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Nov 4

Large Language Models are Biased Reinforcement Learners

In-context learning enables large language models (LLMs) to perform a variety of tasks, including learning to make reward-maximizing choices in simple bandit tasks. Given their potential use as (autonomous) decision-making agents, it is important to understand how these models perform such reinforcement learning (RL) tasks and the extent to which they are susceptible to biases. Motivated by the fact that, in humans, it has been widely documented that the value of an outcome depends on how it compares to other local outcomes, the present study focuses on whether similar value encoding biases apply to how LLMs encode rewarding outcomes. Results from experiments with multiple bandit tasks and models show that LLMs exhibit behavioral signatures of a relative value bias. Adding explicit outcome comparisons to the prompt produces opposing effects on performance, enhancing maximization in trained choice sets but impairing generalization to new choice sets. Computational cognitive modeling reveals that LLM behavior is well-described by a simple RL algorithm that incorporates relative values at the outcome encoding stage. Lastly, we present preliminary evidence that the observed biases are not limited to fine-tuned LLMs, and that relative value processing is detectable in the final hidden layer activations of a raw, pretrained model. These findings have important implications for the use of LLMs in decision-making applications.

  • 3 authors
·
May 18, 2024

CIPO: Counterfactual Imagination Policy Optimization for Adaptive Tool Granularity Selection

Large language model (LLM) agents solve complex tasks through multi-step interactions with external tools. These interactions often contain recurring local tool sequences. Treating such sequences as composite "Skills" can shorten tool-use trajectories and reduce repeated low-level decisions. However, when atomic tools and composite skills coexist, skill use becomes a policy problem: the agent must decide whether the current state requires atomic fine control or skill-level abstraction. In this paper, we argue that effective skill use should be studied as adaptive tool granularity selection. The most direct training signal for this problem is to compare the consequences of atomic and skill choices available from the same state. Based on this view, we propose CIPO, a Counterfactual Imagination Policy Optimization framework for adaptive tool granularity. CIPO constructs executable skills through budget-constrained mining of successful tool-use trajectories and trains granularity decisions with counterfactual branch rollouts. For each base rollout, CIPO branches at the first eligible granularity decision and replaces the chosen action with a feasible atomic or skill alternative. The paired outcome difference serves as a supplementary reward for policy optimization. Experiments across multiple benchmarks and model backbones show that CIPO improves task success and decision efficiency over baselines. Further analyses show that CIPO learns effective skill use by improving the choice between atomic tools and composite skills based on the current state, without simply increasing skill frequency.

  • 7 authors
·
Oct 3

ForkPilot: Self-Evolving Policy for Retrospective Search in Long-Horizon Agents

Interactive language-model agents increasingly solve complex tasks through long-horizon, multi-call reasoning, where errors in beliefs or actions can compound across tool interactions. Retrospective search can recover from such failures but is prone to misallocation. Delayed outcomes obscure the contribution of intermediate search decisions, leading to Attribution Complexity, while evolving execution evidence leads to Adaptation Complexity, where previously learned estimates become stale. To address these challenges, we first introduce Search Value Dynamics (SVD), which characterizes the evolving trade-off between the gain and cost of retrospective search. Building on SVD, we propose ForkPilot, a self-evolving two-stage policy-learning framework. In the first stage, ForkPilot learns a search-value policy offline from completed trajectories through automatically constructed outcome comparisons. In the second stage, it makes search decisions based on current observations and then self-evolves by incorporating newly completed trajectories into subsequent policy updates. We evaluate ForkPilot across 6 diverse benchmarks and 7 widely used LLM backbone families, including four open-source families, GPT-5.6 Sol, and Opus 4.8 in a production agentic system, against 9 competitive baselines, including a real-world harness deployment used by hundreds of thousands of paid users. ForkPilot achieves comparable state-of-the-art performance while reducing token usage by up to 59.2%, demonstrating its efficacy.

  • 9 authors
·
Oct 3

Probing Outcome-Level Resemblance and Mechanism-Level Alignment in LLM Risk Decisions: Evidence from the St. Petersburg Game

LLMs can appear cautious in risk decision-making tasks, yet cautious-looking outputs do not necessarily indicate alignment with human decision-making mechanisms. We investigate this distinction using the St. Petersburg game as a controlled testbed, a classical paradox in which the expected payoff is infinite, yet humans typically report low, finite willingness to pay. We evaluate 28 LLMs with a structured prompt suite that includes the original game; controlled decision variants that perturb truncation, repeated play, numeric endowment, and occupational identity; a human-perspective prompt that asks models to reason as human decision makers; and paired comparisons between base models and their instruction-tuned counterparts. In the original game, most models generate finite bids, creating the appearance of human-like risk behavior. However, this outcome-level resemblance masks substantial mechanism-level differences. The controlled variants reveal that rather than maintaining human-like behavior seen in the original game, models often shift to conditionally and computationally rational behavior. Human-cue prompting and instruction tuning often lower bids and reduce some visible pathologies, but most mechanism-level response patterns remain largely unchanged. These findings show that behavioral alignment in risk decision-making can be surface-level: LLMs may produce human-like risk decisions without exhibiting human-consistent mechanisms. High-stakes evaluations of LLM decision-making should therefore move beyond outcome similarity and examine whether the alignment is supported by mechanism-level consistency.

  • 6 authors
·
Jun 2 1

Why Deterministic PRM Guidance Underperforms in Discrete Diffusion Reasoning

Discrete diffusion language models (dLLMs) expose a denoised solution at every step, which makes process reward model (PRM) guidance look like a way to spend compute at test time. We show that once denoising, PRM scoring, and outcome reward model (ORM) scoring are charged in the same budget of forward passes, its deterministic form loses to a much simpler baseline. Our PRMs score intermediate denoising states and are trained on the correctness of the final answer. On Dream-v0-Instruct-7B with 8 candidates per GSM8K problem, keeping the candidate with the highest PRM score at every scoring step reaches 65.18%, while independent sampling plus an ORM reranker trained for the task reaches 75.13%. The gap grows to 12.69 percentage points (pp) with 32 candidates, and is 9.85 pp on MATH and 12.16 pp on MBPP. We trace it to two separable failures. First, guidance prunes on a weak signal: on GSM8K, PRM ROC-AUC falls from 0.77 to 0.54 as the mask ratio rises, a decay that persists when states are relabeled with fresh rollouts, and pruning lowers the best accuracy reachable from the candidate pool from 81.05% for independent samples to 67.30%. Second, on GSM8K and MATH, the PRM is a poor final judge: a sequential Monte Carlo sampler at the same budget restores that ceiling to 77.89%, yet selecting with the PRM gives 65.48%, on par with deterministic guidance, while a PRM retrained on final states matches the ORM on identical candidates. MBPP separates the two: there the PRM reaches 65.47% when reranking finished programs, on par with the ORM, but 50.88% when it guides denoising. The results point to two targets for dLLM guidance: keep correct partial solutions alive through early denoising, and leave the final choice to a verifier trained on final states. We release the corpus of denoising states with outcome labels and evaluation toolkit for reproducible comparisons at matched compute.

RGDT-Bench: Benchmarking LLM Reasoning for Rule-Governed Decisions and Their Justifications

We study reasoning in Rule-Governed Decision Tasks (RGDTs), where models apply external rules to case facts and justify decisions, as required in policy, contract, and compliance settings. Beyond the deductive capability emphasized by standard mathematical and logical reasoning tasks, RGDTs require interpreting rules and their applicability, assessing conditions from evidence, combining judgments under rules and exceptions, and providing checkable justifications. These demands motivate a benchmark assessing both decisions and their stated grounds. We introduce RGDT-Bench, providing 202.1K condition-level supervision slots across four task tracks and eight supported task-probe combinations that vary access to supporting information. Label-blind extraction and deterministic checks produce labels for warrant completeness: source-referenced coverage and consistency of stated decision grounds. The benchmark attributes failures to four process layers: rule use, condition, evidence, and aggregation, and checks the final outcome. Among evaluable correct responses, warrant incompleteness averages 40.2% across six evaluated LLMs and supported task-probe combinations. Such warrant incompleteness poses potential safety risks and remains difficult to detect: the best of seventeen existing evaluators reaches only 57.69% (random: 50%) task-averaged area under the receiver operating characteristic curve (AUROC). To address this difficulty, we train a simple reward model with warrant supervision. It achieves 69.24% task-averaged AUROC among correct answers, exceeding the matched outcome-supervised baseline by 10.37 pp (percentage points) and the best existing evaluator by 11.55 pp. Beyond completeness assessment, the model outperforms both outcome-supervised baselines across nearly all response-selection comparisons, supporting RGDT-Bench's warrant supervision for RGDT reasoning.

  • 10 authors
·
Sep 27

CodeActionBench: Evaluating Agentic Code-as-Policy for Embodied Manipulation

How well can general-purpose multimodal models turn visual understanding and reasoning into embodied manipulation via executable code? We introduce CodeActionBench, a benchmark of 25 manipulation tasks that evaluates this capability through agentic Code-as-Policy. Without task-specific fine-tuning, demonstrations, external specialist perception or grasp modules, privileged scene state, or predefined task policies, agents should select visual evidence, form task-relevant 3D estimates, construct manipulation targets, and iteratively execute and revise their policies. A shared robot API provides RGB observations, calibrated geometric operations, robot feedback, and bounded motion, leaving task-dependent decisions to the evaluated agent. Fixed task instances, resource budgets, and a hidden physical-outcome verifier support controlled comparisons across models and harness configurations. Extensive evaluations across nine configurations and 675 attempts achieve success rates ranging from 2.7% to 73.3%. The strongest configuration, GPT-6 Astra with Codex CLI, solves 22 of 25 tasks at least once in three attempts, demonstrating the best performance while still leaving substantial room for improvement. Trajectory analyses reveal difficulties in spatial alignment, object retention, and completion judgment, including task failures despite successfully completed motions. CodeActionBench provides a controlled testbed for measuring how general-purpose models translate their capabilities into manipulation behavior and for examining typical failure scenarios in that process.

  • 5 authors
·
Sep 26

GUI-HARVEST: Self-Improving GUI Agents through Evidence-Driven Harness Evolution

The executable harness surrounding a GUI model determines how observations are assembled, actions are executed, and verification, recovery, and termination are controlled. Compared with harness optimization for non-GUI agents, automatically optimizing this harness poses three coupled challenges: reconciling model intent with observed visual effects, diagnosing failures under variable execution outcomes, and identifying recurrent failure patterns across tasks and translating them into reusable runtime changes. We introduce GUI-HARVEST, an automatic harness optimizer that enables self-improving GUI agents with frozen backbone models. First, to ground diagnosis in observed action effects, it aligns model outputs and executed actions with before-and-after screenshots, tying findings to specific interface transitions. Second, to account for execution variability, it treats repeated runs of the same task as a joint evidence unit, using within-task comparisons to locate outcome-relevant behavioral differences. Third, it consolidates verified findings across tasks into recurring failure patterns, maps them to bounded source-code edits with predictions recorded before evaluation, and checks the predicted behavioral effects alongside task performance through repeated execution. Experiments on OSWorld-Verified show consistent held-out gains across six general-purpose open, GUI-specialized open, and proprietary backbone models; Qwen3-VL-32B-Instruct gains 12.33 points on the full suite. Frozen-harness transfer improves GPT-5 by 13.87 percentage points on WindowsAgentArena at 50 steps without further optimization. With the same backbone and initial harness, GUI-HARVEST outperforms Self-Harness and Meta-Harness, suggesting that GUI-specific diagnosis and validation help harness improvements generalize to unseen tasks. The code is available at https://github.com/GaryYang12345/GUI-HARVEST.

Evidence Inference 2.0: More Data, Better Models

How do we most effectively treat a disease or condition? Ideally, we could consult a database of evidence gleaned from clinical trials to answer such questions. Unfortunately, no such database exists; clinical trial results are instead disseminated primarily via lengthy natural language articles. Perusing all such articles would be prohibitively time-consuming for healthcare practitioners; they instead tend to depend on manually compiled systematic reviews of medical literature to inform care. NLP may speed this process up, and eventually facilitate immediate consult of published evidence. The Evidence Inference dataset was recently released to facilitate research toward this end. This task entails inferring the comparative performance of two treatments, with respect to a given outcome, from a particular article (describing a clinical trial) and identifying supporting evidence. For instance: Does this article report that chemotherapy performed better than surgery for five-year survival rates of operable cancers? In this paper, we collect additional annotations to expand the Evidence Inference dataset by 25\%, provide stronger baseline models, systematically inspect the errors that these make, and probe dataset quality. We also release an abstract only (as opposed to full-texts) version of the task for rapid model prototyping. The updated corpus, documentation, and code for new baselines and evaluations are available at http://evidence-inference.ebm-nlp.com/.

  • 5 authors
·
May 8, 2020

What Can a Leaderboard Certify? Compositional Controllability for Fair Evaluation and Training of Biomedical Literature-Review Agents

Leaderboards rank long-horizon agents by their final outputs. Yet a higher score alone does not establish whether two systems are comparable or which stage accounts for the difference. Unequal evidence, inputs, or budgets can affect scores, and statistical corrections do not remove this mismatch. We introduce compositional controllability to address these questions. A comparison window covers one stage, several stages, or the whole agent. Our central result bounds the gap between observed and controlled score differences using only nuisance outside the window. This yields an admissibility test applied before scores are inspected. Inadmissible comparisons are refused. For admissible pairs, an ordering is certified only when the score gap exceeds the combined sampling and nuisance radii; otherwise, it remains undecided. These decisions give each system a rank interval. We introduce BioLitBench, a benchmark of 2,042 biomedical articles represented as structured claim graphs. Among seven published pipelines, a conventional statistical analysis declares a winner in 14 of 21 pairwise comparisons. Yet the top-ranked system alone received the target review's bibliography. To isolate pipeline performance, our test requires matched inputs and a fixed backbone model. It refuses 11 of the 21 comparisons, including every comparison involving the top-ranked system. Seven of the 14 conventional conclusions fall within these refused pairs. The same comparison windows support stage-level training. We train SCRIBE on Qwen3.8-27B using rewards measured at each stage's exit. Under matched evidence, SCRIBE achieves a certified rank interval of [1,2], with certified advantages over all evaluated published pipelines and the evaluated Claude and OpenAI agents. Under same pool, SCRIBE matches the strongest published retriever and is certified above three published pipelines.

  • 7 authors
·
Sep 25

Medical Adaptation of Large Language and Vision-Language Models: Are We Making Progress?

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

  • 4 authors
·
Nov 6, 2024

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

Rethinking How We Evaluate Methodological Progress in Health AI

Methodological progress in artificial intelligence (AI) for electronic health records (EHRs) depends on our ability to determine which algorithms work better, and under which conditions. However, such progress is thought to be hindered by difficulties in reproducibility and in defining clinically meaningful evaluation tasks. We empirically study these barriers by re-implementing 12 historical and recent algorithms within a shared evaluation framework and evaluating them on two clinical datasets, MIMIC-IV and NWICU. We compare two complementary task families: expert-authored clinically meaningful tasks and generated tasks defined from randomly sampled event codes and prediction horizons. We ask whether relative algorithms comparisons transfer across task families and datasets, whether residual task heterogeneity contains useful methodological structure, and what a controlled comparison reveals about progress over the last decade. We find that aggregate pairwise comparisons transfer strongly across evaluation settings, including from randomly generated tasks to clinically meaningful tasks and across datasets. At the same time, clinically meaningful tasks exhibit greater task-method interaction, providing preliminary evidence that task properties can help explain when particular modeling choices are advantageous. Finally, newer algorithms do not consistently outperform earlier approaches: gradient-boosted trees remain highly competitive when paired with a modern, wide and sparse representation of the EHR. Together, these results suggest that useful methodological knowledge may require less task engineering than commonly assumed, while highlighting the importance of understanding the structured heterogeneity that remains across tasks and methods.

  • 2 authors
·
Sep 20

A Gold Standard Dataset for the Reviewer Assignment Problem

Many peer-review venues are using algorithms to assign submissions to reviewers. The crux of such automated approaches is the notion of the "similarity score" -- a numerical estimate of the expertise of a reviewer in reviewing a paper -- and many algorithms have been proposed to compute these scores. However, these algorithms have not been subjected to a principled comparison, making it difficult for stakeholders to choose the algorithm in an evidence-based manner. The key challenge in comparing existing algorithms and developing better algorithms is the lack of publicly available gold-standard data. We address this challenge by collecting a novel dataset of similarity scores that we release to the research community. Our dataset consists of 477 self-reported expertise scores provided by 58 researchers who evaluated their expertise in reviewing papers they have read previously. Using our dataset, we compare several widely used similarity algorithms and offer key insights. First, all algorithms exhibit significant error, with misranking rates between 12%-30% in easier cases and 36%-43% in harder ones. Second, most specialized algorithms are designed to work with titles and abstracts of papers, and in this regime the SPECTER2 algorithm performs best. Interestingly, classical TF-IDF matches SPECTER2 in accuracy when given access to full submission texts. In contrast, off-the-shelf LLMs lag behind specialized approaches.

  • 5 authors
·
May 29, 2025

Cost-effectiveness analysis for therapy sequence in advanced cancer: A microsimulation approach with application to metastatic prostate cancer

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

  • 5 authors
·
Oct 10, 2022

Model-free Approach to Evaluate a Censored Intermediate Outcome as a Surrogate for Overall Survival

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.

  • 4 authors
·
Dec 18, 2024

Resources for Brewing BEIR: Reproducible Reference Models and an Official Leaderboard

BEIR is a benchmark dataset for zero-shot evaluation of information retrieval models across 18 different domain/task combinations. In recent years, we have witnessed the growing popularity of a representation learning approach to building retrieval models, typically using pretrained transformers in a supervised setting. This naturally begs the question: How effective are these models when presented with queries and documents that differ from the training data? Examples include searching in different domains (e.g., medical or legal text) and with different types of queries (e.g., keywords vs. well-formed questions). While BEIR was designed to answer these questions, our work addresses two shortcomings that prevent the benchmark from achieving its full potential: First, the sophistication of modern neural methods and the complexity of current software infrastructure create barriers to entry for newcomers. To this end, we provide reproducible reference implementations that cover the two main classes of approaches: learned dense and sparse models. Second, there does not exist a single authoritative nexus for reporting the effectiveness of different models on BEIR, which has led to difficulty in comparing different methods. To remedy this, we present an official self-service BEIR leaderboard that provides fair and consistent comparisons of retrieval models. By addressing both shortcomings, our work facilitates future explorations in a range of interesting research questions that BEIR enables.

  • 6 authors
·
Jun 12, 2023

QureRadEmbed: Structuring Radiological Similarity through Attribute and Reasoning Supervision

Radiological similarity depends on disease relationships and on fine details such as laterality, lobe, severity, size, and certainty. Broad biomedical similarity can overlook these qualifiers, particularly when several attributes vary together. We introduce QureRadEmbed, a 4B radiology-aware encoder trained with two complementary signals: RadSim supplies deterministic, attribute-decomposed ranking targets, while RadThought aligns reports with hierarchical evidence and reasoning descriptions. A three-stage curriculum combines these signals with report triplets, finding perturbations, and single- and cross-attribute contrasts. The final model achieves 0.996 mean ordering accuracy across ten controlled synthetic attributes and raises Spearman correlation with the designed joint-attribute targets from 0.501 to 0.976. On external findings-to-impression retrieval, Recall@1 reaches 10.5% on Open-I, 12.4% on testing XR, and 42.9% on testing CT, compared with 6.6%, 5.7%, and 31.4% for its backbone. Frozen embeddings support finding extraction with only 100 labeled testing-XR reports (macro-F1 0.481 versus 0.412 for the backbone). Whole-report comparison costs 8.8 seconds per 1,000 pairs in our benchmark, versus 2,755.1 seconds for the generative evaluator GREEN. Sentence-level comparison improves sensitivity to local discrepancies, although generative evaluation remains stronger on several expert-rated and subtle-error tasks. The results support reusable radiology-aware representations for search, structured report indexing, and efficient report comparison.

  • 4 authors
·
Sep 26

The Single-File Test: A Longitudinal Public-Interface Evaluation of First-Output LLM Web Generation with Social Reach Tracking

This paper presents an eight-week observational comparison of 68 single-file HTML generations collected across 17 public experiments in the "HTML AI Battle" project between December 10, 2025 and February 4, 2026. Four reasoning model families, GPT, Gemini, Grok, and Claude, were compared under a fixed public-interface protocol with no custom instructions, no personality tuning, and no repair prompts. Each output was evaluated from a rendered browser video using human scores and a Gemini LLM-as-a-judge layer for prompt adherence, functional correctness, and UI quality, then packaged into a standardized social-media protocol spanning X (Twitter), TikTok, and YouTube. The tracker was also used for two supervised predictive analyses: an experiment-level model for 24-hour X impressions and a generation-level model for HTML verbosity. Under this protocol, Claude was the strongest and most consistent family, leading mean performance and winning 9/17 prompts under the primary human weighted score. Longer measured reasoning time was not associated with higher quality overall. Gemini as a judge was significantly more lenient than the human evaluator on functional correctness and overall performance, while stable self-favoring bias remained unresolved. The exploratory X-impressions model remained weak under post-screen cross-validation (MAE = 46,874, R^2 = -0.377), whereas the HTML-lines model performed better, with a model-family-only baseline outperforming prompt-aware alternatives (MAE = 135.2, R^2 = 0.576). Overall, selected pre-publication technical/audio variables were not sufficient to predict 24-hour X reach, while code verbosity was driven much more by model family than by prompt wording. The comparisons remain observational and are limited by public-interface drift, access-path differences, and one primary human scorer.

  • 1 authors
·
May 5

CACSurv: Concordance-Aligned Comparative Learning with Large Language Models for Cancer Survival Prediction

Cancer survival prediction supports treatment planning, risk stratification, and follow-up management. Existing methods use structured clinical variables, whole-slide images, genomic profiles, or multimodal inputs, while patient reports remain underexplored. We study report-centric survival prediction using reports that organize pathological, clinical, and molecular evidence. Large language models (LLMs) can reason over such reports, but case-wise time regression introduces two mismatches. First, a formulation mismatch arises because survival evaluation depends on ordering comparable patients, whereas independent time predictions do not enforce ranking consistency. Second, a supervision mismatch arises because a censored patient's observed time indicates survival beyond that point and cannot serve as an exact regression target, although it still implies orderings relative to patients who died earlier. To address these mismatches, we propose CACSurv, a Concordance-Aligned Comparative framework for report-centric survival prediction. CACSurv reformulates survival modeling as mini-cohort comparative reasoning, where an LLM predicts relative prognostic orderings. We introduce concordance-aligned rewards derived from comparable relations under right censoring, enabling censored outcomes to provide ranking supervision without exact event-time targets. At inference, Monte Carlo Reference Aggregation compares each patient with sampled references and aggregates positions into a cohort-level ranking. We establish TCGA-SurvReport, a benchmark covering six TCGA cancer cohorts. CACSurv achieves the highest C-index on all six cohorts and an average C-index of 0.722, outperforming the strongest published survival model by 6.5 percentage points and the strongest LLM time-regression baseline by 4.2 percentage points. Our code, models, and dataset will be available at https://github.com/xmed-lab/CACSurv.

  • 5 authors
·
Aug 16

How Discriminative Are Your Qrels? How To Study the Statistical Significance of Document Adjudication Methods

Creating test collections for offline retrieval evaluation requires human effort to judge documents' relevance. This expensive activity motivated much work in developing methods for constructing benchmarks with fewer assessment costs. In this respect, adjudication methods actively decide both which documents and the order in which experts review them, in order to better exploit the assessment budget or to lower it. Researchers evaluate the quality of those methods by measuring the correlation between the known gold ranking of systems under the full collection and the observed ranking of systems under the lower-cost one. This traditional analysis ignores whether and how the low-cost judgements impact on the statistically significant differences among systems with respect to the full collection. We fill this void by proposing a novel methodology to evaluate how the low-cost adjudication methods preserve the pairwise significant differences between systems as the full collection. In other terms, while traditional approaches look for stability in answering the question "is system A better than system B?", our proposed approach looks for stability in answering the question "is system A significantly better than system B?", which is the ultimate questions researchers need to answer to guarantee the generalisability of their results. Among other results, we found that the best methods in terms of ranking of systems correlation do not always match those preserving statistical significance.

  • 3 authors
·
Aug 18, 2023

The Alzheimer's Disease Prediction Of Longitudinal Evolution (TADPOLE) Challenge: Results after 1 Year Follow-up

We present the findings of "The Alzheimer's Disease Prediction Of Longitudinal Evolution" (TADPOLE) Challenge, which compared the performance of 92 algorithms from 33 international teams at predicting the future trajectory of 219 individuals at risk of Alzheimer's disease. Challenge participants were required to make a prediction, for each month of a 5-year future time period, of three key outcomes: clinical diagnosis, Alzheimer's Disease Assessment Scale Cognitive Subdomain (ADAS-Cog13), and total volume of the ventricles. The methods used by challenge participants included multivariate linear regression, machine learning methods such as support vector machines and deep neural networks, as well as disease progression models. No single submission was best at predicting all three outcomes. For clinical diagnosis and ventricle volume prediction, the best algorithms strongly outperform simple baselines in predictive ability. However, for ADAS-Cog13 no single submitted prediction method was significantly better than random guesswork. Two ensemble methods based on taking the mean and median over all predictions, obtained top scores on almost all tasks. Better than average performance at diagnosis prediction was generally associated with the additional inclusion of features from cerebrospinal fluid (CSF) samples and diffusion tensor imaging (DTI). On the other hand, better performance at ventricle volume prediction was associated with inclusion of summary statistics, such as the slope or maxima/minima of biomarkers. TADPOLE's unique results suggest that current prediction algorithms provide sufficient accuracy to exploit biomarkers related to clinical diagnosis and ventricle volume, for cohort refinement in clinical trials for Alzheimer's disease. However, results call into question the usage of cognitive test scores for patient selection and as a primary endpoint in clinical trials.

  • 96 authors
·
Feb 9, 2020

HiPhO: How Far Are (M)LLMs from Humans in the Latest High School Physics Olympiad Benchmark?

Recently, the physical capabilities of (M)LLMs have garnered increasing attention. However, existing benchmarks for physics suffer from two major gaps: they neither provide systematic and up-to-date coverage of real-world physics competitions such as physics Olympiads, nor enable direct performance comparison with humans. To bridge these gaps, we present HiPhO, the first benchmark dedicated to high school physics Olympiads with human-aligned evaluation. Specifically, HiPhO highlights three key innovations. (1) Comprehensive Data: It compiles 13 latest Olympiad exams from 2024-2025, spanning both international and regional competitions, and covering mixed modalities that encompass problems spanning text-only to diagram-based. (2) Professional Evaluation: We adopt official marking schemes to perform fine-grained grading at both the answer and step level, fully aligned with human examiners to ensure high-quality and domain-specific evaluation. (3) Comparison with Human Contestants: We assign gold, silver, and bronze medals to models based on official medal thresholds, thereby enabling direct comparison between (M)LLMs and human contestants. Our large-scale evaluation of 30 state-of-the-art (M)LLMs shows that: across 13 exams, open-source MLLMs mostly remain at or below the bronze level; open-source LLMs show promising progress with occasional golds; closed-source reasoning MLLMs can achieve 6 to 12 gold medals; and most models still have a significant gap from full marks. These results highlight a substantial performance gap between open-source models and top students, the strong physical reasoning capabilities of closed-source reasoning models, and the fact that there is still significant room for improvement. HiPhO, as a rigorous, human-aligned, and Olympiad-focused benchmark for advancing multimodal physical reasoning, is open-source and available at https://github.com/SciYu/HiPhO.

  • 17 authors
·
Sep 9, 2025

Option-Aware Retrieval and Task-Specific VLM Adaptation for Medical VQA

We describe our submission to the MedReason 2026 challenge, covering multiple-choice (MCQ) and open-ended (OE) medical visual question answering (VQA) under fully offline, containerized inference. Our first finding is that MCQ retrieval must compare answer semantics rather than answer labels: labels are independently assigned per question, so copying a retrieved neighbor's label transfers no useful information, whereas scoring each current option's text against correct-answer text from similar training cases raises retrieval-only accuracy from 20.0\% to 57.5\% on a 200-case retrieval-excluded development holdout. Our second finding attributes the submitted system's accuracy: holding the task-specific MCQ Low-Rank Adaptation (LoRA) adapter fixed and varying the number \(k\) of in-prompt retrieved examples changes accuracy by at most one case --- 187/200 (93.5\%) at both \(k=0\) and the adapter's training-time \(k=1\), 188/200 (94.0\%) at the packaged runtime's default \(k=3\) --- and the submitted confidence-gated override adds no net accuracy on top of \(k=3\), selecting the VLM in 198/200 cases. With the final MCQ adapter fixed, retrieval changes accuracy by at most one case, and gating provides no net gain. On 20 OE cases, token-F1 and RaTEScore~zhao2024ratescore decrease as \(k\) grows, but paired sign tests on token-F1 differences are nonsignificant (\(p \ge 0.29\)); a single-annotator comparison found 6/20 wrong-anchor errors for the final configuration and 14/20 for an earlier configuration that jointly differed in routing, adapter, and prompting. The system reaches 94.0\% MCQ accuracy on the development holdout and 93.20\% on the organizer's official pre-evaluation, versus 29.43\% for the off-the-shelf reference baseline, while both of the organizer's open-ended scores are lower than that baseline's (ground-truth agreement 1.245 versus 1.588, visual accuracy 1.995 versus 2.696, each out of 4).

  • 3 authors
·
Sep 13

The Limited Impact of Medical Adaptation of Large Language and Vision-Language Models

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

  • 5 authors
·
Nov 13, 2024

Fixing a Model That Learned Worse Cancer Means Lower Risk: Monotonic Constraints in Bladder Cancer Recurrence Prediction

Background and Objective: Clinicians expect recurrence risk to climb with cancer severity. In a UK multicentre trial, an unconstrained XGBoost model learnt that higher tumour stage and carcinoma in situ predicted lower recurrence risk, and discrimination, calibration, and SHAP were all blind to it. We developed a counterfactual testing framework to detect this inversion and a monotonic-constraint framework to remove it without hurting performance. Methods: BOXIT enrolled 472 patients with protocol-mandated cystoscopy across 51 UK sites (2007-2012); 435 had at least two years' follow-up (153 recurrences, 35.2%). We developed a counterfactual direction test and a monotonic-constraint correction, with constraint directions drawn from the EORTC and EAU risk systems, and evaluated both against unconstrained XGBoost and logistic regression on 18 predictors (seven directed) over 50 cross-validation folds. The test worsened each patient on one directed feature at a time to check whether risk fell; SHAP direction and calibration were also assessed. Key Findings and Limitations: Tumour stage and carcinoma in situ were associated with lower recurrence, opposite to medical intuition; the unconstrained model reversed carcinoma in situ counterfactuals in 90.2% of cases and stage in 74.3%. Discrimination (ΔAUC 0.005, p=0.47), calibration, and SHAP magnitude were all blind to the inversion. Monotonic constraints eliminated every violation at no cost to discrimination (0.723 vs 0.718) and outperformed EORTC (p=8.9e-16). Limitations: single trial, internal-external validation only. Conclusions and Clinical Implications: A model that had learned this inversion passed every conventional check. A counterfactual direction test, run as a single refit with pre-specified monotonic constraints, catches this failure at no cost to performance and should be routine before clinical deployment.

  • 6 authors
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Sep 30

Bayesian aggregation of average data: An application in drug development

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.

  • 6 authors
·
May 12, 2020

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
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Apr 26, 2023

OmniMed-Jev: Calibrating LVLM Confidence for Trustworthy Medical Multimodal Decisions via System One

Medical models are judged not only on correctness, but on whether reported confidence matches actual accuracy. Generalist multimodal medical models have expanded what a single model can perceive, yet they still express bounded decisions such as diagnoses, findings or cell counts as generated text, so the reported probability reflects the next token rather than the decision itself. Motivated by decision-native interfaces such as Jev, we introduce OmniMed-Jev, which represents each medical decision as a Choice, Noul or Score decision over a runtime-supplied candidate set and returns a full distribution over that set: mutually exclusive classes, binary presence of a finding, or a bounded ordered value. The design is omni in three respects: it accepts diverse imaging modalities, covers different prediction tasks, and expresses them through one candidate-conditioned probability model, so heterogeneous outputs become comparable probabilities rather than task-specific strings. In an interface-controlled comparison against a generative baseline trained on the same backbone, data and schedule, OmniMed-Jev's reported probabilities track observed correctness far more closely, reducing calibration error by up to an order of magnitude and reliability error by up to two, while point-prediction performance remains comparable; counting is the one family where the generative baseline stays ahead. Making the decision distribution the model's output is not a format change but what turns reported numbers into probabilities that mean what they say. These results support explicit decision modeling as a way to make reported confidence meaningful within the evaluated tasks, and they are not evidence of clinical readiness: the comparison cannot separate the interface from associated training differences, which we state alongside the results. Code is available at github.com/lytang63/OmniMed-Jev.

  • 2 authors
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Sep 29

A Vision-language Framework for Comparative Reasoning in Radiology

Medical imaging artificial intelligence has achieved strong performance in isolated image interpretation, but remains poorly aligned with radiological practice, where diagnosis and follow-up rely on comparison across prior studies and analogous reference cases. Here we formulate radiological comparison as an entity-aware cross-image reasoning problem and introduce a framework that supports both reference-case retrieval and temporal comparative interpretation. We construct MedReCo-DB, a large-scale comparative imaging resource derived from routine image-report pairs, comprising more than 690,000 images from over 160,000 patients across eight institutions, four countries and seven imaging modalities. Reports are decomposed into anatomical structures, abnormal findings and pathological conditions to provide supervision for entity-conditioned retrieval and comparative visual question answering. Using this resource, we develop MedReCo, an entity-aware visual encoder for controllable retrieval of clinically analogous cases, and MedReCo-VLM, a vision--language extension for generative interpretation of interval change. Across internal, external and cross-center evaluations, MedReCo achieved the highest Recall@1 in all 12 internal retrieval settings and improved external retrieval by a mean of 6.0 percentage points. In clinically confusable differential groups, it consistently outperformed the strongest baselines. MedReCo-VLM achieved the best performance across all comparative generation evaluations and improved longitudinal follow-up accuracy by 14.5-46.5 percentage points on chest radiographs and 13.0-27.9 percentage points on CT. These findings suggest that entity-aware comparative reasoning can be learned from routine clinical data at scale and may provide a more clinically aligned foundation for medical imaging AI.

  • 8 authors
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Jun 7

OOM-RL II: Reality Is an Oracle, Not a Debugger Provenance-Constrained Diagnosis in Continually Evolving Agent-Engineered Systems

Reality may establish that an outcome occurred without identifying which evolving procedure produced it or why. This distinction matters in production ML systems whose code, configuration, and artifacts change while external feedback accumulates. We examine it in a human-directed, agent-engineered quantitative trading system, using oracle to mean an external source of realized outcomes rather than a complete correctness specification. Across one year, the account gained and outperformed a broad market index, while annual alpha was not statistically distinguishable from zero under the main retrospective specification. Retrospectively selected subperiods include adverse relative performance and conditional candidate-level weakness under declared approximate references. Engineering records document changes during the episode, and complete recommendation-to-runtime binding is unavailable. The archive does not establish a common frozen instance or a unique cause. The case motivates an outcome--diagnosis gap: outcome evidence, evaluated-object identity, and causal explanation support distinct claims. We distinguish frozen instances, pre-specified adaptive procedures, and ad-hoc development; organize archive-relative claim identifiability and an evidence hierarchy; and propose a prospective production-binding protocol. An illustrative compatible-history example shows how factual binding can resolve a recommendation's referent without supplying its counterfactual effect. The protocol is proposed rather than prospectively validated. External feedback constrains outcome claims, while provenance and additional identification structure determine the resolution of diagnosis.

  • 2 authors
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Oct 6

Neural Rankers for Effective Screening Prioritisation in Medical Systematic Review Literature Search

Medical systematic reviews typically require assessing all the documents retrieved by a search. The reason is two-fold: the task aims for ``total recall''; and documents retrieved using Boolean search are an unordered set, and thus it is unclear how an assessor could examine only a subset. Screening prioritisation is the process of ranking the (unordered) set of retrieved documents, allowing assessors to begin the downstream processes of the systematic review creation earlier, leading to earlier completion of the review, or even avoiding screening documents ranked least relevant. Screening prioritisation requires highly effective ranking methods. Pre-trained language models are state-of-the-art on many IR tasks but have yet to be applied to systematic review screening prioritisation. In this paper, we apply several pre-trained language models to the systematic review document ranking task, both directly and fine-tuned. An empirical analysis compares how effective neural methods compare to traditional methods for this task. We also investigate different types of document representations for neural methods and their impact on ranking performance. Our results show that BERT-based rankers outperform the current state-of-the-art screening prioritisation methods. However, BERT rankers and existing methods can actually be complementary, and thus, further improvements may be achieved if used in conjunction.

  • 4 authors
·
Dec 18, 2022

Exploring the Inquiry-Diagnosis Relationship with Advanced Patient Simulators

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

  • 10 authors
·
Jan 16, 2025 4

Summarizing Patients Problems from Hospital Progress Notes Using Pre-trained Sequence-to-Sequence Models

Automatically summarizing patients' main problems from daily progress notes using natural language processing methods helps to battle against information and cognitive overload in hospital settings and potentially assists providers with computerized diagnostic decision support. Problem list summarization requires a model to understand, abstract, and generate clinical documentation. In this work, we propose a new NLP task that aims to generate a list of problems in a patient's daily care plan using input from the provider's progress notes during hospitalization. We investigate the performance of T5 and BART, two state-of-the-art seq2seq transformer architectures, in solving this problem. We provide a corpus built on top of progress notes from publicly available electronic health record progress notes in the Medical Information Mart for Intensive Care (MIMIC)-III. T5 and BART are trained on general domain text, and we experiment with a data augmentation method and a domain adaptation pre-training method to increase exposure to medical vocabulary and knowledge. Evaluation methods include ROUGE, BERTScore, cosine similarity on sentence embedding, and F-score on medical concepts. Results show that T5 with domain adaptive pre-training achieves significant performance gains compared to a rule-based system and general domain pre-trained language models, indicating a promising direction for tackling the problem summarization task.

  • 6 authors
·
Aug 17, 2022

Comprehensive Evaluation of Machine Learning for Type 2 Diabetes Risk Prediction: Large-Scale External Validation and Fairness Analysis

Machine learning-based Type 2 diabetes risk prediction models obtain good internal validation results but lose effectiveness in real-world applications due to deficient external testing and fairness assessment. We developed a multi-dimensional framework evaluating discrimination, calibration, interpretability, and algorithmic fairness on nationally representative populations. An XGBoost model was trained on NHANES 2015-2020 (n=15,685) using eight non-laboratory predictors: age, sex, race/ethnicity, BMI, smoking status, physical activity, history of heart attack, and history of stroke. External validation was performed on BRFSS 2020-2022 (n=1,285,783) under realistic distribution shift. Internal validation showed good discrimination (AUC=0.794, 95% CI 0.788-0.800), with performance loss on external validation (AUC=0.717, relative decrease: -9.7%, p<0.001). Fairness analysis revealed severe bias: elderly adults (>=60) showed AUC=0.607 vs 0.742 for young adults (difference=0.135, p<0.001); obese individuals showed AUC=0.698 vs 0.735 for normal weight (difference=0.037, p<0.001). Gender showed comparable performance (male=0.723 vs female=0.712, p=0.142). Calibration revealed risk overestimation (Brier score=0.123). SHAP analysis identified age, BMI, and physical activity as primary risk drivers. Populations with highest diabetes risk receive the worst algorithmic performance, underscoring the need for fairness-aware, age-stratified deployment strategies before clinical use.

  • 6 authors
·
Jun 26

How Closely Do LLM Reviews Align with Human Peer Review?

Large language models (LLMs) are increasingly used to generate scientific reviews, yet existing evaluations rarely examine whether different providers align with both conference decisions and human reviewing priorities within the same controlled setting. We compare reviews from OpenAI GPT-5.4, Google Gemini 3.1 Pro Preview, and Anthropic Claude Opus 4.6 with human reviews and final decisions for 300 topic-matched ICLR 2026 submissions, equally divided among oral, poster, and rejected papers. Each model reviewed every paper using identical instructions and rating scales after decision information was removed. Our study contributes a cross-provider analysis of three complementary dimensions: alignment with broad and fine-grained decision categories, differences in recommendation-scale usage, and thematic agreement in identified weaknesses. All three LLMs distinguished accepted from rejected papers, but none reproduced the oral versus poster distinction present in human ratings. Scoring patterns were provider-specific: Gemini assigned systematically higher ratings, while OpenAI and Claude were closer to humans for rejected and poster papers but more critical of oral papers. Human and LLM reviews also differed in emphasis, with LLMs more frequently identifying missing baseline comparisons and humans more often raising computational-efficiency concerns. These results show that broad decision alignment does not imply agreement with finer human judgments or reviewing priorities.

  • 2 authors
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Aug 3

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

The Ideation-Execution Gap: Execution Outcomes of LLM-Generated versus Human Research Ideas

Large Language Models (LLMs) have shown promise in accelerating the scientific research pipeline. A key capability for this process is the ability to generate novel research ideas, and prior studies have found settings in which LLM-generated research ideas were judged as more novel than human-expert ideas. However, a good idea should not simply appear to be novel, it should also result in better research after being executed. To test whether AI-generated ideas lead to better research outcomes, we conduct an execution study by recruiting 43 expert researchers to execute randomly-assigned ideas, either written by experts or generated by an LLM. Each expert spent over 100 hours implementing the idea and wrote a 4-page short paper to document the experiments. All the executed projects are then reviewed blindly by expert NLP researchers. Comparing the review scores of the same ideas before and after execution, the scores of the LLM-generated ideas decrease significantly more than expert-written ideas on all evaluation metrics (novelty, excitement, effectiveness, and overall; p < 0.05), closing the gap between LLM and human ideas observed at the ideation stage. When comparing the aggregated review scores from the execution study, we even observe that for many metrics there is a flip in rankings where human ideas score higher than LLM ideas. This ideation-execution gap highlights the limitations of current LLMs in generating truly effective research ideas and the challenge of evaluating research ideas in the absence of execution outcomes.

  • 3 authors
·
Jun 25, 2025

Eureka: Evaluating and Understanding Large Foundation Models

Rigorous and reproducible evaluation is critical for assessing the state of the art and for guiding scientific advances in Artificial Intelligence. Evaluation is challenging in practice due to several reasons, including benchmark saturation, lack of transparency in methods used for measurement, development challenges in extracting measurements for generative tasks, and, more generally, the extensive number of capabilities required for a well-rounded comparison across models. We make three contributions to alleviate the above challenges. First, we present Eureka, an open-source framework for standardizing evaluations of large foundation models beyond single-score reporting and rankings. Second, we introduce Eureka-Bench as an extensible collection of benchmarks testing capabilities that (i) are still challenging for state-of-the-art models and (ii) represent fundamental but overlooked language and multimodal capabilities. The inherent space for improvement in non-saturated benchmarks enables us to discover meaningful differences between models at a capability level. Third, using Eureka, we conduct an analysis of 12 state-of-the-art models, providing in-depth insights into failure understanding and model comparison, which can be leveraged to plan targeted improvements. In contrast to recent trends in reports and leaderboards showing absolute rankings and claims for one model or another to be the best, our analysis shows that there is no such best model. Different models have different strengths, but there are models that appear more often than others as best performers for some capabilities. Despite the recent improvements, current models still struggle with several fundamental capabilities including detailed image understanding, benefiting from multimodal input when available rather than fully relying on language, factuality and grounding for information retrieval, and over refusals.

  • 9 authors
·
Sep 13, 2024

Same Model, Different Harness: Different Coding-Agent Results

A coding agent combines a model with a harness, which decides what the model sees, which tools it can use, and how the work continues. We ask whether changing the harness changes the result when the model and task stay fixed. We compare two configurations of the same harness on three coding benchmarks. The control supplies the full conversation in time order, while the treatment keeps the same record but mechanically shortens older tool results as the context fills and responds to repeated or stalled work. Under tight context, the treatment raises mean per-task fail-to-pass fraction (F2PF) in all three pressure comparisons and increases complete solutions on SWE-bench Verified and SWE-bench Pro. The tight-window Verified comparison uses 169 tasks, a 20,480-token window, and a fixed 480-second attempt endpoint; on this cohort, treatment raises mean per-task F2PF from 28 percent to 49 percent and complete solutions from 43 to 72. Without model-specific retuning, the same frozen treatment also raises both endpoints on the same cohort for three additional models with different designs. In the wide-window Qwen3.6 comparisons, observed arm outcomes are close on Verified and Pro, while FeatureBench retains a higher mean per-task F2PF under treatment. On the wide-window Verified cohort, treatment also serves fewer prompt tokens per turn. Because changing the harness changed what unchanged model weights could accomplish, coding-agent evaluations should treat the model and harness together as the tested solver.

  • 1 authors
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Aug 25

Reducing Annotation Burden in Physical Activity Research Using Vision-Language Models

Introduction: Data from wearable devices collected in free-living settings, and labelled with physical activity behaviours compatible with health research, are essential for both validating existing wearable-based measurement approaches and developing novel machine learning approaches. One common way of obtaining these labels relies on laborious annotation of sequences of images captured by cameras worn by participants through the course of a day. Methods: We compare the performance of three vision language models and two discriminative models on two free-living validation studies with 161 and 111 participants, collected in Oxfordshire, United Kingdom and Sichuan, China, respectively, using the Autographer (OMG Life, defunct) wearable camera. Results: We found that the best open-source vision-language model (VLM) and fine-tuned discriminative model (DM) achieved comparable performance when predicting sedentary behaviour from single images on unseen participants in the Oxfordshire study; median F1-scores: VLM = 0.89 (0.84, 0.92), DM = 0.91 (0.86, 0.95). Performance declined for light (VLM = 0.60 (0.56,0.67), DM = 0.70 (0.63, 0.79)), and moderate-to-vigorous intensity physical activity (VLM = 0.66 (0.53, 0.85); DM = 0.72 (0.58, 0.84)). When applied to the external Sichuan study, performance fell across all intensity categories, with median Cohen's kappa-scores falling from 0.54 (0.49, 0.64) to 0.26 (0.15, 0.37) for the VLM, and from 0.67 (0.60, 0.74) to 0.19 (0.10, 0.30) for the DM. Conclusion: Freely available computer vision models could help annotate sedentary behaviour, typically the most prevalent activity of daily living, from wearable camera images within similar populations to seen data, reducing the annotation burden.

  • 5 authors
·
May 5, 2025

Deep Research, Shallow Evaluation: A Case Study in Meta-Evaluation for Long-Form QA Benchmarks

Recent advances have made long-form report-generating systems widely available. This has prompted evaluation frameworks that use LLM-as-judge protocols and claim verification, along with meta-evaluation frameworks that seek to validate these methods. Many of the meta-evaluations estimate an evaluation quality's by comparing its assessments against human pairwise preferences. Prior work, however, suggests that human pairwise preference may be overly simplistic and can fail to capture nuances of expert expectations. We conduct a case study in meta-evaluation for long-form QA benchmarks using ScholarQA-CS2, a benchmark designed for assessing retrieval-augmented deep-research QA in the scientific domain. We comprehensively validate the benchmark through human pairwise preference judgments, then critically examine the strengths, weaknesses, and confounders of this approach. We show that pairwise preference rankings are best suited for system-level evaluation, while explicit metric-wise annotations and expert annotators are critical for reliable metric-level assessment, with subjectivity remaining a key challenge. Based on our findings, we offer practical guidelines for designing future meta-evaluations that better align evaluation methods, annotator expertise, and reporting practices. By surfacing these methodological challenges, we aim to advance evaluation standards for deep-research systems.

  • 12 authors
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Mar 5

Diminished Diversity-of-Thought in a Standard Large Language Model

We test whether Large Language Models (LLMs) can be used to simulate human participants in social-science studies. To do this, we run replications of 14 studies from the Many Labs 2 replication project with OpenAI's text-davinci-003 model, colloquially known as GPT3.5. Based on our pre-registered analyses, we find that among the eight studies we could analyse, our GPT sample replicated 37.5% of the original results and 37.5% of the Many Labs 2 results. However, we were unable to analyse the remaining six studies due to an unexpected phenomenon we call the "correct answer" effect. Different runs of GPT3.5 answered nuanced questions probing political orientation, economic preference, judgement, and moral philosophy with zero or near-zero variation in responses: with the supposedly "correct answer." In one exploratory follow-up study, we found that a "correct answer" was robust to changing the demographic details that precede the prompt. In another, we found that most but not all "correct answers" were robust to changing the order of answer choices. One of our most striking findings occurred in our replication of the Moral Foundations Theory survey results, where we found GPT3.5 identifying as a political conservative in 99.6% of the cases, and as a liberal in 99.3% of the cases in the reverse-order condition. However, both self-reported 'GPT conservatives' and 'GPT liberals' showed right-leaning moral foundations. Our results cast doubts on the validity of using LLMs as a general replacement for human participants in the social sciences. Our results also raise concerns that a hypothetical AI-led future may be subject to a diminished diversity-of-thought.

  • 3 authors
·
Feb 13, 2023

Humains-Junior: A 3.8B Language Model Achieving GPT-4o-Level Factual Accuracy by Directed Exoskeleton Reasoning

We introduce Humans-Junior, a 3.8B model that matches GPT-4o on the FACTS Grounding public subset within a pm 5 pp equivalence margin. Results. On Q1--Q500 under identical judges, GPT-4o scores 73.5% (95% CI 69.5--77.2) and Humans-Junior 72.7% (95% CI 68.7--76.5); the paired difference is 0.8 pp (bootstrap 95% CI -3.1 to +4.7; permutation p = 0.72; Cohen's d = 0.023). TOST establishes equivalence at pm 5 pp (not at pm 3 pp). When purchased as managed APIs, Humans-Junior's base model (Phi-3.5-mini-instruct) is approx 19times less expensive than GPT-4o on Microsoft AI Foundry pricing; self-hosted or edge deployments can drive incremental inference cost toward zero. Measured vs estimated pricing sources are tabulated in Appendix E. Method. Our approach combines minimal directed "Exoskeleton Reasoning" scaffolds with behavioral fine-tuning that teaches protocol compliance (epistemic discipline) rather than domain answers. Fine-tuning alone adds little; combined, they synergize (+17.7 pp, p < 0.001) and reduce variance (approx 25%). In prompt-only settings on frontier models (Q1--Q100; non-comparable), directed reasoning improved GPT-4o by +11.8 pp to 85.3% and Gemini-2.5-Pro by +5.0 pp to 93.3% (baseline 88.3%, n = 100); see Section~5. TL;DR. A 3.8B model achieves GPT-4o-level FACTS accuracy (equivalent within pm 5 pp on Q1--Q500). Cloud pricing shows approx 19times lower cost versus GPT-4o, and self-hosted/edge deployments can approach zero marginal cost. Pricing sources are listed in Appendix E. Frontier prompt-only gains (Q1--Q100; non-comparable) and optimized-prompt exploratory results under earlier judges are summarized in Appendix F. Keywords: Small Language Models, Factual Grounding, Directed Reasoning, Fine-Tuning, Model Alignment, Cost-Efficient AI

  • 3 authors
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Oct 29, 2025 2

Free Process Rewards without Process Labels

Different from its counterpart outcome reward models (ORMs), which evaluate the entire responses, a process reward model (PRM) scores a reasoning trajectory step by step, providing denser and more fine grained rewards. However, training a PRM requires labels annotated at every intermediate step, presenting significant challenges for both manual and automatic data collection. This paper aims to address this challenge. Both theoretically and empirically, we show that an implicit PRM can be obtained at no additional cost, by simply training an ORM on the cheaper response-level labels. The only assumption is to parameterize the outcome reward as the log-likelihood ratios of the policy and reference models, which can be optimized regardless of the specific choice of loss objectives. In experiments, we instantiate our implicit PRMs with various objectives and evaluate their performance on MATH. We show that our implicit PRM outperforms a strong MCTS-based baseline \'a la Math-Shepherd using less than 1/38 of the training data. Its performance can be further improved with majority voting. We further find that scaling up instructions and responses benefits our implicit PRM, and the latter brings a larger gain. Particularly, we find that our implicit PRM, when instantiated with the cross-entropy (CE) loss, is more data-efficient and can keep improving generation models even when trained with only one response per instruction, the setup that suffers from extreme data scarcity and imbalance. Further, instructions should be relevant to downstream tasks while the diversity of responses does not bring gains. Surprisingly, training on extra Math-Shepherd step labels brings no further improvements to our implicit PRM trained on only outcome data. We hope that our work will encourage a rethinking of PRM training approaches and contribute to making training PRMs more accessible.

  • 9 authors
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Dec 2, 2024 2

Enhancing Large Language Models with Domain-specific Retrieval Augment Generation: A Case Study on Long-form Consumer Health Question Answering in Ophthalmology

Despite the potential of Large Language Models (LLMs) in medicine, they may generate responses lacking supporting evidence or based on hallucinated evidence. While Retrieval Augment Generation (RAG) is popular to address this issue, few studies implemented and evaluated RAG in downstream domain-specific applications. We developed a RAG pipeline with 70,000 ophthalmology-specific documents that retrieve relevant documents to augment LLMs during inference time. In a case study on long-form consumer health questions, we systematically evaluated the responses including over 500 references of LLMs with and without RAG on 100 questions with 10 healthcare professionals. The evaluation focuses on factuality of evidence, selection and ranking of evidence, attribution of evidence, and answer accuracy and completeness. LLMs without RAG provided 252 references in total. Of which, 45.3% hallucinated, 34.1% consisted of minor errors, and 20.6% were correct. In contrast, LLMs with RAG significantly improved accuracy (54.5% being correct) and reduced error rates (18.8% with minor hallucinations and 26.7% with errors). 62.5% of the top 10 documents retrieved by RAG were selected as the top references in the LLM response, with an average ranking of 4.9. The use of RAG also improved evidence attribution (increasing from 1.85 to 2.49 on a 5-point scale, P<0.001), albeit with slight decreases in accuracy (from 3.52 to 3.23, P=0.03) and completeness (from 3.47 to 3.27, P=0.17). The results demonstrate that LLMs frequently exhibited hallucinated and erroneous evidence in the responses, raising concerns for downstream applications in the medical domain. RAG substantially reduced the proportion of such evidence but encountered challenges.

  • 22 authors
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Sep 20, 2024

NAS evaluation is frustratingly hard

Neural Architecture Search (NAS) is an exciting new field which promises to be as much as a game-changer as Convolutional Neural Networks were in 2012. Despite many great works leading to substantial improvements on a variety of tasks, comparison between different methods is still very much an open issue. While most algorithms are tested on the same datasets, there is no shared experimental protocol followed by all. As such, and due to the under-use of ablation studies, there is a lack of clarity regarding why certain methods are more effective than others. Our first contribution is a benchmark of 8 NAS methods on 5 datasets. To overcome the hurdle of comparing methods with different search spaces, we propose using a method's relative improvement over the randomly sampled average architecture, which effectively removes advantages arising from expertly engineered search spaces or training protocols. Surprisingly, we find that many NAS techniques struggle to significantly beat the average architecture baseline. We perform further experiments with the commonly used DARTS search space in order to understand the contribution of each component in the NAS pipeline. These experiments highlight that: (i) the use of tricks in the evaluation protocol has a predominant impact on the reported performance of architectures; (ii) the cell-based search space has a very narrow accuracy range, such that the seed has a considerable impact on architecture rankings; (iii) the hand-designed macro-structure (cells) is more important than the searched micro-structure (operations); and (iv) the depth-gap is a real phenomenon, evidenced by the change in rankings between 8 and 20 cell architectures. To conclude, we suggest best practices, that we hope will prove useful for the community and help mitigate current NAS pitfalls. The code used is available at https://github.com/antoyang/NAS-Benchmark.

  • 3 authors
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Dec 28, 2019

Expert Evaluation of Clinical AI Tools on Real Point-of-Care Clinical Queries

Physicians now pose millions of clinical questions to AI tools each week, yet these tools are evaluated largely on hypothetical or exam-style questions, not those actually asked in practice. We report a blinded evaluation built on 620 Real-world Point-Of-Care Queries (Real-POCQi) submitted to the OpenEvidence (OE) platform by physicians spanning 30 specialties, as well as 187 questions from HealthBench. 149 practicing physicians across 36 states made head-to-head comparisons between answers from three frontier general-purpose models (Claude Opus 4.8, Gemini 3.1 Pro, and GPT-5.5) and a specialized clinical tool (OE), with graders matched to each question's specialty. When comparing answers along five dimensions relevant to clinical decision support -- accuracy, clinical utility, source quality, verifiability, & completeness -- physicians scored the specialized tool highest on all axes; in the primary analysis on Real-POCQi, win differences (margins between win and loss rates) ranged from 25 to 39 percentage points (p<0.001). Results remained consistent in sensitivity analyses stratifying by citation display, answer length, OE-user status, and Real-POCQi versus HealthBench. In parallel, LLM judges were found to systematically differ from expert judges, though both generally agreed on the best model. These findings underscore two conclusions: (i) AI tool evaluations should reflect real-world query distributions and use expert judges that mirror the specialization defining modern medicine and (ii) the consistent advantage of the specialized tool over general-purpose models does not necessarily mean that the latter cannot serve similar purposes, but that targeted engineering and customization can yield meaningful gains in performance for its users. We release Real-POCQi as a public benchmark, as well as the prespecified statistical analysis for reproducing results of this study.

  • 8 authors
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Jun 26

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

Out of the BLEU: how should we assess quality of the Code Generation models?

In recent years, researchers have created and introduced a significant number of various code generation models. As human evaluation of every new model version is unfeasible, the community adopted automatic evaluation metrics such as BLEU to approximate the results of human judgement. These metrics originate from the machine translation domain and it is unclear whether they are applicable for the code generation tasks and how well they agree with the human evaluation on this task. There are also other metrics, CodeBLEU and RUBY, developed to estimate the similarity of code, that take into account the properties of source code. However, for these metrics there are hardly any studies on their agreement with the human evaluation. Despite all that, minimal differences in the metric scores have been used in recent papers to claim superiority of some code generation models over the others. In this paper, we present a study on the applicability of six metrics -- BLEU, ROUGE-L, METEOR, ChrF, CodeBLEU, and RUBY -- for evaluation of code generation models. We conduct a study on two different code generation datasets and use human annotators to assess the quality of all models run on these datasets. The results indicate that for the CoNaLa dataset of Python one-liners, none of the metrics can correctly emulate human judgement on which model is better with >95% certainty if the difference in model scores is less than 5 points. For the HearthStone dataset, which consists of classes of a particular structure, a difference in model scores of at least 2 points is enough to claim the superiority of one model over the other. Our findings suggest that the ChrF metric is a better fit for the evaluation of code generation models than the commonly used BLEU and CodeBLEU. Yet, finding a metric for code generation that closely agrees with humans requires additional work.

  • 4 authors
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Aug 5, 2022

The Complexity Kink: A Prompt-Side Structural Complexity Index for Code-Generation Reliability

Measuring complexity from a model's own code is biased by failure: a hard prompt can produce a short, broken program that looks simple. We instead score each prompt's structure on six dimensions from the prompt alone, never from generated code or test results. We draw 5,000 Python prompts across six bands of a preliminary single-rater score, and four out-of-panel LLM judges rescore every prompt (composite ICC(2,1) = 0.872). Twenty-one models answer every prompt (105,000 generations), and an independent LLM auditor, checked against known-answer cases, reviews each unit-test verdict. Averaged over models, pass rate has a nonmonotone breakpoint at composite 14.0: 83.4% at or below, 90.1% above. That jump is not a law of difficulty: with task-type fixed effects the breakpoint stays at 14.0 but the adjusted jump shrinks from 6.8 to 0.4 points, and neither of the benchmark's two prompt sources reproduces it on its own. Nineteen models pass more often above their own breakpoint and two less often; one of those declines comes from API calls that returned nothing. In post hoc follow-up, Kimi K2.5 shows the clearest decline, at 14.25, under a prompt-source control and within the later source alone. Among failed generations with measurable output complexity, 25.0% pair a prompt composite above 8 with output complexity of at most 10, twice the share among passing ones. The pooled breakpoint moves to 11.25 on raw test outcomes. Human agreement with the index is moderate, paraphrase and cross-language rescoring preserve its ordering, and overidentification tests reject the six dimensions as instruments, so we make no causal claim. The contribution is a prompt-side way to locate where each model's pass rate changes and to test how much that depends on the prompt mix and on how success is scored.

  • 2 authors
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Oct 19

Limitations of Automatic Relevance Assessments with Large Language Models for Fair and Reliable Retrieval Evaluation

Offline evaluation of search systems depends on test collections. These benchmarks provide the researchers with a corpus of documents, topics and relevance judgements indicating which documents are relevant for each topic. While test collections are an integral part of Information Retrieval (IR) research, their creation involves significant efforts in manual annotation. Large language models (LLMs) are gaining much attention as tools for automatic relevance assessment. Recent research has shown that LLM-based assessments yield high systems ranking correlation with human-made judgements. These correlations are helpful in large-scale experiments but less informative if we want to focus on top-performing systems. Moreover, these correlations ignore whether and how LLM-based judgements impact the statistically significant differences among systems with respect to human assessments. In this work, we look at how LLM-generated judgements preserve ranking differences among top-performing systems and also how they preserve pairwise significance evaluation as human judgements. Our results show that LLM-based judgements are unfair at ranking top-performing systems. Moreover, we observe an exceedingly high rate of false positives regarding statistical differences. Our work represents a step forward in the evaluation of the reliability of using LLMs-based judgements for IR evaluation. We hope this will serve as a basis for other researchers to develop more reliable models for automatic relevance assessment.

  • 3 authors
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Nov 20, 2024

Ontology-Based Concept Distillation for Radiology Report Retrieval and Labeling

Retrieval-augmented learning based on radiology reports has emerged as a promising direction to improve performance on long-tail medical imaging tasks, such as rare disease detection in chest X-rays. Most existing methods rely on comparing high-dimensional text embeddings from models like CLIP or CXR-BERT, which are often difficult to interpret, computationally expensive, and not well-aligned with the structured nature of medical knowledge. We propose a novel, ontology-driven alternative for comparing radiology report texts based on clinically grounded concepts from the Unified Medical Language System (UMLS). Our method extracts standardised medical entities from free-text reports using an enhanced pipeline built on RadGraph-XL and SapBERT. These entities are linked to UMLS concepts (CUIs), enabling a transparent, interpretable set-based representation of each report. We then define a task-adaptive similarity measure based on a modified and weighted version of the Tversky Index that accounts for synonymy, negation, and hierarchical relationships between medical entities. This allows efficient and semantically meaningful similarity comparisons between reports. We demonstrate that our approach outperforms state-of-the-art embedding-based retrieval methods in a radiograph classification task on MIMIC-CXR, particularly in long-tail settings. Additionally, we use our pipeline to generate ontology-backed disease labels for MIMIC-CXR, offering a valuable new resource for downstream learning tasks. Our work provides more explainable, reliable, and task-specific retrieval strategies in clinical AI systems, especially when interpretability and domain knowledge integration are essential. Our code is available at https://github.com/Felix-012/ontology-concept-distillation

  • 3 authors
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Aug 27, 2025

A Flexible Parametric Modelling Framework for Survival Analysis

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.

  • 3 authors
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Jan 10, 2019