Daily Papers

Clinical trials are pivotal for developing new medical treatments but typically carry risks such as patient mortality and enrollment failure that waste immense efforts spanning over a decade. Applying artificial intelligence (AI) to predict key events in clinical trials holds great potential for providing insights to guide trial designs. However, complex data collection and question definition requiring medical expertise have hindered the involvement of AI thus far. This paper tackles these challenges by presenting a comprehensive suite of 23 meticulously curated AI-ready datasets covering multi-modal input features and 8 crucial prediction challenges in clinical trial design, encompassing prediction of trial duration, patient dropout rate, serious adverse event, mortality rate, trial approval outcome, trial failure reason, drug dose finding, design of eligibility criteria. Furthermore, we provide basic validation methods for each task to ensure the datasets' usability and reliability. We anticipate that the availability of such open-access datasets will catalyze the development of advanced AI approaches for clinical trial design, ultimately advancing clinical trial research and accelerating medical solution development.

Patient recruitment is challenging for clinical trials. We introduce TrialGPT, an end-to-end framework for zero-shot patient-to-trial matching with large language models. TrialGPT comprises three modules: it first performs large-scale filtering to retrieve candidate trials (TrialGPT-Retrieval); then predicts criterion-level patient eligibility (TrialGPT-Matching); and finally generates trial-level scores (TrialGPT-Ranking). We evaluate TrialGPT on three cohorts of 183 synthetic patients with over 75,000 trial annotations. TrialGPT-Retrieval can recall over 90% of relevant trials using less than 6% of the initial collection. Manual evaluations on 1,015 patient-criterion pairs show that TrialGPT-Matching achieves an accuracy of 87.3% with faithful explanations, close to the expert performance. The TrialGPT-Ranking scores are highly correlated with human judgments and outperform the best-competing models by 43.8% in ranking and excluding trials. Furthermore, our user study reveals that TrialGPT can reduce the screening time by 42.6% in patient recruitment. Overall, these results have demonstrated promising opportunities for patient-to-trial matching with TrialGPT.

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

Judicial work depends on close reading of long records, charge sheets, pleadings, annexures, orders, often spanning hundreds of pages. With limited staff support, exhaustive reading during hearings is impractical. We present CourtNav, a voice-guided, anchor-first navigator for legal PDFs that maps a judge's spoken command (e.g., "go to paragraph 23", "highlight the contradiction in the cross-examination") directly to a highlighted paragraph in seconds. CourtNav transcribes the command, classifies intent with a grammar-first(Exact regex matching), LLM-backed router classifying the queries using few shot examples, retrieves over a layout-aware hybrid index, and auto-scrolls the viewer to the cited span while highlighting it and close alternates. By design, the interface shows only grounded passages, never free text, keeping evidence verifiable and auditable. This need is acute in India, where judgments and cross-examinations are notoriously long.In a pilot on representative charge sheets, pleadings, and orders, median time-to-relevance drops from 3-5 minutes (manual navigation) to 10-15 seconds; with quick visual verification included, 30-45 seconds. Under fixed time budgets, this navigation-first design increases the breadth of the record actually consulted while preserving control and transparency.

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

Building on developments in machine learning and prior work in the science of judicial prediction, we construct a model designed to predict the behavior of the Supreme Court of the United States in a generalized, out-of-sample context. To do so, we develop a time evolving random forest classifier which leverages some unique feature engineering to predict more than 240,000 justice votes and 28,000 cases outcomes over nearly two centuries (1816-2015). Using only data available prior to decision, our model outperforms null (baseline) models at both the justice and case level under both parametric and non-parametric tests. Over nearly two centuries, we achieve 70.2% accuracy at the case outcome level and 71.9% at the justice vote level. More recently, over the past century, we outperform an in-sample optimized null model by nearly 5%. Our performance is consistent with, and improves on the general level of prediction demonstrated by prior work; however, our model is distinctive because it can be applied out-of-sample to the entire past and future of the Court, not a single term. Our results represent an important advance for the science of quantitative legal prediction and portend a range of other potential applications.

Clinical trials or studies oftentimes require long-term and/or costly follow-up of participants to evaluate a novel treatment/drug/vaccine. There has been increasing interest in the past few decades in using short-term surrogate outcomes as a replacement of the primary outcome i.e., in using the surrogate outcome, which can potentially be observed sooner, to make inference about the treatment effect on the long-term primary outcome. Very few of the available statistical methods to evaluate a surrogate are applicable to settings where both the surrogate and the primary outcome are time-to-event outcomes subject to censoring. Methods that can handle this setting tend to require parametric assumptions or be limited to assessing only the restricted mean survival time. In this paper, we propose a non-parametric approach to evaluate a censored surrogate outcome, such as time to progression, when the primary outcome is also a censored time-to-event outcome, such as time to death, and the treatment effect of interest is the difference in overall survival. Specifically, we define the proportion of the treatment effect on the primary outcome that is explained (PTE) by the censored surrogate outcome in this context, and estimate this proportion by defining and deriving an optimal transformation of the surrogate information. Our approach provides the added advantage of relaxed assumptions to guarantee that the true PTE is within (0,1), along with being model-free. Finite sample performance of our estimators are illustrated via extensive simulation studies and a real data application examining progression-free survival as a surrogate for overall survival for patients with metastatic colorectal cancer.

Developing artificial intelligence (AI) for vertical domains requires a solid data foundation for both training and evaluation. In this work, we introduce TrialPanorama, a large-scale, structured database comprising 1,657,476 clinical trial records aggregated from 15 global sources. The database captures key aspects of trial design and execution, including trial setups, interventions, conditions, biomarkers, and outcomes, and links them to standard biomedical ontologies such as DrugBank and MedDRA. This structured and ontology-grounded design enables TrialPanorama to serve as a unified, extensible resource for a wide range of clinical trial tasks, including trial planning, design, and summarization. To demonstrate its utility, we derive a suite of benchmark tasks directly from the TrialPanorama database. The benchmark spans eight tasks across two categories: three for systematic review (study search, study screening, and evidence summarization) and five for trial design (arm design, eligibility criteria, endpoint selection, sample size estimation, and trial completion assessment). The experiments using five state-of-the-art large language models (LLMs) show that while general-purpose LLMs exhibit some zero-shot capability, their performance is still inadequate for high-stakes clinical trial workflows. We release TrialPanorama database and the benchmark to facilitate further research on AI for clinical trials.

Analyzing outcomes in long-term cancer survivor studies can be complex. The effects of predictors on the failure process may be difficult to assess over longer periods of time, as the commonly used assumption of proportionality of hazards holding over an extended period is often questionable. In this manuscript, we compare seven different survival models that estimate the hazard rate and the effects of proportional and non-proportional covariates. In particular, we focus on an extension of the the multi-resolution hazard (MRH) estimator, combining a non-proportional hierarchical MRH approach with a data-driven pruning algorithm that allows for computational efficiency and produces robust estimates even in times of few observed failures. Using data from a large-scale randomized prostate cancer clinical trial, we examine patterns of biochemical failure and estimate the time-varying effects of androgen deprivation therapy treatment and other covariates. We compare the impact of different modeling strategies and smoothness assumptions on the estimated treatment effect. Our results show that the benefits of treatment diminish over time, possibly with implications for future treatment protocols.

Recruiting patients to participate in clinical trials can be challenging and time-consuming. Usually, participation in a clinical trial is initiated by a healthcare professional and proposed to the patient. Promoting clinical trials directly to patients via online recruitment might help to reach them more efficiently. In this study, we address the case where a patient is initiating their own recruitment process and wants to determine whether they are eligible for a given clinical trial, using their own language to describe their medical profile. To study whether this creates difficulties in the patient trial matching process, we design a new dataset and task, Natural Language Inference for Patient Recruitment (NLI4PR), in which patient language profiles must be matched to clinical trials. We create it by adapting the TREC 2022 Clinical Trial Track dataset, which provides patients' medical profiles, and rephrasing them manually using patient language. We also use the associated clinical trial reports where the patients are either eligible or excluded. We prompt several open-source Large Language Models on our task and achieve from 56.5 to 71.8 of F1 score using patient language, against 64.7 to 73.1 for the same task using medical language. When using patient language, we observe only a small loss in performance for the best model, suggesting that having the patient as a starting point could be adopted to help recruit patients for clinical trials. The corpus and code bases are all freely available on our Github and HuggingFace repositories.

Synthesizing clinical evidence largely relies on systematic reviews of clinical trials and retrospective analyses from medical literature. However, the rapid expansion of publications presents challenges in efficiently identifying, summarizing, and updating clinical evidence. Here, we introduce TrialMind, a generative artificial intelligence (AI) pipeline for facilitating human-AI collaboration in three crucial tasks for evidence synthesis: study search, screening, and data extraction. To assess its performance, we chose published systematic reviews to build the benchmark dataset, named TrialReviewBench, which contains 100 systematic reviews and the associated 2,220 clinical studies. Our results show that TrialMind excels across all three tasks. In study search, it generates diverse and comprehensive search queries to achieve high recall rates (Ours 0.711-0.834 v.s. Human baseline 0.138-0.232). For study screening, TrialMind surpasses traditional embedding-based methods by 30% to 160%. In data extraction, it outperforms a GPT-4 baseline by 29.6% to 61.5%. We further conducted user studies to confirm its practical utility. Compared to manual efforts, human-AI collaboration using TrialMind yielded a 71.4% recall lift and 44.2% time savings in study screening and a 23.5% accuracy lift and 63.4% time savings in data extraction. Additionally, when comparing synthesized clinical evidence presented in forest plots, medical experts favored TrialMind's outputs over GPT-4's outputs in 62.5% to 100% of cases. These findings show the promise of LLM-based approaches like TrialMind to accelerate clinical evidence synthesis via streamlining study search, screening, and data extraction from medical literature, with exceptional performance improvement when working with human experts.

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

Test-time scaling evaluates reasoning LLMs by sampling multiple outputs per prompt, but ranking models in this regime remains underexplored. We formalize dense benchmark ranking under test-time scaling and introduce Scorio, a library that implements statistical ranking methods such as paired-comparison models, item response theory (IRT) models, voting rules, and graph- and spectral-based methods. Across 20 reasoning models on four Olympiad-style math benchmarks (AIME'24, AIME'25, HMMT'25, and BrUMO'25; up to N=80 trials), most full-trial rankings agree closely with the Bayesian gold standard Bayes_{U}@80 (mean Kendall's τ_b = 0.93--0.95), and 19--34 methods recover exactly the same ordering. In the single-trial regime, the best methods reach τ_b approx 0.86. Using greedy decoding as an empirical prior (Bayes_{R_0}@N) reduces variance at N=1 by 16--52%, but can bias rankings when greedy and stochastic sampling disagree. These results identify reliable ranking methods for both high- and low-budget test-time scaling. We release Scorio as an open-source library at https://github.com/mohsenhariri/scorio.

Throughout the different phases of a drug development program, randomized trials are used to establish the tolerability, safety, and efficacy of a candidate drug. At each stage one aims to optimize the design of future studies by extrapolation from the available evidence at the time. This includes collected trial data and relevant external data. However, relevant external data are typically available as averages only, for example from trials on alternative treatments reported in the literature. Here we report on such an example from a drug development for wet age-related macular degeneration. This disease is the leading cause of severe vision loss in the elderly. While current treatment options are efficacious, they are also a substantial burden for the patient. Hence, new treatments are under development which need to be compared against existing treatments. The general statistical problem this leads to is meta-analysis, which addresses the question of how we can combine datasets collected under different conditions. Bayesian methods have long been used to achieve partial pooling. Here we consider the challenge when the model of interest is complex (hierarchical and nonlinear) and one dataset is given as raw data while the second dataset is given as averages only. In such a situation, common meta-analytic methods can only be applied when the model is sufficiently simple for analytic approaches. When the model is too complex, for example nonlinear, an analytic approach is not possible. We provide a Bayesian solution by using simulation to approximately reconstruct the likelihood of the external summary and allowing the parameters in the model to vary under the different conditions. We first evaluate our approach using fake-data simulations and then report results for the drug development program that motivated this research.

Machine learning based decision-support tools in criminal justice systems are subjects of intense discussions and academic research. There are important open questions about the utility and fairness of such tools. Academic researchers often rely on a few small datasets that are not sufficient to empirically study various real-world aspects of these questions. In this paper, we contribute WCLD, a curated large dataset of 1.5 million criminal cases from circuit courts in the U.S. state of Wisconsin. We used reliable public data from 1970 to 2020 to curate attributes like prior criminal counts and recidivism outcomes. The dataset contains large number of samples from five racial groups, in addition to information like sex and age (at judgment and first offense). Other attributes in this dataset include neighborhood characteristics obtained from census data, detailed types of offense, charge severity, case decisions, sentence lengths, year of filing etc. We also provide pseudo-identifiers for judge, county and zipcode. The dataset will not only enable researchers to more rigorously study algorithmic fairness in the context of criminal justice, but also relate algorithmic challenges with various systemic issues. We also discuss in detail the process of constructing the dataset and provide a datasheet. The WCLD dataset is available at https://clezdata.github.io/wcld/.

In many jurisdictions, the excessive workload of courts leads to high delays. Suitable predictive AI models can assist legal professionals in their work, and thus enhance and speed up the process. So far, Legal Judgment Prediction (LJP) datasets have been released in English, French, and Chinese. We publicly release a multilingual (German, French, and Italian), diachronic (2000-2020) corpus of 85K cases from the Federal Supreme Court of Switzerland (FSCS). We evaluate state-of-the-art BERT-based methods including two variants of BERT that overcome the BERT input (text) length limitation (up to 512 tokens). Hierarchical BERT has the best performance (approx. 68-70% Macro-F1-Score in German and French). Furthermore, we study how several factors (canton of origin, year of publication, text length, legal area) affect performance. We release both the benchmark dataset and our code to accelerate future research and ensure reproducibility.

This paper introduces a novel Russian speech dataset called Golos, a large corpus suitable for speech research. The dataset mainly consists of recorded audio files manually annotated on the crowd-sourcing platform. The total duration of the audio is about 1240 hours. We have made the corpus freely available to download, along with the acoustic model with CTC loss prepared on this corpus. Additionally, transfer learning was applied to improve the performance of the acoustic model. In order to evaluate the quality of the dataset with the beam-search algorithm, we have built a 3-gram language model on the open Common Crawl dataset. The total word error rate (WER) metrics turned out to be about 3.3% and 11.5%.

We describe a dataset developed for Named Entity Recognition in German federal court decisions. It consists of approx. 67,000 sentences with over 2 million tokens. The resource contains 54,000 manually annotated entities, mapped to 19 fine-grained semantic classes: person, judge, lawyer, country, city, street, landscape, organization, company, institution, court, brand, law, ordinance, European legal norm, regulation, contract, court decision, and legal literature. The legal documents were, furthermore, automatically annotated with more than 35,000 TimeML-based time expressions. The dataset, which is available under a CC-BY 4.0 license in the CoNNL-2002 format, was developed for training an NER service for German legal documents in the EU project Lynx.

We introduce Legal RAG Bench, a benchmark and evaluation methodology for assessing the end-to-end performance of legal RAG systems. As a benchmark, Legal RAG Bench consists of 4,876 passages from the Victorian Criminal Charge Book alongside 100 complex, hand-crafted questions demanding expert knowledge of criminal law and procedure. Both long-form answers and supporting passages are provided. As an evaluation methodology, Legal RAG Bench leverages a full factorial design and novel hierarchical error decomposition framework, enabling apples-to-apples comparisons of the contributions of retrieval and reasoning models in RAG. We evaluate three state-of-the-art embedding models (Isaacus' Kanon 2 Embedder, Google's Gemini Embedding 001, and OpenAI's Text Embedding 3 Large) and two frontier LLMs (Gemini 3.1 Pro and GPT-5.2), finding that information retrieval is the primary driver of legal RAG performance, with LLMs exerting a more moderate effect on correctness and groundedness. Kanon 2 Embedder, in particular, had the largest positive impact on performance, improving average correctness by 17.5 points, groundedness by 4.5 points, and retrieval accuracy by 34 points. We observe that many errors attributed to hallucinations in legal RAG systems are in fact triggered by retrieval failures, concluding that retrieval sets the ceiling for the performance of many modern legal RAG systems. We document why and how we built Legal RAG Bench alongside the results of our evaluations. We also openly release our code and data to assist with reproduction of our findings.

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

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

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

We study auto research as a closed empirical loop driven by external measurement. Each submitted trial carries a hypothesis, an executable code edit, an evaluator-owned outcome, and feedback that shapes the next proposal. The output is not a generated paper or a single model checkpoint, but an auditable trajectory of proposals, code diffs, experiments, scores, and failure labels. We instantiate this loop with specialist agents that partition recipe surfaces and share measured lineage across trials. The central empirical finding is that lineage feedback lets agents turn evaluator outcomes, including crashes, budget overruns, size failures, and accuracy-gate misses, into later program-level recipe edits rather than one-shot suggestions. Across 1,197 headline-run trials plus 600 Parameter Golf control trials after one-time setup and launch, humans did not choose proposals, edit recipes, override scores, or repair failed trials during the search. In the three headline runs, the same submitted-trial loop reduces Parameter Golf validation bpb by 0.81%, raises NanoChat-D12 CORE by 38.7%, and reduces CIFAR-10 Airbench96 wallclock by 4.59%, with each task measured by its own external evaluator and legality checks. The trace includes a strict architecture-domain audit of 157 headline-run submissions and program rewrites such as a NanoChat attention-kernel path change. Within this scope the loop autonomously writes code, submits experiments, absorbs feedback, applies and combines known techniques inside each environment, and improves public starting recipes.

To enable building and testing models on long-document comprehension, we introduce QuALITY, a multiple-choice QA dataset with context passages in English that have an average length of about 5,000 tokens, much longer than typical current models can process. Unlike in prior work with passages, our questions are written and validated by contributors who have read the entire passage, rather than relying on summaries or excerpts. In addition, only half of the questions are answerable by annotators working under tight time constraints, indicating that skimming and simple search are not enough to consistently perform well. Our baseline models perform poorly on this task (55.4%) and significantly lag behind human performance (93.5%).

This study quantifies the association between non-adherence to antipsychotic medications and adverse outcomes in individuals with schizophrenia. We frame the problem using survival analysis, focusing on the time to the earliest of several adverse events (early death, involuntary hospitalization, jail booking). We extend standard causal inference methods (T-learner, S-learner, nearest neighbor matching) to utilize various survival models to estimate individual and average treatment effects, where treatment corresponds to medication non-adherence. Analyses are repeated using different amounts of longitudinal information (3, 6, 9, and 12 months). Using data from Allegheny County in western Pennsylvania, we find strong evidence that non-adherence advances adverse outcomes by approximately 1 to 4 months. Ablation studies confirm that county-provided risk scores adjust for key confounders, as their removal amplifies the estimated effects. Subgroup analyses by medication formulation (injectable vs. oral) and medication type consistently show that non-adherence is associated with earlier adverse events. These findings highlight the clinical importance of adherence in delaying psychiatric crises and show that integrating survival analysis with causal inference tools can yield policy-relevant insights. We caution that although we apply causal inference, we only make associative claims and discuss assumptions needed for causal interpretation.

The global cost of drug discovery and development exceeds $200 billion annually. The main results of drug discovery and development are the outcomes of clinical trials, which directly influence the regulatory approval of new drug candidates and ultimately affect patient outcomes. Despite their significance, large-scale, high-quality clinical trial outcome data are not readily available to the public. Suppose a large clinical trial outcome dataset is provided; machine learning researchers can potentially develop accurate prediction models using past trials and outcome labels, which could help prioritize and optimize therapeutic programs, ultimately benefiting patients. This paper introduces Clinical Trial Outcome (CTO) dataset, the largest trial outcome dataset with around 479K clinical trials, aggregating outcomes from multiple sources of weakly supervised labels, minimizing the noise from individual sources, and eliminating the need for human annotation. These sources include large language model (LLM) decisions on trial-related documents, news headline sentiments, stock prices of trial sponsors, trial linkages across phases, and other signals such as patient dropout rates and adverse events. CTO's labels show unprecedented agreement with supervised clinical trial outcome labels from test split of the supervised TOP dataset, with a 91 F1.

This paper describes the results of SemEval 2023 task 7 -- Multi-Evidence Natural Language Inference for Clinical Trial Data (NLI4CT) -- consisting of 2 tasks, a Natural Language Inference (NLI) task, and an evidence selection task on clinical trial data. The proposed challenges require multi-hop biomedical and numerical reasoning, which are of significant importance to the development of systems capable of large-scale interpretation and retrieval of medical evidence, to provide personalized evidence-based care. Task 1, the entailment task, received 643 submissions from 40 participants, and Task 2, the evidence selection task, received 364 submissions from 23 participants. The tasks are challenging, with the majority of submitted systems failing to significantly outperform the majority class baseline on the entailment task, and we observe significantly better performance on the evidence selection task than on the entailment task. Increasing the number of model parameters leads to a direct increase in performance, far more significant than the effect of biomedical pre-training. Future works could explore the limitations of large models for generalization and numerical inference, and investigate methods to augment clinical datasets to allow for more rigorous testing and to facilitate fine-tuning. We envisage that the dataset, models, and results of this task will be useful to the biomedical NLI and evidence retrieval communities. The dataset, competition leaderboard, and website are publicly available.

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

We introduce a general, flexible, parametric survival modelling framework which encompasses key shapes of hazard function (constant, increasing, decreasing, up-then-down, down-then-up), various common survival distributions (log-logistic, Burr type XII, Weibull, Gompertz), and includes defective distributions (i.e., cure models). This generality is achieved using four basic distributional parameters: two scale-type parameters and two shape parameters. Generalising to covariate dependence, the scale-type regression components correspond to accelerated failure time (AFT) and proportional hazards (PH) models. Therefore, this general formulation unifies the most popular survival models which allows us to consider the practical value of possible modelling choices for survival data. Furthermore, in line with our proposed flexible baseline distribution, we advocate the use of multi-parameter regression in which more than one distributional parameter depends on covariates - rather than the usual convention of having a single covariate-dependent (scale) parameter. While many choices are available, we suggest introducing covariates through just one or other of the two scale parameters, which covers AFT and PH models, in combination with a `power' shape parameter, which allows for more complex non-AFT/non-PH effects, while the other shape parameter remains covariate-independent, and handles automatic selection of the baseline distribution. We explore inferential issues in simulations, both with and without a covariate, with particular focus on evidence concerning the need, or otherwise, to include both AFT and PH parameters. We illustrate the efficacy of our modelling framework by investigating differences between treatment groups using data from a lung cancer study and a melanoma study. Censoring is accommodated throughout.

The task of Prior Case Retrieval (PCR) in the legal domain is about automatically citing relevant (based on facts and precedence) prior legal cases in a given query case. To further promote research in PCR, in this paper, we propose a new large benchmark (in English) for the PCR task: IL-PCR (Indian Legal Prior Case Retrieval) corpus. Given the complex nature of case relevance and the long size of legal documents, BM25 remains a strong baseline for ranking the cited prior documents. In this work, we explore the role of events in legal case retrieval and propose an unsupervised retrieval method-based pipeline U-CREAT (Unsupervised Case Retrieval using Events Extraction). We find that the proposed unsupervised retrieval method significantly increases performance compared to BM25 and makes retrieval faster by a considerable margin, making it applicable to real-time case retrieval systems. Our proposed system is generic, we show that it generalizes across two different legal systems (Indian and Canadian), and it shows state-of-the-art performance on the benchmarks for both the legal systems (IL-PCR and COLIEE corpora).

Nearly all jurisdictions in the United States require a professional license exam, commonly referred to as "the Bar Exam," as a precondition for law practice. To even sit for the exam, most jurisdictions require that an applicant completes at least seven years of post-secondary education, including three years at an accredited law school. In addition, most test-takers also undergo weeks to months of further, exam-specific preparation. Despite this significant investment of time and capital, approximately one in five test-takers still score under the rate required to pass the exam on their first try. In the face of a complex task that requires such depth of knowledge, what, then, should we expect of the state of the art in "AI?" In this research, we document our experimental evaluation of the performance of OpenAI's `text-davinci-003` model, often-referred to as GPT-3.5, on the multistate multiple choice (MBE) section of the exam. While we find no benefit in fine-tuning over GPT-3.5's zero-shot performance at the scale of our training data, we do find that hyperparameter optimization and prompt engineering positively impacted GPT-3.5's zero-shot performance. For best prompt and parameters, GPT-3.5 achieves a headline correct rate of 50.3% on a complete NCBE MBE practice exam, significantly in excess of the 25% baseline guessing rate, and performs at a passing rate for both Evidence and Torts. GPT-3.5's ranking of responses is also highly-correlated with correctness; its top two and top three choices are correct 71% and 88% of the time, respectively, indicating very strong non-entailment performance. While our ability to interpret these results is limited by nascent scientific understanding of LLMs and the proprietary nature of GPT, we believe that these results strongly suggest that an LLM will pass the MBE component of the Bar Exam in the near future.

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

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

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

Bail decisions are among the most frequently adjudicated matters in Indian courts, yet they remain plagued by subjectivity, delays, and inconsistencies. With over 75% of India's prison population comprising undertrial prisoners, many from socioeconomically disadvantaged backgrounds, the lack of timely and fair bail adjudication exacerbates human rights concerns and contributes to systemic judicial backlog. In this paper, we present the Indian Bail Prediction System (IBPS), an AI-powered framework designed to assist in bail decision-making by predicting outcomes and generating legally sound rationales based solely on factual case attributes and statutory provisions. We curate and release a large-scale dataset of 150,430 High Court bail judgments, enriched with structured annotations such as age, health, criminal history, crime category, custody duration, statutes, and judicial reasoning. We fine-tune a large language model using parameter-efficient techniques and evaluate its performance across multiple configurations, with and without statutory context, and with RAG. Our results demonstrate that models fine-tuned with statutory knowledge significantly outperform baselines, achieving strong accuracy and explanation quality, and generalize well to a test set independently annotated by legal experts. IBPS offers a transparent, scalable, and reproducible solution to support data-driven legal assistance, reduce bail delays, and promote procedural fairness in the Indian judicial system.

This paper presents Non-Attentive Tacotron based on the Tacotron 2 text-to-speech model, replacing the attention mechanism with an explicit duration predictor. This improves robustness significantly as measured by unaligned duration ratio and word deletion rate, two metrics introduced in this paper for large-scale robustness evaluation using a pre-trained speech recognition model. With the use of Gaussian upsampling, Non-Attentive Tacotron achieves a 5-scale mean opinion score for naturalness of 4.41, slightly outperforming Tacotron 2. The duration predictor enables both utterance-wide and per-phoneme control of duration at inference time. When accurate target durations are scarce or unavailable in the training data, we propose a method using a fine-grained variational auto-encoder to train the duration predictor in a semi-supervised or unsupervised manner, with results almost as good as supervised training.

Next token prediction paradigm has been prevailing for autoregressive models in the era of LLMs. The current default sampling choice for popular LLMs is temperature scaling together with nucleus sampling to balance diversity and coherence. Nevertheless, such approach leads to inferior performance in various NLP tasks when the model is not certain about testing questions. To this end, we propose a brand new training-free decoding strategy, dubbed as Cautious Next Token Prediction (CNTP). In the decoding process, if the model has comparatively high prediction entropy at a certain step, we sample multiple trials starting from the step independently and stop when encountering any punctuation. Then we select the trial with the lowest perplexity score viewed as the most probable and reliable trial path given the model's capacity. The trial number is negatively correlated with the prediction confidence, i.e., the less confident the model is, the more trials it should sample. This is consistent with human beings' behaviour: when feeling uncertain or unconfident, one tends to think more creatively, exploring multiple thinking paths, to cautiously select the path one feels most confident about. Extensive experiments on both LLMs and MLLMs show that our proposed CNTP approach outperforms existing standard decoding strategies consistently by a clear margin. Moreover, the integration of CNTP with self consistency can further improve over vanilla self consistency. We believe our proposed CNTP has the potential to become one of the default choices for LLM decoding. Code is available at https://github.com/wyzjack/CNTP.

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