subsets of ranks. While computing these quantiles is NP-hard in general, we show that it can be done efficiently in many cases of interest, most notably for batch score functions with a compositional structure -- which includes examples of interest such as the mean -- via a dynamic programming algorithm that we develop. Batch PI has advantages over naive approaches (such as partitioning the calibration data or directly extending conformal prediction) in many settings, as it can deliver informative prediction sets even using small calibration sample sizes. We illustrate that our procedures provide informative inference across the use cases mentioned above, through experiments on both simulated data and a drug-target interaction dataset.

  • 3 authors
·
Sep 20, 2024

Modeling of learning curves with applications to pos tagging

An algorithm to estimate the evolution of learning curves on the whole of a training data base, based on the results obtained from a portion and using a functional strategy, is introduced. We approximate iteratively the sought value at the desired time, independently of the learning technique used and once a point in the process, called prediction level, has been passed. The proposal proves to be formally correct with respect to our working hypotheses and includes a reliable proximity condition. This allows the user to fix a convergence threshold with respect to the accuracy finally achievable, which extends the concept of stopping criterion and seems to be effective even in the presence of distorting observations. Our aim is to evaluate the training effort, supporting decision making in order to reduce the need for both human and computational resources during the learning process. The proposal is of interest in at least three operational procedures. The first is the anticipation of accuracy gain, with the purpose of measuring how much work is needed to achieve a certain degree of performance. The second relates the comparison of efficiency between systems at training time, with the objective of completing this task only for the one that best suits our requirements. The prediction of accuracy is also a valuable item of information for customizing systems, since we can estimate in advance the impact of settings on both the performance and the development costs. Using the generation of part-of-speech taggers as an example application, the experimental results are consistent with our expectations.

  • 3 authors
·
Feb 4, 2024

Reliable and Efficient Amortized Model-based Evaluation

Comprehensive evaluations of language models (LM) during both development and deployment phases are necessary because these models possess numerous capabilities (e.g., mathematical reasoning, legal support, or medical diagnostic) as well as safety risks (e.g., racial bias, toxicity, or misinformation). The average score across a wide range of benchmarks provides a signal that helps guide the use of these LMs in practice. Currently, holistic evaluations are costly due to the large volume of benchmark questions, making frequent evaluations impractical. A popular attempt to lower the cost is to compute the average score on a subset of the benchmark. This approach, unfortunately, often renders an unreliable measure of LM performance because the average score is often confounded with the difficulty of the questions in the benchmark subset. Item response theory (IRT) was designed to address this challenge, providing a reliable measurement by careful controlling for question difficulty. Unfortunately, question difficulty is expensive to estimate. Facing this challenge, we train a model that predicts question difficulty from its content, enabling a reliable measurement at a fraction of the cost. In addition, we leverage this difficulty predictor to further improve the evaluation efficiency through training a question generator given a difficulty level. This question generator is essential in adaptive testing, where, instead of using a random subset of the benchmark questions, informative questions are adaptively chosen based on the current estimation of LLM performance. Experiments on 22 common natural language benchmarks and 172 LMs show that this approach is more reliable and efficient compared to current common practice.

  • 5 authors
·
Mar 17, 2025

CUPCase: Clinically Uncommon Patient Cases and Diagnoses Dataset

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.

  • 4 authors
·
Mar 8, 2025

On the application of Large Language Models for language teaching and assessment technology

The recent release of very large language models such as PaLM and GPT-4 has made an unprecedented impact in the popular media and public consciousness, giving rise to a mixture of excitement and fear as to their capabilities and potential uses, and shining a light on natural language processing research which had not previously received so much attention. The developments offer great promise for education technology, and in this paper we look specifically at the potential for incorporating large language models in AI-driven language teaching and assessment systems. We consider several research areas and also discuss the risks and ethical considerations surrounding generative AI in education technology for language learners. Overall we find that larger language models offer improvements over previous models in text generation, opening up routes toward content generation which had not previously been plausible. For text generation they must be prompted carefully and their outputs may need to be reshaped before they are ready for use. For automated grading and grammatical error correction, tasks whose progress is checked on well-known benchmarks, early investigations indicate that large language models on their own do not improve on state-of-the-art results according to standard evaluation metrics. For grading it appears that linguistic features established in the literature should still be used for best performance, and for error correction it may be that the models can offer alternative feedback styles which are not measured sensitively with existing methods. In all cases, there is work to be done to experiment with the inclusion of large language models in education technology for language learners, in order to properly understand and report on their capacities and limitations, and to ensure that foreseeable risks such as misinformation and harmful bias are mitigated.

  • 15 authors
·
Jul 17, 2023

Evaluating Large Language Models on the GMAT: Implications for the Future of Business Education

The rapid evolution of artificial intelligence (AI), especially in the domain of Large Language Models (LLMs) and generative AI, has opened new avenues for application across various fields, yet its role in business education remains underexplored. This study introduces the first benchmark to assess the performance of seven major LLMs, OpenAI's models (GPT-3.5 Turbo, GPT-4, and GPT-4 Turbo), Google's models (PaLM 2, Gemini 1.0 Pro), and Anthropic's models (Claude 2 and Claude 2.1), on the GMAT, which is a key exam in the admission process for graduate business programs. Our analysis shows that most LLMs outperform human candidates, with GPT-4 Turbo not only outperforming the other models but also surpassing the average scores of graduate students at top business schools. Through a case study, this research examines GPT-4 Turbo's ability to explain answers, evaluate responses, identify errors, tailor instructions, and generate alternative scenarios. The latest LLM versions, GPT-4 Turbo, Claude 2.1, and Gemini 1.0 Pro, show marked improvements in reasoning tasks compared to their predecessors, underscoring their potential for complex problem-solving. While AI's promise in education, assessment, and tutoring is clear, challenges remain. Our study not only sheds light on LLMs' academic potential but also emphasizes the need for careful development and application of AI in education. As AI technology advances, it is imperative to establish frameworks and protocols for AI interaction, verify the accuracy of AI-generated content, ensure worldwide access for diverse learners, and create an educational environment where AI supports human expertise. This research sets the stage for further exploration into the responsible use of AI to enrich educational experiences and improve exam preparation and assessment methods.

  • 3 authors
·
Jan 1, 2024

Preserving Privacy, Increasing Accessibility, and Reducing Cost: An On-Device Artificial Intelligence Model for Medical Transcription and Note Generation

Background: Clinical documentation represents a significant burden for healthcare providers, with physicians spending up to 2 hours daily on administrative tasks. Recent advances in large language models (LLMs) offer promising solutions, but privacy concerns and computational requirements limit their adoption in healthcare settings. Objective: To develop and evaluate a privacy-preserving, on-device medical transcription system using a fine-tuned Llama 3.2 1B model capable of generating structured medical notes from medical transcriptions while maintaining complete data sovereignty entirely in the browser. Methods: We fine-tuned a Llama 3.2 1B model using Parameter-Efficient Fine-Tuning (PEFT) with LoRA on 1,500 synthetic medical transcription-to-structured note pairs. The model was evaluated against the base Llama 3.2 1B on two datasets: 100 endocrinology transcripts and 140 modified ACI benchmark cases. Evaluation employed both statistical metrics (ROUGE, BERTScore, BLEURT) and LLM-as-judge assessments across multiple clinical quality dimensions. Results: The fine-tuned OnDevice model demonstrated substantial improvements over the base model. On the ACI benchmark, ROUGE-1 scores increased from 0.346 to 0.496, while BERTScore F1 improved from 0.832 to 0.866. Clinical quality assessments showed marked reduction in major hallucinations (from 85 to 35 cases) and enhanced factual correctness (2.81 to 3.54 on 5-point scale). Similar improvements were observed on the internal evaluation dataset, with composite scores increasing from 3.13 to 4.43 (+41.5%). Conclusions: Fine-tuning compact LLMs for medical transcription yields clinically meaningful improvements while enabling complete on-device browser deployment. This approach addresses key barriers to AI adoption in healthcare: privacy preservation, cost reduction, and accessibility for resource-constrained environments.

  • 6 authors
·
Jul 2, 2025 1

Automated Rubrics for Reliable Evaluation of Medical Dialogue Systems

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

  • 4 authors
·
Jan 21

TutorBench: A Benchmark To Assess Tutoring Capabilities Of Large Language Models

As students increasingly adopt large language models (LLMs) as learning aids, it is crucial to build models that are adept at handling the nuances of tutoring: they need to identify the core needs of students, be adaptive, provide personalized guidance, and be accurate. To this end, we introduce TutorBench, a dataset and evaluation benchmark designed to rigorously evaluate the core tutoring skills of LLMs. The dataset comprises 1,490 samples curated by human experts, focused on high-school and AP-level curricula. The samples are drawn from three common tutoring tasks: (i) generating adaptive explanations tailored to a student's confusion, (ii) providing actionable feedback on a student's work, and (iii) promoting active learning through effective hint generation. To account for the inherent complexity of tutoring, samples are accompanied by sample-specific rubrics which are used to judge model responses during evaluation. TutorBench uses a reliable and fine-grained automatic evaluation method that uses an LLM-judge and the sample-specific rubrics. We evaluate 16 frontier LLMs on TutorBench and present a detailed analysis of their performance and behavior. Our results show that none of the frontier LLMs achieve a score of greater than 56%, showing a large room for improvement. We find that LLMs fall short in exhibiting the full range of tutoring skills needed to guide, diagnose, and support students effectively, with all the frontier models achieving less than a 60% pass rate on rubric criteria related to these skills. We also find that different model families exhibit varied strengths and limitations: the Claude models outperform others in supporting active learning, while they lag behind in the other two use cases. By releasing TutorBench, we provide a comprehensive and unsaturated benchmark to guide the development of the next-generation of AI tutors.

  • 14 authors
·
Oct 2, 2025

GPT as Knowledge Worker: A Zero-Shot Evaluation of (AI)CPA Capabilities

The global economy is increasingly dependent on knowledge workers to meet the needs of public and private organizations. While there is no single definition of knowledge work, organizations and industry groups still attempt to measure individuals' capability to engage in it. The most comprehensive assessment of capability readiness for professional knowledge workers is the Uniform CPA Examination developed by the American Institute of Certified Public Accountants (AICPA). In this paper, we experimentally evaluate OpenAI's `text-davinci-003` and prior versions of GPT on both a sample Regulation (REG) exam and an assessment of over 200 multiple-choice questions based on the AICPA Blueprints for legal, financial, accounting, technology, and ethical tasks. First, we find that `text-davinci-003` achieves a correct rate of 14.4% on a sample REG exam section, significantly underperforming human capabilities on quantitative reasoning in zero-shot prompts. Second, `text-davinci-003` appears to be approaching human-level performance on the Remembering & Understanding and Application skill levels in the Exam absent calculation. For best prompt and parameters, the model answers 57.6% of questions correctly, significantly better than the 25% guessing rate, and its top two answers are correct 82.1% of the time, indicating strong non-entailment. Finally, we find that recent generations of GPT-3 demonstrate material improvements on this assessment, rising from 30% for `text-davinci-001` to 57% for `text-davinci-003`. These findings strongly suggest that large language models have the potential to transform the quality and efficiency of future knowledge work.

  • 4 authors
·
Jan 11, 2023

HuatuoGPT, towards Taming Language Model to Be a Doctor

In this paper, we present HuatuoGPT, a large language model (LLM) for medical consultation. The core recipe of HuatuoGPT is to leverage both distilled data from ChatGPT and real-world data from doctors in the supervised fine-tuned stage. The responses of ChatGPT are usually detailed, well-presented and informative while it cannot perform like a doctor in many aspects, e.g. for integrative diagnosis. We argue that real-world data from doctors would be complementary to distilled data in the sense the former could tame a distilled language model to perform like doctors. To better leverage the strengths of both data, we train a reward model to align the language model with the merits that both data bring, following an RLAIF (reinforced learning from AI feedback) fashion. To evaluate and benchmark the models, we propose a comprehensive evaluation scheme (including automatic and manual metrics). Experimental results demonstrate that HuatuoGPT achieves state-of-the-art results in performing medical consultation among open-source LLMs in GPT-4 evaluation, human evaluation, and medical benchmark datasets. It is worth noting that by using additional real-world data and RLAIF, the distilled language model (i.e., HuatuoGPT) outperforms its teacher model ChatGPT in most cases. Our code, data, and models are publicly available at https://github.com/FreedomIntelligence/HuatuoGPT. The online demo is available at https://www.HuatuoGPT.cn/.

  • 13 authors
·
May 24, 2023

How Much Would a Clinician Edit This Draft? Evaluating LLM Alignment for Patient Message Response Drafting

Large language models (LLMs) show promise in drafting responses to patient portal messages, yet their integration into clinical workflows raises various concerns, including whether they would actually save clinicians time and effort in their portal workload. We investigate LLM alignment with individual clinicians through a comprehensive evaluation of the patient message response drafting task. We develop a novel taxonomy of thematic elements in clinician responses and propose a novel evaluation framework for assessing clinician editing load of LLM-drafted responses at both content and theme levels. We release an expert-annotated dataset and conduct large-scale evaluations of local and commercial LLMs using various adaptation techniques including thematic prompting, retrieval-augmented generation, supervised fine-tuning, and direct preference optimization. Our results reveal substantial epistemic uncertainty in aligning LLM drafts with clinician responses. While LLMs demonstrate capability in drafting certain thematic elements, they struggle with clinician-aligned generation in other themes, particularly question asking to elicit further information from patients. Theme-driven adaptation strategies yield improvements across most themes. Our findings underscore the necessity of adapting LLMs to individual clinician preferences to enable reliable and responsible use in patient-clinician communication workflows.

  • 7 authors
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Jan 16

Automated essay scoring in Arabic: a dataset and analysis of a BERT-based system

Automated Essay Scoring (AES) holds significant promise in the field of education, helping educators to mark larger volumes of essays and provide timely feedback. However, Arabic AES research has been limited by the lack of publicly available essay data. This study introduces AR-AES, an Arabic AES benchmark dataset comprising 2046 undergraduate essays, including gender information, scores, and transparent rubric-based evaluation guidelines, providing comprehensive insights into the scoring process. These essays come from four diverse courses, covering both traditional and online exams. Additionally, we pioneer the use of AraBERT for AES, exploring its performance on different question types. We find encouraging results, particularly for Environmental Chemistry and source-dependent essay questions. For the first time, we examine the scale of errors made by a BERT-based AES system, observing that 96.15 percent of the errors are within one point of the first human marker's prediction, on a scale of one to five, with 79.49 percent of predictions matching exactly. In contrast, additional human markers did not exceed 30 percent exact matches with the first marker, with 62.9 percent within one mark. These findings highlight the subjectivity inherent in essay grading, and underscore the potential for current AES technology to assist human markers to grade consistently across large classes.

  • 2 authors
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Jul 15, 2024

Accuracy of a Vision-Language Model on Challenging Medical Cases

Background: General-purpose large language models that utilize both text and images have not been evaluated on a diverse array of challenging medical cases. Methods: Using 934 cases from the NEJM Image Challenge published between 2005 and 2023, we evaluated the accuracy of the recently released Generative Pre-trained Transformer 4 with Vision model (GPT-4V) compared to human respondents overall and stratified by question difficulty, image type, and skin tone. We further conducted a physician evaluation of GPT-4V on 69 NEJM clinicopathological conferences (CPCs). Analyses were conducted for models utilizing text alone, images alone, and both text and images. Results: GPT-4V achieved an overall accuracy of 61% (95% CI, 58 to 64%) compared to 49% (95% CI, 49 to 50%) for humans. GPT-4V outperformed humans at all levels of difficulty and disagreement, skin tones, and image types; the exception was radiographic images, where performance was equivalent between GPT-4V and human respondents. Longer, more informative captions were associated with improved performance for GPT-4V but similar performance for human respondents. GPT-4V included the correct diagnosis in its differential for 80% (95% CI, 68 to 88%) of CPCs when using text alone, compared to 58% (95% CI, 45 to 70%) of CPCs when using both images and text. Conclusions: GPT-4V outperformed human respondents on challenging medical cases and was able to synthesize information from both images and text, but performance deteriorated when images were added to highly informative text. Overall, our results suggest that multimodal AI models may be useful in medical diagnostic reasoning but that their accuracy may depend heavily on context.

  • 4 authors
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Nov 9, 2023

Large Language Models Encode Clinical Knowledge

Large language models (LLMs) have demonstrated impressive capabilities in natural language understanding and generation, but the quality bar for medical and clinical applications is high. Today, attempts to assess models' clinical knowledge typically rely on automated evaluations on limited benchmarks. There is no standard to evaluate model predictions and reasoning across a breadth of tasks. To address this, we present MultiMedQA, a benchmark combining six existing open question answering datasets spanning professional medical exams, research, and consumer queries; and HealthSearchQA, a new free-response dataset of medical questions searched online. We propose a framework for human evaluation of model answers along multiple axes including factuality, precision, possible harm, and bias. In addition, we evaluate PaLM (a 540-billion parameter LLM) and its instruction-tuned variant, Flan-PaLM, on MultiMedQA. Using a combination of prompting strategies, Flan-PaLM achieves state-of-the-art accuracy on every MultiMedQA multiple-choice dataset (MedQA, MedMCQA, PubMedQA, MMLU clinical topics), including 67.6% accuracy on MedQA (US Medical License Exam questions), surpassing prior state-of-the-art by over 17%. However, human evaluation reveals key gaps in Flan-PaLM responses. To resolve this we introduce instruction prompt tuning, a parameter-efficient approach for aligning LLMs to new domains using a few exemplars. The resulting model, Med-PaLM, performs encouragingly, but remains inferior to clinicians. We show that comprehension, recall of knowledge, and medical reasoning improve with model scale and instruction prompt tuning, suggesting the potential utility of LLMs in medicine. Our human evaluations reveal important limitations of today's models, reinforcing the importance of both evaluation frameworks and method development in creating safe, helpful LLM models for clinical applications.

  • 30 authors
·
Dec 26, 2022

DREAM: Improving Situational QA by First Elaborating the Situation

When people answer questions about a specific situation, e.g., "I cheated on my mid-term exam last week. Was that wrong?", cognitive science suggests that they form a mental picture of that situation before answering. While we do not know how language models (LMs) answer such questions, we conjecture that they may answer more accurately if they are also provided with additional details about the question situation, elaborating the "scene". To test this conjecture, we train a new model, DREAM, to answer questions that elaborate the scenes that situated questions are about, and then provide those elaborations as additional context to a question-answering (QA) model. We find that DREAM is able to create better scene elaborations (more accurate, useful, and consistent) than a representative state-of-the-art, zero-shot model (Macaw). We also find that using the scene elaborations as additional context improves the answer accuracy of a downstream QA system, including beyond that obtainable by simply further finetuning the QA system on DREAM's training data. These results suggest that adding focused elaborations about a situation can improve a system's reasoning about it, and may serve as an effective way of injecting new scenario based knowledge into QA models. Finally, our approach is dataset-neutral; we observe improved QA performance across different models, with even bigger gains on models with fewer parameters. We make our dataset and model publicly available at https://github.com/allenai/dream.

  • 3 authors
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Dec 16, 2021

Can open source large language models be used for tumor documentation in Germany? -- An evaluation on urological doctors' notes

Tumor documentation in Germany is largely done manually, requiring reading patient records and entering data into structured databases. Large language models (LLMs) could potentially enhance this process by improving efficiency and reliability. This evaluation tests eleven different open source LLMs with sizes ranging from 1-70 billion model parameters on three basic tasks of the tumor documentation process: identifying tumor diagnoses, assigning ICD-10 codes, and extracting the date of first diagnosis. For evaluating the LLMs on these tasks, a dataset of annotated text snippets based on anonymized doctors' notes from urology was prepared. Different prompting strategies were used to investigate the effect of the number of examples in few-shot prompting and to explore the capabilities of the LLMs in general. The models Llama 3.1 8B, Mistral 7B, and Mistral NeMo 12 B performed comparably well in the tasks. Models with less extensive training data or having fewer than 7 billion parameters showed notably lower performance, while larger models did not display performance gains. Examples from a different medical domain than urology could also improve the outcome in few-shot prompting, which demonstrates the ability of LLMs to handle tasks needed for tumor documentation. Open source LLMs show a strong potential for automating tumor documentation. Models from 7-12 billion parameters could offer an optimal balance between performance and resource efficiency. With tailored fine-tuning and well-designed prompting, these models might become important tools for clinical documentation in the future. The code for the evaluation is available from https://github.com/stefan-m-lenz/UroLlmEval. We also release the dataset as a new valuable resource that addresses the shortage of authentic and easily accessible benchmarks in German-language medical NLP.

  • 4 authors
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Jan 21, 2025 1

CAT-LM: Training Language Models on Aligned Code And Tests

Testing is an integral part of the software development process. Yet, writing tests is time-consuming and therefore often neglected. Classical test generation tools such as EvoSuite generate behavioral test suites by optimizing for coverage, but tend to produce tests that are hard to understand. Language models trained on code can generate code that is highly similar to that written by humans, but current models are trained to generate each file separately, as is standard practice in natural language processing, and thus fail to consider the code-under-test context when producing a test file. In this work, we propose the Aligned Code And Tests Language Model (CAT-LM), a GPT-style language model with 2.7 Billion parameters, trained on a corpus of Python and Java projects. We utilize a novel pretraining signal that explicitly considers the mapping between code and test files when available. We also drastically increase the maximum sequence length of inputs to 8,192 tokens, 4x more than typical code generation models, to ensure that the code context is available to the model when generating test code. We analyze its usefulness for realistic applications, showing that sampling with filtering (e.g., by compilability, coverage) allows it to efficiently produce tests that achieve coverage similar to ones written by developers while resembling their writing style. By utilizing the code context, CAT-LM generates more valid tests than even much larger language models trained with more data (CodeGen 16B and StarCoder) and substantially outperforms a recent test-specific model (TeCo) at test completion. Overall, our work highlights the importance of incorporating software-specific insights when training language models for code and paves the way to more powerful automated test generation.

  • 5 authors
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Oct 2, 2023

Revisiting Text-to-Image Evaluation with Gecko: On Metrics, Prompts, and Human Ratings

While text-to-image (T2I) generative models have become ubiquitous, they do not necessarily generate images that align with a given prompt. While previous work has evaluated T2I alignment by proposing metrics, benchmarks, and templates for collecting human judgements, the quality of these components is not systematically measured. Human-rated prompt sets are generally small and the reliability of the ratings -- and thereby the prompt set used to compare models -- is not evaluated. We address this gap by performing an extensive study evaluating auto-eval metrics and human templates. We provide three main contributions: (1) We introduce a comprehensive skills-based benchmark that can discriminate models across different human templates. This skills-based benchmark categorises prompts into sub-skills, allowing a practitioner to pinpoint not only which skills are challenging, but at what level of complexity a skill becomes challenging. (2) We gather human ratings across four templates and four T2I models for a total of >100K annotations. This allows us to understand where differences arise due to inherent ambiguity in the prompt and where they arise due to differences in metric and model quality. (3) Finally, we introduce a new QA-based auto-eval metric that is better correlated with human ratings than existing metrics for our new dataset, across different human templates, and on TIFA160.

  • 11 authors
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Apr 25, 2024 2

Answer Matching Outperforms Multiple Choice for Language Model Evaluation

Multiple choice benchmarks have long been the workhorse of language model evaluation because grading multiple choice is objective and easy to automate. However, we show multiple choice questions from popular benchmarks can often be answered without even seeing the question. These shortcuts arise from a fundamental limitation of discriminative evaluation not shared by evaluations of the model's free-form, generative answers. Until recently, there appeared to be no viable, scalable alternative to multiple choice--but, we show that this has changed. We consider generative evaluation via what we call answer matching: Give the candidate model the question without the options, have it generate a free-form response, then use a modern language model with the reference answer to determine if the response matches the reference. To compare the validity of different evaluation strategies, we annotate MMLU-Pro and GPQA-Diamond to obtain human grading data, and measure the agreement of each evaluation approach. We find answer matching using recent models--even small ones--achieves near-perfect agreement, in the range of inter-annotator agreement. In contrast, both multiple choice evaluation and using LLM-as-a-judge without reference answers aligns poorly with human grading. Improving evaluations via answer matching is not merely a conceptual concern: the rankings of several models change significantly when evaluating their free-form responses with answer matching. In light of these findings, we discuss how to move the evaluation ecosystem from multiple choice to answer matching.

  • 5 authors
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Jul 3, 2025 2

Promptor: A Conversational and Autonomous Prompt Generation Agent for Intelligent Text Entry Techniques

Text entry is an essential task in our day-to-day digital interactions. Numerous intelligent features have been developed to streamline this process, making text entry more effective, efficient, and fluid. These improvements include sentence prediction and user personalization. However, as deep learning-based language models become the norm for these advanced features, the necessity for data collection and model fine-tuning increases. These challenges can be mitigated by harnessing the in-context learning capability of large language models such as GPT-3.5. This unique feature allows the language model to acquire new skills through prompts, eliminating the need for data collection and fine-tuning. Consequently, large language models can learn various text prediction techniques. We initially showed that, for a sentence prediction task, merely prompting GPT-3.5 surpassed a GPT-2 backed system and is comparable with a fine-tuned GPT-3.5 model, with the latter two methods requiring costly data collection, fine-tuning and post-processing. However, the task of prompting large language models to specialize in specific text prediction tasks can be challenging, particularly for designers without expertise in prompt engineering. To address this, we introduce Promptor, a conversational prompt generation agent designed to engage proactively with designers. Promptor can automatically generate complex prompts tailored to meet specific needs, thus offering a solution to this challenge. We conducted a user study involving 24 participants creating prompts for three intelligent text entry tasks, half of the participants used Promptor while the other half designed prompts themselves. The results show that Promptor-designed prompts result in a 35% increase in similarity and 22% in coherence over those by designers.

  • 5 authors
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Oct 12, 2023

Prompt Triage: Structured Optimization Enhances Vision-Language Model Performance on Medical Imaging Benchmarks

Vision-language foundation models (VLMs) show promise for diverse imaging tasks but often underperform on medical benchmarks. Prior efforts to improve performance include model finetuning, which requires large domain-specific datasets and significant compute, or manual prompt engineering, which is hard to generalize and often inaccessible to medical institutions seeking to deploy these tools. These challenges motivate interest in approaches that draw on a model's embedded knowledge while abstracting away dependence on human-designed prompts to enable scalable, weight-agnostic performance improvements. To explore this, we adapt the Declarative Self-improving Python (DSPy) framework for structured automated prompt optimization in medical vision-language systems through a comprehensive, formal evaluation. We implement prompting pipelines for five medical imaging tasks across radiology, gastroenterology, and dermatology, evaluating 10 open-source VLMs with four prompt optimization techniques. Optimized pipelines achieved a median relative improvement of 53% over zero-shot prompting baselines, with the largest gains ranging from 300% to 3,400% on tasks where zero-shot performance is low. These results highlight the substantial potential of applying automated prompt optimization to medical AI systems, demonstrating significant gains for vision-based applications requiring accurate clinical image interpretation. By reducing dependence on prompt design to elicit intended outputs, these techniques allow clinicians to focus on patient care and clinical decision-making. Furthermore, our experiments offer scalability and preserve data privacy, demonstrating performance improvement on open-source VLMs. We publicly release our evaluation pipelines to support reproducible research on specialized medical tasks, available at https://github.com/DaneshjouLab/prompt-triage-lab.

  • 5 authors
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Nov 14, 2025

Language Models (Mostly) Know What They Know

We study whether language models can evaluate the validity of their own claims and predict which questions they will be able to answer correctly. We first show that larger models are well-calibrated on diverse multiple choice and true/false questions when they are provided in the right format. Thus we can approach self-evaluation on open-ended sampling tasks by asking models to first propose answers, and then to evaluate the probability "P(True)" that their answers are correct. We find encouraging performance, calibration, and scaling for P(True) on a diverse array of tasks. Performance at self-evaluation further improves when we allow models to consider many of their own samples before predicting the validity of one specific possibility. Next, we investigate whether models can be trained to predict "P(IK)", the probability that "I know" the answer to a question, without reference to any particular proposed answer. Models perform well at predicting P(IK) and partially generalize across tasks, though they struggle with calibration of P(IK) on new tasks. The predicted P(IK) probabilities also increase appropriately in the presence of relevant source materials in the context, and in the presence of hints towards the solution of mathematical word problems. We hope these observations lay the groundwork for training more honest models, and for investigating how honesty generalizes to cases where models are trained on objectives other than the imitation of human writing.

  • 36 authors
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Jul 11, 2022

A Benchmark of Domain-Adapted Large Language Models for Generating Brief Hospital Course Summaries

Brief hospital course (BHC) summaries are common clinical documents generated by summarizing clinical notes. While large language models (LLMs) depict remarkable capabilities in automating real-world tasks, their capabilities for healthcare applications such as BHC synthesis have not been shown. To enable the adaptation of LLMs for BHC synthesis, we introduce a novel benchmark consisting of a pre-processed dataset extracted from MIMIC-IV notes, encapsulating clinical note, and brief hospital course (BHC) pairs. We assess the performance of two general-purpose LLMs and three healthcare-adapted LLMs to improve BHC synthesis from clinical notes. Using clinical notes as input for generating BHCs, we apply prompting-based (using in-context learning) and fine-tuning-based adaptation strategies to three open-source LLMs (Clinical-T5-Large, Llama2-13B, FLAN-UL2) and two proprietary LLMs (GPT-3.5, GPT-4). We quantitatively evaluate the performance of these LLMs across varying context-length inputs using conventional natural language similarity metrics. We further perform a qualitative study where five diverse clinicians blindly compare clinician-written BHCs and two LLM-generated BHCs for 30 samples across metrics of comprehensiveness, conciseness, factual correctness, and fluency. Overall, we present a new benchmark and pre-processed dataset for using LLMs in BHC synthesis from clinical notes. We observe high-quality summarization performance for both in-context proprietary and fine-tuned open-source LLMs using both quantitative metrics and a qualitative clinical reader study. We propose our work as a benchmark to motivate future works to adapt and assess the performance of LLMs in BHC synthesis.

  • 12 authors
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Mar 8, 2024

PEEM: Prompt Engineering Evaluation Metrics for Interpretable Joint Evaluation of Prompts and Responses

Prompt design is a primary control interface for large language models (LLMs), yet standard evaluations largely reduce performance to answer correctness, obscuring why a prompt succeeds or fails and providing little actionable guidance. We propose PEEM (Prompt Engineering Evaluation Metrics), a unified framework for joint and interpretable evaluation of both prompts and responses. PEEM defines a structured rubric with 9 axes: 3 prompt criteria (clarity/structure, linguistic quality, fairness) and 6 response criteria (accuracy, coherence, relevance, objectivity, clarity, conciseness), and uses an LLM-based evaluator to output (i) scalar scores on a 1-5 Likert scale and (ii) criterion-specific natural-language rationales grounded in the rubric. Across 7 benchmarks and 5 task models, PEEM's accuracy axis strongly aligns with conventional accuracy while preserving model rankings (aggregate Spearman rho about 0.97, Pearson r about 0.94, p < 0.001). A multi-evaluator study with four models shows consistent relative judgments (pairwise rho = 0.68-0.85), supporting evaluator-agnostic deployment. Beyond alignment, PEEM captures complementary linguistic failure modes and remains informative under prompt perturbations: prompt-quality trends track downstream accuracy under iterative rewrites, semantic adversarial manipulations induce clear score degradation, and meaning-preserving paraphrases yield high stability (robustness rate about 76.7-80.6%). Finally, using only PEEM scores and rationales as feedback, a zero-shot prompt rewriting loop improves downstream accuracy by up to 11.7 points, outperforming supervised and RL-based prompt-optimization baselines. Overall, PEEM provides a reproducible, criterion-driven protocol that links prompt formulation to response behavior and enables systematic diagnosis and optimization of LLM interactions.

  • 4 authors
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Mar 11

Prometheus: Inducing Fine-grained Evaluation Capability in Language Models

Recently, using a powerful proprietary Large Language Model (LLM) (e.g., GPT-4) as an evaluator for long-form responses has become the de facto standard. However, for practitioners with large-scale evaluation tasks and custom criteria in consideration (e.g., child-readability), using proprietary LLMs as an evaluator is unreliable due to the closed-source nature, uncontrolled versioning, and prohibitive costs. In this work, we propose Prometheus, a fully open-source LLM that is on par with GPT-4's evaluation capabilities when the appropriate reference materials (reference answer, score rubric) are accompanied. We first construct the Feedback Collection, a new dataset that consists of 1K fine-grained score rubrics, 20K instructions, and 100K responses and language feedback generated by GPT-4. Using the Feedback Collection, we train Prometheus, a 13B evaluator LLM that can assess any given long-form text based on customized score rubric provided by the user. Experimental results show that Prometheus scores a Pearson correlation of 0.897 with human evaluators when evaluating with 45 customized score rubrics, which is on par with GPT-4 (0.882), and greatly outperforms ChatGPT (0.392). Furthermore, measuring correlation with GPT-4 with 1222 customized score rubrics across four benchmarks (MT Bench, Vicuna Bench, Feedback Bench, Flask Eval) shows similar trends, bolstering Prometheus's capability as an evaluator LLM. Lastly, Prometheus achieves the highest accuracy on two human preference benchmarks (HHH Alignment & MT Bench Human Judgment) compared to open-sourced reward models explicitly trained on human preference datasets, highlighting its potential as an universal reward model. We open-source our code, dataset, and model at https://github.com/kaistAI/Prometheus.

  • 11 authors
·
Oct 12, 2023 4

Reshaping Free-Text Radiology Notes Into Structured Reports With Generative Transformers

BACKGROUND: Radiology reports are typically written in a free-text format, making clinical information difficult to extract and use. Recently the adoption of structured reporting (SR) has been recommended by various medical societies thanks to the advantages it offers, e.g. standardization, completeness and information retrieval. We propose a pipeline to extract information from free-text radiology reports, that fits with the items of the reference SR registry proposed by a national society of interventional and medical radiology, focusing on CT staging of patients with lymphoma. METHODS: Our work aims to leverage the potential of Natural Language Processing (NLP) and Transformer-based models to deal with automatic SR registry filling. With the availability of 174 radiology reports, we investigate a rule-free generative Question Answering approach based on a domain-specific version of T5 (IT5). Two strategies (batch-truncation and ex-post combination) are implemented to comply with the model's context length limitations. Performance is evaluated in terms of strict accuracy, F1, and format accuracy, and compared with the widely used GPT-3.5 Large Language Model. A 5-point Likert scale questionnaire is used to collect human-expert feedback on the similarity between medical annotations and generated answers. RESULTS: The combination of fine-tuning and batch splitting allows IT5 to achieve notable results; it performs on par with GPT-3.5 albeit its size being a thousand times smaller in terms of parameters. Human-based assessment scores show a high correlation (Spearman's correlation coefficients>0.88, p-values<0.001) with AI performance metrics (F1) and confirm the superior ability of LLMs (i.e., GPT-3.5, 175B of parameters) in generating plausible human-like statements.

  • 8 authors
·
Mar 27, 2024

Code Soliloquies for Accurate Calculations in Large Language Models

High-quality conversational datasets are integral to the successful development of Intelligent Tutoring Systems (ITS) that employ a Large Language Model (LLM) backend. These datasets, when used to fine-tune the LLM backend, significantly enhance the quality of interactions between students and ITS. A common strategy for developing these datasets involves generating synthetic student-teacher dialogues using advanced GPT-4 models. However, challenges arise when these dialogues demand complex calculations, common in subjects like physics. Despite its advanced capabilities, GPT-4's performance falls short in reliably handling even simple multiplication tasks, marking a significant limitation in its utility for these subjects. To address these challenges, this paper introduces an innovative stateful prompt design. Our approach generates a mock conversation between a student and a tutorbot, both roles simulated by GPT-4. Each student response triggers a soliloquy (an inner monologue) in the GPT-tutorbot, which assesses whether its response would necessitate calculations. If so, it proceeds to script the required code in Python and then uses the resulting output to construct its response to the student. Our approach notably enhances the quality of synthetic conversation datasets, especially for subjects that are calculation-intensive. Our findings show that our Higgs model -- a LLaMA finetuned with datasets generated through our novel stateful prompt design -- proficiently utilizes Python for computations. Consequently, finetuning with our datasets enriched with code soliloquies enhances not just the accuracy but also the computational reliability of Higgs' responses.

  • 6 authors
·
Sep 21, 2023

A Comparative Study of Open-Source Large Language Models, GPT-4 and Claude 2: Multiple-Choice Test Taking in Nephrology

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.

  • 7 authors
·
Aug 9, 2023

RAVEN: RAnking and Validation of ExoplaNets

We present RAVEN, a newly developed vetting and validation pipeline for TESS exoplanet candidates. The pipeline employs a Bayesian framework to derive the posterior probability of a candidate being a planet against a set of False Positive (FP) scenarios, through the use of a Gradient Boosted Decision Tree and a Gaussian Process classifier, trained on comprehensive synthetic training sets of simulated planets and 8 astrophysical FP scenarios injected into TESS lightcurves. These training sets allow large scale candidate vetting and performance verification against individual FP scenarios. A Non-Simulated FP training set consisting of real TESS candidates caused primarily by stellar variability and systematic noise is also included. The machine learning derived probabilities are combined with scenario specific prior probabilities, including the candidates' positional probabilities, to compute the final posterior probabilities. Candidates with a planetary posterior probability greater than 99% against each FP scenario and whose implied planetary radius is less than 8R_{oplus} are considered to be statistically validated by the pipeline. In this first version, the pipeline has been developed for candidates with a lightcurve released from the TESS Science Processing Operations Centre, an orbital period between 0.5 and 16 days and a transit depth greater than 300ppm. The pipeline obtained area-under-curve (AUC) scores > 97% on all FP scenarios and > 99% on all but one. Testing on an independent external sample of 1361 pre-classified TOIs, the pipeline achieved an overall accuracy of 91%, demonstrating its effectiveness for automated ranking of TESS candidates. For a probability threshold of 0.9 the pipeline reached a precision of 97% with a recall score of 66% on these TOIs. The RAVEN pipeline is publicly released as a cloud-hosted app, making it easily accessible to the community.

  • 8 authors
·
Sep 22, 2025

Unraveling Downstream Gender Bias from Large Language Models: A Study on AI Educational Writing Assistance

Large Language Models (LLMs) are increasingly utilized in educational tasks such as providing writing suggestions to students. Despite their potential, LLMs are known to harbor inherent biases which may negatively impact learners. Previous studies have investigated bias in models and data representations separately, neglecting the potential impact of LLM bias on human writing. In this paper, we investigate how bias transfers through an AI writing support pipeline. We conduct a large-scale user study with 231 students writing business case peer reviews in German. Students are divided into five groups with different levels of writing support: one classroom group with feature-based suggestions and four groups recruited from Prolific -- a control group with no assistance, two groups with suggestions from fine-tuned GPT-2 and GPT-3 models, and one group with suggestions from pre-trained GPT-3.5. Using GenBit gender bias analysis, Word Embedding Association Tests (WEAT), and Sentence Embedding Association Test (SEAT) we evaluate the gender bias at various stages of the pipeline: in model embeddings, in suggestions generated by the models, and in reviews written by students. Our results demonstrate that there is no significant difference in gender bias between the resulting peer reviews of groups with and without LLM suggestions. Our research is therefore optimistic about the use of AI writing support in the classroom, showcasing a context where bias in LLMs does not transfer to students' responses.

  • 6 authors
·
Nov 6, 2023